Secular trends in height, weight and body mass index of 6-year-old children in Bremerhaven

Secular trends in growth processes of children can be important indicators of changes in public health. Common to studies on secular trends in children is that evaluation is based on comparison of data collected at two (or more) distinct points on a time scale. The quantitative characteristic of the secular trend is estimated by linear interpolation between the two end points of the underlying time interval, which in studies of children are usually at least 10 years apart. The purpose of the present paper is to analyse secular trends in height, weight and body mass index (BMI) of 6-year-old children from Bremerhaven over the period 1968-1987 (the year refers to the birth cohort). The results are based on data drawn from health records of the City Health Centre, where all 6-year-old children are routinely measured in a school entrance examination. Thus the data represent complete birth cohorts of children entering school in Bremerhaven and not selected samples. The data reported here refer only to children of German origin. The sample sizes vary from n = 313 (girls born in 1982) to n = 737 (boys born in 1968), and total sample size is n = 7601. Regression of the arithmetic means of height on year of birth showed that the trend in stature for children born between 1968 and 1987 was 0.67 cm/decade for boys and 0.49 cm/decade in girls. Both trends are statistically significant (p < 0.05). Although there was an increasing tendency for weight as well, which was more marked for the 95th percentile than for the median, neither of the trends in both sexes was statistically significant. While the BMI in both sexes showed no trend at all for the median and the 5th percentile, there was a significant linear increase of the 95th percentile. Furthermore, the results for height show that an evaluation of secular trends under qualitative and quantitative perspective critically depends on the selection of points on the time scale.     

Secular trends in height,weight and body mass index of 6-year-old children in Bremerhaven

Secular trends in growth processes of children can be important indicators of changes in public health. Common to studies on secular trends in children is that evaluation is based on comparison of data collected at two (or more) distinct points on a time scale. The quantitative characteristic of the secular trend is estimated by linear interpolation between the two end points of the underlying time interval, which in studies of children are usually at least 10 years apart. The purpose of the present paper is to analyse secular trends in height, weight and body mass index (BMI) of 6-year-old children from Bremerhaven over the period 1968-1987 (the year refers to the birth cohort). The results are based on data drawn from health records of the City Health Centre, where all 6-year-old children are routinely measured in a school entrance examination. Thus the data represent complete birth cohorts of children entering school in Bremerhaven and not selected samples. The data reported here refer only to children of German origin. The sample sizes vary from n = 313 (girls born in 1982) to n = 737 (boys born in 1968), and total sample size is n = 7601. Regression of the arithmetic means of height on year of birth showed that the trend in stature for children born between 1968 and 1987 was 0.67cm/decade for boys and 0.49cm/decade in girls. Both trends are statistically significant (p &lt; 0.05). Although there was an increasing tendency for weight as well, which was more marked for the 95th percentile than for the median, neither of the trends in both sexes was statistically significant. While the BMI in both sexes showed no trend at all for the median and the 5th percentile, there was a significant linear increase of the 95th percentile. Furthermore, the results for height show that an evaluation of secular trends under qualitative and quantitative perspective critically depends on the selection of points on the time scale.     

Relationship between child health literacy and body mass index in overweight children

Objective

To test the relationship between child health literacy and body mass index (BMI) Z-score in overweight children.

Methods

Cross-sectional survey of overweight children and parents. Parent and child health literacy was measured by the Short Test of Functional Health Literacy (STOFHLA). Linear regression tested for predictors of childhood BMI Z-score, adjusting for confounders.

Results

Of 171 total children, 107 (62%) participated, of whom 78 (73%) had complete data for analysis. Mean child BMI Z-score (SD) was 2.3 (0.40); median child age (interquartile range) was 11.5 (10–16); 53% were female; 80% were Medicaid recipients. Mean child STOFHLA was 22.9 (9.0); mean parental STOFHLA was 29.1 (8.6). Child STOFHLA correlated negatively with BMI Z-score (r = −0.37, p = 0.0009) and positively with child eating self-efficacy (r = 0.40, p < 0.0001). After adjusting for confounders, child STOFHLA was independently associated with child BMI Z-score (standardized B = −0.43, p < 0.0001). Overall adjusted r-squared for the regression model was 38%. Child STOFHLA contributed 13% to the overall model.

Conclusions

Child health literacy was negatively correlated with BMI Z-scores in overweight children, suggesting the need to consider health literacy in the intersection between self-efficacy and behavior change when planning interventions that aim to improve child BMI.     

Prevalence of overweight and obesity in Chinese children and adolescents from 2015

Background: To update the prevalence of overweight and obesity in children and adolescents from 2015.

Methods: Data for this study were obtained from children and adolescents aged 7–17?years with measured weight and height from the National Surveys on Chinese Students’ Constitution and Health in 2015.

