Estimated burden of paediatric obesity and co-morbidities in Europe. Part 1. The increase in the prevalence of child obesity in Europe is itself increasing.

OBJECTIVES: Surveys have shown the prevalence of overweight among school age children to be as high as 35% in parts of Europe, and several countries have reported prevalence rates increasing year-on-year. The purpose of the present paper is to review the rate of change in prevalence of overweight and obesity among children in the European region. METHODS: A search of published and unpublished surveys was undertaken to find pairs of surveys that could indicate rates of change of prevalence within comparable population groups using comparable measures. Data from 45 pairs of surveys from 11 countries were analysed. RESULTS: Annual increases in prevalence of overweight (including obesity) rose from typically below 0.5 percentage points in the 1980s, to over 1.0 percentage points in the late 1990s. For obesity alone, the annual increase in prevalence was typically below 0.1 percentage points in the 1980s and typically 0.3 percentage points in the late 1990s. CONCLUSIONS: The prevalence of overweight and obesity among children is rising in the European region, and the annualised rates of increase are themselves increasing. Unless action is taken to counteract these trends, by the year 2010 the European Union can expect to see the numbers of overweight and obese children rising by approximately 1.3 million children per year, of which the numbers of obese children will be rising by over 0.3 million per year.     

High prevalence of overweight and obesity among 6-year-old children in Finnmark County, North Norway

Aim: The aim was to determine the prevalence of overweight and obesity among 6‐year‐old children in Finnmark, the northernmost county of Norway. Methods: This is a survey of 1774 children born during 1999 and 2000 from 18 of 19 child healthcare centres in Finnmark. Body mass index data extracted retrospectively in 2007 from health records at the age of 6 years were compared with international definitions of over‐ and underweight. The prevalence figures were further compared with socio‐demographic figures on municipality level. Results: Overall, 19% of the children were classified as overweight or obese; 5% were classified as obese. The prevalence of overweight and obesity was higher among girls (22%) than among boys (16%) (p < 0.01). The prevalence of underweight was 8% among both girls and boys. Despite large variations in the prevalence of overweight and obesity between municipalities (9–35%), no association was found with municipality figures on socio‐demographic factors. Conclusion: In the northernmost county Finnmark, the prevalence of overweight including obesity among 6‐year‐old children was somewhat higher than in previous surveys from Norway, especially among girls.     

基于不同体块指数筛查标准的2011年北京市儿童青少年超重和肥胖检出率比较研究

目的 描述2011年北京市7~18岁儿童青少年超重和肥胖的检出率,并比较基于不同BMI筛查标准的检出率的差异。方法 研究对象为2011年北京市中小学体检的7~18岁学龄儿童青少年。采用BMI作为评价超重和肥胖的指标。超重和肥胖筛查分别采用4种不同的国内（CN2010和WGOC）和国际（IOTF和WHO2007）标准。不同BMI筛查标准之间超重、肥胖检出率比较采用McNemar检验。结果 ①92 212名男女生BMI在P50、P85和P95上均显著高于全国水平(2009年“中国0~18岁儿童青少年体块指数的生长曲线”),男女生在对应百分位曲线上无交叉现象,男生BMI水平高于女生。②基于CN2010和WGOC标准,男生肥胖检出率分别为17.8%和18.2%,女生检出率分别为10.8%和10.9%;基于IOTF和WHO2007标准,男生肥胖检出率分别为12.9%和21.0%,女生检出率分别为6.0%和8.6%。③基于CN2010和WGOC标准,男生超重（含肥胖）检出率两标准间差异无统计学意义,均为36.0%,各年龄组差异亦不明显,但女生检出率CN2010标准高于WGOC标准（28.1％ vs 24.1%）,在7~15岁组差异较为明显,但在16~18岁组差异较小;与国际标准相比,基于国内标准的男生超重（含肥胖）检出率略高于IOTF标准,但却明显低于WHO2007标准,女生检出率超重（含肥胖）明显高于IOTF标准,但与WHO2007标准较为接近。④与基于WGOC标准的2004年北京市7~18岁儿童青少年超重和肥胖检出率相比,2011年超重和肥胖检出率显著增长,男女肥胖检出率分别增长5.8%和3.8%,超重（含肥胖）检出率分别增长9.3%和7.6%。结论 2011年北京市7~18岁学生中有1/3处于超重或肥胖状态。国内标准与国际标准存在明显差异,在反映中国儿童的超重肥胖流行状况时建议采用国内标准,而理想的国内标准应实现2～18岁的统一,并与成人接轨。     

Overweight and obesity among affluent Bengalee schoolgirls of Lake Town, Kolkata, India

A cross-sectional study was undertaken to determine the prevalence of overweight and obesity among 431 Bengalee schoolgirls aged 6-9 years in Kolkata, India. Anthropometric measurements of height and weight were made on 431 girls. The body mass index (BMI) was computed following the standard equation. Overweight and obesity was defined following the internationally accepted BMI cut-off points. Results revealed that the overall rates of overweight and obesity were 17.63% and 5.10%, respectively. A steady increase in number of overweight individuals was observed from 6 to 9 years. The prevalence of overweight among affluent Bengalee children was higher than those reported from other Asian countries.     

