Central obesity in Yemeni children: A population based cross-sectional study

AIM: To establish percentile curves and to explore prevalence and correlates of central obesity among Yemeni children in a population based cross-sectional study.METHODS: A representative sample of 3114 Yemeni children(1564 boys,1550 girls) aged 6-19 years participating in the HYpertension and Diabetes in Yemen study was studied.Data collection was conducted at home by survey teams composed of two investigators of both genders.Study questionnaire included questions about demographics,lifestyle,and medical history.Anthropometric measurements included body weight,height,waist circumference(WC) and hip circumferences.Waist to hip ratio(WHR) and waist-toheight ratio(WHtR) were then calculated.Age and gender specific smoothed percentiles of WC,WHR,and WHtR were obtained using lambda-mu-sigma parameters(LMS method).The independent predictors of central obesity defined as(1) WC percentile ≥ 90th;(2) WHtR ≥ 0.5;or(3) WC percentile ≥ 90thand WHtR ≥ 0.5,were identified at multivariate logistic regression analysis adjusted for age,gender,urban/rural location,years of school education,sedentary/active life-style.RESULTS: Percentile curves for WC,WHR and WHtR are presented.Average WC increased with age for both genders.Boys had a higher WC than girls until early adolescence and thereafter girls had higher values than boys.WHR decreased both in boys and girls until early adolescence.Thereafter while in boys it plateaued in girls it continued to decrease.Mean WHtR decreased until early adolescence with no gender related differences and thereafter increased more in girls than in boys towards adult age.Prevalence of central obesity largely varied according to the definition used which was 10.9% for WC ≥ 90thpercentile,18.3% for WHtR ≥ 0.5,and 8.6% when fulfilling both criteria.At adjusted logistic regression WC ≥ 90thpercentiles and WHtR ≥ 0.5 were less prevalent in rural than in urban areas(OR = 0.52,95%CI: 0.41-0.67 and 0.66,0.54-0.79 respectively),being more prevalent in children with sedentary lifestyle rather than an active one(1.52,95%CI: 1.17-1.98 and 1.42,95%CI: 1.14-1.75,respectively).CONCLUSION: Yemeni children central obesity indicespercentile curves are presented.Central obesity prevalence varied according to the definition used and was more prevalent in urban sedentary subjects.     

Obesity in the Iranian population

There is an obesity epidemic worldwide, which has been increasing in recent years. An epidemiologic cross-sectional study was conducted among 3799 persons who were 30–70 years old in Semnan Province, Iran. Multistage cluster sampling was performed, and subjects were selected from urban and rural populations. Body weight, height and waist circumference (WC) were measured, and body mass index (BMI) and waist to hip ratio (WHR) were calculated. Overweight and obesity were defined as 25 ≤ BMI < 30 and ≥30 respectively in men with WHR ≥ 0.9 or WC ≥ 102 cm, and women with WHR ≥ 0.8 or WC ≥ 88 cm were considered centrally obesite. Prevalence of obesity and overweight was 26.3% and 40.6% respectively. Prevalence of obesity was more among women (39.5%) than men (14.5%) with central obesity prevalence using WHR and WC cut-points of 72.2% and 26.6% respectively. There was a significant association between obesity and age, gender, residential area and educational level ( P  < 0.01). In conclusion, prevalence of obesity and overweight among 30–70 years old, especially among women, was higher than expected. A comprehensive educational programme on obesity risk factors and obesity-related diseases is necessary.     

