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PubMed2006

Rapid infant weight gain predicts childhood overweight.

OBJECTIVE: To determine among a contemporary cohort whether rapid weight gain between birth and 6 months is associated with risk of childhood overweight and if this risk differs by ethnicity and/or breast-feeding history. RESEARCH METHODS AND PROCEDURES: This was a cross-sectional survey in 1999 to 2000 of parents/guardians of children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children in New York State. Measurements were abstracted by chart review, including weight at birth and 6 months, and height and weight at time of survey and every 6 months subsequently. Overweight at 4 years of age was defined as a BMI > or = 95th age- and sex-specific percentiles. RESULTS: The study sample was 32% Hispanic, 19% black, and 49% white; 17% of children were overweight. Rate of infant weight gain (expressed in terms of 100 g/mo) was significantly associated with being overweight at 4 years (odds ratio, 1.4; 95% confidence interval, 1.3 to 1.6 after adjusting for history of breast-feeding, birth weight, and ethnicity). The odds of being overweight at 4 years of age for Hispanic children were twice those of non-Hispanic children (odds ratio, 2.2; 95% confidence interval, 1.5 to 3.3). The population-attributable risk of overweight at 4 years of age was 19% for children in the highest quintile of infant weight gain. DISCUSSION: Among this contemporary, multi-ethnic cohort, rapid infant weight gain was associated with increased risk of being overweight at 4 years of age, independently of potential confounders. Identification of the risk factors contributing to rapid weight gain during infancy might improve early recognition and guide strategies for optimal nutrition to prevent the development of childhood overweight.

Body Weight↗

PubMed2006

Burden of overweight in Germany: prevalence differences between former East and West German children.

BACKGROUND: Given the increasing prevalence of childhood overweight, we aimed to quantify the population burden and evaluate potential regional differences in anthropometric characteristics and prevalence of overweight in fourth graders in two German cities. METHODS: Data were analysed from a cross-sectional school-based study conducted in 1995-96 in Dresden (former East Germany) and Munich (former West Germany) as part of the International Study of Asthma and Allergies in Childhood. Height and weight of the children were measured, and the parents completed a questionnaire. 2474 children age 9-10 years provided anthropometric data. Overweight was defined based on the age-specific and gender-specific international cut-off values for body mass index. RESULTS: Dresden children were on average 1.2 kg lighter and >1 cm taller than their Munich peers. The prevalence of overweight in Dresden was 15.2% in girls and 14.2% in boys compared with 24 and 22.2%, respectively, in Munich. Differences were observed between Dresden and Munich with respect to the proportion of children of non-German nationality, household smoking, breastfeeding practices, and individual dietary behaviours. Even in combination these factors were not able to explain entirely the between-city overweight differences. CONCLUSIONS: A substantial proportion of pre-adolescent children in Germany is now considered overweight with marked regional differences in prevalence. Comparison of population-level factors indicate that other unmeasured determinants of overweight may be responsible for the marked differences in the prevalence of overweight.

Body Mass Index↗

PubMed2006

Overweight children reduce their activity levels earlier in life than healthy weight children.

OBJECTIVE: To determine differences in the time overweight and nonoverweight youth spend on light, moderate, hard, and very hard activity plus gender and age differences in activity patterns. DESIGN AND SETTING: This study was a cross-sectional design in a primary care hospital. PARTICIPANTS: A total of 197 children and adolescents (4-16 years) participated. The overweight group (n = 107) were on a waiting list for an obesity treatment program and were defined as overweight, with a body mass index >95th percentile, and the nonoverweight group (n = 90) were volunteers recruited via advertisements and had a body mass index <75th percentile. INTERVENTIONS AND OUTCOME MEASUREMENTS: To determine activity patterns and perception of activity level, an interview was conducted with the child and a parent using a validated 7-day recall. Body fat was measured with bioelectrical impedance. RESULTS: There was a negative correlation between adiposity and total amount of activity performed, with the amount of moderate activity the best predictor of obesity. Girls did less activity than boys whether overweight or not. Between the ages of 4 and 7 years, overweight and nonoverweight subjects did similar amounts of activity. In the older subjects, the activity of the overweight was less than in nonoverweight. The overweight subjects perceived themselves to be just as active as others their same age and sex. CONCLUSIONS: Clinicians need to be aware that overweight children and adolescents are less active than nonoverweight children at an earlier age, particularly females, but feel that their activity level is similar to that of nonobese children.

Activities of Daily Living↗

PubMed2005

Identification and management of overweight and obesity by internal medicine residents.

BACKGROUND: Obesity is a major cause of morbidity and mortality in the United States. OBJECTIVE: To assess how frequently Internal Medicine residents identify and manage overweight and obese patients and to determine patient characteristics associated with identification and management of overweight compared with obesity. DESIGN: A cross-sectional medical record review. PATIENTS: Four hundred and twenty-four overweight or obese primary care patients from 2 Internal Medicine resident clinics in Connecticut. MEASUREMENTS: Measurements included the frequency with which obese and overweight patients were identified as such by their resident physicians, patient demographics, and co-morbid illnesses, as well as use of management strategies for excess weight. RESULTS: In this population of obese and overweight patients, obese patients were identified and treated more often compared with overweight patients (76/246%, 30.9% vs 12/178%, 7.3% for identification, P=.001, and 59/246%, 24.0% vs 11/178%, 6.2% for treatment, P=.001). Overall, only 70/424 (17%) of patients received any form of management. Only higher body mass index (BMI) (BMI> or =30 kg/m2 compared with BMI 25-29.9 kg/m2) was independently associated with identification of overweight or obesity (odds ratio 7.51%, 95% confidence interval [CI] 3.76 to 15.02) or with any management for excess weight (odds ratio 4.79%, 95% CI 2.44 to 9.42). CONCLUSIONS: Our results suggest that Internal Medicine residents markedly underrecognize and undertreat overweight and obesity.

