Premature adiposity rebound in children treated for acute lymphoblastic leukemia

The adiposity rebound (AR), when body mass index begins to increase after its nadir in childhood, is a critical period for the regulation of energy balance and adult obesity risk. The aim of the present study was to test whether children treated for acute lymphoblastic leukemia (ALL) experience premature AR. This might, in part, explain their tendency to develop obesity. Timing of AR was assessed by visual inspection of body mass index plots in 68 patients treated for ALL in first remission. This sample comprised all eligible patients treated in Scotland between 1991 and 1998, age 30 months or less at the time of diagnosis. Timing of AR in patients was compared against a cohort of 889 healthy British children studied during the 1990s using the same method. AR occurred significantly earlier in the patients treated for ALL (chi(2) test, P < 0.001). The AR had occurred in 43% (29 of 68) of the patients and 4% (40 of 889) of the comparison group by age 37 months. At 49 months AR had occurred in 81% (55 of 68) of the patients and 21% (190 of 889) of the comparison group. Treatment of ALL is associated with a significantly advanced AR. This might, in part, explain the extremely high prevalence of obesity in long-term survivors. Clinical management should focus on minimizing excess weight gain during therapy to reduce long-term obesity risk.     

A study of malnutrition in Iranian patients with primary antibody deficiency

Nutrition is an important factor that influences immunity, and nutritional deficiencies can impair resistance to infections. Malnutrition is the most common cause of immunodeficiency worldwide. Trace elements such as zinc, selenium, iron, and copper can influence several components of immunity. Primary antibody deficiency disorders are a group of disorders characterized by an unusual susceptibility to infections and malnutrition. Impaired nutritional status has been reported in immunodeficient patients. The aim of this study was to determine anthropometric indices and trace elements status in these patients. Thirty-eight children (28 males, 10 females, aged 2-18 years) with primary antibody deficiency referring to Children's Medical Center of Tehran University of Medical Science were enrolled in this research. Primary immunodeficiency disorders consisting of CVID, XLA, IgA deficiency, IgG subclass deficiency, and hyper IgM were assessed. Anthropometric indices, comprised of height, weight that were measured and body mass index (BMI) was calculated. Height-for-age (HAZ), weight-for-height (WHZ) and weight-for-age (WAZ) were determined according to Z-score to study mild, moderate and severe malnutrition. Serum copper, zinc, selenium and iron levels were measured by an atomic absorption spectrometer. The most common disorders were CVID 52.5% and X-linked agammaglobulinaemia 27.5%. Based on BMI measurements 21.1% of patients had malnutrition. According to HAZ, 13.2%, 13.2% and 36.8% had severe, moderate and mild malnutrition, respectively. According to WAZ, 10.5%, 18.4% and 28.6% had severe, moderate and mild malnutrition, respectively. Regarding to WHZ, 14.3% and 28.6% had moderate and mild malnutrition, respectively. Low selenium levels and high copper levels were observed in 37.5% and 70.3%, respectively. Anthropometric data showed that the frequency of malnutrition in these patients was higher than the CDC standard. Low serum selenium levels and high serum copper levels were observed, suggesting further research is needed on these parameters. Most of the patients had serum zinc and iron levels within the normal range. It is recommeded that clinical immunologists and nutritionists should make a collective effort to provide these patients with standard or specialized diets so as to decrease the risk of infection.     

Obesity in Iranian children.

We surveyed 4315 2-5 year olds in Iran. Prevalence of obesity (BMI >95th centile, Iranian reference data) was compared with the recent "IOTF" approach. Prevalence was significantly higher than expected, and increased with age, but contradictory trends were obtained from the two approaches. Monitoring of childhood obesity using the BMI in developing countries is indicated, but differences associated with obesity definition should be considered.     

Household Food Insecurity May Predict Underweightand Wasting among Children Aged 24–59 Months

The aim of this study was to examine the association between household food insecurity and nutritional status among children aged 24–59 months in Haromaya District. Children (N = 453) aged 24–59 months were recruited in a community-based cross-sectional survey with a representative sample of households selected by a multistage sampling procedure in Haromaya District. Household Food Insecurity Access Scale and anthropometry were administered. Multinomial logistic regression models were applied to select variables that are candidate for multivariable model. The prevalences of stunting, underweight, and wasting among children aged 24–59 months were 61.1%, 28.1%, and 11.8%, respectively. The mean household food insecurity access scale score was 3.34, and 39.7% of households experienced some degree of food insecurity. By logistic regression analysis and after adjusting for the confounding factors, household food insecurity was significantly predictive of underweight (AOR = 2.48, CI = 1.17–5.24, p = .05) and chronic energy deficiency (AOR = 0.47, CI = 0.23–0.97, p = .04) and marginally significant for wasting (AOR = 0.53, CI = 0.27–1.03, p = .06). It is concluded that household food security improves child growth and nutritional status.     

