Prevalence of overweight in north Florida elementary and middle school children: effects of age, sex, ethnicity, and socioeconomic status

BACKGROUND: The number of overweight children has been rapidly increasing, although its prevalence varies by age, sex, ethnicity, and socioeconomic (SES) status. METHODS: Height and weight assessments were used to calculate body mass index (BMI) and BMI percentile on more than 17,000 children in 1 north Florida school district's elementary and middle schools. Based on the child's BMI percentile, each child was placed into 1 of 4 groups: underweight, normal, at risk for overweight, and overweight. Logistic regression was used to test the relative contribution of sex, ethnicity, school (elementary vs middle), age, and SES (indicated by free/reduced vs full-pay lunch status) to a child's weight classification. RESULTS: Overall, 36.2% of the children were either overweight (18.9%) or at risk for overweight (17.4%). Approximately 30% of the kindergarten children were overweight (14.0%) or at risk for overweight (15.5%). African American children were most likely to begin kindergarten overweight. The prevalence of overweight increased for all ethnic groups during the elementary school years. However, African American girls and Hispanic boys were more likely to be overweight than any other ethnic group; Asian girls were least likely to be overweight. These findings could not be readily explained by the effects of SES. Higher SES appeared to be protective but only for white and Hispanic children. CONCLUSIONS: These results confirm the increasing prevalence of overweight in US school children, especially among African American girls and Hispanic boys.     

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.     

Association between overweight or obesity and household income and parental body mass index in Australian youth: analysis of the Australian National Nutrition Survey, 1995

This study is a secondary data analysis based on the 1995 Australian National Nutrition Survey (NNS). A random subsample of 1581 school children aged 7-15 years old from the NNS was studied. The results show the prevalence of overweight, obesity and combined overweight and obesity was 10.6-20.9%, 3.7-7.2% and 15.6-25.7%, respectively. The odds ratio of overweight or obese boys with highest household income was significantly smaller than those with the lowest household income. The proportion of combined overweight and obesity in children whose parents were overweight or obese was significantly greater compared with those whose parents were not. The trend of increasing prevalence of overweight or obesity among children with increasing parental body mass index (BMI) was significant after adjusting for age except the trend of father's BMI for boys. This study provided baseline data on the recent prevalence of overweight or obesity of Australian school children using new international absolute BMI cut-off points. It indicated that young school girls (7-9 years) were more likely to be overweight or obese compared with boys, the prevalence rates of overweight or obesity in older boys (13-15 year) was significantly greater than in other age groups while in girls it was the opposite. The boys with lowest household income ($0-17 500) were more likely to be overweight or obese compared with those with the highest household income (greater than $67 500). Having parents especially mothers who were overweight or obese may increase the risk of children being overweight or obese.     

Are American children and adolescents of low socioeconomic status at increased risk of obesity? Changes in the association between overweight and family income between 1971 and 2002

BACKGROUND: A good understanding of the association between obesity and socioeconomic status (SES) has many important public health and policies implications, particularly for the prevention and management of obesity. OBJECTIVE: The objective was to examine secular trends in the relations between overweight (body mass index > or = 95th percentile) and SES. DESIGN: We examined secular trends in the relation between overweight and SES using nationally representative data collected in the National Health and Nutrition Examination Surveys (NHANES) between 1971 and 2002 for 30 417 US children aged 2-18 y. Poverty income ratio tertiles at each survey were used to indicate low, middle, and high SES. RESULTS: Considerable race, sex, and age differences were observed in the association between overweight and SES. A reverse association only existed in white girls; African American children with a high SES were at increased risk. Socioeconomic disparities in overweight have changed over time, with an overall trend of weakening. Compared with the medium-SES group, the adjusted odds ratios and 95% CIs were 0.79 (0.47, 1.33), 1.08 (0.73, 1.61), 1.24 (0.73, 2.09), and 1.04 (0.82, 1.33) in NHANES I, II, and III and in the 1999-2002 NHANES for the low-SES group and 0.66 (0.43, 1.00), 0.60 (0.35, 1.03), 0.42 (0.23, 0.76), and 0.99 (0.68, 1.43) for the high-SES group, respectively. Between 1988-1994 and 1999-2002, the ratio in the prevalence of overweight between adolescent boys with a low or high SES decreased from 2.5 to 1.1 and from 3.1 to 1.6 in girls. Consistently across almost all SES groups, the prevalence of overweight was much higher in blacks than in whites. CONCLUSIONS: Complex patterns in the association between SES and overweight exist. Efforts solely targeting reductions in income disparities probably cannot effectively reduce racial disparities in obesity.     

