Further evidence for a low body weight in male children and adolescents with Asperger's disorder

The study explores the common clinical impression and previously reported finding by Hebebrand et al. (7) of reduced body weight in male children and adolescents with Asperger's disorder (AD). Body weight and height of 36 consecutively admitted male patients with AD were retrospectively assessed for the calculation of body mass indices (BMI, kg/m²). The BMIs were transformed to percentile ranks and plotted into BMI-centiles representative for the German population. In addition, comorbid psychopathology was assessed to explore a possible relationship between associated psychopathology and body weight. The mean BMI-centile of all patients was 34.7 ± 31.8 and, thus, differed significantly from the mean centile of an age- and gender-matched psychiatric control group, which was 52.7 ± 28.3. Thirteen patients had a BMI below the 10th centile and five even below the third. Three of the latter presented with disturbed eating behaviour. Altogether four patients showed disturbed eating behaviour. They had a significantly lower mean BMI-centile than the rest of the group. The BMI-centiles of patients with other additional psychopathology did not differ significantly from the mean percentile of the whole cohort. The results clearly show an increased risk for underweight and disturbed eating behaviour in patients with Asperger's disorder which should be evaluated in further studies. Accepted: 26 January 1999     

The significance of under- or overweight during childhood as a risk factor for hypertensive diseases in pregnancy

Hypertensive diseases in pregnancy are still a major cause of foetal and maternal mortality. Known risk factors allow identification of only a small number of patients at risk of developing such a complication. However, better knowledge of the risk profile would improve an early adequate monitoring of these pregnancies. We therefore investigated the correlation between under- or overweight during childhood and the development of hypertensive diseases during pregnancy. The study was designed as a cross-sectional case control study. A self-administered questionnaire was distributed to 2600 women, who had contacted the German pre-eclampsia self-help group for information on hypertensive diseases in pregnancy and 1233 control women recruited in different hospitals. Diagnosis according to criteria of the international society for hypertensive diseases in pregnancy was based on medical records. 766 women with a hypertensive disease during their pregnancy and 951 control women with normal pregnancies were evaluated after verifying for exclusion criteria and complete data sets. Student t-test, chi square test and multivariate logistic regression models were used for statistical analysis. A history of under- (OR 2.1, 95% CI 1.23-3.61) or overweight (OR 1.46, 95% CI 1.01-2.12) during childhood is associated with an increased risk for hypertensive diseases in pregnancy, which is at least partly independent of pre-pregnancy BMI. In combination with other risk factors, a history of under- or overweight during childhood will help to identify patients at risk for hypertensive diseases in pregnancy.     

Nutritional state of Polish prepubertal children assessed by population-specific and international standards

OBJECTIVE: To assess the frequency of obesity, overweight and underweight (thinness) in Polish 7-9-year-old children using a population specific definition as compared to the French, US and IOTF references based on body mass index (BMI). DESIGN: Height and weight were measured and BMI was calculated in a randomly selected representative sample of 7-9-year-old Polish children (N = 2916; 1445 girls; 1471 boys) to define their nutritional status. Overweight (including obesity) was estimated according to four and underweight (thinness) according to three definitions Polish national references; French references; United States references and International Obesity Task Force references. RESULTS: According to Polish, French, U.S. and IOTF references overweight (including obesity) was found in 12.1, 14.3, 20.7 and 15.4% of children, respectively; 3.5, 9.4 and 3.6% of children were obese according to national, U.S. and IOTF references, respectively while underweight (thinness) was present in 6.9, 2.6 and 4.2% of children according to Polish, French and U.S. references, respectively. A trend of decreasing overweight and increasing underweight through age classes was observed. CONCLUSION: The rates of underweight (thinness), overweight and obesity in Polish 7-9-year-old children calculated according to the national, French, U.S. and IOTF references were significantly different. Therefore even if the IOTF reference is considered superior for international epidemiological studies, population specific standards should probably coexist for clinical practice.     

2006年中国10省(区)农村婴幼儿体格发育不良影响因素分析

目的 了解中国10省(区)农村婴幼儿体格发育不良的影响因素.方法 采用多阶段分层整群随机抽样方法,对随机选取的吉林、山西、甘肃、新疆、江苏、四川、江西、湖南、广西和贵州10省(区)农村婴幼儿进行问卷调查和体检.结果 共调查婴幼儿58 926名,男女童分别占50.91％和49.09％.总低体重率为5.05％,生长迟缓率为10.49％,其中0～6月龄组最低(分别为1.97％和3.79％),24～ 36月龄组最高(分别为7.80％和16.83％).儿童年龄、性别、出生体重、孕周、父母文化程度与儿童体格发育状况有关,差异有统计学意义(P＜0.0001).结论 中国农村地区婴幼儿体格发育不良状况仍不乐观,且低出生体重是儿童体格发育的重要影响因素,应加强围产期保健.     

Self-reported general health and Body Mass Index: a U-shaped relationship?

Objectives

A sizable literature demonstrates an increased likelihood of self-reported poor health with increasing Body Mass Index (BMI). A U-shaped relationship between BMI and health is evident in research but it is not believed that the health of people who are underweight gets the attention it deserves. The relationship between BMI categories and poor general health including those persons who are underweight has been investigated.

Study design

Cross-sectional study.

