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Prevalence and sociodemographic determinants of overweight in young French adolescents.

BACKGROUND: The prevalence of overweight in adults and in children is increasing in most industrialised countries. Our purpose is to estimate the prevalence of overweight and obesity in a population of 12-year-old French adolescents and to analyse its association with different sociodemographic factors. METHODS: A cross-sectional study was conducted in 2001 on a representative sample of sixth-grade adolescents (mean age 12.1 +/- 0.6 years) living in the Department of the Bas-Rhin (Eastern part of France). Height and weight were measured in 4326 adolescents. Overweight and obesity were defined as recommended by the International Obesity Task Force. Sociodemographic data were obtained for 3436 adolescents. RESULTS: The prevalence of overweight was 22.7% (17.5% of moderate overweight and 5.2% of obesity) and it was not different by gender or by size of the commune of residence. Overweight was more frequent in low economic zones (p < 10(-4) in girls, p < 10(-2) in boys) and in public schools than in private schools (p < 10(-3) in girls). The prevalence of overweight was inversely associated with family income tax (p < 10(-3) in girls, p = 0.012 in boys), mother's (p = 10(-4) in girls, p = 10(-3) in boys) and father's (p = 0.001 in girls, p = 0.004 in boys) educational level. Multiple logistic regression analysis indicated an independent association of being overweight with low family income tax (p = 0.2195) and poor mother's educational level (p = 0.0193). CONCLUSIONS: This study indicates that, as in other industrialised countries, much overweight and obesity are present in 12-year-old French adolescents. It suggests the existence of an influence of socio-economic factors with a predominant effect of the mother's educational level rather than the financial resources.

Adolescent↗

Effects of peanut oil load on energy expenditure, body composition, lipid profile, and appetite in lean and overweight adults.

OBJECTIVE: We evaluated the effects of peanut oil intake on appetite, energy expenditure, body composition, and lipid profile in lean and overweight adults. METHODS: In a parallel-arm, long-term feeding trial, lean and overweight participants received a daily peanut oil load in a milk shake equivalent to 30% of their resting energy expenditure for 8 wk. Forty-eight adults (24 lean and 24 overweight, 12 male and 12 female in each group) completed the protocol. Anthropometric indices, appetite, dietary intake, energy expenditure, and plasma lipids were monitored. RESULTS: Energy intake increased significantly in the overweight but not in the lean participants. A statistically significant body weight gain (median 2.35 kg) was also observed among the overweight subjects, although this corresponded to only 43% of the theoretical weight gain. Among overweight subjects, high-density lipoprotein cholesterol increased significantly and low-density lipoprotein cholesterol decreased at week 4, but neither concentration was significantly different from baseline at week 8. Similar, but less marked, changes were observed in lean subjects. Resting energy expenditure was 5% greater (P < 0.01) in the overweight group, but no significant difference was observed in the lean subjects. No marked differences of appetite were observed over time in either group or between overweight and lean participants. CONCLUSION: These data indicate that ingestion of peanut oil elicits a weaker compensatory dietary response among overweight compared with lean individuals. Body weight increased, albeit less than theoretically predicted. The weaker effect of whole nuts on body weight reported in previous studies suggests components other than oil may be responsible.

Adult↗

Acculturation and overweight-related behaviors among Hispanic immigrants to the US: the National Longitudinal Study of Adolescent Health.

Little is known about the factors underlying the striking increase in overweight occurring between first and second generation US immigrants. Using data from the National Longitudinal Study of Adolescent Health, this study addressed two goals. First, we determined which measures of acculturation (defined as the acquisition of dominant cultural norms by members of a non-dominant group) were important. Second, we determined how the acculturation process affected differences in overweight and its proximate determinants (e.g., physical activity, diet, and smoking) as immigrants acculturated to American society. In addition, we sought to elucidate the role of underlying structural factors (e.g., family income and crime) and acculturation factors (e.g., language spoken at home and proportion of foreign-born neighbors) in generation differences in overweight. Results showed clear structural and acculturation differences between foreign and US-born immigrants to the US. Foreign-born immigrants were more likely to have lower family income and maternal education, and to live in areas of higher immigrant density and greater linguistic isolation. In addition, results suggested rapid acculturation of overweight-related behaviors, such as diet, smoking, and inactivity, in US-born relative to foreign-born immigrants. Multivariate analysis indicated that longer US residence was associated with increased overweight among Puerto Ricans and Cubans. Predicted probabilities showed that controlling for acculturation and proximate factors increased overweight among foreign-born adolescents, but had minimal impact for US-born adolescents. Thus, without the beneficial pattern of: acculturation factors, diet, and physical activity, first generation Hispanic adolescents would have higher overweight prevalence. We found important generation differences in structural, acculturation, and proximate overweight determinants. These lifestyle differences between foreign- and US-born Hispanic adolescent immigrants are likely to underlie the striking increase in overweight prevalence between first and subsequent generation of US residence.

