Risk Factors for Obesity Among Children Aged 24 to 80 months in Korea: A Decision Tree Analysis

Abstract

Purpose: The purpose of this study was to examine the multiple intergenerational risk factors of obesity among children aged 24 to 80 months using national cohort data. Design and methods: This is a retrospective longitudinal cohort study using the Korean National Health Insurance (KNHI)database, and the number of study participants was 1,001,775 families. Social-Economic Status (SES), parental and child-related factors were examined. Descriptive statistics and Chi-squared Automatic Interaction Detection (CHAID)for a decision tree analysis were conducted. Results: The prevalence of obesity was 6.57%, and that of overweight was 11.31% among the entire study population. The 17 groups with a prevalence of childhood obesity higher than the mean prevalence rate were classified as high-risk groups for childhood obesity; there were 6 groups with a prevalence of childhood obesity twice as high as the mean prevalence rate from this study. The best predictors were as follows: mothers being obese prior to conception, fathers being obese, non- medical aid beneficiaries, and mothers with hypertension during gestation. Conclusions: The best predictors of children obesity were parental obesity history and SES. Other parental predictors of outcomes were gestational hypertension and diabetes, older pregnancy, drinking during gestation, and depression after delivery. Child-related outcome predictors were noncompliance with exclusive breastfeeding, a sugar-sweetened beverage intake ≥200 ml per day, and irregular breakfast consumption. Practice implications: These findings could help community health nurses assess high-risk groups for early childhood obesity and develop or provide effective interventions in the early stages of life. © 2019 Elsevier Inc.