Intergenerational Transmission of Obesity from Mothers to Their Offspring: Trends and Associated Factors Derived from the Malaysian National Health and Morbidity Survey (NHMS)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Ethical Approval
2.3. Study Sample
2.4. Body Mass Index (BMI) of the Participants
2.5. Statistical Analyses
3. Results
3.1. Characteristics of Mother–Child Pairs
3.2. The Prevalence of Different BMI Categories by Mother–Child Pair
3.3. Factors Associated with Overweight Mother/Overweight Child Pair (OWM/OWC)
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Description | 2006 | 2011 | 2015 |
---|---|---|---|
Total number of households (N) | 15,316 | 7638 | 8427 |
Reasons for exclusion | |||
No data on child in the household | 3797 | 1893 | 2063 |
Living alone | 2144 | 1015 | 1325 |
Child’s age above 17 years old in the household | 1373 | 890 | 1062 |
Living with friends | 207 | 167 | 142 |
Relationship to the head of the household cannot be determined | 1216 | 441 | 992 |
Missing data on height and weight | 574 | 275 | 258 |
Mother–child pairs obtained | 6005 | 2957 | 2871 |
Appendix B
Quintile Income | Household Income Range (RM) | ||
---|---|---|---|
2006 | 2011 | 2015 | |
Quintile 1 (lowest income) | <500 | <950 | <1200 |
Quintile 2 | 500–949 | 950–1727 | 1200–1999 |
Quintile 3 | 950–1499 | 1728–2799 | 2000–3181 |
Quintile 4 | 1500–2499 | 2800–4599 | 3182–5299 |
Quintile 5 (highest income) | 2500 and above | 4600 and above | 5300 and above |
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Characteristics of Mother–Child Pairs | 2006 | 2011 | 2015 | |||
---|---|---|---|---|---|---|
n | % | n | % | n | % | |
Maternal age in years, mean (SD) | 40.9 (7.5) | 41.5 (7.3) | 41.7 (7.7) | |||
<30 | 529 | 8.8 | 187 | 6.3 | 206 | 7.2 |
31–40 | 2335 | 38.9 | 1175 | 39.7 | 1106 | 38.5 |
41–50 | 2490 | 41.5 | 1248 | 42.2 | 1170 | 40.8 |
51 and above | 651 | 10.8 | 347 | 11.7 | 389 | 13.5 |
Total | 6005 | 2957 | 2871 | |||
Ethnicity | ||||||
Malays | 3659 | 60.9 | 1842 | 62.3 | 1915 | 66.7 |
Chinese | 926 | 15.4 | 443 | 15.0 | 331 | 11.5 |
Indian | 485 | 8.1 | 212 | 7.2 | 194 | 6.8 |
Others | 935 | 15.6 | 460 | 15.6 | 431 | 15.0 |
Total | 6005 | 2957 | 2871 | |||
Maternal education level | ||||||
Tertiary | 401 | 6.7 | 510 | 17.4 | 614 | 21.6 |
Secondary | 3246 | 54.3 | 1662 | 56.6 | 1606 | 56.4 |
Primary | 1832 | 30.7 | 609 | 20.7 | 527 | 18.5 |
None | 497 | 8.3 | 156 | 5.3 | 101 | 3.5 |
Total | 5976 | 2937 | 2848 | |||
Household size, mean (SD) | 5.16 (1.82) | 5.23 (1.72) | 4.87 (1.62) | |||
Small (<5 persons) | 2393 | 39.9 | 1091 | 37.0 | 1319 | 45.9 |
Medium (5–7 persons) | 3034 | 50.5 | 1594 | 54.0 | 1394 | 48.6 |
Large (>7 persons) | 577 | 9.6 | 266 | 9.0 | 158 | 5.5 |
Total | 6004 | 2951 | 2871 | |||
Household income | ||||||
Quintile 5 | 1429 | 24.5 | 665 | 22.5 | 677 | 23.6 |
