中国2～18岁儿童青少年超重和肥胖筛查体重指数界值点的研究

目的 研究中国2～18岁儿童青少年超重、肥胖筛查体重指数(BMI)界值点.方法 在中国0～18岁儿童青少年BMI生长参照值的基础上,根据常用的超重、肥胖筛查界值点选择方法(与成年人界值点接轨法、百分位法或Z分值法),初步分别确定[BMI 24kg/m2 (BMI24)、28 kg/m2(BMI28)]、(P85、P95)和(Z1、Z2)三组界值点,通过对不同界值点进行差值和检出率比较,并与中国肥胖问题工作组(WGOC)和国际肥胖问题工作组(IOTF)的超重、肥胖界值点做对比分析,最后确定适宜界值点.结果 按照不同的超重、肥胖筛查BMI界值点选择方法获得三组界值点,不同界值点之间存在不同程度差异,但在超重合并肥胖检出率上差异相对较小.与WGOC相比,男章超重、肥胖及女童肥胖界值点非常接近,女童在8.5～15.5岁其超重界值点比WGOC标准低0.3～1.0 kg/m2,通过筛查"2004年北京市儿童代谢综合征调查"数据库,女童超重检出率比WGOC标准高约3.4%.结论 采用与成年人界值点接轨法(BMI24、BMI28)获得的中国2～18岁儿童青少年超重、肥胖筛查BMI界值点是适宜的,实现了在使用BMI指标上年龄的连贯性和筛查标准的一致性.     

A comparison of international references for the assessment of child and adolescent overweight and obesity in different populations

OBJECTIVE: To compare different references assessing child and adolescent overweight and obesity in different populations. DESIGN: Comparison cross-sectional study. SETTING: The United States, Russia, China. SUBJECTS: A total of 6108 American, 6883 Russian and 3014 Chinese children aged 6-18 y. INVESTIGATION: Using nationwide survey data from the USA (NHANES III, 1988-1994), Russia (1992), and China (1991), we compared three references: (1) the International Obesity Task Force (IOTF) reference, sex-age-specific body mass index (BMI) cut-offs that correspond to BMIs of 25 for overweight and 30 for obesity at age 18; (2) the World Health Organization (WHO) reference--BMI 85th percentiles for overweight in adolescents (10-19 y) and weight-for-height Z-scores for obesity in children under 10; (3) a USA reference--BMI 85th and 95th percentiles to classify overweight and obesity, respectively. RESULTS: Using the IOTF reference and 85th BMI percentiles, overweight prevalence was 6.4 and 6.5% in China, 15.7 and 15.0% in Russia, and 25.5 and 24.4% in the USA, respectively. Notable differences existed for several ages. Kappa (=0.84-0.98) indicated an excellent agreement between the two references in general, although they varied by sex-age groupings and countries. Overweight prevalence was twice as high in children (6-9 y) than in adolescents (10-18 y) in China and Russia, but was similar in the USA. Estimates of obesity prevalence using these three references varied substantially. CONCLUSIONS: The references examined produce similar estimates of overall overweight prevalence but different estimates for obesity. One should be cautious when comparing results based on different references. SPONSORSHIP: University of Illinois and University of North Carolina.     

Using routine growth data to determine overweight and obesity prevalence estimates in preschool children in the Capital Health Region of Alberta

BACKGROUND: Overweight and obesity prevalence is increasing in Canadian children. In the Capital Health region of Alberta, there is a need to examine this public health issue and implement strategies to overcome it. Two growth references, one provided by the US Centers for Disease Control and Prevention (CDC), and the other by the International Obesity Task Force (IOTF), are available to assess individuals and screen populations for overweight and obesity. The prevalence can vary as a function of the reference used. The primary objective of this study is to determine prevalence estimates of overweight and obesity in 4-6 year olds in the Capital Health region. The secondary objective is to explore differences in estimates using both classification systems. METHODS: Anthropometric measurements were incorporated into regular preschool immunization visits. Body Mass Index (BMI), defined as the bodyweight in kilograms divided by height in metres squared was calculated for each record and percentiles for age and sex were determined using cut-offs from the IOTF and CDC. The prevalence estimates of overweight and obesity using both classification systems were determined and compared. RESULTS: Out of 7,369 children, 13.8% were overweight and 11.4% were obese according to the CDC reference. The IOTF reference classified 11.5% as overweight and 6.8% as obese. The two reference systems had moderate agreement (kappa 0.69, p<0.01). CONCLUSION: The results indicate a lower prevalence estimate of overweight and obesity among young children in the Capital Health region compared to other parts of Canada. The IOTF reference provides more conservative estimates than the CDC reference, accounted for more by the difference in estimates of obesity than by the difference in estimates for overweight.     

