Relationship between obesity and school absenteeism in Australian children: Implications for carer productivity

BackgroundEconomic evaluations of childhood obesity interventions are often used to assist decision making when presented with alternative course of action. Including indirect costs related to productivity losses is recommended; in children this would include school absenteeism. Our aim was to determine the association between school absenteeism and weight status among Australian children and estimate the indirect costs of this.MethodsWe used data from a nationally representative sample of 8551 Australian children in the Longitudinal study of Australian Children (LSAC) with follow-up between 2006 and 2018. A mixed-effects negative binomial regression model was used to investigate the relationship between school absenteeism and weight status, controlling for age, sex, socio-economic position, indigenous status, rural/remote status and long-term medical conditions. We used average daily wages for the year 2018 to value the indirect costs of school absenteeism (through caregiver lost productivity).ResultsAustralian children with obesity aged 6−13 years missed on average an extra day of school annually compared to children of a healthy weight (p = 0.004), while adolescents with obesity aged 14−17 years missed on average an extra 0.69 days of school annually (p = 0.006). The estimated national cost for children with obesity aged 6−13 years was approximately $64 million AUD ($43 million USD) or $338 AUD ($230 USD) per child through caregiver lost productivity in 2018.ConclusionsThere is a small but significant association between school absenteeism and childhood obesity in Australia which is estimated to generate a considerable national cost through caregiver productivity losses. Our results will assist health economists evaluating childhood obesity interventions capture the full extent of the associated costs with this condition.     

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.     

青少年超重肥胖及校园欺凌与抑郁的关系研究

目的 了解青少年超重肥胖及校园欺凌对抑郁的联合作用,为防控青少年抑郁提供科学证据。方法 2020年于自贡市进行一次横断面调查,共调查三个区两个县的11所中学。对所有研究对象进行抑郁、校园欺凌等问卷调查和身高、体重等体格测量。使用多重线性模型和logistic模型在控制协变量后分析超重肥胖与校园欺凌的联合作用与抑郁的关系。结果 3 022名青少年（51.8%男性;平均年龄14.5岁）纳入本研究,超重肥胖率为17.3%,校园欺凌率为20.2%,抑郁平均得分为11.8,抑郁倾向占比25.6%。超重肥胖青少年相对于体重正常青少年其受到校园欺凌的可能性更高（23.3% vs 19.5%,P = 0.046）。相对于无超重肥胖且未受到校园欺凌的青少年,无超重肥胖但受到校园欺凌的青少年和超重肥胖且受到校园欺凌的青少年抑郁得分更高（β = 3.88,P＜0.001; β = 5.04,P＜0.001）、抑郁倾向更明显（OR = 2.37,95%CI:1.88～2.98,P＜0.001;OR = 3.11,95%CI:2.07～4.65,P＜0.001）;超重肥胖但未受到校园欺凌的青少年的抑郁得分和抑郁倾向无差异。无超重肥胖且未受到校园欺凌、超重肥胖但未受到校园欺凌、无超重肥胖但受到校园欺凌、超重肥胖且受到校园欺凌四组抑郁的患病风险呈上升趋势（OR = 1.49,95%CI:1.35～1.63,P＜0.001）。结论 需关注超重肥胖青少年的校园欺凌现象,以预防其出现抑郁倾向。     

Obesity and other predictors of absenteeism in Philadelphia school children

BACKGROUND: Limited data indicate that obese children are absent from school more than their normal‐weight peers. We analyzed administrative data from a large urban school district to investigate the association of obesity and student sociodemographic characteristics with absenteeism. METHODS: We analyzed 291,040 records, representing 165,056 unique students (grades 1‐12). Obesity status was classified according to Centers for Disease Control and Prevention age‐ and sex‐specific percentiles for body mass index (BMI) and analyses were based on negative binomial regression. RESULTS: Overall rates of overweight and obesity were 17% and 20%, respectively, and the estimated absence rate was 17 absences per 180 student‐days. Obesity was weakly associated with increased school absences. The association was present mainly among the most obese students (BMI >99th percentile), who had an 11% greater absence rate compared to normal‐weight students. Compared to white students, Hispanics and African Americans had higher absence rates (14% and 10%, respectively), and Asians had lower absence rates (43%). Students eligible for free or reduced‐cost meals had 24% higher absence rates than those who were not eligible. CONCLUSIONS: Overweight and obesity do not seem strongly associated with school absence, except among extremely obese children. Race and poverty appear to affect absences to a greater extent than overweight and obesity. Additional research is needed to investigate the contribution of contextual factors in schools and neighborhoods. This study suggests that data routinely collected in schools could be used to track childhood obesity and to efficiently evaluate public health interventions designed to decrease childhood obesity.     

