Pre-natal and perinatal factors affecting body mass index in pre-pubertal Polish children

Abstract

Background: An increased prevalence of body mass deficit among children has been reported in developing countries, including Eastern European states which have undergone political transformation. However, there are few studies evaluating risk factors for body mass deficit in schoolchildren and adolescents.

Aim: To assess selected familial, pre-natal and early life factors in terms of risk associated with the prevalence of body mass deficit in children aged 7–10 years.

Subjects and methods: Logistic regression models based on 812 records for children aged 7–10 years were applied for the evaluation of familial, pre-natal and perinatal risk factors affecting the height-to-weight ratio.

Results: The risk of underweight in 7–10-year-old children is significantly higher for girls (OR?=?1.70) and for children whose mothers reported a traumatic experience during pregnancy (OR?=?2.77). The effect of reported stress during pregnancy differed as regards the child’s sex. Mother’s trauma increased the risk of body weight deficit only in boys (OR?=?2.74), while in girls it significantly decreased this risk (OR?=?0.35). Low birth weight significantly increased the risk of underweight only in boys (OR?=?2.99) and mother’s occupational activity decreased the risk of underweight only in girls (OR?=?0.57).

Conclusion: Low birth weight and mother’s trauma during pregnancy are risk factors for underweight in Polish schoolchildren, particularly in boys.     

Weight and body mass index (BMI): current data for Austrian boys and girls aged 4 to under 19 years

Background: BMI reference charts are widely used to diagnose overweight, obesity and underweight in children and adolescents.

Aim: To provide up-to-date national reference values for Austria.

Methods: A cross-sectional sample of over 14?500 children and adolescents (4–19 years) stratified by provinces according to age- and sex-specific population proportions was drawn via schooling institutions (kindergartens, schools and vocational colleges). The generalized additive models for location, scale and shape were used for a flexible estimation of percentile curves.

Results: Austrian boys and girls have higher average weight compared with previous prevalence data. BMI centiles matching BMI values at age 18 years, which are used for defining thinness, overweight and obesity in adults, were calculated. In Austria, using reference values as thresholds, ～18% of boys and 12% of girls are overweight (with thresholds passing through BMI 25.00–29.99?kg/m² in adults) and 5% of boys and 3% of girls are obese (with thresholds passing through BMI ≥30.00?kg/m² in adults).

Conclusion: Overweight and obesity are common in Austria and their prevalence is increasing (using the same IOTF reference for international comparison). Up-to-date national BMI reference values are provided to classify children and adolescents according to the proposed overweight and obesity thresholds.     

Changes in nutritional status of children and adolescents in Shandong,China from 1995 to 2005

Background: Nutritional status of children and adolescents has long been known to be a determinant of health and disease; both obesity and underweight are associated with health consequences. However, no studies have been reported on changes in nutritional status of children and adolescents in Shandong, China.

Aim: The present study assessed the changes in nutritional status of children and adolescents in Shandong Province from 1995 to 2005.

Subjects and methods: Data used derived from two national surveys on students' constitution and health carried out by the government in 1995 and 2005 in Shandong Province, China. Increments of stature, body weight, body mass index (BMI) and haemoglobin (Hb) for children and adolescents aged 7, 9, 12, 14 and 17 years were reported. Prevalence of underweight, overweight and obesity were obtained according to the screening criteria of underweight, overweight and obesity for Chinese students using BMI and prevalence of anaemia was obtained according to the WHO criteria.

Results: Means of stature, body weight, BMI and Hb for both boys and girls surveyed in 2005 were significantly higher than 1995 values. The range of increments of stature and body weight for adolescents aged 7, 9, 12, 14 and 17 years were 1.95–3.66 cm and 2.21–6.25 kg for boys and 1.40–2.91 cm and 1.48–3.10 kg for girls. In the past 10 years, rates of overweight and obesity increased, while underweight was not as evident: for overweight from 7.95% (boys) and 5.21% (girls) in 1995 to 13.62% (boys) and 8.25% (girls) in 2005; and for obesity from 3.48% (boys) and 2.07% (girls) in 1995 to 11.17% (boys) and 5.64% (girls) in 2005. The rate of anaemia decreased, from 19.99% (boys) and 23.43% (girls) in 1995 to 10.28% (boys) and 13.07% (girls) in 2005.

