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

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

Nutritional status of primary school children from low income households in kuala lumpur

Growth status was examined in relation to gender and age factors in urban primary school children (6-10 years old) from low income households in Kuala Lumpur, Wilayah Persekutuan. The sample consisted of 4212 boys (53%) and 3793 girls (47%). Data on weight and height data were obtained from two sources - investigator's and teachers' measurements of the school children. This study defined mildly and significantly underweight, stunted or wasted as z-score below minus one and below minus two of the NCHS/CDC reference median, respectively. Approximately 52% (n = 4149), 50% (n = 3893) and 30% (n = 2568) of the school children were underweight, stunted and wasted, respectively. However, the majority of these undernourished children were in the mild category. Prevalence of overweight (> 2 SD of NCHS/WHO reference median) was found in 5.8% of the sample. For both, prevalence of undernutrition and overnutrition, more boys than girls were found to be underweight stunted wasted and overweight. Compared to girls, boys had lower mean z-scores for the variables height-for-age (p<0.05) and weight-for-height (p<0.01). Older children had significantly lower mean z-scores for height-for-age (p<0.001) but higher mean z-scores for weight-for-height (P<0.001) than younger children. This finding indicates that with increasing age, stunting is associated with improved weight-for-height or that the children's weights have been adapted to their short statures. In conclusion, results demonstrate a high prevalence of underweight, stunting and wasting and an increasing prevalence of overweight among these low-income school children. Efforts recommended to address health and nutrition problems among school children should include health and nutrition monitoring (e.g. growth monitoring using the existing growth data collected by schools) and interventions.     

Assessment of the nutritional status of children with special needs in Alexandria. Part II: Anthropometric measures

The present study was undertaken to evaluate the nutritional status of children with special needs in Alexandria city, on the basis of anthropometric measures. The following variables were determined in a sample of 278 disabled children (171 males, 107 females) aged 6 to 24 years, recruited from five specialized day care centers for retarded children in Alexandria: birth order, type of disability, socioeconomic status, body weight, height, body mass index (BMI) and hemoglobin level. Mentally retarded children represent the highest proportion of subjects followed by Down's syndrome and autism. There is an increase in the mean body weight of males with the increase in age among the three type of disability except at age from 14 to 18 years, while there is a fluctuation in the mean body weight between ages and disability among females. Down syndrome groups at all ages are shorter than the other groups, while disabled males are taller than females at all ages. Based on BMI for age, the incidence of obesity was higher among Down's syndrome and mentally retarded females and among autistic males (19.8%, 16.1% of males versus 15.8%, 6.7% of females with mental retardation and autism were underweight). Majority of subjects have mild degree anemia. Hemoglobin levels below the cut-off levels issued by WHO were found higher among autistic and mentally retarded females. The levels were comparable among males with autism and mental retardation and among Down's syndrome males and females. The results also revealed that underweight, overweight and obesity were more common in subjects who showed an evidence of anemia.     

Nutritional Status among Chinese Preschoolers in Subang Jaya, Selangor

A nutritional status study was carried out among Chinese preschoolers (4- 6 years old) residing in Subang Jaya, Selangor. 91 preschoolers (48 boys and 43 girls) of Chinese descent participated in the study. Anthropometric measurements such as weight and height were taken and compared with the NCHS reference. Food habits and demographic background were also evaluated. The results indicated that the prevalence of underweight, wasting and stunting was 2% respectively, while the prevalence of overweight was 3%. Food habits data showed that most preschoolers consumed the daily main meals and snack once a day. Fruits were consumed between three to four times per week. Food items preferred by these preschoolers were milk, fish and fruits. In general, preschoolers in this study favoured foods, which were deep fried rather than steamed or roasted. Correlation analysis showed that there was no significant relationship between income, education of parents and anthropometric index (weight for age, height for age and weight for height). The nutritional status of these preschool children in Subang Jaya was satisfactory.     

Impact of Parental Socioeconomic Status on Childhood and Adolescent Overweight and Underweight in Korea

Background

The prevalence of overweight and underweight is steadily increasing among children and adolescents. To explore the relationship between parental socioeconomic status and body mass index, we examined levels of overweight and underweight among representative samples of children and adolescents in South Korea.

