Metabolic syndrome and its association with diet and physical activity in US adolescents

BACKGROUND: Research on the metabolic syndrome and its association with lifestyle behaviors in adolescents is important for identifying subgroups of youth at whom interventions should be targeted. OBJECTIVE: To examine the relationship of metabolic syndrome with diet and physical activity in US adolescents. DESIGN: A sample of 4,450 12- to 19-year-olds was obtained from 4-year combined data of the National Health and Nutrition Examination Survey 1999-2002. METHOD: The metabolic syndrome was defined as having three or more of the following conditions: waist circumference > or =90th percentile for age/sex, fasting blood glucose > or =100 mg/dL (5.6 mmol/L), blood triglycerides > or =110 mg/dL (> or =1.2 mmol/L), HDL cholesterol < or =35 mg/dL (0.9 mmol/L), and systolic/diastolic blood pressure > or =90th percentile for height or taking antihypertensive drugs. Diet quality was assessed using the Healthy Eating Index and its components, and nutrient intakes. The association between the metabolic syndrome and physical activity was presented as the prevalence of metabolic syndrome by different physical activity levels. RESULTS: Overall prevalence of metabolic syndrome among US adolescents was 3.5%. More males than females (5.1% vs 1.7%; P<0.0001) had metabolic syndrome. The metabolic syndrome was 16 times higher in overweight adolescents (body mass index > or =95th percentile) compared to those with body mass index <85th percentile (14.5% vs 0.9%; P<0.0001). Prevalence of metabolic syndrome decreased with increments of overall Healthy Eating Index and fruit score quartiles. Higher overall Healthy Eating Index and fruit scores were associated with lower metabolic syndrome (P<0.001). There was a trend toward lower prevalence of metabolic syndrome in adolescents with high physical activity levels (2.6%) compared to those who had low (4.3%) or moderate (3.1%) physical activity levels. CONCLUSION: Results support the need to engage adolescents in regular physical activity and healthful dietary practices to prevent excessive weight gain. Weight control should be recommended as the first-line intervention to decrease metabolic syndrome in adolescents.     

Obesity and risk factors for the metabolic syndrome among low-income, urban, African American schoolchildren: the rule rather than the exception?

BACKGROUND: Adult obesity is associated with the metabolic syndrome; however, the prevalence of the metabolic syndrome among young children has not been reported. Clinic-based screening efforts for the metabolic syndrome in low-income neighborhoods, where obesity is prevalent, are limited by minimal health insurance coverage and inadequate access to health care. School-based obesity screening programs may effectively target high-risk populations. OBJECTIVE: The objective was to describe the prevalence of overweight and features of the metabolic syndrome (defined as the presence of > or =3 of the following risk factors: HDL < or = 40 mg/dL, triacylglycerol > or = 110 mg/dL, and blood pressure or waist circumference at or above the 90th percentile) in a pilot, school-based screening program. DESIGN: A cross-sectional study of obesity and the metabolic syndrome was conducted in third- to sixth-grade, low-income, urban, African American children. Lipid and glucose concentrations were measured in fasting capillary finger-stick samples. RESULTS: Age- and sex-specific BMI percentiles were assessed in 385 students, 90 of whom were full participants in this study (participants) and 295 of whom had only height and weight measurements taken (other students). Risk factors of the metabolic syndrome were assessed in the 90 participants (23%). No significant differences in BMI percentiles were found between the participants and the other students. Overall, 44% of the participants had BMIs at or above the 85th percentile, and 59% had an elevated BMI or one metabolic syndrome risk factor. The metabolic syndrome was present in 5.6% of all participants, in 13.8% of participants with BMIs at or above the 95th percentile, and in 0% of participants with BMIs below the 95th percentile. CONCLUSIONS: Most of the African American children attending 2 urban schools in low-income neighborhoods were overweight or had one or more risk factors for the metabolic syndrome. School-based screening programs in high-risk populations may provide an efficient venue for the screening of obesity and related risk factors.     