Conclusion: The nutritional status of children and adolescents has shown some improvement, although prevalence of overweight and obesity increased significantly during the 10-year period. Concerted efforts should be made to appropriately control the prevalence of overweight and obesity.     

Overweight and obesity in a rural Amerindian population in Oaxaca, Southern Mexico, 1968-2000.

The purpose of this study was to evaluate secular change in the prevalence of overweight and obesity in a rural Zapotec Indian community in southern Mexico between 1968 and 2000. Cross-sectional surveys of children 6-13 years, adolescents 13-17 years, and adults 19 years of age and older resident in a rural community in Oaxaca were conducted in 1968/1971, 1978, and 2000. Individuals present in the 1968, 1978, and 2000 surveys provided a small longitudinal component. Height and weight were measured; the BMI was calculated. International criteria for overweight and obesity were used. Overweight and obesity were virtually absent in school children 6-13 years in 1968 and 1978 and in adolescents in 1978. Small proportions of children (boys, 5%; girls, 8%) and adolescents (boys, 3%; girls, 15%) were overweight in 2000; two children (1%) and no adolescents were obese. Among adults, 7% of males and 19% of females were overweight and <1% of males and 4% of females were obese in 1971/1978, but 46% of males and 47% of females were overweight; and 5% of males and 14% of females were obese in 2000. The trends for children, adolescents, and adults were confirmed in the longitudinal subsamples. In conclusion, overweight and obesity are not presently a major problem in children and adolescents in this rural Zapotec community. Overweight, in particular, and to a lesser extent obesity have increased in prevalence among adults since the late 1970s. The results suggest adulthood as a critical period for onset of overweight and obesity in this sample.     

Analysis of main risk factors contributing to obesity in the region of East Africa: meta-analysis

BackgroundOver a few decades obesity has become a major global health problem. Its prevalence worldwide has more than doubled since 1980. The situation is expected to worsen in the future, especially in the developing countries that experience nutrition transition due to economic growth. It contributes to reduction in malnutrition which supports an increase in obesity prevalence.ObjectivesThe aim of this study was to analyse the predictors of obesity in the region of East Africa.MethodsMeta-analysis of existing studies was used in order to find the different risk factors and their significance in obesity development. Data extracted from 16 published academic research articles described the situation in East African countries. The significance of the effect of each variable was tested by means of an asymptotic chi-square test, or Fisher''s exact (factorial) test and the risk ratios were calculated.ResultsBased on the chi-square test and the risk ratios of the aggregated data, three risk factors were found to be significant in the development of obesity – gender, type of residence and socio-economic status. In East African countries, women are significantly more likely to be obese. Living in an urban area and socioeconomic status are also positively associated with obesity. Because of insufficient data three other risk factors did not prove to be of any significance – alcohol consumption, smoking and education level.ConclusionConclusions of this meta-analysis confirm world trends but we also found results that are not in line with them (e.g. education). This meta-analysis confirms the huge existing research gap concerning obesity predictors in the East African region.     

Lower levels of maternal capital in early life predict offspring obesity in adulthood

Background: As of 2013, 65% of the world’s population lived in countries where overweight/obesity kills more people than being underweight. Evolutionary perspectives provide a holistic understanding of both how and why obesity develops and its long-term implications.

Aim: To test whether the maternal capital hypothesis, an evolutionary perspective, is viable for explaining the development of obesity in adulthood.

Subjects and methods: Restricted-use data from the National Longitudinal Study of Adolescent Health (Add Health; n?=?11?403) was analysed using logistic regressions. The sample included adolescents and their biological mothers.

Results: The odds of obesity in adulthood increased by 22% for every standard deviation increase in lack of maternal capital (Exp (B)?=?1.22, p?Conclusion: The maternal capital perspective is useful for explaining how and why early life characteristics (including maternal resources) predict obesity in adulthood. Implications of the findings are discussed.     