Prevalence and time trends in obesity among adult West African populations: a meta-analysis

The objective of this study was to determine the distribution of and trends in obesity in adult West African populations.
Between February and March 2007, a comprehensive literature search was conducted using four electronic databases. Journal hand searches, citations and bibliographic snowballing of relevant articles were also undertaken. To be included, studies had to be population-based, use well-defined criteria for measuring obesity, present data that allowed calculation of the prevalence of obesity and sample adult participants. Studies retrieved were critically appraised. Meta-analysis was performed using the DerSimonian-Laird random effect model.
Twenty-eight studies were included. Thirteen studies were conducted in urban settings, 13 in mixed urban/rural and one in rural setting. Mean body mass index ranged from 20.1 to 27.0 kg². Prevalence of obesity in West Africa was estimated at 10.0% (95% CI, 6.0–15.0). Women were more likely to be obese than men, odds ratios 3.16 (95% CI, 2.51–3.98) and 4.79 (95% CI, 3.30–6.95) in urban and rural areas respectively. Urban residents were more likely to be obese than rural residents, odds ratio 2.70 (95% CI, 1.76–4.15). Time trend analyses indicated that prevalence of obesity in urban West Africa more than doubled (114%) over 15 years, accounted for almost entirely in women.
Urban residents and women have particularly high risk of overweight/obesity and obesity is rising fast in women. Policymakers, politicians and health promotion experts must urgently help communities control the spread of obesity in West Africa.     

Urbanization and the risk of asthma among schoolchildren in the Palestinian Authority.

The aim of the present survey was to compare the prevalence of symptoms suggestive of asthma in boys and girls aged 6-7 and 13-14 years in a rural and an urban area in the West Bank. For this purpose, the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was issued to 970 schoolchildren in the two regions. The response rate was 92.2%. The prevalences of ever wheezing in the urban and rural areas were 16.4% and 12.0%, respectively (p < 0.05); the 12-month prevalences of wheezing were 10.5% and 5.5%, respectively (p < 0.05); the prevalences of more severe wheeze were 4.5% and 1.7%, respectively (p < 0.05); and prevalences of diagnosed asthma were 4.2% and 2.8%, respectively (p = NS). When controlling for age by stratification, the significant association between prevalence rates and place of residence persisted in the 13-14-year age group. These results also show that the prevalence of asthma among Palestinian children is moderately high in comparison with that reported from developing countries, but lower than those reported from Western countries. This survey, the first epidemiological survey on asthma in the West Bank, demonstrates a marked difference between urban and rural areas. The findings emphasize the need for further study of the environmental determinants of the disease among Palestinian children.     

Prevalence of childhood and adolescent overweight and obesity in Benue State,Nigeria

Objective To evaluate demographic variation in the prevalence of overweight (OW) and obesity (OB) among 3240 children and adolescents (girls: n = 1714; boys: n = 1526) aged 9–16 years attending primary and secondary schools in Benue State of Nigeria. Methods Participants’ anthropometric characteristics (body weight, stature, body mass index: BMI and lean body mass: LBM) were determined using standard protocols. OW and OB were estimated using International Obesity task Force diagnostic criteria. Data were analysed with one‐way anova and binary logistic regression method. Results Overall, 88.5%, 9.7% and 1.8% of the adolescents had normal BMI and were OW and obese, respectively. Prevalence of OW was higher among girls (20.3%) than boys (16.2%), whereas a relatively higher incidence of OB was noted among the boys (3.5%). Girls in urban areas had a significantly higher BMI (t₅₂₄ = 3.61, P = 0.002) than their rural peers, but the rural girls were more significantly OW than their urban counterparts (BMI: t₁₁₈₆ = 2.506). Logistic regression models assessing the influence of age, gender and location on OW/OB in children (α²_{(3, N = 1014)} = 6.185, P = 0.103) and adolescents (α²_{(3, N = 2226)} = 1.435, P = 0.697) did not turn up significant results. In the gender‐specific analysis, the younger boys’ model was also not significant (α²_{(2, N = 488)} = 1.295, P = 0.523) in contrast to the girls’ (α²_{(2, N = 526)} = 15.637, P = 0.0005), thus discriminating between OW and healthy weight among the children. Overall, the model explained 2.9–4.4% of the variance in weight status and correctly classified 76.8% of the cases. Age wise, the model yielded a significant odds ratio of 1.49, suggesting that the likelihood of being OW increases by a factor of 1.5 with a unit increase in age. Also, the likelihood of an urban girl becoming OW or obese was 0.57 times that of a rural girl. Conclusions In general, girls in urban areas had higher prevalence of OW and OB than girls in rural settings. Among the boys, similar but less marked trends were found, except that the rural boys tended to be more OW on average than their peers in urban areas. In view of its public health significance, it is important to periodically evaluate the prevalence of weight disorders in children and adolescents so that appropriate preventative strategies can be instituted.     

