Eating frequency is higher in weight loss maintainers and normal-weight individuals than in overweight individuals

Eating frequency has been negatively related to body mass index (BMI). The relationship between eating frequency and weight loss maintenance is unknown. This secondary analysis examined eating frequency (self-reported meals and snacks consumed per day) in weight loss maintainers (WLM) who had reduced from overweight/obese to normal weight, normal weight (NW) individuals, and overweight (OW) individuals. Data collected July 2006 to March 2007 in Providence, RI, included three 24-hour dietary recalls (2 weekdays, 1 weekend day) analyzed using Nutrient Data System for Research software from 257 adults (WLM n=96, 83.3% women aged 50.0±11.8 years with BMI 22.1±1.7; NW n=80, 95.0% women aged 46.1±11.5 years with BMI 21.1±1.4; OW n=81, 53.1% women aged 51.4±9.0 years with BMI 34.2±4.1) with plausible intakes. Participant-defined meals and snacks were ≥50 kcal and separated by more than 1 hour. Self-reported physical activity was highest in WLM followed by NW, and then OW (3,097±2,572 kcal/week, 2,062±1,286 kcal/week, and 785±901 kcal/week, respectively; P<0.001). Number of daily snacks consumed was highest in NW, followed by WLM, and then OW (2.3±1.1 snacks/day, 1.9±1.1 snacks/day, and 1.5±1.3 snacks/day, respectively; P<0.001). No significant group differences were observed in mean number of meals consumed (2.7±0.4 meals/day). Eating frequency, particularly in regard to a pattern of three meals and two snacks per day, may be important in weight loss maintenance.     

Urbanization and obesity in The Gambia: a country in the early stages of the demographic transition

OBJECTIVE: To investigate the distribution of overweight and obesity and its relationship with socio-economic and behavioural factors in a developing-country population undergoing rapid nutritional transition. DESIGN: Cross-sectional house-to-house survey in urban Gambia. SUBJECTS: Four groups of 50 subjects were sampled as follows: young men (YM, 14-25 years), young women (YW, 14-25 years), older men (OM, 35-50 years) and older women (OW, 35-50 years). MEASUREMENTS: Several socio-economic and behavioural factors were investigated. Composite indices for socio-economic status, education, healthy lifestyle and western influences were created. Body weight, height, waist and hip circumferences were measured and body mass index (BMI) was calculated. Body composition was assessed by leg-to-leg bioimpedance. Overweight was defined as BMI=25.0-29.9 kg/m(2) and obesity as BMI>or=30.0 kg/m(2). RESULTS: There were highly significant gender and age differences in overweight (YM=0%, YW=10%, OM=6% and OW=34%) and obesity (YM=0%, YW=4%, OM=6% and OW=50%). Only 16% of OW were neither overweight nor obese compared to 88% of OM. OW had a higher fat mass percent (38.4%) than other groups, while fat-free mass (kg) was significantly higher in males than females with YW having the lowest value. Young generations were more educated and more influenced by western ideals than OM and OW. Weight gain was not always associated with weight concern and many overweight/obese subjects did not perceive themselves as overweight. CONCLUSION: Social and behavioural changes are already creating a perceptible 'generational gap' among this population undergoing rapid transition. The improved education and current lean status of the younger adults offers opportunities for preventative interventions. These need to be specially targeted at women.     

