Breast-feeding history and overweight in Latino preschoolers.

OBJECTIVE: Describe the relationship between breast-feeding history and risk of overweight in the preschool years in a sample of primarily Mexican-origin Latinos. METHODS: Children's breast-feeding history, health history, and demographics were obtained in interviewer-administered questionnaires of a convenience sample of 364 parents of children ages 2-5 in an outpatient clinic waiting room serving a predominantly Mexican immigrant population in a large Midwestern city. Child weight status was determined by weighing and measuring each child and calculating age- and sex-specific body mass index (BMI) percentile using 2000 Centers for Disease Control reference values, with children > or =95th percentile defined as overweight. RESULTS: Seventy-six of 364 children (21%) were overweight. Eighty-seven percent of children had been breast-fed. Increased duration of breast-feeding was associated with a linearly decreased risk of overweight in bivariate analysis, ranging from an overweight prevalence of 35% for those never breast-fed to 12% for those breast-fed for at least a year. This inverse relationship remained significant in the smaller sample for which maternal BMI data were available (n = 127), as each additional month of breast-feeding was associated with a 10% decreased odds ratio (OR) of overweight (adjusted OR = 0.90; 95% CI = 0.81, 0.99) after controlling for child's sex, current age, prematurity, birth-weight category, maternal education level, and maternal weight status. CONCLUSION: This sample of children of Mexican-origin immigrant families had high rates of overweight at very young ages but also very high rates of breast-feeding. Duration of breast-feeding was strongly and inversely related with prevalence of overweight as a preschooler.     

Breast-feeding and overweight in Singapore school children

Background:  Studies from developed Western countries have shown inconsistent associations between breast-feeding and overweight/obesity in children and adolescents. Few data are available from Asian populations. The purpose of the present study was therefore to evaluate the association between breast-feeding and overweight/obesity in a study of 10–12-year-old children in Singapore.
Methods:  A total of 797 school children (49% girls, 76% Chinese) who participated in the Singapore Cohort Study of the Risk Factors for Myopia (SCORM) were examined. Overweight/obesity ( n  = 179) was defined as age–sex-specific body mass index (BMI) cut-offs corresponding to BMI of 25 kg/m² for overweight and 30 kg/m² for obesity at age 18 based on the International Obesity Task Force (IOTF) reference.
Results:  The prevalence of overweight/obesity was 22.5%. Overall, breast-feeding was not found to be associated with overweight/obesity. After adjusting for potential confounders, the multivariable odds ratio (95% confidence interval) of overweight/obesity was 1.14 (0.80–1.63) for ever breast-fed compared with never breast-fed, 1.00 (0.57–1.72) for breast-fed for >3 months compared to ≤3 months and 0.79 (0.47–1.34) for exclusive/mostly breast-fed compared to partly breast-fed.
Conclusions:  No significant associations were detected among breast-feeding, its type, and duration with overweight/obesity in this Asian cohort of 10–12-year-old children.     

Decreased quality of life associated with obesity in school-aged children

OBJECTIVES: To examine the association between health-related quality of life and body mass index (BMI) in preadolescent school-aged children and to provide the possible risk factors among participant characteristics, BMI status, and health-related quality of life.Design, Setting, and PARTICIPANTS: Cross-sectional analysis of 371 (50% female; 32% minority) children from a community-based sample of 8- to 11-year-olds participating in an ongoing cohort study, excluding those who had sleep apnea or who were born prematurely. Using BMI percentiles for age and sex, 17.5% of the children were considered overweight (BMI > or =95th percentile), 12.4% were at risk for overweight (BMI 85th-94th percentile), 8.1% were relatively underweight (BMI <20th percentile), and the remaining 62.0% were of normal weight (BMI 20th-84th percentile). MAIN OUTCOME MEASURES: Health-related quality-of-life scores as determined by the Child Health Questionnaire-Parent Form 50, dichotomized into the bottom quartile or decile. RESULTS: After adjustment for covariates (host factors and health status measurements), overweight children compared with normal weight children scored lower on the Psychosocial Health Summary (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.1-3.6) and on subscales measuring self-esteem (OR, 3.5; 95% CI, 1.9-6.3), physical functioning (OR, 2.8; 95% CI, 1.7-6.8), and effect on the parent's emotional well-being (OR, 2.0; 95% CI, 1.1-3.6). Compared with the normal weight group, children who are at risk for overweight scored significantly lower for physical functioning. CONCLUSION: Overweight children have an increased odds of low scores for several health-related quality-of-life domains, suggesting the importance in considering such dimensions in programs aimed at further understanding obesity in children.     