Acculturation↗

Geographic and demographic variation in the prevalence of overweight Canadian children.

OBJECTIVE: To examine the geographic and demographic variation in the prevalence of overweight Canadian children. RESEARCH METHODS AND PROCEDURES: Using BMI data from the 1981 Canada Fitness Survey and the 1996 National Longitudinal Survey of Children and Youth, this study assessed: 1). the prevalence of overweight and obesity among Canadian boys and girls ages 7 to 13 years; 2). secular trends in the prevalence of overweight from 1981 to 1996, by province and adjusted for age and sex; and 3). provincial variation in the prevalence of overweight, before and after adjusting for socioeconomic and demographic characteristics. RESULTS: The prevalence of boys and girls classified as overweight in 1996 was 33% and 26%, respectively. The corresponding figures for obesity were 10% for boys and 9% for girls. Provincial variation was observed with a trend of increasing risk of being overweight from west to east. Socioeconomic status was inversely related to the prevalence of overweight regardless of geographic region. The risk of being overweight was more related to geography (province) than demographic variables (income and family background); however, the effect of secular trends (1981 to 1996) exceeded the effect of geographic or demographic variables. DISCUSSION: The prevalence of childhood overweight and obesity is increasing in all areas of Canada and can be explained only partially by geographic or demographic characteristics.

Adolescent↗

Relationship of physical fitness to prevalence and incidence of overweight among schoolchildren.

OBJECTIVES: We examined the relationship between comprehensive fitness tests and overweight using a school surveillance system in a racially diverse city in the United States. RESEARCH METHODS AND PROCEDURES: Trained physical education teachers measured weight, height, and fitness annually from 2001 to 2003. We compiled data for a cross-sectional analysis (11,845 measurements on 6297 students, 5 to 14 years of age) and a 1-year prospective analysis (4215 measurements on 2927 students not overweight at baseline, 5 to 13 years of age). Overweight was defined as a BMI > or =95th percentile (Centers for Disease Control and Prevention 2000 growth charts), and underfit was defined as failing at least one of five fitness tests: endurance run, abdominal strength, flexibility, upper body strength, and agility (Amateur Athletic Union and Fitnessgram). Associations between fitness and overweight were examined using multivariate logistic regression models, adjusting for sociodemographic status and repeated measurements over time. RESULTS: The mean number of fitness tests passed was lower among students with a BMI above the 80th percentile. Overweight incidence over 1 year was 7% and 2% for underfit and fit girls, respectively (odds ratio, 3.3; 95% confidence interval, 2.0 to 5.6). Not passing either the endurance run or upper body strength test was associated with overweight incidence in both boys and girls. After adjusting for baseline BMI, the endurance run remained a significant predictor of incident overweight among girls (odds ratio, 2.0; 95% confidence interval, 1.1 to 3.5). DISCUSSION: Findings support a cross-sectional inverse relationship between physical fitness and overweight among school-aged children. The direction of causation between fitness and overweight is not clearly established and merits further study.

Adolescent↗

Implications of the prevalence of stunting, overweight and obesity amongst South African primary school children: a possible nutritional transition?

