Body mass index of children from the United Kingdom diagnosed with pervasive developmental disorders

BACKGROUND: The aim of the present study was to ascertain the Body Mass Index (BMI) (kg m(-2)) derived from parental reports of height (metres) and weight (kilograms) of a pilot sample of boys born and resident in the UK diagnosed with pervasive developmental disorders (PDD). METHOD: Analysis of parental reporting of height and weight measurements in boys (n=50) diagnosed with PDD and comparison with age and sex-matched reference populations. RESULTS: The majority of patients were above the 50th percentile for height (70%), weight (74%) and BMI (80%) with 21% exceeding cut-off points for overweight and 10% for clinical obesity. There were no significant differences (P < 0.05) found between PDD subgroups for any of the measures. CONCLUSION: Further studies are required to validate findings of skewed height, weight and BMI data in PDD.     

Association between white blood cell count and components of metabolic syndrome

Background:  Components of metabolic syndrome (MetS) were found to be associated with several inflammatory factors including white blood cell count (WBCC), which is an easily available test in clinical practice. In the present study, the relationships between WBCC and MetS components were investigated in children.
Methods:  A total of 288 Taiwanese children, under 10 years old, with normal WBCC, were enrolled in the study. They were divided into quartiles according to WBCC (lowest, WBCC1; highest, WBCC4). The mean values of each MetS component for every group were compared in boys and girls separately. Multivariate linear regression between the WBCC and the MetS components after adjusting for age and body mass index (BMI) were also evaluated.
Results:  In group comparison, only the high-density lipoprotein-cholesterol (HDL-C) was found to be significantly lower in WBCC4 in boys. Other components were not different. After multivariate linear regression, WBCC was negatively correlated to HDL-C and positively to BMI in boys. Although not significant, similar relationships were also observed in girls. Interestingly, borderline positive correlation was noted between triglyceride (TG) and WBCC in girls.
Conclusion:  BMI was positively and HDL-C was negatively related to WBCC in boys. A similar trend could also be observed in girls but without significance. Borderline significant correlation between TG and WBCC was noted in girls. These findings suggest that cardiovascular risks might commence even in childhood. Early detection of children with these abnormalities may help to prevent cardiovascular disease and diabetes in adolescence or even adulthood.     

Reference body mass index curves for Turkish children 6 to 18 years of age

AIM: To determine reference body mass index (BMI) curves for Turkish children 6 to 18 years old and to compare with BMI in other countries. METHODS: A cross-sectional study conducted in Kayseri, Turkey. A total of 5,727 children (2,942 girls, 2,785 boys) aged between 6 and 18 years were selected to construct a reference curve using LMS method. RESULTS: BMI age reference charts of Turkish children were constructed. The 50th percentile curve of Turkish girls is lower than Italian and Turkish girls in The Netherlands but higher than Iranian girls. The 50th percentile curve of Turkish boys is lower than Italian and Turkish boys in The Netherlands and similar to Iranian boys after 13 years of age. CONCLUSION: BMI references of Turkish children are lower than in South East Europe, UK and North American populations, but higher than in Central European and Scandinavian countries.     

Birthweight, breast-feeding, parental weight and prevalence of obesity in schoolchildren aged 10–12 years, in Greece; the Physical Activity, Nutrition and Allergies in Children Examined in Athens (PANACEA) study

Background: The purpose of the present study was to determine the prevalence of overweight and obesity in a sample of Greek children aged 10–12 years, and to evaluate these rates in relation to parental weight and birthweight.
Methods: During the 2005–2006 school period, 700 schoolchildren (323 boys, 377 girls) were randomly recruited from 18 schools, in Athens. Height and weight were measured and body mass index (BMI) was calculated. Cut-off points for BMI defining obesity and overweight for gender and age were calculated in accordance with international standards.
Results: Overall, 8.6% of boys and 9.0% of girls were obese, and 33.9% of boys and 22.1% of girls were overweight. Having an obese parent increased the odds of having an overweight or obese child (P < 0.01). Compared to non-breast-fed, boys who were breast-fed for >3 months had 70% lower likelihood of being overweight or obese (P < 0.01) and breast-fed girls had 80% lower odds (P < 0.01). Excessive birthweight (>3500 g) increased by 2.5-fold the likelihood of being overweight or obese only in girls (P < 0.05).
Conclusions: Parental weight, lack of breast-feeding and excess birthweight (in girls) were significant predictors of overweight or obesity in Greek children aged 10–12 years.     