Effect of activity restriction owing to heart disease on obesity

OBJECTIVE: To determine whether exercise intolerance and recommended activity restrictions are associated with development of overweight and obesity in children with congenital heart disease. DESIGN: Retrospective review. SETTING: Pediatric cardiology practice at a teaching hospital. PARTICIPANTS: A total of 110 pediatric congenital heart disease patients followed up for a mean of 8.4 years. MAIN OUTCOME MEASURES: Body mass index (BMI), sex-appropriate BMI percentiles, overweight (BMI percentile > or =85), and obesity (BMI percentile > or =95) at follow-up. RESULTS: As a group, the increase in BMI percentiles was close to 10 points, but the increase was 21.6 points for exercise intolerant children and 27.3 points for activity restricted children. Activity restriction was significantly associated with both overweight (risk ratio [RR], 2.60; 95% confidence interval [CI], 1.34-3.54) and obesity at follow-up (RR, 4.08; 95% CI, 1.42-7.38) after adjusting for weight at baseline. For the subset of 92 children at a healthy weight at baseline, activity restriction was again significantly associated with overweight (RR, 2.51; 95% CI, 1.24-3.52) and obesity (RR, 6.14; 95% CI, 2.54-8.82) at follow-up. Exercise intolerance did not attain statistical significance. CONCLUSIONS: Exercise intolerant and activity restricted children experienced larger increases in absolute BMI and BMI percentile than children with neither exercise intolerance nor activity restriction. Activity restriction was the strongest predictor of risk of overweight and obesity at follow-up. Elevated weight and obesity may cause these children significant additional health burdens. Therefore, when patients must be counseled against physical exertion, they also need to be educated about the importance of appropriate physical activity and good dietary practices.     

Breast-feeding history and overweight in 11 to 13-year-old children in Iran

Background  The relationship between breast-feeding history and risk of overweight in pre-adolescent children was investigated. Methods  Children’s breast-feeding history and demographics were obtained in interviewer-administered questionnaires of a multistage cluster sample survey of 800 parents of children aged 11–13 years living in Yazd, Iran. Height and weight were measured in the children. Overweight was defined as body mass index ≥90th age- and sex-specific percentile of the 2000 Centers for Disease Control reference values. Results  One hundred and four (13.0%) of 800 children were overweight. A total of 783 (97.9%) of the children had been breast fed. There was a markedly lower overweight prevalence among breast-fed than non breast-fed children. Controlling for age and sex, children breast fed for at least 24 months were substantially less likely to be overweight than children breast fed for less than 12 months (OR 0.56, 95% CI 0.31–0.9). A longer overall duration and duration of exclusive breast-feeding were associated significantly with the decreasing prevalence of overweight. Conclusion  This sample of Iranian children shows high rates of overweight at young ages but also high rates of breast-feeding. The duration of breast-feeding is inversely related with the prevalence of overweight in pre-adolescent children.     

Gender, type of education, family background and overweight in adolescents.

OBJECTIVE: To examine gender-specific socio-educational correlations of overweight in adolescents enrolled in post-mandatory education. SUBJECTS AND METHODS: Data were drawn from the Swiss Multicenter Adolescent Survey on Health, a cross-sectional study conducted on a representative sample of 3439 females and 4109 males aged 16 to 20 and enrolled in either vocational education (apprentices) or full time school (students). Adolescents reporting a body mass index (BMI) > 85th percentile for age and gender were compared with those reporting a BMI around the median (25th-75th percentile). RESULTS: Multivariate logistic regression showed that apprentices of both genders were more likely to report a BMI > or = 85th percentile than students: odds ratio (OR) in females 1.49 (95% confidence interval [CI] 1.11, 1.99), OR in males 1.61 (95%CI 1.19, 2.19). In females, but not in males, reported BMI was associated with parental education level (father with baccalaureate or university degree, OR = 1.00; father with vocational proficiency certificate, OR = 1.48 [95% CI 1.06, 2.07] and father without post-mandatory education, OR =3.44 [95% CI 2.20, 5.38]). CONCLUSIONS: The observed differences in the correlation of parents' and adolescents' own educational status with overweight suggest that parental and adolescents' own education represent distinct risk factors for overweight. Apprentices' higher risk of being overweight might be of particular interest for prevention, as they represent a large number of adolescents, who enter the adult workforce at a young age. Overall, socio-educational characteristics explained only a small fraction of the variance in overweight, particularly in males.     

