Prevalence of overweight and obesity on the island of Ireland: results from the North South Survey of Children's Height,Weight and Body Mass Index, 2002

Background  

Childhood obesity is emerging as a major public health problem in developed and developing countries worldwide. The aim of this survey was to establish baseline data on the prevalence and correlates of overweight and obesity among children and adolescents in the Republic of Ireland (RoI) and Northern Ireland (NI).     

Obesity in K-8 students - New York City, 2006-07 to 2010-11 school years

Overweight and obese children are more likely to develop risk factors that can lead to respiratory, metabolic, and cardiovascular illness. The increase in prevalence of childhood overweight and obesity in the United States since the 1960s has been well documented. In New York City, in 1996, an estimated 19.7% of third grade children and 21.2% of sixth grade children in public and private schools were found to be overweight; in 2003, an estimated 43% of the city's public elementary school students were found to be overweight, and 24% of these students were obese. To update city data on childhood obesity and evaluate public health interventions, the New York City Department of Health and Mental Hygiene analyzed body mass index (BMI) data for public schoolchildren in kindergarten through eighth grade (K-8), using data from the 2006-07 to 2010-11 school years. This report summarizes the results of that analysis, which found that, overall, the prevalence of obesity in grades K-8 decreased 5.5%, from 21.9% in 2006-07 to 20.7% in 2010-11. Obesity decreased significantly among children in all age groups and in all socioeconomic and racial/ethnic populations; however, the decrease was smaller among black (1.9%) and Hispanic (3.4%) children than among Asian/Pacific Islander (7.6%) and white (12.5%) children. Despite the decreases in obesity, continued public health interventions are needed to further reduce the prevalence of obesity and to eliminate disparities among schoolchildren in New York City.     

Prevalence and association between obesity and metabolic syndrome among Chinese elementary school children: a school-based survey

Background  

China has experienced an increase in the prevalence of childhood overweight/obesity over the last decades. The purpose of this study was to examine the prevalence of obesity and metabolic syndrome among Chinese school children and determine if there is a significant association between childhood obesity and metabolic syndrome.     

Obesity in Latin American children: situation,diagnostic criteria and challenges

Obesity has emerged as an alarming public health problem, having increased rapidly in both adults and children. Considering 12 countries with reported levels of overweight and obesity, one third have a 20% prevalence of one or both conditions. In 17 countries reporting data on obesity, the mean rate was 4.6%; four countries reported rates over 6%, while three reported less than 2%. The majority of these countries showed increases of 70% in overweight and 60% in obesity during the last decade. Only two countries reported decreasing prevalence rates. Countries may be classified in four groups: (1) low or even downward prevalence of overweight and obesity; (2) underweight reported simultaneously with an increase in obesity; (3) a large territory and population with differences in the prevalence of overweight and obesity between regions and socioeconomic groups; and (4) little underweight and high prevalence of obesity. In conclusion, there is no doubt about the increasing trend in overweight and obesity among Latin American children. However, since there is no consensus as to diagnostic criteria for overweight and obesity, the real prevalence is not known.     

An Increasing Socioeconomic Gap in Childhood Overweight and Obesity in China

We used a new conceptual framework that integrates tenets from health economics, social epidemiology, and health behavior to analyze the impact of socioeconomic forces on the temporal changes in the socioeconomic status (SES) gap in childhood overweight and obesity in China. In data from the China Health and Nutrition Survey for 1991 to 2006, we found increased prevalence of childhood overweight and obesity across all SES groups, but a greater increase among higher-SES children, especially after 1997, when income inequality dramatically increased. Our findings suggest that for China, the increasing SES gap in purchasing power for obesogenic goods, associated with rising income inequality, played a prominent role in the country’s increasing SES gap in childhood obesity and overweight.It is well documented that family socioeconomic status (SES) is associated with childhood overweight and obesity1–3; however, the pathways linking SES with overweight and obesity may be strongly conditioned by a country’s stage of economic development. For example, an inverse relationship between SES and obesity is typically observed among children in developed countries,2,4 whereas in many developing countries, overweight and obesity are more common among socioeconomic elites.1,5,6 Several questions are unanswered: What contextual factors connect the stage of economic development with the sign and strength of the association between SES and childhood overweight and obesity? What is the relative importance of these factors? What happens when these contextual factors exert contradictory effects on risk for childhood obesity and overweight? The dramatic social and economic changes in China that took place after 1997 provided a unique opportunity to explore these questions.Until now, the only study of the change in the SES–overweight and obesity association among Chinese children focused on the annual change in overweight prevalence by income.7 This study found that overweight prevalence increased fastest among high-income children between 1991 and 2004. To date, however, no study has thoroughly explored the contextual factors contributing to the changing relationship between SES and overweight and obesity in children and adolescents, in China or in any other developing country.The direction of causality between SES and obesity for children is relatively easy to discern, because their SES is predetermined by that of their parents; hence, their obesity status is unlikely to affect their childhood SES.1 We developed a conceptual framework to address specific contextual factors that could shape the SES–childhood overweight and obesity relationship. We test several major tenets of this framework in data collected from 1991 to 2006 by the China Health and Nutrition Survey (CHNS).8     

