学龄前儿童家庭环境中超重和肥胖危险因素分析

目的对北京市1173名儿童家长进行问卷调查,探讨北京市学龄前儿童家庭中与儿童超重和肥胖有关的危险因素。方法在北京市2个城区在园儿童数200人以上的机关直属幼儿园中随机选择5所幼儿园为调查单位,5所幼儿园中的1364名儿童为调查对象,对调查儿童进行身高和体重的测量,采用国际肥胖工作组不同年龄和性别的体重指数作为儿童超重和肥胖的判定标准。对所有调查儿童家长发放问卷进行调查,共收集填写完整的问卷1173份,回收率86％。问卷内容为家庭饮食习惯和生活方式、喂养方式、家长特征等。结果调查儿童中肥胖和超重的检出率分别为4．1％和6．9％。父母均肥胖的家庭儿童肥胖和超重的总检出率为15．2％,父母非肥胖家庭肥胖和超重的总检出率为7．5％;父母和儿童在体重指数、餐馆就餐频率、运动时间和看电视时间上存在正相关;多因素分析发现,父母肥胖、母亲文化程度低、儿童看电视和玩电脑游戏时间长是儿童肥胖和超重的危险因素。结论家庭环境对儿童肥胖的发生、发展影响较大,应针对家庭危险因素对儿童超重和肥胖进行有效干预。     

The impact of early lifestyle factors on wheezing and asthma in Austrian preschool children

AIM: This study investigated the influence of early lifestyle factors on the prevalence of asthma and wheezing in preschool children in Tyrol, Austria. METHODS: A cross-sectional questionnaire survey was performed in 1761 preschool children to obtain information on wheezing and asthma in the light of early lifestyle factors. RESULTS: Factors independently associated with an increased risk for wheezing in the past 12 months included high parental education (OR: 1.5, 95% CI: 1.1-2.1) and parental hay fever (OR: 1.5, 95%CI: 1.1-2.2). Risk factors for doctor-diagnosed asthma (DDA) were early pet contact (OR: 2.2, 95% CI: 1.1-4.8) and parental asthma (OR: 3.0, 95%CI: 1.0-9.1), whereas breastfeeding decreased the risk (OR: 0.5, 95% CI: 0.2-1.0). Boiling the pacifier/sucker daily increased the risk for wheezing in the past 12 months (OR: 1.4, 95%CI: 1.0-2.0) and revealed a tendency towards DDA (OR: 1.9, 95% CI: 0.9-4.0). CONCLUSION: In preschool children, we established an independent association between wheezing in the past 12 months, DDA and boiling frequency of the pacifier/bottle sucker during infancy. The impact of pacifier boiling frequency on atopic diseases on the basis of the hygiene hypothesis needs further investigation.     

Association between peer relationship problems and childhood overweight/obesity

Aims:  To assess the association between peer relationship problems and childhood overweight and obesity.
Methods:  Data on 4718 preschool children were obtained at the obligatory school entry health examination in Bavaria. Parentally reported peer relationship problems ('normal', 'borderline' or 'abnormal') were assessed from the Strengths and Difficulties Questionnaire. Overweight and obesity were defined according to age- and gender-specific BMI cut-off points. Multivariate logistic regression analysis was performed to control potential confounders.
Results:  The prevalence of overweight and obesity was higher among children with 'borderline' or 'abnormal' peer relationship problems compared to 'normal' children. The association of 'abnormal' peer relationship problems was still significant in the final logistic regression model for girls [odds ratio (OR) for overweight 2.0; 95% confidence interval (CI): 1.4–3.0; OR for obesity 2.6; 95% CI: 1.3–5.0]. Among boys the adjusted odds ratio were lower and no longer significant.
Conclusion:  The significantly increased prevalence of overweight and obesity among preschool children with peer relationship problems could not be explained by confounding. It seems evident that there is a relevant co-morbidity of peer relationship problems and obesity in pre-school children pointing to the need of interventions focusing on both physical as well as psychosocial health.     