Body mass index measurements and prevalence of overweight and obesity in school-children living in the province of Belgian Limburg

In order to evaluate the distribution of body mass index (BMI) and the prevalence of overweight and obesity in school-children living in the province of Belgian Limburg, BMI percentiles for 9,487 children aged 3.2 to 16.0 years were calculated and compared with the Dutch 1980 values. Although the 5th and 50th percentile BMI values were comparable to or only slightly above the reference values, the 85th and 95th percentiles were much higher revealing an increased degree of obesity in the studied population. The prevalence of overweight and obesity, determined by calculating the proportion of children with a BMI value above the 85th or 95th percentile of the Dutch 1980 reference, ranged for overweight from 15% at the age of 3-4 years to 33% at the age of 12-13 years, and for obesity from 6% to 19%. CONCLUSION: this study shows a dramatic increase in upper body mass index percentiles and in the prevalence of overweight and obesity in children living in the province of Belgian Limburg. Strategies to prevent obesity in childhood should be a priority in child public health programmes.     

Do mothers of overweight Argentinean preschool children perceive them as such?

Childhood overweight is rapidly on the rise and underlies the younger presentation of diabetes. The aim of this study was to determine the association between overweight and age, sex, and the perception of the overweight children by their mothers. Three hundred and twenty-one (160 males) children (mean age 4.39 +/- SD 0.83 yr) [body mass index (BMI) 16.6 +/- 2.11] from schools at the kindergarten level were evaluated. Data on age, sex, weight, and height were recorded. At risk for overweight and overweight were defined as a BMI of > or = 85th or > or = 95th percentile, respectively. Written questionnaires for mothers' perceptions about their children's eating habits (a lot, right, little, or very little) and shape (very fat, fat, normal, and thin) were performed. The prevalence of at risk of overweight and overweight was 19 and 18.4%, respectively. There was a significant difference in the proportion of distorted perception of shape between mothers of normal-weight children vs. those of at risk of overweight and overweight children (17 vs. 87.5%, p < 0.001). Seventy-six and 98% of mothers of overweight and at risk of overweight children, respectively, rated them as normal or thin. Mothers exhibited poor overall ability to estimate the way at risk of overweight and overweight children ate. There was a significant difference in the proportion of distorted perception of eating habits between mothers of normal-weight children vs. those of at risk of overweight and overweight children (36.3 vs. 90.8%, p < 0.001). Eighty-four and 96% of mothers of obese and overweight children, respectively, thought that their children ate right or little. A multiple regression analysis using BMI > 95th percentile as the dependent variable showed that the mothers' perceptions of shape and eating habits [odds ratio 4.5; 95% confidence interval (CI) 2.5-7.8; p < 0.0001] were both significant independent risk factors for overweight, adjusted for age and sex. The agreement between the perception of shape and eating habits vs. the medical records BMI > 95th percentile was poor; for shape: kappa 0.31 + 0.07; 95% CI 0.17-0.44, and for nutrition: 0.14 + 0.06; 95% CI 0.02-0.27. This suggests that the mothers' perceptions of shape and eating behavior is a predictor of obesity and could be used in clinical practice as a simple tool to identify children at high risk for overweight.     

Risk factors in childhood obesity-findings from the All Babies In Southeast Sweden (ABIS) cohort

AIM: Our objective was to investigate whether overweight at a very young age predicts overweight at 5 years and to identify risk factors for overweight/obesity at 5 years, thereby making it easier for Child Health Services to focus their prevention strategies on risk groups. METHODS: We analysed data from the ABIS study (All Babies In Southeast Sweden), a prospective cohort study. Parents answered questionnaires between childbirth (n = 16,058) and 5 years (n = 7356). RESULTS: High body mass index (BMI; >95th percentile) at 1 year (adjusted odds ratio [AOR]= 6.57; 95% CI = 4.63-9.33; p < 0.001) and age-adjusted BMI > 25 at 2.5 years (AOR = 14.24; 95% CI = 10.52-19.29; p < 0.001) were associated with increased risk of obesity (age-adjusted BMI > 30) at 5 years. Heredity for type 2 diabetes (p = 0.022), high parental BMI and the child's own BMI at birth and at 1 year predicted higher BMI of the child at 5 years (p < 0.001). High parental education was inversely associated with child overweight (p = 0.054 respective p < 0.005). CONCLUSION: Obesity at age 1 and at 2.5 years predicts obesity at 5 years. Obese parents, especially in families with heredity for type 2 diabetes and low education, should be targeted in early obesity prevention strategies by the Child Health Service.     

