Study of Childhood Obesity Among School Children Aged 6 to 12 Years in Union Territory of Puducherry

Objective:

To study the prevalence of obesity and overweight among school children in Puducherry. To identify any variation as per age, gender, place of residence and type of school.

Setting and design:

Secondary data analysis of a school-based cross sectional study in all the four regions of Puducherry.

Materials and Methods:

Children between 6 and 12 yrs were sampled using multistage random sampling with population proportionate to size from 30 clusters. Anthropometric data (BMI) was analyzed using CDC growth charts. Data was analyzed using SPSS, BMI (CDC) calculator, CI calculator and OR calculator.

Results:

The prevalence of overweight (≥85^th percentile) among children was 4.41% and prevalence of obesity (>95^th percentile) was 2.12%. Mahe region had the highest prevalence of overweight (8.66%) and obesity (4.69%). Female children from private schools and urban areas were at greater risk of being overweight and obese.

Conclusions:

Childhood obesity is a problem in Puducherry and requires timely intervention for its control.     

Does nutritional status interfere with adolescents' body image perception?

Adolescents' body image (BI) may not match their nutritional status. This study selected representative sample of healthy adolescents aged between 12 and 18 from public and private schools. Anthropometric measures were performed in order to calculate the body mass index (BMI) percentile. The silhouette scale proposed by Childress was used to evaluate BI, making it possible to assess BI satisfaction and BI distortion. The sample was composed of 1168 adolescents with a mean age of 14.7 years; 52.9% were female, 50.9% were fair-skinned, 62.4% had consumed or still consume alcohol and 67% attended public school. Male adolescents presented more overweight and obesity (28.4%) (p < 0.05) than the female (17.1%). It was observed that 69.4% were dissatisfied with BI, 91.1% of the obese and 69.8% of those with overweight wished to lose body weight and 82.5% of those underweight wished to gain body weight. BI distortion was identified, since 35% of the adolescents who were underweight did not regard themselves thin, 39.1% of the overweight individuals and 62.1% of the obese did not see themselves in their adequate classifications. Adolescents with overweight/obesity were those who presented higher dissatisfaction with BI, mainly the females. Male individuals presented a greater wish of gaining weight. BI distortion was present in adolescents of all classes of BMI percentile.     

Trends in Body Mass Index and Prevalence of Extreme High Obesity Among Pennsylvania Children and Adolescents, 2007–2011: Promising but Cautionary

