Body satisfaction in 8-year-old children after long-term dietary counseling in a prospective randomized atherosclerosis prevention trial

OBJECTIVE: To investigate whether dietary counseling designed for primary prevention of atherosclerosis and given repeatedly since infancy had an effect on prepubertal children's body satisfaction. DESIGN: Randomized controlled trial. PARTICIPANTS: At the age of 7 months, 1062 infants were randomized to an intervention group (n = 540) or a control group (n = 522). At the age of 8 years, body satisfaction of 217 children in the intervention group and 218 in the control group was evaluated.Intervention Since the children were 8 months old, families in the intervention group had regularly received individualized health education and dietary advice aimed at decreasing the children's intake of saturated fat and cholesterol. MAIN OUTCOME MEASURES: A pictorial instrument was used in measuring estimated current and desired body sizes; a difference between the 2 indicated body dissatisfaction. Weight and height were measured. RESULTS: When adjusted for relative weight, there were no differences in the mean values of estimated current size, desired size, or body dissatisfaction between the girls in the intervention and control groups (P =.62, P =.72, and P =.39, respectively), or between the boys in the intervention and control groups (P =.21, P =.64, and P =.53, respectively). The proportions of children who were satisfied with their size, who wished to be thinner, or who wished to look heavier did not differ between the intervention and control groups in either girls (P =.65) or boys (P =.85). CONCLUSION: Long-term, individualized dietary counseling since infancy with the focus on dietary fat did not enhance body dissatisfaction or desire to be thinner in 8-year-old children.     

Overweight concerns and body dissatisfaction among third-grade children: the impacts of ethnicity and socioeconomic status

OBJECTIVE: To examine the prevalence of overweight concerns and body dissatisfaction among third-grade girls and boys and the influences of ethnicity and socioeconomic status (SES). STUDY DESIGN: Nine hundred sixty-nine children (mean age, 8.5 years) attending 13 northern California public elementary schools completed assessments of overweight concerns, body dissatisfaction, and desired shape, height, and weight. RESULTS: The sample was 44% white, 21% Latino, 19% non-Filipino Asian American, 8% Filipino, and 5% African American. Twenty-six percent of boys and 35% of girls reported wanting to lose weight, and 17% of boys and 24% of girls reported dieting to lose weight. Among girls, Latinas and African Americans reported significantly more overweight concerns than Asian Americans and Filipinas, and Latinas reported significantly more overweight concerns than whites. White and Latina girls also reported greater body dissatisfaction than Asian American girls. Some differences persisted even after controlling for actual body fatness. Higher SES African American girls reported significantly more overweight concerns than lower SES African American girls, but higher SES white girls reported less overweight concerns than lower SES white girls. CONCLUSION: Overweight concerns and body dissatisfaction are highly prevalent among third-grade girls and boys, across ethnicity and SES. Young Latina and African American girls manifest equivalent or higher levels of disordered eating attitudes and behaviors as white and Asian American girls.     

Early life factors predict abnormal growth and bone accretion at prepuberty in former premature infants with/without neonatal dexamethasone exposure

Growth, bone, and body composition were studied at prepuberty in former very low birth weight (VLBW) infants who received dexamethasone (DEX) for bronchopulmonary dysplasia (BPD) compared with VLBW infants without DEX and term-born infants (TERM) to identify early life risk factors for later low bone mass. Children (56 girls/63 boys, 5-10 y) previously studied in neonatal life were recruited into three groups: VLBW + DEX, VLBW - DEX, and TERM children. Anthropometry and whole body bone, fat, and lean mass were measured. At prepuberty, the average height and weight for VLBW + DEX group were significantly lower than that for VLBW - DEX and TERM. Both VLBW groups had lower bone mass even adjusted for height and lean mass than TERM children and lower lean mass both total and adjusted for height. Z-scores for whole body bone mineral content below -1.5 occurred in 27.9% of VLBW + DEX children. The key factors for low bone mass were earlier gestational age and having BPD with DEX in neonatal life. In former VLBW infants, growth and bone mass attainment before puberty can be predicted from early life variables. VLBW + DEX children may be protected from overweight, but are at risk for short stature and low bone mass.     

