Accuracy of weight status perception in contemporary Australian children and adolescents

Aim: To explore weight status perception and its relation to actual weight status in a contemporary cohort of 5‐ to 17‐year‐old children and adolescents. Methods: Body mass index (BMI), derived from height and weight measurements, and perception of weight status (‘too thin’, ‘about right’ and ‘too fat’) were evaluated in 3043 participants from the Healthy Kids Queensland Survey. In children less than 12 years of age, weight status perception was obtained from the parents, whereas the adolescents self‐reported their perceived weight status. Results: Compared with measured weight status by established BMI cut‐offs, just over 20% of parents underestimated their child's weight status and only 1% overestimated. Adolescent boys were more likely to underestimate their weight status compared with girls (26.4% vs. 10.2%, P < 0.05) whereas adolescent girls were more likely to overestimate than underestimate (11.8% vs. 3.4%, P < 0.05). Underestimation was greater by parents of overweight children compared with those of obese children, but still less than 50% of parents identified their obese child as ‘too fat’. There was greater recognition of overweight status in the adolescents, with 83% of those who were obese reporting they were ‘too fat’. Conclusion: Whilst there was a high degree of accuracy of weight status perception in those of healthy weight, there was considerable underestimation of weight status, particularly by parents of children who were overweight or obese. Strategies are required that enable parents to identify what a healthy weight looks like and help them understand when intervention is needed to prevent further weight gain as the child gets older.     

Predictive value of body mass index and waist circumference for metabolic syndrome in 6-12-year-olds

Aim: To determine the predictive value of body mass index (BMI) and waist circumference (WC) and their optimal cut‐off points for metabolic syndrome (MetS), and also the incidence of MetS. Methods: This study included 888 children, aged 6–12 years, who were followed for a mean of 6.6 years. BMI, WC and their optimal cut‐off points to predict MetS were investigated. Results: The cumulative incidence of MetS was 10.7%. The adjusted ORs for age, sex and family history to predict MetS for BMI and WC z‐scores were 2.6 (95% CI, 2.0–3.5) and 2.6 (95% CI, 1.9–3.5), respectively. In their correspondent models, area under the receiver operating characteristic (ROC) curve was 0.73 (95% CI, 0.68–0.79) for BMI z‐scores and 0.72 (95% CI, 0.67–0.78) for WC z‐scores with no statistically significant difference. The optimal cut‐off values for BMI were 16.5 kg/m² for boys and 16.3 kg/m² for girls and those for WC were 57.5 cm for boys and 56.5 cm for girls. Conclusions: Our findings suggest that both BMI and WC have the same power to predict MetS and also children with higher BMI or WC are more susceptible to MetS. Moreover, a high incidence of MetS in children highlights the importance of interventional strategies during early childhood.     

Body mass index and body composition in relation to sexual maturation

AIM: To assess body mass index. (BMI) in relation to sexual maturation and verify how fat-free mass (FFM) and fat mass (FM) contribute to its increase. METHODS: 1,275 White adolescents (656 girls and 619 boys), aged 9 to 18 years, were evaluated according to Tanner stages. FFM and FM were calculated by triceps and subscapular skinfold measurements and leg-to-leg bioelectrical impedance. BMI-for-maturation was distributed into percentiles. Fat-free mass index (FFMI) and body fat mass index (BFMI) were calculated based on BMI 50t" ph percentile values. RESULTS: During maturation, as BMI increases, girls gain FFMI (13.3 kg/m2 at B1 and 15.8 kg/m2 at B5) and BFMI (3.7 kg/m2 at B1 and 5.7 kg/m2 at B5)--proportionally more fat-- while boys gain FFMI (14.3 kg/m2 at G1 and 17.9 kg/m2 at G5) and lose BFMI (4.8 kg/m2 at G1 and 3.2 kg/m2 at G5). CONCLUSION: These data suggest that FFMI and BFMI-for-maturation should be assessed in adolescents monitored for overweight and obesity.     