Prevalence and trends of overweight among preschool children in developing countries

BACKGROUND: Obesity during childhood is a matter of growing concern. Several reports show increasing rates of obesity in developed countries, whereas the extent of the problem in developing countries remains unknown. OBJECTIVE: The aim of this study was to fill this gap by quantifying the prevalence and trends of overweight among preschool children in developing countries. DESIGN: One hundred sixty nationally representative cross-sectional surveys from 94 countries were analyzed in a standardized way to allow comparisons across countries and over time. Overweight was defined as a weight-for-height >2 SDs from the National Center for Health Statistics/World Health Organization international reference median. Prevalences of wasted children (< -2 SDs) are also presented to enable comparisons between both ends of the distribution. RESULTS: The global prevalence of overweight was 3.3%. Some countries and regions, however, had considerably higher rates, and overweight was shown to increase in 16 of 38 countries with trend data. Countries with the highest prevalences of overweight are located mainly in the Middle East, North Africa, and Latin America. Rates of wasting were generally higher than those of overweight; Africa and Asia had wasting rates 2.5-3.5 times higher than overweight rates. Countries with high wasting rates tended to have low overweight rates and vice versa. CONCLUSIONS: These estimates show that attention should be paid to monitoring levels and trends of overweight in children. This, however, should not be done at the expense of decreasing international commitments to alleviating undernutrition. The data presented confirm that undernutrition remains a major public health problem worldwide.     

Childhood obesity in Asian Indians: a burgeoning cause of insulin resistance, diabetes and sub-clinical inflammation

Recent data indicate a rise in obesity both in children and adolescents in developing countries. The overall prevalence of overweight/obesity in urban children in New Delhi has shown an increase from 16% in 2002 to about 24% in 2006-2007. Our recent data show that the prevalence among adolescent children was 29% in private schools and 11.3% in government funded schools. While India already has highest number of patients with type 2 diabetes mellitus (T2DM) globally, rapid rise of obesity in children is the prime reason for increasing insulin resistance, the metabolic syndrome, dyslipidemia, polycystic ovarian syndrome and raised levels of C-reactive protein. Excess body fat, thick truncal subcutaneous fat, and abdominal adiposity are important predisposing factors for development of insulin resistance in Asian Indian children. As compared to other ethnic groups, children with ancestral origin in South Asia manifest adiposity, insulin resistance and metabolic perturbations earlier in life and these derangements are of higher magnitude than white Caucasian children. Since the metabolic syndrome and obesity track into adulthood, these clinical entities need to be recognized early for effective prevention of T2DM and coronary heart disease. Therapeutic lifestyle changes, maintenance of high levels of physical activity and normal weight are most important prevention strategies. Both high-risk surveillance and cost-effective population intervention programs are urgently needed. In this context, we have launched one of the largest program ("MARG", The Path) to curb childhood obesity in India.     

Marital status and educational level associated to obesity in Greek adults: data from the National Epidemiological Survey

Background  

Obesity is an important public health issue and its prevalence is reaching epidemic proportions in both developed and developing countries. The aim of the present study was to determine associations of overweight (OW), obesity (OB) and abdominal obesity (AO) with marital status and educational level in Greek adults of both genders based on data from the National Epidemiological Survey on the prevalence of obesity.     