Overweight and Obesity Between Adolescence and Young Adulthood: A 10-year Prospective Cohort Study

ObjectivesTo assess changes in overweight and obesity between adolescence and young adulthood.DesignProspective 8-wave cohort study in Victoria, Australia, with 1,520 adolescents tracked from the age of 14 for a period of 10 years.Main outcome measuresParticipants aged <18 years were classified as non-overweight, overweight, or obese according to International Obesity Taskforce cutoff points. In those aged >18 years overweight was defined as a body mass index (BMI) ≥25; and obesity as a BMI ≥30.ResultsThe proportion of overweight individuals increased from 20% in mid-adolescence to 33% at the age of 24 years. Obesity increased from 3.6% to 6.7%. Approximately 40% of young adults with a BMI ≥25 had been persistently at normal weights during adolescence and approximately 80% had been at a normal weight at some point. Around half of obese young adults had never been classified as obese as adolescents. No individual with persistent obesity in adolescence had a BMI <25 at 24 years. A total of 31% of females and 59% of males who had been overweight for only one or two waves of adolescent data collection had a BMI ≥25 at 24 years.ConclusionsSubstantial shifts in overweight and obesity occur between adolescence and young adulthood; the extent of continuity depends on both the severity and persistence of adiposity in adolescence. Few adolescents who peak into obesity or are persistently overweight achieve a normal weight in young adulthood. Resolution is more common in those who are less persistently overweight as teenagers, suggesting scope for lifestyle interventions in this subgroup.     

开封市中学生超重肥胖与血压偏高的关联

目的 探索开封市中学生超重、肥胖与血压偏高之间的关联,为相关部门制定有效的干预措施提供依据.方法 2019年9-10月,采用多阶段分层整群随机抽样方法,选取开封市4058名中学生进行血压、身高、体重的测量,分析超重肥胖与血压偏高的关系.结果 中学生血压偏高率为11.78％.与正常体重相比,超重(OR=1.65)和肥胖(...     

Does the fat-but-fit paradigm hold true for all-cause mortality when considering the duration of overweight/obesity? Analyzing the WATCH (Weight,Activity and Time Contributes to Health) paradigm

BackgroundPhysical activity has been shown to attenuate the association between overweight/obesity and mortality. Much less is known, however, on how the duration of overweight/obesity potentially alters this association, which was the purpose of this study.MethodsThe 1999–2006 NHANES was used and 11,057 adults (ages 36–85) were evaluated. Eight mutually exclusive groups were created: (1) physically active, normal weight now and 10 years ago; (2) physically inactive, normal weight now and 10 years ago; (3) physically active, overweight/obese now but normal weight 10 years ago; (4) physically inactive, normal weight now but overweight/obese 10 years ago; (5) physically active, overweight/obese now but normal weight 10 years ago; (6) physically inactive, overweight/obese now but normal weight 10 years ago; (7) physically active, overweight/obese now and 10 years ago; and (8) physically inactive, overweight/obese now and 10 years ago.ResultsAfter adjustments, only those individuals that were inactive were at a significantly increased risk for all-cause mortality independent of overweight/obesity status (Groups 2, 4, 6, 8).ConclusionIn alignment with the Exercise is Medicine initiative®, our results provide support for clinicians to perform routine assessments of physical activity, and to further promote physical activity among all individuals regardless of body mass status.     

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,...     

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?

     

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.     