Dietary energy density and successful weight loss maintenance

Research shows a positive relationship between dietary energy density (ED) and body mass index (BMI), but dietary ED of weight loss maintainers is unknown. This preliminary investigation was a secondary data analysis that compared self-reported dietary ED and food group servings consumed in overweight adults (OW: BMI=27-45kg/m(2)), normal weight adults (NW: BMI=19-24.9 kg/m(2)), and weight loss maintainers (WLM: current BMI=19-24.9kg/m(2) [lost≥10% of maximum body weight and maintained loss for ≥5years]) participating in 2 studies, with data collected from July 2006 to March 2007. Three 24-h phone dietary recalls from 287 participants (OW=97, NW=85, WLM=105) assessed self-reported dietary intake. ED (kcal/g) was calculated by three methods (food+all beverages except water [F+AB], food+caloric beverages [F+CB], and food only [FO]). Differences in self-reported consumption of dietary ED, food group servings, energy, grams of food/beverages, fat, and fiber were assessed using one-way MANCOVA, adjusting for age, sex, and weekly energy expenditure from self-reported physical activity. ED, calculated by all three methods, was significantly lower in WLM than in NW or OW (FO: WLM=1.39±0.45kcal/g; NW=1.60±0.43 kcal/g; OW=1.83±0.42 kcal/g). Self-reported daily servings of vegetables and whole grains consumed were significantly higher in WLM compared to NW and OW (vegetables: WLM=4.9±3.1 servings/day; NW=3.9±2.0 servings/day; OW=3.4±1.7 servings/day; whole grains: WLM=2.2±1.8 servings/day; NW=1.4±1.2 servings/day; OW=1.3±1.3 servings/day). WLM self-reported consuming significantly less energy from fat and more fiber than the other two groups. Self-reported energy intake per day was significantly lower in WLM than OW, and WLM self-reported consuming significantly more grams of food/beverages per day than OW. These preliminary findings suggest that consuming a diet lower in ED, characterized by greater intake of vegetables and whole grains, may aid with weight loss maintenance and should be further tested in prospective randomized controlled trials.     

Dual forms of malnutrition in the same households in Malaysia--a case study among Malay rural households

This report is a part of a multi-centre study in Asia on the problem of dual forms of malnutrition in the same households. In Malaysia, the prevalence of underweight and stunting persist among young children from poor rural areas. Overweight in adults, especially women from poor rural areas has been reported in recent years. Thus, this study was undertaken in order to assess the presence of the dual burden of underweight child-overweight mother pairs in a poor rural community. Out of 140 Malay households identified to have at least one child aged 1-6 years and mother aged above 20 years, 52.1% of the mothers were overweight, 15.7% of the children were underweight, 27.1% stunted and 5% wasted. Socio-economic background and food intake frequency data were collected from 54 underweight child/overweight mother pairs (UW/OW) and 41 normal weight child/normal weight mother pairs (NW/NW). Compared with the overweight mothers, a higher percentage of the normal weight mothers had received secondary education, were employed and with a higher household monthly income, although these differences were not significant. Patterns of food intake of the mothers and children appeared to have more similarities than differences between the UW/OW and NW/NW groups. Quantitative dietary intakes for 2 days using 24-hr recall and physical activity energy expenditure over the same period were assessed in a sub-group of UW/OW and NW/NW mothers and children. The NW/NW children showed significantly higher intake of total calories, fat and riboflavin than the UW/OW counterparts. Mean energy and nutrient intake of mothers from both groups were not significantly different, although the NW/NW mothers showed higher intake adequacy for total calories and most nutrients. While most of the mothers from both groups reported having no chronic illnesses, about half of the children in both groups had infections, especially gastrointestinal infections, over a 2-week period. Energy expenditure from physical activity for both UW/OW and NW/NW mothers and children did not differ significantly. This study confirmed inadequate intake of total energy and nutrients as the major factor for underweight in Malay children from rural areas. However, assessing intake and physical activity by interview methods were not sensitive enough to overcome perceived problems of under-reporting of energy intake and over-estimation of energy expenditure, especially by overweight subjects. Further investigations on a larger sample are necessary to understand the family dynamics leading to the double burden of malnutrition within the same household.     