Obesity and Dyslipidemia in South Asians

Obesity and dyslipidemia are emerging as major public health challenges in South Asian countries. The prevalence of obesity is more in urban areas than rural, and women are more affected than men. Further, obesity in childhood and adolescents is rising rapidly. Obesity in South Asians has characteristic features: high prevalence of abdominal obesity, with more intra-abdominal and truncal subcutaneous adiposity than white Caucasians. In addition, there is greater accumulation of fat at “ectopic” sites, namely the liver and skeletal muscles. All these features lead to higher magnitude of insulin resistance, and its concomitant metabolic disorders (the metabolic syndrome) including atherogenic dyslipidemia. Because of the occurrence of type 2 diabetes, dyslipidemia and other cardiovascular morbidities at a lower range of body mass index (BMI) and waist circumference (WC), it is proposed that cut-offs for both measures of obesity should be lower (BMI 23–24.9 kg/m² for overweight and ≥25 kg/m² for obesity, WC ≥80 cm for women and ≥90 cm for men for abdominal obesity) for South Asians, and a consensus guideline for these revised measures has been developed for Asian Indians. Increasing obesity and dyslipidemia in South Asians is primarily driven by nutrition, lifestyle and demographic transitions, increasingly faulty diets and physical inactivity, in the background of genetic predisposition. Dietary guidelines for prevention of obesity and diabetes, and physical activity guidelines for Asian Indians are now available. Intervention programs with emphasis on improving knowledge, attitude and practices regarding healthy nutrition, physical activity and stress management need to be implemented. Evidence for successful intervention program for prevention of childhood obesity and for prevention of diabetes is available for Asian Indians, and could be applied to all South Asian countries with similar cultural and lifestyle profiles. Finally, more research on pathophysiology, guidelines for cut-offs, and culturally-specific lifestyle management of obesity, dyslipidemia and the metabolic syndrome are needed for South Asians.     

Chronic Malnutrition Among Overweight Hispanic Children: Understanding Health Disparities

Obesity may be masking other health problems such as height deficit, or stunting. Stunting may reflect the cumulative effect of chronic malnutrition especially in underserved immigrant communities. Exploratory analysis of a sample of children 2–19 years old from the 2007–2008 NHANES was used to assess the relationship between chronic malnutrition and overweight/obesity in Hispanic children. Overall, overweight/obesity prevalence was nearly 1 in 3 children and stunting prevalence was 3.1%. The prevalence of stunting varied significantly across race/ethnicity, with prevalence among Hispanics of 6.6%. Prevalence of stunting varied significantly by socio-economic characteristics within the Hispanic population. Our exploratory study showed differences in the prevalence of stunting across racial/ethnic groups and highlighted that overweight/obese Hispanic children have a higher prevalence of stunting compared with Non-Hispanic White overweight/obese children. More studies are needed to better understand the phenomenon and the implications for health inequities.     

Nutritional status of urban schoolchildren of high and low socioeconomic status in Quetzaltenango, Guatemala.

OBJECTIVE: The prevalence of overweight and obesity is growing in children in many developing countries, increasing chronic disease risk. Our objective was to assess the prevalence of stunting, underweight, overweight, and obesity in schoolchildren 8 to 10 years old who were of high or low socioeconomic status (SES) in Quetzaltenango, which is the second largest city in Guatemala. METHODS: Between April and June 2005 we conducted a cross-sectional survey among 583 children in private and public elementary schools, in which we measured height and weight. The Centers for Disease Control and Prevention (CDC) 2000 height-for-age z-scores, weight-for-age z-scores, and body mass index-for-age centiles were used to define stunting, underweight, overweight, and obesity. RESULTS: Mean height, weight, and body mass index were significantly higher in the 327 children of high SES than in the 256 children of low SES, across sexes and age groups. The prevalence of stunting was significantly higher in low-SES children than in high-SES ones (27.0% vs. 7.3%, P < 0.01) , and this was also true for underweight (14.1% versus 4.6%, P < 0.01). In contrast, the prevalence of overweight (17.7% versus 10.5%, P < 0.01) was higher in high-SES children than in low-SES ones; the same was true for obesity (14.4% versus 2.3%, P < 0.01). The prevalence of stunting among children of low SES, and the prevalence of overweight and obesity among children of high SES far exceeded the CDC 2000 reference ranges. CONCLUSIONS: A high prevalence of both stunting and excess body weight was found in this urban Guatemalan population, with notable contrasts between social classes. The obesity among high-income children indicates that the city is undergoing the nutrition transition, with further implications for future risks related to chronic disease. Nutrition and health interventions are needed to reduce these risks.     

