Prevalence of overweight and obesity in children and adolescents in a county in Sweden

Overweight among young people in Sweden is increasing. The aim of the present study was to investigate the frequency of overweight and obesity based on body mass index (BMI) values among children and adolescents. Overweight was defined as a BMI value > or = 91st percentile and obesity as a BMI value > 98th percentile on an international reference BMI curve. The study population included boys and girls from four age groups: 9, 12, 15 and 18 y. The data consisted of self-reported measures of height and weight that were obtained from questionnaires used in a cross-sectional study in December 1997. A validation study was performed using a part of the study population. A total of 7011 (81.7%) participants completed the questionnaire. The correlation between self-reported estimations and objective measures of height and weight was high in the oldest age groups (0.88-0.98), but lower in the 9-y-old age groups (0.37-0.72). These self-reported estimations in the 9-y-olds were excluded from further analysis. It was found that 12.3%, 11.6% and 11.4% of the boys in the 12-, 15- and 18-y-old age groups and 6.8%, 5.5% and 4.8% of the girls in the same age groups were overweight and 7.9%, 8.9% and 7.3% of the boys and 5.1%, 4.2% and 3.9% of the girls were obese. Conclusion: The prevalence of overweight and obesity was found to be high in the study population and is a serious public health problem. The prevalence of obesity was significantly higher (p < 0.05) in 15-y-old boys living in rural areas than in city and town dwellers of the same age.     

儿童睡眠时间与肥胖的关系

目的了解儿童睡眠时间与肥胖的关系。方法采用分层随机整群抽样方法抽取1 145名7～12岁儿童,测量身高和体质量,计算体质指数(BMI)。对受试儿童及家长进行睡眠时间、运动时间、家庭作业时间和看电视、玩游戏时间的问卷调查。结果该组儿童的肥胖发生率为3.8%;睡眠时间≥10 h儿童的肥胖发生率为2.0%,8～10 h儿童发生率为5.0%,≤8 h儿童发生率为10.0%,差异有统计学意义(P<0.001)。结论睡眠时间过短是导致肥胖的危险因素,保证充足的睡眠时间是预防肥胖的重要手段。     

Overweight and obesity in Norwegian children: prevalence and socio‐demographic risk factors

Aim: The aim of this study was to estimate the prevalence of childhood overweight and obesity and to identify socio‐demographic risk factors in Norwegian children. Methods: The body mass index of 6386 children aged 2–19 years was compared with the International Obesity Task Force (IOTF) cut‐off values to estimate the prevalence of overweight including obesity (OWOB) and obesity (OB). The effect of socio‐demographic factors on this prevalence was analysed using multiple ordinal logistic regression analysis in a subsample of 3793 children. Results: The overall prevalence of OWOB was 13.8% (13.2% in boys and 14.5% in girls, p = 0.146), but the prevalence was higher in primary school children aged 6–11 years (17%, p < 0.001). The risk of being OWOB or OB increased in children with fever siblings (p = 0.003) and with lower parental educational level (p = 0.001). There was no association with parental employment status, single‐parent families or origin. Conclusion: The prevalence of OWOB and OB in Norwegian primary school children is of concern. Socio‐demographic factors have pronounced effects on the current prevalence of overweight and obesity in a cohort of Norwegian children. This knowledge could help to work out strategies to reduce the burden of overweight and obesity in children.     

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。     

Prevalence of overweight and obesity in 5- and 12-year-old Finnish children in 1986 and 2006

Objective: To investigate the prevalence and the trends of overweight and obesity in Finnish 5- and 12-year-old children in 1986 and 2006.
Design: Retrospective cross-sectional study.
Subjects and methods: Anthropometric data were collected retrospectively from health examinations in Tampere and in three rural municipalities. The size of the 5- and 12-year-old cohorts were 2108 in 1986 and 4013 in 2006, respectively. The body mass index (BMI) was calculated. Overweight and obesity was estimated using the International Obesity Task Force cutoff values (ISO BMI).
Results: The prevalence of overweight (ISO BMI >25) and obesity (ISO BMI >30) in 5-year-old boys in 2006 was 9.8% and 2.5% and in girls 17.7% and 2.5%, respectively. At the age of 12 years, the corresponding figures in boys were 23.6% and 4.7% and in girls 19.1% and 3.2%. Between 1986 and 2006, the prevalence of overweight in 12-year-old children had increased 1.8 fold in boys (p < 0.001) and 1.5 fold in girls (p = 0.008). Overweight was significantly more common in rural than in urban areas.
Conclusion: During the last 20 years the prevalence of overweight has markedly increased in 12-year-old Finnish children, but remained nearly unchanged in 5-year-old children.     