Overweight in classical phenylketonuria children: A retrospective cohort study

PurposeThis cohort study aimed to determine the frequency of overweight and obesity in classical phenylketonuria children and to identify the possible influence of metabolic control on the BMI of the studied patients.Patients and methodsThe study group included 63 classical phenylketonuria patients (40 girls and 23 boys; aged 5–16 years). Their z-score BMI, metabolic control, educational level of parents and socioeconomic status were determined.ResultsTwenty children were overweight or obese and only three were underweight. The percentages of overweight and obese children were 31.7% for the whole group, 21.7% (5 out of 23) for boys and 37.5% (15 out of 40) for girls. Overweight and obesity in these phenylketonuria patients was statistically significantly more frequent when compared to national reference studies (p = 0.0031).The five-year index of dietary control and the percentage of spikes exceeding 6 and 12 mg/dl (Spikes 6 and 12) indicated better metabolic control in the case of normal weight children than those who were overweight and obese (p < 0.049, p < 0.041 and p < 0.011, respectively). The odds ratio of being overweight or obese for those having poorer metabolic control (values higher vs lower than mean) was statistically significantly higher than for the remaining patients (for Spikes 12: 6.926 < 95%CI: 2.011–23.854 > ; p < 0.002). These results strongly suggest a link between overweight and diet non-compliance.ConclusionsChildren with classical phenylketonuria presented higher odds of being overweight or obese as compared with reference national studies, with girls only having a higher frequency of overweight.     

The epidemiology of obesity and asthma

The prevalences of asthma and obesity have increased substantially in recent decades in many countries, leading to speculation that obese persons might be at increased risk of asthma development. In adults cross-sectional, case-control, prospective, and weight-loss studies are in the aggregate consistent with a role for obesity in the pathogenesis of asthma. In children 3 of 4 prospective studies also show a significant association between excess weight and asthma incidence. Because of the methodologic shortcomings of many studies, these findings are inconclusive, however. Population surveys do suggest that persons with asthma are disproportionately obese compared with persons who have never had asthma. Weight-loss studies on the basis of behavioral change and bariatric studies have shown substantial improvements in the clinical status of many obese patients with asthma who lost weight. Clarifying the nature of the relationship between obesity and asthma incidence and the role of weight management among patients with asthma are both critical areas with important ramifications for the prevention and treatment of asthma.     

Neck fat and obstructive sleep apnea in obese adolescents

Study ObjectivesIncreased neck circumference, a surrogate for the neck fat that can narrow the upper airway in obese individuals, is a risk factor for obstructive sleep apnea syndrome (OSAS) in adults, but the association between neck fat and OSAS in adolescent males and females is unknown. We hypothesized that obese adolescents with OSAS have more neck fat than controls, females more neck fat than males, and that neck fat correlates with obesity and OSAS severity.MethodsObese adolescents with OSAS and obese and normal-weight controls underwent upper airway magnetic resonance imaging, polysomnography, and anthropometrics, including neck circumference measurement. Intra-neck and subcutaneous neck fat measurements were manually segmented and compared among the three groups using ANOVA and between males and females using t-tests. The relationship between polysomnographic parameters and neck fat measurements was assessed in adolescents with OSAS using Pearson correlations.ResultsOne-hundred nineteen adolescents (38 females) were studied: 39 obese with OSAS, 34 obese controls, and 46 normal-weight controls. Neck fat was not greater in adolescents with OSAS compared to obese controls (p=0.35), and neck fat volume was not related to OSAS severity (p = 0.36). However, obese adolescents had more neck fat than normal-weight controls (p < 0.001), and neck fat volume correlated with neck circumference (r = 0.53, p < 0.001). Females had significantly greater cross-sectional neck fat than males (p < 0.001).ConclusionsWhile neck fat is associated with obesity and neck circumference in adolescents and is greater in females versus males, it does not appear to correlate with presence and severity of OSAS.     