Body dissatisfaction in female adolescents: extent and correlates

This study aimed to assess the extent, patterns, and predictors of feelings of body dissatisfaction experienced by female German adolescents. Using 3D-avatar software, a sample population of 144 girls between 14 and 17 years of age was asked to estimate their actual body image, their desired body image (individual ideal), and the body image they believed their parents and their best female friend considered to be the ideal body image for them. The participants estimated their actual body mass index (BMI) to be 18.82?±?3.01. The individual ideal body shape reported was significantly thinner, with a BMI score of 16.84?±?2.51. Given a girl who stands 1.65 m and weighs 55 kg, this corresponds to a difference in weight of about 5.5 kg. After adjustment for the participant’s self-reported BMI, participating in an esthetic sport was correlated with a significantly lower body dissatisfaction. Conversely, low socio-economic status and the amount of time spent watching TV was correlated with a significantly higher body dissatisfaction. Negative body image-related comments made by parents were significantly associated with body dissatisfaction. The girls who participated in this study would like to be an average of 1.97 BMI units thinner. The findings presented here suggest that future intervention measures should focus on the risk groups of physically inactive girls, those who smoke, and those with a lower social status and high rates of TV consumption. Intervention measures would be especially effective in German schools which offer lower education levels and should include the pupils’ parents, who should be informed about the negative effects weight- and diet-related comments have on their children’s body images.     

Analysis of factors that influence body mass index from ages 3 to 6 years: A study based on the Toyama cohort study

BACKGROUND: The aim of the present study was to elucidate both environmental and behavioral factors that influence body mass index (BMI, kg/m2) among Japanese children from ages 3-6. METHODS: In 1992 (at age 3) and 1995 (at age 6), 8170 6-year-old children (4176 boys and 3994 girls) were surveyed using a questionnaire on both body build (height and weight) and lifestyle. The correlation between BMI for 3-year-olds and for 6-year-olds were analyzed. From the temporal changes of body build between age 3 and 6 years, we categorized children into four groups: group 1, normal at both age 3 years and 6 years (normal/normal); group 2, overweight at age 3 years and normal at age 6 years (overweight/normal); group 3, normal at age 3 years and overweight at age 6 years (normal/overweight); and group 4, overweight at both age 3 years and 6 years (overweight/overweight). The authors compared the four groups with each other according to sex, concerning frequencies of children who matched the categories of environmental and behavioral factors. Each factor was tested using the chi2 test. Overweight children were defined as those whose BMI value was age-sex specific in the 90th percentile or more. RESULTS: A significant correlation was found between body builds for children aged 3 and 6 years in both genders (boys, r = 0.559, P < 0.01; girls, r = 0.584, P < 0.01). Significant factors associated with overweight children were diet (eating rice, green tea, eggs, meat, but less breads and juice), rapid eating, short sleep duration, early bedtime, long periods of television viewing, avoidance of physical activity, and frequent bowel movement. DISCUSSION: Temporal changes in BMI from age 3 years to 6 years are significantly associated with both environmental and behavioral factors at age 6 years. The results of this study may be useful for health promotion programs designed to prevent obesity during the early stages of childhood.     

Current conceptualisation of body image dissatisfaction: have we got it wrong?