OBJECTIVE: To investigate the relationship between stunting and levels of overweight/obesity among South African school children, using two definitions of overweight and obesity, based on the WHO and International Obesity Task Force (IOTF) criteria. DESIGN: Cross-sectional descriptive analysis of the nutritional status of primary school children, using primary data from a rural community-based study undertaken in 1995 and secondary data from the South African National Primary Schools (SANPS) survey conducted in 1994. Stunting was measured according to the WHO definition of -2 Z scores height-for-age. Two sets of criteria were used to measure overweight and obesity-the WHO/NCHS standard based on the 85th and 95th centiles and the IOTF criteria. SETTING: The primary data source was from a rural KwaZulu-Natal community based survey. The secondary data source SANPS consisted of data at National and Provincial level; for this study only data from the province of KwaZulu-Natal was considered. SUBJECTS: Primary school children aged between 8 and 11 y of age; 802 from the primary data source and 24 391 from the secondary source. RESULTS: Moderate stunting ranged from 2.9 to 40.2%, and mild stunting ranged from 31.4 to 75%. The prevalence of overweight ranged from 0.4 to 13.3% (WHO criteria) and from 0.4 to 11.9% using the IOTF criteria; while obesity ranged from 0.1 to 3.7% (WHO) and from 0.1 to 1.5% (IOTF criteria). The prevalence of overweight and obesity was observed to be higher using the WHO definition than that of IOTF (0.05 0.55, in all cases). The levels of agreement in all cases were less for obesity than overweight (both ranged from 0.55 to 1.0). Females were observed to have higher kappa levels than their male counterparts; they also had higher prevalence levels of overweight and obesity across age and geographical group. Uniformly high levels of both mild and moderate stunting were observed both nationally and provincially. However, no excess relative risk of being overweight if stunted was observed in this study (P>0.05). CONCLUSIONS: Caution must be applied when using either definition for obesity. However, very high levels of agreement occur for overweight. There is no obvious relationship between overweight and stunting in this study, but high levels of mild stunting were observed. Regular clinical and epidemiological monitoring of nutritional status needs to be undertaken in South Africa to examine possible future trends of overweight/obesity and their relationship with stunting, and for comparisons with global trends.

Age Distribution↗

Determinants of overweight tracking from childhood to adolescence: a 5 y follow-up study of Hat Yai schoolchildren.

OBJECTIVE: To study the determinants of overweight tracking from childhood to adolescence of Hat Yai schoolchildren. DESIGN: A longitudinal study. SETTING: Primary and secondary schools of Hat Yai municipality, southern Thailand. SUBJECTS: 2252 schoolchildren recruited in 1992 and follow-up for 5y. MEASUREMENTS: Child's annual body mass index (BMI, kg/m2) from 1992 to 1997; parental BMIs, parental income, and family history of diseases by a questionnaire completed by parents in 1992. RESULTS: Prevalence of overweight of males using the 85th percentile of the U S First National Health and Nutritional Examination Survey reference for age and sex as a cut-off point increased from 12.4% in 1992 to 21% in 1997, whereas that of females went down from 15.2 to 12.6. At the end of the fifth year, 11.8% of children remained overweight while 4.5% became overweight. Comparing to the non-overweights, the risk for becoming an overweight adolescent of an overweight boy was 8.2 (95% confidence interval (CI) = 6, 11.2) whereas that of the overweight girls was 20 (95% CI = 12.4, 32.3). The generalized estimating equations model predicted an increase in child BMI associated with having a father or a mother with high BMI, a family history of obesity, a monthly income greater than 5000 baht, and a lower level of exercise than their peers. Secular increase in BMI was also observed. CONCLUSION: Predictors of overweight tracking found in this study would be useful to select children at risk for preventive intervention.

Adolescent↗

Overweight at age 21: the association with body mass index in childhood and adolescence and parents' body mass index. A cohort study of New Zealanders born in 1972-1973.

BACKGROUND: Obesity is an increasing problem so understanding the association between childhood and adolescent measures of body mass index (BMI) and being overweight at age 21 has implications for treatment or strategies to reduce its prevalence. OBJECTIVE: To examine the association between measures of BMI in childhood and adolescence and parents' BMI and being overweight at age 21. DESIGN: The study was based on a birth cohort born in Dunedin, New Zealand in 1972-1973. RESULTS: BMI tracked from childhood to early adulthood. The point on the BMI distribution where the probability of being overweight at age 21 was 0.5 was close to the 75th centile for boys throughout childhood and adolescence. It was rather higher for girls in childhood but similar in adolescence. Boys with a BMI above the 75th centile at age 7 were more than 4.0 times more likely to be overweight at age 21 than those with a BMI below the median. The relative risk for girls was 3.2. By age 15 this increased to 9.8 for males and 6.8 for females. Having overweight parents, particularly a mother, increased the likelihood of being overweight. Only 40% of those who were overweight at age 21 could be identified by age 7 and 25% were not identified until they were at least 15. CONCLUSION: Although a high BMI in childhood predicts being overweight at age 21, many of those who were overweight at age 21 had a BMI below the 75th centile or even the median in childhood and early adolescence. Population strategies, complemented by an individual approach for those above the 75th centile, are needed to reduce the average BMI of the population.