Prevalence of the hypertriglyceridemic waist phenotype in Iranian adolescents

BACKGROUND: No evidence exists regarding the prevalence of the hypertriglyceridemic waist phenotype in adolescents. We aimed to evaluate the prevalence of this phenotype in a representative sample of Tehranian adolescents. METHODS: Anthropometry and serum triglyceride concentration were assessed in a population-based cross-sectional study of 3036 Tehranian adolescents (1413 male and 1623 female) aged 10 to 19 years in 1998. Hypertriglyceridemic waist phenotype was defined as concurrently having serum triglyceride concentration>or=110 mg/dL and waist circumference equal to or greater than the 90th percentile for age and gender. Overweight (>or=95th percentile) and at risk for overweight (>or=85th to <95th percentile) was defined based on the standardized percentile curves of body mass index suggested for Iranian adolescents. RESULTS: The prevalence of the hypertriglyceridemic waist phenotype was 6.4% (95% confidence interval [CI]=5.5-7.2) among Tehranian adolescents (males 7.3%, CI=5.9-8.7; females 5.6%, CI=4.4-6.7). When examined by body mass index category, 38.7% of overweight adolescents had a hypertriglyceridemic waist compared to 7.7% of adolescents at risk for overweight and 0.7% of adolescents at normal weight (p=0.001). CONCLUSIONS: This study provides evidence showing that the hypertriglyceridemic waist phenotype is prevalent among 6.5% of Tehranian adolescents, and particularly among overweight adolescents.     

上海市2000-2014年中小学生体质量指数变化趋势

了解2000-2014年上海市学龄儿童青少年体质量指数(BMI)的变化趋势,为儿童青少年超重、肥胖判别标准研制及预防干预提供参考.方法 选取2000,2005,2010,2014年4次全国学生体质与健康调研中7~18岁儿童青少年作为研究对象.应用最小均方(Least Mean Square,LMS)法探讨不同性别、年龄组儿童青少年BMI的变化趋势.结果 14年间学生BMI P85低年龄组差异比较小,随年龄增加差异逐渐增大,青春期后有减小的趋势,男生平均增加2.1百分点,女生平均增加1.3百分点.学生BMI增长主要集中在中等和高百分位数,尤其是P90后,差值逐渐增大.7~11,12~15岁男生在P5o后差值均逐渐增大,P95分别达2.0,3.2百分点,其中12岁男生从23.4 kg/m2增加到26.8 kg/m2,14岁女生从24.0 kg/m2增加到25.9 kg/m2.与WGOC标准相比,2014年男生BMI P85,P95均较高,而女生BMI P85 10岁之前高于WGOC标准,从11岁开始与WGOC标准基本相一致.2014年上海市7~18岁儿童青少年超重、肥胖检出率分别为15.4%,9.1%,较2000年总体均呈上升趋势,分别上升6.4,5.2百分点.结论 BMI分布高百分位的个体比低百分位个体的变化更大.在肥胖防治工作中,加强对群体BMI曲线的监测分析,对适时调整宏观调控战略意义重大.     

北京市2004年2-18岁儿童青少年超重和肥胖流行现状

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

Trends in overweight among adolescents living in the poorest and richest regions of Brazil

OBJECTIVES: We assessed changes in body mass index (BMI) among Brazilian adolescents. METHODS: In 1975, 1989, and 1997, we conducted household surveys of the weights and statures of a probabilistic sample of about 50,000 Brazilian adolescents aged 10 to 19 years. Weighted prevalences were calculated and an analysis was performed with the sample design taken into account. RESULTS: Adolescents of rich (southeast) and poor (northeast) regions showed a substantial increase in BMI. In the southeast, the prevalence of overweight, defined by international age- and gender-specific BMI cutoffs, for both genders reached 17% in 1997, whereas in the northeast, the prevalence tripled, reaching 5% among boys and 12% among girls. Older girls living in urban areas in the southeast showed a decrease in prevalence from 16% to 13% in the latter 2 surveys. For all boys and for young girls, the BMI values for the 85th percentile in 1997 were much higher than the 95th percentile values in 1975. CONCLUSIONS: BMI increased dramatically in Brazilian adolescents, mainly among boys; among older girls from the richest region, the prevalence of overweight is decreasing.     