喂养习惯与婴儿出生后前6个月按身长体质量增加的相关性

目的 探讨导致婴儿出生早期生长过快,尤其是按身长体质量增长过快的相关喂养习惯,包括婴儿的喂养方式、喂养环境以及喂养者的一般情况和喂养行为等,方法以上海市控江社区医疗服务中心常规健康体检的200例足月、单胎、正常出生体质量的健康5～6月龄婴儿及其主要喂养者作为研究对象.有关婴儿喂养习惯的调查问卷,包括婴儿喂养模式、喂养环境、以及喂养者的行为等,由研究小组成员在现场对婴儿的主要喂养者进行一对一调查.记录婴儿的出生体质最,并在婴儿6月龄时测量其体质量和身长.结果 200例婴儿中有70例超重(BAZ>+1),占35%.男婴超重多于女婴(40.0%对30.9%,x2=1.798,P=0.180).超重婴儿和体质量正常婴儿的出生体质量一致(3.30±0.35 kg对3.35±0.32 kg,t=1.010,P=0.314),6月龄时两组婴儿的身长也一致(67.64±2.10 cm对67.91±1.97cm,t=0.896,P=0.371).超重婴儿在出生后前6个月内按身长体质量增加速度明显快于正常体质量婴儿,6月龄时超重婴儿的体质量以及BMI显著高于正常体质量婴儿(9.16±0.67对7.94±0.64,t=12.324,P<0.01;19.86±1.24对17.41±0.80,t=14.953,P<0.01).两组婴儿中纯母乳喂养时间至少4个月,6月龄时持续母乳喂养、辅助食品稠厚度和喂养次数差异无统计学意义(x2=0.723～2.701,P均>0.05).祖父母在上海婴儿的喂养照料中扮演着重要的角色,39.0%的婴儿完全由祖父母承担喂养和照料的责任,而23.0%的婴儿则由父母与祖父母共同承担.两组婴儿的主要喂养者、喂养者学历、婴儿喂养知识掌握差异无统计学意义(x2=0.175、0.446,t=0.949,P均>0.05).超重婴儿喂养者的喂养速度明显快于正常体质量婴儿(Z=2.753,P<0.01),超重婴儿喂养者在喂养过程中与婴儿的语言交流明显较少(Z=2.932,P<0.01).在超重婴儿中,喂养者的过度喂养行为与超重婴儿的BAZ呈显著正相关(r=0.281,P<0.05).结论 上海婴儿出生早期按身长体质量增长过快与某些婴儿喂养习惯相关.婴儿出生后前6个月按身长体质量增加过快是否会增加儿章期肥胖的风险值得进一步观察和研究.     

Moderately elevated body mass index is associated with metabolic variables and cardiovascular risk factors in Swedish children

Aim: To evaluate associations between anthropometrics and metabolic variables as well as cardiovascular risk factors among children. Methods: Subjects were recruited from a cohort of 274 healthy children in Umeå, Sweden. Anthropometric measures, blood pressure and venous blood samples were collected at age 10 years and simultaneously from parents. Results: Altogether 144 children (53%), 142 mothers and 123 fathers participated. The prevalence of overweight and obesity among the children was 18 and 2%, respectively. Overweight children (above age‐ and sex‐specific cut offs corresponding adult BMI ≥ 25 kg/m²), compared to normal weight children, had significantly higher BMI already during infancy and higher S‐insulin and Homeostatic Model Assessment (HOMA) index at 10 years. The children’s BMI was positively associated with waist (boys’ r = 0.67, girls’ r = 0.81), hip (r = 0.68), waist/hip ratio (girls’ r = 0.37), waist/height ratio (boys’ r = 0.59, girls’ r = 0.80), sagittal abdominal diameter (r = 0.75), S‐insulin (r = 0.45), HOMA index (r = 0.49), systolic blood pressure (r = 0.24), mothers’ BMI (girls’ r = 0.42) and mothers’ waist (girls’ r = 0.42). Conclusion: Children at 10 years of age with moderately elevated BMI had higher levels of some metabolic variables and cardiovascular risk factors than did normal weight children, and there was a correlation between BMI and some metabolic variables as well as cardiovascular risk factors.     

Preschool children born moderately preterm have increased waist circumference at two years of age despite low body mass index

Aim: To investigate the development of waist circumference (WC) in preschool children born preterm compared with a population‐based reference. Background: Children born preterm are reported to be insulin resistant, despite being lean during early childhood. We hypothesize that the mechanism is through increased visceral adiposity. Methods: Data from 4446 preschool children (2169 girls/2277 boys) born in 2001–2006 from a population‐based study were compared with longitudinal measurements of body mass index (BMI) and WC from a cohort of 152 children (64 girls/88 boys) born moderately preterm in 2002–2004 (gestational age, 32–37 weeks). Results: In the preterm children, the mean WC was 2.8 cm larger compared with the reference group (p < 0.001) at 2 years of age but not at 5 years of age. There was no significant difference in the mean BMI at 2 years of age. The preterm group was significantly leaner at 5 years of age, with a mean BMI of 15.13 compared with 15.98 in the reference group (p < 0.001). Conclusion: Children born moderately preterm present as lean during early childhood but have an increased waist circumference in infancy, pointing towards a change in fat distribution with more abdominal fat. This may have implications for their metabolic status.     