Assessment of the medial longitudinal arch in children and adolescents with obesity: footprints and radiographic study

The purpose of this study was to evaluate foot arch types of obese children and adolescents aged 9–16.5 years using both indirect and direct measures. Fifty-eight obese children/adolescents attending the paediatric endocrinology unit of the University Hospital “Lozano Blesa” in Zaragoza were selected as experimental subjects. Fifty-eight gender and age matched, normal-weight children/adolescents were selected as control subjects. To assess the medial longitudinal arch (MLA) height, which is used as a main reference for the diagnosis of flatfoot, footprints from both feet were collected (in both groups) and lateral weight-bearing radiographs of both feet were taken (of 49 of the 58 obese children). Footprint angle (FA) and the Chippaux-Smirak index (CSI) were calculated from the footprints. Talus-first metatarsal (TFMA) and calcaneal inclination angles (CIA) were obtained from lateral feet radiographs. In the normal-weight group, mean values of FA and CSI indicated a normal MLA. In the obese group, morphological flatfoot was identified. Comparison between both groups, by side and gender, showed a decrease of FA (p < 0.001) and an increase of CSI (p <0.001) in obese subjects. Mean values of TFMA and CIA in the obese group indicated a lowering of the MLA. Obese children/adolescents between 9 and 16.5 years of age had significantly lower values of FA and higher CSI, related to a lower MLA. Radiographic parameters supported these findings and mean values were associated with a fall of this arch.     

Trends in the duration of school-day sleep among 10- to 15-year-old South Australians between 1985 and 2004

AIM: To compare self-reported school-day sleep duration in 10- to 15-year-old South Australians between 1985 and 2004. METHODS: Data were collected from 10- to 15-year-old participants in the 1985 Australian Schools Health and Fitness Survey (n = 390) and the 2004 South Australian Physical Activity Survey (n = 510). Identical self-report questionnaires were administered in both surveys, providing data on school-day bed-time, wake-time and sleep duration; as well as age, gender and socioeconomic status (SES). Analysis of co-variance (ANCOVA), controlling for age and SES, was used to compare all sleep variables between surveys. RESULTS: Declines in sleep duration were found for both girls (28 min) and boys (33 min) between surveys. The reduction was more pronounced in 'lower SES' boys (44 min) than 'higher SES' boys (23 min). Boys reported later bed-time than girls in the 2004 survey, while no gender differences were apparent in the 1985 survey. CONCLUSION: Our findings suggest reductions in school-day sleep duration have occurred in Australian children and adolescents over the last 20 years, due largely to later bed-times. The physiological significance of these declines and mediating influences, such as SES, are yet to be explicated.     

Sleep and obesity in children and adolescents

The purpose of this review is to provide a comprehensive update of epidemiologic studies that have assessed the association between sleep and obesity risk. Data suggest that short sleep is associated with an increased risk for being or becoming overweight/obese or having increased body fat. Late bedtimes are also a risk factor for overweight/obesity. Findings also suggest that changes in eating pathways may lead to increased body fat. Future experimental studies are needed to enhance our understanding of the underlying mechanisms through which sleep may play a role in the development and maintenance of childhood obesity.     