Quintile 4 | 1396 | 23.9 | 633 | 21.4 | 607 | 21.1 |
Quintile 3 | 960 | 16.4 | 536 | 18.1 | 635 | 22.1 |
Quintile 2 | 1310 | 22.4 | 559 | 18.9 | 461 | 16.1 |
Quintile 1 | 747 | 12.8 | 432 | 14.6 | 491 | 17.1 |
Total | 5842 | 2825 | 2871 | |||
Family structure | ||||||
Dual-parent family | 5682 | 94.7 | 2803 | 94.8 | 2671 | 93.0 |
Single-parent family | 319 | 5.3 | 154 | 5.2 | 200 | 7.0 |
Total | 6001 | 2957 | 2871 | |||
Residential area | ||||||
Rural | 2613 | 43.5 | 1265 | 42.8 | 1233 | 42.9 |
Urban | 3392 | 56.5 | 1692 | 57.2 | 1638 | 57.1 |
Total | 6005 | 2957 | 2871 | |||
Child age in years, mean (SD) | 9.2 (3.6) | 9.7 (3.7) | 9.6 (3.7) | |||
5–9 | 3587 | 59.7 | 1629 | 55.1 | 1603 | 55.8 |
10–14 | 1730 | 28.8 | 892 | 30.2 | 876 | 30.5 |
15–17 | 688 | 11.5 | 436 | 14.7 | 392 | 13.7 |
Total | 6005 | 2957 | 2871 | |||
Sex of child | ||||||
Girls | 2906 | 48.4 | 1464 | 49.5 | 1405 | 48.9 |
Boys | 3099 | 51.6 | 1493 | 50.5 | 1466 | 51.1 |
Total | 6005 | 2957 | 2871 |
Characteristics of Mother–Child Pairs | 2006 | 2011 | 2015 | p-Value a | |||
---|---|---|---|---|---|---|---|
(n = 6005) | (n = 2957) | (n = 2871) | |||||
n | % | n | % | n | % | ||
Maternal BMI, mean (SD) | 26.19 (5.19) | 26.66 (5.39) | 27.36 (5.55) | <0.001 b | |||
Underweight | 248 | 4.1 | 100 | 3.4 | 81 | 2.8 | |
Normal weight | 2438 | 40.6 | 1130 | 38.2 | 970 | 33.8 | |
Overweight | 2060 | 34.3 | 1041 | 35.2 | 1003 | 34.9 | |
Obese | 1259 | 21.0 | 686 | 23.2 | 817 | 28.5 | |
Child BMI, mean (SD) | 17.26 (4.45) | 17.78 (4.66) | 18.28 (5.05) | <0.001 b | |||
Underweight | 617 | 10.2 | 299 | 10.1 | 219 | 7.6 | |
Normal weight | 4034 | 67.2 | 1961 | 66.3 | 1839 | 64.1 | |
Overweight | 774 | 12.9 | 367 | 12.4 | 374 | 13.0 | |
Obese | 580 | 9.7 | 330 | 11.2 | 439 | 15.3 |
Mother–Child Pairs Categories | 2006 | 2011 | 2015 | |||
---|---|---|---|---|---|---|
(n = 6005) | (n = 2957) | (n = 2871) | ||||
n | % | n | % | n | % | |
UWM/UWC | 52 | 0.9 | 25 | 0.8 | 13 | 0.5 |
UWM/NWC | 171 | 2.8 | 62 | 2.1 | 60 | 2.1 |
UWM/OWC | 25 | 0.4 | 13 | 0.4 | 8 | 0.3 |
NWM/UWC | 320 | 5.3 | 142 | 4.8 | 104 | 3.6 |
NWM/NWC | 1705 | 28.4 | 782 | 26.4 | 684 | 23.8 |
NWM/OWC | 413 | 6.9 | 206 | 7.0 | 182 | 6.3 |
OWM/UWC | 245 | 4.1 | 132 | 4.5 | 102 | 3.6 |
OWM/NWC | 2158 | 35.9 | 1117 | 37.8 | 1095 | 38.1 |
OWM/OWC | 916 | 15.3 | 478 | 16.2 | 623 | 21.7 |
Risk Factors | 2006 (n = 2621) | 2011 (n = 1260) | 2015 (n = 1307) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
OR | 95% CI | p-Value | OR | 95% CI | p-Value | OR | 95% CI | p-Value | ||||
Maternal age | ||||||||||||
≤30 | 1.00 | 1.00 | 1.00 | |||||||||
31–40 | 1.74 | 1.21, 2.49 | 0.003 | 1.19 | 0.71, 2.01 | 0.510 | 1.51 | 0.96, 2.38 | 0.078 | |||
41–50 | 3.22 | 2.25, 4.60 | <0.001 | 1.66 | 0.99, 2.78 | 0.054 | 1.72 | 1.09, 2.70 | 0.019 | |||
51 and above | 3.21 | 2.12, 4.87 | <0.001 | 2.07 | 1.15, 3.74 | 0.015 | 2.01 | 1.20, 3.38 | 0.008 | |||