Relationship between Eating Behavior, Breakfast Consumption, and Obesity Among Finnish and Greek Adolescents

ObjectiveTo investigate the relationship between eating-related behaviors, particularly breakfast consumption, and weight status in Finnish and Greek adolescents.MethodsA total of 6,468 16-year-old Finnish adolescents and 2,842 17- and 18-year-old Greek adolescents, based on the latest follow-up of 2 population-based cohorts, were studied. Univariate analysis examined the associations between breakfast consumption, family meals, emotional eating, bingeing, and weight status in both populations. Multiple logistic regression models focused on the relationship between breakfast consumption and overweight/obesity taking potential confounders into account.ResultsDaily breakfast consumption was associated with lower levels of overweight/obesity among Finnish and Greek boys, but not among girls. Adjusting for confounders did not change the result among Greek boys, but adjustment for father's body mass index, weight control, and fear of getting fat attenuated the association among Finnish boys.Conclusions and ImplicationsThis study highlights the importance of breakfast consumption, particularly among male adolescents, in obesity prevention programs.     

Nutritional Status in Sick Children and Adolescents Is Not Accurately Reflected by BMI-SDS

Objective: Nutritional status provides helpful information of disease severity and treatment effectiveness. Body mass index standard deviation scores (BMI-SDS) provide an approximation of body composition and thus are frequently used to classify nutritional status of sick children and adolescents. However, the accuracy of estimating body composition in this population using BMI-SDS has not been assessed. Thus, this study aims to evaluate the accuracy of nutritional status classification in sick infants and adolescents using BMI-SDS, upon comparison to classification using percentage body fat (%BF) reference charts.

Design: BMI-SDS was calculated from anthropometric measurements and %BF was measured using dual-energy x-ray absorptiometry (DXA) for 393 sick children and adolescents (5 months–18 years). Subjects were classified by nutritional status (underweight, normal weight, overweight, and obese), using 2 methods: (1) BMI-SDS, based on age- and gender-specific percentiles, and (2) %BF reference charts (standard). Linear regression and a correlation analysis were conducted to compare agreement between both methods of nutritional status classification. %BF reference value comparisons were also made between 3 independent sources based on German, Canadian, and American study populations.

Results: Correlation between nutritional status classification by BMI-SDS and %BF agreed moderately (r ² = 0.75, 0.76 in boys and girls, respectively). The misclassification of nutritional status in sick children and adolescents using BMI-SDS was 27% when using German %BF references. Similar rates observed when using Canadian and American %BF references (24% and 23%, respectively).

Conclusions: Using BMI-SDS to determine nutritional status in a sick population is not considered an appropriate clinical tool for identifying individual underweight or overweight children or adolescents. However, BMI-SDS may be appropriate for longitudinal measurements or for screening purposes in large field studies. When accurate nutritional status classification of a sick patient is needed for clinical purposes, nutritional status will be assessed more accurately using methods that accurately measure %BF, such as DXA.     

Peer Reviewed: Physical Activity, Watching Television, and the Risk of Obesity in Students, Texas, 2004-2005

Introduction

The epidemic of childhood obesity has been well-documented. Prevalence of obesity among students in Texas is higher than the US prevalence. Our objective was to understand the combined influence of physical activity and television viewing on weight status of students in Texas.

Methods

Students in grades 4, 8, and 11 participated in the School Physical Activity and Nutrition survey during the 2004-2005 academic year. Multinomial logistic regression tested the associations between both being overweight and obese (vs underweight/normal weight) and the combined influence of physical activity and watching television, adjusting for age, grade, race/ethnicity, language spoken at home, and percentage of economically disadvantaged students in the school. We used 5 physical activity indicators to describe students'' physical activity.

Results

Girls who participated in less than 3 days of exercise per week to strengthen or tone muscles and watched 2 hours or less per day of television had increased odds of being obese (adjusted odds ratio, 1.8; 95% confidence interval, 1.1-3.0) compared with girls who participated in 3 or more days per week of exercise to strengthen or tone muscles and watched 2 hours or less per day of television. Boys in our study who watched 3 or more hours per day of television and did not meet physical activity recommendations had increased odds of being obese in all of our 5 physical activity indicators.