Results: Measurements from 29 418 children and adolescents (14 480 boys and 14 938 girls) were analysed. Among children and adolescents aged 7–17?years, the prevalence of obesity was 13.2% (95% CI?=?12.8–13.7%) in 2015. Moreover, the prevalence of obesity for children aged 7–12?years (20.3% (95% CI?=?19.5–21.1%)) was significantly higher than in adolescents aged 13–17?years (9.6% (95% CI?=?9.2–10.0%)) (p?< 0.001).

Comment: Obesity was much worse in children than adolescents in China; future studies are warranted to understand why these differences may be occurring.     

Centiles of body mass index for Dutch children aged 0-20 years in 1980--a baseline to assess recent trends in obesity.

OBJECTIVE: To document the distribution of body mass index (BMI) in Holland in 1980 when obesity was uncommon. DESIGN: Nationally representative growth survey. SUBJECTS: Forty-one-thousand boys and girls age 0-20 years. METHOD: BMI centiles based on the original height and weight data were derived using the LMS method. RESULTS: Median BMI showed the familiar pattern of a rise in the first year, followed by a fall, then a second rise after 6 years. The level of overweight was less than for children from the USA, France and Norway measured at the same time or earlier. CONCLUSIONS: Dutch children in 1980 were relatively free of obesity, so the BMI centiles are a suitable baseline to monitor international trends in obesity since then.     

Prevalence of overweight and obesity in a Portuguese sample of adults: results from the Azorean Physical Activity and Health Study.

The sample of this study comprised 9,991 adults who participated in the Azorean Physical Activity and Health Study, Portugal. Body mass index was calculated from self-reported weight and height and used as a depended variable. Physical activity was assessed by the International Physical Activity Questionnaire-short version, participants were classified in three categories according to their METs min/week values: low physical activity level, moderate physical activity level, and health-enhancing physical activity. Smoking status, alcohol consumption, and socio-economic status were also collected. Results showed that the prevalence of overweight and obesity was 33.5 and 18.8% in women, and 45.8 and 16% in men, respectively. The prevalence of health-enhancing physical activity individuals was 23.6% for women and 43.8% for men. Logistic regression analysis showed that age was a predictor of overweight and obesity, in both genders. Smoking status was negatively associated with overweight and obesity, in both genders. Men with low physical activity level and higher sitting time (>or=3 h/day) were more likely to be obese. Low socio-economic status and alcohol consumption were found to be predictors for overweight and obesity for women. In summary, the prevalence of overweight and obesity among Azorean adults is high. Targeted programs aimed to lower the prevalence of overweight and obesity, among the Azoreans, should focus on elderly, on women with low socio-economic status, and on men aged 26-40 years, due to the higher prevalence of overweight and obesity and low levels of physical activity observed in these groups.     

Prevalence of overweight,obesity and physical activity levels in children from Azores Islands

Abstract

Background: Childhood overweight and obesity are increasing all over the world and have been associated with low levels of physical activity (PA).

Aims: To determine the prevalence of overweight, obesity and PA levels in Azorean children according to age and sex; and to determine the association between levels of PA and prevalence of overweight and obesity.

Subjects and methods: Weight, height and PA levels were measured in 3699 children aged 6–10 years, from the Azores Islands, Portugal. Overweight and obesity were classified according to the cut-offs of .

Results: In girls, prevalences of overweight and obesity were 22.8% and 13.2%, and in boys 17.6% and 12.3%, respectively. No age trends were found in the prevalence of overweight or obesity; however, girls had a higher risk of being overweight (OR = 1.4, 95% CI = 1.2–1.7) than boys. Levels of PA were higher in boys compared to girls (F(1) = 52.8, p < 0.001). A protective effect of PA practice (very active versus less active) was observed for obesity (OR = 0.7; 95% CI = 0.5–0.9).

Conclusion: The results demonstrate the existence of high prevalence of overweight and obesity in children from the Azores Islands, which is associated with low levels of PA.     

Diagnostic performance of neck circumference to identify overweight and obesity as defined by body mass index in children and adolescents: systematic review and meta-analysis

Background: The neck circumference (NC) has been shown to be an accurate index for screening overweight and obesity in children and adolescents.

Aim: To perform a meta-analysis to assess the performance of NC for the assessment of overweight and obesity.

Subjects and methods: Data sources were PubMed and EMBASE up to March 2016. Studies providing measures of diagnostic performance of NC and using body mass index as reference standard were included.

Results: Six eligible studies that evaluated 11 214 children and adolescents aged 6–18 years were included in the meta-analysis. NC showed pooled sensitivity to detect high body mass index of 0.780 (95% confidence interval [CI]?=?0.765–0.794), specificity of 0.746 (95% CI?= 0.736–0.756) and a diagnostic odds ratio of 17.343 (95% CI?= 8.743–34.405).

Conclusions: The NC had moderate diagnostic accuracy for identifying overweight and obesity in children and adolescents.     

