Neighbourhood Influences on Children's Weight-related Behaviours and Body Mass Index

IntroductionNeighbourhood contextual factors such as accessibility of food shops and green spaces are associated with adult bodyweight but not necessarily weight-related behaviours. Whether these associations are replicated amongst children is unknown.AimTo understand which aspects of childrens'' neighbourhoods are associated with unhealthy weight and weight-related behaviours.MethodsIndividual-level data for children from the 2006/7 New Zealand Health Survey (of Body Mass Index (BMI), dietary indicators and socioeconomic variables) were linked with geographic level data on neighbourhood deprivation, rural/urban status, percentage of community engaged in active travel, access to green space, food shops and sports/leisure facilities. Logistic regression models were fitted for measures of BMI and weight-related behaviours; sugar sweetened beverage (SSB) consumption; fast-food consumption; and television viewing.ResultsIncreased community engagement in active transport was, counterintuitively, the only neighbourhood contextual factor associated with unhealthy weight amongst children. After adjustment for socioeconomic and environmental variables, greater access to green space appeared to have a protective effect on SSB consumption and neighbourhood deprivation was associated with all three unhealthy weight-related behaviours (SSB and fast-food consumption and television viewing).ConclusionsAlthough further research is needed, evidence from the current study suggests that a repertoire of health promotion interventions and policies to change unhealthy weight-related behaviours in high deprivation neighbourhoods may be required to address childhood obesity.     

苏州市成年居民体质指数现状及影响因素

目的了解苏州市区成年居民体质指数(body mass index,BMI)现状及其影响因素,为改善苏州市居民健康状况提供依据。方法采用分层随机抽样的方法,对苏州市6个区640名18周岁以上常驻成年居民进行问卷调查和身高、体重等指标测量,对BMI影响因素进行统计分析。结果被调查居民体重过低者占4.5%,超重和肥胖者占37.3%;单因素和Logistic多因素回归分析显示,性别、年龄、学历和饮食行为对BMI的影响有显著性。结论苏州市成年居民超重和肥胖人数所占比例较高,尤其男性,中老年人和低学历居民超重和肥胖问题突出,应加强健康教育,使其养成良好饮食习惯,保持健康体重。     

Improvement of Return Rates in a Neonatal Hearing Screening Program

Abstract

This paper aims to describe the implementation of a Neonatal Hearing Screening Program in a school hospital, focusing on the return rates among infants who failed the first screening. The population who goes to the school hospital for health services comes mainly from economically underprivileged groups. Even though our previous return rates were comparable to those reported elsewhere, we felt it was important to improve the methodology of the screening process in order to try and obtain better results. Our hypothesis was that scarce knowledge on early hearing loss detection and on the benefits of early intervention could be reasons for mothers to give less importance to the second screening. So, a strategy was developed around the idea of providing very detailed information to the mothers about the screening process since preliminary data, gathered with a different group of in-patients, had shown that mothers possessed little knowledge about neonatal hearing screening and the consequences of hearing loss for children's development. The no-return rates decreased considerably (from 39.8% to 25.8%). The findings of this research showed both the need of an adequate way of imparting information to the mothers of newborns about hearing screening in economically underprivileged populations, and the role of social work in this process. Without adequate knowledge on hearing screening and the consequences of hearing loss, a high percentage of newborns may not take advantage of free universal hearing screening programs.     

Prenatal and Postnatal Bisphenol A Exposure and Body Mass Index in Childhood in the CHAMACOS Cohort