Is the prevalence of overweight and obesity declining among 4‐year‐old Swedish children?

Aim:  To investigate the trend in overweight and obesity prevalence among 4-year-old Swedish children.
Methods:  Height and weight data registered at the regular health check up at the child health centres in the county of Västerbotten during the years 2007/2008 (2225 boys and 2156 girls) were analysed and compared with data from 2002/2003 (2231 boys and 2176 girls). Overweight and obesity were estimated using the International Obesity Task Force cut-off values (ISO BMI).
Results:  In both boys and girls, overweight prevalence (ISO BMI > 25) decreased over the 5-year period, boys from 17.2% to 14.2% and girls from 22.3% to 19.0%. Among girls, there was also a decrease in obesity prevalence (ISO BMI > 30) from 5.7% to 3.1%.
Conclusion:  The result of this study indicates that the overweight and obesity epidemic among Swedish pre-school children may be levelling off.     

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.     

Body mass index for Saudi children with Down's syndrome

Aim: Children with Down's syndrome (DS) have a higher prevalence of obesity than children without DS. This study aimed to assess the prevalence of overweight/obesity and to establish reference body mass index (BMI) percentile curves for Saudi children with uncomplicated DS below the age of 5 y. Methods : BMI was measured prospectively in 785 children with DS and compared with 989 Saudi children without DS. Both groups were compared with the international cut-off point figures for age and gender. Results : Obesity was not a prominent features in Saudi children with DS and their mean BMI curves were linear to the international cut-off points for BMI, indicating a clear tendency for overweight. BMI reference percentile curves were constructed.
Conclusion : Reference curves for BMI worked out in this study, taken in conjunction with those for height and weight, will be useful in monitoring the size and shape of Saudi children with DS up to the age of 5 y.     

Blood pressure measurement in preschool children: The Hisayama study

Objective: To establish the blood pressure (BP) measurement protocol for Japanese preschool children, systolic BP (K1) and diastolic BP (K4, K5) were measured along with anthropometric values.
Methodology: Commercially available mercury sphygmomanometers were used. In the first group of children (group A), BP was measured in 79 boys and 85 girls using a cuff 9 cm wide and 23 cm long. In the second group (group B), the length and circumference of the upper right arm of 147 boys and 139 girls were measured to select cuffs appropriate for their sizes. Blood pressure measurements were performed twice on the right arm of the children in the seated position at a mean interval of 5 min.
Results: There were no significant differences in the anthropometric values (height, bodyweight, body mass index [BMI], length and circumference of the upper arm) between groups A and B. The BP values at K1, K4 and K5 in the first measurement of group B were 91 ± 9, 54 ± 8, and 48 ± 10 mmHg (boys) and 90 ± 9, 54 ± 8, and 48 ± 12 mmHg (girls), respectively. There were no significant differences between the first and second measurements in both groups, however, there were significant differences in the first and second measurements of K4 between groups A and B. Multiple regression analysis by the stepwise method revealed a strong correlation between K1 and the length of the upper arm in the boys and the bodyweight in the girls: between K4 and the bodyweight in the boys and the BMI in the girls, and between K5 and the height in the boys and the upper arm circumference in the girls.
Conclusions: From these results it would appear that a single measurement is sufficient under appropriate measurement conditions such as rest before measurement and the choice of the cuff size according to the upper arm circumference, and that BP is closely correlated with the anthropometric values in preschool children.     

Age and gender differences in VO2max in Swedish obese children and adolescents

AIM: To describe age and gender differences in estimated maximum oxygen uptake (VO2max) and participation in organized physical activity in Swedish obese children and adolescents, and compare the results with an age-matched reference group representative of the general population. METHODS: Two hundred and nineteen obese children (102 boys, 117 girls, aged 8-16 years, Body Mass Index (BMI) 24.3-57.0 kg.m-2) performed a submaximal bicycle ergometry test and an interview concerning participation in organized physical activity. RESULTS: The obese children had lower relative VO2max (p<0.001) than the reference group. In contrast to the reference group no age or gender differences were detected in the obese children aged 11-13 years and 14-16 years. With increased age (after 11 years) the obese children participated less in organized physical activity than the reference group (p<0.001). In obese adolescents, participation in organized physical activity in leisure time explained 7% and BMI 45% of the variance in relative VO2max. CONCLUSION: The obese children had lower relative VO2max, and participated less in organized physical activity than the reference group. The variance in relative VO2max was primarily explained by BMI. Obese adolescents, especially boys, were found to be at risk of physical inactivity.     

