Impact of objective and subjective social status on obesity in a biracial cohort of adolescents

OBJECTIVE: To characterize the associations between socioeconomic status (SES), two levels of subjective social status (SSS), and adolescent obesity. RESEARCH METHODS AND PROCEDURES: Cross-sectional study of 1491 black and white adolescents attending public school in a suburban school district in Greater Cincinnati, Ohio. BMI > or =95th percentile derived from measured height and weight defined overweight. Students rated SSS on separate 10-point scales for society and school. A parent provided information on parent education and household income for SES. RESULTS: Although there were no sex differences in SES, black students were more likely to come from families with less well-educated parents and lower incomes (p < 0.001). Black girls had the lowest societal SSS (p = 0.003), lowest school SSS (p = 0.046), and highest BMI (p < 0.001). Prevalence of overweight was highest among black girls (26.0%) and boys (26.2%), intermediate for white boys (17.2%), and least for white girls (11.6%). Logistic regression modeling revealed that parent education, household income, and school SSS were each associated with overweight. In a fully adjusted model, school SSS retained its association to overweight (odds ratio, 1.16; 95% CI, 1.06,1.26) independent of SES. The association of school SSS was strongest among white girls, intermediate for white and black boys, and absent for black girls. DISCUSSION: Perceptions of social stratification are independently associated with overweight. There were important racial and sex differences in the social status-overweight association. SSS in the more immediate, local reference group, the school, had the strongest association to overweight.     

Nutrient intake, lipids, and lipoprotein cholesterols in black and white children: the Lipid Research Clinics Prevalence Study

Our specific aim was to assess differences in nutrient intake and in lipids and lipoprotein cholesterols between blacks and whites in 259 black children (129 boys, 130 girls) and in 811 white children (424 boys, 387 girls) ages 5-19. The nutrient intake data were obtained by 24-hr recall from the Houston and Cincinnati Lipid Research Clinics. The fundamental nutrient differences between blacks and whites were in total calories and in calories per kilogram of body weight, both of which were uniformly and significantly lower among black than white boys and generally, but less consistently and significantly, lower among black than white girls. No racial differences in total cholesterol or cholesterol intake per kilogram body weight were observed. After statistically controlling for education of the head of household, there were no consistent significant racial differences in Quetelet index. There was no significant independent effect of education of head of household on the children's caloric intake and racial differences in socioeconomic status did not appear to systematically account for differences in total energy intake. In aggregate, black children had lower triglyceride and very-low-density lipoprotein cholesterol levels, and higher levels of high-density lipoprotein cholesterol than whites; there were no significant differences by race in low-density lipoprotein cholesterol levels. Race was a significant independent explanatory variable for high-density lipoprotein cholesterol levels (higher in blacks) and for very-low-density lipoprotein and triglyceride levels (higher in whites) (P less than 0.005), after covariance adjusting for education of head of household, sex, age, Quetelet index, calories, saturated fat (g/day/kg body wt), and clinic. Lower caloric intake among blacks compared with whites, the major nutrient difference in the current study, did not account for differences in lipoprotein cholesterol levels between the two groups.     

Weight status in childhood as a predictor of becoming overweight or hypertensive in early adulthood