Epidemiology of hypertension among a population of school children in Sousse, Tunisia

BACKGROUND: Pediatric hypertension is a field of increasing interest and importance. Early identification of children at risk for hypertension is important to prevent the serious, long-term complications associated with the condition. In Tunisia, there are no data available on the cardiovascular disease risk profile, such as hypertension, in the population of children. OBJECTIVE: To establish the prevalence of hypertension, the percentile distribution of blood pressure and the inter-relationships between hypertension and other cardiovascular disease risk factors among school children. METHODS: An epidemiological survey was conducted based on a representative sample of 1569 urban school children in Sousse, Tunisia. RESULTS: The prevalence of arterial hypertension was 9.6%, with no significant difference between boys (9.2%) and girls (9.9%). The prevalence of systolic and diastolic hypertension was 6.4% and 4.5%, respectively. In both boys and girls, systolic pressure had a highly significant positive correlation with height (boys: r=0.33, P<0.001; girls: r=0.08, P=0.02), weight (boys: r=0.47, P < or = 0.001; girls: r=0.35, P<0.001) and triglyceride concentrations (boys: r=0.13, P<0.001; girls: r=0.10, P=0.006). Among boys, a positive correlation was found between systolic blood pressure and age (r=0.12, P=0.001) and, among girls, a negative correlation was found (r=-0.12, P=0.001). CONCLUSION: This information will be used to help launch a regional program of heart health promotion in schools.     

Urbanization and the Risk of Asthma Among Schoolchildren in the Palestinian Authority

The aim of the present survey was to compare the prevalence of symptoms suggestive of asthma in boys and girls aged 6-7 and 13-14 years in a rural and an urban area in the West Bank. For this purpose, the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was issued to 970 schoolchildren in the two regions. The response rate was 92.2%. The prevalences of ever wheezing in the urban and rural areas were 16.4% and 12.0%, respectively (p < 0.05); the 12-month prevalences of wheezing were 10.5% and 5.5%, respectively (p < 0.05); the prevalences of more severe wheeze were 4.5% and 1.7%, respectively (p < 0.05); and prevalences of diagnosed asthma were 4.2% and 2.8%, respectively (p = NS). When controlling for age by stratification, the significant association between prevalence rates and place of residence persisted in the 13-14-year age group. These results also show that the prevalence of asthma among Palestinian children is moderately high in comparison with that reported from developing countries, but lower than those reported from Western countries. This survey, the first epidemiological survey on asthma in the West Bank, demonstrates a marked difference between urban and rural areas. The findings emphasize the need for further study of the environmental determinants of the disease among Palestinian children.     

Vitamin D deficiency in rural girls and pregnant women despite abundant sunshine in northern India