BACKGROUND: This study addresses limitations of previous research by examining the prevalence of body image dissatisfaction within two developmental periods: childhood and adolescence. METHODS: A sample of 448 boys and 508 girls completed self-report measures of global body image dissatisfaction. Weight and height of all participants were also determined. RESULTS: Our results indicated that body image dissatisfaction differs significantly depending upon sex and body mass. Importantly, the results revealed a multi-modal distribution in the data, particularly for boys. That is, for females there was a significant increase in body dissatisfaction across bodyweight, reflecting a predominant desire to be thinner. In contrast, for boys, there was a differential pattern; with those who were overweight wanting to be thinner, but those who were underweight wanting to be larger. Moreover, whilst for both sexes, body image dissatisfaction was found to be evident in childhood as well as adolescence, during the former developmental period, it appeared to be less pronounced. CONCLUSIONS: These findings indicate that, contrary to previous propositions, body image dissatisfaction is of concern for males as well as females, although the distribution of such is strikingly different. The outcomes suggest that it is time to reframe our conceptualisation of this construct. Specifically, the identified non-linear distribution of means indicates that inferential analysis of body image dissatisfaction data needs to be conducted independently for each sex, as well as each body mass grouping.     

Survey of Occupational Therapy Practitioners in Southwestern Schools

Inadequate physical activity in children is a major health concern. The purpose of this study was to examine changes in physical activity of boys and girls, between 6–8 and 8–10 years of age and how activity patterns correlated with selected family, child, and environment factors. The sample included 59 children without motor delays (26 boys and 23 girls) between 8 and 10 years of age. Twenty-two of the children participated in a previous study at 6–8 years of age. Parents completed a questionnaire on their children's non-physical and physical activities. Children wore a pedometer during two weekdays and two weekend days. The results indicate that girls spent more time on homework and reading and on crafts and indoor play than boys. Girls spent more time on musical and cultural activities and boys spent more time on screen-based activities at 8–10 years of age. Children spent significantly less time on physical activity at 8–10 years of age. Boys took more steps per day than girls on weekends. The average number of steps taken per weekday increased for boys, but not girls, at 8–10 years of age. There was an inverse relationship between body mass index and number of steps taken per day (weekdays r = ?.28; weekend r = ?.32). Socioeconomic status was associated with the number of steps taken by children on weekends (r = .34). The results have implications for physical activities for girls and school and community programs for children.     

Physical activity of young children: a two-year follow-up

Inadequate physical activity in children is a major health concern. The purpose of this study was to examine changes in physical activity of boys and girls, between 6-8 and 8-10 years of age and how activity patterns correlated with selected family, child, and environment factors. The sample included 59 children without motor delays (26 boys and 23 girls) between 8 and 10 years of age. Twenty-two of the children participated in a previous study at 6-8 years of age. Parents completed a questionnaire on their children's non-physical and physical activities. Children wore a pedometer during two weekdays and two weekend days. The results indicate that girls spent more time on homework and reading and on crafts and indoor play than boys. Girls spent more time on musical and cultural activities and boys spent more time on screen-based activities at 8-10 years of age. Children spent significantly less time on physical activity at 8-10 years of age. Boys took more steps per day than girls on weekends. The average number of steps taken per weekday increased for boys, but not girls, at 8-10 years of age. There was an inverse relationship between body mass index and number of steps taken per day (weekdays r = -.28; weekend r = -.32). Socioeconomic status was associated with the number of steps taken by children on weekends (r = .34). The results have implications for physical activities for girls and school and community programs for children.     

Birthweight and stature, body mass index and fat distribution of 14-year-old Polish adolescents

OBJECTIVES: The relationships between intra-uterine growth retardation and stature, relative weight and fat distribution at adolescence have not been comprehensively established. The aim of this report is to assess the effect of low birthweight on stature, relative weight and fat distribution in 14-year-old boys and girls from Wroclaw, Poland. METHODOLOGY: Cross-sectional measurements of 1197 boys and 819 post-menarcheal girls aged 13.50-14.49 years were performed during medical examinations in 1997. Stature, body mass index (BMI; kg/m2), waist-to-hip ratio (WHR) and waist-to-thigh ratio (WTR) were used in the present study. A cut-off value of the 10th percentile of birthweight for particular gestational weeks was used in order to define subjects born small for gestational age (SGA) or appropriate for gestational age (AGA). Two-way ANOVA was used to evaluate the effect of birthweight on anthropometric variables of 14-year-old adolescents, allowing for socioeconomic status (determined by the level of the mother's education). RESULTS: Birthweight affected stature in boys and girls (P < 0.001), BMI in boys (P < 0.05) and WHR and WTR in girls (P < 0.001 and P < 0.05, respectively). At the age of 14 years, both SGA boys and girls were shorter than their AGA peers. The SGA boys had lower BMI, whereas SGA girls accumulated more centralized fat compared with their AGA counterparts. CONCLUSION: Fetal growth retardation has a long-lasting adverse effect on later physical growth. Polish SGA children do not catch up with their peers in terms of stature by adolescence. Moreover, central fat distribution, as observed among SGA girls, constitutes a significant risk for several adult degenerative diseases.     