OBJECTIVE: To assess the extent to which weight status in childhood or adolescence predicts becoming overweight or hypertensive by young adulthood. RESEARCH METHODS AND PROCEDURES: We conducted a prospective study of 314 children, who were 8 to 15 years old at baseline, and were followed up 8 to 12 years later. Weight, height, and blood pressure were measured by trained research staff. Incident overweight was defined as BMI>or=25 kg/m2 among participants who had not been overweight as children. RESULTS: More male subjects (48.3%) than female subjects (23.5%) became overweight or obese between their first childhood visit and the young adult follow-up (p<0.001). Being in the upper one half of the normal weight range (i.e., BMI between the 50th and 84th percentiles for age and gender in childhood) was a good predictor of becoming overweight as a young adult. Compared with children with a BMI<50th percentile, girls and boys between the 50th and 74th percentiles of BMI were approximately 5 times more likely [boys, odds ratio (OR)=5.3, p=0.002; girls, OR=4.8, p=0.07] and those with a BMI between the 75th and 84th percentiles were up to 20 times more likely (boys, OR=4.3, p=0.02; girls, OR=20.2, p=0.001) to become overweight. The incidence of high blood pressure was greater among the male subjects (12.3% vs. 1.9%). Compared with boys who had childhood BMI below the 75th percentile, boys between the 75th and 85th percentiles of BMI as children were four times more likely (OR=3.6) and those at above the 85th percentile were five times more likely (OR=5.1) to become hypertensive. DISCUSSION: High normal weight status in childhood predicted becoming overweight or obese as an adult. Also, among the boys, elevated BMI in childhood predicted risk of hypertension in young adulthood.     

Elevated blood pressure among Southeast Asian refugee children in Minnesota

The blood pressures and body sizes of children aged 10-15 years in the Minneapolis and St. Paul, Minnesota, public schools were measured during 1986 and 1987. The sample consisted of 1,680 Southeast Asian refugees--including 219 Cambodians, 1,086 Hmong, 149 Lao, and 226 Vietnamese--and 3,424 blacks and 11,336 whites. Mean systolic blood pressure in Hmong boys was higher than that in black boys and white boys. Mean systolic blood pressures of Hmong, Lao, and Vietnamese girls were lower than those of black girls and white girls. The mean diastolic blood pressures of Hmong boys and of Cambodian and Hmong girls were greater than those of blacks and whites of the same sexes. Southeast Asian children were shorter and weighed less than black children and white children. Body size may confound associations between ethnic groups and blood pressures and may obscure the problem of hypertension among the smaller Southeast Asian children. Southeast Asian boys had greater mean systolic blood pressures than did black and white boys across all weight strata; a similar contrast among girls did not reveal this difference. The risk of hypertension, defined by US National Heart, Lung, and Blood Institute guidelines, was assessed in multiple logistic regression analyses that controlled for differences in weight, height, age, and pulse rate. The odds ratios for hypertension, relative to blacks and whites of the same sexes, were 2.69 (95% confidence interval (CI) 1.85-3.65) in Hmong boys, 2.89 (95% CI 1.35-6.21) in Lao boys, 2.10 (95% CI 1.03-4.28) in Cambodian girls, and 1.49 (95% CI 1.00-2.20) in Hmong girls. Hypertension and subsequent cardiovascular disease may emerge as a significant problem among Southeast Asian refugees in the United States.     

Additive interactions of maternal prepregnancy BMI and breast-feeding on childhood overweight

OBJECTIVE: To examine the interactions of maternal prepregnancy BMI and breast-feeding on the risk of overweight among children 2 to 14 years of age. RESEARCH METHODS AND PROCEDURES: The 1996 National Longitudinal Survey of Youth, Child and Young Adult data in the United States were analyzed (n = 2636). The weighted sample represented 51.3% boys, 78.0% whites, 15.0% blacks, and 7.0% Hispanics. Childhood overweight was defined as BMI >/=95th percentile for age and sex. Maternal prepregnancy obesity was determined as BMI >/=30 kg/m(2). The duration of breast-feeding was measured as the weeks of age from birth when breast-feeding ended. RESULTS: After adjusting for potential confounders, children whose mothers were obese before pregnancy were at a greater risk of becoming overweight [adjusted odds ratio (OR), 4.1; 95% confidence interval (CI), 2.6, 6.4] than children whose mothers had normal BMI (<25 kg/m(2); p < 0.001 for linear trend). Breast-feeding for >/=4 months was associated with a lower risk of childhood overweight (OR, 0.6; 95% CI, 0.4, 1.0; p = 0.06 for linear trend). The additive interaction between maternal prepregnancy obesity and lack of breast-feeding was detected (p < 0.05), such that children whose mothers were obese and who were never breast-fed had the greatest risk of becoming overweight (OR, 6.1; 95% CI, 2.9, 13.1). DISCUSSION: The combination of maternal prepregnancy obesity and lack of breast-feeding may be associated with a greater risk of childhood overweight. Special attention may be needed for children with obese mothers and lack of breast-feeding in developing childhood obesity intervention programs.     