Methods

We analyzed data from the 2009 Korean Survey on the Obesity of Youth and Children, conducted by the National Youth Policy Institute. The sample response rate for this survey was 93.9%. After excluding 745 subjects who had missing information on age, height, or weight, 9411 subjects were included. To measure parental socioeconomic status, 4 categories were assessed by using a structured questionnaire: subjective economic status, parental education level, parental occupational status, and family structure. We used the chi-squared test in univariable analysis and multinomial logistic regression in multivariable analysis.

Results

Multinomial logistic regression analysis identified sex, education level, parental interest in weight management, and parental body shapes as statistically significant characteristics affecting overweight in children, and sex, place of residence, parental interest in weight management, and paternal and maternal body shapes as statistically significant characteristics affecting underweight (P < 0.05).

Conclusions

Underweight and overweight coexist among adolescent Korean males of low socioeconomic status, which indicates that these conditions can coexist in developed countries. Appropriate interventions to address both overweight and underweight in adolescents are required.Key words: childhood and adolescent overweight and underweight, Korea, parental factors, risk factor, socioeconomic status     

The association between weight perception and BMI among high school students

OBJECTIVE: To assess the association between weight perception and BMI among a large, diverse sample of adolescents. This study used both measured and self-reported height and weight to calculate BMI. RESEARCH METHODS AND PROCEDURES: A convenience sample of students (n = 2032) in grades 9 through 12 completed a questionnaire assessing demographic characteristics, self-reported height and weight, and body weight perception. These students were then weighed and had their height measured using a standard protocol. RESULTS: Using BMI calculated from measured height and weight, 1.5% of students were classified as underweight or at risk for underweight, 51.2% of students were normal weight, and 47.4% were overweight or at risk for overweight. Among this same sample of students, however, 34.8% perceived themselves as underweight, 42.9% perceived themselves as about the right weight, and 22.3% perceived themselves as overweight. Even when using BMI calculated from self-reported height and weight, >20% of students who were overweight or at risk for overweight perceived themselves as underweight. DISCUSSION: Because perception of overweight is a key determinant of adolescent nutritional habits and weight management, many students who are overweight or at risk for overweight but who do not perceive themselves as such are unlikely to engage in weight control practices. Increasing awareness of medical definitions of overweight might improve accuracy of weight perceptions and lead to healthier eating and increased physical activity.     

Nutritional status in childhood malignancies

In children affected by tumor, nutritional status is important to sustain aggressive chemotherapy and to support normal growth during and after therapy. The aim of this study was to investigate the prevalence of nutritional status disorders in a sample of pediatric oncology day-hospital patients. We measured weight and height in patients affected by solid tumors on or off therapy at short-term follow-up (1-24 mo). The study was performed at a pediatric oncology day-hospital over a period of 20 consecutive days. A suitable computer package was used to estimate relative body weight (%RBW) and body mass index (BMI) for each patient. Thereafter, the same sample was divided into four weight classes (underweight, normal weight, overweight, and obese) according to %RBW and BMI. Moreover, patients were divided into two groups: on and off therapy. In the off-therapy group, no patient was underweight; in the on-therapy group, 26.3% and 15.8% of patients were underweight (not significant) according to %RBW and BMI, respectively. The prevalence of overweight (overweight ++obese) according to %RBW was 36.9% in the on-therapy group and 52.9% in the off-therapy group (P < 0.05); whereas the prevalence of overweight according to BMI was 21% in the on-therapy group and 35.3% in the off-therapy group (P = 0.05). These preliminary data suggest that, in pediatric oncology, nutritional assessment is required to provide nutritional strategies in on-therapy patients whose underweight status prevalence is impressive or in off-therapy children in whom the causes of overweight should be explored.     

