[An alternative method to describe an "obesogenic" environment for children: Relevance of a multiple correspondence...

The purpose of this study was to describe an "obesogenic" environment for a group of schoolchildren using a multiple correspondence analysis (MCA) as an alternative approach to traditional methodological choices. MCA is applicable even for small samples. Ninety-one children (39 girls and 52 boys) aged 10.0 +/- 0.9 years were randomly recruited from two French public schools. Data on their family context, parental involvement, television time and their eating habits were obtained through questionnaires. Their level of physical activity and sedentary time were assessed using an accelerometer (MTI Actigraph model 7164) for three days, including a holiday. The data were processed using an MCA together with a technique for estimating relative risks (RRs) of overweight/obesity according to the distribution of children in the factorial plane produced by the MCA. The "obesogenic" factors appeared as four possible combinations between family environments and various behaviours with regard to physical activity, sedentary behaviour and diet. The RR of overweight/obesity was 2.64 [1.52, 4.57] (P < 0.0001) for a combined association of a "disadvantaged" family environment + low physical activity and high fat diet. The RR of overweight/obesity was 0.36 [0.14, 0.94] (P < 0.05) for an association of a "privileged" family environment + high physical activity and low fat diet. Thus, MCA appears sufficiently robust and relevant to effectively guide etiological hypotheses and decisions about individual and collective intervention strategies.