Researchers: Varda Soskolne¹, Mary Rudolf¹, Michal Cohen Dar², Samira Ubeid², Nitsa Cohen²

Background: Scientific knowledge is widespread regarding the risk factors that explain the higher rates of obesity among children of low socio-economic status, but little is known about the protective factors that contribute to a healthy weight.

Objectives: To compare the association between protective and risk factors and obesity among children of low socio-economic status in the Jewish and Arab sectors.

Method: Qualitative and quantitative research, which involved children aged five years attending Mother and Child clinics in towns of low socioeconomic ranking in the Northern District of the Ministry of Health. Qualitative focus group interviews were conducted among mothers of children who were of normal weight or were obese. Quantitative research was conducted on children randomly selected from 20 Mother and Child clinics. Data were collected from clinic records and from a questionnaire addressing psychosocial, behavioral and environmental factors which was completed by mothers. 946 children participated in the research.

Findings: Obesity rates (BMI≥85%) were higher in Jewish children than among Arabs (25% vs 19%). In both sectors, maternal weight and birth weight were risk factors for obesity, and the mother's self-efficacy regarding their children’s health behaviors was protective for normal weight. Additional protective and risk factors for child obesity were identified but differed for each sector. In the Jewish sector, the association between maternal BMI and child BMI was moderated by maternal education.

Conclusions: The findings point to protective factors that contribute to healthy childhood weight alongside risk factors, although these differ across the two sectors.

Recommendations: Early childhood programs to reduce childhood obesity in disadvantaged populations would be strengthened through a focus on protective factors such as maternal self-efficacy regarding healthy behaviors. Cultural adaptation is important as protective factors differ across the sectors.

Research end date: 06/2017