Obesity, overweight and thinness in schoolchildren of the city of Florianópolis, Southern Brazil

OBJECTIVE: To assess the prevalence of obesity, overweight (including obesity) and thinness in children of the city of Florianopolis (southern Brazil). DESIGN: Cross-sectional study. SUBJECTS: Representative sample of 7-10-y-old schoolchildren of the first four grades of elementary schools (1432 girls, 1504 boys). METHODS: Measurements of weight, height and triceps skinfold thickness (TSF) were taken following standard techniques. The body mass index (BMI) was computed as weight/height2. Nutritional status was defined using two references: (1) the Must et al reference for BMI and TSF to define thinness, overweight and obesity (5th, 85th and 95th percentiles, respectively); (2) the International Obesity Task Force (IOTF) BMI cutoffs to define overweight and obesity. RESULTS: Using BMI, according to the Must et al, and IOTF references, the prevalence of obesity was 10.6 and 5.5%, respectively; overweight (including obesity) affected 26.2 and 22.1% of children, respectively. According to the Must et al reference, the prevalence of thinness was 3.2%. Using TSF rather than BMI, according to the Must et al references, fewer children were classified as obese (8.0%) or overweight (20.2%) and more children were classified as thin (4.9%). CONCLUSION: This study supports the previously reported high frequencies of childhood overweight and obesity in developing countries. The data allow comparisons with other studies carried out in Brazil and other parts of the world.     

1991—2015年中国9个省份儿童青少年超重和肥胖率的变化趋势分析

目的分析1991—2015年中国9个省份儿童青少年超重和肥胖率的变化趋势。方法采用1991—2015年9次“中国健康与营养调查”数据,选取资料完整的14888名6~17岁儿童青少年为研究对象。超重和肥胖分别采用2000年国际肥胖工作组(IOTF)制定的全球儿童超重和肥胖标准(IOTF标准)、2007年世界卫生组织(WHO)制定的学龄儿童青少年生长参照标准(WHO标准)、2009年李辉等制定的儿童超重肥胖筛查体重指数界值(专家标准)及2018年原国家卫生和计划生育委员会发布的学龄儿童青少年超重与肥胖筛查界值(行业标准)进行判定。采用多元线性回归模型分析1991—2015年儿童青少年体重指数变化趋势,采用logistics回归模型分析1991—2015年超重和肥胖率的变化趋势。结果调整年龄、性别和地区后,体重指数由1991年(2363名)的17.26 kg/m2上升至2015年(1060名)的18.72 kg/m2(P趋势<0.001)。根据IOTF标准、WHO标准、专家标准和行业标准,超重率分别由1991年的4.06%、5.37%、5.16%、4.27%增长至2015年的13.58%、16.23%、13.30%、11.70%(P趋势<0.001),肥胖率分别由1991年的1.02%、1.86%、2.24%、2.41%增长至2015年的7.45%、10.75%、12.08%、12.74%(P趋势<0.001)。结论1991—2015年,我国9个省份儿童青少年体重指数水平、超重和肥胖率均呈逐年增加趋势。     

Detection of overweight and obesity in a national sample of 6-12-y-old Swiss children: accuracy and validity of reference values for body mass index from the US Centers for Disease Control and Prevention and the International Obesity Task Force