Metabolic syndrome in children and adolescents in Crete, Greece, and association with diet quality and physical fitness

Aim  To determine the prevalence of metabolic syndrome in children and adolescents in Crete (Greece) and examine associations with diet quality and physical fitness. Subjects and Methods  A representative sample of 1,209 Cretan children and adolescents aged 3–17 1/2 years participated in this cross-sectional survey. The study took place in kindergartens, primary and secondary schools in the cities of Heraklion and Chania and kindergartens and schools in semi-urban and rural regions outside Heraklion. The metabolic syndrome was defined as the presence of ≥3 of: impaired fasting blood glucose, hypertension, abdominal obesity, hypertriglyceridaemia, and low HDL-cholesterol. Diet quality was assessed by the Healthy Eating Index score (USDA) and physical fitness by the 20-m shuttle run test. Results  Approximately 4% of Cretan children and adolescents assessed (4.2% of boys, 3.6% of girls) had three or more metabolic syndrome factors. Over 25% of the subjects had a “poor” diet, defined as Healthy Eating Index <51, and higher diet quality scores correlated with decreased mean body mass index, waist/height ratio, systolic blood pressure, total cholesterol, and number of metabolic syndrome risk factors present. Clustering of metabolic syndrome risk factors was also associated with decreased physical fitness, as well as increased body mass index, waist/height ratio and total cholesterol/HDL-cholesterol ratio. Conclusions  Presence of three or more factors related to the metabolic syndrome was strongly associated with poor diet quality and low physical fitness, as well as overweight, in Cretan children and adolescents. Health promotion strategies in childhood should encourage weight control, the establishment of healthier dietary patterns, and adequate physical activity, as a means of preventing the increase in the prevalence of this public health issue.     

Changing prevalences of overweight and obesity in primary school children--a glimmer of hope?

BACKGROUND: The current epidemic of childhood obesity is a growing public health concern. Estimates of the prevalence of obesity are necessary so that secular trends can be monitored and the need for preventative measures assessed. AIMS: To establish the prevalences of overweight and obesity in Aberdeen primary schoolchildren and to investigate how children have been changing with respect to body fatness during their primary school years. METHODS: Retrospective study of two cohorts of school entrants, using height and weight data from school nurse records. RESULTS: Data were collected on 1018 children. The prevalence of overweight among children in primary year 1 decreased from 28.7% in 1997/98 to 21.5% in 2001/02 (P<0.01). The mean BMI SD score also significantly decreased in boys from 0.51 in 1997/98 to 0.32 in 2001/02. For the 1997/98 school entrants, the prevalences of overweight and obesity did not change between school entry and the end of primary school. The mean BMI SD score decreased significantly during primary school in boys but not in girls. CONCLUSION: Although childhood overweight and obesity remain major public health concerns, we report a slight improvement in measures of obesity over time, particularly in boys.     

Prevalence of Metabolic Syndrome and Associated Cardiovascular Risk Factors in Guatemalan School Children

Guatemala is experiencing a nutritional and lifestyle transition. While chronic malnutrition is prevalent, overweight, obesity and chronic diseases have increased substantially in the country. This study was conducted to investigate the prevalence of metabolic syndrome and the associated cardiovascular risk factors in the pre-adolescent Guatemalan population. A cross-sectional study was conducted among 302 Guatemalan children (8–13 years old) attending public and private schools in the Municipality of Chimaltenango. Demographic data and anthropometric and blood pressure measurements were collected. A blood sample was taken after an 8 h overnight fast and analyzed for glucose, triglyceride and high-density lipoprotein cholesterol levels. The data were analyzed to identify factors associated with metabolic syndrome and with its components. The prevalence of metabolic syndrome in the study population was 2.0 %. However, approximately 54 % of the children had at least one component of metabolic syndrome, while none had four or five of the components. The three most prevalent risk factors were high triglycerides (43.4 %), low HDL cholesterol (17.2 %) and obesity (12.3 %). Boys were more likely to be obese than girls and rural children were more likely to have higher triglyceride levels than urban children. Although the prevalence of metabolic syndrome is low, the fact that majority of the children already have at least one component of metabolic syndrome is cause for concern since components of metabolic syndrome can continue into adulthood and increase the risk for chronic diseases later in life. Therefore, immediate action should be taken to address the problem.     

