Prevention of obesity: the role of the food industry

The food industry is a critical factor in any potentially successful long-term strategy to prevent obesity. By producing new products low in energy density and improving the nutritional quality (and reducing the energy content) of existing products, as well as through advances in responsible marketing and labeling, the food industry can provide foods that enable consumers to achieve lower energy intakes without going short of essential nutrients. The food industry is not the sole factor and government policies regarding agriculture, prices and subsidies are equally essential. Caterers and retailers are yet another important cog in the wheel for progress in obesity prevention. Intensive collaboration between all these players will only be attained if obesity prevention is given the priority it deserves in future public health planning.     

Estimated overweight and obesity in Mexican American school children

The prevalence of overweight and obesity in Mexican American children 6 to 17 years of age was estimated in 1972 (n = 1269) and 1983 (n = 868). Children were classified as overweight or obese on the basis of the body mass index (weight/stature2), the triceps skinfold, or both, relative to reference data for white children in NHANES-1. Overweight was defined as greater than or equal to 90th percentiles, while obesity was defined as greater than or equal to 95th percentiles of age- and sex-specific reference data. Over the entire age range, there was a significant increase in the prevalence of overweight and obesity between 1972 and 1983, but there was variation with age and sex. Fewer children were classified as overweight or obese when the two criteria were used together than when they were used individually. The results suggest that the body mass index and the triceps skinfold may vary in sensitivity as indicators of overweight and obesity particularly in 10- to 17-year-old children. Children classified as obese by the body mass index had significantly larger estimated midarm muscle circumferences than those classified as obese by the triceps skinfold or by both the body mass index and the triceps skinfold.     

Prevalence of overweight and obesity among children in the United Arab Emirates

The aim of the study was to determine the prevalence of overweight and obesity in children in the United Arab Emirates (UAE). Secondary analysis was undertaken of data on 4381 children aged 5-17 years from the 1999 UAE-National Iodine Deficiency Surveillance Study. Data on weight and height from that study were used to calculate body mass index. The prevalence of overweight and obesity was estimated using International Obesity Task Force criteria. Overall, 944 (21.5%) of children were overweight and 601 (13.7%) of these were obese. More girls than boys were overweight (22.9% vs. 20.2%; P < or = 0.001). Non-citizen girls were more likely to be obese (odds ratios [OR] 1.767, 95% confidence intervals [CI] 1.48-2.102) than UAE girls. Boys in the rural areas had the lowest prevalence (23.6%) and were the least likely of all the children to be either overweight (OR 0.785, 95% CI 0.629-0.974) or obese 0.732 (95% CI 0.591-0.912). This study demonstrates a high prevalence of overweight in children in the UAE. Prompt actions are needed to initiate preventative and interventionist strategies to reverse the trend of this emerging epidemic.     

Trends and predictors of overweight and obesity in East German children

OBJECTIVE: Childhood overweight and obesity seem to be increasing at an alarming rate throughout the Western world. During the 1990's, tremendous socioeconomic changes have taken place in East Germany, and studies about the prevalence and trends of childhood overweight and obesity in Central Eastern European countries are rare. Therefore, we analyzed trends in overweight and obesity in East German school children. DESIGN AND SUBJECTS: We examined 5- to 7-y-old school entrants, 8- to 10-y-old third graders and sixth-grade school children aged 11-14 y in three consecutive surveys performed in 1992-93, 1995-96, and 1998-99 in Eastern Germany. In total, we received 7611 questionnaires. Information about height and weight was available for 6650 children. RESULTS: Overweight and obesity showed a significant increasing trend for 11- to 14-y and 8- to 10-y-old children but not for the school entrants aged 5-7 y. After adjustment for age, sex, season and area, the risk of being overweight in 1998-99 compared to 1992-93 was 1.6 (CI 1.4-1.9) and 1.9 (CI 1.4-2.5) for obesity, respectively. Low birth weight and higher parental education were protective factors for overweight and obesity. Breast feeding was protective with regard to obesity. This effect was stronger if the children were exclusively breast-fed. CONCLUSIONS: In conclusion, our data provide further evidence that the prevalence of overweight and obesity increases. These results might suggest that preventive actions should start as early as possible and children from disadvantaged families might be considered as a susceptible subgroup.     

Developmental coordination disorder and overweight and obesity in children: a systematic review

Children with developmental coordination disorder (DCD) find themselves less competent than typically developing children with regard to their physical abilities and often experience failure. They are therefore likely to avoid physical activity. Physical inactivity is considered an important risk factor for developing overweight and obesity. The aim of this study is to assess the association between DCD and overweight and obesity in children and whether this association is influenced by age and/or gender. Six electronic databases were systematically searched. Titles and abstracts were screened for relevance. Remaining studies were subjected to full paper review. The quality of the included articles was assessed and relevant data were extracted for comparison. The search yielded 273 results. Twenty‐one studies, based on 10 cohorts, were included. Participants' ages ranged from 4 to 14 years. In all cohorts, children with DCD had higher body mass index scores, larger waist circumference and greater percentage body fat compared with controls. Seven studies assessed the effect of gender and four studies provided information on the effect of age. Children with DCD seem to be at greater risk for overweight and obesity. This risk may be higher for boys and seems to increase with age and with the severity of motor impairment.     