Prevalence of abnormal serum aminotransferase values in overweight and obese adolescents

OBJECTIVES: (1) To determine the prevalence of abnormal liver enzymes in overweight and obese adolescents and (2) to determine the relationship of alcohol ingestion and serum antioxidants to the presence of abnormal liver enzymes in overweight and obese adolescents. METHODS: Serum alanine aminotransferase (ALT) and gamma-glutamyl transpeptidase levels were measured in 2450 children between the ages of 12 and 18 years, enrolled in the National Health and Examination Survey, cycle III (NHANES III). Obesity was defined as a body mass index >95th percentile for age and sex. Overweight was defined as a body mass index >85th percentile for age and sex. Nutritional intake was assessed by 24-hour dietary recall and food frequency questionnaires. Serum antioxidants were measured by high-pressure liquid chromatography. RESULTS: Sixty percent of adolescents with elevated ALT levels were either overweight or obese. Overall, 6% of overweight adolescents had elevated ALT levels (odds ratio: 3.4 [95% CI: 3.5-12.8]). Ten percent of obese adolescents had elevated ALT levels (odds ratio: 6.7 [95% CI: 3.5-12.8]). In addition, approximately 1% of obese adolescents demonstrated ALT levels over twice normal. Approximately 50% of of obsese adolescents who reported modest alcohol ingestion (4 times per month or more) had elevated ALT levels (odds ratio: 10.8, 95% CI: 1.5-77). Other factors associated with elevated ALT levels in overweight and obese adolescents include increased age, elevated glycolated hemoglobin, elevated triglycerides, and decreased levels of serum antioxidants-vitamin E, beta-carotene, and vitamin C. CONCLUSION: Overweight and obesity are the most common findings in adolescents with elevated ALT levels. Even modest alcohol consumption may significantly increase the likelihood of obese adolescents developing obesity-related liver disease.     

Association between school children's overweight and maternal obesity and perception of their children's weight status

AIM: To determine the association between overweight children and a) other components of the mothers' metabolic syndrome, such as body mass index (BMI), waist circumference (WC), HDL-cholesterol, triglycerides, glucose, HOMA-IR, blood pressure (BP), and age; and b) the mothers' perception of their children's overweight. METHODS: Six hundred and twenty children (297 M) aged 9 +/- 2 years and their mothers aged 37.7 +/- 7 years were examined between April and August 2006. BMI, BP, fasting glucose and lipids and children's Tanner stage were determined. Questionnaires were filled in about the mothers' perceptions of their children's eating habits and of their children's shape. RESULTS: Ninety-five (17.4%) of the children were obese (> 95th percentile), 108 (15.3%) overweight (> 85th percentile) and 418 (67.3%) normal. One hundred and twelve (18%) of the mothers were obese and 183 (29.5%) overweight. Mean values for measures in mothers differed between normal vs overweight/obese children: z-BMI (-0.19 vs 0.42), triglycerides (84 vs 105 mg/dl), cholesterol (147 vs 157 mg/dl), glucose (78 vs 82 mg/dl) and insulin resistance (HOMA-IR 1.34 vs 1.72). There were significant differences in the proportion with distorted perception of shape (2.2% vs 47.5%) and eating habits (11.2% vs 37%) between mothers of normal versus overweight/ obese children. Logistic regression analysis using BMI > or = 85th percentile as the dependent variable showed that the mothers' perceptions of their children's shape (OR: 18.84; 95% CI: 5.0-69.6), eating habits (OR: 3.82; 95% CI: 1.5-9.5) and mothers' BMI (OR: 2.1; 95% CI: 1.3-3.4) were associated with children's overweight. CONCLUSIONS: There was an association between mothers' distorted perception of their children's shape and eating habits and mothers' obesity and their children's overweight. This observation provides clues for obesity prevention programs.     