Background: Bisphenol A (BPA), a widely used endocrine-disrupting chemical, has been associated with increased body weight and fat deposition in rodents.Objectives: We examined whether prenatal and postnatal urinary BPA concentrations were associated with body mass index (BMI), waist circumference, percent body fat, and obesity in 9-year-old children (n = 311) in the CHAMACOS longitudinal cohort study.Methods: BPA was measured in spot urine samples collected from mothers twice during pregnancy and from children at 5 and 9 years of age.Results: Prenatal urinary BPA concentrations were associated with decreased BMI at 9 years of age in girls but not boys. Among girls, being in the highest tertile of prenatal BPA concentrations was associated with decreased BMI z-score (β = –0.47, 95% CI: –0.87, –0.07) and percent body fat (β = –4.36, 95% CI: –8.37, –0.34) and decreased odds of overweight/obesity [odds ratio (OR) = 0.37, 95% CI: 0.16, 0.91] compared with girls in the lowest tertile. These findings were strongest in prepubertal girls. Urinary BPA concentrations at 5 years of age were not associated with any anthropometric parameters at 5 or 9 years, but BPA concentrations at 9 years were positively associated with BMI, waist circumference, fat mass, and overweight/obesity at 9 years in boys and girls.Conclusions: Consistent with other cross-sectional studies, higher urinary BPA concentrations at 9 years of age were associated with increased adiposity at 9 years. However, increasing BPA concentrations in mothers during pregnancy were associated with decreased BMI, body fat, and overweight/obesity among their daughters at 9 years of age.     

Neighborhood Environment and Body Mass Index Trajectories From Adolescence to Adulthood

Objectives

To investigate whether neighborhood conditions during adolescence are associated with body mass index (BMI) extending into young adulthood.

Methods

Latent growth curve modeling was used to examine BMI over three waves (1996, 2001, and 2008) of the National Longitudinal Study of Adolescent Health (n = 9,115).

Results

Parental perceptions of neighborhood disorder and neighborhood structural disadvantage were positively associated with BMI at baseline. Although parental perceptions of disorder were not associated with the rate of change in BMI over time, neighborhood structural disadvantage was positively associated with the slope of BMI. Adolescents who lived in more disadvantaged neighborhoods not only had higher BMI at the beginning of the study, but they also gained weight at a faster rate than those who lived in more advantaged neighborhoods at the first wave of data collection. The data also revealed notable gender, racial, and ethnic subgroup variations in the relationship between neighborhood context and BMI.

Conclusion

The neighborhood environment during the critical period of adolescence appears to have a long-term effect on BMI in adulthood. Policy interventions focusing on the neighborhood environment may have far-reaching effects on adult health.     

孕前不同体重指数对阴道分娩的影响

目的探索孕前不同体重指数对阴道分娩的影响。方法2008年1月至5月在我院住院并进行阴道试产的初产妇975例,按照孕前体重指数分为低体重组(BMI<18.5)93例、正常体重组(18.5≤BMI<23)604例、超重组(23≤BMI<25)176例、肥胖组(BMI≥25)102例,观察孕前BMI与妊娠结局的关系。结果(1)孕前肥胖组的妇女的第一产程时限、第二产程时限明显长于其它组的妇女,差异有显著性(P<0.05),第三产程时限在不同孕前BMI组间比较没有显著差异;(2)随着孕前BMI的增长,孕妇的剖宫产率逐渐增加,各组间剖宫产率比较有显著性差异(P<0.05),其中肥胖组妇女的剖宫产率为33%。低体重组、正常体重组、超重组和肥胖组妇女的阴道助产率比较没有统计学差异。各组妇女的镇痛分娩比率有逐渐增加的趋势,其中肥胖组妇女的分娩镇痛率显著高于其它BMI组的妇女,差别有统计学意义(P<0.05);(3)低体重组、正常体重组、超重组和肥胖组间妇女分娩巨大儿的比率有统计学差异(P<0.05),随着孕前BMI的增加,妇女分娩巨大儿的比率也增加,其中以肥胖组妇女分娩巨大儿的比例最高为17.6%。各组妇女发生肩难产的比例没有统计学差异。各组妇女分娩的新生儿转入新生儿监护的比例没有统计学差异,其中以正常体重组妇女分娩的新生儿NICU转入率最低,为27%,而以肥胖组妇女分娩的新生儿NICU转入率最高,为35%。结论孕前肥胖导致第一产程、第二产程延长,同时会增加剖宫产率、镇痛分娩率、分娩巨大儿的比例以及新生儿转监护率。     