Child age | ||||||||||||
5–9 | 1.00 | 1.00 | 1.00 | |||||||||
10–14 | 2.13 | 1.78, 2.55 | <0.001 | 1.96 | 1.52, 2.53 | <0.001 | 1.47 | 1.15, 1.88 | 0.002 | |||
15–17 | 1.44 | 1.11, 1.87 | 0.006 | 1.25 | 0.89, 1.76 | 0.193 | 0.83 | 0.60, 1.13 | 0.235 | |||
Child sex | ||||||||||||
Girl | 1.00 | 1.00 | 1.00 | |||||||||
Boy | 0.90 | 0.76, 1.05 | 0.180 | 1.13 | 0.90, 1.42 | 0.294 | 1.08 | 0.87, 1.35 | 0.465 | |||
Household size a | ||||||||||||
Small | 1.00 | 1.00 | 1.00 | |||||||||
Medium | 0.83 | 0.70, 0.99 | 0.033 | 0.80 | 0.63, 1.01 | 0.062 | 0.99 | 0.79, 1.24 | 0.923 | |||
Large | 0.64 | 0.47, 0.87 | 0.005 | 0.64 | 0.41, 1.01 | 0.055 | 0.52 | 0.31, 0.87 | 0.013 | |||
Ethnicity | ||||||||||||
Malay | 1.00 | 1.00 | 1.00 | |||||||||
Chinese | 0.43 | 0.34, 0.55 | <0.001 | 0.38 | 0.27, 0.53 | <0.001 | 0.43 | 0.31, 0.61 | <0.001 | |||
Indian | 1.39 | 1.03, 1.88 | 0.031 | 1.44 | 0.93, 2.22 | 0.100 | 1.23 | 0.79, 1.92 | 0.359 | |||
Other | 0.53 | 0.41, 0.67 | <0.001 | 0.56 | 0.39, 0.79 | 0.001 | 0.79 | 0.58, 1.07 | 0.122 | |||
Maternal education level | ||||||||||||
Tertiary | 1.00 | 1.00 | 1.00 | |||||||||
Secondary | 1.49 | 1.07, 2.08 | 0.018 | 1.29 | 0.95, 1.74 | 0.100 | 1.60 | 1.21, 2.12 | 0.001 | |||
Primary | 1.77 | 1.26, 2.50 | 0.001 | 1.20 | 0.83, 1.74 | 0.330 | 1.62 | 1.15, 2.29 | 0.006 | |||
None | 0.84 | 0.53, 1.31 | 0.438 | 1.74 | 1.01, 2.99 | 0.044 | 1.66 | 0.91, 3.02 | 0.097 | |||
Household income ᵇ | ||||||||||||
Quintile 5 | 1.00 | 1.00 | 1.00 | |||||||||
Quintile 4 | 1.24 | 0.99, 1.56 | 0.064 | 1.08 | 0.78, 1.51 | 0.637 | 1.01 | 0.73, 1.40 | 0.932 | |||
Quintile 3 | 1.23 | 0.96, 1.58 | 0.107 | 1.19 | 0.84, 1.69 | 0.328 | 1.34 | 0.98, 1.84 | 0.067 | |||
Quintile 2 | 0.82 | 0.64, 1.04 | 0.094 | 1.09 | 0.76, 1.55 | 0.649 | 0.92 | 0.65, 1.31 | 0.649 | |||
Quintile 1 | 0.53 | 0.39, 0.72 | <0.001 | 1.14 | 0.78, 1.67 | 0.510 | 1.22 | 0.87, 1.72 | 0.247 | |||
Family structure | ||||||||||||
Dual-parent family | 1.00 | 1.00 | 1.00 | |||||||||
Single-parent family | 0.88 | 0.61, 1.26 | 0.474 | 1.41 | 0.84, 2.37 | 0.191 | 1.08 | 0.69, 1.67 | 0.739 | |||
Residential area | ||||||||||||
Rural | 1.00 | 1.00 | 1.00 | |||||||||
Urban | 1.12 | 0.95, 1.32 | 0.184 | 1.00 | 0.80, 1.27 | 0.971 | 0.77 | 0.62, 0.96 | 0.019 |
Risk Factors | 2006 (n = 2621) | 2011 (n = 1260) | 2015 (n = 1307) | ||||||
---|---|---|---|---|---|---|---|---|---|
AOR | 95% CI | p-Value | AOR | 95% CI | p-Value | AOR | 95% CI | p-Value | |
Maternal age | |||||||||
≤30 | 1.00 | 1.00 | 1.00 | ||||||
31–40 | 1.72 | 1.17, 2.53 | 0.005 | 0.94 | 0.54, 1.65 | 0.836 | 1.47 | 0.92, 2.37 | 0.108 |
41–50 | 2.82 | 1.91, 4.18 | <0.001 | 1.14 | 0.64, 2.02 | 0.657 | 1.68 | 1.03, 2.74 | 0.038 |
51 and above | 2.87 | 1.77, 4.66 | <0.001 | 1.27 | 0.64, 2.54 | 0.497 | 2.11 | 1.16, 3.84 | 0.015 |
Child age | |||||||||
5–9 | 1.00 | 1.00 | 1.00 | ||||||