不同肥胖程度儿童罹患心血管代谢异常风险的横断面调查

目的 通过对肥胖学生健康评估体检,了解不同肥胖程度儿童青少年罹患高血压、高血糖和血脂异常等心血管代谢异常风险现况。方法 采用现况调查方法,对北京市西城区、海淀区和密云县17所中小学2012至2013年度参加学校常规年度体检并以BMI为评价指标筛查为肥胖的学生,进行以健康风险评估为目的的临床体检,体检内容包括体量（身高、体重及体质成分）,血压,空腹血糖,血脂（总胆固醇、三酰甘油、高密度脂蛋白和低密度脂蛋白）等指标。采用中国肥胖问题工作组（WGOC）制定的BMI超重、肥胖筛查标准判定肥胖状态;采用中国儿童青少年血压参照标准评定儿童高血压;采用儿童青少年血脂异常防治专家共识推荐的中国2岁以上儿童青少年血脂异常诊断标准判断血脂异常;以空腹血糖作为评价指标,采用美国糖尿病联盟推荐糖尿病诊断和分类标准进行评价。结果 1 809/3 227名(56.1%)肥胖学龄儿童青少年完成了现况调查且具有完整体检数据,平均年龄12.2岁。肥胖学生心血管代谢异常指标检出率分别为：高血压30.8%,血脂异常43.3%,糖尿病和空腹血糖受损66.6%,肝功能异常11.6%,脂肪肝16.0%,黑棘皮症21.9%。肥胖男生高血压、空腹血糖受损、肝功能异常、脂肪肝和2项及以上心血管代谢异常检出率均高于肥胖女生。重度肥胖占总肥胖人数的29.9%,协方差分析调整年龄和性别后,重度肥胖学生高血压、肝功能异常、脂肪肝、黑棘皮症和2项及以上心血管代谢异常检出率均高于轻中度肥胖学生。结论 肥胖儿童青少年高血压、高血糖和血脂代谢紊乱等心血管代谢异常高发,心血管代谢异常随肥胖程度增加呈上升趋势;儿童肥胖相关心血管代谢异常高发需要得到更广泛关注。     

Relationship between breast feeding duration and risk of overweight/obesity among Egyptian children

Background and aim

Breast feeding (BF); as risk factor for/or protective against childhood overweight/obesity; remains matter of debate. This study assesses relationship between BF duration, and development of overweight/obesity among Egyptian children, with respect for wide range of potentially confounding variables.

Addition of orlistat to conventional treatment in adolescents with severe obesity

To investigate the efficacy and tolerability of orlistat in obese adolescents, a prospective, open-label, randomised, controlled pilot trial was performed. A total of 22 adolescents with exogeneous obesity were started on orlistat (120 mg tid) and a daily multivitamin preparation in addition to conventional treatment which included nutritional and lifestyle modification programmes. The control group consisted of 20 obese adolescents who had similar duration of follow-up under conventional treatment alone. Of the 22 patients, 7 dropped out within the 1st month of the trial due to side-effects attributable to orlistat. The remaining 15 patients on orlistat were followed for 5–15 months (average duration of treatment 11.7±3.7 months). The control group was similar in age, sex, and duration of follow-up (10.2±3.7 months, range 6–17 months) to the orlistat group. Compared to initial body weight, patients in the orlistat group lost –6.27±5.4 kg, whereas those in the control group gained 4.16±6.45 kg (P<0.001) during the study period. Patients in the orlistat group lost –7.65%±6.5% of their initial body weight, whereas, those of the control group gained 5.7%±8.3% (P<0.001). The body mass index decreased in the orlistat group by –4.09±2.9 kg/m² while it increased by +0.11±2.49 kg/m² in the control group (P<0.001). Mild gastrointestinal complaints (frequent stools) were experienced by all patients in the orlistat group. Conclusion:Orlistat could be a useful adjunct in the treatment of severe obesity in adolescents; however, gastrointestinal side-effects limit its usefulness in almost one in three adolescents.This work was presented in part at the 41st Annual Meeting of the ESPE, Madrid, 2002.     