BACKGROUND: For defining overweight in children, reference values for body mass index (BMI) are available from the US Centers for Disease Control and Prevention (CDC) and the International Obesity Task Force (IOTF). However, these 2 sets of reference criteria differ, and their accuracy in classifying adiposity has not yet been validated in most countries. OBJECTIVE: We compared BMI criteria from the IOTF and the CDC with percentage of body fat (%BF) from multisite skinfold thicknesses (SFTs) for identification of overweight in 6-12-y-old Swiss children. DESIGN: In a representative sample (n = 2431), weight, height, and 4 SFTs were measured. Regression and receiver operating characteristic (ROC) curves were used to evaluate BMI as an indicator of adiposity. RESULTS: BMI and %BF were well correlated (r(2) = 0.74), and the areas under the ROC curves for overweight and obesity were 0.956-0.992. The sensitivity and specificity of the IOTF and CDC overweight criteria and of the CDC obesity criteria were high. The sensitivity of the IOTF obesity criteria was only 48% and 62% in boys and girls, respectively. Overall, the performance of the CDC criteria was superior. With the use of the CDC criteria, the prevalence of overweight in girls and boys was 19.1% and 20.3%, respectively. CONCLUSIONS: BMI is an excellent proxy measure of adiposity in 6-12-y-old children. In Swiss children, both BMI criteria accurately predict overweight, but the sensitivity of the IOTF obesity criteria is poor. They failed to detect one-half of the children identified as obese on the basis of %BF from SFTs.     

Diagnosis of overweight and obesity in adolescents from the 1993 Pelotas Birth Cohort Study, Rio Grande do Sul State, Brazil: comparison of two diagnostic criteria

Various cut-off points for body mass index have been proposed to assess nutritional status in adolescents. The aim of this study was to compare two methods for evaluating overweight and obesity. In 2004-5, 4,452 adolescents from the 1993 Pelotas (Brazil) birth cohort study were evaluated, representing 87.5% of the original cohort. Overweight and obesity were evaluated using the methods proposed by the World Health Organization (WHO) and International Obesity Task Force (IOTF). Prevalence of overweight was similar when comparing the two methods (WHO: 23.2%; IOTF: 21.6%). Prevalence of obesity was higher according to the WHO criterion (total sample: 11.6%; boys: 15.1%; girls: 8.2%) as compared to IOTF (total sample: 5.0%; boys: 5.6%; girls: 4.4%). The kappa statistic was around 0.9 for determining overweight and 0.4 for obesity. The IOTF classification showed high specificity in comparison to the WHO criterion for determining overweight and obesity. However, sensitivity was high for overweight but low for obesity. Our data show that the IOTF classification underestimates the prevalence of obesity in early adolescence.     

Prevalence and socio-demographic associations of undernutrition and obesity among preschool children in Cyprus

OBJECTIVE: To estimate the prevalence of undernutrition and obesity in preschool children in Cyprus and identify possible associations. DESIGN: Cross-sectional study. SETTING: Private and public nursery schools. SUBJECTS: A representative sample (n=1412) stratified by age, gender, district and area of residence. INTERVENTIONS: Weight (kg) and height (cm) were obtained and BMI (kg/m2) was calculated. Z scores for weight-for-age, height-for-age, and weight-for-height were calculated using the cutoffs from the CDC/WHO 1978 reference. Socio-demographic associations with nutritional status were examined in a logistic regression analysis. RESULTS: The prevalence of undernutrition (WHO definition, Z-scores <-2) was low. Specifically the prevalence of underweight was 2.3%, wasting 2.8%, and stunting 1.1%. Undernutrition was associated with a low birth weight (LBW); odds ratio (OR) for underweight 4.1 (95% CI: 1.4, 12.2), P=0.012, stunting 5.2 (95% CI: 1.1, 23.3), P=0.033, and wasting 4.2 (95% CI: 1.3, 14.3), P=0.021.The prevalence of obesity (IOTF definition) was higher than undernutrition, and increased with age: 1.3% in 2 y olds to 10.4% in 6 y olds. Overweight and obesity prevalence were higher in rural (16.1%) than urban children (12.8%; P=0.046). Obesity in preschool children was associated with paternal obesity, OR 3.24 (95% CI: 1.59, 6.61), P=0.001, and maternal obesity 3.91 (95% CI: 1.78, 8.59), P=0.001. A birth weight (BW)> or =4000 g was associated with obesity compared to a BW between 2501 and 3000 g, OR 7.63 (95% CI: 1.91, 30.52), P=0.004. CONCLUSIONS: The prevalence of undernutrition among preschool children in Cyprus was low but obesity prevalence was higher. Parental obesity and high BW were significantly associated with obesity while LBW was associated with undernutrition in preschool children.     