Investigating Environmental Determinants of Diet,Physical Activity,and Overweight among Adults in Sao Paulo,Brazil

There is worldwide recognition that the burden of noncommunicable diseases (NCDs) and obesity-related health problems is rapidly increasing in low- and middle-income countries. Environmental determinants of obesity are likely to differ between countries, particularly in those undergoing rapid socioeconomic and nutrition transitions such as Brazil. This study aims to describe some built environment and local food environment variables and to explore their association with the overweight rate and diet and physical activity area-level aggregated indicators of adults living in the city of Sao Paulo, the largest city in Brazil. This formative study includes an ecological analysis of environmental factors associated with overweight across 31 submunicipalities of the city of Sao Paulo using statistical and spatial analyses. Average prevalence of overweight was 41.69% (95% confidence interval 38.74, 44.64), ranging from 27.14% to 60.75% across the submunicipalities. There was a wide geographical variation of both individual diet and physical activity, and indicators of food and built environments, favoring wealthier areas. After controlling for area socioeconomic status, there was a positive correlation between regular fruits and vegetables (FV) intake and density of FV specialized food markets (r = 0.497; p < 0.001), but no relationship between fast-food restaurant density and overweight prevalence was found. A negative association between overweight prevalence and density of parks and public sport facilities was seen (r = −0.527; p < 0.05). Understanding the relationship between local neighborhood environments and increasing rates of poor diet, physical activity, and obesity is essential in countries undergoing rapid economic and urban development, such as Brazil, in order to provide insights for policies to reduce increasing rates of NCDs and food access and health inequalities.     

Obesity and health in Europeans aged 50 years and older

BACKGROUND: Obesity is increasing globally across all population groups. Limited data are available on how obesity patterns differ across countries. OBJECTIVE: To document the prevalence of obesity and related health conditions for Europeans aged 50 years and older, and to estimate the association between obesity and health outcomes across 10 European countries. METHODS: Data were obtained from the 2004 Survey of Health, Ageing and Retirement in Europe, a cross-national survey of 22,777 Continental Europeans over the age of 50 years. The health outcomes included self-reported health, disability, doctor-diagnosed chronic health conditions and depression. Multivariate regression analysis was used to predict health outcomes across weight classes (defined by body mass index [BMI] from self-reported weight and height) in the pooled sample and individually in each country. RESULTS: The prevalence of obesity (BMI >or=30) ranged from 12.8% in Sweden to 20.2% in Spain for men and from 12.3% in Switzerland to 25.6% in Spain for women. Adjusting for compositional differences across countries changed little in the observed large heterogeneity in obesity rates throughout Europe. Compared with normal weight individuals, men and women with greater BMI had significantly higher risks for all chronic health conditions examined except heart disease in overweight men. Depression was linked to obesity in women only. Particularly pronounced risks of impaired health and chronic health conditions were found among severely obese people. The effects of obesity on health did not vary significantly across countries. CONCLUSIONS: Cross-country differences in the prevalence of obesity in older Europeans are substantial and exceed socio-demographic differentials in excessive body weight. Obesity is associated with significantly poorer health outcomes among Europeans aged 50 years and over, with effects similar across countries. Large heterogeneity in obesity throughout Europe should be investigated further to identify areas for effective public policy.     

