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.     

A comparative study of haematological parameters in children suffering from sickle cell anaemia (SCA) from different regions of Saudi Arabia.

Sickle cell anaemia (SCA) occurs frequently in several regions of Saudi Arabia but the haematological and clinical presentations are significantly variable. We investigated 264 Saudi children suffering from SCA originating from different regions of Saudi Arabia. Normal children from the same region were used as controls. Freshly obtained blood samples from patients and controls were used to estimate haematological parameters, red cell indices, Hb A2 and Hb F levels. The results of children from the different regions were separately analysed using the Statistical Analysis System (SAS). Significant variations were seen in the haematological parameters in SCA patients compared to controls in each region. In addition, comparison of patients from different areas also showed wide variations. The highest levels of haemoglobin, red blood cells and haematocrit were in the SCA children from the eastern province, and the lowest levels were from those in the western province. Red cell indices and Hb A2 levels did not differ significantly but HbF levels were significantly higher compared to the control group. Inter-regional differences were seen in the Hb F level. A slight but statistically significant increase was seen in the total haemoglobin with Hb F. This paper compares the haematological parameters of SCA in different regions of Saudi Arabia and shows a significant haematological heterogeneity in SCA in Saudis.     

Enuresis: prevalence and associated factors among primary school children in Saudi Arabia

The aim of this study was to determine the prevalence of enuresis and the factors associated with it among primary school children. This is a cross-sectional population-based study. Data were collected using a self-administered questionnaire. Six hundred and forty school children aged 6–16 years were selected randomly. Enuresis prevalence was 16.3% among boys and 13.8% among girls. The overall prevalence was 15%. Breastfeeding, first born children, family integrity and stability were found to be protective. Stressful life events before the age of 6 years, deep sleep, acute family psycho-social problems, recurrent urinary tract infection, constipation and congenital defects were found to be strongly associated with enuresis. Enuresis was also found to be associated with family history of enuresis. An important finding is that of the 83 children who had enuresis during sleep, 25 (30.1%) wet their beds during day time sleep (day sleep wetting). The importance of enuresis as a health problem has been affirmed and specific guidelines were suggested.     

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.     

基于不同体块指数筛查标准的2011年北京市儿童青少年超重和肥胖检出率比较研究

目的 描述2011年北京市7~18岁儿童青少年超重和肥胖的检出率,并比较基于不同BMI筛查标准的检出率的差异。方法 研究对象为2011年北京市中小学体检的7~18岁学龄儿童青少年。采用BMI作为评价超重和肥胖的指标。超重和肥胖筛查分别采用4种不同的国内（CN2010和WGOC）和国际（IOTF和WHO2007）标准。不同BMI筛查标准之间超重、肥胖检出率比较采用McNemar检验。结果 ①92 212名男女生BMI在P50、P85和P95上均显著高于全国水平(2009年“中国0~18岁儿童青少年体块指数的生长曲线”),男女生在对应百分位曲线上无交叉现象,男生BMI水平高于女生。②基于CN2010和WGOC标准,男生肥胖检出率分别为17.8%和18.2%,女生检出率分别为10.8%和10.9%;基于IOTF和WHO2007标准,男生肥胖检出率分别为12.9%和21.0%,女生检出率分别为6.0%和8.6%。③基于CN2010和WGOC标准,男生超重（含肥胖）检出率两标准间差异无统计学意义,均为36.0%,各年龄组差异亦不明显,但女生检出率CN2010标准高于WGOC标准（28.1％ vs 24.1%）,在7~15岁组差异较为明显,但在16~18岁组差异较小;与国际标准相比,基于国内标准的男生超重（含肥胖）检出率略高于IOTF标准,但却明显低于WHO2007标准,女生检出率超重（含肥胖）明显高于IOTF标准,但与WHO2007标准较为接近。④与基于WGOC标准的2004年北京市7~18岁儿童青少年超重和肥胖检出率相比,2011年超重和肥胖检出率显著增长,男女肥胖检出率分别增长5.8%和3.8%,超重（含肥胖）检出率分别增长9.3%和7.6%。结论 2011年北京市7~18岁学生中有1/3处于超重或肥胖状态。国内标准与国际标准存在明显差异,在反映中国儿童的超重肥胖流行状况时建议采用国内标准,而理想的国内标准应实现2～18岁的统一,并与成人接轨。     