Context  Vitamin D deficiency is common in urban Indians despite living in the tropics and its public health consequences are enormous. However, 70% of India is rural, and data from rural subjects, who are expected to have good sun exposure, are scant.
Objectives  To determine the population prevalence of vitamin D deficiency in rural pregnant women and adolescent girls, compare serum 25-hydroxyvitamin D (25OHD) status in adolescent boys from the same families, and determine seasonal differences in serum 25OHD.
Design  A cross-sectional study conducted over 18 months.
Subjects  A random selection of 121 adolescent girls from a survey of a population of 8270 in a rural low socioeconomic community; 139 pregnant women in the second trimester; and a subset of 28 adolescent girls compared with 34 brothers.
Measurements  Serum 25OHD, serum alkaline phosphatase (AP), sun exposure, and dietary calcium intake.
Results  The age-adjusted community prevalence of vitamin D deficiency (25OHD < 50 nmol/l) in adolescent girls was 88·6%. Seventy-four per cent of pregnant women had vitamin D deficiency. Mean ± SD 25OHD in girls and women in summer was 55·5 ± 19·8 nmol/l compared to 27·3 ± 12·3 nmol/l in winter ( P  < 0·001). Winter serum 25OHD in boys (67·5 ± 29·0 nmol/l) was higher than that in their sisters (31·3 ± 13·5 nmol/l, P  < 0·001).
Conclusion  We report a high prevalence of vitamin D deficiency among pregnant women and adolescent girls from a rural Indian community. Boys are relatively protected. Seasonal variation in serum 25OHD is significant at latitude 26° N.     

Changing patterns of diet, physical activity and obesity among urban, rural and slum populations in north India

Rapid urbanization and accompanying lifestyle changes in India lead to transition in non-communicable disease risk factors.
A survey was done in urban, urban slum and rural population of Haryana, India, in a sample of 4129 men and 3852 women using WHO STEPS questionnaire.
A very high proportion of all the three populations reported inadequate intake of fruits and vegetables. Rural men reported five times physical activity as compared with urban and urban slum men and rural women reported seven times physical activity as compared with women in the other two settings. Mean body mass index (BMI) was highest among urban men (22.8 kg m⁻²) followed by urban slum (21.0 kg m⁻²) and rural men (20.6 kg m⁻²) ( P -value < 0.01). Similar trend was seen for women but at a higher level than men. Prevalence of obesity (BMI ≥ 30 kg m⁻²) was highest for urban population (male = 5.5%, female = 12.6%) followed by urban slum (male = 1.9%, female = 7.2%) and rural populations (male = 1.6%, female = 3.8%).
Urbanization increases the prevalence of the studied non-communicable disease risk factors, with women showing a greater increase as compared with men. Non-communicable disease control strategy needs to address urbanization and warrants gender sensitive strategies specifically targeting women.     

Prevalence of excessive body weight and high blood pressure in children and adolescents in the city of Łódź

BACKGROUND: Overweight and elevated blood pressure in children and adolescents are two independent risk factors of basic importance for early prevention of cardiovascular and metabolic diseases. AIM: To evaluate the prevalence of overweight and elevated blood pressure in children and adolescents aged 7-18 years from the city of ?ód?. METHODS: A total of 25,309 children and adolescents (12,669 girls and 12,640 boys) aged 7-19 years from 111 schools in the city of ?ód? were examined. Basic anthropometric measurements (body mass and height) as well as three independent blood pressure measurements using the auscultatory method were performed. The prevalence of overweight and obesity were evaluated based on BMI analysis and using international criteria (IOTF). The prevalence of prehypertension state and hypertension was evaluated using the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. RESULTS: The mean prevalence of overweight (without obesity) was 15.1% (13.2% for girls and 17% for boys) and obesity was found in 3.7% of children (2.9% of girls and 4.4% of boys). Prevalence of the prehypertensive state and hypertension was 11.1% and 4.9%, respectively. In the younger groups of children aged 7-13 years the prevalence of overweight as well as elevated blood pressure was significantly (p <0.001) higher than in groups aged 14-19 years. CONCLUSIONS: The results indicate that the prevalence of overweight as well as elevated blood pressure is significantly higher in younger groups of children. The observed relations may result from specific social determinants and improper nutritional habits. The results show that intensive preventive activities should also be directed towards younger groups of children.     