A study of growth parameters and prevalence of overweight and obesity in school children from delhi

OBJECTIVE: (1) To assess the height, weight and body mass index (BMI) of school children from Delhi and generate percentile charts as appropriate for age, gender and socio-economic status. (2) To determine the prevalence of overweight and obesity in school children from low and upper socioeconomic status (LSES and USES respectively). DESIGN: Cross sectional evaluation of anthropometric parameters in Delhi school children (5-18 years) from different geographical zones. SETTING: Government schools (non-fee paying) and Private Schools (fee paying) in Delhi. SUBJECTS: 21485 children, 8840 (3566 boys, 5274 girls) from government schools and 12645 (6197 boys, 6448 girls) from private schools. Methods: Subjects underwent assessment of height and weight and calculation of BMI. Children were classified as normal, overweight and obese as per IOTF guidelines. Height, weight and BMI percentile charts specific for the socioeconomic status were generated using the LMS method. Prevalence of overweight and obesity was assessed and compared between the two socio-economic groups. RESULTS: A significant difference was noted in height, weight and BMI between LSES and USES. The prevalence of overweight and obesity in USES children was 16.75 % and 5.59 % in boys and 19.01 % and 5.03 % in girls respectively. CONCLUSIONS: There is a significant disparity in anthropometric parameters between children from USES and LSES, with a high prevalence of overweight and obesity in USES children.     

Rise in childhood obesity with persistently high rates of undernutrition among urban school-aged Indo-Asian children.

BACKGROUND: Childhood obesity is an emerging global public health challenge. Evidence for the transition in nutrition in Indo-Asian developing countries is lacking. We conducted these analyses to determine the trends in nutritional status of school-aged children in urban Pakistan. METHODS: Data on the nutritional status of children aged 5 to 14 years from two independent population-based representative surveys, the urban component of the National Health Survey of Pakistan (NHSP; 1990-1994) and the Karachi survey (2004-2005), were analysed. Using normative data from children in the United States as the reference, trends for age- and gender-standardised prevalence (95% CI) of underweight (more than 2 SD below the weight-for-age reference), stunted (more than 2 SD below the height-for-age reference) and overweight and obese (body mass index (BMI) 85(th) percentile or greater) children were compared for the two surveys. The association between physical activity and being overweight or obese was analysed in the Karachi survey using logistical regression analysis. RESULTS: 2074 children were included in the urban NHSP and 1675 in the Karachi survey. The prevalence of underweight children was 29.7% versus 27.3% (p = 0.12), stunting was 16.7% versus 14.3% (p = 0.05), and prevalence of overweight and obese children was 3.0 versus 5.7 (p<0.001) in the NHSP and Karachi surveys, respectively. Physical activity was inversely correlated with being overweight or obese (odds ratio, 95% CI, 0.51, 0.32-0.80 for those who engaged in more than 30 minutes of physical activity versus those engaged in less than 30 minutes' activity). CONCLUSIONS: Our study highlights the challenge faced by Pakistani school-aged children. There has been a rapid rise in the number of overweight and obese children despite a persistently high burden of undernutrition. Focus on prevention of obesity in children must include strategies for promoting physical activity.     

Birthweight, breast-feeding, parental weight and prevalence of obesity in schoolchildren aged 10–12 years, in Greece; the Physical Activity, Nutrition and Allergies in Children Examined in Athens (PANACEA) study

Background: The purpose of the present study was to determine the prevalence of overweight and obesity in a sample of Greek children aged 10–12 years, and to evaluate these rates in relation to parental weight and birthweight.
Methods: During the 2005–2006 school period, 700 schoolchildren (323 boys, 377 girls) were randomly recruited from 18 schools, in Athens. Height and weight were measured and body mass index (BMI) was calculated. Cut-off points for BMI defining obesity and overweight for gender and age were calculated in accordance with international standards.
Results: Overall, 8.6% of boys and 9.0% of girls were obese, and 33.9% of boys and 22.1% of girls were overweight. Having an obese parent increased the odds of having an overweight or obese child (P < 0.01). Compared to non-breast-fed, boys who were breast-fed for >3 months had 70% lower likelihood of being overweight or obese (P < 0.01) and breast-fed girls had 80% lower odds (P < 0.01). Excessive birthweight (>3500 g) increased by 2.5-fold the likelihood of being overweight or obese only in girls (P < 0.05).
Conclusions: Parental weight, lack of breast-feeding and excess birthweight (in girls) were significant predictors of overweight or obesity in Greek children aged 10–12 years.     

Can the metabolic syndrome identify children with insulin resistance?

