Poverty and other correlates of obesity and underweight among 7-year-olds from Croatia and Montenegro.

Objectives: This study aimed at investigating poverty and other correlates of childhood underweight and obesity in two urban regions with lower (Podgorica, Montenegro) and higher economic development (Osijek, Croatia).

Study Design: Comparative study.

Methods: A comparative study was conducted on 693 children (52% boys), aged 7 years old (224 from Podgorica and 469 from Osijek). Parents completed the study-specific questionnaire on relevant factors for children's nutritional status. We measured children's height and weight and calculated their body mass index (BMI). International Obesity Task Force cut-off values of BMI were used to assess children's nutritional status. Subjective social position was assessed by the Mac Arthur scale.

Results: There were more underweight children in Osijek compared with Podgorica, both among boys (5.5% vs. 1.6%) and girls (6.9% vs. 1.0%). Obesity was more frequent in Podgorica than Osijek, both among boys (11.3% vs. 5.9%) and girls (10.0% vs. 4.3%). However, poverty in two cities diminished observed differences in children's nutritional status. The odds for child underweight decreased by 12.2%, while the odds for obesity increased by 3.6% per each paternal BMI unit. The frequency of child obesity was lowered per each step higher on the Mac Arthur scale and with breastfeeding by 23.2% and 68.0%, respectively.

Conclusions: We show that a higher economic development is related to less obese children but more underweight children. However, poverty seems to impact nutritionally all children equally, regardless of the regional economic development. Paternal and not maternal BMI is relevant for both extremes in children's nutritional status. Breastfeeding and higher social position independently protect from child obesity.