兰州市儿童肥胖与睡眠障碍的相关性分析

目的 调查兰州市儿童肥胖与睡眠障碍的流行情况及相互关系。方法 采用分层整群随机抽样的方法在甘肃省兰州市4个区选取3 283名小学生,进行体格检查和睡眠问卷调查,选出符合睡眠障碍和符合肥胖标准的两组儿童作为研究对象,同时随机选出既无睡眠障碍也无肥胖的健康儿童200名作为对照组。结果 3 283名儿童中,肥胖检出率为5.76%（189/3 283）,肥胖合并睡眠障碍的儿童占42.3%（80/189）。睡眠障碍检出率为16.24%（533/3 283）,睡眠障碍儿童中肥胖的检出率为24.6%（131/533）。肥胖儿童中,打鼾是最常见的睡眠障碍;肥胖合并睡眠障碍儿童中,阻塞性睡眠呼吸暂停低通气综合征的检出率为45%（36/80）。肥胖儿童睡眠障碍的检出率（42.3%）明显高于体重正常儿童（20.0%,40/200）,差异有统计学意义（P < 0.01）。结论 兰州市儿童肥胖和睡眠障碍之间关系密切,互为影响因素。     

Tangled relationship between insulin resistance and microalbuminuria in children with obesity

Childhood obesity represents a complex disease with a well-known cardiometabolic burden including fatty liver, type 2 diabetes, metabolic syndrome, and cardiovascular disease. From a pathogenic point of view, insulin resistance (IR) represents the key factor underlying the spectrum of these obesity consequences. As observed in adults, recent data supported the occurrence of microalbuminuria (MA) as marker of early kidney dysfunction and its potential link with cardiometabolic factors also in children with obesity. In fact, a well-documented pathophysiological hypothesis both in adults and children supported an intimate correlation with the major feature of obesity such as IR through the influence of insulin on renal hemodynamics. Based on the clinical and prognostic relevance of this relationship in daily practice (including an increased risk of chronic kidney disease development overtime), more scientific attention needs to be paid to the evaluation of early kidney damage in children with obesity. In this paper, we attempt to address three debated questions regarding the intriguing liaison between IR and MA in children with obesity: (1) What is the prevalence of pediatric MA? (2) What is the state of art of MA in children with obesity? and (3) Is there a link between IR and MA in children with obesity?     

Association between asthma and sleep hours in Brazilian adolescents: ERICA

ObjectiveTo investigate the association between asthma and sleep duration in participants of the Study of Cardiovascular Risks in Adolescents.Materials and methodsCross-sectional, national, school-based study, involving adolescents aged 12–17 years. In the period between 2013?14, data from 59,442 participants were analyzed. Bivariate analysis between current asthma and short sleep duration, defined as < 7 h/night, was performed separately with the other variables analyzed: sex, age group, type of school, weight categories, and common mental disorders. Then, different generalized linear models with Poisson family and logarithmic link functions were used to assess the independence of potential confounding covariates associated with both asthma and short sleep duration in the previous analysis. Crude and adjusted prevalence ratios and respective 95% confidence intervals were calculated, and a value of p < 0.05 was considered significant for all analyses performed.ResultsPrevalence of current asthma was 13.4%, being significantly higher among students with short sleep duration (PR: 1.17; 95% CI: 1.01–1.35; p = 0.034). This remained significant even after adjusting for the other study covariates.ConclusionThere was a positive association between the prevalence of current asthma and short sleep duration among Brazilian adolescents. Considering the high prevalence and morbidity of the disease in this age group, the promotion of sleep hygiene should be considered as a possible health strategy aimed at contributing to better control of asthma in this population.     

Self-esteem in a clinical sample of morbidly obese children and adolescents

Aim: To study self-esteem in clinical sample of obese children and adolescents.
Methods: Obese children and adolescents aged 8–19 years (n = 107, mean age 13.2 years, mean BMI 32.5 [range 22.3–50.6], mean BMI z-score 3.22 [range 2.19–4.79]; 50 boys and 57 girls) were referred for treatment of primary obesity. Self-esteem was measured with a validated psychological test with five subscales: physical characteristics, talents and skills, psychological well-being, relations with the family and relations with others. A linear mixed effect model used the factors gender and adolescence group, and the continuous covariates: BMI z-scores, and BMI for the parents as fixed effects and subjects as random effects.
Results: Age and gender, but neither the child's BMI z-score nor the BMI of the parents were significant covariates. Self-esteem decreased (p < 0.01) with age on the global scale as well as on the subscales, and was below the normal level in higher ages in both genders. Girls had significantly lower self-esteem on the global scale (p = 0.04) and on the two subscales physical characteristics (p < 0.01) and psychological well-being (p < 0.01).
Conclusion: Self-esteem is lower in girls and decreases with age. In treatment settings special attention should be paid to adolescent girls.     

