Effect of Food Preference and Mothers Nutritional Knowledge on Obesity in Schoolgirls in Saudi Arabia: A Case-Control Study

Abstract

Background: Childhood obesity is a major public health challenge of the 21st century. Obese children have double the risk of being obese adults than children who are of normal weight. Obese children bhave increased risks of developing hypertension, dyslipidemia, and other cardio-metabolic morbidities. Objectives: to investigate the effect of the children food knowledge and preferences on their BMI and the effects of mothers’ nutritional knowledge on their children’s BMI. Methods: A school-based case-control study design was carried out in the Eastern Region of Saudi Arabia. Data collection was carried out from November 2017 to February 2018. A multistage stratified cluster random sampling technique was used. Four clusters (schools) were selected based on size and equal numbers of participants were included from each cluster. From each of grade 4th, 5th, and 6th, one class was selected randomly. The weight and height of each girl were recorded, BMI calculated, and the students were divided into obese/ overweight group and the normal weight group from which cases and control randomly selected thereafter. Out of total 442 students measured BMI, 348 were included in the study, 116 cases and 232 controls. Data were collected by face to face interview with the girl, and a self-administrated questionnaire was sent to the same student's mother. Determinants of girls' obesity were calculated using regression analysis. Results were presented as adjusted Odds Ratio (aOR) and 95% confidence intervals (CI). Result: After controlling for the confounding variables, more healthy food preferences in children and higher mother's knowledge were associated with 77% and 51% reduced odds of overweight-obesity (aOR = 0.23 95% CI 0.09–0.64 and aOR = 0.49 95% CI 0.33–0.71). Conclusion: Healthy food preferences among girls and adequate nutritional knowledge among their mothers were significantly associated with decreased obesity in girls. Limitations: The main limitations were its inability to assess causation and the potential for recall bias, especially in the questions related to behaviors; namely, physical activity and diet recall.