孕前不同体重指数对阴道分娩的影响

目的探索孕前不同体重指数对阴道分娩的影响。方法2008年1月至5月在我院住院并进行阴道试产的初产妇975例．按照孕前体重指数分为低体重组（BMI〈18．5）93例、正常体重组（18．5≤BMI〈23）604例、超重组（23≤BMI〈25）176例、肥胖组（BMI≥25）102例,观察孕前BMI与妊娠结局的关系。结果（1）孕前肥胖组的妇女的第一产程时限、第二产程时限明显长于其它组的妇女,差异有显著性（P〈0．05）,第三产程时限在不同孕前BMI组间比较没有显著差异;（2）随着孕前BMI的增长,孕妇的剖宫产率逐渐增加．各组间剖宫产率比较有显著性差异（P〈O．05）,其中肥胖组妇女的剖宫产率为33％。低体重组、正常体重组、超重组和肥胖组妇女的阴道助产率比较没有统计学差异。各组妇女的镇痛分娩比率有逐渐增加的趋势,其中肥胖组妇女的分娩镇痛率显著高于其它BMI组的妇女,差别有统计学意义（P〈0．05）;（3）低体重组、正常体重组、超重组和肥胖组间妇女分娩巨大儿的比率有统计学差异（P〈0．05）,随着孕前BMI的增加,妇女分娩巨大儿的比率也增加,其中以肥胖组妇女分娩巨大儿的比例最高为17．6％。各组妇女发生肩难产的比例没有统计学差异。各组妇女分娩的新生儿转入新生儿监护的比例没有统计学差异,其中以正常体重组妇女分娩的新生儿NICU转入率最低,为27％,而以肥胖组妇女分娩的新生儿NICU转入率最高,为35％。结论孕前肥胖导致第一产程、第二产程延长．同时会增加剖宫产率、镇痛分娩率、分娩巨大儿的比例以及新生儿转监护率。     

浙江省农村成年居民体质指数调查分析

目的探讨体质指数(BMI)在浙江农村成年居民中的分布特征。方法2006年1月采用多阶段分层整群抽样方法随机抽取浙江省18个县(市),90个乡镇、5400个农村住户中的成年居民为调查对象,通过自制问卷实施入户调查及体测。结果共收集有效问卷14317份。样本人群BMI的均值为22.96±2.65,超重和肥胖率分别为26.8%和4.2%;男性的超重比例与女性无差别,肥胖比例低于女性;15～岁年龄组超重和肥胖率最低,随着年龄的增长,超重和肥胖率都呈上升趋势,45～岁组超重率最高(36.7%),55～岁组肥胖率最高(6.4%);已婚组的超重和肥胖率都高于未婚组,与离婚组无显著性差异;男性随文化程度的升高超重率和肥胖率呈上升趋势,女性的文化程度与体质指数关系不大。结论浙江省农村成年居民超重率高于巴基斯坦等发展中国家,且近几年呈上升趋势;其超重率和肥胖率都低于河北省等华北地区。     

中年人群体重指数与代谢指标和相关疾病的相关性分析

目的 探讨上海地区社区中年人群体重指数（BMI）与代谢指标和相关疾病的关系.方法 选择上海地区社区45～59岁的2 296名中年人作为研究对象,进行横断面调查,计算BMI,根据WHO制定的BMI中国参考标准对人群进行分层,统计人群一般情况、有无高血压和糖尿病,监测其尿酸、空腹血糖、餐后2h血糖、低密度脂蛋白、高密度脂蛋白、总胆固醇和甘油三酯等代谢指标,分析BMI与代谢指标及疾病的相关性.结果 2 296名中年人偏瘦、正常和超重的比例为2.6％、47.0％和50.3％;超重人群高血压发生率、尿酸、空腹血糖、餐后2h血糖、低密度脂蛋白、高密度脂蛋白、总胆固醇和甘油三酯等代谢指标与偏瘦、正常人群比较有显著性差异（P＜0.05）;BMI与体重（r=0.742,P＜0.001）和甘油三酯）（r=0.202,P＜0.001）呈显著正相关,与身高呈负相关（r=0.116,P＜0.001）;其他相关代谢指标与BMI无相关性（P＞0.05）.结论 不同BMI人群中,高血压发生率、尿酸、空腹血糖、餐后2h血糖、低密度脂蛋白、高密度脂蛋白、总胆固醇和甘油三酯等代谢指标有显著性差异,BMI与甘油三酯呈显著正相关,控制甘油三酯能够有效地降低肥胖的发生率.     