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

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

Season of birth and prevalence of overweight and obesity in Canada

BACKGROUND:: The contexts of prenatal life, such as one's season of birth, have been shown to influence health later in life. For example, research has shown a disproportionate number of schizophrenic patients are born during the late winter and early spring. The purpose of this study was to examine season of birth as a possible risk for overweight and obesity. METHODOLOGY:: Utilizing cycle 2.1 of the Canadian Community Health Survey, birth data of respondents 12 to 64 years old were examined. The risk associated with season of birth was compared to risks previously identified for overweight and obesity (e.g. physical inactivity, low socioeconomic status etc.). RESULTS:: Overall, among the 20-64 year olds, those in the obese III (BMI>/=40 kg/m(2)) category were 1.54 times more likely to be born in the winter (95% CI: 1.21-1.95). This effect appears largely due to a winter/spring season of birth effect among the obese II/III (BMI>/=35) 20-29 y cohort (Winter OR: 1.53, 95% CI: 1.08-2.18; Spring OR: 1.55, 95% CI: 1.10-2.18). A summer season of birth effect was observed for the obese II/III 40-49 y cohort (OR: 1.59, 95% CI: 1.21-2.11). No season of birth effects were observed among any BMI categories for those 12-19 years, or among those 20 y and over in the overweight BMI category. CONCLUSION:: A greater proprtion of class III obese Canadians are born during the winter/spring, particularly in the 20-29 y age cohort. However, other factors (e.g. physical inactivity) represent greater risks for obesity than season of birth.     

High prevalence of overweight and obesity among 6-year-old children in Finnmark County, North Norway

Aim: The aim was to determine the prevalence of overweight and obesity among 6‐year‐old children in Finnmark, the northernmost county of Norway. Methods: This is a survey of 1774 children born during 1999 and 2000 from 18 of 19 child healthcare centres in Finnmark. Body mass index data extracted retrospectively in 2007 from health records at the age of 6 years were compared with international definitions of over‐ and underweight. The prevalence figures were further compared with socio‐demographic figures on municipality level. Results: Overall, 19% of the children were classified as overweight or obese; 5% were classified as obese. The prevalence of overweight and obesity was higher among girls (22%) than among boys (16%) (p < 0.01). The prevalence of underweight was 8% among both girls and boys. Despite large variations in the prevalence of overweight and obesity between municipalities (9–35%), no association was found with municipality figures on socio‐demographic factors. Conclusion: In the northernmost county Finnmark, the prevalence of overweight including obesity among 6‐year‐old children was somewhat higher than in previous surveys from Norway, especially among girls.     

两种标准筛查儿童超重和肥胖的比较

目的 探讨更适合中国儿童的超重、肥胖初筛标准.方法 对广西南宁地区13万余儿童(年龄7～18周岁)进行流行病学调查,参照国内、国际两种儿童超重及肥胖标准进行分析比较.结果 大多数年龄组超重及肥胖儿童国内标准的检出率均高于国际标准,肥胖的发生率在7～10岁组升高,男童超重及肥胖的检出率高于女童.结论 使用国内的儿童超重及肥胖标准可能更有利于我国儿童青少年超重、肥胖的早期干预.     

Attention-deficit hyperactive disorder in school-aged children in Saudi Arabia

The current study was designed to explore the prevalence of attention-deficit hyperactive disorder (ADHD) in primary schools in Saudi Arabia. The study collected data from both teachers and parents for 708 primary school pupils attending grades 1–3 (7–9 years old), using DSM-IV criteria of ADHD. The result showed that the overall rate of ADHD was 2.7%, and in particular, the rate of attention types, 2.0%; hyperactive/impulsivity type, 1.4% and combined type, 0.7%. Teachers reported ADHD in a higher frequency than parents. However, applying a combination of reports from teachers and parents, screening of ADHD is likely to be more accurate. These findings highlight the importance of detecting ADHD in pupils at an early age and to develop a specific set of psychological clinical interventions for helping them.     

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.     

