A contemporary description of French newborns’ growth using the Efemeris cohort

BackgroundOverweight and obesity in childhood are a major concern in developed countries. Reference growth curves are used in current practice to identify children at risk, especially at risk of overweight or obesity. National reference growth curves were published 35 years ago from children born in the 1950s to study growth from birth to adulthood. Additionally, more recent national curves exist to study birth weight and height according to gestational age. The primary objective was to describe anthropometric measurements of French children born in the 2000s and to compare them with the French references. The secondary objective was to describe overweight indicators during infancy.MethodsA total of 77,315 singletons live-born from 1 July 2004 to 31 December 2013 recorded in the Efemeris (a French cohort of women and their children) were included. The z-score means based on the French references for weight, height, and body mass index (BMI) at birth, 9 months, and 24 months were calculated.ResultsAt birth, the weight and height of the cohort did not deviate from the recent French references taking into account gestational age. At 9 and 24 months, the cohort was between 0.12 and 0.39 standard deviations (SD) heavier and between 0.70 and 0.97 SD taller than the old French reference population. Between 0 and 2 years, 28.6% of the children underwent a rapid weight gain (change in SD scores > 0.67). The prevalence of overweight at 2 years was between 5 and 6% using the International obesity task force (IOTF) references.ConclusionThe distributions of the height, weight, and BMI during early childhood differ from those of children in the national growth references. Contemporary children at 2 years are taller and heavier than children born in the 1950s. Approximately one in 20 children is overweight at 2 years.     

Excess of weight,but not underweight,is associated with poor physical fitness in children and adolescents from Castilla-La Mancha,Spain

We estimated the prevalence of underweight, overweight and obesity of children and adolescents from Castilla-La Mancha region (Spain), applying the new International Obesity Task Force (IOTF) 2012 criteria, and analysed differences in physical fitness components in relation to weight status. The sample was 2,330 schoolchildren aged 6–17 years. We measured height and weight, calculated body mass index (BMI) and assessed physical fitness using four tests included in the EUROFIT battery. Differences in physical fitness components across BMI categories, by sex, were calculated using ANOVA models. In children aged 6–11 years, 4.9 % were underweight, 26.7 % overweight and 11.0 % obese; in adolescents aged 12–17 years, 6.4 % were underweight, 16.7 % overweight and 5.8 % obese. Overall, overweight and obesity were associated with worse physical fitness but students in the underweight category did not score worse than their normal weight counterparts on fitness tests. Conclusion: Childhood obesity in Spain remains a public health problem. Our results show low physical fitness levels in overweight/obese children and adolescents and low levels of handgrip strength in underweight adolescents compared with normal weight subjects. Exercise programmes must be tailored to the specific needs of the subjects according to the different weight status.     

Polish 2010 growth references for school-aged children and adolescents

Growth references are useful in monitoring a child's growth, which is an essential part of child care. The aim of this paper was to provide updated growth references for Polish school-aged children and adolescents and show the prevalence of overweight and obesity among them. Growth references for height, weight, and body mass index (BMI) were constructed with the lambda, mu, sigma (LMS) method using data from a recent, large, population-representative sample of school-aged children and adolescents in Poland (n = 17,573). The prevalence of overweight and obesity according to the International Obesity Taskforce definition was determined with the use of LMSGrowth software. Updated growth references for Polish school-aged children and adolescents were compared with Polish growth references from the 1980s, the Warsaw 1996-1999 reference, German, and 2000 CDC references. A positive secular trend in height was observed in children and adolescents from 7 to 15 years of age. A significant shift of the upper tail of the BMI distribution occurred, especially in Polish boys at younger ages. The prevalence of overweight or obesity was 18.7% and 14.1% in school-aged boys and girls, respectively. The presented height, weight, and BMI references are based on a current, nationally representative sample of Polish children and adolescents without known disorders affecting growth. Changes in the body size of children and adolescents over the last three decades suggest an influence of the changing economical situation on anthropometric indices.     