Cost-Effectiveness of a School-Based Emotional Health Screening Program

Background:  School-based screening for health conditions can help extend the reach of health services to underserved populations. Screening for mental health conditions is growing in acceptability, but evidence of cost-effectiveness is lacking. This study assessed costs and effectiveness associated with the Developmental Pathways Screening Program, in which students undergo universal classroom emotional health screening and those who have positive screens are provided with on-site clinical evaluation and referral.
Methods:  Costs are enumerated for screening and clinical evaluation in terms of labor and overhead and summarized as cost per enrolled student, per positive screen, and per referral. Cost-effectiveness is summarized as cost per student successfully linked to services. School demographics are used to generate a predictive formula for estimating the proportion of students likely to screen positive in a particular school, which can be used to estimate program cost.
Results:  Screening costs ranged from $8.88 to $13.64 per enrolled student, depending on the prevalence of positive screens in a school. Of students referred for services, 72% were linked to supportive services within 6 weeks. Cost-effectiveness was estimated to be $416.90 per successful linkage when 5% screened positive and $106.09 when 20% screened positive. A formula to estimate the proportion of students screening positive proved accurate to within 5%.
Conclusion:  Information concerning costs and effectiveness of school-based emotional health screening programs can guide school districts in making decisions concerning resource allocation.     

大学生体质指数和饮食相关行为调查分析

目的:了解安徽医专学生体质指数和饮食相关行为现状,为采取相应营养干预措施,有针对性的培养良好的饮食行为提供依据。方法:采用分层整群随机抽样方法问卷调查,用体质指数评价营养状况。结果:①调查对象BMI值平均(20.08±2.33)kg/m2,体重过低占25.8%,超重和肥胖占4.8%。②在口渴时选择白开水等饮料的种类差异有统计学意义(x2=22.380,P=0.004)。③BMI的多因素logistic回归分析显示年龄、偏食挑食、肉类摄入、宵夜、暴饮暴食和体育锻炼等因素有统计学意义。结论:不良饮食行为是导致大学生体质指数异常的原因。根据年龄适时开展合理膳食教育,从而纠正偏食挑食、宵夜和暴饮暴食,提供适量肉类摄入和体育锻炼等对大学生保持理想体重有益。     

冀东油田体检人员体重指数与高血压病、高血脂和糖尿病的相关性分析研究

目的：探讨体重指数与高血压病、高血脂和糖尿病之间的关系。方法：对8760例在本院行健康体检的冀东油田职工,测量身高、体重、血压,测定血脂、血糖,计算体重指数。根据体重指数的诊断标准进行分组,对其与血压、血脂、血糖进行相关性分析研究。结果：本次体检者中男性体检者肥胖发生率是女性体检者的2．8倍,提示该人群不同性别肥胖的发生率存在差异,男性肥胖发病率明显高于女性。研究还显示,冀东油田职工和离退休人员高血压、高血糖、高血脂的患病率随着肥胖程度的不断加重,呈上升趋势。结论：体重超标及肥胖在冀东油田男性职工中发病率已经较高,由肥胖导致的高血压、高血脂、高血糖等慢性病在冀东油田职工中患病率也已经较高,严重影响职工的身心健康,应研究制订行之有效的卫生政策,大力开展健康教育,保障广大职工的身体健康。     

The Association Between Body Mass Index in Adolescence and Obesity in Adulthood

PURPOSE: This study used data from the National Longitudinal Study of Youth 1979 to examine the association between body mass index (BMI) in adolescence and obesity in adulthood. METHODS: Measurements of height and weight from 1981 and 2002 were used to calculate BMI for a cohort of 1309 adolescents at baseline and during adulthood. Associations between BMI at age 16/17 and obesity (BMI > or =30) at age 37/38 were analyzed using logistic regression analysis. RESULTS: When the predicted probability of adult obesity equaled 0.5, the point on the adolescent BMI distribution was close to the 85th percentile for both sexes (83rd percentile for females and 86th percentile for males). Among adolescents with a BMI in the 85th-<95th percentile, 62% of the males and 73% of the females became obese adults. Among those with a BMI > or =95th percentile, 80% of the males and 92% of the females became obese adults. Versus those with a BMI <85th percentile, those with a BMI in the 85th-<95th percentile were more likely to be obese (odds ratio = 7 for males, 11 for females) as adults, and those with a BMI > or =95th percentile were most likely to be obese (odds ratio = 18 for males, 49 for females) as adults. CONCLUSION: Adolescents with a BMI > or =85th percentile are at elevated risk for obesity in adulthood. To prevent the development of obesity and its associated health risks, population-based efforts combined with targeted interventions for these high-risk adolescents are needed.     