Adolescent↗

Prevalence of overweight in a triethnic pediatric population of San Antonio, Texas.

OBJECTIVES: To investigate the prevalence of overweight among different ethnic and gender groups of children and adolescents in the San Antonio, Texas, area and to compare the prevalence with that of the US national figures. DESIGN: Cross-sectional study SUBJECTS: A total of 7208 schoolchildren in kindergarten through 12th grade. There were 4215 Mexican American (MA) (58.5%), 2040 non-Hispanic white (NHW) (28.3%) and 953 African American (AA) (13.2%) subjects. MEASUREMENTS: Weight, height and skinfold thicknesses. RESULTS: The body mass index (BMI, kg/m2) values of MA boys were almost consistently and significantly (P<0.05) larger than NHW boys and showed a tendency to be larger than AA boys, beginning as early as age 6 and continuing through age 17. Although rarely significant, a similar trend in ethnic difference was also noted for girls, with the smallest BMI seen in NHW girls. The subscapular skinfold thickness (SST) for MA boys and girls was significantly (P<0.05) larger than that for NHW counterparts and showed a tendency to be larger than AA counterparts. No significant ethnic differences were present in the triceps skinfold thickness (TST) for girls, but MA boys' TST were occasionally larger (P<0.05) than other ethnic-gender groups. Girls' TST were frequently larger (P<0.05) than boys for each ethnic groups. Using the population data from the National Health and Nutrition Examination Survey (NHANES) I as reference, the prevalence of overweight (BMI> or =95th percentile) was greater in MA (15-28%) and AA (11-29%) boys and girls than in NHW (7-17%) counterparts. The combined prevalence of overweight and 'at risk of overweight' (BMI>85th percentile) was much larger in MA boys (40-50%), MA girls (34-52%), and AA girls (33-51%) than other subgroups. The onset of overweight is quite early, starting at 5-6 y of age, especially in girls. Compared to the data from national surveys, the prevalence of overweight found in this study is higher than reported nationally. We found a marked increase in the skinfold thickness, especially SST for boys, but the increase is less for girls. CONCLUSIONS: The prevalence of overweight is higher in MA boys and girls and AA girls than other ethnic-gender groups in the San Antonio, Texas, area. The prevalence of childhood overweight in the San Antonio area is higher than national figures. The findings of increasing prevalence and early onset of childhood overweight are concerning, because these are known risk factors for diabetes and diseases of many other organ systems. Measures to prevent, reduce or treat childhood obesity are urgently needed.

Adolescent↗

Neighbourhood deprivation and overweight: the GLOBE study.

BACKGROUND: Increasing morbidity and mortality rates of coronary heart disease (CHD) by increasing levels of neighbourhood deprivation may be explained by a positive association between neighbourhood deprivation and risk factors of CHD. In this study we investigated the association between neighbourhood deprivation and overweight. Further, we examined whether this association was modified by educational level, age and sex of the neighbourhood residents. METHODS: Data were used from 8897 subjects who participated in the baseline measurement of the Dutch GLOBE Study in 1991 and lived in 86 neighbourhoods of the fifth largest city in The Netherlands (Eindhoven). Neighbourhood deprivation was based on aggregated self-reported information about educational and occupational level and employment status. Self-reported body height and body weight were used to define overweight body mass index ((BMI) >or=25). RESULTS: Adjusted for educational level, age and sex of neighbourhood residents, odds ratios of overweight increased significantly by increasing neighbourhood deprivation (odds ratio=1.20, 95% CI 1.02, 1.41 in the highest vs lowest quartile of neighbourhood deprivation). Stratified analyses showed a stronger association between neighbourhood deprivation and overweight in females compared to males, and in older (>or=49 y of age) compared to younger participants. The pattern of increasing odds ratios of overweight by neighbourhood deprivation was generally similar in all educational groups, the highest educational group being the exception with no association between neighbourhood deprivation and overweight. CONCLUSIONS: Increased prevalence rates of overweight in more compared to less deprived neighbourhoods are likely to contribute to the positive association between neighbourhood deprivation and CHD. Our results justify the development of a community-based strategy of primary prevention of overweight in deprived neighbourhoods, which may have a larger impact in females and older residents in particular. Prior to implementation, however, longitudinal research needs to further examine responsible mechanisms for the development of neighbourhood inequalities in overweight.

