Early-life determinants of undernutrition and overweight/obesity in Polish toddlers
Abstract
Rationale: Undernutrition and overweight /obesity represent a double burden of malnutrition, emerging already in early childhood. However, their determinants in children under 3 years remain insufficiently understood.
Methods: This cross-sectional study was conducted in a sample of Polish children aged 13–36 months (n = 1,373), with data collected at three time points (2010, 2016, 2024). Nutritional status was assessed using weight-for-height z-scores (WHZ) according to WHO standards. In an initial step, Selected socio-demographic variables (parental age and education) were included as covariates. Multivariable logistic regression models were then applied separately for undernutrition and overweight, including birth weight, child age, breastfeeding, material situation and survey year,.
Results: Undernutrition was observed in 6,3% of children (n = 86), and overweight/obesity in 9.8% (n = 134). Breastfeeding was associated with lower odds of both undernutrition (OR = 0.56; p = 0.043) and overweight/obesity (OR = 0.60; p = 0.041). High birth weight (above 4 kg) was strongly associated with increased odds of overweight/obesity (OR = 4.72; p = 0.007). Better material situation showed a borderline protective effect for undernutrition (OR = 0.66; p = 0.064). No significant associations were found for, parental age, parental education, child age, or survey year.
Conclusions: Nutritional outcomes in children aged 13–36 months appear to be driven primarily by early-life biological and feeding-related factors rather than socio-economic characteristics. Breastfeeding plays a protective role across both forms of malnutrition, while hight birth weight is a key risk factor for overweight/obesity. These findings support the need for early-life interventions, particularly building awareness of the role of nutrition during the first 1000 days and targeted monitoring of high-risk children, to prevent both undernutrition and overweight/obesity
The study was funded by the Nutricia Foundation
Key messages: • Early-life factors; not socio-economic status, drive both undernutrition and overweight in toddlers. Breastfeeding protects, while high birth weight strongly increases obesity risk.
• Findings highlight the first 1000 days as critical: promoting breastfeeding and monitoring high-birth-weight infants can prevent both undernutrition and excess weight.
Related
- Combined nutrition and physical activity education for early adolescents with malnutrition: A systematic review of overweight interventions and the undernutrition evidence gap
- Early pregnancy overweight/obesity and adverse maternal outcomes among pregnant women in Eastern Ethiopia: an ambispective cohort study
- Long-Term Trends and Regional Heterogeneity in Overweight and Obesity Among Adults — 11 Intermittent Surveys in China, 1991–2024
- A pilot randomized controlled trial of melatonin supplementation on plasma 2-arachidonoylglycerol, ghrelin, and hedonic appetite intensity in females with overweight/obesity
- Exploring overweight and obesity among Pakistani university students: a nationwide prevalence and knowledge, attitude, and practice (KAP) assessment – a cross-sectional study
BibTeX
@article{kawiakjawor2026earlylife,
title = {{Early-life determinants of undernutrition and overweight/obesity in Polish toddlers}},
author = {EA Kawiak-Jawor and G Rowicka and J Kowalkowska and M Więch and M Barańska and A Święcicka and H Weker},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1327},
url = {https://doi.org/10.1093/eurpub/ckag169.1327},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Early-life determinants of undernutrition and overweight/obesity in Polish toddlers
AU - EA Kawiak-Jawor
AU - G Rowicka
AU - J Kowalkowska
AU - M Więch
AU - M Barańska
AU - A Święcicka
AU - H Weker
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1327
UR - https://doi.org/10.1093/eurpub/ckag169.1327
AB - Rationale: Undernutrition and overweight /obesity represent a double burden of malnutrition, emerging already in early childhood. However, their determinants in children under 3 years remain insufficiently understood. Methods: This cross-sectional study was conducted in a sample of Polish children aged 13–36 months (n = 1,373), with data collected at three time points (2010, 2016, 2024). Nutritional status was assessed using weight-for-height z-scores (WHZ) according to WHO standards. In an initial step, Selected socio-demographic variables (parental age and education) were included as covariates. Multivariable logistic regression models were then applied separately for undernutrition and overweight, including birth weight, child age, breastfeeding, material situation and survey year,. Results: Undernutrition was observed in 6,3% of children (n = 86), and overweight/obesity in 9.8% (n = 134). Breastfeeding was associated with lower odds of both undernutrition (OR = 0.56; p = 0.043) and overweight/obesity (OR = 0.60; p = 0.041). High birth weight (above 4 kg) was strongly associated with increased odds of overweight/obesity (OR = 4.72; p = 0.007). Better material situation showed a borderline protective effect for undernutrition (OR = 0.66; p = 0.064). No significant associations were found for, parental age, parental education, child age, or survey year. Conclusions: Nutritional outcomes in children aged 13–36 months appear to be driven primarily by early-life biological and feeding-related factors rather than socio-economic characteristics. Breastfeeding plays a protective role across both forms of malnutrition, while hight birth weight is a key risk factor for overweight/obesity. These findings support the need for early-life interventions, particularly building awareness of the role of nutrition during the first 1000 days and targeted monitoring of high-risk children, to prevent both undernutrition and overweight/obesity The study was funded by the Nutricia Foundation Key messages: • Early-life factors; not socio-economic status, drive both undernutrition and overweight in toddlers. Breastfeeding protects, while high birth weight strongly increases obesity risk. • Findings highlight the first 1000 days as critical: promoting breastfeeding and monitoring high-birth-weight infants can prevent both undernutrition and excess weight.
SN - 1101-1262
SN - 1464-360X
ER -