Overweight and obesity in Portuguese children and adolescents

The objective of this study is to obtain reliable data from recent studies concerned with obesity and its determinants in Portuguese children and adolescents. We searched in Medline/PubMed published data on overweight and obesity in Portuguese children and adolescents; search terms included “Portugal”, “overweight”, “obesity”, “children” and “adolescents”. We also conducted limited hand-searching of additional studies from PhD theses and other academic theses that addressed overweight or obesity in children and adolescents. Studies that considered body mass index based on self-reported weight and height were excluded. We identified 15 studies that reported overweight and obesity in children and adolescents in Portugal, but 1 study was excluded because it included self-reported weight and height. The International Task Force Recommendation (IOTF) using Cole cut-offs was the most used criterion to estimate overweight and obesity, followed by the age- and sex-specific BMI reference percentiles developed by the United States Centers for Disease Control and Prevention (CDC). The range of ages in these studies was between 2 and 15 years. There were some variations in the prevalence of overweight and obesity among studies and different regions. In children between 3 and 5 years of age, one study reported that overweight reached 13.6% in boys and 20.4% in girls, and obesity varied between 6.5% and 6.9%, respectively, in boys and girls. Between 6 and 10 years of age (using the IOTF definition), in boys, the prevalence of overweight varied from 14.7 to 30.5% and obesity from 5.3 to 13.2%; in girls, overweight values ranged from 16.5 to 29.1% and obesity from 6.4 to 12.6%. One study evaluated only adolescents that were born in 1990 (ages varied between 13 and 14 years) and reported both prevalences of overweight and obesity; the applied method was CDC criteria; in boys, the percentage of overweight was 16.9%, and obesity prevalence was 11.3%; in girls, overweight was 16.0% and the percentage of obese was 9.2%. The prevalence of overweight and obesity in Portuguese children and adolescents may be considered as alarming, and early intervention to prevent obesity is needed.     

儿童青少年超重肥胖评价方法及SPSS和SAS实现

超重肥胖已成为世界各国儿童青少年面临的重大公共卫生问题之一。现行的儿童青少年超重肥胖筛查标准不统一,逐条评价或自行编写程序容易出错且效率较低。本研究以中国学龄儿童青少年超重与肥胖筛查标准为例,详细介绍了国际和中国共四种评价儿童青少年超重肥胖的方法和步骤,结合具体案例详细介绍其应用方法,同时编制SPSS和SAS程序包和解...     

深圳市2013-2017年儿童青少年超重肥胖流行趋势分析

目的 了解2013-2017年深圳市儿童青少年肥胖现状和变化趋势。方法 采用分层整群随机抽样的方法,在深圳市随机抽取6所小学、3所初中和3所高中,监测所有在校学生2013-2017年5年间的身高及体重。结果 2013-2017年6~18岁儿童青少年共监测94 868人次,超重率为13.31%,肥胖率为9.60%;男生超重率和肥胖率（17.60%和12.43%）均高于女生（10.27%和5.93%）;近5年来男、女生超重肥胖率总体呈下降趋势;男、女生超重率峰值分别出现在10~12岁和13~15岁年龄组,而肥胖率峰值均在6~9岁组。结论 2013-2017年深圳市儿童青少年超重肥胖率总体呈下降趋势,但仍处于较高水平,应继续加强监测和采取相应防控措施。     

中国6~17岁儿童青少年超重肥胖流行特征

目的 分析我国6~17岁儿童青少年超重肥胖流行情况,为制定肥胖防治策略提供科学依据。方法 利用"2010-2012年中国居民营养与健康状况监测"中6~17岁儿童青少年调查资料,分析我国儿童青少年超重肥胖现状。6岁儿童采用WHO 2007年推荐的分年龄性别BMI超重肥胖判定标准判定超重肥胖,7~17岁儿童青少年采用《中国学龄儿童青少年超重和肥胖预防与控制指南》中的分年龄、性别的BMI超重肥胖判定标准进行判定。结果 6~17岁儿童青少年超重率和肥胖率分别为9.6%和6.4%,其中城市儿童青少年超重率和肥胖率分别为11.0%（男生：12.8%,女生：9.0%）和7.7%（男生：9.7%,女生：5.5%）,农村儿童青少年超重率和肥胖率分别为8.4%（男生：9.3%,女生：7.4%）和5.2%（男生：6.2%,女生：4.1%）。按家庭经济收入水平分,高、中和低家庭收入儿童青少年的超重率分别为12.3%、10.7%和8.2%,肥胖率分别为8.6%、7.2%和5.7%。结论 2012年,我国6~17岁儿童青少年超重肥胖表现为城市高于农村,男生高于女生;患病率与家庭经济收入水平有关。     