Bodyfat percentage in girls increased steadily with age and percentile rank of body mass index

BACKGROUND: The purpose of the present study was to determine the body composition of elementary school children by bioelectrical impedance analysis (BIA) method with a subject in a standing position. The method is frequently used in Japan. The other aim was to evaluate the relationship between the body composition and percentile rank of the body mass index (BMI) in Japanese children. METHODS: The number of subjects were 1042 children (530 boys and 512 girls aged from 6- to 12-years-old) from an elementary school. The bioelectrical impedance (BI) in the standing position was measured late in the morning before lunch. The fat percentage was derived from the body density according to the formula of Brozek et al. Each percentile value of BMI for each age and sex was determined from the frequency table of height and weight published by the Ministry of Education in Japan. RESULTS: The fat percentage in both boys and girls was significantly correlated with the BMI, however, girls showed a closer linear relation than boys. The fat percentage in girls increased steadily with age and percent rank of the BMI. The fat percentage in boys was scattered in a wide range at each percentile rank of the BMI. CONCLUSIONS: The fat percentage measured by the BIA in the standing position is closely associated with the percentile rank of the BMI in elementary school girls. For boys, it will be necessary to compare data among different types of BI measurement methods.     

Validity of BMI based on self-reported weight and height in adolescents

Aim:  To assess in a subset of a nationally representative sample of Portuguese adolescents, the validity of Body Mass Index (BMI) based on self-reported weight and height.
Methods:  This study included 462 students in grades 6, 8 and 10 (mean age 14.0 ± 1.9 years) from 12 public schools randomly selected from the list of schools which took part in the 2006 Health Behaviour in School Aged Children Portuguese survey, corresponding to approximately 10% of the sample. Self-reported weight and height were recorded and then measured.
Results:  Prevalence of normal weight, overweight and obesity based on self-report compared with that of measured values was not significantly different for boys and girls, and among age groups. BMI based on measured weight and height was underestimated compared with BMI based on self-reported data, both among girls and boys. Larger limits of agreement were found for boys, indicating a higher variability of self-reported BMI in estimating measured BMI, specifically below the age of 14 years.
Conclusion:  These data suggest that BMI based on self-reported weight and height is not accurate for BMI prediction at an individual level. However, self-reported BMI may be used as a simple and valid tool for BMI estimates of overweight and obesity in epidemiological studies.     

Ten-year trends in obesity among Israeli schoolchildren: 1990-2000

AIM: To analyze trends in childhood body mass index (BMI) in Israel between 1990 and 2000, and to determine the proportion of obese children using US and population-specific reference values. METHODS: Cross-sectional data from 13 284 second- and fifth-grade schoolchildren were collected, including age, sex, height, weight, country of birth, and time since immigration. Age- and sex-specific BMI means and centiles were calculated, and the prevalence of obesity was determined using Israeli and US reference values. RESULTS: BMI values at the 95th centile increased monotonously over time in all age and sex categories. Between 1990 and 2000, 95th centile values increased by 12.7% and 11.8% among second-grade boys and girls, respectively. Among fifth-grade children, 95th centile values increased by 10.2% and 8.4%, respectively. Among second graders in 2000, 11.4% of both boys and girls exceeded the BMI value recorded at the 95th centile in 1990. Among fifth-graders in 2000, 10.7% of boys and 11.1% of girls exceeded the 1990 BMI reference value (p for all comparisons < 0.001). The proportion of obese children increased over time using both Israeli and US reference values. CONCLUSION: This substantial increase in childhood obesity poses a serious health threat, and requires implementation of suitable public health interventions.     

Body mass index reference values (mean and SD) for Japanese children

The aim of this study was to derive the mean and +/-1, 2 and 2.5 SD body mass index (BMI) reference ranges as a supplement to the BMI centile reference values published previously for the same group of Japanese children. It is based on 14,012 boys and 13,781 girls of 1.5-18.5 years of age as studied in 1978-1981. The LMS method was utilized for the study. CONCLUSIONS: The BMI-SD reference values and charts presented have appropriately reflected the age-dependent skewed distribution of BMI values, and could be a useful tool in growth and nutritional evaluation of Japanese children.     