Prevalence and risk factors of obesity among school-aged children in Xi'an, China

The purpose of this study was to examine the prevalence and the risk factors associated with obesity among school-aged children in Xi'an city. The body mass index of 6,740 children aged 7–18 years was compared with the Working Group on Obesity in China cut-off value to estimate the prevalence of obesity. A case–control study of obese and non-obese children was carried out to study risk factors for obesity. A standardized questionnaire was used to collect information on possible risk factors causing obesity. Univariate analysis was performed first to compare the distribution of risk factors between cases and controls. Conditional logistic regression analysis was used to assess independent risk factors of obesity. The results showed that the overall prevalence of obesity among school-aged children was 4.11% (4.63% for males and 3.57% for females). A total of 516 subjects (258 pairs of cases and controls) were included in the final analysis. High maternal education and a longer sleeping time were shown to be protective factors against obesity (odds ratio [OR] 0.148, 95% confidence interval [CI] 0.074–0.296 and OR 0.472, 95% CI 0.342–0.652, respectively). Whereas family history of diabetes (OR 5.498, 95% CI 2.606–11.600), parental overweight (OR 3.720, 95% CI 2.068–6.689), and watching television, playing video games, and using computers (OR 1.564, 95% CI 1.133–2.159) were associated with a higher obesity risk. Conclusion: the prevalence of childhood obesity in Xi'an has become a concern, and sleeping time, sedentary behavior, and family factors have pronounced effects on the prevalence of obesity.     

Socio-economic, familial and perinatal factors associated with obesity in Sydney schoolchildren

Aim: To examine associations between socio‐economic, familial and perinatal factors with overweight/obesity in 6‐ and 12‐year‐old schoolchildren. Methods: Eligible year‐1 (1765/2238, mean age 6.7 years) and year‐7 students (2353/3144, mean age, 12.7 years) from a random cluster sample of 55 Sydney schools were examined during 2003–2005. Height, weight and body mass index were measured. Overweight or obesity was classified using International Obesity Task Force cut points. Information about each child's socio‐demographic status, familial and perinatal information was sought in parental questionnaires. Results: After multivariate adjustment, lower parental education was significantly associated with prevalent overweight and obesity in 6‐year‐old children, odds ratio (OR) 1.52 (95% confidence interval (CI) 1.15–2.01) and OR 2.16 (CI 1.34–4.13), respectively. Smoking during pregnancy was associated with a higher likelihood of being obese among both 6‐ and 12‐year‐old children, OR 1.90 (CI 1.05–3.46) and OR 1.78 (CI 1.22–2.61). Population attributable risk estimates indicate that 14.9% and 10.1% of prevalent cases of obesity in 12‐year‐old children may be attributable to being: an only child or a heavy newborn, respectively. Conclusions: We show interdependent relationships between socio‐economic, familial and perinatal factors and childhood weight status. Improved understanding of these pathways may help in developing childhood obesity prevention strategies.     

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

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

Television, computer use, physical activity, diet and fatness in Australian adolescents.

PURPOSE: To examine sedentary behaviours (including television viewing, playing computer games and computer use), diet, exercise and fitness in relation to overweight/obesity in Australian adolescents. METHODS: Questionnaires elicited food frequency data, time spent in TV-viewing, using computers, other sedentary occupations and physical activity recall. Weight, height and fitness (laps completed in the Leger test) were measured. RESULTS: Among 281 boys and 321 girls, mean age 12 years (SD 0.9), 56 boys (20.0%) and 70 girls (23.3%) were overweight/obese. Greater fitness was associated with decreased risk of overweight/obesity in boys (Odds ratio [OR] 0.74; 95% CI 0.55, 0.99) and girls (OR 0.93; 95% CI 0.91, 0.99). TV-viewing predicted increased risk in boys (OR 1.04; 95% CI 1.01, 1.06) and decreased risk in girls (OR 0.99; 95% CI 0.96, 0.99). Computer use, video games, and other sedentary behaviours were not significantly related to risk of overweight/obesity. Vegetable intake was associated with lower risk in boys (OR 0.98; 95% CI 0.97, 0.99); greater risk was associated with lower fat intake in boys and girls, lower consumption of energy-dense snacks in boys (OR 0.74; 95% CI 0.62, 0.88) and greater intake of vegetables in girls (OR 1.02; 95% CI 1.00, 1.03), suggesting dieting or knowledge of favourable dietary choices in overweight/obese children. CONCLUSIONS: Among these adolescents, fitness was negatively related to risk for overweight/obesity in boys and girls. TV-viewing was a positive predictor in boys and a negative predictor in girls but the effect size was small; other sedentary behaviours did not predict risk.     