Child obesity cut-offs as derived from parental perceptions: cross-sectional questionnaire

BackgroundOverweight children are at an increased risk of premature mortality and disease in adulthood. Parental perceptions and clinical definitions of child obesity differ, which may lessen the effectiveness of interventions to address obesity in the home setting. The extent to which parental and objective weight status cut-offs diverge has not been documented.AimTo compare parental perceived and objectively derived assessment of underweight, healthy weight, and overweight in English children, and to identify sociodemographic characteristics that predict parental under- or overestimation of a child’s weight status.MethodParental derived cut-offs for under- and overweight were derived from a multinomial model of parental classification of their own child’s weight status against school nurse measured body mass index (BMI) centile.ResultsMeasured BMI centile was matched with parent classification of weight status in 2976 children. Parents become more likely to classify their children as underweight when they are at the 0.8th centile or below, and overweight at the 99.7th centile or above. Parents were more likely to underestimate a child’s weight if the child was black or South Asian, male, more deprived, or the child was older. These values differ greatly from the BMI centile cut-offs for underweight (2nd centile) and overweight (85th).ConclusionClinical and parental classifications of obesity are divergent at extremes of the weight spectrum.     

Prevalence of Metabolic Syndrome and Impaired Glucose Metabolism among 10- to 17-Year-Old Overweight and Obese Lithuanian Children and Adolescents

BackgroundOverweight (Ow) and obesity among adults and children increases the risk of metabolic consequences. Metabolic syndrome (MS) and impaired glucose metabolism are well-known risk factors for cardiovascular diseases and type 2 diabetes. The aim of this study was to evaluate the prevalence of MS and impaired glucose metabolism among Ow and obese (Ob) children and adolescents (aged 10–17 years) in Lithuania, and to evaluate the associations between insulin resistance (IR) indices and anthropometric parameters as well as metabolic disturbances.MethodsThe study population consisted of 344 OwOb children and adolescents of all pubertal stages. Oral glucose tolerance tests (OGTTs), IR and β cell function indices, lipid profile, and anthropometric parameters of all subjects were analyzed. MS was defined according to the International Diabetes Federation consensus guidelines.ResultsMS was found in 21.3% of the OwOb children and adolescents, and 12.1% had impaired glucose metabolism (6.9% with impaired fasting glucose, 4.5% with impaired glucose tolerance, and 0.6% with type 2 diabetes). IR was directly related to body mass index and waist circumference, waist-to-height and waist-to-hip ratios, and sum of skin-fold thicknesses. Children with MS were more insulin-resistant, had higher odds ratio for prediabetes and had a more disturbed lipid profile than subjects without MS. Moreover, total cholesterol and low-density lipoprotein cholesterol levels were significantly lower in the more mature OwOb adolescents.ConclusionMS and lipid profile disturbances are common in OwOb children and adolescents. MS is directly associated with IR. Therefore, OwOb children and adolescents should be carefully followed up for metabolic abnormalities during late childhood as these can persist into adulthood.     

Porphyria attacks in prepubertal children and adolescents

ContextThe clinical and laboratory features of dominant acute hepatic porphyrias (AHPs) in prepubertal children and adolescents have not been well established.ObjectiveTo evaluate clinical and laboratory features of AHPs in prepubertal children and adolescents compared to adults.Data sourcesOVID (Embase Classic+Embase and MEDLINE), Scopus, and Google Scholar.Study selectionStudies describing symptomatic children or adolescents (<18 years old) with increased urinary porphobilinogen were included.Data extractionTwo reviewers independently extracted the data, with a third reviewer arbitrating discrepancies.Results100 studies were included describing 112 patients (26 prepubertal children and 86 adolescents). Differences were found between prepubertal children and adolescents regarding sex distribution (female-to-male ratio: 1:2 vs. 4:1), clinical manifestations, and concomitant clinical manifestations.LimitationsThere was variation in the methods used to diagnose porphyria attacks across studies, and some elements of the quality of individual studies were unclear.ConclusionsPrepubertal children with AHPs and porphyria attacks presented with distinct demographic and clinical characteristics from adolescents and adults. Nearly two-thirds of the affected children were males, and about half had a concomitant medical condition that can constitutively upregulate hepatic δ-aminolevulinic acid synthase-1. Adolescents were comparable to adults in almost all respects.     