OBJECTIVE: The metabolic syndrome is associated with insulin resistance in adults. We defined pediatric metabolic syndrome using criteria analogous to Adult Treatment Panel III. The purpose of this study was to determine whether these criteria are reliable for insulin resistance in children. RESEARCH DESIGN AND METHODS: Out of 167 children (6.7 +/- 3 yr), 73 overweight [body mass index (BMI) > 95 percentile], 41 at risk of overweight (BMI > 85 < 95 percentile), and 53 normal-weight (BMI < 85 percentile) children matched for sex and age were examined. The results for waist circumference, blood pressure, oral glucose tolerance test, C-reactive protein, adiponectin, insulin, and lipids were obtained. RESULTS: There was a comparable prevalence of the metabolic syndrome in both sexes. The prevalence of the metabolic syndrome was 11.3% [95% confidence interval (CI) 6.56-16.19%] among the whole group and 21.9% (95% CI 12.24-31.0%) among overweight children. Waist circumference >75 percentile 53.2% (95% CI 45.73-60.86%) and low high-density lipoprotein 27.5% (95% CI 20.77-34.32%) were common in this sample. Compared with patients without any component of the metabolic syndrome, homeostasis model assessment insulin resistance (HOMA-IR) for patients with one through four components was higher (beta = 0.6, 95% CI 0.4-0.7, p < 0.0001, R(2) = 0.185). A logistic regression analysis using the metabolic syndrome as the dependent variable showed that HOMA-IR (odds ratio 1.52, 95% CI 1.2-2.0, p = 0.007) was the only independent risk factor for the metabolic syndrome, adjusted for age and sex. CONCLUSIONS: The importance of insulin resistance in the metabolic syndrome is supported by the results of logistic regression analysis. Early identification of children may be useful to predict future cardiovascular disease and type 2 diabetes.     

Association between obesity and asthma in Japanese preschool children

Obesity may increase the risk of subsequent asthma. We have previously reported that there is a clear association between obesity and asthma in Japanese school-aged children. To evaluate whether a similar association exists in younger children, a nationwide cross-sectional questionnaire-based survey was performed focusing on children aged 4-5 yr. A child who had experienced wheezing during the past 12 months and had ever been diagnosed with asthma by a physician was defined as having current asthma. Overweight and underweight were defined as BMI ≥90th percentile and ≤10th percentile, respectively, according to the reference values for Japanese children from 1978 to 1981. After excluding 2547 children because of incomplete data, 34,699 children were analyzed. Current asthma was significantly more prevalent in overweight children compared with underweight and normal weight children (13.2% for overweight vs. 10.5% for underweight and 11.1% for normal weight; both p < 0.001). Even after adjusting for other variables, such as gender, other coexisting allergic diseases, and parental history of asthma, there was an association between overweight and current asthma (adjusted odds ratio: 1.23, 95% CI: 1.10-1.38, p < 0.001). Even in preschool children, obesity is already associated with asthma, and there was no gender effect on this association. Physicians should consider the impact of obesity when managing asthma in younger children.     

High body mass index, asthma and allergy in Swedish schoolchildren participating in the International Study of Asthma and Allergies in Childhood: Phase II

AIM: To assess the relationship between high body mass index (BMI) and asthma and atopic manifestations in 12-y-old children. METHODS: The relationship between high BMI and asthma symptoms was studied in 457 sixth-grade children, with (n = 161) and without (n = 296) current wheeze. High BMI was defined as > or = 75th percentile of gender-specific BMI reference values for Swedish children at 12 y of age; overweight as a subgroup of high BMI was defined as > or = 95th percentile. Children with a BMI < 75th percentile served as controls. Questionnaires were used to assess asthmatic and allergic symptoms, and bronchial hyperresponsiveness was assessed by hypertonic saline provocation tests. RESULTS: Current wheeze was associated with high BMI after adjustment for confounding factors (adjusted OR 1.7, 95% CI 1.0-2.5) and overweight had an even more pronounced effect (adjusted OR 1.9, 95% CI 1.0-3.6). In addition, asthma severity was associated with high BMI, as evaluated by the number of wheezing episodes during the previous 12 mo among the wheezing children (adjusted OR 2.0, 95% CI 1.0-4.0). There was also an association between high BMI and the presence of eczema in wheezing children (adjusted OR 2.2, 95% CI 1.0-4.6). However, high BMI was not significantly associated with hay fever, positive skin prick tests or bronchial hyperresponsiveness. CONCLUSION: The study confirms and extends a previously observed relationship between BMI and the presence of wheezing and asthma.     