Childhood Asthma and Extreme Values of Body Mass Index: The Harlem Children’s Zone Asthma Initiative

To examine the association between body mass index (BMI) percentile and asthma in children 2-11 years of age, we performed a cross-sectional analysis of 853 Black and Hispanic children from a community-based sample of 2- to 11-year olds with measured heights and weights screened for asthma by the Harlem Children's Zone Asthma Initiative. Current asthma was defined as parent/guardian-reported diagnosis of asthma and asthma-related symptoms or emergency care in the previous 12 months. Among girls, asthma prevalence increased approximately linearly with increasing body mass index (BMI) percentile, from a low of 12.0% among underweight girls (BMI 95th percentile). After adjusting for age, race/ethnicity, and household smoking, among girls, having asthma was associated with being at risk for overweight (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.4-5.0) and being overweight (OR, 2.1; 95% CI, 1.2-3.8) compared to normal weight; among boys, having asthma was associated both with overweight (OR, 2.4; 95% CI, 1.4-4.3) and with underweight (OR, 2.9; 95% CI, 1.1-7.7). Large, prospective studies that include very young children are needed to further explore the observed association between underweight and asthma among boys. Early interventions that concomitantly address asthma and weight gain are needed among pre-school and school-aged children.     

Prevalence of overweight and associated factors in southern Brazilian adolescents

OBJECTIVE: The aim of this study was to determine the prevalence of overweight in adolescents in a southern Brazilian city, and ascertain gender differences and association with socio-economic and demographic conditions, family factors and individual behaviours. METHODS: Cross-sectional population-based study with random cluster sampling of households, including 722 adolescents (10-19 years), from a city in southern Brazil. Body mass index (BMI) was calculated based on the National Center for Health and Statistics reference curve, defining overweight as BMI 85th percentile. RESULTS: Prevalence of overweight was 17% in girls and 19% in boys. In multivariate Poisson regression, chronic illness in parent(s) and household of up to four people were associated with overweight in boys, whereas low fibre intake, more hours spent watching television and regular exercise were associated with overweight in girls. CONCLUSION: The prevalence of overweight in Brazilian adolescents is high, with gender differences in associated factors. Health workers in schools and public health services should be aware of these differences in order to improve preventive and therapeutic strategies in this age group.     

Socio-economic status and body mass index in low-income Mexican adults

The study reported here explored the associations of body mass index (BMI), socio-economic status (SES), and beverage consumption in a very low-income population. A house-to-house survey was conducted in 2003 of 12,873 Mexican adults. The sample was designed to be representative of the poorest communities in seven of Mexico's 31 states. Greater educational attainment was significantly associated with higher BMI and a greater prevalence of overweight (25 < or = BMI<30) and obesity (30 < or = BMI) in men and women. The combined prevalence of overweight and obesity was over 70% in women greater than the median age of 35.4 years with at least some primary education compared with a prevalence of 45% in women below the median age with no education. In both sexes, BMI was positively correlated with education, occupation, quality of housing conditions, household assets, and subjective social status. BMI and household income were significantly correlated in women but not in men. In the models including all SES variables, education, occupation, housing conditions and household assets all contributed independently and significantly to BMI, and household income and subjective social status did not. Increased consumption of alcoholic and carbonated sugar beverages was associated with higher SES and higher BMI. Thus, in spite of the narrow range of socio-economic variability in this population, the increased consumption of high calorie beverages may explain the positive relationship between SES and BMI. The positive associations between SES and BMI in this low-income, rural population are likely to be related to the changing patterns of food availability, food composition, consumption patterns and cultural factors. Contextually sensitive population-level interventions are critically needed to address obesity and overweight in poor populations, particularly in older women.     

Parental overweight as an indicator of childhood overweight: how sensitive?