Application of body mass index principles in a model elementary school: implications for overweight and obese children

The first model elementary school in Richmond, VA formed the study site for this project. Changes in this model will lay the groundwork for changes throughout the Richmond Public School System. Of the 283 students in grades one through five, 66 students (23.3%) were randomly selected. Of the 66 students, 54 (81.8%) were black. Each student underwent height and weight measurement. Using the Nutstat module of the Centers for Disease Control (CDC) Epi Info software program available at no cost on the Internet, we identified Body Mass Index (BMI), BMI percentile for sex and age, and z-score for each student. Z-score measurements placed the 19 black male children at the 98.08th percentile for BMI (fewer than 2% of U.S. male children were larger). Similarly, the 35 black female children's BMI was at the 95.35th percentile (fewer than 5% of U.S. female children were larger). Based on data in the literature, the typical black male and female elementary child included in our study can expect a significant reduction in life expectancy compared with their nonobese counterparts.     

中国新疆地区哈萨克族7～18岁中小学生体重指数分布和超重肥胖筛查参考值的建立

目的建立中国新疆地区哈萨克族7～18岁中小学生超重和肥胖的体重指数（BMI）百分位曲线和界值点参考标准。方法采用横断面调查研究,在中国新疆阿勒泰市及其所属乡镇的中小学采用整群随机抽样方法抽取4所学校（共49个班级）同意参加调查的哈萨克族7～18岁中小学生为调查对象。采集性别、年龄、身高和体重测量资料;应用偏度-中位数-变异系数法建立哈萨克族7～18岁中小学生的BMI百分位曲线;利用儿童青少年超重和肥胖的BMI百分位数曲线在18岁通过国际肥胖工作小组（IOTF）定义的成人超重和肥胖BMI界值点（25kg·m^-2/30kg·m^-2）和中国肥胖问题工作组（WGOC）定义的界值点（24kg·m^-2和28kg·m^-2）的方法,计算出哈萨克族7～18岁各年龄超重和肥胖的BMI界值点。结果共采集7～18岁中小学生2487名,其中男1158名,女1329名。①按照IOTF标准,超重和肥胖的BMI百分位曲线：男性分别为P88.63和P98.28,女性分别为P84.41和P98.12;按照WGOC标准,超重和肥胖的BMI百分位数曲线：男性分别为P92.96和P99.28,女性分别为P90.53和P99.38。②哈萨克族男性超重和肥胖BMI标准曲线低于WGOC和IOTF标准;女性肥胖标准曲线13～14岁前低于WGOC和IOTF标准,之后略高于WGOC和IOTF标准。③哈萨克族男性超重、肥胖的界值百分位曲线均低于或接近的汉族和维吾尔族水平;哈萨克族女性超重界值百分位曲线在14岁前介于汉族和维吾尔族间,之后接近或达到汉族水平;肥胖界值百分位曲线在10岁前低于汉族和维吾尔族水平,14岁后达到或接近汉族水平。结论儿童青少年BMI分布有显著的地域差异和民族差异,哈萨克族中小学生超重和肥胖BMI界值标准不同于IOTF和WGOC所建议的相应标准。因此哈萨克族中小学生超重、肥胖人群的筛查可以参考本研究建立的标准。     

The relationship between resting blood pressure,body mass index and lean body mass index in British children

Background: Elevated blood pressure (BP) in childhood is associated with overweight and obesity. However, lean body mass index (LBMI, cm²/kg) has been suggested as a better means than body mass index (BMI, kg/m²) by which to consider the relations between weight status and health indices in children.

Objective: To assess the relationship between resting BP and weight status in youth whilst considering BMI and LBMI when examining this issue.

Methods and procedures: Height, body mass and resting blood pressure were assessed in 384 boys and 277 girls, aged 11–14 years from Central England.

Results: SBP was significantly lower in ‘normal weight’ children compared to overweight and obese children and in overweight compared to obese children (both p = 0.0001). DBP was significantly lower in ‘normal weight’ children compared to those classified as overweight (p = 0.006). BMI and LBMI were both significant predictors of SBP and DBP (p = 0.0001). However, LBMI was normally distributed, unlike BMI, and was a better predictor of BP than BMI.

Conclusions: Overweight and obesity is associated with higher resting BP in British children. However, when examining the effect of weight status on BP, the researcher should consider use of LBMI over BMI.     