Prevalence of overweight in children and adolescents with attention deficit hyperactivity disorder and autism spectrum disorders: a chart review

Background  

The condition of obesity has become a significant public health problem in the United States. In children and adolescents, the prevalence of overweight has tripled in the last 20 years, with approximately 16.0% of children ages 6–19, and 10.3% of 2–5 year olds being considered overweight. Considerable research is underway to understand obesity in the general pediatric population, however little research is available on the prevalence of obesity in children with developmental disorders. The purpose of our study was to determine the prevalence of overweight among a clinical population of children diagnosed with attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASD).     

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.     

Overweight and obesity trends in Copenhagen schoolchildren from 2002 to 2007

Aim: The purpose of this study is to monitor the prevalence trend in overweight and obesity among Copenhagen schoolchildren from the school years 2002 to 2007. Methods: Copenhagen community health service doctors conducted routine examinations at school entry (ages 5–8 years) and exit (ages 14–16 years). Body mass index (kg/m²) of 33 245 schoolchildren was calculated. The prevalence of overweight (including obesity) and obesity was classified using the International Obesity Task Force definitions. Results: From 2002 to 2007, although the prevalence of overweight (including obesity) in young girls decreased from 17.8 to 15.9%, the trend was non‐significant. In young boys, the trend slightly decreased, and the prevalence fell from 14.0 to 11.6%. In adolescent girls, the prevalence varied considerably and increased from 22.7 to 25.4% without a discernable trend. In adolescent boys, the trend slightly increased, and the prevalence rose from 15.8 to 18.9%. There were no significant changes in the prevalence of obesity. Conclusion: In contrast to the preceding decades, we identified a potential stagnation in the obesity epidemic among children but a continuing increase among adolescents. It remains critical to continue monitoring and to increase preventive measures to reduce the prevalence of overweight and obesity.     

Increasing prevalence of obesity in South Australian 4-year-olds: 1995-2002

OBJECTIVE: To determine prevalence of, and trends in, overweight and obesity in South Australian children aged 4 years during the period 1995-2002. METHODS: Data from 114 669 children collected as part of Child and Youth Health 'preschool health assessments' of 4-year-olds throughout the state in the years 1995-2002 were analysed. Body mass index was calculated from height and weight data and prevalence of overweight and obesity for males and females determined using a standard world-wide definition. Yearly prevalence rates were compared for changes over time. RESULTS: Rates of overweight and obesity have increased over the period 1995-2002. In 1995, of females 12.8% were overweight or obese (obese 3.5%). Of males 10.2% were overweight or obese (obese 3.2%). The equivalent figures in 2002 were for females 21.4% (obese 5.8%) and males 17.3% (obese 4.1%). Rates of overweight and obesity were greater in females than males in all years (except obesity rate in 1995). CONCLUSION: Data from this large, consecutive yearly dataset of South Australian 4-year-old children show a significant increase in the rates of overweight and obesity. Much of this increase appears to have occurred in the mid-to-late 1990s. It is uncertain if these changes have plateaued at this time. These results reinforce rising obesity prevalence as a significant child health issue. They also indicate that obesity is seen as early as the preschool years; with implications for theories of causation and for prevention and treatment strategies.     

High incidence of obesity co-morbidities in young children: a cross-sectional study

