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).     

Obesity and related risk factors

Objective To study the prevalence of overweight and obesity among Iranian schoolgirls and to identify risk factors which lead to obesity. Method This cross-sectional study was conducted in 2002 and a sample of 1800 female students between 7–12 years old was obtained using a multistage cluster sampling method from Tehran. Height and weight were measured and related socioeconomic information was collected. Results The overall percent of overweight and obesity was 13.3% and 7.7% respectively. BMI (Body Mass Index) was directly and significantly (r=+0.28, P<0.001) correlated with increasing age. Physical activity was significantly different between obese and non-obese children. (P=0.03) Also, economical factors such as the type of school (private& public) were different in these children. (P=0.03) The statistical analysis of the data revealed a significant and inverse correlation (r=-0.03, P=0.04) between maternal education and occurrence of overweight and obesity in children. Conclusion The prevalence of overweight and obesity in young Iranian girls was high. Advanced age, lack of physical inactivity, low economical factors and maternal educational status could be risk factors for obesity in children.     

Declining prevalence rates for overweight and obesity in German children starting school

To estimate the development of prevalence rates for overweight and obesity in children starting school in Germany, data for children’s height and weight out of the compulsory school enrolment examinations (SEE), conducted annually in every German federal state, were available. A former analysis of these data showed a marked increase of prevalence of overweight and obesity until 2004. The aim of this project was to give an updated overview on the development of prevalence rates for overweight and obesity in children upon school entry by including recent data until 2008. Data on measured height and weight from the yearly conducted SEE were obtained from all 16 German federal states. Overweight and obesity were defined by BMI > 90th and BMI > 97th age- and gender-related percentiles of German reference values, respectively. In 2008, the prevalence for overweight varied from 8.4% in Saxony to 11.9% in Bremen and Thuringia. The current prevalence rates for obesity ranged from 3.3% in Brandenburg and Saxony till 5.4% in Saarland. The current data from SEE by the majority of the individual states showed that the prevalence for both overweight and obesity did not increase any more after 2004 and is even declining in some states compared to the former data inquiry. Absolute decrease of prevalence rates was up to 3% for overweight and 1.8% for obesity. Conclusion: The current data from the SEE of individual German states are based on census and showed by the majority that the prevalence of overweight and obese children starting school did not increase anymore and even declined in the last 4 years, respectively. It is supposed that the measures for prevention initiated in the 1990s and implemented afterwards have contributed to this positive development in Germany.     

Prevalence of overweight and obesity among children and adolescents in Thessaloniki-Greece and Kayseri-Turkey

The aim of this study was to investigate the prevalence of overweight and obesity among children and adolescents in the city of Thessaloniki, Greece and in the Kayseri area of Turkey and compare the results. For this purpose, data concerning the weight and height of 2458 Greek school children aged 6-17 years (1226 6-10 years, 1232 11-17 years) and 3703 Turks (1032 6-10 years, 2671 11-17 years) were collected. BMI was calculated. The prevalence of overweight Greek schoolchildren was 22.2% while that of Turks was 10.6%. The obesity prevalence was 4.1% and 1.6%, respectively (total overweight and obese children 26.3% and 12.2%, respectively). In the analyses, the estimations of the prevalence of overweight and obesity are based on the international BMI percentile curves and cut-off points in subjects aged 2-18 years recently established. A significant gender difference was found, males being more overweight and obese compared to females. Finally, the prevalences for both Greeks and Turks were higher in children when compared to adolescents. In conclusion, Greece (as represented by the Thessaloniki area) has one of the highest prevalences of overweight schoolchildren recorded in Europe while Turkey (as represented by Kayseri area) one of the lowest recorded among developed and developing countries. Differences in lifestyle and socioeconomic status in the two regions are most probably responsible for these results.     

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.     

Overweight and obesity and their associated factors in adolescents in Tehran, Iran, 2004–2005

Overview Obesity is a significant health crisis around the world. Of great concern are the data pointing to the recent increase in the prevalence of obesity irregardless of age group and country. Overweight and obesity in adolescence are markers of overweight and obesity in adults, respectively. Very little data are currently available on the prevalence of childhood obesity in Iran, and more research on the risk factors is required before preventive public health programs can be formulated and put into practice.Objective The objective of this study was to quantify the prevalence of overweight and obesity and their associated factors in adolescent children living in Tehran.Materials and methods During a multistage stratified cluster sampling, 2900 students (1200 males and 1700 females) aged 11–17 years were selected from 20 secondary schools in the school year of 2004–2005. A questionnaire was filled, and weight and height were measured.Discussions and conclusions The body mass index (BMI) was calculated and adjusted for age and sex. Prevalences of overweight and obesity were 17.9 and 7.1%, respectively. BMI increased with age, and it was higher in those who had lower levels of physical activity. Age at menarche was negatively associated with BMI. There was no relationship between macro- and micronutrient intake and overweight and obesity. This study highlights the high prevalence of overweight and obesity in adolescent children in Tehran.     