10–14 | 1.59 | 1.30, 1.96 | <0.001 | 1.76 | 1.30, 2.36 | <0.001 | 1.21 | 0.91, 1.61 | 0.185 |
15–17 | 0.92 | 0.67, 1.26 | 0.594 | 1.02 | 0.67, 1.55 | 0.937 | 0.60 | 0.40, 0.89 | 0.012 |
Household size a | |||||||||
Small | 1.00 | 1.00 | 1.00 | ||||||
Medium | 0.87 | 0.72, 1.04 | 0.132 | 0.82 | 0.63, 1.07 | 0.150 | 0.93 | 0.73, 1.19 | 0.573 |
Large | 0.62 | 0.44, 0.86 | 0.005 | 0.56 | 0.34, 0.91 | 0.019 | 0.44 | 0.25, 0.76 | 0.003 |
Ethnicity | |||||||||
Malay | 1.00 | 1.00 | 1.00 | ||||||
Chinese | 0.33 | 0.25, 0.43 | <0.001 | 0.30 | 0.21, 0.43 | <0.001 | 0.44 | 0.31, 0.63 | <0.001 |
Indian | 1.31 | 0.95, 1.82 | 0.101 | 1.29 | 0.82, 2.04 | 0.273 | 1.31 | 0.83, 2.07 | 0.254 |
Other | 0.69 | 0.53, 0.89 | 0.005 | 0.57 | 0.39, 0.84 | 0.005 | 0.78 | 0.56, 1.09 | 0.142 |
Maternal education level | |||||||||
Tertiary | 1.00 | 1.00 | 1.00 | ||||||
Secondary | 1.74 | 1.20, 2.52 | 0.003 | 1.26 | 0.88, 1.79 | 0.209 | 1.73 | 1.26, 2.38 | 0.001 |
Primary | 2.24 | 1.49, 3.36 | <0.001 | 1.21 | 0.76, 1.92 | 0.423 | 2.00 | 1.32, 3.03 | 0.001 |
None | 1.15 | 0.67, 1.95 | 0.615 | 1.65 | 0.84, 3.23 | 0.147 | 1.93 | 1.00, 3.73 | 0.052 |
Household income ᵇ | |||||||||
Quintile 5 | 1.00 | 1.00 | 1.00 | ||||||
Quintile 4 | 1.05 | 0.81, 1.35 | 0.726 | 1.01 | 0.71, 1.45 | 0.960 | 0.76 | 0.54, 1.10 | 0.149 |
Quintile 3 | 1.06 | 0.80, 1.40 | 0.684 | 0.99 | 0.66, 1.47 | 0.954 | 0.90 | 0.63, 1.29 | 0.577 |
Quintile 2 | 0.67 | 0.50, 0.89 | 0.005 | 0.86 | 0.57, 1.29 | 0.471 | 0.61 | 0.41, 0.92 | 0.017 |
Quintile 1 | 0.45 | 0.31, 0.64 | <0.001 | 0.83 | 0.52, 1.32 | 0.434 | 0.81 | 0.55, 1.21 | 0.309 |
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Mohamed, N.N.; Rohana, A.J.; Hamid, N.A.A.; Hu, F.B.; Malik, V.S.; Mohd Yusoff, M.F.; Aris, T.; The Global Nutrition and Epidemiologic Transition Initiative (GNET). Intergenerational Transmission of Obesity from Mothers to Their Offspring: Trends and Associated Factors Derived from the Malaysian National Health and Morbidity Survey (NHMS). Nutrients 2022, 14, 2186. https://doi.org/10.3390/nu14112186
Mohamed NN, Rohana AJ, Hamid NAA, Hu FB, Malik VS, Mohd Yusoff MF, Aris T, The Global Nutrition and Epidemiologic Transition Initiative (GNET). Intergenerational Transmission of Obesity from Mothers to Their Offspring: Trends and Associated Factors Derived from the Malaysian National Health and Morbidity Survey (NHMS). Nutrients. 2022; 14(11):2186. https://doi.org/10.3390/nu14112186
Chicago/Turabian StyleMohamed, Nur Nadia, Abdul Jalil Rohana, Noor Aman A Hamid, Frank B. Hu, Vasanti S. Malik, Muhammad Fadhli Mohd Yusoff, Tahir Aris, and The Global Nutrition and Epidemiologic Transition Initiative (GNET). 2022. "Intergenerational Transmission of Obesity from Mothers to Their Offspring: Trends and Associated Factors Derived from the Malaysian National Health and Morbidity Survey (NHMS)" Nutrients 14, no. 11: 2186. https://doi.org/10.3390/nu14112186