Risk Factors for Overweight in early ages: longitudinal design with Spanish Preschoolers


  • Iris Pérez-Bonaventura Unitat d’Epidemiologia i de Diagnòstic en Psicopatologia del Desenvolupament, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain. Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain. http://orcid.org/0000-0001-7100-6205
  • Roser Granero Unitat d’Epidemiologia i de Diagnòstic en Psicopatologia del Desenvolupament, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain. Departament de Psicobiologia i Metodologia de las Ciències de la Salut, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain. http://orcid.org/0000-0001-6308-3198
  • Lourdes Ezpeleta Ascaso Departament de Psicologia Clínica i de la Salut, Unitat d'Epidemiologia i de Diagnòstic en Psicopatologia del Desenvolupament. Universitat Autònoma de Barcelona http://orcid.org/0000-0002-8957-083X




BMI, overweight, preschool children, risk factor, Spain


Previous studies have shown that there are several significant early-life risk factors associated with childhood overweight. However, research has mainly focused on school-aged children. The aim of this study is to identify risk factors in early life for overweight in a community sample of Spanish preschoolers. A sample of 622 three-year-olds was monitored until the age of 5, and their height and weight were registered annually. Overweight status was defined by World Health Organization standards. A large set of risk factors including sociodemographic variables, family structure, pregnancy, birth, postnatal period, school and neighborhood were measured through semi-structured interviews. Stepwise logistic regressions created predictive models with the best predictors of overweight for each age group. This is the first longitudinal study to examine a large set of risk factors among Spanish preschoolers. Several potential early risk factors in preschool children were associated with later overweight: high birth weight, ethnicity, excess screen time, low attention span, maternal smoking during pregnancy, inconsistent discipline, fewer rules, corporal punishment and parents psychopathology. Among them, the most powerful factor was high birth-weight (odds ratio = 1.89 at age 3, 1.87 at age 4, and 2.35 at age 5), underlining the importance of weight monitoring from postpartum and routine screening for overweight in children who have high birth weight. With the increasing prevalence of overweight in children at early ages, understanding the determinants for overweight risk becomes crucial for public health professionals and policy-makers in order to implement effective prevention and intervention programs 


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Achenbach, T. M. & Rescorla, L. A. (2003). Manual for the ASEBA Adult Forms & Profiles. Burlington, VT: University of Vermont, Research Center for Chil¬dren.

American Academy of Pediatrics. (2013). Children, Adolescents, and the Media. Pediatrics, 132(5), 957–961 https://doi.org/10.1542/peds.2013-2656

Afifi, T. O., Mota, N., MacMillan, H. L., & Sareen, J. (2013). Harsh Physical Punishment in Childhood and Adult Physical Health. Pediatrics, 132(2), 333–340. https://doi.org/10.1542/peds.2012-4021

Baker, J. L., Olsen, L. W., & Sørensen, T. I. (2007). Childhood Body-mass Index and the Risk of Coronary Heart Disease in Adulthood. New England Journal of Medicine, 357, 2329–2337. https://doi.org/10.1056/NEJMoa072515

Cominato, L., Di Biagio, G. F., Lellis, D., Franco, R. R., Mancini, M. C., & de Melo M., E. (2018). Obesity Prevention: Strategies and Challenges in Latin America. Current Obesity Reports, 7(2), 97–104 https://doi.org/10.1007/s13679-018-0311-1.

De Onis, M., Blössner, M., & Borghi, E. (2010). Global Prevalence and Trends of Overweight and Obesity among Preschool Children. American Journal of Clinical Nutrition, 92, 1257–1264. https://doi.org/10.3945/ajcn.2010.29786

Ezpeleta, L., de la Osa, N., & Doménech, J. M. (2014). Prevalence of DSM-IV Disorders, Comorbidity and Impairment in 3-year-old Spanish Preschoolers. Social Psychiatry and Psychiatric Epidemiology, 49, 145–155. https://doi.org/10.1007/s00127-013-0683-1