基于国内外不同标准的苏州市6~17岁儿童青少年营养状况的比较

目的 比较最新颁布的儿童青少年消瘦超重肥胖国家标准与WHO及国际标准,描述苏州市6~17岁儿童青少年营养状况。 方法 选取苏州市7 340名6~17岁儿童青少年,男性3 821名,女性3 519名,测量其身高、体重,计算体质指数。分别采用WHO标准、国际标准、中国标准进行评价。 结果 依据WHO标准、国际标准、中国标准,消瘦检出率分别为2.3%,8.4%,5.2%(两两比较均P<0.05);超重检出率分别为20.0%,19.6%,17.4%(中国标准低于WHO和国际标准,P<0.05);肥胖检出率分别为11.5%,6.7%,14.1%(两两比较均P<0.05)。与此同时,不同年龄、性别分组,基于不同标准的营养状况差异不同。WHO和国际标准一致性(Kappa=0.705)、中国和国际标准一致性(Kappa=0.692)低于WHO和中国标准对不同营养状况检出率的一致性(Kappa=0.811)。 结论 儿童营养健康(消瘦、超重、肥胖)成为苏州的重要公共卫生问题。中国标准与WHO及国际标准检出情况存在一定差异,应谨慎使用。     

Prevalence and factors associated to overweight and obesity in public schools

This study assessed the association between environmental factors and the prevalence of overweight and obesity in public schools. It was studied 480 students, by means of anthropometric measurements evaluation, weight and height--BMI by sex and age and in accordance with the parameters of WHO and IOTF. Environmental information was obtained using a questionnaire applied to students. The Epi Info Program, version 3.3.2, was used to data collection and analysis. Prevalence rates of obesity varied according to the criteria it was used. According to the IOTF, prevalence of obesity was 7.1%, while, according parameters of the WHO, the prevalence was 18%. The significant risk factor for obesity was the father obesity (PR = 1.08; CI: 0.57-2.04). We concluded that the nutritional profile of the school serves as a subsidy for tracking trends of overweight in this group. This study could instruct the rationalization of the use of the time and public financial resources, proving the need to invest in the school feeding and in the health students.     

济南市城区6～17岁儿童青少年超重和肥胖流行现状

目的采用国内外儿童超重肥胖筛查标准描述济南市城区儿童青少年超重和肥胖流行现状,为政府和教育部门制定儿童肥胖干预策略提供基础数据。方法数据来源于2012年9月-2014年9月开展的"十二五"国家科技支撑计划项目"儿童心血管疾病预警、诊治技术研究"分课题济南调查点。共纳入济南市城区7 840名6~17岁儿童青少年。使用中国标准、美国疾病预防控制中心(CDC)标准、国际肥胖问题工作组(IOTF)标准和世界卫生组织(WHO)标准描述济南市城区学龄儿童超重肥胖流行现状,并计算加权kappa值(kw)比较中国标准与国际标准之间的一致性。结果采用4种BMI筛查标准,济南市城区6~17岁儿童青少年超重率分别为21.0%(中国标准)、17.2%(CDC标准)、21.0%(IOTF标准)和22.1%(WHO标准),肥胖率分别为19.9%(中国标准)、17.4%(CDC标准)、12.4%(IOTF标准)和18.6%(WHO标准)。无论采用何种标准,男生肥胖率显著高于女生,6~11岁组肥胖率显著高于12~17岁组。中国标准与三种国际标准即CDC、IOTF和WHO标准之间的一致性很好,kw值分别为0.88、0.80和0.91。结论济南市城区6~17岁儿童青少年超重肥胖流行现状严峻,主要集中在男童和6~11岁儿童,提示相关部门应尽早采取干预措施。     