Iron-fortified flour: can it induce lipid peroxidation?

This community-based study was conducted to evaluate the effects of iron-fortified bread consumption on certain biomarkers of oxidative stress in an apparently healthy population. Evaluation of food intake, anthropometric and laboratory variables was performed in the beginning and after the 8-month intervention for all participants. There was no significant change in oxidative stress biomarkers in women following 8 months intervention. However, in men, final values of total antioxidant capacity, compared to the initial ones, showed a significant decrease in (p?=?0.01) which was accompanied by a significant increase in superoxide dismutase (p?=?0.002). It could be concluded that although the short-term period (8 months) of extra iron intake did not show severe effects of lipid per oxidation, significant changes of serum iron and some oxidative stress indices suggested that fortification of flour with iron among non-anemic adults in the long term was not without adverse effects.     

Perception of Weight and Health Status among Women Working at Health Centres of Tehran

Perception of body-weight status is an important determinant of weight-related behaviours and may affect the burden of weight disturbances as a public-health problem. No study has assessed self-perception of the weight status regarding body-fat distribution among health workers to date. The aim of this study was to evaluate the association of the perception of weight and health status among 542 women working at health centres of Tehran. We assessed their perceived body-weight and health status and measured waist- and hip-circumference, weight, and height to calculate waist-to-hip ratio (WHR) as a measure of fat distribution and body mass index (BMI, kg/m²). Women reported their sociodemographic information, and the perceived weight and health status were compared with their actual fatness status, defined based on WHR and BMI, to determine misperception of weight status. Multivariate logistic regression models were performed to assess the predictive effects of various sociodemographic factors and actual fatness on the perception of weight and health status. The results showed that more than 40% of women with normal BMI overestimated their body-weight status while only 15.8% of these women had central obesity. BMI was the most important variable associated with misperceived weight status as normal-weight women had significantly more misperception (OR 8.16, 95% CI 4.82-13.82) than overweight/obese women. WHR did not show any significant relationships with perceived weight status. In addition, perception of health status was not associated with actual fatness indices. It is concluded, BMI was the main predictor of the perception of weight status in female employees. The importance of using body-fat distribution in the perceptions of weight and health status should be emphasized.Key words: Body mass index, Health centres, Perception of health status, Perception of weight status, Waist-to-hip ratio, Iran     

Obesity in Iranian children

We surveyed 4315 2-5 year olds in Iran. Prevalence of obesity (BMI >95th centile, Iranian reference data) was compared with the recent "IOTF" approach. Prevalence was significantly higher than expected, and increased with age, but contradictory trends were obtained from the two approaches. Monitoring of childhood obesity using the BMI in developing countries is indicated, but differences associated with obesity definition should be considered.     

Coexistence of social inequalities in undernutrition and obesity in preschool children: population based cross sectional study

Aims: To test for the coexistence of social inequalities in undernutrition and obesity in preschool children. Methods: Retrospective, cross sectional, study of routinely collected data from 74 500 children aged 39–42 months in 1998/99. Main outcome measures were weight, height, sex, and age routinely recorded by health visitors. Body mass index (BMI) standardised for age and sex, relative to UK 1990 reference data, was used to define undernutrition (BMI <2nd centile) and obesity (BMI >95th centile; BMI >98th centile). Social deprivation was assessed as Carstairs deprivation category (1 = most affluent to 7 = most deprived). Results: Both undernutrition (3.3%) and obesity (8.5% above 95th centile; 4.3% above 98th centile) significantly exceeded expected frequencies from UK 1990 reference data. Undernutrition and obesity were significantly more common in the more deprived families. Odds ratios in deprivation category 7 relative to category 1 were 1.51 (95% CI 1.22 to 1.87) for undernutrition (BMI <2nd centile) and 1.30 (95% CI 1.05 to 1.60) for obesity (BMI >98th centile). The cumulative prevalence of under and overnutrition (malnutrition) in the most deprived group was 9.5% compared to 6.9% in the least deprived group. Conclusions: Undernutrition and obesity are significantly more common than expected in young children and strongly associated with social deprivation. Both undernutrition and obesity have adverse short and long term health effects. Public health strategies need to tackle malnutrition (both undernutrition and obesity) in children and take into consideration the association with social deprivation.