Objectives. We determined current trends and patterns in overweight, obesity, and extreme high obesity among Pennsylvania pre-kindergarten (pre-K) to 12th grade students and simulated future trends.Methods. We analyzed body mass index (BMI) of pre-K to 12th grade students from 43 of 67 Pennsylvania counties in 2007 to 2011 to determine trends and to discern transition patterns among BMI status categories for 2009 to 2011. Vinsem simulation, confirmed by Markov chain modeling, generated future prevalence trends.Results. Combined rates of overweight, obesity, and extreme high obesity decreased among secondary school students across the 5 years, and among elementary students, first increased and then markedly decreased. BMI status remained constant for approximately 80% of normal and extreme high obese students, but both decreased and increased among students who initially were overweight and obese; the increase in BMI remained significant.Conclusions. Overall trends in child and adolescent BMI status seemed positive. BMI transition patterns indicated that although overweight and obesity prevalence leveled off, extreme high obesity, especially among elementary students, is projected to increase substantially over time. If current transition patterns continue, the prevalence of overweight, obesity, and extreme high obesity among Pennsylvania students in 2031 is projected to be 16.0%, 6.6%, and 23.2%, respectively.The economic consequences of obesity in the United States were estimated at $147 billion annually in 2008.1 To better understand these costs, obesity trends to the year 2030 were predicted.2 Obesity prevalence could reach 51% by 2030, but is more likely to stay at more than 40% because of recently emerging positive developments. A subcategory, severe obesity, that is, body mass index (BMI; defined as weight in kilograms divided by the square of height in meters) of 40 or greater for adults, has increased faster than overall obesity and is projected to grow from 5% of adults in 2010 to 11% of adults by 2030.2 This growth, with its attendant increased risks of disease, will escalate costs even if overall obesity prevalence stabilizes.2Because obesity rates vary across states, the financial burden is not uniform.3 State-specific differences, such as lower cost of less healthy foods, can affect obesity and severe obesity prevalence together with current and projected health care costs.2 Because of the state-specific nature of Medicaid and Medicare expenditures, much of the high cost of obesity-related disease is borne by public sector health plans.Today’s children and adolescents will be the youngest adults in 2030; therefore, obesity prevention for the future requires monitoring of obesity prevalence rates among this population over time. Prevalence and trends in obesity among US children from 1999 to 2010 were determined based on National Health and Nutrition Examination Survey data.4 Prevalence of high BMI in US children and adolescents has also been studied.5 By 2010, fewer than 12% of those aged 2 to 19 years nationwide were at or above the 97th percentile (extreme high obese [ExHi obese]); 17% were above the 95th percentile (obese), and 32% were above the 85th percentile (overweight). A statistically significant increase among 6- to 19-year-old males with a BMI at or above the 97th percentile was found between 1999 and 2008.4To inform prevention efforts, state governments have a vested interest in monitoring obesity prevalence among all age groups, and especially among children and adolescents. Pennsylvania, for example, mandates annual height and weight screening with BMI calculation for all public school students statewide.6 One recent study assessed child and adolescent BMI trends in Pennsylvania, excluding Philadelphia and surrounding counties, for 2005 to 20097 and found combined overweight and obese rates decreased from 28.5% to 23.1% at the middle school level and from 24.6% to 20.9% at high school levels, but increased from 10.9% to 20% at the elementary level. The largest shift in BMI over the subset of years from 2007 to 2009 was among overweight elementary students; 58% of those who were overweight in 2007 were obese in 2009. Overweight and obese increased for the study population as a whole because of this sharp increase among elementary students. In a second, separate study,8 trends in obese (BMI ≥ 95th percentile) and ExHi obese (defined8 as BMI ≥ 35 kg/m²) among 5- to 18-year-old students attending Philadelphia schools in 2006 to 2010 were determined; obesity across all ages decreased from 21.5% to 20.5% and ExHi obese from 8.5% to 7.9%. Obese and ExHi obese were most prevalent among middle school students, Hispanic boys, and Black girls.8The purpose of our study was to determine prevalence, trends, and patterns in overweight, obese, and ExHi obese among Pennsylvania school children. Specific research questions were:

1. What were the prevalence and trends in overweight, obese, and ExHi obese from 2007 to 2011 among elementary, middle, and high school students?
2. What movement patterns, if any, occurred in normal weight, overweight, obese, and ExHi obese among Pennsylvania elementary, middle, and high school students from 2009 to 2011?
3. If current patterns continue, what percentage of children and adolescents would be overweight, obese, and ExHi obese in 2030?

     

Body Weight Statuses and Their Sociodemographic Correlates Among Adolescents in Southern Taiwan: Results Using Two Sets of Cutoff References

PurposeTo examine the differences in the prevalence of overweight and obesity based on the cutoff references established by the International Obesity Task Force (IOTF) and the Working Group on Obesity in China (WGOC), the prevalence of underweight on the IOTF reference, and the sociodemographic correlates of body weight statuses in Taiwanese adolescents.MethodsOverweight and obesity in 10,371 Taiwanese adolescents were determined by the IOTF and WGOC cutoff references for body mass index (BMI). Underweight was determined by the IOTF. The prevalence of overweight and obesity using the IOTF standard were compared to those using the WGOC standard. Associations of body weight statuses with gender, age, residential status, and parental education level were also examined.ResultsUsing the IOTF standard, 3.4% were underweight, 15.2% were overweight, and 6.1% obese, whereas 14.1% were considered overweight and 8.7% were obese by the WGOC standard. For both genders, more adolescents were classified as overweight by the IOTF standard and as obese by the WGOC standard. Although females were more likely to be underweight than males, males were more likely to be overweight or obese than females. For both genders, although older age increased the risk of being underweight, younger age increased the risk of being overweight or obese. For males, living in urban areas was associated with being overweight, and low paternal education level was associated with being obese.ConclusionsThe prevalence of overweight and obesity may differ depending on the reference standard consulted. Paternal education level and urbanicity were associated with gender differences in the proportion of adolescents who were overweight or obese.     