Obesity rates among rural Ontario schoolchildren

BACKGROUND: The majority of existing studies of obesity risk among Canadian children come from urban populations. The purpose of this study is to assess the prevalence of obesity in a sample of rural Ontario children. METHODS: Measures of height and weight were obtained for 504 children attending seven public elementary schools in Grey and Bruce Counties, a predominantly rural area of Southern Ontario. Body mass index (BMI, or weight/height2) scores were calculated and compared with reference data from the Centers for Disease Control. RESULTS: Rates of overweight and obesity were high in this sample, with 17.7% of children classified as overweight and 10.9% classified as obese. There was a significantly high prevalence of overweight for both boys (17.8%) and girls (17.5%) (Chi-square = 75.70, p < 0.001). However there was a significant gender difference in obesity prevalence: 15.0% of boys were obese, compared with 6.8% of girls (Mann-Whitney U = 29133.0, p > 0.05). CONCLUSION: Findings indicate that among rural children--particularly boys--risk of overweight and obesity are at least as high as in their urban Canadian counterparts. There appear to be fewer girls than boys at the extreme high end of the distribution of BMI, which may indicate differences in the growth environment of rural boys and girls.     

Obesity and all-cause mortality among black adults and white adults

In recent pooled analyses among whites and Asians, mortality was shown to rise markedly with increasing body mass index (BMI; weight (kg)/height (m)(2)), but much less is known about this association among blacks. This study prospectively examined all-cause mortality in relation to BMI among 22,014 black males, 9,343 white males, 30,810 black females, and 14,447 white females, aged 40-79 years, from the Southern Community Cohort Study, an epidemiologic cohort of largely low-income participants in 12 southeastern US states. Participants enrolled in the cohort from 2002 to 2009 and were followed up to 8.9 years. Hazard ratios and 95% confidence intervals for mortality were obtained from sex- and race-stratified Cox proportional hazards models in association with BMI at cohort entry, adjusting for age, education, income, cigarette smoking, and alcohol consumption. Elevated BMI was associated with increased mortality among whites (hazard ratios for BMI >40 vs. 20-24.9 = 1.37 (95% confidence interval (CI): 1.02, 1.84) and 1.47 (95% CI: 1.15, 1.89) for white males and white females, respectively) but not significantly among blacks (hazard ratios = 1.13 (95% CI: 0.89, 1.43) and 0.87 (95% CI: 0.72, 1.04) for black males and black females, respectively). In this large cohort, obesity in mid-to-late adulthood among blacks was not associated with the same excess mortality risk seen among whites.     

Obesity in a cohort of black Jamaican children as estimated by BMI and other indices of adiposity

OBJECTIVE: To examine the relationships of body mass index (BMI) to obesity indices derived from anthropometry and to determine tracking of overweight between late childhood and early adolescence, in a cohort of children with mixed nutritional history. We also compared identification of overweight children using The International Obesity Task Force (IOTF) BMI cut-off points with skinfolds. DESIGN: Prospective study. SETTING: Kingston, Jamaica. SUBJECTS: A total of 306 children examined at 7-8 y and at 11-12 y. MEASUREMENTS: Triceps (TSF) and subscapular skinfolds (SSF), height and weight were measured. The sum of the skinfolds (sum SF), BMI, percentage body fat (%fat) and fat mass (FM) were calculated. Pubertal stage was assessed at 11-12 y. RESULTS: Overweight increased from 3.5 to 9.5% over the follow-up period. BMI was better correlated with the other indices of adiposity in girls and in the older age group. BMI tracking over follow up was high. In regression analysis BMI explained 52 and 61% of the variance in FM in boys and girls at 7-8 y. This increased to 69% in both sexes at 11-12 y. Using the IOTF cut-off points BMI had low sensitivity to identify children >85th percentile of the NHANES references for SSF. The sensitivity for those assessed by TSF and sum SF was higher, but between 14 and 30% of the children were misclassified. The specificity of BMI was high. CONCLUSIONS: Adiposity increased over follow-up. Although the cohort remained relatively lean BMI rank among the fattest children was maintained. Girls were fatter than boys, reflecting adult obesity patterns. Children identified as overweight by the IOTF BMI cut-off points are likely to have high body fatness. However the BMI cut-off points may not identify many children with high body fatness.     