Obesity and bullying: different effects for boys and girls.

AIMS: To investigate whether weight category (underweight, average weight, overweight, and obese) at age 7.5 predicts bullying involvement at 8.5 years. Models were tested separately for boys and girls to investigate gender differences in association patterns. METHODS: Prospective cohort study in southwest England. Height and weight were measured in children at age 7.5 (n = 8210). BMI (kg/m2) was used to define underweight, average weight, overweight, and obese children, according to British age and gender specific growth reference data. Overt (n = 7083) and relational (n = 6932) bullying behaviour was assessed in children at age 8.5. RESULTS: After adjustment for parental social class, compared to average weight boys, obese boys were 1.66 (95% CI 1.04 to 2.66) times more likely to be overt bullies and 1.54 (1.12 to 2.13) times more likely to be overt victims. Obese girls were 1.53 (1.09 to 2.15) times more likely to be overt victims compared to average weight girls. CONCLUSIONS: Obesity is predictive of bullying involvement for both boys and girls. Preadolescent obese boys and girls are more likely to be victims of bullying because they deviate from appearance ideals. Other obese boys are likely to be bullies, presumably because of their physical dominance in the peer group.     

Moderate–vigorous physical activity and body fatness in Chinese urban school children

Background: The exact relation between moderate-vigorous physical activity (MVPA) and body fatness in children has yet to be fully defined. This study examined the relationship between MVPA and body fatness in Chinese urban school children aged 9-11 years, in an 8 month longitudinal study. Methods: Two hundred and ten children (aged 9-11 years; 97 boys and 113 girls) were recruited from two public primary schools in the Beijing urban area. The baseline and the 8 month follow-up percent body fat (fat%), fat mass (FM), body mass index (BMI), waist size, hip size and the waist : hip ratio were investigated as measures of body fatness. Habitual MVPA level (activity-related energy expenditure, AEE) was measured using a validated self-report questionnaire recall. Results: Nine-year-old girls who were in the top quartile for MVPA had significantly lower fat% than other girls at the same age (P < 0.05); 10-11-years girls who were in the top quartile for MVPA had significantly less increase in all of the indices of body fatness (P < 0.05). There was no difference in fat% between the highly physically active (top quartile for MVPA) and less active 9-11 year boys in both cross-sectional and longitudinal statistical analyses. Conclusions: Highly physically active girls had lower fat% and less increase in body fatness. In light of world trends showing increasing childhood obesity, this study supports the hypothesis that MVPA might be effective in fighting excess body fat gain in Chinese school-age girls.     

Prediction of obesity from infancy to adolescence

Aim: To examine the development of childhood obesity and to determine the earliest age when estimating body mass using only weight and height data is associated with a corresponding estimate at the age of 15. Methods: Subjects included are all children born in 1991 in Östergötland County, Sweden. Weight and height data collected during regular check‐ups at well‐child centres and school health care assessments up to 15 years of age were assembled from health records. Correlations between childhood estimates of body mass and the body mass index (BMI) at 15 years of age were computed pairwise. Correlations with r > 0.5 were defined as reliably strong. Results: Complete data were available for 3579 children (62%). Fewer girls (2.6%; C.I. 1.9–3.3) than boys (4.6%; C.I. 3.7–5.5) were obese at 15 years of age. Correlations with BMI at 15 years of age were strong (significantly higher than 0.5) from 5 years of age. Only 23% of girls and 8% of boys found to be obese at 5 years of age were of normal weight at the age of 15. Conclusion: From 5 years of age, point estimates of body mass using only weight and height data are strongly associated with BMI at the age of 15. More data sources are needed to predict weight trajectories in younger children.     