Maternal perceptions of children's weight status

Background Several studies have addressed mothers' perceptions of their children's weight status; however, there is no investigation on Portuguese children (a country with one of the highest levels of children's overweight and obesity in Europe). The aim of this study was to quantify maternal misclassification of child weight status in a sample of Portuguese children aged 9 to 12 years, according to gender, family income, and maternal weight status, education level and age. Methods Data were collected in a school‐based study (school year 2009/2010) in northern Portugal with 499 urban children (236 girls; 47.3%). Body mass index was calculated from measurements of height and weight [body mass (kg)/height (m²)]. Mothers' perceptions of child's weight status, age, height and weight were accessed by a questionnaire. Children's age, gender and socio‐economic status were extracted from the schools' administrative record systems. Cohen's Kappa was used to analyse the misperceptions and the agreement between children's objectively measured weight status and mothers' perception of their child's weight status. Results The prevalence of underweight, overweight and obesity in children was 4.6%, 25.5% and 6.4%, respectively. A proportion of 65.2% of underweight and 61.6% of overweight/obese children were misclassified by their mothers. For the majority of variables presented, the values of agreement were fair (k ranged from 0.257 to 0.486), but were statistically significant. Significant differences in the percentages of mothers who correctly classified their children's weight status were only found among the most educated in the overweight/obese group and among the normal‐weight mothers in the underweight group. Conclusions Many mothers do not properly recognize their children's weight status and frequently underestimate their children's body size.     

Body fat percentages measured by dual-energy X-ray absorptiometry corresponding to recently recommended body mass index cutoffs for overweight and obesity in children and adolescents aged 3-18 y

BACKGROUND: Body mass index (BMI; in kg/m2) cutoffs for use with children and adolescents aged 2-18 y that correspond to the well-accepted BMI cutoffs for overweight (> or = 25 but < 30) and obesity (> or = 30) in adults were published recently. OBJECTIVE: The objective was to estimate the percentage body fat (%BF) values typically associated with these BMI cutoffs in children and adolescents. DESIGN: The %BF was measured by dual-energy X-ray absorptiometry in 661 subjects (49% male) aged 3-18 y. Regression equations using BMI, age, and sex were developed to predict the %BF associated with BMI cutoffs for overweight (age-specific BMI equivalent to a BMI of 25 in an 18-y-old) and obesity (age-specific BMI equivalent to a BMI of 30 in an 18-y-old) over this age range. RESULTS: Measurements classified 17.1% of males and 19.8% of females as overweight and 5.5% of males and 7.5% of females as obese. The %BF associated with an obese BMI tended to be higher in peripubertal males (34-36%) than in younger (24-30%) or older (27-30%) males. Although the predicted %BF of young females was similar to that of young males, values rose steadily with age, such that an 18-y-old female with a BMI of 30 had an estimated %BF of 42%, whereas that in males of similar age was 27%. CONCLUSION: The %BF values associated with BMI classifications of overweight and obesity vary considerably with age in growing children, particularly in girls.     

The association of obesity with socioeconomic factors in Missouri.

The prevalence of obesity and underweight was estimated for residents of Missouri more than 9 years old on the basis of age, sex, household income, educational attainment, and population density from the results of a survey conducted in 1973. The incidence of overweight was greatest among children 10 to 16 years old and the least for adults 17 to 35 years old. Four percent of the girls 10 to 16 were greater than 159% of average weight for height. Among women greater than 59 years old the incidence of overweight and underweight were high. The proportion of adult women who were overweight as defined by average weight for height and body mass index (W/H2) was inversely related to household income and education. The same was true for adult men in relation to income but the reverse results were observed for education. A larger proportion of urban men were overweight as defined by body mass index compared to rural men. The incidence of obesity among males of all ages and females greater than 59 years old appeared to be related to residence in specific types of communities.     