Conclusion

Although results varied by physical activity indicator and sex, our findings provide further evidence for the combined effect of high television watching and low physical activity engagement on the risk for obesity in children and adolescents.     

Cost of obesity in the workplace

As the prevalence of obesity increases, its economic consequences must be understood. This review summarizes published literature on the costs and resource use associated with obesity in the workplace. A Medline literature search was conducted for English-language publications. References from identified articles were also reviewed for relevance. The identified studies evaluated several cost components, including absenteeism, sick leave, disability, injuries, and claims data. Overall, overweight or obese employees had higher sick leave or disability use. Workplace injuries were higher among overweight or obese employees. Health care costs, based on claims data analyses, were also consistently higher for employees with higher body mass indices. Obesity is an important driver of costs in the workplace. These findings quantify the costs and can help employers consider whether to introduce workplace interventions or provide coverage for weight loss programs.     

Weight status and weight-related behaviors of children commencing school

ObjectiveTo describe the weight status and weight-related behaviors of children commencing school.MethodsThis study is a representative cross-sectional survey of Australian children in their first year of schooling (n = 1141) in 2010. Height and weight were measured, and parents reported their child's diet, physical activity and screen-time.Results18.7% of children were overweight/obese. Compared with non-overweight/obese peers, overweight/obese boys were 1.73 times (95% CI 1.08, 2.79) as likely to exceed recommended screen time and 2.07 times (95% CI 1.11, 3.87) as likely to eat dinner three or more times/week in front of the TV. Overweight/obese girls were twice as likely to have a TV in their bedroom (OR 2.00, 95% CI 1.12, 3.59) and usually be rewarded with sweets for good behavior (OR 1.96, 95% CI 1.09, 3.51) and were 1.65 times as likely to be inactive (95% CI 1.08, 2.55).ConclusionWe showed that many children begin school with established weight-related behaviors that occur in the home environment. The inclusion of parents and the home environment in intervention strategies will be important to support changes to reduce childhood obesity. The weight status and weight-related behaviors of children entering school may potentially be a general indicator of the overall effectiveness of obesity prevention interventions among preschool-aged children.     

The Implications of Maternal Overweight and Obesity on the Course of Pregnancy and Birth Outcomes

The increasing prevalence of overweight and obesity among women of childbearing age is a growing public health concern in the United States. The average body mass index (BMI) is increasing among all age categories and women enter pregnancy at higher weights. Women are also more likely to retain gestational weight with each pregnancy. Women who are overweight (BMI 25–30) and obese (BMI ≥30) are at greater risk of adverse reproductive health outcomes compared to women of normal weight status (BMI 19.8–25). This article provides an overview of the complications associated with maternal overweight and obesity including diabetes, pre-eclampsia, c-sections, and birth defects. We present updated information on the weight trends among women. Finally, we present an overview of the prevention studies aimed at adolescents and women prior to pregnancy.

     

北京市黄庄职业高中职高和普高专业学生营养状况和身高体质量分析

目的 分析黄庄职业高中2016—2019学年职业高中与普通高中学生营养状况和身高体质量现状,制定本校健康教育方案。方法 学校根据《北京市学校卫生防病工作技术规范》(2006—2010年),对2016—2019年在校学生进行健康体检。使用中国学龄儿童少年超重肥胖筛查BMI分类标准与身高体质量标准采用离差法进行发育状况判定。结果 职高与普高专业学生在3个学年中,超重和肥胖检出率均大于营养不良检出率;15～18岁普高学生超重率和肥胖率均大于职高学生,普高女生身高体质量均值普遍高于职高女生,普高男生身高、体质量比职高男生普遍略高。结论 北京市黄庄职业高中2组专业学生营养状况良好率逐年下降,超重肥胖率呈现上升趋势,需要社会、家庭和学校共同关注,采取有效的预防干预措施。     