Relationship between maternal pre‐pregnancy body mass index,gestational weight gain and childhood fatness at 6–7 years by air displacement plethysmography

This study aims to investigate the effect of maternal pre‐pregnancy body mass index (BMI) and gestational weight gain (GWG) on offspring body composition. In this prospective cohort study, offspring body composition at 6 years of age was obtained through air displacement plethysmography. Linear regression was used to obtain crude and adjusted coefficients. Information regarding offspring body composition and maternal pre‐pregnancy BMI was available for 3156 children and on offspring body composition and GWG for 3129 children. There was a direct association of maternal pre‐pregnancy BMI and GWG with offspring's fat mass (FM), fat‐free mass (FFM), fat mass index (FMI), fat‐free mass index (FFMI) and body fat percent (BF%) in crude and adjusted analyses. After adjustment for co‐variables, for each kg m^?2 of maternal pre‐pregnancy BMI increase, there was a mean increment of 0.13 kg in the offspring FFM, 0.06 kg m^?2 in FFMI, 0.11 kg in FM, 0.07 kg m^?2 in FMI and 0.18% in BF%. For each kilogram of maternal GWG increase, there was a mean increment of 0.08 kg in offspring's FM, 0.05 kg m^?2 in FMI, 0.04 kg in FFM, 0.01 kg m^?2 in FFMI and 0.18 % in BF%. Mothers with a higher pre‐pregnancy BMI or GWG tend to have children with greater adiposity at age 6 years. Fetal overnutrition is more likely among mothers with greater BMI during pregnancy; as a consequence, it can accelerate the childhood obesity epidemic.     

Association between school children's overweight and maternal obesity and perception of their children's weight status

AIM: To determine the association between overweight children and a) other components of the mothers' metabolic syndrome, such as body mass index (BMI), waist circumference (WC), HDL-cholesterol, triglycerides, glucose, HOMA-IR, blood pressure (BP), and age; and b) the mothers' perception of their children's overweight. METHODS: Six hundred and twenty children (297 M) aged 9 +/- 2 years and their mothers aged 37.7 +/- 7 years were examined between April and August 2006. BMI, BP, fasting glucose and lipids and children's Tanner stage were determined. Questionnaires were filled in about the mothers' perceptions of their children's eating habits and of their children's shape. RESULTS: Ninety-five (17.4%) of the children were obese (> 95th percentile), 108 (15.3%) overweight (> 85th percentile) and 418 (67.3%) normal. One hundred and twelve (18%) of the mothers were obese and 183 (29.5%) overweight. Mean values for measures in mothers differed between normal vs overweight/obese children: z-BMI (-0.19 vs 0.42), triglycerides (84 vs 105 mg/dl), cholesterol (147 vs 157 mg/dl), glucose (78 vs 82 mg/dl) and insulin resistance (HOMA-IR 1.34 vs 1.72). There were significant differences in the proportion with distorted perception of shape (2.2% vs 47.5%) and eating habits (11.2% vs 37%) between mothers of normal versus overweight/ obese children. Logistic regression analysis using BMI > or = 85th percentile as the dependent variable showed that the mothers' perceptions of their children's shape (OR: 18.84; 95% CI: 5.0-69.6), eating habits (OR: 3.82; 95% CI: 1.5-9.5) and mothers' BMI (OR: 2.1; 95% CI: 1.3-3.4) were associated with children's overweight. CONCLUSIONS: There was an association between mothers' distorted perception of their children's shape and eating habits and mothers' obesity and their children's overweight. This observation provides clues for obesity prevention programs.     