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.     

Prevalence of overweight and obesity in urban and semi-urban Jordanian children aged 3-6 years

Objectives   To show the prevalence of overweight and obesity among the Jordanian urban and semi-urban children; to compare their body mass index (BMI) with the international standards of BMI.
Methods   We measured 1695 healthy children (842 boys and 853 girls) between 3 and 6 years for height, weight and mid upper arm circumference. BMI was calculated and transformed into percentiles. Children were divided into boys and girls.
Results   The mean and SD values of BMI observed in our study were 16.69 ± 4.9 kg/m² for boys and 16.82 ± 4.77 kg/m² for girls aged 3–6 years. The prevalence of obesity and overweight among boys was 20.8% and 3.8% respectively and among girls was 19.1% and 7.2% respectively. In total, 48.0% of boys and 38.1% of girls were of healthy weight.
Conclusions   The mean BMI observed in our study's children aged 3–6 years was higher than the expected 50th percentile of the (World Health Organization/Centers for Disease Control and Prevention) reference values for a similar age range but, it was equivalent to the 75th percentile values. Obesity was more frequent than overweight among boys and girls aged 3–6 years.     

Prevalence of overweight and obesity among Costa Rican elementary school children.

OBJECTIVE: Given that excessive body weight during childhood influences the development of several chronic diseases in adulthood, this study was conducted to determine the prevalence of overweight and obesity in urban and rural Costa Rican elementary school children. METHODS: The study was carried out from July 2000 to April 2001. A total of 1 718 students ages 7-12 were selected from 34 schools in the capital city of San José and in other nearby urban and rural areas. Both younger children (ones aged 7 through 9 years) and older children (ones aged 10 through 12 years) with a body mass index (BMI) at or above the sex-specific 85th percentile were considered overweight. The younger children were classified as being obese if their triceps skinfold was greater than or equal to the 85th percentile for age and sex using the percentiles by age for children in the United States of America as normative standards. The older children were considered obese if they had a BMI at or above the sex-specific 85th percentile and both the triceps and subscapular skinfold thickness at or above the 90th percentile. RESULTS: The prevalence of overweight was 34.5%. Children aged 7-9, boys, children from urban areas, and children of a higher socioeconomic status had a higher prevalence of overweight. The prevalence of obesity was 26.2%. A higher prevalence of obesity was found among children aged 7-9, boys, children from urban areas, and children of middle socioeconomic status. CONCLUSIONS: Given the high prevalence of obesity that we found in the Costa Rican children, primary and secondary prevention measures are needed in order to reduce the proportion of deaths due to chronic nontransmissible diseases among Costa Rican adults in the coming decades.     

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.     