Ethnicity, socio-economic status, overweight and underweight in East London adolescents

Background The developed world is experiencing an ‘epidemic’ of childhood obesity but little is known about the prevalence of obesity, or underweight, amongst adolescents from minority ethnic groups in the UK. An understanding of the prevalence of obesity and overweight in these populations is important since some ethnic groups may be particularly vulnerable to the adverse health effects associated with obesity.

Study Objectives To examine levels of extreme obesity, obesity, overweight and underweight amongst a representative sample of adolescents from different ethnic groups in East London and to explore the association between socio-economic status and body mass index (BMI).

Design A school-based survey of adolescents aged 11–14. Obesity and overweight were estimated using the 1990 UK growth reference (UK 90) and the International Obesity Task Force (IOTF) cut-off points. Extreme obesity was defined as a BMI more than three SD above the UK 90 mean. Underweight was examined by looking at those with a BMI below the 15th or the 5th UK 90 percentiles.

Main Results A total of 2,482 adolescents were surveyed (response rate 84%), 73% from non-white ethnic groups. Although there were significant differences in BMI between ethnic groups, high levels of overweight were seen in all ethnic groups. More than one-third were overweight and one-fifth were obese using the UK 90; and over a quarter were overweight and almost one-tenth were obese using the IOTF cut-offs. Two per cent were extremely obese. Indian males were at higher risk of being overweight than white British males. The prevalence of obesity and overweight was similar in white British and Bangladeshi males. Overall the prevalence of underweight was slightly lower than that predicted by the UK 90, but South Asian ethnic groups, especially males, had a higher prevalence of underweight than other groups. No associations between BMI and measures of socio-economic status were found in this relatively deprived population.

Conclusions The ‘epidemic’ of childhood obesity observed in the UK involves adolescents from all ethnic groups, although there are some differences between ethnic groups in the prevalence of overweight. Indian males appear to be at increased risk of being overweight. There is no evidence of a simultaneous increase in underweight amongst this population overall, but Bangladeshi, Indian and Pakistani boys appear to be at increased risk of being underweight.     

Prevalence of overweight,obesity and low weight in the Czech child population up to 18 years of age in the last 50 years

Aim  The main purpose of the study was to analyze the changes in the prevalence of underweight, overweight, and obesity among Czech children and adolescents aged 3–18 within the last 50 years. The secondary purpose of the study was to determine the prevalence of overweight and obesity among children and adolescents in 2001 and compare it to the reference standards recommended by the International Obesity Task Force (IOTF). Subject and methods  Anthropometric data collected from nationally representative samples of 3–18-year-old children and adolescents in the Czech Republic in 1951, 1981, 1991, and 2001 were analyzed in the study. The prevalence of child overweight and obesity among Czech children using data from the most recent 2001 National Anthropological Survey was estimated using the 1991 Czech reference values and the IOTF standards. Results  There has been a gradual increase in the number of children in both extreme categories of BMI values in most age categories, including underweight (<10th percentile), overweight (>90th percentile), and obesity (>97th percentile) between 1951 and 2001. In both genders, the number of underweight children increased dramatically in the lowest age categories. At the same time, the rates of overweight and obesity increased among 6–11- and 11–15-year-old individuals. The prevalence of underweight has also increased among older adolescents. However, our study indicated that the 2001 prevalence of overweight/obesity among Czech adolescents, especially in older age categories and among girls, was lower compared to the 1991 reference values. Conclusion  Given the continuous increase in child obesity rates in the US and most of Europe, it is interesting that the prevalence of overweight and obesity has remained relatively low among children and adolescents in the Czech Republic. Given the increased number of Czech school-aged children with excess adiposity, a gradual rise in the prevalence of overweight and obesity among Czech adolescents could be expected.     