Body mass index and the risk of infection - from underweight to obesity

BackgroundNutritional status is a well-known risk factor for metabolic and endocrine disorders. Recent studies suggest that dietary intake also affects immune function and as a consequence infection risk.AimsThis reviews aims to give an overview on the effect of body weight on infection rate at different periods of life.SourcesClinically relevant prospective, cross-sectional and case–control community-based studies are summarized.ContentIn children and adolescents underweight is a significant risk factor for infection especially in developing countries, probably reflecting malnutrition and poor hygienic standards. Data from industrialized countries suggest that infection rate is also increased in obese children and adolescents. Similarly, several studies suggest a U-shaped increased infection rate in both underweight and obese adults. In the latter, infections of the skin and respiratory tract as well as surgical-site infections have consistently been reported to be more common than in normal-weight participants. Paradoxically, mortality of critically ill patients was reduced in obesity in some studies.ImplicationsSeveral studies in children or adults suggest that both underweight and obesity are associated with increased infection risk. However, confounding factors such as malnutrition, hygienic status and underlying disease or co-morbidities might aggravate accurate assessment of the impact of body weight on infection risk.     

A case-control study of body mass index and asthma in Asian children.

BACKGROUND: The prevalence of obesity and asthma in the United States has increased in past decades. Numerous studies have focused on the relationship between the 2 factors. However, to our knowledge, this association in Asian Americans has not been extensively studied. OBJECTIVE: To assess the association between body mass index (BMI) and asthma in an Asian American pediatric population. METHODS: We conducted a case-control medical record review study of 94 pediatric patients with and without asthma at Tufts-New England Medical Center, Boston, Massachusetts. The BMI of asthmatic children before and after their asthma diagnosis was compared with the BMI of children without asthma. RESULTS: Multiple analyses showed no significant (P > .05) association between various measures of BMI and asthma in this population. After adjustment for atopic dermatitis, allergic rhinitis, and other allergies, the odds ratio in our longitudinal analysis using BMI greater than the 85th percentile for asthmatic children vs nonasthmatic children was 0.92 (95% confidence interval, 0.40-2.20). CONCLUSIONS: Either overweight and obesity do not lead to asthma in Asian immigrant children, consistent with our results, or something about our method limited our ability to observe the association. In either case, more research in the population is needed.     

Next-generation sequencing of 12 obesity genes in a Portuguese cohort of patients with overweight and obesity

We examined 12 monogenic obesity genes in 72 Portuguese individuals with overweight and obesity (class 1 and class 2), some of which with suspected genetic obesity, to identify known or unknown potential obesity variants. Genomic DNA was analyzed for variants in genes LEP, LEPR, MC4R, POMC, PCSK1, BDNF, NTRK2, SIM1, SH2B1, UCP3, GCG and ADCY3 through next generation sequencing (NGS). The impact of the rare variants was investigated in the ClinVar database and using in silico tools for prediction of pathogenicity. Four potential pathogenic missense variants were detected at the heterozygous state in five individuals: two in the ADCY3 gene, NM_004036.5:c.1153G > A (p.Val385Ile) (rs756783003) and NM_004036.5:c.1222G > A (p.Gly408Arg) (rs201606553), one in gene SH2B1, NM_001145795.1:c.127C > A (p.Arg43Ser) (rs547678855), and the fourth in gene POMC NM_000939.4:c.706C > G (p.Arg236Gly) (rs28932472), which was found in two individuals. Moreover, six rare variants near splicing sites were also identified, as well as eight rare synonymous variants. In summary, some potential pathogenic rare missense variants were identified, two of them in ADCY3 gene, the most recently identified gene as having a role in monogenic obesity. Further analysis should be performed to confirm the clinical relevance of these variants.     

Prevalence of overweight and obesity in young adults in Uganda

Background:

Obesity in young adults is rising and predicts diabetes and cardiovascular diseases later in life. Data on prevalence and determinants of obesity in developing countries are needed for primary prevention.

Objectives

To determine the prevalence of overweight and obesity in young adults in urban (Kampala city) and rural areas (Kamuli District) of Uganda.

Methods

Cross-sectional survey of 683 randomly selected young adults aged 18–30 years. Obesity was defined as body mass index (BMI) > 30 kg/m² and overweight as BMI > 25 kg/m². Distribution of BMI by socio-demographic characteristics was determined.

Results

Of the 683 participants, 50.5% were female and 53.2% were from Kampala. The overall prevalence of obesity and overweight was 2.3% and 10.4%, respectively. The prevalence of obesity was 4.4% in Kampala and 0% in Kamuli while the prevalence of overweight was 10.2% and 10.6% in Kampala and Kamuli, respectively. Compared to males, females were more likely to be obese (2.9% vs. 1.8%) or overweight (17.4% vs. 3.3%). Residing in the city, alcohol consumption, smoking, non-engagement in sports activities, commuting to school by taxi or private vehicle and being from a rich family were the main factors significantly associated (P<0.05) with obesity. Being female (p = 0.0001) and not engaging in any sports activities (P = 0.002) were two factors significantly associated with being overweight.

Conclusion

We observed significant gender differences in the prevalence of obesity among young adults in Uganda. Contrary to expectation, we did not observe significant rural-urban differences in the prevalence of overweight.