Ezpeleta, L., de la Osa, N., Granero, R., Doménech, J. M., & Reich, W. (2011). The Diagnostic Interview for Children and Adolescents for Parents of Preschool Children: Psychometric Properties in the General Population. Psychiatry Research, 190, 137–144. https://doi.org/10.1016/j.psychres.2011.04.034

Faith, M. S. & Hittner, J. B. (2010). Infant Temperament and Eating Style Predict Change in Standardised Weight Status and Obesity Risk at 6 years of AGE. International Journal of Obesity, 34, 1515–1523. https://doi.org/10.1038/ijo.2010

Freedman, D. S., Mei, Z., Srinivasan, S. R., Berenson, G. S., & Dietz, W. H. (2007). Cardiovascular risk Factors and Excess Adiposity among Overweight Children and Adolescents: The Bogalusa Heart Study. Journal of Pediatrics, 150(1), 12–17. https://doi.org/10.1016/j.jpeds.2006.08.042

Gardner, D. S., Hosking, J., Metcalf, B. S., Jeffery, A. N., Voss, L. D., & Wilkin T. J. (2009). Contribution of Early Weight Gain to Childhood Overweight and Metabolic Health: A Longitudinal Study (EarlyBird 36). Pediatrics, 123(1), e67–73. https://doi.org/10.1542/peds.2008-1292.

Gordon-Larsen, P., Adair, L. S., Nelson, M. C., & Popkin, B. M. (2004). Five-year Obesity Incidence in the Transition Period between Adolescence and Adulthood: The National Longitudinal Study of Adolescent Health. American Journal of Clinical Nutrition, 80, 569–575. https://doi.org/10.1093/ajcn/80.3.569

Hodges, E. L., Cochrane, C. E., & Brewerton, T. D. (1998). Family Characteristics of Binge Eating Disorder Patients. International Journal of Eating Disorders, 23(2), 145–151. https://doi.org/10.1002/(SICI)1098-108X(199803)23:2<145::AID-EAT4>3.0.CO;2-K

Hollingshead, A. A. (1975). Four-factor Index of Social Status. New Haven, CT: Yale University, Unpublished manuscript.

Howe, L. D., Tilling, K., & Lawlor, D. A. (2009). Accuracy of Height and Weight Data from Child Health Records. Archives of Disease in Childhood, 94, 950–954. https://doi.org/10.1136/adc.2009.162552

Hui, L. L., Nelson, E. A., Yu, L. M., Li, A. M., & Fok, T. F. (2003). Risk Factors for Childhood Overweight in 6- to 7-y-old Hong Kong Children. International Journal of Obesity and Related Metabolic Disorders, 27(11), 1411–1418.

Jansen, P. W., Mensah, F. K., Nicholson, J. M., & Wake, M. (2013). Family and Neighbourhood Socioeconomic Inequalities in Childhood Trajectories of BMI and Overweight: Longitudinal Study of Australian Children. PloS One, 8, e69676. https://doi.org/10.1371/journal.pone.0069676

Kuhle, S., Allen, A. C., & Veugelers, P. J. (2010). Prevention potential of risk factors for childhood overweight. Canadian Journal of Public Health, 101(5), 365–368.

Lakshman, R., Elks, C. E., & Ong, K. K. (2012). Childhood Obesity. Circulation, 126, 1770–1779. https://doi.org/10.1161/CIRCULATIONAHA.111.047738

Limaye, S. & Salvi, S. (2014). Obesity and Asthma: The Role of Environmental Pollutants. Immunology and Allergy Clinics of North America, 34(4), 839–855. https://doi.org/10.1016/j.iac.2014.07.005

Miqueleiz, E., Lostao, L., Ortega, P., Santos, J. M., Astasio, P., & Regidor, E. (2014). Trends in the Prevalence of Childhood Overweight and Obesity According to Socioeconomic Status: Spain, 1987-2007. European Journal of Clinical Nutrition, 68, 209–214. https://doi.org/10.1038/ejcn.2013.255