Adolescent↗

Body mass index in 7-9-y-old French children: frequency of obesity, overweight and thinness.

OBJECTIVE: To assess the frequency of different grades of nutritional status (obesity, overweight and thinness) in French children aged 7-9 y using four current definitions based on body mass index (BMI). METHODS: Data were collected in 2000 in a randomly selected sample of French children following the protocol recommended by the European Childhood Obesity Group (ECOG). After computing the BMI (weight/height squared), four references were used to define grades of nutritional status: (1) the French references to define thinness and overweight (3rd and 97th percentiles respectively); (2) the Must et al references to define thinness, overweight and obesity (5th, 85th and 95th percentiles respectively); (3) the International Obesity Task Force cut-offs to define overweight and obesity; and (4) the Center for Disease Control 2000 references to define thinness, overweight and obesity (5th, 85th and 95th percentiles respectively). RESULTS: Age and gender standardized frequencies were estimated in 1582 children. According to the French, Must et al, IOTF and CDC references, overweight (including obesity) affected 16.3, 23.9, 18.1 and 20.6% of children, respectively; obesity affected 9.3, 3.8 and 6.4% of children according to the Must, IOTF and CDC references, respectively. Thinness was present in 3.9, 6.0 and 6.0% of children according to the French, Must and CDC references. Whatever the definition, little difference was observed between sexes. Through age classes, as a rule, overweight and obesity tended to decrease while thinness tended to increase. CONCLUSION: The present study revealed an increasing prevalence of overweight in comparison with previous French data and a trend for increasing prevalence of thinness. The IOTF-based prevalence of overweight (including obesity) in 2000 in France was similar with the prevalence recorded in the late 1980s in the USA and the prevalence of obesity in 2000 in France was similar to the prevalence of obesity in the late 1970s in the USA. Data in France are comparable to those reported in other studies conducted in Western Europe. This study provides baseline information for analysis of time trends and for geographical comparisons.

Body Mass Index↗

Food behaviors and other strategies to prevent and treat pediatric overweight.

OBJECTIVE: To summarize the evidence for the following six strategies to prevent or treat overweight among children: promoting breastfeeding, promoting physical activity, reducing TV/video viewing, increasing fruit and vegetable consumption, reducing sugar-sweetened drink consumption, and reducing portion sizes. METHODS: Summarization of the relevant literature including review articles, relevant newly published work, the Institute of Medicine's Report on Preventing Childhood Obesity and the Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity, 2001. This is not a comprehensive review. RESULTS: Evidence for the association between each strategy and overweight varies. For breastfeeding, physical activity, and TV viewing, there are large review studies. Breastfed children may have a small reduction in risk for overweight. Participation in physical activity may reduce the risk of overweight among school-aged children and adolescents. For preschool- and school-aged children, reducing TV viewing time may reduce their risk of overweight, but most studies report small significant associations. Evidence for an association between each dietary factor and overweight is limited and inconclusive. The biggest gaps in evidence are for the effectiveness of interventions using these strategies. The reviewed interventions based on increasing physical activity (n=7) were effective. Two randomized trials suggest that reducing TV viewing reduces overweight. No intervention studies were found that examined the effectiveness of changing fruit and vegetable consumption, sugar-sweetened drink consumption, or portion sizes. Further clarification of the effect of breastfeeding on obesity is needed. CONCLUSIONS: These six strategies are reasonable ways to attempt prevention or treatment of overweight in children. Strength of the evidence varies by strategy. The key finding is that more applied research is needed to determine the effectiveness of these and other strategies.

Beverages↗

LEPR gene polymorphisms: associations with overweight, fat mass and response to diet in women.