Exposure to local violent crime and childhood obesity and fitness: Evidence from New York City public school students

This paper estimates the relationship between neighborhood violent crime and child and adolescent weight and fitness. It uses detailed data from the Fitnessgram assessments of public school students in New York City matched to point specific crime data geocoded to students’ residential location. Our empirical approach compares the weight and fitness outcomes of students exposed to a violent crime on their residential H-block with those living in the same census tract but not exposed to violent crime in close proximity to their home. We find for adolescent girls, increases in BMI that range from 0.01 to 0.035 standard deviations and an increase in the probability of overweight of 0.5 to 1.7 percentage points. We find little evidence that BMI, obesity, and overweight change as a result of violent crime for adolescent boys, and younger children. Results are not explained by declines in physical fitness.     

丹东市≥15岁居民超重肥胖的现状和影响因素分析

目的 了解丹东市≥15岁居民超重和肥胖的现状和影响因素,为卫生部门制定相关措施和政策提供科学依据。方法 采取多阶段分层整群随机抽样方法,抽取丹东市10 713名≥15岁居民。采用卫生部《中国成年人超重和肥胖症预防控制指南》推荐的标准判断超重和肥胖,运用统计学描述方法、χ2检验及非条件多因素Logistic回归模型描述分析数据。结果 丹东市≥15岁居民的超重率、肥胖率分别是30.076%、11.677%,标化率为27.355%、11.241%。城市地区超重粗率(32.781%)高于农村地区(28.052%);农村地区的肥胖粗率(12.875%)高于城市地区(10.076%),女性(12.691%)高于男性(10.639%)。Logistic回归分析超重和肥胖的危险因素是较高年龄段、无配偶、低文化程度、活动量小的职业类型。结论 丹东市≥15岁居民超重和肥胖率较高,中年居民超重现象严重,青年男性、中老年女性肥胖现象严重,城市地区肥胖人群老龄化现象明显。     

Methodological considerations for childhood surveillance systems: the case of obesity

An international consensus on the methodology of a public health surveillance system will be essential in order to have a correct understanding of the progress of the growing challenge posed by the epidemic of obesity, to make inter-country comparisons possible, and overall to evaluate the effectiveness of preventive programmes and interventions. Recently, the European Charter on Counteracting Obesity, adopted at the WHO European Ministerial Conference on Counteracting Obesity in November 2006, called as well for the development of internationally comparable core indicators for inclusion in national health surveillance systems to be used for advocacy, policy making and monitoring purposes. At present, however, there is not yet a universal agreement on the appropriate methodology to carry out an epidemiological study or surveillance system to assess the prevalence and incidence of both overweight and obesity and monitor their trends over time in children and adolescents. The current disagreement involves the diagnosis method for overweight and obesity, the reference values and cut-off points to be applied and the age of the subjects. At the moment body mass index (BMI) is the most accepted anthropometric measure to assess overweight and obesity in epidemiological studies. The new WHO child growth standards from 0 to 5 years and the International Obesity Task Force internationally based criteria for overweight and obesity among children and adolescents aged 2 to 18 years are useful tools for international comparisons.

中国0~5岁儿童超重肥胖分布特征

目的 研究中国0~5岁儿童的超重肥胖现况及其分布特点。方法 数据来自"2010-2013年中国居民营养与健康状况监测"数据,2013年儿童调查采用多阶段分层整群抽样的方法,研究对象为全国30个省（自治区、直辖市）55个调查县（区）中0~5岁儿童32 862名。超重肥胖的判定：5岁以下儿童采用WHO 2006年生长发育标准;5岁儿童采用WHO 2007年生长发育参考值。结果采用2010年国家统计局的人口数据进行复杂加权计算。结果 2013年中国0~5岁儿童超重率为8.4%,男童和女童超重率分别为9.4%和7.2%;城、乡儿童超重率均为8.4%。0~、6~、12~、24~、36~、48~和60~71月龄组超重率分别为13.0%、11.1%、8.3%、6.0%、4.8%、3.9%和15.9%;家庭低、中和高收入水平儿童超重率分别为8.0%、8.8%和8.9%。0~5岁儿童肥胖率为3.1%,男童和女童肥胖率分别为3.6%和2.5%;城市和农村儿童肥胖率分别为3.3%和2.9%。0~、6~、12~、24~、36~、48~和60~71月龄组儿童的肥胖率分别为5.8%、3.8%、2.5%、1.6%、1.2%、1.3%和7.8%;低、中和高收入水平儿童肥胖率分别为2.8%、3.3%和3.5%。结论 中国0~5岁儿童的超重和肥胖率正在增高攀升,及时监测0~5岁儿童的超重肥胖状况和实施合理干预十分必要。     