Prevalence and factors affecting underweight,overweight and obesity using Asian and World Health Organization cutoffs among adults in Nepal: Analysis of the Demographic and Health Survey 2016

ObjectiveThere is a little published data on prevalence and determinants of underweight, overweight and obesity among adults in Nepal. This study analysed the cross-sectional Nepal Demographic and Health Survey (NDHS) 2016 to obtain these using the World Health Organization (WHO) and Asian-specific cutoffs of body mass index (BMI).MethodsThe 2016 NDHS used a multistage cluster-sampling design to obtain data on major health indicators in Nepal. The BMI cutoffs for underweight was <18.5 kg/m². The BMI cutoffs for overweight/obesity as per the Asian and WHO classifications were ≥23, and ≥25 kg/m², respectively. After reporting the prevalence according to sex and background characteristics, multilevel logistic regression was conducted to estimate odds ratios.SubjectsThis analysis included 12,652 adults (5283 males and 7369 females) with a median age of 40 years (interquartile range [IQR]: 28–54).ResultsThe overall median BMI was 21.5 kg/m² (IQR:19.3–24.3). The overall prevalence of underweight was 16.7% (15.1% among males and 17.1% among females). The Asian-specific BMI cutoffs found the prevalence of overweight and obesity as 26.4% (27.4% among males and 25.6% among females) and 11.0% (7.7% among males and 13.3% among females), respectively. The WHO-recommended BMI cutoffs found 18.2% people overweight (16.7% among males and 19.3% among females) and 4.3% (2.5% among males and 5.6% among females) people obese. The prevalence and odds of extreme body weight categories (i.e., underweight, overweight and obesity) varied according to age, sex, education level, household wealth status, place, ecological zone and provinces of residence as per both recommended cutoffs. Overall, higher education level and wealth status were positively associated with overweight/obesity and inversely associated with underweight as per both cutoffs.ConclusionA large proportion Nepalese adults have either underweight, overweight or obesity, and could be at a greater risk of mortality and morbidity due to these extreme body weight categories. It is essential to address the factors or characteristics that are associated with the higher prevalence and likelihood of these extreme body weight categories to reduce the overall burden of underweight and overweight/obesity in Nepal.     

Body mass status of school children and adolescents in Kuala Lumpur, Malaysia

Lifestyle and disease patterns in Malaysia have changed following rapid economic development. It is important to find out how these changes have affected the nutritional status and health behaviour of the population, especially school children and adolescents. Therefore a survey on school children's and adolescents' health behaviours and perception in Kuala Lumpur was initiated. This paper only reports the observed body mass status of the school children. A total of 3620 school children were selected in this survey using the method of multi-stage sampling. The students were surveyed using pre-tested questionnaires while weight and height were measured by the research team in the field. Using the cut-off of BMI-for-age >or= 95th percentile and <5th percentile for overweight and underweight respectively, there were a total of 7.3% of overweight students and 14.8% of underweight students. When analysed by gender; 7.5% of boys and 7.1% girls were overweight, while 16.2% of the boys and 13.3% of the girls were underweight. The youngest age group (11 years old) had the highest prevalence of underweight as well as overweight. With increasing age, the prevalence of underweight and overweight decreased and more children were in the normal weight range. The overall prevalence of overweight among the three ethnic groups was similar. However the prevalence of underweight was highest among the Indian students (24.9%), followed by Malays (18.9%) and Chinese (9.5%) (P <0.001). The results showed that both the problems of under- and over-nutrition co-exist in the capital city of Malaysia. The promotion of healthy eating and physical activities is required to address the problems of under- and over-nutrition in order to build up a strong and healthy nation in the future.     