Asthma and overweight are associated with symptoms of gastro-oesophageal reflux

AIM: To explore the prevalence of symptoms suggestive of gastro-oesophageal reflux disease (GERD) in asthmatics and controls, and to control for the possible effect of overweight. METHODS: The prevalence of GERD symptoms was assessed using a questionnaire about reflux symptoms in children with asthma (n=872, mean age 10.4 y, 65% males) compared to non-asthmatic controls (n=264, mean age 10.8 y, 48% males), and a symptom score was calculated. The association between GERD symptoms and overweight (age-adjusted BMI > 25) was assessed independently. RESULTS: A positive reflux symptom score was found in 19.7% of the asthmatics compared to 8.5% of the non-asthmatic control group (odds ratio (OR) 2.6, 95% CI 1.7-4.2). Overweight children reported GERD symptoms more frequently than children with normal weight (OR 1.8, 95% CI 1.2-2.6). Asthma and obesity remained significant predictors when analysed simultaneously by logistic regression analysis. One hundred and fifty-two children with asthma consented to an oesophageal pH study, and an abnormal pH study result (reflux index > 5.0) correlated positively with overweight (OR 4.9, 95% CI 2.2-11.0). CONCLUSION: The prevalence of symptoms associated with gastro-oesophageal reflux was increased in children with asthma and in overweight children. Overweight and asthma were independently associated with GERD symptoms, and overweight did not explain the higher frequency of GERD in asthma patients.     

Situación ponderal de la población escolar de 6 a 9 años en España: resultados del estudio ALADINO 2015

IntroductionOverweight and obesity in childhood and adolescence has grown alarmingly in the last twenty years or so in many countries of Europe, including Spain. This study presents the prevalences of overweight and obesity in 6 to 9 year-old schoolchildren in 2015, and their associated characteristics.MethodologyALADINO (Its initials in Spanish for Diet, physical activity, child development and obesity) is a cross-sectional study of a representative sample of 6 to 9 year-old schoolchildren in Spain, in line with the Childhood Obesity Surveillance Initiative (COSI) of the World Health Organisation (WHO). The height and weight of the participants, defining the weight status according to WHO standards, and a questionnaire was given to the parents on lifestyle and sociodemographic characteristics.ResultsAnthropometric measurements were taken on 10,899 schoolchildren for 168 primary education centres. Excess weight was observed in 41.3% (95% CI: 40.0-42.6), overweight in 23.2% (95% CI: 22.1-24.3) and obesity in 18.1% (95% CI: 17.2-19.1), with obesity being more prevalent in boys, overweight in girls. The prevalence of abdominal obesity was 23.2% (95% CI: 21.8-24.6). The prevalence of overweight and obesity increased with age. Excess weight decreased by 3.2% compared to 2011, mainly due to the decrease in overweight in boys, while that of obesity remained stable. Excess weight was more prevalent in schoolchildren from families with a lower socioeconomic level.ConclusionsThe prevalence of excess weight in 6 to 9 year-old schoolchildren in Spain has decreased by 3.2% since 2011, due to the decrease in overweight, whilst obesity remained stable. Action must be taken in the obesogenic environment, by promoting healthy eating habits and physical activity, bearing in mind the inequalities in health.     