Methods

Data were obtained from the Health Survey for England pooled for 2006–08 to provide a sample of 26,596 adults aged 16–74 in a series of binary logistic regression models to determine the likelihood of people reporting their general health as being poor.

Results

A clear U-shaped relationship between BMI and health has been found for controlling for individual level demographic, socio-economic and health-related behaviour variables and area deprivation.

Conclusions

The literature largely focuses on the relationship between obesity and health and this is understandable given that many more persons are obese than are underweight. A person who is underweight is about as likely to report poor general health as a person who is obese.     

Maternal pre-pregnancy underweight and fetal growth in relation to institute of medicine recommendations for gestational weight gain

Purpose

Maternal nutritional status is one of the most important factors of fetal growth and development. Consequently, the currently increasing prevalence of underweight women worldwide has come in the focus of interest of perinatal medicine. The aim of the study was to assess the effect of low pre-pregnancy body mass index (BMI) on fetal growth.

Materials and methods

Data on 4678 pregnant women and their neonates were retrospectively analyzed. Pre-pregnancy BMI of study women was categorized according to the WHO standards. Fetal growth was assessed by birth weight and birth length, birth weight for gestational age, and ponderal index.

Results

Study group included 351 (7.6%) women with pregestational BMI < 18.5 kg/m², while all women with pregestational BMI 18.5–25 kg/m² (n = 3688; 78.8%) served as a control group. The mean birth weight and birth length of neonates born to underweight mothers were by 167 g and 0.8 cm lower in comparison with the neonates born to mothers of normal nutritional status, respectively (P < 0.001 both). The prevalence of small for gestational age (SGA) births was twofold that found in the control group of mothers of normal nutritional status (9.7% vs. 4.9%; P < 0.001). The inappropriately low gestational weight gain additionally increased the rate of SGA infants in the group of mothers with low pre-pregnancy BMI (21.4% vs. 10.4%; P = 0.02). Pre-pregnancy BMI category did not influence neonatal growth symmetry.

Conclusion

Low maternal pregestational BMI is associated with fetal growth assessment. Improvement of the maternal nutritional status before pregnancy can increase the likelihood of perinatal outcome.     

Prevalence of overweight,obesity and low weight in the Czech child population up to 18 years of age in the last 50 years

Aim  The main purpose of the study was to analyze the changes in the prevalence of underweight, overweight, and obesity among Czech children and adolescents aged 3–18 within the last 50 years. The secondary purpose of the study was to determine the prevalence of overweight and obesity among children and adolescents in 2001 and compare it to the reference standards recommended by the International Obesity Task Force (IOTF). Subject and methods  Anthropometric data collected from nationally representative samples of 3–18-year-old children and adolescents in the Czech Republic in 1951, 1981, 1991, and 2001 were analyzed in the study. The prevalence of child overweight and obesity among Czech children using data from the most recent 2001 National Anthropological Survey was estimated using the 1991 Czech reference values and the IOTF standards. Results  There has been a gradual increase in the number of children in both extreme categories of BMI values in most age categories, including underweight (<10th percentile), overweight (>90th percentile), and obesity (>97th percentile) between 1951 and 2001. In both genders, the number of underweight children increased dramatically in the lowest age categories. At the same time, the rates of overweight and obesity increased among 6–11- and 11–15-year-old individuals. The prevalence of underweight has also increased among older adolescents. However, our study indicated that the 2001 prevalence of overweight/obesity among Czech adolescents, especially in older age categories and among girls, was lower compared to the 1991 reference values. Conclusion  Given the continuous increase in child obesity rates in the US and most of Europe, it is interesting that the prevalence of overweight and obesity has remained relatively low among children and adolescents in the Czech Republic. Given the increased number of Czech school-aged children with excess adiposity, a gradual rise in the prevalence of overweight and obesity among Czech adolescents could be expected.     

Associations of behavioural, psychosocial and socioeconomic factors with over- and underweight among German adolescents

OBJECTIVES: The prevalence of overweight and obesity has dramatically increased in western societies. This paper examines behavioural, psychosocial and socioeconomic factors associated with overweight and underweight among adolescents in Germany. METHODS: Data from the German part of the 2001/02 Health Behaviour in School-aged Children (HBSC) survey, composed of 5,650 respondents aged 11 to 17 years were analysed. Body mass index (BMI) was calculated based on self-reported weight and height. The overweight category was defined as BMI within or above the 90th percentile of specific BMI values for gender and age in the German national sample. The underweight category was defined as BMI within or below the 10th percentile of this sample. A multinomial logistic regression model was used to investigate the association between behavioural, psychosocial and socioeconomic factors and BMI categories. RESULTS: 9.5 % of the boys and 5.4 % of the girls were classified as overweight. The prevalence of underweight was 12.6 % among boys and 19.1 % among girls. Several factors were associated with over- and/or underweight in the bivariate analysis, showing different patterns for gender and BMI categories. In the multivariable model only low family affluence, high sedentary behaviour, and being bullied (for girls only) remained positively associated with being overweight. Being underweight was negatively associated with higher age and low parental occupation; it differed also by region. CONCLUSION: Despite several variables being associated with overweight and underweight in bivariate models, only three factors remained associated with overweight in multivariable analysis. Other considered variables did not have independent associations with the outcome, but still could be included in respective causal pathways. Our results suggest that preventive strategies focussing on students of low socio-economic status and the avoidance of sedentary behaviours could help to address issues of overweight and obesity.