Persistence of overweight among young children living in low income communities in Ontario

OBJECTIVE: The rise in the prevalence of overweight in pediatric populations is a major health concern. Little is known however, about the prevalence of overweight in younger children. Our objectives were to determine the annual prevalence of overweight in children from junior kindergarten (JK) to grade 3; to assess the persistence of overweight over this time period; and, to identify factors associated with overweight in this group. METHODS: Annual interviews were completed with parents (primarily the mother) living in economically disadvantaged communities in Ontario who are participating in the Better Beginnings, Better Futures project. Weight and height were measured annually for the children (n=760) beginning in JK. Risk of overweight was defined as body mass index (BMI) >or= 85th to < 95th percentile; overweight was BMI >or= 95th percentile. Parents' height and weight were self-reported; BMI >or= 25 was considered overweight. RESULTS: The risk of overweight among children ranged from 14.1% to 17.5%; the prevalence of overweight increased from 9.9% to 15.2%; 68.2% (15/22) of the children who were overweight in JK were >95th percentile in grade 3. BMI >or= 85th to < 95th percentile or >or= 95th percentile in JK were strongly predictive of overweight in grade 3. Almost 50% of the mothers were overweight. CONCLUSIONS: A high prevalence of overweight was found in young children; and, for a large proportion, their early weight status persisted. Strategies promoting healthy eating and physical activity for both children and parents are essential.     

Prevalence of elevated body mass index and blood pressure in a rural school-aged population: implications for school nurses

The growing prevalence of overweight in students and adolescents has become a matter of national concern and is linked to a rise in chronic health conditions in students who previously had low prevalence rates, such as cardiovascular disease. This study examined the relationships between age, ethnicity, race, body mass index (BMI), and elevated blood pressure (BP) in a rural school age population. Data are reported for 1121 students in grades K-11. The sample was 55% African American, 41% Caucasian, 3% Hispanic, and 1% other. The prevalence of students at risk of being overweight (BMI > or =85th percentile) was 46.5%, and the prevalence of overweight students (BMI > or =95th percentile) was 29.1%. The prevalence of elevated BP was 21.6%. Elevated BMI and BP were more prevalent in older students. While there was a direct relationship between elevated BMI and elevated BP for all groups, African Americans were more likely to have an elevated BP with a normal BMI. These findings demonstrate the important role of the school nurse in providing effective prevention strategies related to screening, follow-up, and treatment.     

Childhood Asthma and Extreme Values of Body Mass Index: The Harlem Children’s Zone Asthma Initiative

To examine the association between body mass index (BMI) percentile and asthma in children 2-11 years of age, we performed a cross-sectional analysis of 853 Black and Hispanic children from a community-based sample of 2- to 11-year olds with measured heights and weights screened for asthma by the Harlem Children's Zone Asthma Initiative. Current asthma was defined as parent/guardian-reported diagnosis of asthma and asthma-related symptoms or emergency care in the previous 12 months. Among girls, asthma prevalence increased approximately linearly with increasing body mass index (BMI) percentile, from a low of 12.0% among underweight girls (BMI 95th percentile). After adjusting for age, race/ethnicity, and household smoking, among girls, having asthma was associated with being at risk for overweight (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.4-5.0) and being overweight (OR, 2.1; 95% CI, 1.2-3.8) compared to normal weight; among boys, having asthma was associated both with overweight (OR, 2.4; 95% CI, 1.4-4.3) and with underweight (OR, 2.9; 95% CI, 1.1-7.7). Large, prospective studies that include very young children are needed to further explore the observed association between underweight and asthma among boys. Early interventions that concomitantly address asthma and weight gain are needed among pre-school and school-aged children.     

Physical activity and overweight among adolescents on the Texas-Mexico border.

OBJECTIVE: To investigate differences in associations between physical activity and overweight for students in two adjacent areas on the border between Mexico and the United States of America: students in the city of Matamoros, Mexico, and Mexican-American students in the Lower Rio Grande Valley (LRGV) area of southern Texas. Since the extremely high prevalence of overweight among Mexican-American adolescents is well-recognized, we wanted to determine whether overweight has become a problem among Mexican adolescents as well. METHODS: Students from 6 schools (n = 653), representing 11% of the ninth-grade students in Matamoros during 2002-2003, and students from 13 high schools (n = 4,736), representing 22% of the ninth-grade students in the LRGV during 2000-2001, completed questionnaires. Polytomous logistic regression was performed to estimate the risk of being at risk for overweight (> or = 85th percentile to < 95th percentile of body mass index (BMI) for age and sex) and the risk of being overweight (> or = 95th percentile of BMI-for-age and sex) versus normal weight that were associated with measures of physical activity. For simplicity, the classification of normal weight also included underweight. RESULTS: A higher percentage of adolescents in the LRGV were at risk of overweight (17%) in comparison with adolescents from Matamoros (15%). The percentages of LRGV and Matamoros adolescents who were overweight were identical (17%). LRGV adolescent boys (OR = 0.87, 95% CI = 0.77-0.98) who participated in team sports were less likely to be at or above the 85th percentile of BMI-for-age and sex. Although of borderline significance, Matamoros and LRGV adolescent boys who participated in physical education classes were less likely to be at risk for overweight. Among neither the Matamoros students nor the LRGV students were any of the various other physical activity categories or levels associated with being at risk for overweight or being overweight. CONCLUSIONS: Nearly one-third of the students in both Matamoros and the LRGV are at risk for overweight or are overweight. Implementation of interventions on healthful dietary choices and participation in physical education classes and sports teams are essential for reducing the extremely high prevalence of overweight among students on both sides of the Texas/Mexico border.     