Physical activity and its relationship with obesity, hypertension and diabetes in urban and rural Cameroon

OBJECTIVES: To evaluate and compare physical activity patterns of urban and rural dwellers in Cameroon, and study their relationship with obesity, diabetes and hypertension. METHODS: We studied 2465 subjects aged >or=15 y, recruited on the basis of a random sampling of households, of whom 1183 were urban dwellers from Yaoundé, the capital city of Cameroon and 1282 rural subjects from Bafut, a village of western Cameroon. They all had an interviewer-administered questionnaire for the assessment of their physical activity and anthropometric measurements, blood pressure and fasting blood glucose determination. The procedure was satisfactorily completed in 2325 (94.3%) subjects. Prevalences were age-adjusted and subjects compared according to their region, sex and age group. RESULTS: Obesity was diagnosed in 17.1 and 3.0% urban and rural women, respectively (P<0.001), and in 5.4 vs 1.2% urban and rural men, respectively (P<0.001). The prevalence of hypertension was significantly higher in urban vs rural dwellers (11.4 vs 6.6% and 17.6 vs 9.1% in women and men, respectively; P<0.001). Diabetes was more prevalent in urban compared to rural women (P<0.05), but not men. Urban subjects were characterized by lower physical activity (P<0.001), light occupation, high prevalence of multiple occupations, and reduced walking and cycling time compared to rural subjects. Univariate analysis showed significant associations between both physical inactivity and obesity and high blood pressure. The relationship of physical inactivity with hypertension and obesity were independent in both urban and rural men, but not in women. Body mass index, blood pressure and glycaemia were higher in the first compared with the fourth quartiles of energy expenditure. CONCLUSION: Obesity, diabetes and hypertension prevalence is higher in urban compared to rural dwellers in the populations studied. Physical activity is significantly lower and differs in pattern in urban subjects compared to rural. Physical inactivity is associated with these diseases, although not always significant in women.     

Long‐term changes in prevalence of overweight and obesity in Czech 7‐year‐old children: evaluation of different cut‐off criteria of childhood obesity

The objective of this paper was an evaluation of change in prevalence of overweight and obesity in Czech children, and a comparison of cut‐off points for body mass index references from the Czech Republic (CzR), International Obesity Task Force and WHO. The authors conducted a survey in 7‐year‐old children, and compared data from 1951, 1981, 1991, 2001 and 2008 (WHO cut‐offs). 2008 data were evaluated according to different cut‐offs. Results showed that since 1951 in boys, overweight prevalence increased from 13.0% in 1951 to 26.8% in 2001, in girls from 10.9% to 22.9%. Obesity increased in boys from 1.7% to 8.3%, in girls from 1.7% to 6.9%. From 2001 to 2008 obesity in boys increased; obesity in girls and overweight in both genders decreased. In 2008 cohort the following values were found: overweight and obesity: CzR criteria, percentage was lowest (14.8% boys and 11.1% girls); WHO criteria, highest prevalence (23.5% boys and 19.5% girls); obesity: lowest ratio International Obesity Task Force criteria (4.4% boys, 3.3% girls), highest ratio boys WHO criteria (10.0%), girls CzR criteria (5.0%). Overweight and obesity prevalence increased in 7‐year‐old Czech children since 1951; since 2001 prevalence is plateauing with exception of boys. Using different body mass index references resulted in marked differences in overweight and obesity prevalence.     

Prevalencia e incidencia de sobrepeso y obesidad en 2,5 millones de niños y adolescentes en España