Persistence of overweight among young children living in low income communities in Ontario

OBJECTIVE: The rise in the prevalence of overweight in pediatric populations is a major health concern. Little is known however, about the prevalence of overweight in younger children. Our objectives were to determine the annual prevalence of overweight in children from junior kindergarten (JK) to grade 3; to assess the persistence of overweight over this time period; and, to identify factors associated with overweight in this group. METHODS: Annual interviews were completed with parents (primarily the mother) living in economically disadvantaged communities in Ontario who are participating in the Better Beginnings, Better Futures project. Weight and height were measured annually for the children (n=760) beginning in JK. Risk of overweight was defined as body mass index (BMI) >or= 85th to < 95th percentile; overweight was BMI >or= 95th percentile. Parents' height and weight were self-reported; BMI >or= 25 was considered overweight. RESULTS: The risk of overweight among children ranged from 14.1% to 17.5%; the prevalence of overweight increased from 9.9% to 15.2%; 68.2% (15/22) of the children who were overweight in JK were >95th percentile in grade 3. BMI >or= 85th to < 95th percentile or >or= 95th percentile in JK were strongly predictive of overweight in grade 3. Almost 50% of the mothers were overweight. CONCLUSIONS: A high prevalence of overweight was found in young children; and, for a large proportion, their early weight status persisted. Strategies promoting healthy eating and physical activity for both children and parents are essential.     

Eating style, overeating and weight gain. A prospective 2-year follow-up study in a representative Dutch sample

This study examined which individuals are particularly at risk for developing overweight and whether there are behavioral lifestyle factors that may attenuate this susceptibility. A prospective study with a 2-year follow-up was conducted in a sample representative of the general population of The Netherlands (n=590). Body mass change (self-reported) was assessed in relation to overeating and change in physical activity (both self-reported), dietary restraint, emotional eating, and external eating, as assessed by the Dutch Eating Behavior Questionnaire. There was a consistent main (suppressive) effect of increased physical activity on BMI change. Only emotional eating and external eating moderated the relation between overeating and body mass change. However, the interaction effect of external eating became borderline significant with Yes or No meaningful weight gain (weight gain >3%) as dependent variable. It was concluded that whilst increasing physical activity may attenuate weight gain, particularly high emotional eaters seem at risk for developing overweight, because overconsumption seems to be more strongly related to weight gain in people with high degrees of emotional eating.     

Overweight and obese boys reduce food intake in response to a glucose drink but fail to increase intake in response to exercise of short duration

The effect of short duration exercise (EXR) on food intake (FI) and energy balance (EB) is not well understood in either normal weight (NW) or overweight (OW) and obese (OB) 9-14 years old children. Our purpose was to describe the effects of activity and a glucose drink on short term FI, appetite, and EB in NW, OW, and OB boys. Each boy received in random order either a noncaloric Sucralose sweetened control or glucose (1.0 g·kg(-1) body weight) drink 5 min after either exercise (EXR) or sedentary (SED) activity. Boys exercised for 15 min at their ventilation threshold (V(T)) in experiment 1 or at 25% above their V(T) in experiment 2. FI was measured at an ad libitum pizza meal 30 min after drink consumption. FI was lower after the glucose drink (p < 0.001) but not affected by activity, even though EXR increased appetite (p < 0.001). OW/OB boys ate more total food than NW boys (p = 0.020). EB over the duration of the experiments was reduced by EXR in OW/OB boys (p = 0.013) but not in NW boys in either experiment (p > 0.05). We conclude that intake regulation in OW/OB boys in response to a glucose drink is similar to NW boys, but it may be less responsive to activity.     

Perception of overweight and obesity among Portuguese adolescents: an overview of associated factors

PURPOSE: A national, representative school-based sample of Portuguese youth was used to both identify psychosocial indicators that distinguish obese and overweight adolescents from their peers, and key explainers of body image among obese and overweight adolescents. METHODS: Data on 5697 sixth, eighth and tenth grade public school students, age 11-16 years, from Portugal who participated in the 1998 (HBSC/WHO) survey of adolescent health were analysed. Body mass index (BMI) was calculated based on self-reported weight and height. Body image was measured using a body image tool with a sequence of seven body silhouettes progressing from very thin to overweight. BMI was calculated by reported weight/height (kg/m2), and was categorized based on Cole normalization curve. Adolescents whose BMI was above the 95th percentile (obese) and those with a BMI between 85 and 95 (overweight) were compared with the remainder. Separate analyses of psychosocial variables were conducted by gender, using the chi2-test, t-tests, ANOVA and multiple linear regression. RESULTS: There was a significant difference in physical activity between obese and non-obese youth (P<0.05). Girls reported dieting more than boys (P<0.001), with 15.3% of overweight teens dieting versus 6% of non-overweight teens. Those classified as overweight were significantly more likely to describe themselves as not healthy (P<0.001). A significantly greater proportion of obese/overweight versus non-overweight youth reported difficulty in making friends (P<0.001). BMI (beta=0.491; P=0.000), age (beta=-0.413; P=0.000), involvement in dieting (beta=0.110; P=0.000) and attitude toward appearance (beta=0.032; P=0.007) were significantly associated with body image. CONCLUSIONS: Inaccurate perceptions of the need to diet, poorer self-perceived health status and potential social isolation of those who are overweight were found. The importance of these findings to health promotion strategies is discussed.     