Gestational weight gain and obesity,adiposity and body size in African–American and Dominican children in the Bronx and Northern Manhattan

Gestational weight gain (GWG) is potentially modifiable and is associated with infant size and body composition; however, long‐term effects on childhood obesity have not been reported among multi‐ethnic urban populations. We examined the association between GWG and child anthropometric measures and body composition at 7 years [waist circumference (WC), body mass index z‐score (BMIZ), obesity (BMIZ ≥95%ile) and bioelectrical impedance analysis estimates of percentage body fat (%fat)] in African–American and Dominican dyads (n = 323) in the Columbia Center for Children's Environmental Health prospective birth cohort study from 1998 to 2013. Linear and logistic regression evaluated associations between excessive GWG [>Institute of Medicine (IOM) 2009 guidelines] and outcomes, adjusting for pre‐pregnancy BMI and covariates. Pre‐pregnancy BMI (mean ± standard deviation, all such values) and total GWG were 25.8 ± 6.2 kg m^?2 (45% overweight/obese) and 16.4 ± 7.9 kg (64% > IOM guidelines), respectively. Excessive GWG was associated with higher BMIZ {0.44 [95% confidence interval (CI): 0.2, 0.7], P < 0.001}, WC [β: 2.9 cm (95% CI: 1.1, 4.6), P = 0.002], %fat at 7 years [β: 2.2% (95% CI: 1.0, 3.5), P = 0.001)] and obesity [odds ratio: 2.93 (95% CI: 1.5, 5.8), P = 0.002]. Pre‐pregnancy BMI was positively associated with child size, adiposity and obesity (all P < 0.05). Excessive GWG was highly prevalent and was associated with child obesity, greater percentage body fat and abdominal adiposity. Strategies to support healthy GWG are warranted to promote healthy growth and prevent childhood obesity.     

Early rapid weight gain and current overweight in relation to asthma in adolescents born with very low birth weight

Early catch-up growth and subsequent overweight are suggested to be associated with later cardiovascular diseases and later type II diabetes. However, the impact of early catch-up growth and childhood overweight on the development of asthma has been less studied, particularly in children born with very low birth weight (VLBW). A birth cohort of 74 VLBW children (birth weight < or = 1500 g) was followed from birth and investigated on asthma at 12 yr of age. Early rapid weight gain was in one way defined as an increase of weight > or =1 standard deviation score (SDS) at 6 months of corrected postnatal age. Current overweight was defined by body mass index (BMI) exceeding 21.2 and 21.7 kg/m(2), respectively, for boys and girls at 12 yr of age. Current asthma was diagnosed by a pediatrician, according to asthma ever in combination with a positive response to hypertonic saline bronchial provocation test and/or wheeze at physical examination at 12 yr old. Being overweight at 12 yr of age was associated with an increased risk for current asthma in the VLBW children [crude odds ratio (OR): 5.5, 95% confidence interval (CI): 1.3-22.2]. After adjustment for early weight gain and neonatal risk, the OR of overweight increased nearly three times (adjusted OR: 15.3, 95% CI: 2.5-90.6). Early rapid weight gain seemed to be inversely associated with current asthma (adjusted OR: 0.49 for an increase of weight equal to 1 SDS, 95% CI: 0.23-1.02, p = 0.06). In addition, early rapid weight gain was inversely associated with the magnitude of bronchial responsiveness at 12 yr (coefficient -1.15, p < 0.01). There was a strong and positive association between overweight and asthma at 12 yr of age in the VLBW children. This strong association had been reduced by early rapid weight gain, possibly via the reduction of bronchial responsiveness.     

The relationship between sleep duration and obesity in Turkish children and adolescents

Aim: To determine the relationship between sleep duration and obesity in Turkish children and adolescents.
Methods: This study was conducted in Turkey with 5358 children aged 6 to 17 years. Height, weight, waist circumference (WC), mid-upper arm circumference (MUAC), triceps skinfold thickness were measured. Body mass index (BMI), arm fat area were calculated. Self-reported sleep duration by parents were obtained.
Results: As sleep duration increased, BMI, which was significantly higher in girls sleeping ≤8 h, decreased (p < 0.05). WC, MUAC, BMI were significantly higher in boys sleeping ≤8 h versus males sleeping ≥10 h. Boys sleeping ≤10 h in 6.0–17.0-years had significantly higher risk of overweight/obesity. In 6.0 to 17.0 years, the risk of overweight/obesity in boys sleeping 9–10 h, 8–9 h and ≤8 h were 1.86-, 1.74- and 2.06-times higher respectively, versus children sleeping ≥10 h (p < 0.05).
Conclusion: Sleep duration may be an important factor for obesity and providing ≥10 h of sleep is recommended as a prevention strategy for obesity.     