Screening for Co-Morbidity in 65,397 Obese Pediatric Patients from Germany,Austria and Switzerland: Adherence to Guidelines Improved from the Year 2000 to 2010

ObjectiveThe aim of the study was to analyze the adherence to current guidelines for co-morbidity screening in overweight and obese pediatric patients participating in the Adipositas-Patienten-Verlaufsdokumentation (APV) initiative in three German-speaking countries.MethodsAPV database: 181 centers from Germany, Austria and Switzerland, specialized in obesity care, contributed standardized, anonymous data of medical examinations from 65,397 patients performed between 2000 and 2010. Completeness of screening for hypertension, dyslipidemia, and impaired glucose metabolism was analyzed using adjusted means.ResultsMean age of the cohort was 12.5 ± 2.9 years and 46.5% were male. 17.3% were overweight (>90th-97th percentile), 45.1% obese (>97th-99.5th percentile), and 37.7% extremely obese (>99.5th percentile). In 2000, blood pressure was documented for 55.1% of patients, increasing to 88.7% in 2010. The rate of lipid diagnostics also improved from 45.0 to 67.7%, and screening for diabetes rose from 32.7 to 62.3% in the same time period. Blood pressure measurements were performed more often during inpatient care (88.5%) compared to outpatient programs (77.5%). Screening was more complete with increasing age and increasing degree of obesity. In boys screening rate was higher than in girls.ConclusionDuring the 11-year period, screening for co-morbidity improved significantly in overweight or obese children and adolescents. However, adherence to guidelines is still insufficient in some institutions. Quality control based on benchmarking may improve obesity care and outcome.Key Words: Obesity, Children, Adolescents, Co-morbidity, Screening     

Profiles of body mass index and blood pressure among young adults categorised by waist-to-height ratio cut-offs in Shandong,China

Abstract

Background: Waist-to-height ratio (WHtR) is proposed as a valid measure of abdominal obesity and health risks in practice. The present study examined the profiles of weight status and blood pressure (BP) among young adults categorised by WHtR cut-offs.

Methods: A total of 4226 college students (2107 males and 2119 females) aged 19–22?years participated in the study. The body mass index (BMI) cut-offs recommended by the Working Group on Obesity in China (WGOC) were used to define underweight, normal weight, overweight and obesity. The BMI and BP profiles within each WHtR category were examined.

Results: For both males and females, ‘the high WHtR group’ (WHtR ≥ 0.5) had the highest, and ‘the low WHtR group’ (WHtR < 0.4) had the lowest BMI and BP levels. In the WHtR = 0.30–0.34 sub-group, 66.10% of males and 66.67% of females were underweight; in the WHtR ≥ 0.55 sub-group, 91.49% of males and 83.33% of females were obese; in the WHtR = 0.40–0.44 sub-group, 88.88% of males and 89.85% of females were normal weight. The prevalence of high BP in the WHtR < 0.5 group was 9.99% in males and 2.19% in females; the corresponding figures were 28.92% (males) and 14.06% (females) in the WHtR ≥ 0.5 group; the latter is significantly higher than the former (p?<?0.01).

Conclusion: Individuals with low WHtR were underweight and those with high WHtR were obese with high BP. Results from this study support WHtR as a simple and effective screening tool for abdominal obesity and high BP in practice.     

Dual burden of body weight among Iranian children and adolescents in 2003 and 2010: the CASPIAN-III study

Introduction

Our aim was to compare changes of body mass index (BMI) and waist circumference (WC) curves of Iranian children by comparing the results of two national surveys of a surveillance program, i.e. CASPIAN-I (2003–2004) and CASPIAN-III (2009–2010). The second objective was to evaluate the prevalence of obesity, overweight and underweight among 10–18-year-old Iranian children and adolescents.

Material and methods

This study was performed among students who were selected by multistage random cluster sampling from urban and rural areas of 27 provinces of Iran, as part of a national survey of school student high risk behavior entitled CASPIAN-III, conducted in 2009–2010.

Results

We evaluated 5088 school students (50.2% boys). In rural areas, underweight was more common in boys and overweight and obesity in girls. In urban areas underweight and obesity were more common in boys, whereas overweight was more common in girls. The highest prevalence of underweight (23.5%) was seen in students aged 13 years and the lowest (11.4%) in those aged 18 years. Underweight was significantly more common in rural than in urban areas (22.1% vs. 15.8%, respectively, p < 0.0001) and overweight/obesity was more common in urban than in rural areas. Compared with the findings in 2003–2004, the overall prevalence of elevated body mass index (16.6%) including obesity (9.1%) and overweight (7.5%) as well as underweight (17.5%) increased from 2003 to 2010.