Finding Targets for Obesity Intervention in Urban Communities: School-Based Health Centers and the Interface with Affected Youth

Urban schools and school-based health centers (SBHCs) in low-income minority communities may be important points of intervention for overweight and obese youth. To date, little is known about the interface of overweight youth and the public health system through SBHCs. The objective of this study is to determine the prevalence, geographic distribution, sociodemographic, and comorbidity factors associated with obese status as a part of a public health system needs assessment. We conducted a cross-sectional clustered sampling utilizing prospective anthropometric measurement and chart review. Demographic, anthropometric, and medical comorbidity data were collected from 2,630 students in SBHCs in Baltimore, MD, USA. Students were geocoded to their primary residential address and assigned to a census block group using MapInfo v6.5. Demographic and comorbidity associations were analyzed using multivariable logistic regression analysis. Overall, the mean body mass index (BMI) was 25.5 (SD 6.6), and prevalence of obesity (BMI > 95th percentile) and overweight (BMI 85th–95th percentile) was 26.5% and 15.7%, respectively. Obesity was distributed among all the schools without one school being significantly more affected than others. Obese status was associated with gender, poverty, and several medical comorbidities such as asthma, high blood pressure, and disordered eating. Public health practitioners in this SBHC system appear to be faced with a greater burden of obesity than predicted by Centers for Disease Control and Prevention estimates. Given the ongoing interface with affected youth, these schools and health centers may be well situated to deliver public health obesity interventions.     

Sugar-sweetened carbonated beverage consumption correlates with BMI,waist circumference,and poor dietary choices in school children

Background  

The prevalence of obesity and overweight is increasing globally. Frequently coexisting with under-nutrition in developing countries, obesity is a major contributor to chronic disease, and will become a serious healthcare burden especially in countries with a larger percentage of youthful population. 35% of the population of Saudi Arabia are under the age of 16, and adult dietary preferences are often established during early childhood years. Our objective was to examine the dietary habits in relation to body-mass-index (BMI) and waist circumference (W_C), together with exercise and sleep patterns in a cohort of male and female Saudi school children, in order to ascertain whether dietary patterns are associated with obesity phenotypes in this population.     

昆明市城乡居民超重肥胖流行现状及其特征分析

目的了解昆明市成年人超重肥胖流行情况及其特征,为实施超重肥胖预防控制干预工作提供科学依据。方法采用多阶段抽样方法．随机抽取昆明市城乡20岁及以上常住居民5195人,进行流行病学调查。结果调查人群超重率为28．07％．按2007年昆明市人口构成进行标化,标化超重率为25．73％,其中,男性超重率为30．65％（标化率为29．28％）,女性超重率为26．59％（标化率为23．66％）,男性超重率高于女性（χ^2=7．697,P=0．006）;调查人群肥胖率为9．09％,标化肥胖率为8．09％,其中,男性肥胖率为7．99％（标化率为7．74％）,女性肥胖率为9．71％（标化率为8．32％）,男性肥胖率略低于女性（χ^2=4．285,P=0．038）。不同人群超重肥胖率存在差异,主要受年龄、性别、职业、文化程度和经济条件的影响。结论超重肥胖已成为影响昆明市城乡居民健康的重要公共卫生问题,应积极倡导合理营养、适宜锻炼的健康行为和生活方式．实施超重肥胖的干预和控制．     

Change in the prevalence of overweight and obesity among young Australians, 1969-1997

BACKGROUND: Effective public policy requires information on the prevalence of overweight and obesity. OBJECTIVE: We determined changes in the population prevalence of overweight and obesity among young Australians (aged 7-15 y) from 1969 to 1985 to 1997. DESIGN: Data from 5 independent population surveys were analyzed: the Australian Youth Fitness Survey, 1969; the Australian Health and Fitness Survey, 1985; the South Australian Schools Fitness and Physical Activity Survey, 1997; the New South Wales Schools Fitness and Physical Activity Survey, 1997; and the Health of Young Victorians Study, 1997. Measured body mass index was used as the index of adiposity, and recently published body mass index cutoff values were used to categorize each subject as nonoverweight, overweight, obese, or either overweight or obese. RESULTS: For 1985-1997, the population prevalence of overweight increased by 60-70%, obesity increased 2-4-fold, and the combined overweight and obesity categories doubled. The findings were consistent across data sets and between the sexes. For 1969-1985, there was no change in the prevalence of overweight or obesity among girls, but among boys the prevalence of overweight increased by 35%, the prevalence of obesity trebled, and the prevalence of overweight and obesity combined increased by 60%. CONCLUSIONS: The data show that in 1985-1997, the prevalence of overweight and obesity combined doubled and that of obesity trebled among young Australians, but the increase over the previous 16 y was far smaller. These results should increase our sense of urgency in identifying and implementing effective responses to this major threat to public health.