1. Sevcikova L. 1, Novakova J. 2, Hamade J. 2, Jurkovicova J. 1, Stefanikova Z. 1, Sobotova. L. 1, Aghova L. 1 1 Institute of Hygiene, Faculty of Medicine, Comenius University Bratislava 2 Public Health Authority SR, Bratislava ludmila.sevcikova@fmed.uniba.sk Institute of Hygiene, Comenius University, Spitalska 24, 813 72 Bratislava, Slovak Republic

2. Background The life conditions, which are closely linked to social position of a family, impact physical development of children and adolescents. The many current studies dealing with the relationship among genetic and socio-economic factors and developmental parameters of children are particularly aimed at obesity risk. Object The purpose of the study was to evaluate the growth and body proportionality of children and adolescents in relation to parent education and occupation.

3. Methods  Parameters of height, weight and body mass index have been analyzed on the basis of the 6 th Slovak nation-wide cross-sectional anthropometric survey (2001), which was realized on representative samples (17800 boys and 17400 girls) from all ages (0 - 18years).  The overweight has been evaluated as BMI over 90 th and 97 th percentile for the age of 2 - 18.  Education and occupation of parents were obtained using the questionnaire.  The programs EPI info and S Plus 6.0 were used for analysis.

4. GroupsChanges in growth and development of children and youth Age group [year] Gender Differences in height [cm] Differences in BMI [kg]/[m]2 1991-19812001-1991p-value2001-1991p-value 1 Boys-0.320.1n.s.-0.21* Girls-0.050.18n.s.0.03n.s. 3 Boys0.580.83***0.01n.s. Girls0.760.17*0.25n.s. 5 Boys0.681.09***0.07n.s. Girls0.791.29***0.14n.s. 7 Boys0.951.17***0.07n.s. Girls1.40.42**0.11* 9 Boys11.05***0.28** Girls1.430*0.12** 11 Boys0.910.81***0.3** Girls1.380.93***0.39*** 13 Boys1.71.84***0.42*** Girls1.840.14*-0.17* 15 Boys1.454.02***0.41*** Girls0.962.26***-0.27*** 17 Boys1.461.96***0.15n.s. Girls1.880.81***-0.24*** 18 Boys2.011.48***-0.11n.s. Girls1.940.31**-0.04n.s. The trend in growth and body proportionality of children and youth * p < 0.05 ** p < 0.01 *** p < 0.001 n.s: non-significant Source: 4th - 6th Nation-wide Anthropological Survey of Children and Adolescents in SR « The continuing growth acceleration in boys and girls has been confirmed from 2 years of age, but has slown down in the last decade « The positive secular trend in the age of 18 years continues in boys 2 and 1.5 cm per decade, in girls it stagnates (1.9; 0.3 cm) « Continuing slimming trend in Slovak adolescent girls and also less markedly in boys was confirmed « The trend of the body proportionality does not follow the growth acceleration in boys and girls during the last decade.

5. in 7-11 year old children Prevalence of overweight and obesity (%) in children and adolescents in Europe Source: Ginter E.. Havelková B.. Med Monitor 2005; Lobstein T. Frelut M-L: Prevalence of overweight among children in Europe. Obesity Rev 2003 % % in adolescents (14-17 year) Slovakia Prevalence of overweight and obesity in Slovak girls and boys belong to the lowest in Europe. Russia Netherlands Denmark Germany Slovakia Czech R. Sweden Poland Belgium France England Italy North Croatia Greece Crete Spain Malta Italy South Russia Netherlands Poland Slovakia Germany Denmark Sweden England Bulgaria Serbia Croatia Spain Greece Cyprus

6. Girls (0 - 6 years / 5783) HeightWeightBMI 0.0540.0600.024 0.0990.1220.047 0.0750.0870.029 0.0530.0920.084 -0.075-0.082-0.019 -0.005-0.010-0.013 0.0610.0590.004 0.0850.0890.015 0.042 0.006 0.0780.0790.002 Genetic and SES factors Boys (0 - 6 years/ 5997) HeightWeightBMI Father's height0.0560.0600.010 Father's weight0.0800.1140.069 Mother's height0.0430.0550.032 Mother's weight0.0240.0600.071 Nationality / Ethnic g.-0.065-0.071-0.010 Family (completeness)0.0050.000-0.003 Father's education0.0330.0380.003 Father's employment0.0850.0900.014 Mother's education0.0430.0450.001 Mother's employment0.0830.0860.004 Correlation analysis Correlation coefficients r r 0.05 = 0.0621 r 0.01 = 0.0816 Genetic determination of growth has been confirmed only in some relations between somatic indicators of little children and parents as well as ethnicity. Romany children were the smallest in the followed sample.

7. Genetic and SES factors Boys (7 - 18 years / 9808) HeightWeightBMI Father's height0.1420.1110.037 Father's weight0.1750.2220.223 Mother's height0.1480.1170.037 Mother's weight0.1630.2190.242 Nationality / Ethnic g.-0.061-0.038-0.001 Father's education0.1970.1750.096 Father's employment0.0890.0780.053 Mother's education0.1820.1660.099 Mother's employment0.1480.1350.089 Girls (7 - 18 years / 10787) HeightWeightBMI 0.1410.0950.009 0.1520.1970.190 0.1210.072-0.008 0.1970.2770.287 -0.063-0.0320.007 0.1350.1000.034 0.0860.0700.038 0.1270.0890.025 0.1340.1230.083 r 0.05 = 0.0621 r 0.01 = 0.0816 Correlation analysis Correlation coefficients r Associations between SES factors of family and height, weight and BMI in children and adolescents of the age 7 - 18 year have revealed mostly significantly positive with the exception of association between education of parents and BMI of girls.

8. Prevalence of overweight and obesity in boys (7-18 y, n= 9808) in relation to mother’s education Prevalence of overweight and obesity in girls (7-18 y, n= 10787) in relation to mother’s education Mother’s education level OverweightObesity P -value n%n% Basic4744.83083.1 0.0542 High school6196.33803.8 University1671.7941.0 Mother’s education level OverweightObesity P -value n%n% Basic5104.73142.9 0.0025 High school5655.23162.9 University1041.0490.5 The results have shown significant negative relationship between incidence of overweight (BMI over 90 th percentile) and obesity (BMI over 97 th percentile) and educational level of mother particularly in girls.

9. Conclusions  The continuing growth acceleration has been confirmed in Slovak boys and girls with slowing down in the last decade particularly in girls. Also slimming trend in adolescent girls and less markedly in boys has continued.  The results have shown significant relationship between anthropometric parameters in children and adolescents and socioeconomic / psycho- social factors of family.

10. ...  The results of study have confirmed, that many factors have impacted anthropometric indicators in their mutual condition, but the leading role has been played by age-developmental period, as was shown by the ethnicity and parent education.  Although family social level particularly educational level of mother is related to children overweight, the associations vary according age and gender.  Followed socio-economic factors act together with other habits in the family (nutritional, physical activities, etc.).

11. ...  Obesity prediction connected with parent obesity occurrence requires the more complex analysis.  Primary prevention regarding healthy somatic and psychical development of children has to be family oriented. Health education concentrated on family and systematic preventive healthcare during childhood and adolescence belong to fundamental aspects of health policy. This work was supported in part by Grant 1/3433/06 from the Scientific Grant Agency of Ministry of Education of the Slovak Republic and the Slovak Academy of Sciences.