BACKGROUND: In humans, a mutation of the leptin receptor gene (LEPR) leads to a rare obese syndrome of mendelian inheritance. However, obesity in humans results from interactions between genes and environment, mainly nutritional factors. Variations at the LEPR locus could be involved in the regulation of body weight. DESIGN: Genetic variations at the LEPR locus were screened in a selection of 30 French overweight subjects by Single Strand Conformation Polymorphism (SSCP) analysis, then an association study between genotypes and obesity phenotypes was performed in 179 French overweight patients recruited from the Nutrition Department of Bichat Hospital in Paris who were prescribed a low calorie diet and in 387 unrelated volunteers (98 overweight, 289 normal weight) drawn from the Stanislas Family Study in Nancy. RESULTS: Two new genetic variants were found: T + 70-->C (exon 1) and Asp (A) 96 Asp (G) (exon 4). In Nancy, the T + 70-->C polymorphism was associated with fat mass adjusted for BMI in women (P = 0.025). The genotype and allele frequencies of the Ser (T) 343 Ser (C) polymorphism (exon 9) were significantly different between normal and overweight women, with the T allele being more frequent in the overweight group (T frequency in Nancy, 0.82; in Nancy + Paris, 0.79) than in the normal weight group (0.69; P = 0.017 vs. Nancy overweight, P = 0.003 vs. Nancy + Paris overweight). In women from Nancy, fat mass adjusted for BMI was significantly associated with this polymorphism (P = 0.01). The overweight women carrying the C allele of this polymorphism lost more weight in response to low calorie diet than the non carriers (P = 0.006). CONCLUSIONS: In women, genetic variations at the LEPR gene level are associated with overweight and fat mass in a cross sectional study and with response to low calorie diet in an intervention study. These results indicate that variations at the leptin receptor locus are associated with common obesity phenotypes and are a part of the polygenic influences on the response to nutritional environment.

Adipose Tissue↗

Dietitians' views of overweight and obese people and reported management practices.

OBJECTIVES: To examine dietitians' views of overweight and obese people, to explore the role of level of severity on these perceptions (overweight vs. obesity), and to explore the relationship between dietitians' views and their reported weight management practices. DESIGN: An independent measures survey, questioning dietitians about either overweight or obese people. PARTICIPANTS: One-hundred and eighty-seven members of the British Dietetic Association. MEASUREMENTS: A questionnaire exploring beliefs about the causes, attitudes, perceptions of responsibility and reported weight management practices. RESULTS: Physical inactivity was identified as an important causative factor for both overweight and obesity. Mood, eating too much of the wrong foods, repeated dieting and interpersonal factors were also seen as relatively important for both groups. Attitudes were mixed, but were generally neutral to positive. The most negative attitudes were described in terms of perceived reduced self-esteem, sexual attractiveness and health. Dietitians rated obese people more negatively than overweight people. They viewed both overweight and obese people as being responsible for their excess weight. They also reported very similar management practices for overweight and obese people. Beliefs about the causes of overweight explained more of the variance in practice than dietitians' attitudes towards or perceived responsibility of overweight and obese people. However, these associations were not consistent and strong, and other factors not investigated here are likely to have a greater influence on weight management practices.

Affect↗

The effect of being overweight on survival in endometrioid carcinoma of the endometrium at different ages.

The effect of being overweight on survival in endometrioid carcinoma of the endometrium was examined at different ages in this article. The body mass index [body weight/height(m2)] was evaluated in 287 Japanese women with endometrioid carcinoma. Overweight individuals were defined as those with a body mass index of 24.5 or more. The subjects were divided into two groups, including a younger age group (women less than 50 years of age) and an older age group (women 50 years of age or more). Being overweight was thus analyzed to see if it had any influence on survival. The body mass index ranged from 15 to 40 (mean +/- SD; 23.0 +/- 3.9). Twenty-six (32.1%) of 81 subjects in the younger age group and 78 (37.9%) of 206 subjects in the older age group were found to be overweight. In the younger age group, we could find no effect of being overweight on survival. In the older age group, the cumulative 10-year survival rate was 75.2% in normal weight subjects and 89.4% in overweight subjects (P < 0.02). However, the histologic grade, depth of myometrial invasion, cervical invasion, lymphovascular invasion, ovarian metastases, and lymph node metastases showed no significant difference between normal weight and overweight subjects in both the younger and older age groups. In a multivariate analysis, being overweight was a better independent prognostic factor in older age group. Being overweight may contribute to the heterogenous etiology of endometrioid carcinomas in the older age group.

Journal Article↗

Comparison of dietary and non-dietary risk factors in overweight and normal-weight Chinese adults.