Breast-feeding and overweight in Singapore school children

Background:  Studies from developed Western countries have shown inconsistent associations between breast-feeding and overweight/obesity in children and adolescents. Few data are available from Asian populations. The purpose of the present study was therefore to evaluate the association between breast-feeding and overweight/obesity in a study of 10–12-year-old children in Singapore.
Methods:  A total of 797 school children (49% girls, 76% Chinese) who participated in the Singapore Cohort Study of the Risk Factors for Myopia (SCORM) were examined. Overweight/obesity ( n  = 179) was defined as age–sex-specific body mass index (BMI) cut-offs corresponding to BMI of 25 kg/m² for overweight and 30 kg/m² for obesity at age 18 based on the International Obesity Task Force (IOTF) reference.
Results:  The prevalence of overweight/obesity was 22.5%. Overall, breast-feeding was not found to be associated with overweight/obesity. After adjusting for potential confounders, the multivariable odds ratio (95% confidence interval) of overweight/obesity was 1.14 (0.80–1.63) for ever breast-fed compared with never breast-fed, 1.00 (0.57–1.72) for breast-fed for >3 months compared to ≤3 months and 0.79 (0.47–1.34) for exclusive/mostly breast-fed compared to partly breast-fed.
Conclusions:  No significant associations were detected among breast-feeding, its type, and duration with overweight/obesity in this Asian cohort of 10–12-year-old children.     

Association between peer relationship problems and childhood overweight/obesity

Aims:  To assess the association between peer relationship problems and childhood overweight and obesity.
Methods:  Data on 4718 preschool children were obtained at the obligatory school entry health examination in Bavaria. Parentally reported peer relationship problems ('normal', 'borderline' or 'abnormal') were assessed from the Strengths and Difficulties Questionnaire. Overweight and obesity were defined according to age- and gender-specific BMI cut-off points. Multivariate logistic regression analysis was performed to control potential confounders.
Results:  The prevalence of overweight and obesity was higher among children with 'borderline' or 'abnormal' peer relationship problems compared to 'normal' children. The association of 'abnormal' peer relationship problems was still significant in the final logistic regression model for girls [odds ratio (OR) for overweight 2.0; 95% confidence interval (CI): 1.4–3.0; OR for obesity 2.6; 95% CI: 1.3–5.0]. Among boys the adjusted odds ratio were lower and no longer significant.
Conclusion:  The significantly increased prevalence of overweight and obesity among preschool children with peer relationship problems could not be explained by confounding. It seems evident that there is a relevant co-morbidity of peer relationship problems and obesity in pre-school children pointing to the need of interventions focusing on both physical as well as psychosocial health.     

Prevalence of acanthosis nigricans in relation to anthropometric measures: Community‐based cross‐sectional study in Korean pre‐adolescent school children

Background: This cross‐sectional study was performed to assess the prevalence of acanthosis nigricans (AN) across various anthropometric measures and to identify the cut‐offs for anthropometric indices of adiposity for development of AN in Asian preadolescent school children. Methods: Body mass index (BMI), percentage weight for height (PWH), percentage body fat (PBF), and AN of the neck were evaluated in children in the fifth grade of all elementary schools in one metropolitan, Korean city (2117 boys and 1916 girls, mean age 10.9 ± 0.6 years, mean BMI 18.6 ± 3.3 kg/m²). Results: The prevalence of AN was 8.4% in boys and 5.1% in girls, and was proportional to the BMI, PWH, and PBF. The prevalence of AN rose steeply in the 80th and 90th percentiles of the BMI, PWH, and PBF in boys and girls, respectively. According to receiver operating characteristic analysis, AN was observed in boys with BMI >22.2 kg/m², and in girls with BMI >21.2 kg/m², which are below the current criteria for childhood obesity (local BMI 95th percentile and International Obesity Task Force BMI 30 kg/m²). Conclusions: AN has a good correlation with level of adiposity, and was already present in overweight children that were not considered obese by definition.     

Are C‐reactive protein and homocysteine cardiovascular risk factors in obese children and adolescents?

