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Social and somatic determinants of underweight, overweight and obesity at 5 years of age: a Norwegian regional cohort study
  1. Hilde Mjell Donkor1,
  2. Jacob Holter Grundt1,
  3. Pétur Benedikt Júlíusson2,
  4. Geir Egil Eide3,4,
  5. Jørgen Hurum1,
  6. Robert Bjerknes2,
  7. Trond Markestad2,5
  1. 1 Department of Paediatrics, Innlandet Hospital Trust, Lillehammer, Norway
  2. 2 Department of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
  3. 3 Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
  4. 4 Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
  5. 5 Department of Research, Innlandet Hospital Trust, Lillehammer, Norway
  1. Correspondence to Professor Trond Markestad; trond.markestad{at}


Objective To identify associations between the weight groups underweight (UW), overweight (OW) and obesity (OB) at 5 years of age and exposures related to pregnancy, anthropometric measures at birth, sociodemographic factors, and family health, anthropometric measures and habits.

Design Regional cohort study.

Setting Oppland County, Norway.

Methods Pregnancy data were obtained from a prospective perinatal register for children born in the county, and weight and height were measured by midwives at birth and by public health nurses at 5 years. Other information was obtained from questionnaires completed by parents.

Participants Of 1895 eligible children, current weight and height were obtained for all, weight and length at birth and information from parents for 1119 (59%) and pregnancy register data for 749 (40%) of the children. The significance of potential explanatory variables from descriptive statistics was tested in multinomial logistic regression analysis.

Results The prevalence of UW, OW and OB among participants was 7.8%, 10.6% and 3.5%, respectively. UW was associated with anthropometric measures at birth and those of parents, but not with sociodemographic or behavioural characteristics. OW and OB were associated with anthropometric measures of parents and siblings and with a variety of unfavourable social characteristics, lack of prolonged breast feeding, sedentary behaviour and dental caries, but not with current dietary habits. After adjustments, OW and OB were marginally related to birth parameters and diet and unrelated to physical activity, but significantly related to parental body mass index, low parental education and maternal smoking.

Conclusion The strong associations between sociodemographic and behavioural factors and OW and OB, but not with UW, may suggest that environmental factors are major contributing causes of OW and particularly OB at 5 years. These results may be helpful in targeting preventive measures against OW and OB.

  • child
  • overweight
  • obesity
  • underweight
  • prevention
  • prevalence
  • risk factors

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  • Contributors HMD: planning, statistical analyses, interpretation of results and initial drafting and writing the paper. JHG: planning, participation in collection of data, statistical analyses, interpretation of results and initial drafting and writing the paper. PBJ: planning, presentation, analyses and interpretation of results and writing the paper. GEE: planning of presentation and statistical analyses, interpretation of results and writing of the paper. JH: conceptualisation and design of the study, collection of data, planning and interpretation of the results. RB: planning, presentation, analyses and interpretation of results and writing the paper. TM: conceptualisation and design of the study, collection of data, presentation and interpretation of results and writing the paper. HMD had primary responsibility for writing and final content. All authors read and approved the final version of the paper.

  • Funding This study was supported by unrestricted grants from the Innlandet Hospital Trust. The funding source did not play any role in the design and conduct of the study; in the collection, management, analysis or interpretation of the data; or in the preparation, review or approval of the manuscript.

  • Competing interests All authors have completed the ICMJE uniform disclosure form at and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years; no other relationships or activities that could appear to have influenced the submitted work.

  • Patient consent Guardian consent obtained.

  • Ethics approval Regional Committee on Medical Research Ethics and the Norwegian Data Protection Official for Research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No other data are published or available from the study.

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