ORIGINAL RESEARCH Prevalence and socio-demographic associations of overweight and obesity among children attending child-care services in rural and regional Australia Luke WOLFENDEN, 1 Louise L. HARDY, 2 John WIGGERS, 1,3 Andrew J. MILAT, 4 Colin BELL 1,3 and Rachel SUTHERLAND 3,5 1 University of Newcastle, School of Medicine and Public Health, 2 Physical Activity, Nutrition, Obesity Research Group, The University of Sydney, 3 Hunter New England Population Health, 4 NSW Department of Health, Sydney, 5 The University of Newcastle, School of Health Sciences, New South Wales, Australia Abstract Aim: To describe the prevalence and socio-demographic characteristics associated with body mass index among children attending child-care services in New South Wales, Australia. Methods: Cross-sectional study of parent-reported socio-demographic characteristics and objectively measured height and weight among children aged two to five years attending 40 randomly selected long day care centres and preschools. Results: Seven hundred and sixty-four children, 11% of whom were Indigenous, participated in the study (response rate = 66%). Overall, 16.7% of children and 24.6% of Indigenous children were overweight or obese. Overweight and obesity was higher among children whose mothers did not have a university education (OR 1.91: 95% CI 1.15, 3.12) and who were Indigenous (OR 1.74: 95% CI 1.05, 2.90). No differences in prevalence were found between geographic areas. Multivariate analysis indicated that after adjusting for age, child-care service hours and other demographic covariates, only maternal education remained a significant predictor of weight status (OR 2.06: 95% CI 1.16, 3.66). Conclusion: The high prevalence of overweight and obesity among children attending child-care services under- scores the importance of obesity prevention interventions in early child-care settings, and particularly those catering for Indigenous children. Key words: child, child-care preschool, Indigenous, obesity, rural, socioeconomic. Introduction Epidemiological research has identified child overweight and obesity as an increasingly salient global public health issue. 1,2 Given the importance of the early childhood years on the establishment of healthy eating and physical activity behaviours 3 and the increasing number of children in child care in Australia, 4 the implementation of public health inter- ventions in child-care services has been recommended as a key strategy in the prevention of overweight and obesity in this country. 5 Guidelines for the development of ‘settings-based’ public health interventions highlight the importance of obtaining settings-based epidemiological data to guide intervention planning and implementation. 6 Such data can define the potential reach of interventions in a particular setting and provide information regarding the socio-demographic or ‘setting’ factors upon which to tailor intervention design and content. 6 As such, epidemiological data regarding the preva- lence, and socioeconomic and geographic distribution of overweight and obesity among children in child care is required to facilitate the development of effective public health interventions targeting child weight in this setting. Quantifying the prevalence of obesity among children attending child care from non-metropolitan areas may be particularly important as a lack of access to obesity pre- vention resources and professional development opportuni- ties for child-care service staff 7 and the greater financial L. Wolfenden, PhD, NSW Cancer Institute Early Career Research Fellow L.L. Hardy, PhD, Research Fellow J. Wiggers, PhD, Associate Professor, Director A.J. Milat, MPH, Manager Strategic Research and Development Branch C. Bell, PhD, Conjoint Associate Professor, Program Director, Good For Kids. Good for Life R. Sutherland, MPH, Public Health Nutrition Manager Correspondence: L. Wolfenden, Locked Bag 10, Wallsend, NSW 2298, Australia. Email: luke.wolfenden@hnehealth.nsw.gov.au Accepted November 2010 Nutrition & Dietetics 2011; 68: 15–20 DOI: 10.1111/j.1747-0080.2010.01487.x © 2011 The Authors Nutrition & Dietetics © 2011 Dietitians Association of Australia 15