Relationship of body mass index with serum lipids in elementary school students

Objective  To determine the relationship of body mass index with serum lipids in elementary students. Methods  This prospective analytic study was conducted among 954 elementary school students (9–11years), selected by multi stage random systematic method from 6 cities and their rural areas from The South Khorasan province (eastern Iran) from September to December 2006. Height and weight was measured and Body mass index was calculated. Total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were determined. Results  954 students 9–11 years old were studied. 45.4% were boys. 76.5% were living in the city. 1.8% of students were obese and 3.4% were over weight. There was no significant relation between obesity and overweight with sex, age and the area of residence. There was significant relation between BMI with TC (P= 0.003), TG (P< 0.001) and LDL-C (P= 0.04). TG was significantly higher in obese and overweight students than in normal weight students (P< 0.001). TC (0.002) and LDL-C (0.01) were significantly higher in obese students than normal weight students. The prevalence of high TG was significantly higher in obese and overweight students than normal weight students (0.003). There was no significant difference between different kinds of dyslipidemia with area of residence. Conclusion  it is necessary to measure serum lipid profile in obese and overweight children.     

Mysore childhood obesity study

We conducted this study to document the prevalence of obesity, overweight and underweight in the school children aged 5 to 16 years from Mysore. 5 Principal Investigators and 13 Co-Investigators trained the teachers of 139 schools (Private-111, Govt-28) to record the vital statistics of the children studying in their schools. A total of 43152 school children (23527 boys and 19625 girls) were surveyed. 36354 children were from private schools and 6798 children were from Government (Govt) schools. Indian Academy of Pediatrics growth charts were used as reference. The prevalence of obesity, overweight and underweight were 3.4%, 8.5% and 17.2%, respectively. The prevalence of obesity was maximum in the age group of 5–7 years and in those from private schools.     

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.     

Regional, socioeconomic and urban-rural disparities in child and adolescent obesity in China: a multilevel analysis

Aim: To study socio‐demographic patterns of obesity in Chinese children and adolescents. Methods: Data came from the 2005 cycle of the Chinese National Survey on Student’s Constitution and Health. In all, 231 326 subjects aged 7–18 years, distributed across 622 schools and 30 provinces, were analysed. Multilevel modelling was used to estimate variations at individual, school area and province levels. Results: The prevalence of obesity varied enormously across different areas. Young people living in high socioeconomic and urban areas had higher body mass index (BMI) and higher odds of overweight and obesity than those living in lower socioeconomic and rural areas. Subjects living in provinces with a higher standard of living, as indicated by less perinatal mortality, lower Engel coefficient, and higher personal expenditure on health had higher BMI and higher odds of overweight and obesity than those living in less affluent provinces. An interaction between gender and urbanicity revealed that boys in urban areas were especially prone to obesity. Conclusion: In contrast to most present‐day high income countries, obesity among young people in China is associated with affluence and urban residence. Intervention and strategy for obesity prevention should be targeting high socioeconomic families in urban areas, perhaps with particular focus on boys.     

Appropriateness of US and international BMI-for-age reference curves in defining adiposity among Israeli school children

Effective surveillance of trends in paediatric overweight and obesity requires the establishment of valid cutoff values to identify children at risk. In Israel, standard values for childhood BMI-for-age are currently based on growth charts published by the US Centers for Disease Control and Prevention. However, the appropriateness of using US reference values in populations outside the US is questionable, due to inherent differences in ethnicity, culture and socioeconomic status. We recorded data from 9,988 children aged 6–12 selected by random cluster sampling within the framework of school-based health surveys conducted in Israel during the years 1997 and 2000. We constructed population-specific centile BMI-for-age curves valid for Israeli children, and compared these curves to current standard US and international reference values. Curves were constructed using LMS statistical curve smoothing methods. The data set of Israeli schoolchildren produced reference centiles substantially different than those based on US children. Israeli reference values were closer to centile curves published by the International Obesity Task Force. In conclusion, local and national health planners should recognize the intrinsic limitations associated with the use of “standard” reference values in defining paediatric overweight and obesity in dissimilar populations. The results of this large population-based study highlight the need for population-specific BMI-for-age reference values, in order to accurately describe the prevalence of paediatric overweight and obesity.     