Linear growth and weight gain in diabetic children--a cross-sectional and longitudinal evaluation

OBJECTIVE: To examine linear growth and weight gain in diabetic children and to assess the influence of the age at onset of diabetes on growth. SUBJECTS AND METHODS: A retrospective longitudinal and cross-sectional analysis of the growth data of 61 children attending the diabetic clinic for the whole year of 1998 was completed. RESULTS: The children were of average height and weight at onset with mean (SD) Height SDS = -0.095 (0.96) and mean (SD) body mass index (BMI) SDS = 0.58 (1.15). But amongst the subgroups, boys with onset before five years were found to be significantly taller (Height SDS = 0.39 (0.75), P<0.05) and heavier (BMI SDS = 1.28 (1.05), P<0.05). There was no significant change from onset to time at analysis either within individual subgroups or as a whole. Girls showed a gain in mean (SD) BMI SDS from 0.41 (1.14) to 1.03 (1.25), which however did not reach statistical significance (P=0.08). No similar tendency was observed in boys. There was no significant change in Height SDS for the 12 children who reached final height. Longitudinal follow up of growth data agreed with the observations from cross-sectional data. CONCLUSION: Prepubertal linear growth was not affected even in those children diagnosed early in childhood. The 12 children who reached final height did not show any impairment of growth. Increased growth at onset was observed in the subgroup of boys with onset of diabetes before 5 years. The tendency towards excessive weight gain observed in diabetic girls needs further evaluation.     

Birth weight, subsequent growth, and cholesterol metabolism in children 8-12 years old born preterm.

AIMS: To test the hypothesis that plasma lipids, lipoproteins, and markers of cholesterol biosynthesis (lathosterol) and absorption efficiency (campesterol) in children aged 8-12 years are related to birth size and subsequent growth. METHODS: A total of 412 girls and boys weighing less than 1850 g at birth were studied. Birth weight, gestation, and weight at 18 months were recorded and followed up at 8-12 years. Plasma total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, apolipoprotein A1, apolipoprotein B, triacylglycerol, lathosterol, and campesterol were measured. RESULTS: Birth weight for gestational age was positively related to plasma campesterol, and remained so after adjusting for current body size or fatness. Birth weight was negatively related to current plasma lathosterol but only after adjusting for current body size or fatness. For both lathosterol and campesterol the significant relation with birth size adjusted for current size indicates that the change in size between these points (postnatal upward centile crossing) was influential. These relations were absent for total cholesterol, lipoproteins, apolipoproteins, and triacylglycerol. CONCLUSION: Preterm children who were smaller for gestational age at birth had lower predicted cholesterol absorption efficiency 8-12 years later. Among children of the same current size, predicted endogenous cholesterol synthesis was higher and cholesterol absorption efficiency lower in those who showed the greatest increase in weight centile between birth and follow up. This finding was not confined to children with the smallest birth weights for gestational age. We suggest that both fetal and childhood growth relate to programming of cholesterol metabolism in children born preterm.     