Use of BMI as a measure of overweight and obesity in a field study on 5-7 year old children

Summary Objective The present field study examines the use of BMI in comparison with estimates of percent fat mass to screen for overweight and obesity in children. Design Cross-sectional field study. Setting Four waves of children 1996–1999 at Kiel, North West Germany. Subjects A representative large sample of 2286 5–7 year old children representing 40 % of the total child population examined by school physicians within the same period in Kiel. Main outcome measures BMI was compared with anthropometric measures (TSF, BSF, SIF, SSF) and bioelectrical impedance analysis (BIA). The 90^th and 97^th BMI percentiles were used as cut offs for overweight and obesity, respectively. Results BMI reached a low sensitivity to identify overweight children when compared with the two estimates of % FM (0.60 to 0.78 for girls, 0.71 to 0.82 for boys, respectively). The specificity of BMI was 93 to 95 %. By contrast, BMI reached higher sensitivity to screen for obese children of 0.83 to 0.85 for boys and 0.62 to 0.80 for girls at a concomitant specificity of 0.95 to 0.98 for boys and 0.96 to 0.97 for girls as defined by assessment of body fat mass. Comparing nutritional status of overweight children classified as overweight or non overweight by BMI shows that BMI only identified obese but not-overweight children. Conclusion BMI can be used to screen for obese children. In contrast BMI has a poor sensitivity to screen for overweight children. Body composition analysis should be used to screen for children at risk of becoming obese. Received: 10 October 2001, Accepted: 21 December 2001     

Prevalence of coronary risk factors in healthy adult Kuwaitis

Obesity has been shown to be a serious health risk and is associated with a wide range of comorbid conditions, including diabetes mellitus, coronary heart disease (CHD), gall bladder disease, hypertension, osteoarthritis, and certain cancers. Studies in Kuwait and other Gulf States indicate that obesity is prevalent and may be increasing. Previous studies in Kuwait have mostly focused on the epidemiology of overweight and obesity in children, adolescents, and young adults. Relatively less is known about the prevalence of overweight and obesity and its correlates in older adults for whom obesity may be more closely related to CHD risk. The purpose of this study was to examine the prevalence of overweight and obesity in 9755 adult men and women and to determine the relationship of weight to other risk factors for chronic disease. For the first time we examine a sample of older Kuwaitis to explore the relationship between high BMI, hypercholesterolemia and hyperglycemia. One-third of adult Kuwaitis are obese (BMI > 30 kg/m²), 4.7% of Kuwaiti females have severe obesity (BMI >40 kg/m²). BMI, cholesterol, and glucose values increase with age across the life span. Older Kuwaitis have a greater constellation of risk factors for chronic diseases. The results of a multiple linear regression model in which cholesterol values were studied, controlling for age, BMI, blood glucose, and sex revealed that age, BMI and sex were significant predictors of cholesterol values. These results indicate that actions to reduce obesity, hypercholesterolemia, and hyperglycemia are needed.     

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,...     

Determinants of Overweight and Obesity in Affluent Adolescent in Surat City, South Gujarat region, India

Background:

Obesity is a major global burden. Low levels of physical activity, TV watching, and dietary pattern are modifiable risk factors for overweight and obesity in adolescent.

Objective:

The objective of this study was to determine risk factors for overweight and obesity among affluent adolescent, in Surat city in south Gujarat.

Design:

Cross sectional from July 2009 to April 2010.

Setting:

Two private schools with tuition fees more than Rs. 2000 per month, were selected randomly using a random table.

Participants:

The participants were adolescents, 12 to 15 years of age.

Data collection:

Pre-designed and pre-tested questionnaire was used to elicit the information about dietary history and physical activity.

Measurement:

Height and weight was measured and BMI was calculated. Overweight and obesity were assessed by BMI for age. Student who had BMI for age <85^th and <95^th percentile of reference population were classified as overweight and BMI for age <95^th percentile of reference population were classified as obese (IAP Growth Monitoring Guidelines for Children from Birth to 18 Year).