The role of 1-h physical activity every day in preventing obesity in adolescents in Shandong, China

Several studies have reported that physical inactivity and sedentary lifestyle are associated with being overweight and obese in children and adults. A new policy of 1-h physical activity (PA) every day was released by the Chinese government. The present study examined the role of 1-h PA every day in preventing obesity in adolescents in Shandong, China. A total of 29,030 students (14,578 boys and 14,452 girls) aged 10–18 years participated in this study. Height, weight, waist circumference (WC), and skinfold thickness (SFT) of all subjects were measured; body mass index (BMI) of adolescents was calculated from their height and weight, and the prevalence of overweight and obesity was obtained according to the International Obesity Task Force cutoffs. All subjects were divided into two groups. Group 1 had a PA of more than 1 h/day while group 2 had less than 1 h/day. Comparisons of BMI, WC, SFT, and prevalences of overweight and obesity between the two groups were made. The overall percentages of students in group 1 were 34.29 % in boys and 30.15 % in girls. The prevalences of overweight and obesity for both boys and girls were all significantly lower in group 1 than in group 2 in all age categories. In conclusion, 1-h PA every day has a beneficial effect in preventing obesity in adolescents in Shandong, China. These observations highlight the importance of PA in the prevention of overweight and obesity in adolescents.     

Weight concerns in male low birth weight adolescents: relation to body mass index, self-esteem, and depression

OBJECTIVE: To compare weight concerns and self-reported body mass index (BMI) of low birth weight (LBW) adolescent boys to those of a normative sample and examine relationships among BMI, weight concerns, self-esteem, and depression in the LBW cohort. METHODS: LBW boys (n = 260; mean age, 16.0) belong to the Neonatal Brain Hemorrhage Study birth cohort. Normative boys (n = 305; mean age, 16.5) belong to the National Health and Nutrition Examination Survey. Both samples were assessed in 2001-2004 with self-report questionnaires. BMI was calculated from self-reported height and weight. Weight perception and weight dissatisfaction were assessed with the Eating Symptoms Inventory. In LBW boys, self-esteem was measured with the Rosenberg Self-Esteem Scale and depression with the Beck Depression Inventory. RESULTS: Based on self-reported height and weight, LBW boys were more likely to be healthy weight or underweight and less likely to be overweight than normative boys. Despite having healthier self-reported BMIs, LBW boys reported more weight concerns than the normative sample. A total of 46.9% of LBW boys perceived their weight as abnormal, and 76.5% desired weight change. Weight concerns in LBW boys mostly reflected a perception of being underweight (31.2% of the cohort) and a desire to gain weight (47.5% of the cohort), although only 6.5% were clinically underweight. Weight concerns, but not BMI, were related to clinical depression and lower self-esteem. CONCLUSIONS: LBW adolescent boys are at high risk of experiencing weight concerns. Weight concerns rather than BMI are associated with emotional problems in LBW boys.     

9~12岁超重/肥胖男童血脂代谢谱研究

目的 探讨9~12岁超重/肥胖男童的血脂代谢谱变化特征及儿童超重/肥胖发生的可能机制。方法 将招募的72名9~12岁男童根据体重指数（BMI）分为对照组（n=42）和超重/肥胖组（n=30）。采集清晨空腹静脉血,对受试者的BMI、腰臀比、身体成分及血脂进行测量,同时采用超高效液相色谱与四极杆飞行时间质谱联用的代谢组学检测方法测试血清脂质化合物,并对数据进行统计分析和可视化。结果 超重/肥胖组男童的腰臀比、体脂百分数和三酰甘油水平显著高于对照组（P < 0.05）,高密度脂蛋白胆固醇水平显著低于对照组（P < 0.05）。代谢组学分析筛选出两组150种具有显著差异的脂质化合物,主要包含甘油脂类（40.7%）、甘油磷脂类（24.7%）、脂肪酰基类（10.7%）和鞘脂类（7.3%）。大多数甘油脂类水平在超重/肥胖组呈显著上调,而大部分甘油磷脂和鞘脂类出现下调。关键差异脂质被显著富集到2个KEGG代谢通路中,分别为醚酯代谢以及萜类生物骨架合成通路（P < 0.05）,并可能进一步影响下游的辅酶Q及其他萜类的生物合成代谢（P=0.06）。结论 9~12岁超重/肥胖男童的脂质代谢谱紊乱,绝大部分甘油脂类含量增加,甘油磷脂和鞘脂下调,并可能存在醚酯代谢以及萜类甚至辅酶Q的生物合成紊乱。     