Conclusions

In recent years, the double burden of nutritional disorders has increased among Iranian children and adolescents, especially in rural areas. This change may be related to epidemiologic transition, notably in terms of nutrition transition and rapid changes in lifestyle habits. This finding is an important issue for policy-makers for interventional preventive programs.     

Validation of a Strict Obesity Definition Proposed for Asians to Predict Adverse Pregnancy Outcomes in Korean Pregnant Women

BackgroundPeople are generally considered overweight and obese if their body mass index (BMI) is above 25 kg/m² and 30.0 kg/m², respectively. The World Health Organization proposed stricter criteria for Asians (≥ 23 kg/m²: overweight, ≥ 25 kg/m²: obese). We aimed to verify whether this criteria could predict adverse pregnancy outcomes in Korean women.MethodsWe included 7,547 Korean women from 12 institutions enrolled between June 2016 and October 2018. Women with no pre-pregnancy BMI data, not Korean, or lost to follow-up were excluded, leaving 6,331. The subjects were categorized into underweight, normal, overweight, class I obesity, and class II/III obesity based on a pre-pregnancy BMI of < 18.5, 18.5–22.9, 23.0–24.9, 25.0–29.9, and ≥ 30.0 kg/m², respectively.ResultsOverall, 13.4%, 63.0%, 11.8%, 9.1%, and 2.6% of women were underweight, normal, and overweight and had class I obesity and class II/III obesity, respectively. In the multivariable analysis adjusted for maternal age, a higher BMI significantly increased the risk of preeclampsia, gestational diabetes, preterm delivery caused by maternal-fetal indications, cesarean section, large for gestational age, and neonatal intensive care unit admission.ConclusionAdverse pregnancy outcomes started to increase in those with a pre-pregnancy BMI ≥ 23.0 kg/m² after adjusting for maternal age. The modified obesity criteria could help predict adverse pregnancy outcomes in Koreans.     

Ten-Year Trends of Metabolic Syndrome Prevalence and Nutrient Intake among Korean Children and Adolescents: A Population-Based Study

PurposeMetabolic syndrome (MetS) comprises a cluster of risk factors for future cardiovascular and metabolic diseases. Only a few recent studies have reported the trend in the prevalence of MetS in youth. This study aimed to analyze trends in the prevalence of MetS and nutrient intake in the last 10 years and investigate the changes in MetS components among Korean children and adolescents.Materials and MethodsWe analyzed the data of 9513 children and adolescents aged 10–19 years from the 2008–2017 Korean National Health and Nutrition Examination Surveys. Diagnosis of MetS was based on the International Diabetes Federation (IDF) and modified National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) criteria.ResultsBased on the IDF criteria, MetS prevalence increased from 1.53% in 2008 to 3.19% in 2017 (p=0.007). Based on the NCEP-ATP III criteria, MetS prevalence increased from 2.18% in 2008 to 3.19% in 2017; however, the increase was not statistically significant. Daily calorie and fat intakes increased significantly during the study period. Among the risk factors that MetS comprises, the prevalence rates of central obesity, low high-density lipoprotein cholesterol levels, and high fasting glucose levels increased significantly.ConclusionOver the last 10 years, the prevalence of MetS has grown significantly with increasing calorie and fat intake in Korean children and adolescents. Central obesity and high-density lipoprotein cholesterol and fasting glucose levels have worsened. Therefore, active support and close monitoring are required to control MetS and prevent further increase in the prevalence of cardiovascular diseases.     