Body mass index distribution affects discrepancies in weight classifications in children

Background: The aim of the present study was to investigate the effect of body mass index (BMI) distribution, ethnicity and age at menarche on the consistency in the prevalence of underweight and overweight defined by the Centers for Disease Control and Prevention (CDC) and the International Obesity Task Force (IOTF) cut‐off points in 2–17‐year‐old Chinese and US children. Methods: Data from the China Health and Nutrition Survey (CHNS) 1991 (n= 3895), CHNS 2004 (n= 1902), and the National Health and Nutrition Examination Survey (NHANES) 2003–2004 (n= 3344) were used to define the prevalence of underweight and overweight using the CDC and IOTF BMI cut‐off points. Results: An upward shift in the BMI distribution was observed from the CHNS 1991 to CHNS 2004, and between the CHNS and NHANES 2004. The prevalence of underweight defined by the IOTF cut‐off points was higher than that obtained using the CDC cut‐off points; absolute differences between IOTF and CDC classifiers were 7%, 5%, and 2% in boys, and 12%, 11%, and 4% in girls in the CHNS 1991, CHNS 2004, and NHANES 2004, respectively. There was a greater consistency in the prevalence of overweight. The consistency of the two classification systems increased with the higher BMI distribution and was not affected significantly by ethnicity or age at menarche. Conclusions: The BMI distribution of a population can affect the classification of childhood underweight and overweight differentially as defined by the CDC and IOTF cut‐off points, and thus should be considered in the interpretation of results in clinical and population settings.     

Prevalencia de obesidad infantil en la Región de Murcia,valorando distintas referencias para el índice de masa corporal

IntroductionChildhood obesity is a problem of high magnitude with serious repercussions on health, which justifies estimating its prevalence at local level to identify conditioning factors and to take preventive actions. The main objective of the present work is to estimate the prevalence of overweight and obesity in the children in the general population of the Murcia Region, using the body mass index (BMI) and applying the International Obesity Task Force (IOTF) criteria, and to compare these results with the ones obtained from other frequently used references in Spain.Material and methodsThe BMI of 178,894 children aged from 2 to 14 years was determined. The prevalence of overweight and obesity was compared to the IOTF, to the studies of the World Health Organization, as well as those of the Orbergozo Foundation (FO), and the Cross-sectional Spanish Growth Study (ETEC) references. The agreement between the different results was evaluated using the kappa index.ResultsThe evaluation using the IOTF cut-off points gave an overweight prevalence of 20.6% (95% CI: 20.4-20.8), an obesity prevalence of 11.4% (95% CI: 11.2-11.5) and an overweight plus obesity prevalence of 32% (95% CI: 31.8-32.2), with this last one being higher in girls (33.2%) than in boys (30.9%). The highest agreement is between IOTF and FO-2011 (kappa = .795) and between FO-2011 and ETEC (kappa = .794).ConclusionA high prevalence of overweight and obesity in children in the Region of Murcia was found. The ETEC and the FO-2011 study showed the highest agreement with the results obtained using the IOTF criteria.     

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。     

Anthropometric changes in Sweden during the obesity epidemic--increased overweight among adolescents of non-Nordic origin

Aim: To compare overweight, obesity and thinness prevalences in adolescents born in 1979 and 1985 and to evaluate the influence of parental migration background. Methods: A total of 2306 15‐ to 16‐year‐old girls and boys in Gothenburg, Sweden, participated in two cross‐sectional surveys (1994 and 2000). Height and weight were measured and interviews about parental origin were conducted. Overweight and obesity were classified according to International Obesity Task Force (IOTF) and WHO. Thinness was classified according to Cole. Results: Among girls, the prevalence of thinness decreased, 8.4% vs. 4.7%. The prevalence of overweight, including obesity, according to IOTF criteria, was 11.8% and 13.7% in 1994 and 2000, respectively. The corresponding figures according to WHO criteria were 14.5% and 17.5%. No significant changes occurred between cohorts in prevalences of overweight and obesity. However, when interaction between survey year and origin was tested, there was a significant difference in overweight according to WHO criteria (p = 0.022). Conclusion: A shift entailing increased risk for overweight in adolescents of non‐Nordic origin was observed, while no changes occurred in the general population. Individual background factors are important to consider both for correct conclusions about health development in the population and for identification of target groups for health‐promoting interventions.     