Mitchell, E. A., Stewart, A. W., Braithwaite, I., Hancox, R. J., Murphy, R., Wall, C., ...Beasley, R. (2016). Birth Weight and Subsequent Body Mass Index in Children: An International Cross-Sectional Study. Pediatric Obesity, 1–6. https://doi.org/10.1111/ijpo.12138

Osa, N. de la, Granero, R., Penelo, E., Domènech, J. M., & Ezpeleta, L. (2014). Psychometric Properties of the Alabama Parenting Questionnaire - Preschool revision (APQ-Pr) in 3 year-old Spanish preschoolers. Journal of Child and Family Studies, 23, 776–784. https://doi.org/ 10.1007/s10826-013-9730-5

Perez-Bonaventura, I., Granero, R., & Ezpeleta, L. (2015). The Relationship Between Weight Status and Emotional and Behavioral Problems in Spanish Preschool. Journal of Pediatric Psychology, 40, 455–463. https://doi.org/10.1093/jpepsy/jsu107

Reilly, J. J., Methven, E., McDowell, Z. C., Hacking, B., Alexander, D., Stewart, L., …Kelnar, C. J. (2003). Health Consequences of Obesity. Archives of Disease in Childhood, 88, 748–752. https://doi.org/ 10.1136/adc.88.9.748

Rothbart, M. K., Ahadi, S. A., Hershey, K. L., & Fisher, P. (2001). Investigations of Temperament at 3–7 years: The Children’s Behavior Questionnaire. Child Development, 72(5), 1394–1408. https://doi.org/10.1111/1467-8624.00355

Stamatakis, E., Wardie, J., & Cole, T. J. (2010). Childhood Obesity and Overweight Prevalence Trends in England: Evidence for Growing Socioeconomic Disparities. International Journal of Pediatric Obesity, 34(1), 41–47. https://doi.org/10.1038/ijo.2009.217

Unitat d'Epidemiologia i de Diagnòstic en Psicopatologia del Desenvolupament. (2009). Protocolo de Factores de Riesgo. Versión para preescolares [Risk Factors Protocol. Preschool version]. Barcelona, Spain: Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona.

van Stralen, M. M., te Velde, S. J., van Nassau, F., Brug, J., Grammatikaki, E., Maes, L., …Chinapaw, M. J. (2012). ToyBox-study Group. Weight Status of European Preschool Children and Associations with Family Demographics and Energy Balance-related Behaviours: A Pooled Analysis of Six European Studies. Obesity Reviews, 13, 29–41. https://doi.org/10.1111/j.1467-789X.2011.00959.x

Veldhuis, L., van Dooremaal, M., Kroeze, W., Renders, C. M., Hirasing, R. A., & Raat, H. (2013). Ethnic Background and Overweight Among 5-year-old CHILDREN: The "Be Active, Eat Right" study. Pediatrics, 10, 861246. https://doi.org/10.1155/2013/861246

Weng, S. F., Redsell, S. A., Swift, J. A., Yang, M., & Glazebrook, C. P. (2012) Systematic Review and Meta-analyses of Risk Factors for Childhood Overweight Identifiable during Infancy. Archives of Disease in Childhood, 97(12), 1019–1026. https://doi.org/10.1136/archdischild-2012-302263

Whitaker, R. C., Phillips, S. M., Orzol, S. M., & Burdette, H. L. (2007). The Association between Maltreatment and Obesity among Preschool Children. Child Abuse & Neglect, 31(11–12), 1187–1199. https://doi.org/10.1016/j.chiabu.2007.04.008

World Health Organization Multicentre Growth Reference Study Group. (2006). WHO child Growth Standards Based on Length/Height, Weight and Age. Acta Paediatrica, 450, 76–85. https://doi.org/10.1080/08035320500495548




How to Cite

Pérez-Bonaventura, I., Granero, R., & Ezpeleta Ascaso, L. (2019). Risk Factors for Overweight in early ages: longitudinal design with Spanish Preschoolers. Acción Psicológica, 16(1), 1–12. https://doi.org/10.5944/ap.16.1.22098



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