北京城区9～10岁儿童体质量超标肥胖与血脂关系的分析

目的 分析北京市城区儿童体质量超标肥胖与血脂的关系。方法 采用多阶段随机整群抽样法抽取852名北京市城区9～10岁学生。按照WGOC推荐的体质量超标肥胖标准，中华心血管病杂志编辑委员会和Ferranti等提出的血脂异常的标准来诊断儿童体质量超标肥胖和血脂异常。使用Mantel-Haenszel卡方、Wilcoxon检验、Spearman相关和logistic回归等方法，分析了其中847份有效样本。结果 ①控制性别的影响后，BMI与总三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）独立相关（P〈0.01），偏相关系数分别为0.457、0.189、0.409和-0.399；②TG、TC、LDL、HDL中位数和血脂紊乱（dyslipidemia）患病率在非体质量超标、体质量超标、肥胖组间均有显著差异（P〈0.01），血脂紊乱有性别差异（P〈0.01）；③Logistic回归分析表明，调整体质量、性别后，非体质量超标、体质量超标和肥胖者中，体质量分类每升高一级，患血脂紊乱的OR分别是低一级体重分类的1.51倍，95%CI为1.11～2.03。结论 北京城区9～10岁儿童BMI与血脂水平独立相关，体质量超标和肥胖者患血脂异常的危险性显著增加。     

肥胖指标在青少年高血压病预测中的价值

目的评价体重指数（BMI）、腰围／身高比值（WHtR）、腰围（WC）及腰臀比（WHR）在预测青少年高血压病中的价值。方法通过分层整群随机抽样,共抽取12～18岁青少年3953例（男1947例,女2006例）。据血压水平分为正常对照组（3724例）和高血压组（229例）。测量身高、体重、腰围、收缩压（SBP）、舒张压（DBP）水平。结果高血压组BMI、WC、WHtR、WHR、SBP及DBP均明显高于正常对照组,差异有统计学意义（P〈0．05）。校正年龄、性别后,4个指标（BMI、WHtR、WC及WHR）均与SBP和DBP呈正相关,BMI与SBP和DBP的偏相关分析r’最大（r’分别为0．3228和0．2358）（P〈0．05）。4个指标预测高血压的受试者工作特性曲线下面积以BMI最大,分别为男性0．715（95％CI0．659～0．771）和女性0．702（95％CI0．646—0．757）。以SBP和DBP为因变量,以性别、年龄、BMI、腰围、WHtR和WHR为自变量,行多元线性回归,BMI均第一个被引入方程。结论BMI是预测青少年高血压病的有效指标。     

蒙古族7?18岁青少年超重肥胖25年变化趋势分析

目的 了解25(1985-2010)年间蒙古族7～18岁青少年超重肥胖长期变化趋势.方法 采用现况研究方法,应用1985、2000和2010年共计18 366人的蒙古族7～18岁青少年体质健康调研数据,分析比较不同监测年份、性别、城乡间的儿童青少年BMI均数和超重肥胖检出率.结果 25年间蒙古族7～18岁青少年BMI均数总体变化趋势为逐年升高,1985、2000和2010年超重、肥胖检出率分别为2.1％、0.5％,6.3％、2.4％和9.1％、6.6％;1985-2000年的15年间超重、肥胖率分别增长了2倍和4倍,2010年时比1985年增长4倍和12倍.1985、2000和2010年超重、肥胖检出率在城市男性中分别为1.2％、0,7.9％、3.4％和11.0％、11.8％;农村男性分别为0.6％、0.6％,2.8％、2.1％和9.0％、3.4％;城市女性分别为1.8％、0.3％,8.1％、4.3％和9.4％、8.4％;农村女性分别为4.5％、0.9％,8.8％、2.2％和10.2％、4.5％,各组间不同监测年份其超重、肥胖检出率的差异均有统计学意义(P＜0.05),且呈逐年增加趋势.结论 1985-2010年蒙古族青少年的超重、肥胖检出率大幅上升,并有继续升高的趋势,应采取合理有效措施预防和控制肥胖的发生.     