The prevalence of overweight and obesity in pediatric survivors of cancer

OBJECTIVE: To compare the prevalence of overweight in a cohort of pediatric survivors of cancer with that in the general population. STUDY DESIGN: We reviewed the charts of 441 cancer survivors followed at a Canadian tertiary care pediatric hospital and calculated their most recent body mass index. We compared this cohort with population data generated from the Canadian Community Health Survey. RESULTS: At a median age of 14.7 years (range, 3.4 to 19.5 years) and a median time from diagnosis of 9.7 years (range, 3.4 to 19.2 years), 140 of 441 patients (31.7%) were overweight or obese. Only 12 of the 441 patients (2.7%) were underweight. Males age 6 to 11 years (odds ratio [OR] = 2.29; 95% confidence interval [CI] = 1.36 to 3.86; P < .001) and male survivors of acute lymphoblastic leukemia (OR = 1.55; 95% CI = 1.03 to 2.52; P = .04) were more likely to be overweight than the general population. No other age or diagnostic group had an increased risk of overweight. CONCLUSIONS: The prevalence of overweight was not increased in this cohort compared with the general population. However, almost 1/3 of these patients are overweight, necessitating a clinical and research focus on preventing and combating overweight in childhood cancer survivors.     

A clinico-epidemiological study of sickle cell anaemia in Saudi Arabia.

Ninety-nine Saudi Arabian children aged between 3 months and 15 years attending the sickle cell anaemia (SCA) clinic were studied using a review of case notes and an interview at clinic visits. All the patients come from the southwest and west area of Saudi Arabia. Despite the lack of infant screening for SCA, 73 per cent were diagnosed before the age of 3 years, reflecting severe early symptoms of the disease. The serious complications of SCA were two times higher, the number of admissions were three times higher and the attack rate for pneumococcal meningitis was nine times higher in our study population than previously reported from the Eastern Province of the country. Hand-foot syndrome was the commonest complication affecting 58 per cent of the children. It has been stated previously that there is no need to give penicillin prophylaxis to SCA children in Saudi Arabia, based on the observations in the Eastern Province only. Our study shows that SCA in western and southwestern population of Saudi Arabia is as severe as is described in American blacks. Therefore, we recommend penicillin prophylaxis to be given to the SCA children in the southwest and west regions of the country.     

Aetiology of overweight and obesity in children and adolescents

The epidemic diffusion of obesity in industrialised countries has promoted research on the aetiopathogenesis of this disorder. The purpose of this review is to focus mainly on the contribution that European research has made to this field. Available evidence suggests that obesity results from multiple interactions between genes and environment. Parents obesity is the most important risk factor for childhood obesity. Twin, adoption, and family studies indicated that inheritance is able to account for 25% to 40% of inter-individual difference in adiposity. Single gene defects leading to obesity have been discovered in animals and, in some cases, confirmed in humans as congenital leptin deficiency or congenital leptin receptor deficiency. However, in most cases, genes involved in weight gain do not directly cause obesity but they increase the susceptibility to fat gain in subjects exposed to a specific environment. Both genetic and environmental factors promote a positive energy balance which cause obesity. The relative inefficiency of self-adapting energy intake to energy requirements is responsible for fat gain in predisposed individuals. The role of the environment in the development of obesity is suggested by the rapid increase of the prevalence of obesity accompanying the rapid changes in the lifestyle of the population in the second half of this century. Early experiences with food, feeding practices and family food choices affect children's nutritional habits. In particular, the parents are responsible for food availability and accessibility in the home and they affect food preferences of their children. Diet composition, in particular fat intake, influences the development of obesity. The high energy density and palatability of fatty foods as well as their less satiating properties promotes food consumption. TV viewing, an inactivity and food intake promoter, was identified as a relevant risk factor for obesity in children. Sedentarity, i.e. a low physical activity level, is accompanied by a low fat oxidation rate in muscle and a low fat oxidation rate is a risk factor of fat gain or fat re-gain after weight loss. Conclusion Further research is needed to identify new risk factors of childhood obesity, both in the genetic and environmental areas, which may help to develop more effective strategies for the prevention and treatment of obesity.     