The association between self perceptions of psychological well-being and overweight in Brazilian children

Our objective was to estimate the prevalence and test the association between psychological well-being and overweight in children. We conducted a cross-sectional study using anthropometrical measures and interviews with 1048 6-10-year-old school children from a Brazilian town. Overweight was assessed by the body mass index and included obesity. Psychological data of children and their parents were collected using a face scale. Poisson regression models were used to test the associations and to obtain unadjusted and adjusted prevalence ratios (PR). The prevalence of overweight was of 15.3% (95% CI: 13.2-17.6) and of only obesity was 3.8% (2.8-5.2). After controlling for age, sex, school type and parental overweight, the prevalence of overweight was 52% and 44% higher in children who reported a psychological dissatisfaction in themselves and in their mothers when compared with those with positive self perception (PR = 1.52 95% CI = 1.02-2.28; P = 0.038) and (PR = 1.44 95% CI = 1.00-2.09; P = 0.049), respectively. The study suggests that actions aiming weight control of children should take into account psychological aspects of children and their families.     

Low and high birth weight as risk factors for obesity among 4 to 5-year-old Australian children: does gender matter?

Studies testing whether birth weight and childhood obesity differ by gender are lacking. We aimed to describe the relationship between birth weight and childhood overweight/obesity and investigate the influence that gender has on this relationship among 4 to 5-year-old children. We performed a secondary analysis of an Australian nationally representative cross-sectional study in 4 to 5-year-old children. The main outcome measure was child overweight and obesity. We found that low birth weight (LBW) was associated with lower risk of overweight/obesity among girls at 4–5 years before (OR 0.50, 95%CI 0.32, 0.77) and after adjusting for socio-demographic factors (OR 0.51 95% CI 0.33, 0.80) and ethnicity (OR 0.52, 95%CI 0.33, 0.81) but was not associated with child overweight/obesity among boys before or after adjustment. High birth weight (HBW) was associated with a higher risk of overweight/obesity among both girls (adjusted OR: 1.76, 95%CI 1.12, 2.78) and boys (adjusted OR: 2.42 95% CI 2.06, 2.86). Conclusion: There are gender differences in the association of birth weight with child overweight/obesity. HBW was associated with a higher risk of child overweight/obesity in boys and girls before and after adjustment for socio-demographic factors. However, LBW was associated with a lower risk of child overweight/obesity in girls but not in boys. These gender differences need to be considered when planning interventions to reduce child overweight/obesity.     

Decreased quality of life associated with obesity in school-aged children

OBJECTIVES: To examine the association between health-related quality of life and body mass index (BMI) in preadolescent school-aged children and to provide the possible risk factors among participant characteristics, BMI status, and health-related quality of life.Design, Setting, and PARTICIPANTS: Cross-sectional analysis of 371 (50% female; 32% minority) children from a community-based sample of 8- to 11-year-olds participating in an ongoing cohort study, excluding those who had sleep apnea or who were born prematurely. Using BMI percentiles for age and sex, 17.5% of the children were considered overweight (BMI > or =95th percentile), 12.4% were at risk for overweight (BMI 85th-94th percentile), 8.1% were relatively underweight (BMI <20th percentile), and the remaining 62.0% were of normal weight (BMI 20th-84th percentile). MAIN OUTCOME MEASURES: Health-related quality-of-life scores as determined by the Child Health Questionnaire-Parent Form 50, dichotomized into the bottom quartile or decile. RESULTS: After adjustment for covariates (host factors and health status measurements), overweight children compared with normal weight children scored lower on the Psychosocial Health Summary (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.1-3.6) and on subscales measuring self-esteem (OR, 3.5; 95% CI, 1.9-6.3), physical functioning (OR, 2.8; 95% CI, 1.7-6.8), and effect on the parent's emotional well-being (OR, 2.0; 95% CI, 1.1-3.6). Compared with the normal weight group, children who are at risk for overweight scored significantly lower for physical functioning. CONCLUSION: Overweight children have an increased odds of low scores for several health-related quality-of-life domains, suggesting the importance in considering such dimensions in programs aimed at further understanding obesity in children.     

