Violência contra criança, práticas parentais de alimentação e o excesso de peso na infância

Abstract

The central aim of this thesis is to investigate the relationship between violence against children, parental feeding practices and childhood overweight. The two manuscripts in this thesis come from a cross-sectional study entitled ‘Family violence, parental feeding styles and practices and childhood overweight’, carried out between 2015 and 2017. This study analysed 180 children aged between 2 and 5 years, seen at the Family Health Clinic in the municipality of Rio de Janeiro. In the first manuscript, using multinomial logistic regression models and odds ratios, the associations between violence against children and childhood overweight were analysed. The results showed that psychological violence increased the odds of childhood overweight by 3 times (OR=3,02; 95%CI=1,28 - 7,12; p=0.012) and times the odds of obesity by 5 times (OR=5.53; 95%CI=1,08 - 28,36; p=0.041). Physical violence, on the other hand, increased the odds of obesity risk by 7 times (OR=7,65; 95%CI=1,47 - 39,76; p=0.016). When both forms of violence (psychological and physical) were present, the odds of childhood obesity increased by approximately 7 times (OR=7,19; 95%CI=1,37– 37,67; p=0.020). In the second manuscript, structural equation modelling showed that psychological violence against the child had a direct effect on parental food monitoring practices, with a standardised coefficient of 0.218 (p = 0.045). In addition, these monitoring practices had a direct effect on child overweight, with a standardised coefficient of 0.143 (p = 0.044). The environment in which children live during childhood plays a fundamental role in their nutritional status. The findings of this study which elucidate how childhood overweight can be influenced by psychological and physical violence, as well as parental feeding practices, are of great relevance for the implementation of public health strategies aimed at improve identification, care and prevention of childhood overweight.