Physical activity and overweight among adolescents on the Texas-Mexico border.

OBJECTIVE: To investigate differences in associations between physical activity and overweight for students in two adjacent areas on the border between Mexico and the United States of America: students in the city of Matamoros, Mexico, and Mexican-American students in the Lower Rio Grande Valley (LRGV) area of southern Texas. Since the extremely high prevalence of overweight among Mexican-American adolescents is well-recognized, we wanted to determine whether overweight has become a problem among Mexican adolescents as well. METHODS: Students from 6 schools (n = 653), representing 11% of the ninth-grade students in Matamoros during 2002-2003, and students from 13 high schools (n = 4,736), representing 22% of the ninth-grade students in the LRGV during 2000-2001, completed questionnaires. Polytomous logistic regression was performed to estimate the risk of being at risk for overweight (> or = 85th percentile to < 95th percentile of body mass index (BMI) for age and sex) and the risk of being overweight (> or = 95th percentile of BMI-for-age and sex) versus normal weight that were associated with measures of physical activity. For simplicity, the classification of normal weight also included underweight. RESULTS: A higher percentage of adolescents in the LRGV were at risk of overweight (17%) in comparison with adolescents from Matamoros (15%). The percentages of LRGV and Matamoros adolescents who were overweight were identical (17%). LRGV adolescent boys (OR = 0.87, 95% CI = 0.77-0.98) who participated in team sports were less likely to be at or above the 85th percentile of BMI-for-age and sex. Although of borderline significance, Matamoros and LRGV adolescent boys who participated in physical education classes were less likely to be at risk for overweight. Among neither the Matamoros students nor the LRGV students were any of the various other physical activity categories or levels associated with being at risk for overweight or being overweight. CONCLUSIONS: Nearly one-third of the students in both Matamoros and the LRGV are at risk for overweight or are overweight. Implementation of interventions on healthful dietary choices and participation in physical education classes and sports teams are essential for reducing the extremely high prevalence of overweight among students on both sides of the Texas/Mexico border.     

Body mass status of school children and adolescents in Kuala Lumpur, Malaysia

Lifestyle and disease patterns in Malaysia have changed following rapid economic development. It is important to find out how these changes have affected the nutritional status and health behaviour of the population, especially school children and adolescents. Therefore a survey on school children's and adolescents' health behaviours and perception in Kuala Lumpur was initiated. This paper only reports the observed body mass status of the school children. A total of 3620 school children were selected in this survey using the method of multi-stage sampling. The students were surveyed using pre-tested questionnaires while weight and height were measured by the research team in the field. Using the cut-off of BMI-for-age >or= 95th percentile and <5th percentile for overweight and underweight respectively, there were a total of 7.3% of overweight students and 14.8% of underweight students. When analysed by gender; 7.5% of boys and 7.1% girls were overweight, while 16.2% of the boys and 13.3% of the girls were underweight. The youngest age group (11 years old) had the highest prevalence of underweight as well as overweight. With increasing age, the prevalence of underweight and overweight decreased and more children were in the normal weight range. The overall prevalence of overweight among the three ethnic groups was similar. However the prevalence of underweight was highest among the Indian students (24.9%), followed by Malays (18.9%) and Chinese (9.5%) (P <0.001). The results showed that both the problems of under- and over-nutrition co-exist in the capital city of Malaysia. The promotion of healthy eating and physical activities is required to address the problems of under- and over-nutrition in order to build up a strong and healthy nation in the future.     