Maturational timing and overweight prevalence in US adolescent girls

OBJECTIVES: This study examined the relation of age at menarche to overweight in US adolescent girls. METHODS: Effects of age at menarche and race/ethnicity on overweight were estimated via logistic regression, after adjustment for sociodemographic characteristics, in a sample of 6507 Hispanic, Black, White, and Asian American girls who participated in wave 2 of the National Longitudinal Study of Adolescent Health. RESULTS: Overweight prevalence rates were significantly higher in early maturing adolescents of all racial/ethnic groups but highest (57.5%) among early maturing Black girls. Early maturation nearly doubled the odds of being overweight (body mass index at or above the 85th percentile). CONCLUSIONS: Greater public health attention should be focused on the high prevalence of overweight, particularly among minority female adolescents.     

杭州市7～18岁儿童青少年体质指数标准研究

目的研究杭州市7～18岁儿童青少年体质指数（BMI）分布、超重和肥胖的检出率。方法抽取21536名杭州城区17所小学和12所中学学生作为研究对象,以国际生命科学会中国肥胖问题工作组（WGOC）颁布的“中国儿童青少年超重、肥胖体质指数筛查分类标准”作为参考标准,对学龄儿童青少年进行体质指数研究。结果杭州市男性学龄儿童青少年超重（P85）和肥胖（P95）普遍要高于WGOC标准;女性学龄儿童青少年超重（％）7—10岁组要稍高于WGOC标准,大于10岁各年龄组的超重BMI值都要低于WGOC标准;而肥胖（P醅）各年龄组的值均低于WGOC标准。各年龄组超重与肥胖检出率男生平均高达23．5％和10．0％,女生也有14．0％和4．9％。结论杭州市学龄儿童青少年超重和肥胖的流行水平较高,尤其是男性学龄青少年,应尽快将超重和肥胖的防治列入学校卫生工作的重点,开展适宜的健康教育,引导学生和家长建立正确的生活习惯和健康观念。     

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

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

A comparison of distribution curves of body mass index from Brazil and the United States for assessing overweight and obesity in Brazilian adolescents.

OBJECTIVE: To assess the validity of recommendations for use of the 85th and 95th percentiles of body mass index (BMI) of the population in the United States of America as a screening tool to assess overweight/obesity in adolescents. METHODS: We investigated the relation between BMI and percent body fat in 1,540 adolescents (717 males and 823 females) aged 10 to 17.9 years old from a private high school in Niterói, a city in the state of Rio de Janeiro, Brazil. We used bioelectric impedance, with the appropriate equations for adolescents, to estimate percent body fat, which served as the gold standard (30% for girls and 25% for boys) to calculate the sensitivity and specificity of the 85th and 95th percentiles of the United States and Brazilian distribution curves of BMI. RESULTS: Sensitivity and specificity were high (above 80%) for the Niterói boys, except for the 85th percentile of the Brazilian curve (specificity = 61.8%) and for the 95th percentile of the United States curve (sensitivity = 55.4%). For the Niterói girls, the 85th- and 95th-percentile BMI cutoff points, from both the United States and Brazilian curves, showed low sensitivity, and that sensitivity decreased with age. Specificity was high for the girls, and much higher than it was for the boys. CONCLUSIONS: These data suggest that using BMI to screen for overweight/obesity in adolescents can generate a high percentage of false-positives for Niterói boys and an even higher percentage of false-negatives for Niterói girls. A more universal approach to using anthropometric measures to screen for overweight/obesity should be developed, preferably linked to stages of maturation.     