Determinants of obesity in the Ulm Research on Metabolism, Exercise and Lifestyle in Children (URMEL-ICE)

We investigated the prevalence of overweight and obesity in German schoolchildren and analyzed determinants of overweight. In the context of a randomized intervention study, a baseline cross-sectional assessment was carried out in 2006. During a physical examination, height, weight, skin fold thickness, and upper arm and waist circumferences were measured according to a standardized protocol among 1.079 children aged 6–9 years. Overweight and obesity were classified according to the definitions of the International Obesity Task Force. Parents completed a questionnaire on potential determinants of overweight. Logistic regression models were calculated for determinants of overweight and obesity. The prevalence of overweight was 16.5% in boys and 17.3% in girls and of obesity 3.5% and 3.6%, respectively. Migration (29.4 %) was correlated with overweight and obesity. In particular, among boys with migration background, overweight (24.0%) and obesity (6.6%) were highly prevalent. Higher obesity prevalence was associated with maternal smoking during pregnancy, parental overweight, and low parental education. Indicators for physical inactivity such as watching television more than 1 h per weekday, participation in club sports less than once a week, consumption of sweetened drinks (≥3 times per week), and skipping breakfast before school were associated with childhood obesity. Our results provide further evidence that parental factors such as migration background and education are strongly associated with body mass of the offspring. Physically inactive children with regular consumption of sweetened drinks and no breakfast were prone to be overweight or obese. Changes of these lifestyle factors as targets of interventions are promising to prevent childhood obesity. Stephan K. Weiland (deceased).     

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

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

Sex disparity and perception of obesity/overweight by parents and grandparents

OBJECTIVE:

To explore the factors associated with the sex disparity showing a greater prevalence of obesity/overweight in boys compared with girls in Chinese school children.

METHODS:

Sampled students and their parents were asked to complete a questionnaire. Perceptions of weight status by the parents, grandparents and children themselves were collected. A logistic regression analysis was used.

RESULTS:

The sampled students included 327 obese/overweight students and 1078 students with normal body mass index (BMI). The crude OR of obesity/overweight for boys compared with girls was 1.57 (95% CI 1.22 to 2.01). The increased risk of childhood obesity/overweight for boys remained after adjustment for prenatal and infant factors, daily habits and family situation, but disappeared after adjustment for perception of weight status (OR 1.27 [95% CI 0.93 to 1.67]). There were differences in underestimation of children’s weight status between boys and girls by their parents and grandparents (OR 1.33 [95% CI 1.08 to 1.64] and OR 1.42 [95% CI 1.15 to 1.75], respectively).

CONCLUSIONS:

Misconceptions about a child’s weight status were prevalent among parents and grandparents, and boys’ weight status was more frequently underestimated than girls. The disparity of underestimating weight according to sex may partially contribute to the difference in the prevalence of obesity/overweight between boys and girls among Chinese school children.     

Socio‐economic and ethnic differences in the prevalence of overweight and obesity among school children