Macronutrient intake, physical activity, serum lipids and increased body weight in primary schoolchildren in Istanbul

BACKGROUND: The aim of this cross-sectional study was to record the prevalence of underweight, overweight and obesity in primary school children living in Istanbul and to examine the relationship between increased body weight and certain cardiovascular disease (CVD) risk factors. METHODS: A total of 510 randomly selected children aged 12 and 13 years of age (257 boys, 253 girls) were examined. Information regarding anthropometrical indices, energy and macronutrient intake, physical activity, physical fitness and lipid profile were collected. Classification of children in overweight and obese subgroups was based on the cut-off points proposed by Cole et al. RESULTS: The prevalence of underweight, overweight and obesity was found to be 15.3%, 10.6% and 1.6%, respectively. Both overweight boys and girls were found to have lower physical fitness compared to their normal-weight counterparts, but no difference was observed for energy and macronutrient intake. Overweight boys were found to have higher total cholesterol (P < 0.001), low-density lipoprotein cholesterol (P < 0.01), triglycerides (P < 0.01) and total cholesterol/high-density lipoprotein cholesterol (HDL-C) ratio (P < 0.05) compared to their normal-weight counterparts, while overweight girls were found to have lower HDL-C (P < 0.05) compared to their normal-weight peers. CONCLUSIONS: Underweight and overweight coexisted in the current population. Increased body weight was accompanied by unfavorable lipid profiles and lower fitness levels. Consequently, there is an emergent need for early identification and understanding of behavioral and physiological variables related to obesity and CVD, so that appropriate interventions can be targeted to children who are at risk for adult onset of these diseases.     

不同营养状况下儿童青少年骨龄发育提前或落后的风险分析

目的 分析不同营养状况下儿童青少年的骨龄发育特点,探讨超重、肥胖及消瘦与骨龄发育提前或落后的相关性。方法 运用CHN法对2012年1月至2019年2月期间在首都儿科研究所附属儿童医院就诊的4~18岁7 062例（男3 310例,女3 752例）儿童的左手腕部骨龄进行评价,利用“儿童生长发育与营养评估系统”计算体质指数Z值（BMIZ）,BMIZ＜-2为消瘦组,BMIZ＞+1和BMIZ＞+2分别为超重组和肥胖组,比较不同性别和营养状况下骨龄年龄差（BAD）的差异,并对超重、肥胖儿童骨龄提前的发生风险进行分析。结果 消瘦和正常儿童平均骨龄与年龄相符,超重、肥胖儿童骨龄提前,且女童提前幅度大于男童,超重男、女童分别提前1.10岁和1.36岁（P=0.000）;肥胖男、女童分别提前1.60岁和1.78岁（P=0.000）。与正常体重相比,超重男、女童骨龄提前的风险分别增加2.358倍（95% CI：2.759~4.086）和2.483倍（95% CI：2.928~4.144）;肥胖男、女童骨龄提前的风险分别增加5.820倍（95% CI：5.066~9.181）和7.537倍（95% CI：6.319~11.534）;消瘦男、女童骨龄落后的风险分别增加1.540倍（95% CI：1.481~4.355）和3.790倍（95% CI：2.245~10.221）（P均＜0.05）。结论 超重肥胖增加骨龄提前的风险,超重男、女童骨龄提前风险接近,肥胖女童骨龄提前风险大于男童。消瘦增加骨龄落后的风险。     

Stature, weight, and body mass among young US children born at term with appropriate birth weights

OBJECTIVE: To describe weight, stature, and body mass index (BMI) changes occurring before the age of 7 years, which may influence the prevalence of overweight in adolescence and adulthood. METHODS: Regression models predicting height and weight at ages 2 months to 6. 75 years were based on the third National Health and Nutrition Examination Survey. Birth certificate data were used to adjust ethnic-specific models for birth weight for gestational age. RESULTS: Attained height is higher for non-Hispanic black children than for either non-Hispanic white or Mexican American children (P 85th percentile than either non-Hispanic white or black children (boys = 25.6%, SE = 2.7 compared with 14.1%, SE = 1.7 and 16.5%, SE = 1.7, respectively; girls = 21.9%, SE = 3.6 compared with 13.0%, SE = 1.7 and 13.7%, SE = 2.2, respectively). For non-Hispanic whites and Mexican Americans and for non-Hispanic black boys, BMI decreased slightly between ages 2 and 6.75 years; BMI for non-Hispanic black girls did not. CONCLUSION: Size differences before the age of 7 years may influence later ethnic-specific overweight prevalence, independent of prenatal influences.     