Overweight,obesity and features of metabolic syndrome in children with diabetes treated with insulin pump therapy

There has been no specific evaluation of atherogenic risk factors in children with type 1 diabetes mellitus (T1DM) treated with continuous subcutaneous insulin infusion (CSII). We, therefore, studied the prevalence of overweight/obesity and metabolic syndrome among these patients. Five hundred children with T1DM treated with CSII and multiple daily insulin (MDI) regimen were included in the study. Anthropometric data/physical examination, data concerning diabetes, and a lipid profile were assessed in this group, and compared with respect to treatment method (CSII vs. MDI). Almost one-third (30.2%) of the children were overweight/obese. The body mass index (BMI) values at the time of the present evaluation were significantly higher in comparison with the BMI values 3–6 months after the diagnosis. Dyslipidemia was recognized in 51.6%, hypertension in 4.8%, and the metabolic syndrome in 3.2%. of the subjects. The overweight/obese children differed from their normal-weight counterparts with respect to metabolic control, the incidence of hypertension, dyslipidemia, and metabolic syndrome. The girls showed higher prevalence of overweight/obesity and higher BMI values compared to the boys. The children treated with CSII had the same prevalence of overweight/obesity, but a lower incidence of dyslipidemia, and a better metabolic control compared to the children treated with MDI regimen. Our study shows a high prevalence of overweight/obesity and dyslipidemia in children with T1DM including those treated with an insulin pump.     

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.     

Risk factors for overweight in 2- to 6-year-old children in Beijing, China.

OBJECTIVE: To assess the prevalence of overweight among Chinese preschool children and to explore risk factors of childhood obesity focusing on parental characteristics, feeding practice and lifestyle. METHODS: Data on 930 families with 2- to 6-year-old children in five kindergartens were obtained in a cross sectional study. Families were randomly selected from two of all six urban districts in Beijing, China. Information on parental characteristics, dietary habits, lifestyle habits, and feeding practice was collected by parental self-report questionnaires. The children's stature and weight were measured in light clothing and without shoes. Overweight and obesity were defined according to international cut-off values, as proposed by the International Obesity Task Force. Multivariate regression analysis was used to explore risk factors of child overweight. RESULTS: The overall prevalence of overweight and obesity was 10.7% and 4.2%, respectively, and increased with age. The prevalence of child overweight was 14.1% and 7.5% in obese and non-obese families, respectively. Significant associations were observed between child and parent characteristics for overweight, frequency of eating in restaurant, television hours, and hours of physical activity. Child overweight was associated with parental overweight (Odds Ratio [OR] 2.43, 95% CI 0.78, 6.59), low maternal education level (OR 2.22, 95% CI 1.39, 3.55), food restriction (OR 2.68, 95% CI 1.64, 4.29), and television watching >2h/d (OR 1.56, 95% CI 1.17, 2.09), after adjusting for sex, age, family income and kindergarten (for cluster study design). CONCLUSIONS: Overweight prevalence among Chinese preschool children in Beijing is comparable to some European countries. Prevention strategies should include identified lifestyle risk factors.     

Excess weight in adolescents and associated factors: data from the ERICA study

ObjectiveTo estimate the prevalence of excessive weight and to identify associations with socioeconomic, demographic, biological, and lifestyle factors in adolescents.MethodsIt is a cross-sectional school-based study, with a stratified and complex sample. The evaluated individuals were adolescents (2404), aged 12–17 years old, participating in the Study of Cardiovascular Risk Factors in Adolescents (ERICA). Demographic, socioeconomic, biological, anthropometric, and lifestyle variables were assessed. Poisson regression was used to verify the association between excess weight and independent variables.ResultsThe prevalence of excessive weight was 26.3% in the study population, being 16.3% for overweight and 10% for obesity. In the multivariate analysis (hierarchical model), were associated with excessive weight: private education network, a higher number of televisions in the residence, eating habits related to the breakfast consumption, snacks purchase in the canteen, snacks in front to screens consumption and consumption of carbohydrates and lipids, in addition to age group (12–14 years) and sexual maturation (post-pubertal).ConclusionsThe prevalence of excessive weight among the school adolescents studied is high, with a value higher than the national average and the results of previous studies with adolescents. Its distribution is associated with different factors, which are socioeconomic, demographic, biological, and related to lifestyle, reinforcing the complexity of this condition, which deserves a broad coping approach, involving not only individual efforts but social and public ones as well.     

Prevalence of obesity and overweight in urban school children in Kerala,India

The objective of this study was to examine the prevalence of obesity and overweight in urban school children in Kochi, Kerala, South India. Three schools from the city were selected representing upper, middle and lower socioeconomic groups and the children aged 6-15 years of age were interviewed. The prevalence of obesity was 3.0% for boys and 5.3% for girls. The prevalence of obesity (7.5%) and overweight (21.9%) were highest among high income group and lowest (1.5% and 2.5%) among low income group. Prevalence of obesity and overweight was found to be higher in the high income group and among girls.     