Aims: To trial the collection of measurements to provide population‐based prevalence of overweight and obesity in school children in western Sydney and examine the association between healthy weight and ethnicity and socio‐economic status (SES) in a socio‐economically and culturally diverse population. Methods: A cross‐sectional population‐based survey of 2341 children in Years 4 and 7 (mean ages 9 and 12 years, respectively) in 2007. Results: Nineteen per cent of children were overweight and a further 6% were obese. The prevalence of combined overweight and obesity was similar for boys and girls (26% vs. 24%, P= 0.35). SES was significantly associated with the prevalence of unhealthy weight: the odds of being overweight or obese were 1.79 times (95% confidence interval (CI) 1.35 to 2.36) higher for children from the lowest quartile than for children from the highest quartile. Compared to children from an English speaking background, children from a non‐English speaking background were significantly more likely to be overweight or obese (21% vs. 31%, P < 0.001). The prevalence of combined overweight and obesity was significantly higher for children from a Pacific Island (odds ratio (OR) 2.66, 95% CI 1.63 to 4.33), Middle Eastern (OR 1.63, 95% CI 1.22 to 2.17) or European (OR 1.67, 95% CI 1.12 to 2.49) background than for English speaking background children. Conclusion: Large jumps in the prevalence of overweight and obesity in children observed from the 1980s appear to be diminishing, with comparable prevalence reports in 2004 and 2007. Ethnicity and SES are each independently associated with the prevalence of unhealthy weight in children.     

Prevalence of overweight,obesity, and associated risk factors among school children and adolescents in Tianjin,China

To estimate the prevalence and determinants of overweight and obesity among school children and adolescents (7–18 years), a cross-sectional study was conducted in Tianjin City of Northeast China. Five primary and middle schools were selected using a multistage random cluster sampling. Anthropometric measurements were taken by the research team. Then, standardized questionnaires on socioeconomic status, diet and lifestyle, parental weight and height were sent to the parents to be completed together with their child. Overall, 3,140 students were screened for overweight and associated risk factors. Body mass index classification reference proposed by the Working Group on Obesity in China was used as a screening reference to calculate the prevalence of overweight in these groups. The prevalence of overweight and obesity was found to be 12.5% and 15.7%, respectively. Logistic regression analysis (overweight compared with normal weight) showed that, overweight in children was significantly associated with male gender, parental obesity, parental educational level, mother’s history of gestational diabetes, high birth weight, less hours of physical activity per day, urban residence, motorized transportation, and eating food not prepared at home. After adjusting for parental obesity, the odds ratio of overweight children was increased by urban residence (rural as a reference, 2.68, 2.16–3.32), positive gestational diabetes (2.76, 1.37–4.50), and fast-food/restaurant food service (2.03, 1.34–3.07). Children who walked to school and participated in outdoor activities were 54% and 63% less likely to be overweight respectively. Conclusions: The prevalence of overweight and obesity is high among school children and adolescents in Tianjin. Changes in lifestyle, high socioeconomic status, parental obesity, mother’s history of gestational diabetes, and high birth weight are among the highly associated risk factors of overweight. An educational approach about maintaining a healthy weight should be introduced much earlier to high-risk children, parents, and women of childbearing age.     

Overweight and obesity trends from 1974 to 2003 in English children: what is the role of socioeconomic factors?

AIMS: To examine the childhood overweight and obesity prevalence trends between 1974 and 2003 and to assess whether these trends relate to parental social class and household income. METHODS: A school based and a general population health survey: the National Study of Health and Growth in 1974, 1984, and 1994, and the Health Survey for England, yearly from 1996 to 2003. Participants were 14,587 white boys and 14,014 white girls aged 5-10 years. Overweight and obesity prevalence were calculated using UK specific as well as international body mass index (kg/m2) cut-offs. Socioeconomic status was measured using the Registrar General's social class; household income (1997 onwards only) was adjusted for household size. RESULTS: The prevalence of obesity (UK specific definition) in boys increased from 1.2% in 1984 to 3.4% in 1996-97 and 6.0% in 2002-03. In girls, obesity increased from 1.8% in 1984 to 4.5% in 1996-97 and 6.6% in 2002-03. Obesity prevalence has been increasing at accelerating rates in the more recent years. Children from manual social classes had marginally higher odds (OR 1.14, 95% CI 0.98 to 1.33) and children from higher income households had lower odds (OR 0.74, 95% CI 0.61 to 0.89) to be obese than their peers from non-manual class, and lower income households, respectively. CONCLUSION: Childhood obesity is increasing rapidly into the 2000s in England and these increases are more marked among children from lower socioeconomic strata. There is an urgent need for action to prevent further increase in obesity among children.     