Body mass index in adolescence in relation to cause-specific mortality: a follow-up of 230,000 Norwegian adolescents

The prevalence of obesity in childhood and adolescence has increased worldwide. Long-term effects of adolescent obesity on cause-specific mortality are not well specified. The authors studied 227,000 adolescents (aged 14-19 years) measured (height and weight) in Norwegian health surveys in 1963-1975. During follow-up (8 million person-years), 9,650 deaths were observed. Cox proportional hazards regression was used to compare cause-specific mortality among individuals whose baseline body mass index (BMI) was below the 25th percentile, between the 75th and 84th percentiles, and above the 85th percentile in a US reference population with that of individuals whose BMI was between the 25th and 75th percentiles. Risk of death from endocrine, nutritional, and metabolic diseases and from circulatory system diseases was increased in the two highest BMI categories for both sexes. Relative risks of ischemic heart disease death were 2.9 (95% confidence interval (CI): 2.3, 3.6) for males and 3.7 (95% CI: 2.3, 5.7) for females in the highest BMI category compared with the reference. There was also an increased risk of death from colon cancer (males: 2.1, 95% CI: 1.1, 4.1; females: 2.0, 95% CI: 1.2, 3.5), respiratory system diseases (males: 2.7, 95% CI: 1.4, 5.2; females: 2.5, 95% CI: 1.4, 4.8), and sudden death (males: 2.2, 95% CI: 1.2, 4.3; females: 2.7, 95% CI: 1.1, 6.6). Adolescent obesity was related to increased mortality in middle age from several important causes.     

Prevalence of overweight among inner city Hispanic-American children and adolescents

OBJECTIVE: National surveys have pointed to a particularly high risk of pediatric overweight among U.S. Hispanics. However, the data have been primarily from the Mexican-American community. We studied the prevalence of overweight and clinical comorbidities in children and youth of predominantly El Salvadoran ancestry. RESEARCH METHODS AND PROCEDURES: A sample of 309 Hispanic youth, 6-18 years was surveyed from two inner city Washington, DC, clinics. BMI; triceps skinfold (TSF) and subscapular skinfold thickness (SSSF); bioelectrical impedance analysis (BIA); and blood pressure measures were obtained, along with information regarding physical activity, sedentary behavior, dietary history, family, and personal medical history. RESULTS: Thirty-eight percent were overweight (BMI > or = 95th percentile) and 22% at risk for overweight (BMI 85-94th percentile). Thirty-four percent had TSF > or = 90th percentile and 29% had SSSF > or = 90th percentile. Fifty-one percent of males and 70% of females had body fat > 30%. Compared to their nonoverweight counterparts, overweight youth had significantly higher systolic blood pressure (111.4 +/- 1.3 vs. 104.5 +/- 0.9 mm Hg, p < 0.0001). Among children younger than 11 years, overweight was associated with onset of adrenarche (23% vs. 10%, p = 0.01). Participation in one or more sports teams was negatively correlated with overweight) p = 0.04). DISCUSSION: The prevalence of overweight and at risk for overweight in this sample was twice the national average for U.S. children and 1.7 times greater than that of Mexican-American children in national surveys. Overweight was associated with advanced pubertal development, high body fat, elevated blood pressure, and decreased sports participation.     

Prevalence of overweight,obesity and low weight in the Czech child population up to 18 years of age in the last 50 years

Aim  The main purpose of the study was to analyze the changes in the prevalence of underweight, overweight, and obesity among Czech children and adolescents aged 3–18 within the last 50 years. The secondary purpose of the study was to determine the prevalence of overweight and obesity among children and adolescents in 2001 and compare it to the reference standards recommended by the International Obesity Task Force (IOTF). Subject and methods  Anthropometric data collected from nationally representative samples of 3–18-year-old children and adolescents in the Czech Republic in 1951, 1981, 1991, and 2001 were analyzed in the study. The prevalence of child overweight and obesity among Czech children using data from the most recent 2001 National Anthropological Survey was estimated using the 1991 Czech reference values and the IOTF standards. Results  There has been a gradual increase in the number of children in both extreme categories of BMI values in most age categories, including underweight (<10th percentile), overweight (>90th percentile), and obesity (>97th percentile) between 1951 and 2001. In both genders, the number of underweight children increased dramatically in the lowest age categories. At the same time, the rates of overweight and obesity increased among 6–11- and 11–15-year-old individuals. The prevalence of underweight has also increased among older adolescents. However, our study indicated that the 2001 prevalence of overweight/obesity among Czech adolescents, especially in older age categories and among girls, was lower compared to the 1991 reference values. Conclusion  Given the continuous increase in child obesity rates in the US and most of Europe, it is interesting that the prevalence of overweight and obesity has remained relatively low among children and adolescents in the Czech Republic. Given the increased number of Czech school-aged children with excess adiposity, a gradual rise in the prevalence of overweight and obesity among Czech adolescents could be expected.     