Overweight and obesity prevalence in children and adolescents from a private school in Recife

OBJECTIVES: To determine the prevalence of overweight and obesity in students from a private school in Recife; compare the prevalence rates of overweight and obesity in boys and girls and in different age groups (children and adolescents) and verify the correlation between body mass index and triceps skinfold thickness in this population. METHODS: Cross-sectional study with 762 students (332 children and 430 adolescents) from a middle/upper class school in Recife, in 1999. Overweight was defined as body mass index equal or above the 85th percentile for age and gender. Obesity was defined as body mass index and triceps skinfold thickness equal or above the 85th percentile. RESULTS: The prevalence rates were 26.2% (95%CI = 23 to 29%) for overweight, and 8.5% (CI95% = 6.5 to 10.5%) for obesity. Overweight was more prevalent among children (34.3%) than among adolescents (20.0%) (P<0.001). Obesity was more frequent among children (14.2%) than among adolescents (4.2%) (P<0.001). The prevalence of overweight in boys (34.6%) was higher than in girls (20.6%) (P<0.001). The prevalence of obesity was also higher in boys (14.7%) than in girls (4.4%) (P<0.001). The correlation coefficient between body mass index and triceps skinfold thickness was equal to 0.64 (95%CI = 0.60 to 0.68). CONCLUSIONS: The prevalence of overweight in our study population was as high as that found in industrialized countries; obesity, however, was less frequent.     

Risk factors for overweight in 2- to 6-year-old children in Beijing, China.

OBJECTIVE: To assess the prevalence of overweight among Chinese preschool children and to explore risk factors of childhood obesity focusing on parental characteristics, feeding practice and lifestyle. METHODS: Data on 930 families with 2- to 6-year-old children in five kindergartens were obtained in a cross sectional study. Families were randomly selected from two of all six urban districts in Beijing, China. Information on parental characteristics, dietary habits, lifestyle habits, and feeding practice was collected by parental self-report questionnaires. The children's stature and weight were measured in light clothing and without shoes. Overweight and obesity were defined according to international cut-off values, as proposed by the International Obesity Task Force. Multivariate regression analysis was used to explore risk factors of child overweight. RESULTS: The overall prevalence of overweight and obesity was 10.7% and 4.2%, respectively, and increased with age. The prevalence of child overweight was 14.1% and 7.5% in obese and non-obese families, respectively. Significant associations were observed between child and parent characteristics for overweight, frequency of eating in restaurant, television hours, and hours of physical activity. Child overweight was associated with parental overweight (Odds Ratio [OR] 2.43, 95% CI 0.78, 6.59), low maternal education level (OR 2.22, 95% CI 1.39, 3.55), food restriction (OR 2.68, 95% CI 1.64, 4.29), and television watching >2h/d (OR 1.56, 95% CI 1.17, 2.09), after adjusting for sex, age, family income and kindergarten (for cluster study design). CONCLUSIONS: Overweight prevalence among Chinese preschool children in Beijing is comparable to some European countries. Prevention strategies should include identified lifestyle risk factors.     

Sex disparity and perception of obesity/overweight by parents and grandparents

OBJECTIVE:

To explore the factors associated with the sex disparity showing a greater prevalence of obesity/overweight in boys compared with girls in Chinese school children.

METHODS:

Sampled students and their parents were asked to complete a questionnaire. Perceptions of weight status by the parents, grandparents and children themselves were collected. A logistic regression analysis was used.

RESULTS:

The sampled students included 327 obese/overweight students and 1078 students with normal body mass index (BMI). The crude OR of obesity/overweight for boys compared with girls was 1.57 (95% CI 1.22 to 2.01). The increased risk of childhood obesity/overweight for boys remained after adjustment for prenatal and infant factors, daily habits and family situation, but disappeared after adjustment for perception of weight status (OR 1.27 [95% CI 0.93 to 1.67]). There were differences in underestimation of children’s weight status between boys and girls by their parents and grandparents (OR 1.33 [95% CI 1.08 to 1.64] and OR 1.42 [95% CI 1.15 to 1.75], respectively).

CONCLUSIONS:

Misconceptions about a child’s weight status were prevalent among parents and grandparents, and boys’ weight status was more frequently underestimated than girls. The disparity of underestimating weight according to sex may partially contribute to the difference in the prevalence of obesity/overweight between boys and girls among Chinese school children.