Introduction and objectivesChildhood obesity trends are plateauing in Spain, but limited information is available about how they differ by region. This study assessed childhood and adolescent the prevalence and incidence of overweight and obesity from 2005 to 2017 across 8 Spanish regions.MethodsThis longitudinal study used height and weight measurements from 2.5 million children aged 2 to 17 years to calculate overweight and obesity, according to the World Health Organization (WHO) guidelines. Data were obtained from The Base de datos para la Investigación Farmacoepidemiológica en Atención Primaria, and the Information System for Research in Primary Care. Prevalence and incidence rates and trends from 2005 to 2017 were calculated and stratified by age, sex, and region.ResultsThe overall obesity prevalence increased in boys and girls from age 2 (0.8%; 95%CI, 0.8-0.9 in both sexes) until peaking at age 7 in girls (17.3%; 95%CI, 17.1-17.5) and age 9 in boys (24.1%; 95%CI 23.9-24.3). The highest and lowest obesity prevalences were observed in Murcia and Navarre. Overall obesity prevalence trends decreased from 2005 to 2017 in all age-sex groups and in most regions. Highest obesity incidence rates were found in children aged 6 to 7 years, (4.5 [4.5-4.5] and 3.5 [3.5-3.5] new obesity cases per 100 person-years in boys and girls, respectively). Boys had higher prevalence and incidence rates than girls across all regions. Overweight/obesity prevalence and incidence rates and their trends were consistently higher than the obesity results, although a similar pattern was observed across sex and age.ConclusionsOverweight and obesity prevalence slightly decreased in Spain from 2005 to 2017, but regional, sex, and age differences persisted. Because incidence peaked around the age of 6 years, it may be important to begin health promotion programs at an early age.     

Prevalence and severity of dental fluorosis and genu valgum among school children in rural field practice area of a medical college

ObjectiveTo assess the prevalence of dental fluorosis and genu valgum among school children in the above mentioned area.MethodsA Cross sectional study was conducted on school children of 1st to 7th standard in the rural field practice area of a medical college. Children were examined for dental fluorosis and genu valgum. Drinking water samples were also tested for fluoride levels. Proportion of children with dental fluorosis and genu valgum were calculated by severity, age and sex. Statistical significance was analyzed by using Chisquare test or Mc Nemar test.ResultsOf the 1 544 children examined 42.1% and 8.4% had dental fluorosis and genu valgum respectively. Prevalence of very mild dental fluorosis and moderate grade genu valgum were high compared to other categories. Prevalence rates increased with the age (P<0.05) and was more among girls (45.2%) as compared to boys (39.1%) (P<0.05). Of the 26 water samples analysed, 18 samples (69.2%) revealed the fluoride content above the permissible limit.ConclusionsFindings of the present study reveal a high prevalence of dental fluorosis and genu valgum amongst school children and high fluoride level in the water. Further studies are needed to evaluate the other risk factors and reasons for gender differences.     

Percentile distribution of the waist circumference among Mexican pre-adolescents of a primary school in Mexico City

AIM: The aim of this study is to describe the percentile distribution of the waist circumference in Mexican pre-pubertal children living in an urban, middle-income area. METHODS: Children, aged 6-10, from a primary school, located in a middle-income area in Mexico City were included (n=833). Anthropometric measurements were made in the case of all children by using standardized procedures. RESULTs: The prevalence of obesity and overweight was greater among boys (p<0.001). Of them, 30 were obese (7.2%) and 47 were overweight (11.4%). Girls had a prevalence of obesity of 2.8% and of overweight of 8.8%. Boys had greater waist circumference than girls (p<0.001). This observation was independent from differences in age or body mass index (BMI). The distribution of the waist circumference was shifted towards higher values among boys. The values corresponding to the 85th percentile ranged, in boys aged 6-10, between 62.9 and 85.9 cm. By contrast, for girls, those values were 66.8 and 72.08 cm, respectively. A receiver-operator curve was constructed in order to identify the waist circumference most likely to be associated with a BMI of > 85th percentile. We found that age- and sex-specific cut-off points are required for the detection of central adiposity in children aged 6-10. CONCLUSIONS: The percentile distribution of the waist circumference in Mexican pre-pubertal children living in urban, middle-income areas is described in this study. Moreover, included are the cut-off points most likely to be associated with increased adiposity. This information can be used for defining abdominal obesity in paediatric populations.     

