Factors associated with body weight status among Malaysian young children aged 6 to 36 months

Malaysia faces the double burden of childhood malnutrition, encompassing undernutrition and overweight issues. Malnutrition during early life can result in lifelong health consequences. While extensive research focuses on factors related to mothers, exploring the role of fathers within the 6 to 36-month age group can offer a more comprehensive understanding of parental influence. Addressing this gap could significantly improve nutritional outcomes for children within this age range. The current cross-sectional study aims to determine the factors associated with the body weight status, BMI-for-age Z-score (BAZ) of children aged 6-36- month. A total of 282 fathers and mothers of full-term-born children with internet access respectively completed the online questionnaire after consenting to participate during the COVID-19 pandemic. The factors examined in the present study encompassed socio-demographic aspects of both fathers and mothers, lifestyle factors, feeding factors, breastfeeding and complementary feeding practices, as well as the birth history and eating behaviours of the children. The questionnaire was constructed into multiple sections. Parents were recruited through government nutritionists, who acted as the proxies to distribute invitation posters containing QR codes for participation. The prevalence of at-risk overweight, overweight, and obesity among children was 10.7%, 2.8%, and 1.1%, respectively, while wasted and severely wasted were 5.7% and 0.4%, respectively. The bivariate analyses showed positive associations of birth weight, birth length, maternal ethnicity, paternal weight and maternal weight with the BAZ of children. Conversely, paternal use of food for calming, maternal persuasive feeding, and the child’s satiety responsiveness were found to be inversely associated with the BAZ of children. Multiple linear regression (MLR) analysis found that five factors contributed significantly towards the BAZ of the children (F (5, 281) = 8.866, p<0.001). These included higher birth weight (B = 0.855, 95% CI: 0.521, 1.190, p<0.001), reduced use of food for calming by fathers (B = -0.134, 95% CI: -0.204, -0.004, p=0.043), delayed initiation of breastfeeding (B = 0.322, 95% CI: 0.033, 0.631, p=0.030), higher maternal BMI (B=0.036, 95% CI: 0.007, 0.065, p=0.0016) and non-Malay maternal ethnicity (B= 0.307, 95% CI: 0.012, 0.603, p=0.0042). These factors significantly contributed to a higher BAZ among children. In conclusion, birth weight, paternal use of food for calming, early initiation of breastfeeding, maternal BMI and maternal ethnicity collectively explained 13.8% of the variances in the children’s BAZ. These findings suggest that future interventions should involve fathers, not just mothers. Further determination of the causal effects of significant factors could be achieved through a longitudinal study.

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