Aim: The prevalence of overweight and obesity in children is a public health problem because of future morbidity. However, the prevalence of medical complications in overweight and obese primary school children in Australia is not well documented. As part of the larger, prospective cohort Growth and Development Study, this report aimed to identify the medical complications of obesity in a population‐based community sample of primary school‐aged children. Methods: Two groups of primary school children were studied: a random community sample of overweight/obese children (not seeking treatment) and a matched community sample of normal weight children. Demographics, medical history, family history and symptoms of complications of overweight were collected. Children had a physical examination, oral glucose tolerance tests with insulins, fasting lipid profiles and liver function tests. Results: Data from 283 children are presented (6.1–13.4 years, mean 9.8 years). There were no differences in birth data, family composition, parental age or socio‐economic status between groups. Overweight and obese children were more likely to complain of musculoskeletal pain, depression, anxiety and bullying, and had more adverse examination findings than control children. They also had more abnormal investigations: overweight children: impaired glucose tolerance (IGT) 1.3%, hyperinsulinism 19.5%, dyslipidaemia 63.8%, raised alanine transaminase (ALT) 9.0%; obese children: IGT 5.3%, hyperinsulinism 38.9%, dyslipidaemia 73.7%, raised ALT 31.6%. Conclusion: Overweight and obese primary school‐aged children have significant medical complications of their weight status. Overweight children, in addition to obese children, should be screened for complications. A secondary finding is a high proportion of normal weight children with lipid levels outside desirable healthy ranges.     

Prevalence of Overweight and Obesity in a Large Clinical Sample of Children With Autism

BackgroundOverweight and obesity are major pediatric public health problems in the United States; however, limited data exist on the prevalence and correlates of overnutrition in children with autism.MethodsThrough a large integrated health care system's patient database, we identified 6672 children ages 2 to 20 years with an assigned ICD-9 code of autism (299.0), Asperger syndrome (299.8), and control subjects from 2008 to 2011 who had at least 1 weight and height recorded in the same visit. We calculated age-adjusted, sex-adjusted body mass index and classified children as overweight (body mass index 85th to 95th percentile) or obese (≥95th percentile). We used multinomial logistic regression to compare the odds of overweight and obesity between groups. We then used logistic regression to evaluate factors associated with overweight and obesity in children with autism, including demographic and clinical characteristics.ResultsCompared to control subjects, children with autism and Asperger syndrome had significantly higher odds of overweight (odds ratio, 95% confidence interval: autism 2.24, 1.74–2.88; Asperger syndrome 1.49, 1.12–1.97) and obesity (autism 4.83, 3.85–6.06; Asperger syndrome 5.69, 4.50–7.21). Among children with autism, we found a higher odds of obesity in older children (aged 12–15 years 1.87, 1.33–2.63; aged 16–20 years 1.94, 1.39–2.71) compared to children aged 6 to 11 years. We also found higher odds of overweight and obesity in those with public insurance (overweight 1.54, 1.25–1.89; obese 1.16, 1.02–1.40) and with co-occurring sleep disorder (obese 1.23, 1.00–1.53).ConclusionsChildren with autism and Asperger syndrome had significantly higher odds of overweight and obesity than control subjects. Older age, public insurance, and co-occurring sleep disorder were associated with overweight or obesity in this population.     

Prevalence of overweight and obesity in primary school children in Port Said city

BackgroundThe highest prevalence rates of childhood obesity have been observed in developed countries, however, its prevalence is increasing in developing countries as well.ObjectivesTo estimate the prevalence of overweight and obesity among primary school children, aged from 6 to 12 years and to estimate risk factors of obesity and overweight, defined by body mass index (BMI).MethodsA cross-sectional study was carried out at Port Said city during the second term of school year 2010/2011. The researcher took the anthropometric measurements inside the nurse’s room in the school and gave a questionnaire to the students to be answered by one of the child’s parents. The questionnaire included questions related to socioeconomic status, life style (physical activity and eating habits) and family history of overweight and obesity.ResultsEight hundred and fifty-two students participated in this study. Prevalence of overweight and obesity was 17.7% and 13.5% respectively. The rate of obesity was the highest at the age of 7–8 years (grade 2) and decreased with an increase in age, while overweight increased with an increase in age to be the highest at the age of 9–10 (grade 4) and 10–11 (grade 5). Socioeconomic class, faulty dietary habits, sedentary life, low level of physical activity and positive family history of overweight and/or obesity were significantly associated with student’s BMI.ConclusionThis study found a relatively high prevalence of overweight and obesity among children aged 6–12 years in Port Said city. Decreased rate of obesity with an increase in age in our study, signifies that faulty feeding habits were the highest at lower ages.     