Breast-feeding and overweight in Singapore school children

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

A comparison study of the prevalence of overweight and obese Italian preschool children using different reference standards

Introduction The number of overweight children is constantly increasing in both developed and underdeveloped countries. Most epidemiological surveys consider school age children with little attention being given to preschool age children. This study was undertaken to define the prevalence of being overweight or obese in a population of children 3–6 years of age, living in North-East Italy. We also identified differences when comparing body mass index (BMI) data against three different national and international standards.Subjects and methods The study involved 258 children (124 males and 134 females) with an average age of 4.8 years. Weight and height were obtained for each child and BMI was calculated according to the formula weight (kg)/height (m)². The prevalence of overweight and obese subjects was then determined using the growth curves of the Centers for Disease Control and Prevention (CDC), the growth curves of the International Obesity Task Force (IOTF) and the curves published in 2003 by Luciano et al.Results All three methods gave similar, but not identical, estimates of the prevalence of overweight in both boys and girls. However, when determining the prevalence of obesity, the use of the CDC curves led to a significantly higher prevalence of obesity in both males and females when compared to the growth charts of the IOTF and Luciano et al.Background The use of the CDC growth curves leads to an increase in the prevalence of obesity when evaluating children under 5 years of age. The lower cut-off values inherent in the CDC charts, in contrast to the ones proposed by the IOTF, allow for earlier identification of a larger number of subjects with weight problems and therefore provide the potential for earlier intervention.     

Prevalence of overweight and obesity among school children and adolescents in Chennai

Objectives

To determine the prevalence of overweight and obesity among children and adolescents in Chennai, India, using national and international age- and sex- specific body mass index (BMI) cut-off points.

Methods

The Obesity Reduction and Awareness and Screening of Non communicable diseases through Group Education in Children and Adolescents (ORANGE) project is a cross-sectional study carried out on 18,955 children (age 6–11 years) and adolescents (age 12–17 years) across 51 schools (31 private and 20 government) of Chennai. Overweight and obesity was classified by the International Obesity Task Force (IOTF 2000) and Khadilkar’s criteria (2012), and Hypertension by the IDF criteria (in children ≥10 years and adolescents).

Results

The prevalence of overweight/obesity was significantly higher in private compared to government schools both by the IOTF criteria [private schools: 21.4%, government schools: 3.6%, (OR: 7.4, 95% CI:6.3–8.6; P<0.001) and by Khadilkar criteria (private school: 26.4%, government schools: 4.6% OR: 6.9, 95% CI:6.2–7.8; P<0.001). Overweight/obesity was higher among girls (IOTF: 18%, Khadilkar: 21.3%) compared to boys (IOTF: 16.2%, Khadilkar: 20.7%) and higher among adolescents (IOTF: 18.1%, Khadilkar: 21.2%) compared to children (IOTF: 15.5%, Khadilkar: 20.7%). Prevalence of hypertension was 20.4% among obese/overweight and 5.2% among non-obese (OR 4.7, 95%CI: 4.2–5.3, P<0.001).

Conclusion

The prevalence of overweight and obesity is high among private schools in Chennai, and hypertension is also common.     

Nutritional status and its relationship with blood pressure among children and adolescents in South China

The present study measures the nutritional status and the blood pressure to assess their relationship in a group of children and adolescents in the Hainan province, China. A total of 5,456 students aged 7 to 18 years were recruited from 10 public schools in Hainan province of South China during the period March 2009 to December 2009. Height, weight, systolic blood pressure, and diastolic blood pressure were measured by health-care professionals. Body mass index (BMI) was calculated and used to define thinness, overweight, and obesity according to the existing standards. Prevalence of thinness, overweight, obesity, pre-hypertension, and hypertension was computed, and logistical regression model was used to examine the association of BMI with elevated blood pressure. A high prevalence of thinness was observed in male and female children and adolescents (34.0% and 34.3%, respectively). The percentage of overweight and obesity was 2.7% and 1.3%, respectively. Pre-hypertension and hypertension were detected in 3.9% and 3.3% children and adolescents, respectively. Multivariate logistical regression analysis showed that obesity was positively associated with both pre-hypertension and hypertension, with adjusted odds ratio of 1.44 (95% confidence interval (CI)?= 1.08-1.92, P = 0.014) and 2.00 (95%CI = 1.53-2.60, P < 0.001) compared to normal weight students. Overweight was also associated with pre-hypertension and hypertension. However, no significant association between thinness and pre-hypertension and hypertension was found. In conclusion, this study showed that thinness, especially mild thinness, was a major public health problem among children and adolescents in Hainan province of South China. Overweight and obesity were strongly associated with pre-hypertension and hypertension among studied students.     

Diagnostic quality of Actigraph‐based physical activity cut‐offs for children: What overweight/obesity references can tell?