This study determined the sensitivity and specificity of parental overweight from self-reported height and weight to identify families with overweight school age children. A cross sectional study was conducted among 3059 parents and their children (1558 boys and 1501 girls) aged 7-12 years in five primary schools of Busan, Korea. BMI was calculated from parental reported height and weight and from children's measured height and weight. Parents were considered overweight when their BMI was >25 kg/m2 (WHO, 2000). Children were considered overweight when their BMI was >95th percentile (CDC, 2000). Prevalence of overweight was calculated and logistic regressions were performed. The sensitivity and specificity of parental overweight were calculated. A total of 26% (805/3059) parents were overweight. Of the families with one overweight parent, 15% (N = 109) had an overweight child. When both parents were overweight, 17% (N = 9) had an overweight child. After adjusting for child's age and gender, parental education, family income, and spouse's BMI as required, the odds of having an overweight child were 2.5 [1.8, 3.3] for one overweight parent, and 3.2 [1.4, 7.1] for both overweight parents. While the sensitivity of one overweight parent to identify families with overweight school age children was 44%, specificity was 75%. The presence of both overweight parents provided a 3% sensitivity and 98% specificity for the identification of an overweight school age child. Although parental overweight was obtained from self-reported weight and height in Busan (Korea), it is a practical indicator to identify families with an overweight school age child, it has poor sensitivity.     

Prevalence and correlates of binge eating in white and African American adolescents

OBJECTIVE: This study examined the prevalence and correlates of binge eating in a biracial sample of adolescent males and females. METHOD: White and African American students in Grades 6-12 (N=822) completed measures of social economic status (SES), body mass index (BMI), depression, current-ideal body image discrepancy, eating attitudes, dieting frequency, dietary intake, and activity level. RESULTS: Binge eating prevalence was highest among African American boys relative to the other demographic groups: 26% African American boys, 17% African American girls, 19% white boys, 18% white girls. Binge eating rates increased with age for white participants and decreased with age for African American participants. Depressive symptoms and consumption of high-fat foods predicted binge status among adolescents, whereas SES, BMI, eating attitudes, body image discrepancy, dieting, and low activity level failed to add predictive value. DISCUSSION: The observation of developmental differences in binging between whites and African Americans corresponds to their physical maturational divergence. These findings underscore the need for population-based surveys that sample binge eating across age, gender, and ethnicity.     

Dietary factors and body mass index in a group of Iranian adolescents: Tehran lipid and glucose study--2

OBJECTIVE: To study the prevalence of overweight and obesity in an adolescent population in Tehran and to determine possible association with energy and nutrient intake and distribution of energy over the day. METHOD: A cross-sectional study on 177 boys and 244 girls between 10-19 years old was performed. Overweight and obesity were defined by using recommended body mass index (BMI) cut-off values for adolescents. Total energy intake, percent of energy derived from protein, carbohydrate and fat and percent of energy supplied by each meal and snack were assessed by means of two 24-hour dietary recalls. RESULTS: Prevalence of overweight and obesity was 10.7 and 5.1 in boys and 18.4 and 2.8 in girls, respectively. The composition of diet was not different between overweight/obese and normal weight subjects. BMI was related with breakfast energy percentage in girls (r = -0.18, p < 0.01), with total energy intake in boys (r = 0.23, p < 0.01), and with lunch energy percentage in both sexes. In boys (r = 0.16, p < 0.05) and in girls (r = 0.22, p < 0.01). CONCLUSION: High prevalence of overweight and obesity among adolescents was seen. In boys some relationship between total energy intake, distribution of energy over the day and BMI was seen. In girls BMI was only related with distribution of energy over the day.     

Waist-hip ratio and waist circumference associated with body mass index in a study with schoolchildren

The objectives of this study were to determine the percentile levels of the anthropometric indices body mass index (BMI), waist-hip ratio (WHR), and waist circumference (WC) and to verify possible correlations among theses indices in schoolchildren registered at the State Institute of Education, Florianópolis, Santa Catarina State, Brazil. A total of 419 children ages 7 to 9 years were investigated: 215 (51.3%) boys and 204 (48.7%) girls. BMI, WHR, and WC were higher for boys than for girls. However, the differences were only statistically significant for WHR and WC. Prevalence rates were 17.9% for overweight and 6.7% for obesity. The anthropometric indices with the highest correlation were BMI and WC (r = 0.87 and p < 0.01). For overweight, BMI and WC also presented the strongest correlation (r = 0.74). For obesity, WHR and WC showed the best correlation (r = 0.54).     

