The Emerging Prevalence of Obesity within Families in Europe and its Associations with Family Socio-Demographic Characteristics and Lifestyle Factors; A Cross-Sectional Analysis of Baseline Data from the Feel4Diabetes Study.

The Feel4Diabetes study is a type 2 diabetes prevention program that recruited 12,193 children [age: 8.20 (±1.01) years] and their parents from six European countries. The current work used pre-intervention data collected from 9576 children-parents pairs, to develop a novel family obesity variable and to examine its associations with family sociodemographic and lifestyle characteristics. Family obesity, defined as the presence of obesity in at least two family members, had a prevalence of 6.6%. Countries under austerity measures (Greece and Spain) displayed higher prevalence (7.6%), compared to low-income (Bulgaria and Hungary: 7%) and high-income countries (Belgium and Finland: 4.5%). Family obesity odds were significantly lower when mothers (OR: 0.42 [95% CI: 0.32, 0.55]) or fathers (0.72 [95% CI: 0.57, 0.92]) had higher education, mothers were fully (0.67 [95% CI: 0.56, 0.81]) or partially employed (0.60 [95% CI: 0.45, 0.81]), families consumed breakfast more often (0.94 [95% CI: 0.91 0.96]), more portions of vegetables (0.90 [95% CI: 0.86, 0.95]), fruits (0.96 [95% CI: 0.92, 0.99]) and wholegrain cereals (0.72 [95% CI: 0.62, 0.83]), and for more physically active families (0.96 [95% CI: 0.93, 0.98]). Family obesity odds increased when mothers were older (1.50 [95% CI: 1.18, 1.91]), with the consumption of savoury snacks (1.11 [95% CI: 1.05, 1.17]), and increased screen time (1.05 [95% CI: 1.01, 1.09]). Clinicians should familiarise themselves with the risk factors for family obesity and choose interventions that target the whole family. Future research should explore the causal basis of the reported associations to facilitate devising tailored family-based interventions for obesity prevention.