Brain-derived neurotrophic factor in relation to central obesity in children with sleep disordered breathing

IntroductionSleep disordered breathing (SDB) represents common comorbidities of childhood obesity leading to interrupted sleep and sleep deprivation. Sleep deprivation alters secretion of brain-derived neurotrophic factor (BDNF), which is an appetite regulator. However, little is known about the relation between BDNF and central obesity in children with SDB. The aim of the study was to evaluate BDNF level and anthropometric indices in relation to SDB in children with obesityMaterial and methodsA prospective case-control study was conducted on 30 children with obesity (BMI > 95^th percentile) and 30 healthy lean children (BMI 5^th-85^th percentile). Polysomnographic, anthropometric data and BDNF serum level were obtained from all included children. Serum level of BDNF and anthropometric indices of obesity were assessed in relation to SDB in children with obesity. Regression analysis was done to determine predictors for SDB in children with obesity.ResultsIn comparison to healthy controls, anthropometric indices of central obesity were significantly higher while BDNF was significantly lower in obese children, especially those with SDB. Respiratory disturbance index has a significant positive correlation with anthropometric indices of central obesity and a significant negative correlation with BDNF level. Central obesity and decreased BDNF were associated with 2-fold increased risk for SDB. Waist circumference/height ratio and neck circumference/height ratio have 89.5%, 75% sensitivity and 81.23%, 84.62% specificity at a cutoff point > 0.62, > 0.24 respectively for prediction of SDB in children with obesity.ConclusionsCentral obesity and decreased BDNF represent independent predictors for SDB in children with obesity. Anthropometric indices adjusted to height are a simple screening tool for SDB in obese children.     

Relationships between different nutritional anthropometric statuses and health-related fitness of South African primary school children

Background: A double burden of both under- and over-nutrition exists among South African children.

Aim: To describe associations between nutritional statuses and health-related fitness test performances.

Subjects and methods: Height and weight of 10 285 children (6–13 years; n?=?5604 boys and 4681 girls) were measured and used to calculate body mass index (BMI) and prevalence of overweight and obesity, stunting, wasting and underweight. Physical fitness scores for standing long jump, shuttle run, sit-and-reach, sit-up (EUROFIT) and cricket ball throw were assessed. Age- and gender-specific z-scores were calculated for these variables. Physical fitness for each nutritional status group was compared to children of normal weight.

Results: Compared to normal weight children, overweight and obese children scored lower on all fitness tests (p?p?=?.235) and sit-and-reach (p?=?.015). Stunted and underweight children performed poorer than normal weight children on most fitness tests (p?p?=?.829; underweight: p?=?.538) and shuttle run (underweight: p?=?.017). Performance of wasted children was not as highly compromised as other under-nourished groups, but they performed poorer on the cricket ball throw (p?Conclusions: When compared to normal weight children, both under- and over-nourished children performed poorer on some, but not all, health-related fitness tests.     

Hepatitis E virus infections in children age 0–15, Uganda outbreak, 2007

BackgroundThe epidemiology of hepatitis E virus (HEV) infections among children is not well understood, with some studies reporting that hepatitis E infections do not affect children.ObjectivesWe analyzed seroepidemiologic data collected during a hepatitis E outbreak in Uganda to determine prevalence of past and recent HEV infections among children aged 0–15 years.Study designIndividuals were randomly selected from a household census to participate in a seroprevalence survey. We analyzed data on IgM and IgG antibody to HEV among children aged 0–15 years. We categorized the study population by age group [aged 0–5, 6–10, and 11–15 years], and further stratified the youngest children [aged 0–1, 2–3, and 4–5 years]. Presence of IgG anti-HEV alone indicated past HEV infection, whereas recent infection was defined as presence of IgM anti-HEV with or without IgG anti-HEV.ResultsAmong children aged 0–15 years (N = 244), prevalence of past HEV infection was 25.4% (62/244) and was highest among children aged 0–5 years [31.0% (27/87)]. Evidence of recent HEV infection was detected in 37.3% (91/244) of children aged 0–15 years. Among younger children, recent HEV infection increased with age from 4.3% (1/23) in children aged 0–1 year to 36.7% (11/30) in children aged 4–5 years.ConclusionThese data show that children are not spared from HEV infections. Illness during childhood in developing countries is common and HEV infections may be misdiagnosed as another acute illness, or under diagnosed. The lack of clinical care, HEV diagnostics, and surveillance in developing countries limit our full understanding of hepatitis E epidemiology.