Development of overweight in an atherosclerosis prevention trial starting in early childhood. The STRIP study

CONTEXT: Recent data indicate a marked increase in the prevalence of obesity among school-aged children. Thus, efficacious programmes that prevent overweight development in children are urgently needed. OBJECTIVE: To evaluate the impact of repeatedly given, individualised dietary and lifestyle counselling on the prevalence of overweight during the first 10 years of life. DESIGN AND PARTICIPANTS: This study was a part of the Special Turku Coronary Risk Factor Intervention Project for Children (STRIP), which is a prospective, randomised trial aimed at reducing the exposure of the intervention children to the known risk factors of atherosclerosis. At the child's age of 7 months, 1062 children were assigned to an intervention group (n=540) or to a control group (n=522). The intervention children received individualised counselling focused on healthy diet and physical activity biannually. Height and weight of the children were measured at least once a year. MAIN OUTCOME MEASURE: Prevalence of overweight and obesity among the intervention and control children by sex and age. Children were classified as overweight or obese if their weight for height was >20% or > or =40% above the mean weight for height of healthy Finnish children, respectively. RESULTS: After the age of 2 years, there were continuously fewer overweight girls in the intervention group than in the control group. At the age of 10 years, 10.2% of the intervention girls and 18.8% of the control girls were overweight (P=0.0439), whereas 11.6% of the intervention boys and 12.1% of the control boys were overweight (P approximately 1.00). Only three children in the intervention group were obese at some age point, whereas 14 control children were classified as obese at some age point. CONCLUSION: Individualised dietary and lifestyle counselling given twice a year since infancy decreases prevalence of overweight in school-aged girls even without any primary energy restrictions.     

A 12-year follow-up study of treated obese children in Japan

OBJECTIVE: To assess tracking for body weight from childhood to adulthood in obese Japanese children who were treated for obesity, investigate the relation between the changes in body weight status and morbidity, and identify correlates of the changes in body weight status. STUDY DESIGN: Twelve-year retrospective cohort study. SUBJECTS: A sample of 276 subjects (age 23.9+/-4.1, 176 males and 100 females) who responded to a questionnaire mailed in 1998 to 1047 children (age 10.6+/-2.2) treated for obesity at Mie National Hospital in Japan between 1976 and 1992. MEASUREMENTS: Based on height and weight from medical records during childhood, the relative weight (RW; weight expressed as a percentage of the standard body weight for age, height, and sex) was calculated. Degrees of childhood obesity were based on RW: slight obesity (120% < or = RW<130%; n=17), moderate obesity (130% < or = RW <150%; n=131), and severe obesity (RW > or = 150%; n=128). Adult body mass index (BMI), which was obtained from the mailed questionnaires, was classified as normal, overweight and obese according to the WHO/NIH criteria. Body weight tracking by degree of obesity was evaluated. Subjects with severe obesity during childhood (n=128) were examined for their weight status in adulthood, prevalence of chronic diseases in adulthood, and factors such as parental obesity, dietary and exercise habits and obesity treatment during childhood. RESULTS: Childhood obesity tracked into adulthood obesity or overweight in 54.7% of all cases. Severely obese children (36.7%) were more likely to be obese as an adult than moderately obese children (16.8%). The prevalence of adult obesity tended to be greater in boys with moderate childhood obesity than in girls (29.7% in boys vs 14.9% in girls, P=0.058). Among the severely obese children who became normal-weight adults, the prevalence of chronic diseases was about one-fifth of those who remained obese in adulthood (P=0.041). Four factors were associated with changes in body weight status: maternal BMI at entry (P=0.044), the changes in dietary and exercise habits after treatment (P=0.014, P=0.030, respectively), and satisfaction with obesity treatment in childhood (P=0.035). CONCLUSIONS: Severely obese children have a higher risk of becoming obese adults even when they received obesity treatment in childhood. The risk of adulthood obesity was twice as high in moderately obese boys than in girls. On the other hand, many cases of childhood obesity can be corrected with obesity treatment, which in turn can decrease the risk for adult chronic diseases.     