上海市7~18岁学生1985至2014年的超重和肥胖流行趋势

目的：分析上海市1985至2014年7~18岁学生的超重和肥胖的动态变化趋势。方法：选取1985（n=14 677）、1995（n=7 916）、2000（n=15 270）、2005（n=7 492）、2010（n=14 301）和2014（n=15 423）年6次中国学生体质与健康调研上海地区资料进行分析。采用中国学龄儿童超重、肥胖BMI分类标准。结果：基于上海市6个区总调查样本量,以10年（1985、1995、2005和2014年）为1个周期,随年代增长上海市7～18岁男、女学生BMI P50百分位数曲线逐年提高,总体男生较女生提高更为明显,不同年龄组的男女生BMI均值呈上升趋势且均为男生高于女生。2014年上海市BMI和全国比较,P50男女生均高于全国水平,P85和P95男女生11和12岁前与全国水平重合,之后高于全国水平。与1985年比较,2014年上海市7～18岁男生超重检出率增加了11倍（19.3% vs 1.7%）,肥胖检出率增加了29倍（11.7% vs 0.4%）,平均增长率为12.3%;上海市7～18岁女生超重检出率增加了7倍（11.6% vs 1.5%）,肥胖检出率增加了31倍（6.4% vs 0.2%）,平均增长率为12.7%。各年龄组男生超重检出率14.3%~26.9%、肥胖检出率7.3%～17.0%,男生11岁超重和肥胖检出率最高;各年龄组女生超重检出率8.6%~14.0%、肥胖检出率2.8%～11.2%,女生7岁超重和肥胖检出率最高。男生各年龄段超重和肥胖检出率均高于女生。结论：上海市1985至2014年7~18岁学生超重与肥胖检出率持续增长。低年龄段男生超重流行程度较为严重,已处于国际高位水平。     

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.     

Prevalence of overweight and obesity in Danish preschool children over a 10-year period: a study of two birth cohorts in general practice

Aim: To determine change in the prevalence of overweight and obesity in preschool children, over a 10‐year period and to identify possible predictors of overweight in 5‐year‐old children. Methods: Anthropometric data from birth and routine child health examinations at 3 and 5 years of age performed in general practice were collected in 5580 children from two Funen birth cohorts (1992 and 2001, respectively) representing 48% of the total population at similar age. The prevalence of overweight and obesity was classified using the International Obesity Task Force definitions. Results: In a Danish representative survey of preschool children, the average body mass index (BMI) and prevalence of overweight and obesity did not vary significantly during the 10‐year period. No significant changes in mean birth weight were registered and mean BMI in the group of obese children did not increase. Overweight or obesity at 5 years was strongly associated with overweight and obesity at 3 years and with birth weight and gender. Conclusion: The prevalence of overweight and obesity was observed to be stable over a decade in Danish preschool children without changes in mean BMI in the group of obese children. A strong association between overweight and obesity at 3 and at 5 years of age was detected.     

Overweight and obesity in 6- to 14-year-old Czech children in 1991: protective effect of breast-feeding

OBJECTIVE: To assess the impact of breast-feeding on childhood overweight/obesity in an Eastern European socialist society with relatively homogeneous lifestyles. STUDY DESIGN: Cross-sectional survey data collected in 1991 on 33,768 school-children aged 6 to 14 years in the Czech Republic were analyzed by using multiple logistic regression analyses (main outcome body mass index [BMI] >90th percentile [overweight] and BMI >97th percentile [obesity]). RESULTS: Overall prevalence of overweight (obesity) was lower in breast-fed children: ever breast-fed (9.3%; 95% CI, 8.9-9.6 [3.2%; 95% CI, 3.0-3.4]) compared with never breast-fed (12.4%; 95% CI, 11.3-13.6 [4.4%; 95% CI, 3.7-5.2]). The effect of breast-feeding on overweight/obesity did not diminish with age in children 6 to 14 years old and could not be explained by parental education, parental obesity, maternal smoking, high birth weight, watching television, number of siblings, and physical activity. Adjusted odds ratios for breast-feeding were for overweight 0.80 (95% CI, 0.71-0.90) and for obesity 0.80 (95% CI, 0.66-0.96). CONCLUSIONS: A reduced prevalence of overweight/obesity was associated with breast-feeding in a setting where socioeconomic status was homogeneous. This suggests that the effect of breast-feeding on the prevalence of obesity is not confounded by socioeconomic status.     

Declining prevalence rates for overweight and obesity in German children starting school