Parental and medical knowledge and management of fever in Italian pre-school children

Background

There are disproportionately higher rates of overweight and obesity in poor rural communities but studies exploring children??s health-related behaviors that may assist in designing effective interventions are limited. We examined the association between overweight and obesity prevalence of 401 ethnically/racially diverse, rural school-aged children and healthy-lifestyle behaviors: improving diet quality, obtaining adequate sleep, limiting screen-time viewing, and consulting a physician about a child??s weight.

Methods

A cross-sectional analysis was conducted on a sample of school-aged children (6?C11 years) in rural regions of California, Kentucky, Mississippi, and South Carolina participating in CHANGE (Creating Healthy, Active, and Nurturing Growing-up Environments) Program, created by Save the Children, an independent organization that works with communities to improve overall child health, with the objective to reduce unhealthy weight gain in these school-aged children (grades 1?C6) in rural America. After measuring children??s height and weight, we17 assessed overweight and obesity (BMI ?? 85th percentile) associations with these behaviors: improving diet quality18 (?? 2 servings of fruits and vegetables/day), reducing whole milk, sweetened beverage consumption/day; obtaining19 adequate night-time sleep on weekdays (?? 10 hours/night); limiting screen-time (i.e., television, video, computer,20 videogame) viewing on weekdays (?? 2 hours/day); and consulting a physician about weight. Analyses were adjusted 21 for state of residence, children's race/ethnicity, gender, age, and government assistance.

Results

Overweight or obesity prevalence was 37 percent in Mississippi and nearly 60 percent in Kentucky. Adjusting for covariates, obese children were twice as likely to eat ?? 2 servings of vegetables per day (OR=2.0,95% CI 1.1-3.4), less likely to consume whole milk (OR=0.4,95% CI 0.2-0.70), Their parents are more likely to be told by their doctor that their child was obese (OR=108.0,95% CI 21.9-541.6), and less likely to report talking to their child about fruits and vegetables a lot/sometimes vs. not very much/never (OR=0.4, 95%CI 0.2-0.98) compared to the parents of healthy-weight children.

Conclusions

Rural children are not meeting recommendations to improve diet, reduce screen time and obtain adequate sleep. Although we expected obese children to be more likely to engage in unhealthy behaviors, we found the opposite to be true. It is possible that these groups of respondent parents were highly aware of their weight status and have been advised to change their children??s health behaviors. Perhaps given the opportunity to participate in an intervention study in combination with a physician recommendation could have resulted in actual behavior change.     

Parental weight status as a moderator of the relationship between television viewing and childhood overweight

OBJECTIVE: To examine whether and to what extent the relationship between television viewing and children's weight status differs according to parental weight status. DESIGN: Population-level survey including in-home and telephone interview components. SETTING: United States. PARTICIPANTS: Representative sample of children aged 6 to 19 years in 2002 (n = 1483). MAIN EXPOSURE: Hours of television viewing. MAIN OUTCOME MEASURES: Child weight status (normal weight, at risk for overweight, overweight) as defined by current Centers for Disease Control and Prevention standards. RESULTS: Parental obesity increased the risk of child overweight for all of the children except boys aged 6 to 9 years. There were significant interactions between television viewing hours and parental obesity among boys aged 14 to 19 years and girls aged 10 to 13 years. For these 2 groups, the odds of overweight status increased with viewing hours for children with at least 1 obese parent but not at all for children of normal-weight parents. CONCLUSIONS: Results indicate that when parental obesity is taken into account, television viewing hours do not significantly relate to increased odds of childhood overweight, and parental body mass index may serve to moderate the relationship between television viewing and child weight status among adolescents (but not among younger children). Further examination of the moderating effect of parental body mass index on the relationship between television viewing and child weight status is warranted.