Background: There is conflicting literature about Actigraph‐based cut‐off points (CoP) that define the lower limit of moderate–to–vigorous physical activity (MVPA) among children. The aim of the present study was to compare the diagnostic quality of Actigraph‐based CoP relative to different body mass index (BMI) classification systems of the weight status of children. Methods: One hundred and thirteen children aged 8–11 years recruited from three randomly selected elementary schools wore the Actigraph, model 7164 (Actigraph Manufacturing Technology) for 3 days. Five CoP, expressed in counts per minute (c.p.m.; CoP 1000 CoP 2000, CoP 3000, CoP 3200, and CoP 3600) were used to compute their MVPA. The area under the receiver operating characteristic curves (AUC) together with specific indices allowed assessment of the performance of these CoP in reference to overweight/obesity status as defined using BMI‐based criteria from the International Obesity Task Force (IOTF), French References (FR) and World Health Organization (WHO) standards. Results: Overweight/obesity frequency ranged from 30% to 42%, with no sex‐related difference. All AUC (range, 0.623–0.660) were significantly higher than 0.500 except from those of CoP 1000 and 2000 using the IOTF criteria (0.602 ± 0.058 and 0.601 ± 0.057, respectively) and the FR (0.608 ± 0.060 for CoP 1000). Furthermore, with the WHO standards, all the CoP provided non‐significant AUC (range, 0.566–0.597). According to the IOTF and the FR criteria, respectively, CoP 3600 had the highest probability of correct decision (0.62 and 0.68), the lowest misclassification errors (0.38 and 0.32), the highest validity coefficient (0.21 and 0.29), and the highest expected maximum utility (59 and 83). Conclusion: When children are classified using BMI‐based criteria, the threshold of 3600 c.p.m. should be more appropriate in discriminating non‐overweight from overweight/obese.     

Prevalence of Overweight and Obesity among Iranian School Children in Different Ethnicities

Objective

Malnutrition, overweight and obesity are major health concerns in modern societies and especially among children. Overweight and obesity affect children''s current and future health. It is known that the prevalence of overweight differs by race, sex, and geographic location.

Methods

In a cross-sectional study 30092 Iranian children aged 7-18 years in six ethnic groups were selected by a cluster sampling. Prevalence of obesity and overweight and distribution of body mass index (BMI) by gender, age, and ethnicity were measured. Cutoff points of BMI for defining obesity and overweight were based on the Iranian, and IOTF standard values.

Findings

This study showed a significant ethnic difference in BMI. Prevalence of overweight and obesity among Iranian children was 9.27% and 3.22% respectively comparing international standards. The frequency of overweight and obesity was higher in boys.

Conclusion

This study showed a significant difference in BMI among different ethnic groups.     

Body mass index reference curves for Tunisian children

Body mass index (BMI) reference curves are used to assess children's health. The aim of this work is to construct BMI reference curves for Tunisian children and adolescents and compare them with local and international references. The BMI reference curves were constructed using the LMS method using data from 4358 Tunisian children (2182 girls and 2176 boys) aged 0–18 years. The result of this study presents the smoothed percentile curves of BMI on the basis of age and sex of Tunisian children. The reference curves of Tunisian children demonstrated some variations in comparison with the median percentiles with the references of the International Obesity Task Force (IOTF), the World Health Organization (WHO), and with local references from Algeria and Turkey. The prevalence study indicated that the rate of overweight has increased mainly in adolescent children.

Perzentile für den Body-mass-Index für das Kindes- und Jugendalter unter Heranziehung verschiedener deutscher Stichproben

Objectives. Both the Childhood Group of the International Obesity Task Force (IOTF) and the European Childhood Obesity Group (ECOG) recommend to use the body mass index (BMI = weight in kilograms/height in meter²) to evaluate overweight and obesity in children and adolescents. Whereas it is customary with adults to use fixed cut off points to define overweight and obesity, in children and adolescents age and sex specific developmental changes in BMI need to be addressed, which are due to physiological alterations of fat mass. Method. Because a national reference population for children and adolescents does not exist in Germany, a BMI reference data set was compiled. Therefore measurements of height and weight from 17 different regional studies including 17147 boys and 17275 girls aged 0 to 18 years were used. Results and conclusions. We recommend the use of the presented percentiles as reference to asses under- and overweight (obesity) in German children and adolescents. In the guidelines of the “Arbeitsgruppe Adipo-sitas im Kindes- und Jugendalter” (AGA) the 90^th and 97^th BMI percentiles as calculated in this reference population are proposed as cut-off points for the definition of overweight and obesity in German children and adolescents.     