Large summer weight gain in relatively overweight preschool Japanese children

Background: Children's lifestyles have changed recently in Japan. These changes are thought to be associated with their physical growth. The aim of the present paper was to describe and interpret the growth seasonality of children attending day‐nurseries in Osaka Prefecture, Japan. Methods: Results were based on a 6 year follow‐up study of preschool children aged 0 at baseline to 6 years old at the end of the follow up. Longitudinal growth data for 148 boys and 113 girls, born between April 1990 and March 1991, attending day‐nursery were obtained monthly from April 1990 through to March 1996. Children were divided into two groups: those with a normal (<17) or high (≥17) body mass index (BMI) at 5 years of age. Weight and height seasonal gains were estimated for each group. Results: Weight gain was higher during autumn among the group with a normal BMI at 5 years of age. Among high BMI group, weight gain was higher during autumn when they were 0 to 4 years of age, while it was higher during summer when they were 5 years of age. Height gain was higher in spring and summer in both BMI groups. Results were similar in boys and girls. Conclusion: Although the findings are consistent with previous studies for normal BMI children, the present study reports new findings for children with a high BMI at 5 years of age, for whom a large weight gain occurred during summer.     

Accuracy of weight perception, life-style behaviours and psychological distress among overweight and obese adolescents

Aim: To compare overweight and obese adolescents with accurate and inaccurate self‐reported weight perception across a range of behaviours and measures of psychological well‐being. Methods: This study uses a cross‐sectional survey of grade 7–12 high school students in New South Wales, Australia, conducted in 2008 (n= 7553). Overweight and obese students based on body mass index were classified as accurate perceivers (weight perception was ‘too fat’) or inaccurate perceivers (weight perception was ‘about right’). Results: Nearly a third of adolescents had incongruity between self‐perceived body weight status and body mass index‐determined weight category. Compared with boys, girls were less likely to underestimate their body weight (odds ratio: 0.26; 95% confidence interval: 0.25, 0.27) and more likely to overestimate their body weight (odds ratio: 3.4; 95% confidence interval: 3.3, 3.5). Accurate body weight perception was higher in obese adolescents compared with overweight adolescents (69.5% vs. 44.0%). Compared with mis‐perceivers, accurate overweight and obese perceivers had significantly higher odds of trying to lose weight and being more physically active; however, they showed a combination of unhealthy and healthy behaviours (i.e. dietary patterns and sedentary activities). Accurate weight perception among overweight and obese adolescents was associated with increased odds of feeling sad or depressed in the past 6 months. Conclusions: Further research on social, familial and psychological factors that predict or mediate healthy and unhealthy weight‐related behaviours among adolescents by accuracy of weight perception is needed. Accurate weight perception should be considered in counselling and behavioural interventions.     

Milk, dairy fat, dietary calcium, and weight gain: a longitudinal study of adolescents

BACKGROUND: Milk is promoted as a healthy beverage for children, but some researchers believe that estrone and whey protein in dairy products may cause weight gain. Others claim that dairy calcium promotes weight loss. OBJECTIVE: To assess the associations between milk, calcium from foods and beverages, dairy fat, and weight change over time.Design, Subjects, and Outcome Measure We followed a cohort of 12 829 US children, aged 9 to 14 years in 1996, who returned questionnaires by mail through 1999. Children annually reported their height and weight and completed food frequency questionnaires regarding typical past-year intakes. We estimated associations between annual change in body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared) and our dietary factors, adjusted for adolescent growth and development, race, physical activity, inactivity, and (in some models) total energy intake. RESULTS: Children who drank more than 3 servings a day of milk gained more in BMI than those who drank smaller amounts (boys: beta +/- SE, 0.076 +/- 0.038 [P = .04] more than those who drank 1 to 2 glasses a day; girls: beta +/- SE, 0.093 +/- 0.034 [P = .007] more than those who drank 0 to 0.5 glass a day). For boys, milk intake was associated with small BMI increases during the year (beta +/- SE, 0.019 +/- 0.009 per serving a day; P = .03); results were similar for girls (beta +/- SE, 0.015 +/- 0.007 per serving a day; P = .04). Quantities of 1% milk (boys) and skim milk (girls) were significantly associated with BMI gain, as was total dietary calcium intake. Multivariate analyses of milk, dairy fat, calcium, and total energy intake suggested that energy was the most important predictor of weight gain. Analyses of year-to-year changes in milk, calcium, dairy fat, and total energy intakes provided generally similar conclusions; an increase in energy intake from the prior year predicted BMI gain in boys (P = .003) and girls (P = .03). CONCLUSIONS: Children who drank the most milk gained more weight, but the added calories appeared responsible. Contrary to our hypotheses, dietary calcium and skim and 1% milk were associated with weight gain, but dairy fat was not. Drinking large amounts of milk may provide excess energy to some children.     