The prevalence of overweight and obesity among Danish school children

In 14 Danish municipalities physicians have gathered weight and height data from 7541 9th grade students (86.7% of all students in 9th grade participating). Overall 25.2% of the population were overweight (body mass index > 90th percentile). Boys were more frequently overweight than girls (29.3% vs. 21.1%) (P < 0.05). 14.1% of the boys and 8.2% of the girls were obese (body mass index > 97th percentile). Categorizing the participating municipalities by socioeconomic status students in municipalities with low status had a significantly higher prevalence of overweight than students in municipalities with high status. Overweight and obesity among Danish school children is a major concern and there are significant social differences in the prevalence of overweight.     

Cardiac autonomic dysfunction in school age children with overweight and obesity

Background and aimsWe investigated cardiac autonomic function in overweight and obese school-age children.Methods and resultsQuantitative cross-sectional study conducted with children (n = 110) of both genders. Children were divided by normal weight (NW; n = 54), overweight (OW; n = 24) and obese (OB; n = 32). Systolic (SBP) and diastolic (DBP) blood pressure and electrocardiograms were recorded and analyzed for heart rate and the heart rate variability (HRV) in time (SDRR, RMSSD, PRR50, SD1 and SD2) and frequency domains (HF, LF and LF/HF). The OB group presented higher SBP (p ≤ 0.01) and DBP (p ≤ 0.01). For HRV, the OB group had a lower PRR50 (p ≤ 0.01) and HF (p ≤ 0.01), associated with higher LF (p ≤ 0.01). Moderate negative correlations were found between the HF, BMI (r = ?0.37; p ≤ 0.01) and WC (r = ?0.38; p ≤ 0.01). Positive moderate correlation were found between LF, LF/HF and BMI (LF: r = 0.32; p ≤ 0.01; LF/HF: r = 0.31; p ≤ 0.01) and WC (LF: r = 0.34; p ≤ 0.01; LF/HF: = 0.34; p ≤ 0.01). Multiple linear regression showed a positive association between body fat and the SDRR (β: 0.48; CI: 0.2–4.2; p = 0.02). No differences were observed in cardiac electrical activity.ConclusionChildren with obesity but not overweight presented higher blood pressure and cardiac autonomic dysfunction, with sympathetic predominance on the heart rate. This fact was positively correlated with BMI and may be considered an important marker for cardiovascular risk in children.     

Attentional biases for food cues in overweight and individuals with obesity: a systematic review of the literature

Obesity rates have increased dramatically in recent decades, and it has proven difficult to treat. An attentional bias towards food cues may be implicated in the aetiology of obesity and influence cravings and food consumption. This review systematically investigated whether attentional biases to food cues exist in overweight/obese compared with healthy weight individuals. Electronic database were searched for relevant papers from inception to October 2014. Only studies reporting food‐related attentional bias between either overweight (body mass index [BMI] 25.0–29.9 kg m^?2) or obese (BMI ≥ 30) participants and healthy weight participants (BMI 18.5–24.9) were included. The findings of 19 studies were reported in this review. Results of the literature are suggestive of differences in attentional bias, with all but four studies supporting the notion of enhanced reactivity to food stimuli in overweight individuals and individuals with obesity. This support for attentional bias was observed primarily in studies that employed psychophysiological techniques (i.e. electroencephalogram, eye‐tracking and functional magnetic resonance imaging). Despite the heterogeneous methodology within the featured studies, all measures of attentional bias demonstrated altered cue‐reactivity in individuals with obesity. Considering the theorized implications of attentional biases on obesity pathology, researchers are encouraged to replicate flagship studies to strengthen these inferences.     

Epidemiologic data on obesity and overweight in the elderly

The incidence and the prevalence of obesity are progressively increasing in all the more industrialized Western nations: in the USA, approximately 280,000 deaths/year are attributable to obesity. Moreover the general structure of the population to world-wide level is enduring a strong change, since it is increasing towards the bands of more advanced ages: the strong aging of population makes it necessary to deepen the behavior and the consequences of obesity as risk factor also in the third age. In Italy, overweight subjects, amounting to more than 15 million over the age of eighteen, have not increased since 1994, but the obese ones in the general population are approximately 8%. The distribution of the prevalence of obesity in the range of age between 45 and 75 does not seem to be much age correlated in the male population, while it is more age related in the women: the prevalence decreases in the last class of age. We can found a similar trend for the overweight conditions. Differences in the distribution of this important risk factor, even if often neglected, also are tied to the professional skills and education.     

