Family matters? Parental influences on primary school children's energy balance-related behaviors and weight

In the Netherlands, as in many other countries, the prevalence of overweight and obesity among children has increased rapidly over the past decades(1–4). Although there is convincing evidence for genetic susceptibility to overweight(5), this cannot explain the rising trend. The current obesogenic environment, characterized by the constant availability of cheap energy-dense food and advancement of sedentary lifestyles, is part of the explanation(6,7). Between 1980 and 2010, the overweight prevalence among Dutch boys (aged 2-21 years) has increased from 5.1% to 13.3% and among Dutch girls from 7.2% to 14.9%(8). Although a recent study among primary school children across Europe aged 10-12 years shows that the prevalence rates among Dutch primary school children were below the European average, 16.8% of Dutch boys aged 10-12 years were overweight (of which 4.5% obese) and 15.4% of the girls (of which 2.5% obese)(9). Overweight and obesity are associated with premature mortality, and an increased risk of several diseases such as type 2 diabetes, musculoskeletal and pulmonary disorders, cardiovascular diseases and various types of cancer(10–12). In addition, they are associated with psychosocial problems such as a low self-esteem, depression and eating disorders(13,14). In view of these consequences, and given the tracking of overweight from childhood into adulthood(15), preventing overweight and obesity during childhood is an important public health target(4). However, to achieve this target requires a detailed understanding of the most important and modifiable risk and preventive factors for childhood overweight, including their underlying determinants.

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