Can waist circumference identify children with the metabolic syndrome?

OBJECTIVE: To determine in children the association between waist circumference (WC) and insulin resistance determined by homeostasis modeling (HOMA-IR) and proinsulinemia and components of the metabolic syndrome, including lipid profile and blood pressure (BP). METHODS: Eighty-four students (40 boys) aged 6 to 13 years and matched for sex and age underwent anthropometric measurements; 40 were obese; 28, overweight; and 16, nonobese. Body mass index (BMI), WC, BP, and Tanner stage were determined. An oral glucose tolerance test, lipid profile, and insulin and proinsulin assays were performed. Children were classified as nonobese (BMI < 85th percentile), overweight (BMI, 85th-94th percentile), and obese (BMI > or = 95th percentile). RESULTS: There was univariate association (P < .01) between WC and height (r = 0.73), BMI (r = 0.96), Tanner stage (r = 0.67), age (r = 0.56), systolic BP (r = 0.64), diastolic BP (r = 0.61), high-density lipoprotein cholesterol level (r = 0.45), triglyceride level (r = 0.28), proinsulin level (r = 0.59), and HOMA-IR (r = 0.59). Multiple linear regression analysis using HOMA-IR as the dependent variable showed that WC (beta coefficient = 0.050 [95% confidence interval, 0.028 to 0.073]; P = .001) and systolic BP (beta coefficient = 0.033 [95% confidence interval, 0.004 to 0.062]; P = .004) were significant independent predictors for insulin resistance adjusted for diastolic BP, height, BMI, acanthosis nigricans, and high-density lipoprotein cholesterol level. CONCLUSION: Waist circumference is a predictor of insulin resistance syndrome in children and adolescents and could be included in clinical practice as a simple tool to help identify children at risk.     

Comparison of body mass index and triceps skinfold at 5 years and young adult body mass index, waist circumference and blood pressure

Aim: To examine which measure of obesity at 5 years, body mass index (BMI) or triceps skinfold thickness, is most strongly associated with 21‐year risk factors for cardiovascular disease (CVD), including BMI, waist circumference (WC), systolic blood pressure (SBP) and diastolic blood pressure (DBP). Methods: Longitudinal birth cohort study with BMI and triceps skinfold measurements at age 5, and BMI, WC and blood pressure at 21 years. Overweight and obesity at 5 years were determined according to Cole‐International Obesity Task Force standards, at 21, by World Health Organization definitions. Triceps skinfold thickness measurements were converted to a z‐score, and cut‐offs for overweight and obesity were chosen to reflect similar proportions to the BMI subgroups. BMI, WC, SBP and DBP were also measured at 21 years. Results: Five‐year BMI and triceps skinfold thickness were both significantly associated with the CVD risk measures at 21 years. For overweight/obesity at 5 years, the adjusted odds ratio (95% confidence interval) for 21‐year overweight/obesity was 5.6 (4.2, 7.4), for 21‐year WC was 1.5 (1.2, 2.0). Mean difference (95% CI) in BMI was 4.4 (3.9, 5.0), in WC 8.3 cm (6.8, 9.8), in SBP 2.4 mm Hg (0.5, 4.3), in DBP 1.1 mm Hg (0.1, 2.2). For skinfold, the similar findings were odds ratio 2.6 (2.0, 3.4) and 1.2 (0.9, 1.6) for 21‐year BMI and WC, and mean differences of 2.6 (2.0, 3.2), WC 4.8 cm (3.3, 6.3), SBP 2.3 mm Hg (0.5, 4.2) and DBP 0.7 mm Hg (?0.4, 1.8). Conclusions: In children with overweight/obesity, BMI rather than triceps skinfold is the preferred epidemiological measure for identifying young adult CVD risk markers of BMI, WC and blood pressure.