The aim of the present study was to compare the differences in dietary and non-dietary factors contributing to normal weight and overweight among urban Chinese adults. Two cross-sectional population surveys were carried out in Tianjin, one of the largest cities in China. A total of 2631 subjects aged 25-64 years were selected by random stratified cluster sampling; 398 men and 490 women were overweight, and 886 men and 857 women were of normal weight. The diet was assessed by food weighing plus consecutive individual 3 d food records. Health-related behaviours and anthropometry were assessed. The overweight group had significantly higher mean daily intakes of energy and carbohydrate than the normal-weight group. Overweight men also had significantly higher mean daily intakes of protein and fat than normal-weight men. Age, daily intakes of energy and carbohydrate, and marital status were positively associated with overweight, while occupational and commuting physical activity, as well as smoking, were inversely associated with overweight among both genders. Daily intakes of protein, fat and alcohol were positively related to the incidence of being overweight among men. People with 7-12 years education were more likely to be overweight compared with those with less than 6 years of education. High intakes of energy and carbohydrate among both genders, as well as high intakes of protein and fat among men, and lower levels of occupational and commuting physical activity, being a non-smoker, and partly higher socio-economic status were related to a greater incidence of being overweight in this population.

Adult↗

Increasing prevalence of overweight in young schoolchildren in Umeå, Sweden, from 1986 to 2001.

AIM: To investigate the current prevalence and trend of overweight in young schoolchildren in Umeå, Sweden. METHODS: Two cross-sectional samples of children were studied: 1115 randomly selected children from preschool class to grade 6 (aged 6-13 y) attending school in 2001 and a matched sample of 507 schoolchildren from grades 0, 1 and 4 (aged 6-11 y) attending school in 1986. Overweight was defined according to age- and gender-specific body mass index (BMI) cut-off values, corresponding to BMI values of 25 kg/m2 (level 1) and 30 kg/m2 (level 2) at late adolescence. RESULTS: In the population from 2001, the prevalence of overweight was 23% (18% at level 1, 5% at level 2). The prevalence differed with age, with a higher prevalence at the ages of 6 and 13 y. Comparing children from grades 0, 1 and 4, attending school in 1986 and 2001, respectively, the total prevalence of overweight was twice as high in 2001 as in 1986. Regarding severe overweight (level 2), the difference was even larger (five times). In the 1986 sample, the prevalence of overweight did not differ between girls and boys, while significantly more girls than boys were overweight in 2001. CONCLUSION: In this sample of young children from Sweden, the prevalence of overweight doubled over the past 15 y and severe overweight increased even more, suggesting a need for intensified preventive efforts in young schoolchildren.

Adolescent↗

Like mother, like daughter: familial patterns of overweight are mediated by mothers' dietary disinhibition.

BACKGROUND: Obese parents are more likely to have obese children. Parents provide both the genes and eating environment for their children and familial patterns of adiposity are the result of gene-environment interactions. Environmental factors are implicated in the rapid increases in prevalence of childhood overweight that have occurred in the past 2 decades. Examination of aspects of the family environment may provide insight into increases in childhood overweight over time. OBJECTIVE: We examined parental characteristics associated with overweight and eating behaviors in preschool children. DESIGN: Seventy-five preschool children and their parents were recruited from local daycare centers. Information was obtained on parents' body mass indexes (BMIs), dietary restraint, and dietary disinhibition. A behavioral index of disinhibited eating in children was used to measure children's eating when given free access to palatable snack foods in the absence of hunger. Children's weight-for-height values were also calculated. RESULTS: Maternal dietary disinhibition (R2 = 0.35, P < 0.01) and maternal BMI (R2 = 0.19, P < 0.05) positively predicted daughters' overweight. Maternal disinhibition (R2 = 0.35, P < 0.05) mediated the relation between mothers' BMI and daughters' overweight when both maternal disinhibition and maternal BMI were used to predict daughters' overweight. Furthermore, when both mothers' disinhibition and daughters' free access intakes were used to predict daughters' overweight, mothers' disinhibition (P < 0.05) showed independent prediction. CONCLUSIONS: These findings suggest that familial influences on child overweight differ according to parent and child sex. Also, these results suggest that mothers' dietary disinhibition mediates familial similarities in degree of overweight for mothers and daughters.

Adult↗