出生重量指数对中年罹患代谢综合征的预测作用

目的　探讨出生重量指数与中年期罹患代谢综合征 (MS)的联系。方法　对 975名“宫内发育与成人疾病”队列研究人群 (男 4 94人、女 4 81人 ,年龄 4 1～ 5 2岁 )的身高、体重、血压和血脂进行了测定 ,并用稳态模式评估法计算胰岛素抵抗指数。根据 1999年WHO定义进行MS诊断。采用多因素logistic回归方法分析出生重量指数对中年期MS患病风险的预测作用 ,及其与成年体重指数的交互作用。结果　人群MS检出率为 180例 (18 7% ) ,出生重量指数 相似文献   

Prevalence and Impact of Unhealthy Weight in a National Sample of US Adolescents with Autism and Other Learning and Behavioral Disabilities

We estimated the prevalence of obesity, overweight, and underweight among US adolescents with and without autism and other learning and behavioral developmental disabilities (DDs) and assessed the health consequences of obesity among adolescents with DDs. From the 2008 to 2010 National Health Interview Survey, we selected 9,619 adolescents ages 12–17 years. Parent respondents reported weight, height, presence of DDs and health conditions. We calculated body mass index (BMI) and defined obesity, overweight, and underweight as ≥95th, ≥85th to <95th, and <5th percentiles, respectively, using established criteria. We created mutually-exclusive DD subgroups using the following order of precedence: autism; intellectual disability; attention-deficit-hyperactivity-disorder; learning disorder/other developmental delay. We compared BMI outcomes among adolescents in each DD group versus adolescents without DDs using multivariable logistic regression. Socio-demographic factors and birthweight were included as confounders. Estimates were weighted to reflect the US population. Both obesity and underweight prevalences were higher among adolescents with than without DDs [adjusted prevalence ratios (aPR) 1.5 (1.25–1.75) and 1.5 (1.01–2.20), respectively]. Obesity was elevated among adolescents with all DD types, and was highest among the autism subgroup [aPR 2.1 (1.44–3.16)]. Adolescents with either a DD or obesity had higher prevalences of common respiratory, gastrointestinal, dermatological and neurological conditions/symptoms than nonobese adolescents without DDs. Adolescents with both DDs and obesity had the highest estimates for most conditions. Obesity is high among adolescents with autism and other DDs and poses added chronic health risks. Obesity prevention and management approaches for this vulnerable population subgroup need further consideration.     

Urban‐Rural Differences in Overweight Status and Physical Inactivity Among US Children Aged 10‐17 Years

ABSTRACT: Context: Few studies have examined the prevalence of overweight status and physical inactivity among children and adolescents living in rural America. Purpose: We examined urban and rural differences in the prevalence of overweight status and physical inactivity among US children. Methods: Data were drawn from the 2003 National Survey of Children's Health, restricted to children aged 10‐17 (unweighted N = 47,757). Overweight status was defined as the gender‐ and age‐specific body mass index (BMI) values at or above the 95th percentile. Physical inactivity was defined using parentally reported moderate‐to‐vigorous intensity leisure‐time physical activity lasting for at least 20 minutes/d on less than three days in the past week. The 2003 Urban Influence Codes were used to define rurality. Multiple logistic regression models were used to examine urban/rural differences in overweight status and physical inactivity after adjusting for potential confounders. Findings: Overweight status was more prevalent among rural (16.5%) than urban children (14.3%). After adjusting for covariates including physical activity, rural children had higher odds of being overweight than urban children (OR: 1.13; 95% CI: 1.01‐1.25). Minorities, children from families with lower socioeconomic status, and children living in the South experienced higher odds of being overweight. More urban children (29.1%) were physically inactive than rural children (25.2%) and this pattern remained after adjusting for covariates (OR: 0.79; 95% CI: 0.73‐0.86). Conclusions: The higher prevalence of overweight among rural children, despite modestly higher physical activity levels, calls for further research into effective intervention programs specifically tailored for rural children.