北京市石景山区中学生超重肥胖现状及影响因素

目的了解北京市石景山区中学生超重肥胖状况及其影响因素,为中学生超重肥胖的预防与干预措施提供依据。方法采用多阶段整群随机抽样的方法,抽取北京市石景山区1240名中学生,进行超重肥胖流行状况调查,并对相关因素进行分析。结果在有效应答的1232名学生中,超重学生有126人,超重率10.23%;肥胖学生有99人,肥胖患病率8.03%,超重肥胖共发生225人,检出率为18.26%。高中男生(8.33%)肥胖率明显高于高中女生(5.74%),超重(26.19%)和肥胖(21.21%)及运动锻炼60 min以上≥3 d/周的比例明显低于正常组(51.64%),以上差异均有统计学意义(P<0.05)。Logistic回归分析结果显示,运动锻炼60 min以上<3 d/周(OR=6.92)、使用计算机时间每天超过2 h(OR=6.55)、经常吃路边摊(OR=5.65)、每天看电视超过2 h(OR=4.30)、每天玩电子游戏超过2 h(OR=3.88)、经常吃油炸食品(OR=1.86)和甜点(OR=1.54)等是中学生超重肥胖的影响因素。结论儿童青少年存在着程度不同静态生活方式和的不良饮食行为和饮食习惯,是引起超重肥胖的危险因素。     

Predicting Weight Status Stability and Change From Fifth Grade to Eighth Grade: The Significant Role of Adolescents' Social-Emotional Well-Being

PurposeThe primary objective of this study was to predict weight status stability and change across the transition to adolescence using parent reports of child and household routines and teacher and child self-reports of social-emotional development.MethodsData were from the Early Childhood Longitudinal Study-Kindergarten Cohort (ECLS-K), a nationally representative sample of children who entered kindergarten during 1998-1999 and were followed through eighth grade. At fifth grade, parents reported on child and household routines and the study child and his/her primary classroom teacher reported on the child’s social-emotional functioning. At fifth and eighth grade, children were directly weighed and measured at school. Nine mutually-exclusive weight trajectory groups were created to capture stability or change in weight status from fifth to eighth grade: (1) stable obese (ObeSta); (2) obese to overweight (ObePos1); (3) obese to healthy (ObePos2); (4) stable overweight (OverSta); (5) overweight to healthy (OverPos); (6) overweight to obese (OverNeg); (7) stable healthy (HelSta); (8) healthy to overweight (HelNeg1); and (9) healthy to obese (HelNeg2).ResultsExcept for breakfast consumption at home, school-provided lunches, nighttime sleep duration, household and child routines did not predict stability or change in weight status. Instead, weight status trajectory across the transition to adolescence was significantly predicted by measures of social-emotional functioning at fifth grade.ConclusionsAssessing children's social-emotional well-being in addition to their lifestyle routines during the transition to adolescence is a noteworthy direction for adolescent obesity prevention and intervention.     

中国6~17岁儿童青少年超重肥胖流行特征

目的 分析我国6~17岁儿童青少年超重肥胖流行情况,为制定肥胖防治策略提供科学依据。方法 利用"2010-2012年中国居民营养与健康状况监测"中6~17岁儿童青少年调查资料,分析我国儿童青少年超重肥胖现状。6岁儿童采用WHO 2007年推荐的分年龄性别BMI超重肥胖判定标准判定超重肥胖,7~17岁儿童青少年采用《中国学龄儿童青少年超重和肥胖预防与控制指南》中的分年龄、性别的BMI超重肥胖判定标准进行判定。结果 6~17岁儿童青少年超重率和肥胖率分别为9.6%和6.4%,其中城市儿童青少年超重率和肥胖率分别为11.0%（男生：12.8%,女生：9.0%）和7.7%（男生：9.7%,女生：5.5%）,农村儿童青少年超重率和肥胖率分别为8.4%（男生：9.3%,女生：7.4%）和5.2%（男生：6.2%,女生：4.1%）。按家庭经济收入水平分,高、中和低家庭收入儿童青少年的超重率分别为12.3%、10.7%和8.2%,肥胖率分别为8.6%、7.2%和5.7%。结论 2012年,我国6~17岁儿童青少年超重肥胖表现为城市高于农村,男生高于女生;患病率与家庭经济收入水平有关。