Epidemiology of infantile hydrocephalus in Saudi Arabia: birth prevalence and associated factors

INTRODUCTION: Hydrocephalus is a common central nervous system disorder in children. In spite of its importance, it has not been subjected to sufficient epidemiological studies, particularly in the developing countries. The aim of this study was to provide information from a representative series of newly diagnosed cases of infantile hydrocephalus on the birth prevalence, associated factors and mortality. METHODOLOGY: A prospective study was conducted over a 1-year period from April 1996 to March 1997 in the city of Al-Madinah Al-Munawarah, Saudi Arabia. Except for neural tube defects and brain tumors, all cases of hydrocephalus diagnosed within the first 28 days of life were included. A control group of 104 subjects was studied for comparison. Information about antenatal, natal and early postnatal periods were obtained by interviewing the mothers of the newborns. RESULTS: During the study period, 26 cases of infantile hydrocephalus were detected. The birth prevalence was 1. 6 per 1,000 live births. There was no sex preponderance as the male to female ratio was 1.2:1. Multiple pregnancies were detected in 21 (81%) cases. Nineteen (73%) cases were the product of consanguineous parent and 4 patients had a positive family history of hydrocephalus. The number of preterm infants was 16 (62%). The number of low birth weights (less than 2,500 g) was 18 (69%). An Apgar score of less than 8 occurred in 18 (69%) cases. The mode of delivery was vaginal in 15 (58%) women. The 6 months mortality rate was 23% (6 infants). CONCLUSION: The birth prevalence of infantile hydrocephalus in this study was significantly higher than in the developed countries. A positive family history of hydrocephalus, low birth weight, low Apgar score and abdominal delivery were found to be associated factors. The mortality rate in the first 6 months of life was significantly higher in hydrocephalus infants than in controls.     

Change in prevalence of overweight and obesity in Finnish children – comparison between 1974 and 2001

Objective: To analyse the possible changes in the prevalence of overweight and obesity comparing birth cohorts from four different decades in Finland. Design: A retrospective longitudinal growth study. Methods: The subjects representing five birth cohorts: 1974 (n = 1109), 1981 (n = 987), 1991 (n = 586), 1995 (n = 856) and 2001 (n = 766) in the city of Tampere and three rural municipalities in Finland. Data included five consecutive height and weight measurements from 2 to 15 years of age. Normal weight, overweight and obesity at the time points were classified by body mass index (BMI, kg/m²) according to international age‐ and gender‐specific BMI cut‐off points. The chi‐square test was used to analyse the differences in the between birth cohorts. Results: The combined prevalence of overweight and obesity decreased significantly in 2‐year‐old boys (p = 0.009) and girls (p = 0.002) from 1974 to 2001. Insignificant fluctuation was seen in 5‐ and 7‐year‐old children. Both the prevalence of obesity and the combined prevalence of overweight and obesity showed a significant increase in 12‐ (p = 0.031 and p < 0.001) and 15‐year‐old boys (p < 0.001 in both) from the 1970s to 2000s. In girls, the prevalence of obesity as well as the combined prevalence of overweight and obesity increased significantly in the age group of 12 years (p = 0.023), but not in that of 15 years. Conclusions: During the last three decades, overweight and obesity have become clearly more prevalent in Finnish young adolescents. This trend has been more obvious in boys than in girls. At the same time, 2‐year‐old children have shown an opposite trend.     

超重、肥胖儿童与代谢综合征患儿心率减速力的研究

目的探讨超重、肥胖儿童及代谢综合征(MS)患儿的心率减速力(DC)、心率加速力(AC)及心率变异性(HRV)差异;体质指数(BMI)与DC、AC、HRV各指标间的相关性。方法选择≥10岁的超重、肥胖儿童103例,其中诊断为MS患儿48例;测定DC、AC、HRV各指标。结果 MS组DC值为(5.97±1.77)ms,低于非MS组的(7.93±1.56)ms;AC值为(-6.78±1.56)ms,高于非MS组的(-8.17±1.61)ms;HF值为335.2 ms~2(157.03~659.33 ms~2),低于非MS组的497.5 ms~2(345.6~767.1 ms~2);BMI为(29.64±2.83)kg/m~2,高于非MS组的(26.79±1.83)kg/m~2,差异均有统计学意义(P0.05)。超重、肥胖儿童BMI与DC呈显著负相关(r=-0.241,P=0.014),与AC呈正相关(r=0.199,P=0.044)。结论 MS患儿的自主神经功能受损,表现为迷走神经张力降低。肥胖程度越高,迷走神经张力越低,机体对心脏的保护力就越差,越易引起心血管疾病的发生。