上海市2000-2014年中小学生体质量指数变化趋势

了解2000-2014年上海市学龄儿童青少年体质量指数(BMI)的变化趋势,为儿童青少年超重、肥胖判别标准研制及预防干预提供参考.方法 选取2000,2005,2010,2014年4次全国学生体质与健康调研中7~18岁儿童青少年作为研究对象.应用最小均方(Least Mean Square,LMS)法探讨不同性别、年龄组儿童青少年BMI的变化趋势.结果 14年间学生BMI P85低年龄组差异比较小,随年龄增加差异逐渐增大,青春期后有减小的趋势,男生平均增加2.1百分点,女生平均增加1.3百分点.学生BMI增长主要集中在中等和高百分位数,尤其是P90后,差值逐渐增大.7~11,12~15岁男生在P5o后差值均逐渐增大,P95分别达2.0,3.2百分点,其中12岁男生从23.4 kg/m2增加到26.8 kg/m2,14岁女生从24.0 kg/m2增加到25.9 kg/m2.与WGOC标准相比,2014年男生BMI P85,P95均较高,而女生BMI P85 10岁之前高于WGOC标准,从11岁开始与WGOC标准基本相一致.2014年上海市7~18岁儿童青少年超重、肥胖检出率分别为15.4%,9.1%,较2000年总体均呈上升趋势,分别上升6.4,5.2百分点.结论 BMI分布高百分位的个体比低百分位个体的变化更大.在肥胖防治工作中,加强对群体BMI曲线的监测分析,对适时调整宏观调控战略意义重大.     

Lower serum adiponectin levels in African-American boys

OBJECTIVE: To examine adiponectin, an adipocyte-secreted hormone with anti-inflammatory and insulin-sensitizing effects, in relation to race or gender in younger subjects. RESEARCH METHODS AND PROCEDURES: The relationship of adiponectin, quantitated by radioimmunoassay, to anthropometric and metabolic factors (fasting insulin, glucose, and leptin) and reproductive hormones was examined in 46 healthy African Americans (25 girls/21 boys) and 40 whites (20 girls/20 boys) ranging in age from 12 to 21 years. RESULTS: There was no statistical difference in BMI or in BMI percentile among the four groups. Sums of skinfolds, but not skinfold percentile, were significantly lower in boys than girls (p = 0.001 and p = 0.896, respectively), whereas there was no difference between racial groups. Leptin was significantly greater in girls (p = 0.0002). There was no difference in fasting serum glucose, insulin, or homeostasis model assessment score among any of the groups. There was a significant negative univariate relationship between serum adiponectin and both BMI and BMI percentile for the entire group (p = 0.006 and p = 0.005). In a multivariate model, BMI percentile (p = 0.005) and the interaction between race and gender (p = 0.026) were significant predictors of serum adiponectin. In this model, African-American boys had the lowest serum adiponectin level, 37% less than white boys, who had the highest adiponectin levels. DISCUSSION: Serum adiponectin levels are reduced in young obese subjects (African Americans and whites) and are lower in African-American boys than white boys. A lower adiponectin level in African-American boys may predispose this group to a greater risk of diabetes and cardiovascular disease.     

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.     

Overweight and aerobic fitness in children in the United States/Mexico border region.

OBJECTIVE: To study overweight and aerobic fitness among children in the third and fourth grades of elementary schools in a city in the United States of America (El Paso, Texas) and a city in Mexico (Chihuahua, Chihuahua) that are on or near the border between those two countries, and to compare the results from those two cities with earlier findings for other children in the United States. METHODS: We followed the El Paso children (427 boys and 385 girls, 93% of them of Mexican descent) from third to fourth grade and assessed the change in their body mass index (BMI). In the city of Chihuahua we cross-sectionally measured the BMI of a sample of third grade children (221 boys and 237 girls) and a sample of fourth grade children (268 boys and 215 girls). BMI and triceps skinfolds were measured for all the children studied in the two cities. BMI was used to assess risk for overweight (at least the 85th percentile BMI for age and gender) and overweight (at least the 95th percentile BMI for age and gender) in all the children. The distance that El Paso children ran in nine minutes was used to assess their aerobic fitness (aerobic fitness was not measured in the Chihuahua children). The data from El Paso were collected in 1999, 2000, and 2001, and the Chihuahua data were collected in 2000 and 2001. RESULTS: In the El Paso boys, overweight significantly increased in the one year from third grade to fourth grade, from 22% to 28%, while risk for overweight significantly increased, from 37% to 44%. In the El Paso girls, risk for overweight significantly increased over the same one-year period, from 29% to 37%. The El Paso boys and girls were significantly less fit when compared to samples of children from throughout the United States. Third and fourth grade children from Chihuahua had similar rates of risk for overweight and of overweight when compared to the children from the same grades in El Paso. CONCLUSIONS: Children in both El Paso and Chihuahua were more overweight than were non-Hispanic white children throughout the United States. In addition, the children in El Paso were less aerobically fit than were non-Hispanic white children and than were other Mexican-American children in the United States. These results clearly show that efforts should be made in the border regions of both Mexico and the United States to develop physical activity and nutrition programs to help stem rising rates of overweight.     