Health-related quality of life in obesity: the role of eating behaviour

A poor health-related quality of life (HRQL) has been repeatedly documented in obesity. Overweight per se and associated diseases affect physical fitness, whereas mental well-being depends on social, cultural and behavioural components. Very few studies are available on HRQL in obese persons in relation to eating behaviour. We measured HRQL by means of Short-Form-36 questionnaire in 183 obese subjects, seeking specific treatment at a University-based weight management center. Only half had a Body Mass Index exceeding 35 kg/m2. Data were compared to age- and gender-adjusted normative values of the Italian population (2031 subjects). The Binge Eating Scale (BES) and the Three-Factor Eating Questionnaire (TFEQ) were used to assess eating behaviour. Most domains of HRQL were impaired in obese subjects, more severely in younger subjects and in females. The severity of overweight progressively affected physical fitness, but had a minor effect on mental status. In over 50% of subjects, BES and TFEQ identified a binge eating pattern, more frequently in females. A positive BES, as well as lower restriction, higher disinhibition and hunger values at TFEQ, identified subjects with poorer HRQL. Logistic regression analysis identified in a positive BES the variable more closely associated with low scores in mental domains of perceived HRQL. Waist-to-hip ratio, degree of obesity, osteoarticular and respiratory diseases, but also positive BES, were selected as variables more closely associated with poor physical fitness. HRQL is variably impaired in obese persons seeking treatment for their disease, mainly in patients with binge eating. Treatment of binge eating may be as important as any weight-reducing intervention for the overall well-being of the majority of obese persons.     

Body Dissatisfaction,Dietary Restraint,Depression, and Weight Status in Adolescents

BACKGROUND: Adolescence may be a crucial period for developing obesity and associated mental health problems. This study examined the relationship of weight status on body image, eating behavior, and depressive symptoms in youth. METHODS: A survey was conducted on 1490 youth attending grades 7–12. Participants completed questionnaires on body image, eating behavior, and mood and were measured for height and weight to calculate body mass index (BMI). Weight classification was based on the International Obesity Task Force guidelines, whereby youth at or above the 95th BMI percentile for age and sex were classified as obese, those between 85th and 94th BMI percentile as overweight, and those between 5th and 84th BMI percentile as normal weight. Several multivariate analyses of variance (MANOVAs) were conducted to examine these relationships. RESULTS: Clear relationships emerged between body image and weight classification. Obese youth reported higher body dissatisfaction than overweight youth, who reported more body dissatisfaction than normal weight youth. These effects were independent of age and gender. A relationship was also found for dietary restraint and weight status whereby higher restraint scores were associated with greater adiposity. Similarly, obese youth reported greater depressive symptoms, including anhedonia, negative self-esteem, and higher overall depression scores compared with overweight and normal-weight youth. CONCLUSIONS: Psychopathology in obese youth is well known in clinical samples but this study suggests that obese youth in the community may be at increased risk of developing body dissatisfaction, dietary restraint, and depressive symptoms compared with overweight or normal weight youth.     

Promotion of healthy weights at preschool public health vaccination clinics in Calgary: an obesity surveillance program

OBJECTIVE: To evaluate the acceptability and feasibility of a surveillance program of overweight and obesity in preschool children in Calgary, and to provide advice for families to promote healthy weights. PARTICIPANTS AND SETTING: Children (mean age 4.9+/-0.6 years) attending pilot-site clinics in September 2002 and all clinics in Calgary between February 2003-December 2003 (n=7048). INTERVENTION: The growth assessment protocol and resources supported a three-pronged approach to promote healthy weights (healthy eating, active living and positive body image). Public health nurses were trained in standardized measurement techniques and information resources. Links with physicians were made to facilitate continuity of care. Children's weight and height measurements were plotted on the Weight-for-Stature growth chart and used to identify children as obese (> or =95th percentile), healthy weight (> or =5th, <95th) or underweight (<5th). Subsequent analysis calculated the Body Mass Index (BMI)-for-Age to identify overweight children (> or =85th, <95th percentile). The protocol was pilot tested and subsequently implemented in all Calgary public health clinics. OUTCOMES: The majority (98%) of parents were either very happy or happy with information received during the visit. Public health nurse counselling confidence significantly improved after the pilot (p<0.001). Data indicated that 9% of children were obese, 15% were overweight and 3% were underweight. INTERPRETATION: This approach to identifying children's weight status appeared satisfactory to stakeholders, maximized use of existing resources to establish a surveillance program for Calgary, and provided an opportunity to give parents health-promoting advice on healthy weights.     