Association between household income and overweight of Korean and American children: trends and differences

The prevalence of overweight in children has been dramatically increasing worldwide, and socioeconomic status is an important risk factor. The purpose of this study was to examine the hypothesis that household income is negatively associated with overweight in Korean and American girls and boys. In the study, 2117 children 7 to 12 years of age from the Korean National Health and Nutrition Examination Survey between 2001 and 2007 and 3016 children from the US National Health and Nutrition Examination Survey between 2001 and 2006 were included. Overweight is defined as the sex- and age-specific body mass index cutoffs recommended by the International Obesity Task Force. Lower household income significantly increased the risk for overweight in Korean boys, irrespective of adjustments. The negative association between household income and overweight of American boys disappeared after adjusting for the frequency of dining out and TV viewing time. There was no significant association between household income and overweight of Korean and American girls. As household income increased, the intake of energy from protein was increased, but energy from carbohydrates was decreased in Korean boys. On the other hand, as household income increased, energy intake from carbohydrates was increased and energy intake from proteins decreased in American boys. In conclusion, positive association between household income and overweight was found in Korean boys, but not in Korean girls and American boys and girls. Effects solely targeting reduction in income disparities cannot effectively reduce sex disparities in overweight of children.     

Impact of parental BMI on the manifestation of overweight 5–7 year old children

Summary Background There is an increase in the prevalence of overweight and obese children. Genetic and environmental factors are contributing factors but the influence of parental nutritional state on early manifestation of overweight is not well characterised. Aim of the study To systematically investigate the impact of parental BMI on the manifestation of overweight in 5 to 7 year old children. Methods Cross-sectional study (as a part of the Kiel Obesity Prevention Study [KOPS]) of 3306 children aged 5–7 years and their parents. The nutritional state of the children (BMI, triceps skinfold, fat mass, prevalence of overweight) was investigated in subgroups differing with respect to parental BMI. Results BMI of the children was significantly correlated with parental BMI (r = 0.272, p < 0.01). Children's BMI showed closer associations with maternal than with paternal BMI (r = 0.254 vs. 0.159, p < 0.01). A multivariate regression analysis showed that parental BMI explained 7.6 % of the variance in children's BMI. OR for overweight was elevated in children with at least one overweight parent (overweight mother: OR 2.9 (boys)/3.1 (girls); overweight father: OR 1.8 (boys)/2.4 (girls). OR was highest for children with two obese parents (OR 7.6 (boys)/6.3 (girls). Children with one obese parent were more frequently overweight than children with one overweight parent. Conclusions Parental BMI showed only a weak correlation with the BMI of their children. However, children's risk of becoming overweight increased with parental overweight and obesity. Thus, familial disposition has to be taken into account to identify risk groups for preventive measures. Received: 5 February 2002, Accepted: 2 May 2002     

Psychosocial, school, and parent factors associated with recent smoking among early-adolescent boys and girls

BACKGROUND: Experimentation with smoking often begins during adolescence, but an adequate understanding of the factors associated with early initiation remains elusive. METHODS: Sixth- to eighth-grade students (n = 4,263, 67.1% white, 23.5% black, 7.2% other) from seven middle schools were surveyed. RESULTS: The overall prevalence of recent smoking (past 30 days) of 10.4% was similar for boys and girls and by race, but increased from 3.7% in sixth to 17.8% in eighth grade. In multiple logistic regression analyses positive outcome expectations, high perceived prevalence, deviance acceptance, and trouble at school were independently associated with smoking for both boys and girls. Among boys, problem-behaving friends, peer pressure, authoritative parenting, and mother's education and among girls, self-control problems, knowledgeable parents, and grade were independently associated with smoking. CONCLUSIONS: This is one of the few studies to report an independent association between smoking and outcome expectations, the first study to report an independent effect for peer influences among boys only, and one of several to find a negative association between smoking and positive parenting behavior. These findings suggest that the effectiveness of preventive interventions might be improved by targeting parent, school, and student outcomes, including outcome expectations, deviance acceptance, and social norms for both boys and girls, peer influences among boys, and self-control among girls.     