Disparities in Obesity and Overweight Prevalence Among US Immigrant Children and Adolescents by Generational Status

We examined the prevalence and socio-behavioral correlates of obesity and overweight among 46,707 immigrant and US-born children and adolescents aged 10–17 years. The 2003 National Survey of Children’s Health was used to estimate obesity and overweight prevalence among children in 12 immigrant groups, stratified by race/ethnicity and generational status. Logistic regression was used to examine immigrant differentials in the prevalence and odds of obesity and overweight. Obesity and overweight prevalence varied from a low of 6 and 18% for second-generation Asian immigrants to a high of 24 and 42% for native-born black children (US-born black children with US-born parents), respectively. After adjusting for age, gender, ethnicity, socioeconomic status, perceived neighborhood safety, television viewing, computer use, and physical activity, first-generation immigrant children, overall, had 26% lower odds of obesity than native-born children. Obesity and overweight prevalence was lower for immigrant black and white children than their native-born counterparts, while obesity and overweight prevalence among Hispanic children did not vary significantly by generational status. Compared with native-born white children, the adjusted odds of obesity were 64% higher for native-born blacks, 55% higher for second-generation Hispanic immigrants, and 63% lower for first-generation Asian immigrants. Adjusted immigrant differentials in overweight risks were also marked. Socioeconomic, demographic, and behavioral factors accounted for 61 and 35% of ethnic-immigrant disparities in obesity and overweight prevalence, respectively. Immigrant patterns in childhood obesity and overweight vary substantially by ethnicity and generational status. To reduce disparities, obesity prevention programs must target at-risk children of both immigrant and US-born parents.     

张家口市卫华小学7~12岁儿童肥胖与血压及肺活量的相关分析

目的 了解张家口市卫华小学7~12岁儿童肥胖发生情况,分析儿童期肥胖与血压及肺活量的关系。 方法 于2012年9月通过整群抽样的方法,对张家口市卫华小学1 530名儿童进行体重、身高、血压、肺活量等相关指标进行测量。计算体质指数(body mass index,BMI),依据BMI值筛查超重、肥胖儿童,统计分析肥胖与血压水平及肺活量的关系。结果 受检人群总体超重检出率为13.01%,肥胖检出率为14.25%,其中男童、女童超重检出率分别为17.2%和8.31%,男童、女童肥胖检出率分别为14.23%和8.59%,男童超重、肥胖检出率均显著高于女童(P<0.01);超重和肥胖儿童的收缩压和舒张压水平均显著高于体重正常儿童(P<0.01),且超重、肥胖和体重正常儿童高血压检出率分别为10.55%、39.95%和4.85%,差异有统计学意义(P<0.01);当儿童BMI<30时,BMI与肺活量呈正相关,当BMI≥30时,BMI与肺活量呈负相关。 结论张家口市卫华小学儿童超重、肥胖流行趋势显著,男童更为突出;随着肥胖程度的增加,儿童的收缩压和舒张压水平呈现上升趋势,高血压检出率增加;当儿童BMI≥30时,肥胖已影响肺功能。提示儿童超重、肥胖使心、肺功能降低,预防和控制儿童肥胖刻不容缓。     

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.