Do physicians discuss needed diet and nutrition health topics with adolescents?

PurposePreventive services guidelines recommend screening all adolescents for diet habits, physical activity and growth, counseling underweight teens about body image and dieting patterns, and counseling overweight or obese teens about dietary habits and exercise. In this study, we assess whether adolescents at risk for overweight or for eating disorders have discussed recommended diet and nutrition topics with their physicians.MethodsWe surveyed 14–18-year-old adolescents who had been seen for well care in primary care pediatric and family medicine practices. Adolescents self-reported their weight, height, body image, dieting habits, and issues they had discussed with their clinicians. Body mass index (BMI) was used to define those “at risk for an eating disorder” (< 5% BMI), “at risk of becoming overweight” (85%–95% BMI), and “overweight” (> 95% BMI).ResultsA total of 8384 adolescents completed surveys (72% completion rate). Nearly one-third of adolescents were “at risk” or overweight. Females were less likely to be overweight than males (9.4% vs. 15.7%; p < .001). Although 26.4% were attempting to lose weight, only 12.2% of all teens were actually overweight. Exercise and restricting intake were the preferred methods of weight loss. Physicians routinely discussed adolescents’ weight during visits, and were more likely to discuss it with those “at risk” (p < .001). Body image was more often discussed with girls than with boys (52% vs. 44.6%, p < .001) and with those at risk (51.6% vs. 45.5%; p < .001). Discussion of healthy eating and weight loss occurred more often with adolescents “at risk” for becoming overweight (p < .001).ConclusionsMany adolescents are at risk for being overweight or are currently overweight, confirming the importance of clinicians discussing diet and nutrition health topics with all teens. Many adolescents also misclassify their body image, and hence perceive their body image to be different from their actual BMI; clinicians should discuss body image with all adolescents, not just those at risk for eating disorders. Better interventions are needed to promote healthy nutrition and physical activity to all adolescents.     

Childhood obesity: do parents recognize this health risk?

OBJECTIVE: This study examined parents' understanding of excess weight as a health risk, knowledge of healthy eating habits, and recognition of obesity in their children. RESEARCH METHODS AND PROCEDURES: An anonymous questionnaire was distributed during well-care visits involving children 4 to 8 years of age at a pediatric faculty practice. Parents indicated their level of concern about excess weight and other familiar health risks using a four-point Likert scale, answered multiple-choice questions concerning healthy eating patterns, and communicated their perceptions about their child's weight using a visual analog scale. A parent's perception was considered "accurate" if it deviated from the child's growth chart percentile by <30 points. RESULTS: Of the 83 parents surveyed, 23% (19/83) had overweight children (> or = 95th percentile of age- and gender-specific BMI growth charts). These parents did not differ from other parents in their level of concern about excess weight as a health risk or in their knowledge of healthy eating patterns, but the two groups of parents did differ in the accuracy of their perceptions about their children's weight. Only 10.5% of parents of overweight children (2/19) perceived their child's weight accurately compared with 59.4% of other parents (38/64; p < 0.001). Parents of overweight children invariably underestimated their children's weight. The median difference between their perception and the growth chart percentile was -45 points. DISCUSSION: Given that most parents of overweight children fail to recognize that their child has a weight problem, pediatricians should develop strategies to help these parents correct their misperceptions.     