合肥市某中学超重、肥胖与不同性别初中学生心理健康水平的相关性

目的了解超重、肥胖与男女初中学生生活满意度、抑郁、焦虑、自我意识水平之间的相关性。方法对象为合肥市某中学1818名初一和初二学生,用多维学生生活满意度量表、流行病学调查中心用抑郁量表、特质焦虑量表和儿童自我意识量表及相应的评价标准进行心理健康评定,同时测量身高、体重,计算体重指数(BMI)值。参考中国儿童青少年超重和肥胖筛查BMI值分类标准进行分组,分析男女生及体重正常、超重、肥胖组学生心理健康状况的差异以及男女生BMI与4个量表评分的相关性。结果男生超重和肥胖检出率(21．5%和7．7%)显著高于女生(8．0%和2．8%)。体重正常组生活满意度评分的性别差异有统计学意义(P=0．002),超重组抑郁评分的性别差异有统计学意义(P=0．046)。在女生中,体重正常、超重和肥胖3组的抑郁、特质焦虑和自我意识评分的差异均有统计学意义(P＜0．05),肥胖组抑郁和焦虑评分显著高于体重正常组(P=0．012和P=0．035),肥胖组自我意识评分低于体重正常组(P=0．014),超重组抑郁评分高于体重正常组(P=0．025)。结论超重、肥胖检出率女生低于男生,但女生超重和肥胖者心理健康水平与体重正常者的差别较男生明显。     

Trajectories of Overweight Among US School Children: A Focus on Social and Economic Characteristics

Much of the research examining the patterns, timing, and socioeconomic characteristics of child overweight has been limited by the lack of longitudinal nationally representative data with sufficiently large or diverse samples. We used the Early Childhood Longitudinal Study-Kindergarten Cohort (ECLS-K), a nationally representative sample of US kindergartners, to identify three distinct patterns of weight gain from kindergarten through eighth grade. The largest group (boys: 59%, girls: 55%) was characterized as having consistently normal weight whereby BMI percentile remained below the 85th percentile. The remaining children (boys: 41%, girls: 45%) fell either into a class characterized as always overweight/at risk of overweight (boys: 27%, girls: 25%) or gradually becoming overweight/at risk for overweight (boys: 15%, girls 20%). We found some evidence that the relationship between socioeconomic status and children’s health may operate differently across gender. Among girls, low parental income and education were both significant risk factors for the gradual onset of overweight after beginning Kindergarten. Parental income or changes in parental income were not related to boys’ risk of developing overweight after entering Kindergarten; only parents’ education. We found that while children of immigrants display higher levels of overweight/at risk for overweight at each grade level, the children of immigrant parents who have had less exposure to the US were more likely to experience early and sustained overweight throughout elementary and middle school, particularly among boys. High rates of overweight as early as kindergarten, combined with race/ethnic differences suggest that interventions should focus on pre-school children’s environments.     

Obesity and socioeconomic status in children of Tijuana

BACKGROUND: Although obesity has been associated with socioeconomic status among Hispanics living in the United States, little is known about whether a similar association exists among Hispanics living in Mexico, particularly among those living along the U.S.-Mexico border. OBJECTIVE: To determine the prevalence of obesity and its association with socioeconomic status in Mexican schoolchildren attending public and private schools in Tijuana, Baja California. METHODS: Anthropometric measurements and socioeconomic status were assessed in a cross-sectional study of 1172 school children, aged 6 to 13 years from 55 schools in Tijuana in 2001-2002. Underweight (body mass index [BMI] for age 5th percentile or lower), risk of overweight (BMI at 85th percentile or higher), and overweight (BMI greater than 95th percentile) were assessed using charts published by the Centers for Disease Control and Prevention. RESULTS: Abnormalities in weight were found in 46.3% of 587 boys and 43.7% of 585 girls in the study. Undernutrition was found in 3.7% of the boys and 3.8% of the girls. The general prevalence of overweight was 23.2% for boys and 21.7% for girls. Children living in low-income neighborhoods had the thickest biceps skinfolds (p<0.01), while children living in moderate-income neighborhoods and attending public schools had the thickest triceps skinfolds (p<0.001). Although boys living in high socioeconomic status neighborhoods were at decreased risk for being overweight, boys and girls attending private schools had a 75% increased risk (odds ratio, 1.75; confidence interval, 1.22-2.52) of being overweight than children attending public schools. CONCLUSIONS: Adiposity varies by type of school and neighborhood socioeconomic status. The biphasic curve in risk for being overweight associated with neighborhood socioeconomic status suggests that Mexican children living along the U.S. border may be experiencing a nutrition transition with respect to an increased risk of obesity and related chronic disease.     