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

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

Body mass index, overweight and obesity among Kuwaiti intermediate school adolescents aged 10-14 years

OBJECTIVES: The purpose of this cross-sectional study was to assess the levels of overweight and obesity among Kuwaiti intermediate school adolescents aged 10-14 y. The study comprised a multistage stratified random sample of 14659 adolescents (7205 males and 7454 females), which constitutes approximately 17% of the target population of this school level. METHODS: Weights and heights of the adolescents were measured, from which the body mass index (BMI), which is the weight in kilograms divided by the height in meters squared (kg/m2), was calculated. Overweight and obesity were defined as BMI >85th and >95th centiles, respectively, of the National Center for Health Statistics (NCHS) reference data. RESULTS: The overall prevalence of overweight and obesity among males were 30.0 and 14.7%, respectively (P<0.001). The overall prevalence of overweight and obesity among females were 31.8 and 13.1%, respectively (P<0.001 and P<0.01). There was no consistent rise or decline in overweight and obesity in both genders with respect to age. However, the overall prevalence of overweight was lower in males than in females but obesity was higher in males than in females. CONCLUSION: When compared to the NCHS reference population, the BMI of Kuwaiti adolescents exceeded that of the Americans in each centile category > or = 50th centile. Health education programmes should be instituted to control this syndrome in order to prevent future risk of obesity-related diseases.     

Overweight exceeds underweight among women in most developing countries

BACKGROUND: It is generally believed that overweight is less prevalent than undernutrition in the developing world, particularly in rural areas, and that it is concentrated in higher socioeconomic status (SES) groups. OBJECTIVE: The purpose of this study was to examine patterns of adult female overweight and underweight in the developing world by using categories of urban or rural status and SES strata. DESIGN: Body mass index (BMI; in kg/m(2)) data collected in 36 countries from 1992 to 2000 by nationally representative cross-sectional surveys of women aged 20-49 y (n = 148579) were classified as indicating underweight (BMI < 18.5) and overweight (BMI >/= 25). Associations between the nutritional status of urban and rural women and each country's per capita gross national income (GNI) and level of urbanization were explored in the overall sample and among different SES groups. RESULTS: Overweight exceeded underweight in well over half of the countries: the median ratio of overweight to underweight was 5.8 in urban and 2.1 in rural areas. Countries with high GNIs and high levels of urbanization had not only high absolute prevalences of overweight but also small urban-rural differences in overweight and very high ratios of overweight to underweight. In the more-developed countries, overweight among low-SES women was high in both rural (38%) and urban (51%) settings. Even many poor countries, countries in which underweight persists as a significant problem, had fairly high prevalences of rural overweight. CONCLUSIONS: In most developing economies, prevalences of overweight in young women residing in both urban and rural areas are higher than those in underweight women, especially in countries at higher levels of socioeconomic development. Research is needed to assess male and child overweight to understand the dynamics facing these groups as well.     

Secondary Analysis of Anthropometric Data from a South African National Food Consumption Survey, Using Different Growth Reference Standards

The National Center for Health Statistics (NCHS) references were used to analyse anthropometric data from the 1999 National Food Consumption Survey (NFCS) of South Africa. Since then, however, The Centers for Disease Control and Prevention (CDC) 2000 reference and the World Health Organization (WHO) 2006 standards were released. It was anticipated that these reference and standards may lead to differences in the previous estimates of stunting, wasting, underweight and obesity in the study population. The aim was to compare the anthropometric status of children using the 1977 NCHS, the 2000 CDC growth references and the 2006 WHO standards. All children 12–60 months of age with a complete set of anthropometric data were included in the analyses. Data for 1,512 children were analysed with SAS 9.1 for Windows. A Z-score was calculated for each child for weight-for-age (W/A), weight-for-length/height (W/H), length/height-for-age (H/A) and body mass index (BMI)-for-age, using each of the three reference or standards for comparison. The prevalence of stunting, obesity and overweight were significantly higher and the prevalence of underweight and wasting were lower when using the WHO standards compared to the NCHS and the CDC references. The higher than previously established prevalence of stunting at 20.1% and combined overweight/obesity at 30% poses a challenge to South African policy makers to implement nutrition programmes to decrease the prevalence of both stunting and overweight. The 2006 WHO growth standard should be the standard used for assessment of growth of infants and children younger than 5 years in developing countries.     

