Growing up in Portugal: Cape Verdean ancestry children exhibit low overweight and obesity compared to Portuguese in urban Lisbon

Portugal has one of the highest rates of childhood overweight and obesity (OW/OB) in Europe. However little is known about the health of ethnic minorities living in its capital city, Lisbon. The Cape Verdean community in Lisbon tend to have low educational levels, material deprivation and they struggle with discrimination and racism, factors that would likely be associated with a higher prevalence of OW/OB. Data for the Cape Verdean population were collected in three different time periods by three different research teams in 1993, 2009 and 2013 and included children from 6 to 12 years living in Cova da Moura neighbourhood, Great Lisbon Metro Area (GLMA). The Portuguese national survey was collected between 2009/2010 at public and private schools in mainland Portugal and included height, weight, skinfolds, arm, and waist circumferences. From these survey data body mass index (BMI) and the prevalence of stunting, (chronic malnutrition - low height-for-age) and underweight (low-weight-for-age) were calculated according to reference values proposed by Frisancho (2008). Overweight and obesity values were defined based on the references established by the International Obesity Task Force (IOTF). Results show that there are significant differences in height for boys and girls between Cape Verdean and Portuguese children. Generally, Cape Verdeans’ growth falls within the healthy range of International growth references across all of the survey data collected. Cape Verdean rates for combined overnutrition (overweight and obesity) in 2013 (9.8% for boys and 16.7% for girls) are lower than the Portuguese (33% for boys and 31.7% for girls). Logistic regression models showed that Cape Verdean children have a lower risk of being OW/OB when accounting for breastfeeding,birthweight,maternal education and occupation. Despite living in a deprived neighbourhood these Cape Verdean children seem to have grown more healthily than Portuguese ancestry children. The challenge for policy makers will be to support improvement of the poverty related living conditions of this community without creating a risky environment for increasing prevalence of overweight and obesity.