肥胖指标在青少年高血压病预测中的价值

目的评价体重指数（BMI）、腰围／身高比值（WHtR）、腰围（WC）及腰臀比（WHR）在预测青少年高血压病中的价值。方法通过分层整群随机抽样,共抽取12—18岁青少年3953例（男1947例,女2006例）。据血压水平分为正常对照组（3724例）和高血压组（229例）。测量身高、体重、腰围、收缩压（SBP）、舒张压（DBP）水平。结果高血压组BMI、WC、WHtR、WHR、SBP及DBP均明显高于正常对照组,差异有统计学意义（P〈0．05）。校正年龄、性别后,4个指标（BMI、WHtR、WC及WHR）均与SBP和DBP呈正相关,BMI与SBP和DBP的偏相关分析r’最大（r’分别为0．3228和0．2358）（P〈0．05）。4个指标预测高血压的受试者工作特性曲线下面积以BMI最大,分别为男性0．715（95％C10．659～0．771）和女性0．702（95％C10．646～0．757）。以SBP和DBP为因变量,以性别、年龄、BMI、腰围、WHtR和WHR为自变量,行多元线性回归,BMI均第一个被引入方程。结论BMI是预测青少年高血压病的有效指标。     

Trend in the prevalence of obesity and overweight among Iranian children and adolescents: A systematic review and meta-analysis

ObjectiveChildhood obesity is an important predisposing factor for most non-communicable diseases. The aim of this review was to provide evidence on the prevalence and trends of childhood obesity and overweight in Iran.MethodsMultiple international and Iranian scientific databases were searched for relevant literatures. Two independent reviewers identified relevant papers in several steps. Separate meta-analyses (using fixed- or random-effect models) were performed to estimate the overall, age, sex, and age–sex specific prevalence of obesity and overweight. Stratified analysis based on Centers for Disease Control and Prevention, International Obesity Task Force, and World Health Organization definition criteria and study year also were performed.ResultsWe included 107 studies in the meta-analysis (49 English and 58 Persian). Based on Centers for Disease Control and Prevention definition criteria, the overall prevalence of obesity and overweight remained relatively constant in the 2000s and are estimated to be about 5.1% (95% confidence interval [CI], 4.4–5.8) and 10.8% (95% CI, 10.2–11.4), respectively. The meta-regression analysis showed that the prevalence of obesity and overweight did not vary significantly with respect to sex and age of study participants. Girls had a lower prevalence of obesity and higher prevalence of overweight than boys.ConclusionThis review, which is the first of its kind in the Middle East and North Africa, suggests that although the trend in the prevalence of childhood obesity in Iranian children is not considerably high, but the escalating trend of excess weight among young children is alarming and should be considered by providers of interventional preventive programs at national and regional levels.     

中国7~17岁儿童青少年宏量营养素摄入与超重肥胖的关系

目的  探讨7~17岁儿童青少年宏量营养素摄入与超重肥胖的关系。方法  1997—2011年基于“中国居民健康与营养调查”的6轮调查数据,纳入膳食及BMI数据完整的7~17岁儿童青少年为研究对象。依照中国肥胖问题工作组制定标准判定超重肥胖,采用Logistic回归分析模型分析宏量营养素摄入与儿童青少年超重肥胖的关系。结果  最终纳入6 360名研究对象,其中7~＜12岁儿童青少年3 529人(55.5%),男生3 360人(52.8%),超重肥胖1 060人(16.7%)。校正相关混杂因素后,与脂肪供能比 < 25%组相比,≥30%组增加20%肥胖风险(OR=1.20, 95% CI：1.03~1.41, P=0.023);与蛋白质供能比 < 10%组相比,≥15%组增加61%肥胖风险(OR=1.61, 95% CI：1.25~2.04, P < 0.001);与碳水化合物供能比 < 55%组相比,55%~ < 65%组降低20%肥胖风险(OR=0.80, 95% CI：0.68~0.95, P=0.011),≥65%组降低21%肥胖风险(OR=0.79, 95% CI：0.66~0.94, P=0.010);脂肪及蛋白质供能比越高、碳水化合物供能比越低,发生超重肥胖的风险越高(P < 0.05);男生摄入过量蛋白质更可能发生肥胖(P=0.034)。结论  儿童青少年摄入过量脂肪和蛋白质可增加超重肥胖发生风险。     

天津市儿童青少年肥胖与血压现状及关系

目的 了解天津市儿童青少年肥胖和血压现状及其关系,为有针对性地制定儿童青少年血压偏高防控策略提供理论依据.方法 2019年9月,采用分层整群抽样的方法,选取天津市16个区94所中小学7～17岁儿童青少年30403人为研究对象.采用标准方法测量身高体重和血压.采用SPSS 24.0进行χ2检验、方差分析和二元logist...     