北京市2004年2-18岁儿童青少年超重和肥胖流行现状

目的分析北京市2～18岁儿童青少年超重和肥胖检出率水平及分布特征.方法利用2004年北京市儿童代谢综合征调查总样本中21 198名2～18岁人群的体重指数数据,分别采用中国（WGOC标准）、美国疾病预防控制中心（CDC 2000标准）和国际肥胖工作组（IOTF标准）推荐的儿童青少年超重和肥胖体重指数分类标准计算超重和肥胖检出率.结果北京市2～18岁儿童青少年合并超重（包括肥胖）检出率、肥胖检出率分别是18.6%和8.1%（CDC 2000标准）,17.4%和5.1%（IOTF标准）;根据WGOC计算的7～18岁合并超重检出率和肥胖检出率是20.9%和8.9%.学龄儿童（6～18岁）的合并超重率高于学龄前儿童（19.8%：14.8%,CDC 2000标准）;学龄儿童中,男性高于女性（26.7%：16.5%,WGOC标准）,城市高于农村（27.0%：15.9%,WGOC标准）;学龄前儿童城乡间差异无统计学意义.结论北京市有1/5的儿童青少年超重或肥胖,居国内最高水平.儿童青少年肥胖已经成为北京市一个重要公共卫生问题,需要引起社会高度关注.     

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

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

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

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

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

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

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.     

宁波地区7岁以下儿童超重和单纯性肥胖调查及三种筛查方法比较研究

目的 了解宁波地区7岁以下儿童单纯性肥胖发生情况,探讨BMI不同参照标准在儿童超重、肥胖筛查的应用.方法 随机整群抽样调查64 038名儿童的身高、体重,按WHO 2006年推荐的身高标准体重值,体重达身高标准体重≥10%为超重、≥20%为肥胖,剔除伴肥胖的遗传性疾病和内分泌疾病.并分别采用WHO与国际肥胖工作组(IOTF)推荐的超重、肥胖BMI参照值对同一人群计算超重、肥胖检出率.结果 按WHO身高标准体重值宁波市7岁以下儿童超重和单纯性肥胖检出率分别为4.25%和2.88%,其中男童分别为4.45%和3.01%,女童分别为3.86%和2.56%,男童与女童的超重和肥胖检出率差异有统计学意义(P<0.01).儿童超重和肥胖检出率随年龄增长而逐渐上升,6岁时男童分别达到11.84%和9.68%、女童分别达到10.14%和9.46%.不同年龄组和性别超重/肥胖比在1.15～1.94:1之间.调查人群BMI的P85、P95均低于WHO与IOTF标准中"超重"、"肥胖"的BMI判断界值,使用WHO与IOTF推荐的BMI参照值宁波市7岁以下儿童超重、肥胖检出率分别为9.72%、2.83%和6.11%、0.55%.结论 儿童早期是预防日后肥胖的关键时期,男童是预防和控制肥胖发生、发展的重点人群,应将预防和控制儿童肥胖工作列入儿童保健服务之中,建议尽快建立适合中国7岁以下儿童超重、肥胖筛查的BMI参考值.     

Prévalence de l’obésité et du surpoids chez les écoliers de primaire à Marrakech,Maroc