Individual and neighborhood-level factors in predicting asthma

OBJECTIVE: To identify the neighborhood socioeconomic and housing factors at the census-block level and the sociodemographic factors at the individual level that are associated with the risk of asthma. DESIGN: Cross-sectional study of children aged between 5 and 18 years seen in a network of urban primary care clinics. SETTING: A network of urban primary care clinics (Indiana University Medical Group) in Marion County, Indiana, in the calendar year 2000. PARTICIPANTS: A total of 2544 subjects with 1541 black children (947 girls, 594 boys) and 1003 white children (568 girls, 435 boys). MAIN OUTCOME MEASURE: Whether a subject ever had asthma. RESULTS: The prevalence rate of ever having asthma was 21% with the lowest (14.6%) in white girls and the highest (27.4%) in black boys. None of the census-block characteristics were significant in predicting ever having asthma. The significant predictors for childhood asthma were age, race, sex, and body mass index. Boys who were overweight had 3.1 times higher odds and girls who were overweight had 1.8 times higher odds of having asthma than girls who were normal weight. There was a stronger association between asthma and being overweight in female subjects than in male subjects. Black children had 1.3-fold higher odds of ever having asthma than white children. The highest likelihood of having asthma is among boys who were young, black, and overweight and the lowest among girls who were older, white, and normal weight. CONCLUSION: Increased efforts at prevention, screening, and treatment may need to be directed at certain subpopulations such as children living in socially and physically at-risk families and neighborhoods.     

The urinary C-peptide excretion in normal healthy children

The 24 h urinary C-peptide excretion was determined in 137 normal healthy children, 52 girls and 85 boys, 3-15 years of age. No significant difference was found between boys and girls. Median value of urinary C-peptide for boys and girls was 0.24 nmol/kg/24 h with a range of 0.07-0.61 nmol/kg/24 h. Urinary C-peptide correlated positively and significantly with age, weight, height, body surface area and the 24 h urinary creatinine excretion. Since the values of C-peptide excretion were not normally distributed they were log transformed and plotted against body weight. The linear regression and the 95% confidence limits were then calculated. Girls at puberty, 11-15 years of age, had significantly higher C-peptide excretion per kg body weight and per body surface area than younger girls, 3-10 years of age. Boys 13-15 years of age had significantly higher C-peptide excretion per body surface area than younger boys, 5-12 years of age. This indicates that children during the maximal growth spurt have an increased insulin secretion as measured by urinary C-peptide per body surface area.     

Quantifying the relationships of blood pressure with weight, height and body mass index in Chinese children and adolescents

Aim: The aim of this study was to quantify the relationships of height, weight and body mass index (BMI) with blood pressure (BP) levels in Chinese children and adolescents. Methods: Height, weight, BMI and BP measurements were obtained from a nationally representative sample of 231 227 children aged 7–18 years. Body size measurements were converted to age‐ and sex‐specific standard deviation (SD) scores. The relationships between body size and BP measurements were assessed using linear regression analysis. Results: All body size measurements were significantly associated with BP levels. Systolic BP increased 4.14, 3.70 and 2.88 mmHg in boys and 2.98, 2.63 and 1.87 mmHg in girls, corresponding to 1 SD increase in weight, BMI and height, respectively. A similar pattern was also observed for diastolic BP. After adjustment for height, systolic BP increased substantially with increasing weight (3.96 mmHg/SD increase for boys and 2.92 mmHg for girls). With adjustment for weight, systolic BP increased slightly with 1 SD increase in height (0.27 mmHg for boys and 0.10 mmHg for girls). The strength of the association between a body size measurement and BP varied among different ages, peaked at 10–11 years in girls and around 12–14 years in boys. Conclusions: Weight is the most powerful driving force of BP in children and adolescents, followed by BMI and height. Height has little impact on BP in children with a given weight, while weight has considerable impact on BP in children with a given height.