家庭相关因素与中国6~17岁儿童青少年超重肥胖关系的研究

目的 分析家庭相关因素与6~17岁儿童青少年超重肥胖的关系。方法 利用"2010-2012年中国居民营养与健康状况监测"数据筛选6~17岁儿童青少年作为研究对象,对其父母体重、文化程度、家庭年人均收入等家庭相关因素进行匹配后获得6 343名研究样本,通过单因素和多因素logistic逐步回归法分析家庭相关因素与儿童青少年超重肥胖的关系。结果 在调整年龄、性别、城乡因素后,多因素logistic回归模型分析结果显示,父母BMI越高（母亲：OR=1.83,95%CI：1.63~2.05;父亲：OR=1.74,95%CI：1.57~1.94）、家庭年人均收入越高（OR=1.30,95%CI：1.15~1.46）、母亲的文化水平越高（OR=1.24,95%CI：1.12~1.37）,儿童青少年的超重肥胖率越高。结论 父母超重肥胖、母亲文化水平高、家庭年人均收入高等相关因素与中国儿童青少年超重肥胖呈正相关。     

中国13～18岁儿童青少年体育锻炼对超重/肥胖与心理困扰关联的修饰作用研究

目的分析我国儿童青少年超重/肥胖与心理困扰的关联及体育锻炼的修饰作用。方法利用2019年全国学生体质与健康调研数据中汉族儿童青少年, 基于超重/肥胖、心理困扰评估和体育锻炼变量信息完全者, 最终纳入95 280名13～18岁儿童青少年, 使用凯斯勒心理困扰量表测量其心理困扰, 以评分≥25判定为高心理困扰, 根据中国《WS/T 586-2018学龄儿童青少年超重与肥胖筛查》标准进行BMI分组, 包括消瘦、正常、超重和肥胖, 采用WHO标准评价个体的BMI Z评分(BMIZ), 并依据人群百分位数分布平均划分为10组, 通过问卷收集调查对象平均每日体育锻炼时间, 并划分为<1 h组和≥1 h组。采用logistic回归模型分析儿童青少年超重/肥胖与高心理困扰之间的关联, 以及在不同体育锻炼时间组中的关联差异。结果 2019年13～18岁汉族儿童青少年超重、肥胖检出率分别为14.5%和7.6%, 高心理困扰率为37.6%, 平均每日体育锻炼的时间≥1 h的比例为17.1%。以BMIZP90组人群高心理困扰概率增加,...     

合肥市区2～6岁儿童超重和肥胖现况分析

目的了解合肥市区2-6岁儿童超重和肥胖的现况,为制定儿童超重和肥胖的干预策略和措施提供科学依据。方法采用整群抽样法,对合肥市区96所幼儿园17 984名儿童进行体格检查,根据WHO标准评价儿童体格发育,用身高别体重评价超重和肥胖,凡身高别体重超过中位数10%-19%者为超重,超过20%为肥胖。运用EpiData 3.1软件建立数据库,SPSS 13.0软件对数据进行统计分析。结果在2-6岁儿童中,超重儿童占11.89%,肥胖儿童占5.57%,随着年龄的增长,超重儿童有逐年下降的趋势（χ2趋势=23.068,P〈0.01）;肥胖儿童有逐年上升的趋势（χ2趋势=44.178,P〈0.01）,男童和女童的超重分别为12.32%和11.38%,无显著性差异（χ2趋势=3.740,P=0.053）;肥胖率分别为6.88%和4.01%,差异有统计学意义（χ2=69.629,P〈0.01）;超重＋肥胖儿童随着年龄增长没有增长或下降趋势（χ2趋势=0.007,P=0.936）。超重、轻度肥胖、中度肥胖和重度肥胖儿童的构成比分别为68.11%、20.23%、10.48%和1.18%。公立幼儿园和私立幼儿园超重儿童分别为12.65%和11.67%,无显著性差异（χ2=2.918,P=0.088）;肥胖儿童分别为6.73%和5.23%,差异有统计学意义（χ2=13.575,P〈0.01）。结论合肥市区2-6岁儿童超重和肥胖率比较高,部分超重儿童可能随着年龄的增长变成肥胖儿童;预防儿童肥胖应先预防超重,并且年龄越小越好。     

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。     

Overweight,obesity, high blood pressure and lifestyle factors among Mexican children and their parents

Objective  

The objective of this study was to identify associations in the prevalence of overweight, obesity and high blood pressure between children and their parents, as well as their eating and physical patterns.