BackgroundChildhood obesity is a phenomenon of growing concern today because of its rapid growth worldwide. The aim of our study was to estimate the prevalence of overweight and obesity among school age children in Marrakech.MethodsWe conducted a cross-sectional study of a random sample of 1418 schoolchildren aged 8–15 years in the public sector in Marrakech in May 2011. Trained physicians measured the weight and size of respondents. The body mass index (BMI) was calculated for each child. Overweight was assessed by comparing BMI with World Health Organization (WHO) and International Obesity Task Force (IOTF) references. Statistical analysis was performed using SPSS version 16.0 and using a macro of WHO Anthro for SPSS.ResultsThe mean age was 10.8 ± 1.6 years. The sex ratio (girl/boy) was 1. The prevalence of overweight and obesity were 8 % (95 % CI [6.7, 9.6]) and 3 % (95 % CI [2.2, 4.1] based on WHO reference. This prevalence were respectively 12.2 % (95 % IC [10.5; 14.0]) and 5.4 % (95 % IC [4.3; 6.7]) using the IOTF reference.ConclusionIn the absence of national data, our results reflect the importance of the phenomenon in our context, hence the importance of monitoring the nutritional status on both individual and collective levels and the need to develop strategies for prevention, diagnosis and early treatment before the problem becomes more widespread.     

Prevalence and trends in overweight and obesity among children and adolescents in Denmark

AIM: To study the current prevalence and trends in overweight and obesity among children and adolescents in Denmark from 1995 to 2000-2002. METHODS: Cross-sectional national dietary surveys were conducted in 1995 and 2000-2002. The analysis was based on two random population samples from the Danish civil registration system. Body mass index (BMI) was calculated from self-reported height and weight for 1,026 and 1,152 children and adolescents (4-18 years), who participated in 1995 and 2000-2002, respectively. The prevalence of overweight and obesity was defined according to the international age and gender-specific child BMI cut-off points. In the statistical analysis, overweight and obesity were included in the prevalence of overweight. RESULTS: Mean BMI increased significantly between 1995 and 2000-2002 for all combinations of age groups (4-6, 7-10, 11-14 and 15-18 years) and genders. Prevalence of overweight increased between survey years for boys and girls for all age groups (4-6, 7-10, 11-14 and 15-18 years), although formal statistical significance was not reached (p>0.05). When all children and adolescents (4-18 years) were analysed, the prevalence of overweight rose significantly from 10.9% (95% confidence interval (CI) 9.0-12.8) to 14.4% (95% CI 12.5-16.3) between 1995 and 2000- 2002 (p=0.01), whereas the increase in the prevalence of obesity did not reach significance (1995, 2.3% (95% CI 1.3-3.3) vs. 2000-2002, 2.4% (95% CI 1.6-3.3); p=0.74). CONCLUSIONS: The present study revealed a significant increase from 1995 to 2000-2002 in mean BMI for boys and girls for all age groups and a significant increase in the prevalence of overweight when all Danish children and adolescents (4-18 years) were analysed.     

Familial risk of overweight and obesity in the Canadian population using the WHO/NIH criteria

OBJECTIVE: To determine the familial risk of overweight and obesity in Canada. RESEARCH METHODS AND PROCEDURES: The sample was comprised of 15,245 participants from 6377 families of the Canada Fitness Survey. The risk of overweight and obesity among spouses and first-degree relatives of individuals classified as underweight, normal weight, pre-obese, or obese (Class I and II) according to the WHO/NIH guidelines for body mass index (BMI) was determined using standardized risk ratios. RESULTS: Spouses and first-degree relatives of underweight individuals have a lower risk of overweight and obesity than the general population. On the other hand, the risk of Class I and Class II obesity (BMI 35 to 39.9 kg/m2) in relatives of Class I obese (BMI 30 to 34.9 kg/m2) individuals was 1.84 (95% CI: 1.27, 2.37) and 1.97 (95% CI: 0.67, 3.25), respectively, in spouses, and 1.44 (95% CI:1.10, 1.78) and 2.05 (95% CI: 1.37, 2.73), respectively in first-degree relatives. Further, the risk of Class II obesity in spouses and first-degree relatives of Class II obese individuals was 2.59 (95% CI: -0.91, 6.09) and 7.07 (95% CI: 1.48, 12.66) times the general population risk, respectively. DISCUSSION: There is significant familial risk of overweight and obesity in the Canadian population using the BMI as an indicator. Comparison of risks among spouses and first-degree relatives suggests that genetic factors may play a role in obesity at more extreme levels (Class II obese) more so than in moderate obesity.