Background: Several prospective epidemiological studies have demonstrated that high-sensitivity C-reactive protein (hsCRP) and plasma homocysteine (hcy) are predictors of future coronary events among healthy men and women. The aim of the present study was therefore to investigate a possible relationship between hsCRP, hcy levels and body mass index (BMI), relative weight (RW), serum leptin levels, and cardiovascular risk factors in obese children and adolescents.
Methods: The study involved 28 obese children and adolescents (13 girls, 15 boys; BMI>95‰ for age and sex), 4.5–15 years of age (mean 10.7 ± 0.6 years), who attended hospital for a basic obesity check-up. The association between hsCRP, hcy levels and BMI, RW, serum leptin levels, and cardiovascular risk factors such as blood pressure (BP), lipid profile, serum fasting insulin levels, and insulin resistance indexes, was investigated.
Results: Serum hsCRP level was positively correlated with BMI ( r = 0.512, P  < 0.01), RW ( r = 0.438, P  < 0.05), systolic and diastolic BP ( r = 0.498, P  < 0.01), serum leptin levels ( r = 0.457, P  < 0.05), but not with serum lipid, glucose, fasting insulin, plasma hcy levels or insulin resistance indexes. For hcy level, in contrast, no correlation was found with BMI, RW, systolic and diastolic BP, serum lipid levels, leptin, hsCRP, glucose, fasting insulin levels, or insulin resistance indexes.
Conclusions: hsCRP is correlated with BMI, RW, BP and leptin, which are risk factors for coronary heart disease, which supports the relationship between obesity, inflammation and atherosclerosis. hsCRP in childhood obesity might be a useful index to predict possible atherosclerotic events.     

The structure of the Autism Diagnostic Interview-Revised: diagnostic and phenotypic implications

Background:  Multivariate statistics can assist in refining the nosology and diagnosis of pervasive developmental disorders (PDD) and also contribute important information for genetic studies. The Autism Diagnostic Interview-Revised (ADI-R) is one of the most widely used assessment instruments in the field of PDD. The current study investigated its factor structure and convergence with measures of adaptive, language, and intellectual functioning.
Methods:  Analyses were conducted on 1,861 individuals with PDD between the ages of 4 and 18 years (mean = 8.3, SD = 3.2). ADI-R scores were submitted to confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). Analyses were conducted according to verbal status ( n  =   1,329 verbal, n  =   532 nonverbal) and separately for algorithm items only and for all items. ADI-R scores were correlated with scores on measures of adaptive, language, and intellectual functioning.
Results:  Several factor solutions were examined and compared. CFAs suggested that two- and three-factor solutions were similar, and slightly superior to a one-factor solution. EFAs and measures of internal consistency provided some support for a two-factor solution consisting of social and communication behaviors and restricted and repetitive behaviors. Measures of functioning were not associated with ADI-R domain scores in nonverbal children, but negatively correlated in verbal children.
Conclusions:  Overall, data suggested that autism symptomatology can be explained statistically with a two-domain model. It also pointed to different symptoms susceptible to be helpful in linkage analyses. Implications of a two-factor model are discussed.     

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.     

Association between body mass index, skinfold thickness and blood pressure in 12-year-old children

The present study examined the association between body mass index (BMI) and skinfold thickness (SFT) with blood pressure (BP) in 12-year-old children in Shandong, China. A total of 920 (464 boys and 456 girls) 12-year-old students participated in this study. All subjects were divided into four groups (BMI < 25th, 25th ≤ BMI < 50th, 50th ≤ BMI < 75th, and BMI ≥ 75th) according to the percentile of BMI and into four groups (SFT < 25th, 25th ≤ SFT < 50th, 50th ≤ SFT < 75th, and SFT ≥ 75th) according to the percentile of SFT, respectively. Comparisons of BP among different groups were made by one-way ANOVA. High BP status was defined as systolic blood pressure (SBP) ≥ 95th and/or diastolic blood pressure (DBP) ≥ 95th percentile for age and gender. BMI and SFT were all significantly (P < 0.001) and positively related to SBP and DBP in both boys and girls. The prevalence of high BP in each group is rising with the percentiles of BMI and SFT in both boys and girls. Conclusion: There is a strong positive relationship between BMI, SFT, and BP in 12-year-old children; the present findings emphasize the importance of preventing excess BMI and SFT in order to prevent future-related problems such as hypertension in children and adolescents.