Trimming the fat: identification of risk factors associated with obesity in a pediatric emergency department

Pediatr Emerg Care. 2010 Oct;26(10):709-15. doi: 10.1097/PEC.0b013e3181f39879.


Objective: The purpose of this study was to assess which knowledge deficits and dietary habits in an urban pediatric emergency department (ED) population are risk factors for obesity.

Methods: This cross-sectional study in an urban pediatric ED used a modified version of the Diet and Health Knowledge Survey, an in-person interview questionnaire, to collect data on demographics, dietary knowledge, and practices. All patients aged 2 to 17 years were enrolled in the study over a 4-month period. Subjects were excluded if they were in extremis, pregnant, incarcerated, institutionalized, considered an emancipated minor, or consumed only a modified consistency diet.

Results: One hundred seventy-nine subjects were enrolled in this study. Based on body mass index, the prevalence of obesity in our study population was 24%. Parents with obese children answered a mean of 62.9% (95% confidence interval, 60.4%-65.5%) of knowledge questions correctly, whereas all others scored 60.3% (95% confidence interval, 58.3%-62.3%) correctly. Based on the univariate analysis, 10 predictors met inclusion criteria into logistic regression analysis: screen time (P = 0.03), race (P = 0.08), sex (P = 0.04), parental education (P = 0.08), parental estimation that child is overweight (P < 0.0001), parental estimation that child is underweight (P = 0.003), trimming fat from meat (P = 0.06), soft-drink consumption (P = 0.03), exercise (P = 0.07), and chip consumption (P = 0.04). In a multivariate analysis, only male sex, regularly trimming fat from meat, and parental assessment of obesity were independently associated with obesity.

Conclusions: Knowledge deficiencies regarding healthy nutrition among parents in an urban pediatric ED population were not significantly associated with having obese children; however, specific habits were. Emergency physicians may provide a valuable role in identification and brief behavioral intervention in high-risk populations during the current epidemic of childhood obesity.

MeSH terms

  • Adolescent
  • Body Mass Index
  • Caregivers / psychology*
  • Child
  • Child Rearing
  • Child, Preschool
  • Cross-Sectional Studies
  • Data Collection
  • Dietary Fats
  • Emergency Service, Hospital*
  • Feeding Behavior
  • Female
  • Florida / epidemiology
  • Habits*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Meat
  • Obesity / epidemiology*
  • Obesity / etiology
  • Obesity / prevention & control
  • Parents / psychology*
  • Pediatrics*
  • Risk Factors
  • Socioeconomic Factors
  • Urban Population


  • Dietary Fats