Parental correlates of physical activity in a racially/ethnically diverse adolescent sample.

PURPOSE: To evaluate relationships between parents' and adolescents' physical activity and television usage and whether these relationships differed among adolescents from different racial/ethnic backgrounds. METHODS: Adolescents and their parents were separately asked to report information about their eating, exercising, and weight-related behaviors. Among the 900 adolescents, 477 were girls and 423 were boys; 60% were in high school; 29% were white, 23% were black, 21% were Asian, 14% were Hispanic, and 13% were considered mixed or other race/ethnicity. RESULTS: Parents' reported encouragement was positively related to physical activity in white (r = 0.39; p <.001) and black boys (r = 0.26; p =.007), and girls (all race/ethnic groups combined: r = 0.15; p <.001). Parents' television time was positively related to television time in Hispanic boys (r = 0.40; p =.009) but negatively related to television time in black boys (r = -0.23; p =.036). Parents' concern about their own fitness was negatively related to television time in white girls (r = -0.19; p =.029) but positively related in black girls (r = 0.23; p =.030). CONCLUSION: This study found significant, although modest, relationships between parents' and adolescents' physical activity attitudes and behaviors. Many of these relationships differed by race/ethnicity. Results from the present and previous studies suggest that factors other than parents' behavior and support explain adolescents' physical activity behaviors.     

Opposing socioeconomic gradients in overweight and obese adults

Objective: Investigate the relationship between socioeconomic status (SES) and prevalence of overweight and/or obesity, by sex, using total annual household income as the indicator of SES and the World Health Organization (WHO) recommended ranges of self‐reported Body Mass Index (BMI) as the indicator of overweight and/or obesity. Methods : Total annual household income and BMI data were obtained from the Victorian Population Health Survey (VPHS), an annual computer‐assisted telephone survey of the health and well‐being of Victorian adults aged 18 years and older. Statistical analysis was conducted using ordinary least squares linear regression on the logarithms of age‐standardised prevalence estimates of overweight (25.0–29.9 kg/m²), obesity (≥30.0 kg/m²), and overweight and obesity combined (≥25.0 kg/m²), by income category and sex. Results: Typical SES gradients were observed in obese males and females, where the prevalence of obesity decreased with increasing income. No SES gradient was observed in overweight females, however, a reverse SES gradient was observed in overweight males, where the prevalence of overweight increased with increasing income. Combining the overweight and obesity categories into a single group eliminated the typical SES gradients observed in males and females for obesity, and resulted in a statistically significant reverse SES gradient in males. Conclusions: Combining the BMI categories of overweight and obesity into a single category masks important SES differences, while combining the data for males and females masks important sex differences. BMI categories of overweight and obesity should be analysed and reported independently, as should BMI data by sex.     

Effect of work related variables on growth among working boys in Jordan

OBJECTIVE: To study the effect of work related variables on the height, weight, and body mass index (BMI) of working boys aged 10-16 years. DESIGN: Cross sectional survey. SETTING: Irbid, Jarash, and North Jordan Valley in Jordan. PARTICIPANTS: 135 working boys aged 10-16 years and their mothers. OUTCOME MEASURES: Height for age z score; weight for age z score; BMI for age z score. RESULTS: In bivariate analysis, child's duration of work (r=-0.20), maternal height (r=0.26), and household per capita income (r=0.23) were significantly correlated with height for age z score and duration of work (r=-0.24), maternal height (r=0.24), and household per capita income (r=0.19) with weight for age z score. Duration of work (p<0.001), child's monthly income (p=0.044), maternal height (p=0.002), and household per capita income (p=0.005) were retained in the regression model fitted on height z score that explained 20.1% of the variance. The regression model fitted on weight z score explained 20.1% of the variance and duration of work (p<0.001), child's monthly income (p=0.022), household per capita income (p=0.017), and maternal height (p=0.004) were retained. Only duration of work (p=0.001) was retained in the model fitted on BMI for age z score. CONCLUSION: The results of this study suggest that the length of time children have been working and low monthly income have a detrimental effect on growth of working boys independent of the effects of low household per capita income and small maternal stature. Relevance of these findings for social policy and health care of working boys in Jordan and elsewhere is discussed.