Fitness levels of Greek primary schoolchildren in relationship to overweight and obesity

Objectives The aim of the present cross-sectional study was to provide estimates for overweight and obesity in a sample of Greek schoolchildren and to determine their possible relation with selected motor and health-related fitness parameters.Materials and methods The study sample consisted of 709 healthy children (328 girls, 381 boys, mean age = 8.9±1.6 years), living in the towns of Agios Stefanos (∼12 000 citizens) and Alexandroupolis (∼60 000 citizens), Greece. All pupils underwent anthropometric, motor and cardiovascular fitness assessments (Eurofit test battery). The body mass index (BMI) cut-off points adopted by the International Obesity Task Force were utilized for the assessment of overweight and obesity.Results 59.4% of the participants had a normal BMI, 25.8% were overweight and 14.8% were obese, without significant differences between genders.Discussions In general, the higher BMI categories were strongly associated with inferior performances in all fitness tests, except flexibility. This graded relationship was consistent for both boys and girls, although the statistical relationship between BMI categories and fitness performance varied by gender.Conclusions In conclusion, the findings of the current study offer some support to the reported high prevalence of childhood obesity in Greece and suggest that overweight and obesity are limiting factors for fitness performance in primary schoolchildren. The present data suggest that interventions promoting children’s health should, ideally, begin early in life and involve measures that simultaneously improve fitness and lower fatness.     

Is the prevalence of overweight and obesity declining among 4‐year‐old Swedish children?

Aim:  To investigate the trend in overweight and obesity prevalence among 4-year-old Swedish children.
Methods:  Height and weight data registered at the regular health check up at the child health centres in the county of Västerbotten during the years 2007/2008 (2225 boys and 2156 girls) were analysed and compared with data from 2002/2003 (2231 boys and 2176 girls). Overweight and obesity were estimated using the International Obesity Task Force cut-off values (ISO BMI).
Results:  In both boys and girls, overweight prevalence (ISO BMI > 25) decreased over the 5-year period, boys from 17.2% to 14.2% and girls from 22.3% to 19.0%. Among girls, there was also a decrease in obesity prevalence (ISO BMI > 30) from 5.7% to 3.1%.
Conclusion:  The result of this study indicates that the overweight and obesity epidemic among Swedish pre-school children may be levelling off.     

宁夏银川市城区儿童青少年不同肥胖表型与血压异常的关系

目的:了解银川市城区儿童青少年不同肥胖表型与血压异常的关系,为肥胖儿童青少年提供适宜的治疗及干预措施。方法:采用现况研究设计,以方便整群抽样的方法于2017年9月至2018年9月共抽取银川市1 047名12～18岁儿童青少年为研究对象,其中男530名、女517名,年龄(13.93±1.24)岁,并对其进行问卷调查、体格...     

Association of sleep duration with socio‐economic status and behavioural problems among schoolchildren

Aim: In this population‐based study, we aimed to determine the total sleep duration (TSD), its association with socio‐economic status (SES) and behavioural symptoms among schoolchildren. Methods: A cross‐sectional study was performed among schoolchildren in Istanbul. A structured questionnaire evaluating the sleep schedule variables was filled out by their parents. SES was determined according to the Turkish SES scale. Results:  The mean age of 2669 children was 8.2 ± 2.4 years, and 51% of the students were girls. The mean TSD was 10.20 ± 1.04, and the mean bedtime was 21.57 ± 0.56 (both in hours, minutes ± SD). Boys tended to go bed later (p = 0.004) and slept less than girls (p = 0.02). The duration of sleep disruptions increased (p < 0.001), whereas TSD decreased with age (p < 0.001). Multiple linear regression revealed that waking time and TSD decreased significantly (p < 0.05) with higher SES among both girls and boys. Sleep fragmentation was associated with habitual snoring, parasomnias, daytime sleepiness and conduct symptoms. Conclusion: Decreased total sleep duration is more prominent in boys, older children and children among higher socio‐economic status. Insufficient sleep attributed to shortened total sleep duration by age and higher socio‐economic status might have a negative effect on both sleep hygiene and psychological well‐being in schoolchildren.