Obesity-related behaviors of Malaysian adolescents: a sample from Kajang district of Selangor state

This study aims to determine the association between obesity-related behaviors (dietary practices, physical activity and body image) and body weight status among adolescents. A total of 382 adolescents (187 males and 195 females) aged 13 to 15 years in Kajang, Selangor participated in this study. Majority of the respondents were Malays (56.0%), followed by Chinese (30.1%) and Indians (13.9%). Dietary practices, physical activity and body image of the adolescents were assessed through the eating behaviors questionnaire, two-day dietary record, two-day physical activity record and multi-dimensional body image scale (MBIS), respectively. Body weight and height were measured by trained researchers. The prevalence of overweight and obesity (19.5%) was about twice the prevalence of underweight (10.5%). About two-thirds of the respondents (72.3%) skipped at least one meal and half of them (56.2%) snacked between meals with a mean energy intake of 1,641 ± 452 kcal/day. More than half of the respondents (56.8%) were practicing sedentary lifestyle with a mean energy expenditure of 1,631 ± 573 kcal per day. Energy intake (r = 0.153, P < 0.05), physical activity (r = 0.463, P < 0.01) and body image (r = 0.424, P < 0.01) were correlated with BMI. However, meal skipping, snacking and energy expenditure per kg body weight were not associated with body weight status. Multiple linear regression analysis showed that body image, physical activity and energy intake contributed significantly in explaining body weight status of the adolescents. In short, overweight and obesity were likely to be associated not only with energy intake and physical activity, but also body image. Hence, promoting healthy eating, active lifestyle and positive body image should be incorporated in future obesity prevention programmes in adolescents.     

烟台城区中小学生超重肥胖影响因素分析

目的 了解烟台城区中小学生超重肥胖影响因素,为制定有针对性的防治措施提供科学依据。方法 采用分层整群抽样的方法,抽取烟台市3个城区6所中小学8~14岁1052名学生进行体格检查、学生问卷和家长问卷调查,运用SPSS 16.1进行t检验、χ2检验和logistic回归等分析影响因素。结果 城区中小学生超重率为17.59%,肥胖率为23.38%。男生的超重肥胖率(48.54%)高于女生(32.81%)(χ2=18.275,P＜0.001)。睡前吃食物、每天吃早餐和偏食挑食对超重肥胖的发生均有影响,差异有统计学意义(χ2=17.647,7.123,24.895,P＜0.01)。父亲超重肥胖、母亲超重肥胖、出生体重超重和父亲抽烟是学生超重肥胖的影响因素,差异有统计学意义(χ2=29.226,28.565,20.886,4.668,P＜0.05)。多因素分析显示,父亲超重肥胖、男生、睡前吃食物、母亲超重肥胖和出生体重≥4kg是超重肥胖的独立危险因素(OR=2.192,2.032,1.865,1.790,1.725);每天吃早餐和偏食挑食是超重肥胖的保护因素(OR=0.676,0.433)。结论 烟台市中小学生超重肥胖受多种因素影响,应采取有针对性的干预措施,以控制超重肥胖的发生。     

Weight loss attempts and attitudes toward body size, eating, and physical activity in American Indian children: relationship to weight status and gender

OBJECTIVE: This study examined dieting, weight perceptions, and self-efficacy to eat healthy foods and engage in physical activity and their relationships to weight status and gender among American Indian elementary schoolchildren. RESEARCH METHODS AND PROCEDURES: Data for this study were collected as part of the baseline examination for the Pathways study. Participants were 1441 second- through third-grade American Indian children in 41 schools representing seven tribes in Arizona, New Mexico, and South Dakota who filled out a questionnaire and had heights and weights taken. RESULTS: Forty-two percent of the children were overweight or obese. No differences were found between overweight/obese and normal weight children for healthy food intentions or self-efficacy. Heavier children (especially those with body mass index > 95th percentile) were more likely to have tried to lose weight or were currently trying to lose weight. No gender differences were found. Normal weight children chose a slightly heavier body size as most healthy compared with overweight/obese children. DISCUSSION: The results indicate that children are concerned about their weight and that weight modification efforts are common among overweight American Indian children. School, community, and family-based programs are needed to help young people adopt lifelong healthful eating and physical activity practices.