Prevalence and Determinants of Overweight and Obesity in Preschoolers in Miami-Dade County

Background: The prevalence of childhood overweight in the United States continues to be a national public health problem. The child care and household environments play an important role in the nutrition, physical activity, and screen-time behaviors of preschoolers. Aims: This dissertation aimed to (1) estimate the prevalence of overweight and obesity in 3-5 year old children enrolled in child care centers in Miami-Dade County; (2) identify early life, dietary, and screen-time risk factors of overweight, and (3) assess child care centers\u27 level of adherence to nutrition, physical activity, and screen-time regulations by center socioeconomic location (SEP). Methods: A total of 366 children ages 3-5 years old from 34 child care centers participated in the study. Caregivers completed a questionnaire on socioeconomic, early life, dietary, and screen-time factors. We measured children\u27s heights and weights. Chi-square and logistic regression analyses were used to examine the association between child overweight and determinants. Results: the prevalence of overweight was 29.8% in this sample. The middle-SEP group had the highest prevalence of overweight (35.3%) when compared to low and high-SEP groups. Being Hispanic was associated with a three-fold risk of overweight/ obesity (AOR: 2.91, 95% CI 1.36, 6.21). Lack of daily fruit consumption increased the risk of overweight in Hispanic children. Middle-SEP children reported lowest consumption of fruits and vegetables. There were significant differences in breastfeeding practices by ethnicity and SEP. Assessment of child care practices resulted in all child care centers adhering to two-hour screen-time regulation for children older than 2-years old. Low and middle SEP centers fared better in serving of fruits , vegetables, and low fat/ fat free milk. The centers had incorporated quite and active play in their routines. Conclusions: This is the first study to examine prevalence by SEP in Miami-Dade County. Findings highlight opportunities for improvement in early life nutrition, as well as dietary and screen-time practices in the household and child care environments