Result:

The overall prevalence of obesity and overweight was 6.55% and 13.9% (boys: 6.7% and 15.1%; girls 6.4% and 13.35%). Final model of multiple logistic regression analysis showed that important determinants of overweight and obesity were low levels of physical activity, watching television or playing computer games, and consuming junk foods, snacks and carbonated drinks.

Conclusion:

The magnitude of obesity and overweight among affluent adolescent of Surat city was found to be 6.55% and 13.9%, respectively. Low level of physical activity, watching TV or playing computer games, and dietary pattern predisposed the adolescent to overweight/obesity.     

Obesity among pre-adolescent and adolescents of a developing country (India)

There are very few reports from the developing world on the prevalence of obesity among children even though in developed countries it has reached epidemic proportions. The objective of this study was to determine the prevalence of obesity in pre-adolescent and adolescent children in a developing country (India) using WHO guidelines for defining obesity and overweight. This cross-sectional study was carried out on 2008 school-children aged 9-15 years. Approximately half the subjects belonged to a school attended by children of well to do families while the rest belonged to two schools from middle and lower socio-economic background. Weight and height were taken for all children and the body mass index (BMI) calculated. Children whose BMI was >85th percentile for age and sex were defined as overweight. Triceps skin fold thickness (TSFT) was measured for all overweight children and those with TSFT >90th percentile for age and sex were defined as obese. The overall prevalence of obesity and overweight was 11.1% and 14.2% respectively. The prevalence of obesity as well as overweight was higher in boys as compared to girls (12.4% vs 9.9%, 15.7% vs 12.9%). Prevalence of obesity decreased significantly with age, from 18.5% at 9 years to 7.6% at 14 years, rising at 15 years to 12.1%. Significantly more children from higher socio-economic status were obese and overweight than those from lower socio-economic status groups. No significant gender difference for obesity prevalence was seen among children from a less privileged background, however, amongst children from affluent families, significantly more boys were obese as compared to girls. Pediatric obesity is an emerging problem in developing countries, especially among higher socio-economic status groups. Significant gender disparity is seen, with boys of affluent background having a higher prevalence.     

Racial differences in the tracking of childhood BMI to adulthood

OBJECTIVE: The possibility that there are racial differences in the patterns of BMI (kilograms per meter squared) change throughout life has not been examined. For example, the high prevalence of obesity among black women could result from a higher prevalence of obesity among black girls or because normal-weight black girls experience larger BMI increases in adolescence or adulthood than do their white counterparts. Therefore, we examined the tracking of childhood BMI into adulthood in a biracial (36% black) sample. RESEARCH METHODS AND PROCEDURES: Five- to 14-year-old children (2392) were followed for (mean) 17 years. Childhood overweight was defined as BMI > or = 95th percentile, and adult obesity was defined as BMI > or = 30 kg/m(2). RESULTS: The tracking of childhood BMI differed between whites and blacks. Among overweight children, 65% of white girls vs. 84% of black girls became obese adults, and predictive values among boys were 71% (whites) vs. 82% (blacks). These racial differences reflected contrasting patterns in the rate of BMI change. Although the initial BMI of black children was not higher than that of white children, BMI increases with age were larger among black girls and overweight black boys than among their white counterparts. In contrast, relatively thin (BMI < 50th percentile) white boys were more likely to become overweight adults than were their black counterparts. DISCUSSION: These findings emphasize the black/white differences in BMI changes with age. Because of the adult health consequences of childhood-onset obesity, early prevention should be given additional emphasis.     