A Comprehensive Analysis of Body Mass Index Effect on in Vitro Fertilization Outcomes

The effect of a raised body mass index (BMI) on the outcome of assisted reproduction technology (ART) still represents a controversial issue. Even less clear is whether BMI acts with a potential detrimental effect on IVF outcomes via a deleterious effect on innate quality of oocytes or on the environmental milieu within the uterus. With the aim to better understand the mechanisms underlying the potential deleterious effect of an increased BMI on IVF outcomes, we have evaluated the effects of female BMI on number and quality of retrieved oocytes, fertilization rate, embryo score and incidences of ongoing pregnancy and live births among couples undergoing IVF in an Italian population. Data from 1602 women who underwent their first IVF cycle were retrospectively analyzed. A significantly reduced percentage of mature oocytes when comparing obese (BMI ≥ 30 kg/m²) and normal-weight patients (BMI = 18.50–24.99 kg/m²) was found. After adjusting for maternal age and other confounders, odds for ongoing pregnancy rate showed no differences across different BMI categories. However, a significant increased odds ratio (OR) could be observed for miscarriage rate in patients with BMI ≥ 25 (OR = 2.5; p = 0.04). These results should be taken into account in order to define optimal strategies for overweight and obese patients referring to ART procedures.     

体重指数与恶性肿瘤之间关系的对照研究

目的探讨体重指数与恶性肿瘤之间的关系。方法选取恶性肿瘤患者180名和健康对照者120名作为调查组和对照组,对调查组患者的体重指数（BodyMassIndex,BMI）和对照组进行比较分析。结果入组者为我院确诊为恶性肿瘤患者180例,其中包括：乳腺癌33例、肺癌30例、食管鳞癌25例、肝癌20例、前列腺癌17例、子宫内膜癌17例、直肠癌15例、结肠癌14例、贲门癌9例,他们的BMI分别为（25.46±4.61）kg/m2、（22.21±3.18）kg/m2、（22.34±3.45）kg/m2、（23.43±3.14）kg/m2、（23.44±3.31）kg/m2、（25.37±4.36）kg/m2、（25.82±4.72）kg/m2、（25.93±4.81）kg/m2、（25.68±4.23）kg/m2,对照组为120例体检者（其中男性66例,女性54例）,平均BMI为（23.06±3.21）kg/m2。乳腺癌、贲门癌、子宫内膜癌、直肠癌、结肠癌患者BMI与健康对照组比较差异有统计学意义（P〈0.05）,肺癌、食管鳞癌、前列腺癌、肝癌患者BMI与健康对照组差异无统计学意义（P〉0.05）。结论 BMI与多种恶性肿瘤具有密切关系,建议控制BMI,减少恶性肿瘤的发生。     

安徽省农村地区受艾滋病影响儿童的体质指数分析

目的研究安徽省农村地区受艾滋病影响儿童体质指数（BMI）状况,为开展相关干预提供依据。方法采用整群抽样方法,在安徽省阜阳市某县抽取2个艾滋病流行重点村,招募受艾滋病影响儿童的监护人,用美国疾病预防控制中心（美国CDC）制定的儿童体质指数（BMI）分布标准,采用半结构式问卷和面对面访谈方式进行调查。结果共调查76名受艾滋病影响儿童。BMI的分类分布是：超重9人（11.8%）、存在超重风险6人（7.9%）、健康体重42人（55.3%）、存在低体重风险10人（13.2%）、低体重9人（11.8%）。超重的比例（11.8%）明显高于标准（5%）。低体重和存在低体重风险的比例（25.0%）明显高于标准（15%）,与之有相关关系的变量有：儿童性别、儿童年龄、监护人年龄、监护人性别、家庭人口数等。结论在安徽省农村地区,受艾滋病影响儿童的BMI分布比较复杂,既面临着超重问题,更面临着低体重问题。