Parents' perception of their child's weight status and intention to intervene: a Western Australian cross‐sectional population survey, 2009–12

Objective: To report on parents' perceptions of their child's weight status and how the child's body mass index (BMI) is associated with parent intentions to change or maintain the child's weight. Methods: Estimates were derived via data collected from 4,437 parents from 2009 to 2012 as part of the Western Australian Health and Wellbeing Surveillance System. To measure weight perceptions, parents were asked, “Is your child underweight, normal weight, overweight or very overweight?” BMI values were also derived via parent‐reported height and weight. Parent intentions were assessed by asking parents, “What are your intentions regarding your child's weight?” Results: Significantly fewer parents perceived their child as overweight (8.2%) or very overweight (0.2%) than was derived via parent‐reported height and weight (16.3% and 5.8%, respectively). More than half the parents with children above or below the healthy BMI range reported an intention to “do nothing” about their child's weight (between 54.5% and 70.0%). Conclusions: A large proportion of Western Australian parents misjudge their child's weight status and the majority express no intention to help their child achieve a healthy weight. Implications: The results reinforce the importance of population‐level, parent‐focussed interventions targeting perceptions of children's weight and appropriate action.     

Perceived weight status in normal weight and overweight women

The current study sought to assess women's knowledge of what objectively constitutes underweight, normal weight, or overweight for a given height, and how this knowledge is affected by a woman's own weight status. A total of 31 normal weight women and 20 overweight women were asked to provide predictions of weight ranges for a female 4 feet 11 in. to 6 feet 2 in. in height for the following categories: extremely underweight, underweight, normal weight, overweight, obese, and extremely obese. Each participant completed the questionnaire for all heights, although the critical values for each participant were the weight ranges given for their own height category. These predictions were then compared to the participants' own weight status using Body Mass Index (BMI). Results suggest that normal weight women tend to believe that women must be smaller in order to be classified as normal weight, overweight, or obese when compared to the objective BMI categories used by physicians and researchers. In other words, the normal weight participants underestimated the BMI ranges for the normal weight, overweight, and obese categories. Overall, the overweight participants were fairly accurate in their BMI predictions for the different weight categories. One implication of these findings is that normal weight women may have a bias toward overestimating their weight to be within an overweight range. The need for health care marketing efforts to increase awareness of objective weight categories is addressed.     

2019—2020年武汉某高校3369例医学研究生BMI和血红蛋白含量的分析

目的 通过研究分析某高校研究生BMI和血红蛋白含量状况,以期为制订有针对性的卫生保健措施提供参考依据。方法 收集武汉某高校2019年—2020年医学研究生新生入学体检资料,对BMI和血红蛋白含量等指标进行统计分析。结果 研究生新生中,不同性别在年龄、文化程度、婚姻状况、身高、体重、体重指数和血红蛋白含量差异均有统计学意义(P<0.05)。男生中体重超重和肥胖的检出率为31.93%(372/1 165),高于女生的6.94%(153/2 204)(χ2=361.794,P<0.001)。而新生中女生体重过低的检出率为21.46%(473/2 204),较男生的6.44%(75/1 165)高,差异具有统计学意义(χ2=126.293,P<0.001)。不同性别之间体重指数分型总体分布不全相同(Z=19.641,P<0.001)。新生中男生和女生血红蛋白含量偏低检出率分别是1.38%(16/1 163)和7.72%(260/2 204),女生中血红蛋白含量偏低检出率明显比男生中检出率高(χ2=109.81,P<0.001)。在BMI分型中,除肥胖组外(χ2=0.032,P=0.858),在体重过低、正常、超重的学生中,女生的血红蛋白含量偏低的发生率均高于男生,差异具有统计学意义(χ2=7.399,P=0.007、χ2=71.385,P<0.001、χ2=8.963,P=0.003)。此外,男、女生中血红蛋白偏低的检出率在不同BMI类型中的分布均无差异(H=1.569,P=0.666、H=5.005,P=0.171)。结论 2019—2020年入学医学研究生新生中,体重过低、血红蛋白含量偏低的女生比男生多,而在超重和肥胖的男生比女生多,因此,对研究生新生有针对性的进行早期干预和健康教育,提高学生的自我保健能力。