To estimate the development of prevalence rates for overweight and obesity in children starting school in Germany, data for children’s height and weight out of the compulsory school enrolment examinations (SEE), conducted annually in every German federal state, were available. A former analysis of these data showed a marked increase of prevalence of overweight and obesity until 2004. The aim of this project was to give an updated overview on the development of prevalence rates for overweight and obesity in children upon school entry by including recent data until 2008. Data on measured height and weight from the yearly conducted SEE were obtained from all 16 German federal states. Overweight and obesity were defined by BMI > 90th and BMI > 97th age- and gender-related percentiles of German reference values, respectively. In 2008, the prevalence for overweight varied from 8.4% in Saxony to 11.9% in Bremen and Thuringia. The current prevalence rates for obesity ranged from 3.3% in Brandenburg and Saxony till 5.4% in Saarland. The current data from SEE by the majority of the individual states showed that the prevalence for both overweight and obesity did not increase any more after 2004 and is even declining in some states compared to the former data inquiry. Absolute decrease of prevalence rates was up to 3% for overweight and 1.8% for obesity. Conclusion: The current data from the SEE of individual German states are based on census and showed by the majority that the prevalence of overweight and obese children starting school did not increase anymore and even declined in the last 4 years, respectively. It is supposed that the measures for prevention initiated in the 1990s and implemented afterwards have contributed to this positive development in Germany.     

北京市超重和肥胖学龄儿童中代谢综合征的流行特征

目的了解北京市6—18岁超重、肥胖儿童青少年中代谢综合征（MS）的流行现状和临床表型特征;比较美国国家胆固醇教育计划和国际糖尿病联盟定义的标准诊断儿童青少年MS的差异。方法以2004年北京儿童青少年MS调查中筛查出的超重和肥胖儿童为研究对象,并选取一组正常体重儿童为对照组,检测空腹血浆葡萄糖和胰岛素、血清甘油三酯和高密度脂蛋白胆固醇水平,采用稳态模式评估法计算胰岛素抵抗指数。符合以下5项指标中3项及以上者为MS：腹型肥胖（腰围≥P90）、高血压（≥P90）、低高密度脂蛋白胆固醇[〈1．03mmol／L（40mg／dl）]、高甘油三酯[≥1．24mmol／L（110mg／dl）]和空腹血糖升高[≥5．6mmol／L（100mg／dl）]。结果（1）采用美国国家胆固醇教育计划定义,MS检出率分别为,对照组0．9％,超重组7．6％,肥胖组29．8％,高于国际糖尿病联盟定义的检出率（0．1％,5．2％,28．6％）;两定义标准诊断的MS检出率均呈现随体重指数升高而增加的趋势（趋势检验,P〈0．001）;（2）肥胖儿童中MS单项异常检出率依次为：腹型肥胖81．6％,高血压47．7％,高甘油三酯35．6％,低高密度脂蛋白胆固醇16．9％,高空腹血糖13．4％;超过四分之一的超重儿童具有高血压（29．8％）、腹型肥胖（27．4％）和高甘油三酯（26．0％）;随体重指数增加,MS指标多项异常者和胰岛素抵抗者呈增加趋势（P〈0．001）。结论北京市肥胖儿童青少年中MS已呈现严重流行趋势;腹型肥胖、高血压、高甘油三酯是超重肥胖儿童最常见的代谢异常。采用美国国家胆固醇教育计划定义的儿童MS检出率高于国际糖尿病联盟定义的检出率。     

Prevalence of obesity and overweight in urban school children in Kerala,India

The objective of this study was to examine the prevalence of obesity and overweight in urban school children in Kochi, Kerala, South India. Three schools from the city were selected representing upper, middle and lower socioeconomic groups and the children aged 6-15 years of age were interviewed. The prevalence of obesity was 3.0% for boys and 5.3% for girls. The prevalence of obesity (7.5%) and overweight (21.9%) were highest among high income group and lowest (1.5% and 2.5%) among low income group. Prevalence of obesity and overweight was found to be higher in the high income group and among girls.     

Worldwide trends in childhood overweight and obesity.

OBJECTIVES: Obesity has become a global epidemic but our understanding of the problem in children is limited due to lack of comparable representative data from different countries, and varying criteria for defining obesity. This paper summarises the available information on recent trends in child overweight and obesity prevalence. METHODS: PubMed was searched for data relating to trends over time, in papers published between January 1980 and October 2005. Additional studies identified by citations in retrieved papers and by consultation with experts were included. Data for trends over time were found for school-age populations in 25 countries and for pre-school populations in 42 countries. Using these reports, and data collected for the World Health Organization's Burden of Disease Program, we estimated the global prevalence of overweight and obesity among school-age children for 2006 and likely prevalence levels for 2010. RESULTS: The prevalence of childhood overweight has increased in almost all countries for which data are available. Exceptions are found among school-age children in Russia and to some extent Poland during the 1990s. Exceptions are also found among infant and pre-school children in some lower-income countries. Obesity and overweight has increased more dramatically in economically developed countries and in urbanized populations. CONCLUSIONS: There is a growing global childhood obesity epidemic, with a large variation in secular trends across countries. Effective programs and policies are needed at global, regional and national levels to limit the problem among children.