The prevalence of obesity and lifestyle behaviors of parents of youth with intellectual and developmental disabilities

BackgroundParents of youth with intellectual and developmental disabilities (IDD) may have a higher prevalence of overweight and obesity and poorer weight management behaviors compared to the general population.ObjectiveTo describe the prevalence of overweight/obesity and related socioeconomic and lifestyle factors including diet quality, physical activity, and reported health habits in parents of youth with IDD.MethodsWe assessed: BMI (kg/m²), moderate-to-vigorous physical activity (MVPA), fruit and vegetable intake (FVI), parental diet and physical activity habits, and socioeconomic characteristics. Associations of BMI on MVPA and FVI were assessed with Spearman's correlation; differences in BMI by parental diet and physical activity habits were assessed with Kruskall-Wallis tests; and the relationships of BMI to household income, race, and education were assessed with Kendall Tau-b and Mann Whitney U tests.ResultsData was obtained from 110 parents (97.3% female) who were study partners for their adolescents/young adults with IDD participating in a weight loss clinical trial. Approximately 81% of parents were overweight or obese (25.7% overweight, 55.1% obese), with 46.3% and 20% meeting the recommended U.S. guidelines for MVPA and FVI, respectively. Higher FVI and higher income were significantly associated with lower parent BMI. BMI was significantly lower in parents who reported to be physically active and choose healthy food.ConclusionWe observed a high prevalence of overweight/obesity, low FVI and low levels of MVPA in parents of adolescents with IDD. These observations suggest that interventions designed to address these factors have the potential to improve the health and wellbeing of both parents and adolescents with IDD.Clinical trials numberNCT02561754.     

Obesity and sleep disorders: A nationwide study of 1.3 million Israeli adolescents

ObjectivesTo assess the association between sleep disorders prevalence and obesity in Israeli adolescents.MethodsA nationwide, population-based, cross-sectional study of 1,348,817 Israeli adolescents (57% males) who were medically examined prior to military service between 1997 and 2015; height and weight were measured along with assessment of medical status at age 17.3⬰±⬰0.4 years. The diagnosis of a sleep disorder was made based on objective diagnostic criteria. The prevalence and odds ratio (OR) for a sleep disorder were computed across BMI subgroups and were adjusted for socio-demographic confounders.ResultsOverall sleep disorders prevalence was 1.8:1000 (males) and 0.45:1000 (females), with a total of 1601 cases. There was a gradual increase in the odds ratio for sleep disorders with increasing BMI. Multivariable-adjusted ORs for sleep disorders were 1.29 (95% CI 1.10⬜1.52), 1.44 (1.18⬜1.75), 3.03 (2.32⬜3.96) and 3.38 (1.98⬜5.75) for overweight, obese class I, II and III, respectively (5^th⬜49th BMI percentile was the reference). Results persisted in extensive sensitivity analyses including limiting the study sample to participants with unimpaired health.ConclusionsWe found a higher prevalence of sleep disorders in males and a dose-dependent association between sleep disorders and adolescent BMI in both sexes. Our findings warrant clinical awareness among healthcare providers, given the rise in obesity in teenagers, and particularly in light of the obesity epidemic that we are experiencing in this era. Sleep related complaints should be actively screened in adolescents who suffer obesity.     

Trends in Body Mass Index among Ohio's Third-Grade Children: 2004-2005 to 2009-2010