Timing of solid food introduction and association with later childhood overweight and obesity: The IDEFICS study

This study investigated associations between timing of solid food introduction and childhood obesity and explored maternal characteristics influencing early feeding practices. Cross‐sectional data from children 2–9 years (n = 10,808; 50.5% boys) residing in 8 European countries of the IDEFICS study (2007–2008) were included. Late solid food introduction (≥7 months of age) was associated with an increased prevalence of later childhood overweight/obesity among exclusively breastfed children (OR [odds ratio]: 1.38, 95% CI [confidence interval] [1.01, 1.88]). In contrast, early solid food introduction (<4 months of age) was associated with lower prevalence of overweight/obesity among children that ceased exclusive breastfeeding earlier than 4 months (OR: 0.63, 95% CI [0.47, 0.84]). Children that were introduced to solids right after 6 months exclusive breastfeeding and continued to receive breastmilk (≥12 months) were less likely to become overweight/obese (OR: 0.67, 95% CI [0.51, 0.88]) compared to children that discontinued to receive breastmilk. Analyses were adjusted for age, sex, country, birth weight, parental education level, parental body mass index, tobacco use in pregnancy, gestational weight gain, and gestational diabetes. Underweight mothers, overweight mothers, mothers who reported daily smoking during pregnancy, and low‐educated mothers were less likely to follow recommendations on breastfeeding and timely solids introduction. Future studies should examine whether guidelines for solid food introduction timing have to distinguish between exclusively breastfed, formula fed, and too early exclusive breastfeeding‐ceased infants. There is also need for more prospective studies; recall bias was an important current limitation. In conclusion, health professionals should emphasize benefits of breastfeeding and appropriate solid food introduction, especially to mothers that are less likely to follow recommendations.     

Prevalence of overweight in children and adolescents with attention deficit hyperactivity disorder and autism spectrum disorders: a chart review

Background  

The condition of obesity has become a significant public health problem in the United States. In children and adolescents, the prevalence of overweight has tripled in the last 20 years, with approximately 16.0% of children ages 6–19, and 10.3% of 2–5 year olds being considered overweight. Considerable research is underway to understand obesity in the general pediatric population, however little research is available on the prevalence of obesity in children with developmental disorders. The purpose of our study was to determine the prevalence of overweight among a clinical population of children diagnosed with attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASD).     

Parental Determinants of Overweight and Obesity in Iranian Adolescents: A National Study

Objective

Overweight among adolescents is not only an important public health problem but also a problem affecting economic growth in developing countries. The aim of this study was to investigate the parental determinants of overweight and obesity in Iranian adolescents at national level.

Methods

This cross sectional study was conducted within the framework of the Comprehensive Study on Household Food Consumption Patterns and Nutritional Status of IR Iran during 2001-2003. In adolescents, anthropometric indices were defined based on the CDC 2000 cut-off points for age and gender-specific body mass index (BMI). Parental characteristics were collected by questionnaire. Among the 7158 participating households, data on 7908 adolescents aged 11-19 years (3750 girls and 4158 boys) was analyzed.

Findings

The prevalence of overweight (85–94th percentile) in boys and girls was 6.2%, and 8.7%, respectively. The prevalence of obesity (≥95th percentile) among boys and girls was similar (3.3%). Parents’ weight status, father''s job and parents’ education showed significant association with weight status in adolescents. Logistic regression analysis showed that parental overweight and obesity, parental education and father''s job were the main parental determinants of overweight and obesity in Iranian adolescents.

Conclusion

Parental overweight and obesity, parental education and father''s job seem to be the major parental determinants of overweight in Iranian adolescents. Future prevention programs must take these risk factors into account.     

Hohe Persistenz von Übergewicht bei Kindern der Mannheimer Risikokinderstudie

Background

The number of overweight or obese children and adolescents is increasing constantly. Apart from a growing prevalence, the persistence of obesity is a particular cause for concern. While the persistence of obesity has been the subject of intensive investigation, few studies have been devoted to the persistence of overweight.

Methods

Data recorded for 327 children taking part in the ?Mannheim Study of Risk Children“ were analysed with reference to prevalence, incidence and persistence of overweight. The longitudinal design of the study made it possible to record the subjects’ weight development over 13 years.

Results

Our investigations show a high persistence of overweight, especially from the age of 8 years onward. The incidence of overweight remains constant at all test times and shows only a slight increase from the age of 8 years.

Conclusions

Because of the high stability of overweight from junior school age onward, preventive programmes should start no later than when children are first enrolled in school.