Authors: Silvano Piffer, Roberto Rizzello, Anna Lina Lauriola, Marta Betta.
Objectives: The study evaluates the trend over time of overweight and obesity in children of the province of Trento subjected to the health check of the sixth year of age.
Study Design: It is a retrospective observational study of all children subjected to the health check of the sixth year of age in Trento province, North East Italy. Ten birth cohorts have been considered 2009-2018. The data was collected through paper forms filled in by family pediatricians. The collective national agreement for family pediatrics allows carrying out the health check of six years with a tolerance of ± 90 days from the 6th birthday. Weight status was analyzed and categorized using the Body Mass Index (BMI) threshold values established by Cole et al., as recommended by the International Obesity Task Force (IOTF). The percentages of overweight and obesity, with 95% confidence intervals, were computed at 6 years for each birth cohort, considering sex and the time of the assessment: before the 6th birthday, exactly at the 6th birthday and after the 6th birthday. We also compute, based on the data of the birth cohorts 2009-2011, the percentages of overweight and obesity, according the territorial area of residence of the children, the individual pediatrician and the citizenship (child with mother with foreign nationality vs. child with Italian mother).
Results: A total of 27,039 (51,6 % males) children were analysed. In males, the average proportions of overweight or obese subjects in all the cohorts under study are respectively 10.4% (CI 95% 10.1- 10.7) and 4.9% (CI 95% 4.7- 5.1). In Females, the corresponding values are 13.5% (CI 95% 13.1-13.9) and 5.7%, (CI 95% 5.2-6.1). The proportions of overweight or obese subjects, calculated in relation to the chronological moment in which the health check of the 6th was carried out show no statistically significant differences, as well as in relation to territorial area of residence of children. There is a wide variability in the prevalence of overweight and obesity in individual family pediatricians. In part, the different proportion of foreign children registered with individual pediatrician can explain this wide variability. Data relating to the birth cohorts 2009-2011 confirm a higher prevalence of overweight and obesity in foreign children. Socio-cultural factors can explain this fact, especially in reference to second-generation immigrants.
Conclusions: The surveillance system based on family pediatricians can integrate with the national surveillance system “OKkio alla SALUTE” with the second oriented towards the general population and the first oriented towards individual “case” children, providing a possible tool for identifying and taking charge of children with overweight/obesity.
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