Prevalence of obesity in Taiwan

In Taiwan, the prevalence and problem of obesity has increased significantly in recent decades and has became an important public health issue. In children (12-15 years), the prevalence of obesity (defined as body weight > 120% of mean body weight with age- and gender-specification) was 12.4%, 14.8% and 15.6% among boys and 10.1%, 11.1% and 12.9% among girls in 1980, 1986 and 1996 respectively. A survey of 1500 12-15-year-old children during 1995-1996 in Taipei city found that about 16.6% of boys and 11.1% of girls were obese, while an additional 11.6% of boys and 10.2% of girls were overweight. In adults, using the criteria defined by the Department of Health in Taiwan [overweight as (body mass index) BMI > or = 24 and obese as BMI > or = 27], the age-adjusted prevalence of obesity was 10.5% and 15.9% for men and 13.2% and 10.7% for women from 1993-1996 to 2000-2001. From these data, we found that the prevalence of obesity in Taiwan has increased steadily from 1980 to 2000 especially in children and in men.     

Prevalence of overweight and obesity among school children in Jena (Germany)

OBJECTIVES: To examine the prevalence and changes in the prevalence of overweight and obesity among school children in Jena (Germany) in the last twenty years and to identify factors associated with childhood overweight. DESIGN: Cross-sectional surveys in 1975, 1985, 1995 and a household questionnaire in 1995. SUBJECTS: Children from schools in Jena, aged 7-14 y, participated (1975 : 1002 boys and 1000 girls; 1985 : 781 boys and 753 girls; 1995 : 989 boys and 912 girls). MEASUREMENTS: Prevalence of overweight or obesity based on the 90th or 97th age- and sex-specific percentile of the body mass index (BMI) developed for French children. In 1995 factors examined in relation to overweight included birth weight, birth length, age-class, number of children in household, occupation of the father, education of the mother and size of flat (apartment). RESULTS: In boys the prevalence of overweight increased from 10.0 to 16.3% and in girls from 11.7 to 20.7% between 1975 and 1995. The prevalence of obesity increased from 5.3 to 8.2% in boys and from 4.7 to 9.9% in girls between 1975 and 1995. However, the peak in the increase of overweight as well as of obesity lie for both sexes between 1985 and 1995. Using logistic regression, statistically significant associations with overweight were found for occupation of the father, birth weight in both sexes and additionally, for size of flat in girls. CONCLUSIONS: Overweight and obesity are increasing health problems among Jena children. Further investigations are needed to explore the influence of factors such as feeding pattern, food habits and physical activity on overweight. Special attention should be paid to the further social development in the society and to the link between low social class and overweight. Through such investigations effective preventive strategies could be developed.     

Assessment of obesity in a community sample of prepubertal children

The aims of this study were to quantify the effect of obesity definition on estimates of prevalence, and to determine the sensitivity and specificity of three commonly used definitions of overweight/obesity in children: body mass index (BMI) s.d. score > 2.00; BMI s.d. score > 1.04; weight > 120% ideal. A representative community sample of children in Edinburgh, Scotland (n=240, 124 boys and 116 girls; mean age 8.5 s.d. 0.4y) was recruited. Obesity was defined by a criterion method based on % body fat: > 25% fat in boys; > 32% fat in girls. Sensitivity of BMI s.d. score > 2.00 was relatively poor in both sexes (60% in girls; 36% in boys) but had high specificity (98%). Sensitivity of the other two clinical definitions was higher, and was better in girls than boys, but with lower specificity. Choice of definition had a profound effect on prevalence estimates. In conclusion, sensitivity of the definitions of obesity currently recommended for children, when tested in this sample, was heavily dependent on the definition used and differed between boys and girls. This should be considered when choosing a definition of obesity in clinical practice and epidemiology.