Prevalence of overweight and obesity in school children of Santos city, Brazil

The aim of this population-based study was to estimate the prevalence of overweight and obesity in public and private schools of Santos city, Brazil. We evaluated a total of 10,822 children aged 7 to 10 years old. Determination of overweight and obesity was obtained by the 85th and 95th percentiles of BMI for age, respectively, as proposed by CDC in 2000. The overall prevalence rates of overweight and obesity were 15.7% (CI 95%= 15.0% to 16.4%) and 18.0% (17.3% to 18.7%), respectively. The prevalence of overweight was 13.7% (12.6% a 14.8%) in boys and 14.8% (13.7% a 15.9%) in girls of public schools. In private schools, the rates were 17.7% (15.7% to 19.7%) in boys and 22.2% (20.0% to 24.4%) in girls. Obesity was found in 16.9% (15.7% to 18.1%) of the boys and 14.3% (13.2% to 15.4%) of the girls of public schools. In the private schools, 29.8% (27.4% to 32.2%) of the boys and 20.3% (18.2% to 22.4%) of the girls were obese. We concluded that the prevalence of obesity in public and private schools in the city of Santos is higher than other studies conducted in Brazil and in other countries of Latin America. Private schools showed higher prevalence rates of obesity than public schools (p= 0.001).     

Prevalence of overweight and obesity in the Netherlands

This paper shows the trends in the prevalence of overweight (body mass index [BMI] >or= 25 kg m-2) and obesity (BMI >or= 30 kg m-2) in the Netherlands. Overweight (obesity) prevalence in adult males increased from 37% (4%) in 1981 to 51% (10%) in 2004, and in adult females from 30% (6%) in 1981 to 42% (12%) in 2004, according to self-reported data. In boys and girls, obesity prevalence doubled or even tripled from 1980 to 1997, and again from 1997 to 2002-2004 a two- or threefold increase was seen for almost all ages. According to the most recent data, overweight (obesity) prevalence figures range, depending on age, from 9.2% to 17.3% (2.5-4.3%) in boys, and from 14.6% to 24.6% (2.3-6.5%) in girls. There is a lack of data on the national prevalence of overweight and obesity based on measured height and weight and on prevalences in different subgroups of the population. Regular national representative health examination surveys that measure height and weight are needed to assess the prevalence of overweight and obesity and its distribution over subgroups in the population, and to properly direct and evaluate prevention activities.     

Prevalence of overweight/obesity and its association with sedentary behavior in children

ObjectiveThe aim of this study was to determine the prevalence of overweight and obesity in children in the northeast region of Portugal, and to examine its association with sedentary behavior.MethodsData were collected on 1786 children (907 boys, 879 girls) aged 6 to 13 years. Body mass index was calculated from measured height and weight (weight in kg/height in m squared). Overweight and obesity were determined using the International Obesity Task Force cutoff values. Sedentary behavior was assessed based on means of transport to and from school and time spent watching TV and playing video games (TVPC).ResultsThe prevalences of overweight and obesity were 22.6% and 9.4% respectively. The differences between the sexes for both overweight and obesity were not significant. Most of the children (78.4%) go to school by car. Boys spend more time on TVPC than girls, both on weekdays and on weekends. The logistic regression model indicated a significant effect of 1.5 hours of TVPC by boys during weekdays (OR=0.246; p=0.015). Boys who spent less than 1.5 hours on weekdays on TVPC were 75.4% less likely to be overweight than those who spent more than 1.5 hours.ConclusionThe prevalence of overweight and obesity was 32%. Only 12.2% of the children spend less than 1.5 hours on TVPC. Boys who spend less than 1.5 hours on TVPC are 75.4% less likely to be overweight/obese than those who spend more than 1.5 hours.     

Epidemic increase in overweight and obesity in Chinese children from 1985 to 2005

This study tracks the temporal changes in prevalence of childhood and adolescent overweight and obesity in different regions of China from 1985 to 2005. Using a series data of the Chinese National Survey on Students Constitution and Health, we compared the temporal changes over a 20-year period of the prevalence of overweight and obesity among ten regions in China for school-aged children between 7 and 18 years of age. Large disparities in the temporal changes of obesity prevalence exist in different regions of China. North coastal residents, especially those of the upper socioeconomic status, had the earliest and largest increase in prevalence. Similar increases then followed successively in other regions of upper, moderate and low socioeconomic status, and finally in the affluent rural regions. No significant increase was found in the developing rural areas. Regions where the obesity epidemic occurred late also began to show rather rapid increases in prevalence in recent years. In 2005, the national estimates indicated that 7.73% of Chinese youth are overweight and 3.71% of them are obese, representing an estimated 21.37 million Chinese children (13.43 million boys and 7.94 million girls).