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

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

Marked increase in the prevalence of obesity in children of the Seychelles, a rapidly developing country, between 1998 and 2004.

BACKGROUND: There are few data on overweight in children in developing countries. Such data are important to guide public health policy. We assessed trends in the prevalence of overweight and obesity in children from the Seychelles, a middle-income island state in the Indian Ocean. METHODS: Multiple cross-sectional surveys were conducted each year between 1998 and 2004 on all students of all schools in four selected school grades (creche, 4th, 7th and 10th years of mandatory school). Weight and height were measured and children were asked about walking time and frequency of physical exercise at leisure time. Excess weight categories were defined according to the criteria of the International Obesity Task Force (IOTF) and the U.S. Centers for Disease Control and Prevention (CDC). RESULTS: Data were available for 33 340 observations in 1998-2004, corresponding to 23,459 individual children measured once or several times. Based on IOTF criteria, the prevalence of 'overweight' or 'obesity' increased from 8.7% to 13.5% in boys, and from 11.8% to 18.6% in girls from 1998 to 2004 (P < 0.001). The prevalence of 'obesity' increased from 2.1% to 5.2% in boys and from 3.1% to 6.2% in girls (P < 0.001). Using CDC criteria, the prevalence of 'at risk of overweight' and 'overweight' increased by similar proportions. The shift towards higher values over time was larger in the upper than the lower tail of the BMI distribution. Physical activity decreased over calendar years and was inversely associated with excess weight. CONCLUSIONS: The prevalence of excess weight increased markedly over a seven-year period in children in the Seychelles. This is likely to reflect a rapid nutrition transition with increasingly positive energy balance. These findings stress the need for programs and policies aimed at promoting physical activity and healthy nutrition in countries in epidemiological transition.     

儿童单纯性肥胖的诊断和治疗

关于肥胖的诊断国内外并尚无统一的判断标准，WHO认为10岁以下和10岁以上应有不同的评价标准，推荐10岁以下儿童使用身高别体质量，10～24岁采用体质量指数（BMI），国际肥胖问题工作组织（IOTF）认为BMI适宜用来判断儿童青少年超重和肥胖。WHO和IOTF提出的18岁BMI超重、肥胖标准完全一样，分别为25和30kg／m^2，而中国肥胖问题工作组（WGOC）制定的标准较比前二者低，18岁BMI超重和肥胖界值点分别为24和28kg／m^2。儿童肥胖的治疗不同于成人，成人期可使用的手术去脂、药物减肥、饥饿疗法、禁食等，在儿童时期均不宜使用。目前国内外公认儿童肥胖治疗方法包括行为矫正、饮食调整和运动等综合治疗方案。     

Association between obesity and asthma in Japanese preschool children

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

Three-in-one weight,height and body mass index charts for children and adults

The aim of the study was to develop four appropriate three-in-one weight, height and built in body mass index (BMI) charts, for under-fives, 0-5-year-olds, > 5-10-year-olds, > 10-18-year-olds, and adults and to delineate the normal range, underweight, overweight and obesity on the above charts. Four different charts were designed for the various age groups as indicated above. Height was made available on the x-axis, weight on the y-axis, and corresponding BMI values on the right margin. Shading of the normal range to denote the health path and marking of the cut-off curves to denote normal status, overweight, and obesity were done selecting appropriate round figures to suit both sexes in accordance with the International Obesity Task Force (IOTF) recommendations for the various age groups. Field trials were done on appropriate subjects belonging to various age groups. 500 in each group with equal male to female ratio. The field trials showed that all the studied subjects belonging to both sexes came within the purview of the chart and those with normal nutritional status, underweight, overweight, and obesity could easily be identified looking at the chart without doing any further calculation. Early intervention also could be advised as the chart could demonstrate how much weight should be gained or reduced to come within the health path. In conclusion, the charts are applicable to both sexes and are user friendly. These are appropriate for general screening of nutritional status and to determine underweight, overweight, and obesity from birth to adulthood. They give a visual display of the ideal health path with respect to weight, height, and BMI and the adjustment in weight required to reach the normal range.