Substantial variation across states in the prevalence and trends in childhood overweight and obesity indicate a need for state-specific surveillance to make state comparisons to national estimates and identify high-risk populations. The purpose of this study was to examine body mass index (BMI) trends among third-grade children in Ohio between the 2004-2005 and 2009-2010 school years and examine changes in prevalence of obesity by specific demographic subgroups. Third-grade children (n=33,672) were directly weighed and measured throughout the school years by trained health care professionals. Trends in overweight/obesity (≥85th percentile of BMI by age/sex), obesity (≥95th percentile), and obesity level 2 (≥97th percentile) over five time periods (2004-2005, 2006-2007, 2007-2008, 2008-2009, 2009-2010) were modeled using logistic regression, accounting for the survey design and adjusting for sex, race/ethnicity, National School Lunch Program (NSLP) participation, and age. Differences in these BMI categories were also examined by these subgroups. BMI estimates did not demonstrate a statistically significant trend over the five time periods for overweight/obesity (34% to 36%), obesity (18% to 20%), or obesity level 2 (12% to 14%). However, increases in overweight/obesity prevalence were found in Hispanic children (37.8% vs 53.1%; P<0.01). Decreases in obesity (16.6% vs 14.1%; P=0.02) and obesity level 2 (11.3% vs 9.3%; P=0.02) were found among children not participating in NSLP and residing in suburban counties (obesity [17.3% vs 14.7%; P=0.03] and obesity level 2 [11.8% vs 9.8%; P=0.05]). Finally, decreases in overweight/obesity and obesity level 2 among boys were observed (15% vs 12.9%; P=0.02). Despite no significant overall trends in overweight/obesity, obesity, or obesity level 2 between 2004 and 2010, prevalence changed among specific subgroups. Obesity prevention efforts should be widespread and include special emphasis on groups experiencing increases or no change in prevalence.     

Associations of behavioural, psychosocial and socioeconomic factors with over- and underweight among German adolescents

OBJECTIVES: The prevalence of overweight and obesity has dramatically increased in western societies. This paper examines behavioural, psychosocial and socioeconomic factors associated with overweight and underweight among adolescents in Germany. METHODS: Data from the German part of the 2001/02 Health Behaviour in School-aged Children (HBSC) survey, composed of 5,650 respondents aged 11 to 17 years were analysed. Body mass index (BMI) was calculated based on self-reported weight and height. The overweight category was defined as BMI within or above the 90th percentile of specific BMI values for gender and age in the German national sample. The underweight category was defined as BMI within or below the 10th percentile of this sample. A multinomial logistic regression model was used to investigate the association between behavioural, psychosocial and socioeconomic factors and BMI categories. RESULTS: 9.5 % of the boys and 5.4 % of the girls were classified as overweight. The prevalence of underweight was 12.6 % among boys and 19.1 % among girls. Several factors were associated with over- and/or underweight in the bivariate analysis, showing different patterns for gender and BMI categories. In the multivariable model only low family affluence, high sedentary behaviour, and being bullied (for girls only) remained positively associated with being overweight. Being underweight was negatively associated with higher age and low parental occupation; it differed also by region. CONCLUSION: Despite several variables being associated with overweight and underweight in bivariate models, only three factors remained associated with overweight in multivariable analysis. Other considered variables did not have independent associations with the outcome, but still could be included in respective causal pathways. Our results suggest that preventive strategies focussing on students of low socio-economic status and the avoidance of sedentary behaviours could help to address issues of overweight and obesity.     

Overweight and obesity at school entry as predictor of overweight in adolescence in an Arctic child population

BACKGROUND: The aim of this study was to analyse the changes in the prevalence of overweight, obesity, and in mean body mass index (BMI) among school children, and to analyse the predictive value of overweight and obesity at school entry to overweight and obesity in adolescence in an Arctic child population. METHODS: Retrospective cohort study. A database was created on the basis of files from health examinations. Data on children aged 5-7 years and 13-17 years and the subsample of children followed from school entry to adolescence was analysed. RESULTS: During the years 1972-2002 the prevalence of overweight and obesity increased significantly, and mean BMI rose by 5.6% at school entry and by 4.7% in adolescence. Sensitivity and specificity: Of the children being obese in adolescence, 56.3% were already obese at school entry; for the overweight children, 50.6% were also overweight or obese at school entry. Of the children with normal weight in adolescence, 91.9% were also normal weight at school entry. The positive predictive value of being overweight or obese combined at school entry was 59.5%, i.e. more than every second retained their overweight or obesity in adolescence. Only 10% of the obese school entry children had gained normal weight in adolescence. The negative predictive value for normal weight children at school entry was 91.3%. CONCLUSION: The study showed that during 30 years from 1972, overweight and obesity among school children in Greenland have increased dramatically. Overweight and obesity at school entry were shown to be a good predictor of overweight or obesity in adolescence.