Clinical Competence↗

PubMed2005

Cardiovascular mortality in overweight subjects: the key role of associated risk factors.

The role of obesity and overweight as independent risk factors for cardiovascular disease is still debated. The aim of this study was to evaluate the impact of overweight on cardiovascular mortality according to the presence or absence of associated risk factors. This study included 139,562 men and 104,236 women, aged 18 to 95 years, who had a standard health checkup at the IPC Center between 1972 and 1988. The follow-up period for mortality ended in December 1997. In both genders, the prevalence of hypertension, diabetes, and hypercholesterolemia increased with body mass index (P<0.001). When compared with subjects with a body mass index <25 kg/m2 without associated risk factors, overweight subjects without associated risk factors did not have an increased risk of cardiovascular mortality. Risk of cardiovascular death increased significantly when overweight was associated with hypertension alone [hazard ratio: 2.05 (1.71 to 2.46) in men; 2.15 (1.48 to 3.11) in women]. In both genders, the association of overweight with diabetes alone or hypercholesterolemia alone did not increase the risk. By contrast, in the presence of hypertension, cardiovascular mortality dramatically increased in overweight subjects with hypercholesterolemia [hazard ratio: 2.65 (2.20 to 3.19) in men, 2.57 (1.80 to 3.68) in women] or diabetes [hazard ratio: 3.01 (2.29 to 3.95) in men; 4.50 (2.67 to 7.58) in women]. The data suggest that the presence of high blood pressure in overweight subjects is the key factor leading to a significant increase in cardiovascular mortality. Because overweight significantly increases the prevalence of associated risk factors, especially hypertension, it should be considered as a major cardiovascular risk determinant.

Adolescent↗

PubMed2006

Pediatric sleep apnea: implications of the epidemic of childhood overweight.

Over the last 30 years, the prevalence of overweight across all pediatric age groups and ethnicities has increased substantially, with the current prevalence of overweight among adolescents estimated to be approximately 30%. Current evidence suggests that overweight is modestly associated with obstructive sleep apnea syndrome (OSAS) among young children, but strongly associated with OSAS in older children and adolescents. The rising incidence of pediatric overweight likely will impact the prevalence, presentation, and treatment of childhood OSAS. The subgroup of children who may be especially susceptible include ethnic minorities and those from households with caregivers from low socioeconomic groups. OSAS, by exposing children to recurrent intermittent hypoxemia or oxidative stress, may amplify the adverse effects of adiposity on systemic inflammation and metabolic perturbations associated with vascular disease and diabetes. When these conditions manifest early in life, they have the potential to alter physiology at critical developmental stages, or, if persistent, provide cumulative exposures that may powerfully alter long-term health profiles. An increased prevalence of overweight also may impact the response to adenotonsillectomy as a primary treatment for childhood OSAS. The high and anticipated increased prevalence of pediatric OSAS mandates assessment of optimal approaches for preventing and treating both OSAS and overweight across the pediatric age range. In this Pulmonary Perspective, the interrelationships between pediatric OSAS and overweight are reviewed, and the implications of the overweight epidemic on childhood OSAS are discussed.

Body Mass Index↗

PubMed2005

Prevalence of overweight in children and adolescents with attention deficit hyperactivity disorder and autism spectrum disorders: a chart review.

BACKGROUND: The condition of obesity has become a significant public health problem in the United States. In children and adolescents, the prevalence of overweight has tripled in the last 20 years, with approximately 16.0% of children ages 6-19, and 10.3% of 2-5 year olds being considered overweight. Considerable research is underway to understand obesity in the general pediatric population, however little research is available on the prevalence of obesity in children with developmental disorders. The purpose of our study was to determine the prevalence of overweight among a clinical population of children diagnosed with attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASD). METHODS: Retrospective chart review of 140 charts of children ages 3-18 years seen between 1992 and 2003 at a tertiary care clinic that specializes in the evaluation and treatment of children with developmental, behavioral, and cognitive disorders. Diagnostic, medical, and demographic information was extracted from the charts. Primary diagnoses of either ADHD or ASD were recorded, as was information on race/ethnicity, age, gender, height, and weight. Information was also collected on medications that the child was taking. Body mass index (BMI) was calculated from measures of height and weight recorded in the child's chart. The Center for Disease Control's BMI growth reference was used to determine an age- and gender-specific BMI z-score for the children. RESULTS: The prevalence of at-risk-for-overweight (BMI > 85th%ile) and overweight (BMI > 95th%ile) was 29% and 17.3% respectively in children with ADHD. Although the prevalence appeared highest in the 2-5 year old group (42.9%ile), differences among age groups were not statistically significant. Prevalence did not differ between boys and girls or across age groups (all p > 0.05). For children with ASD, the overall prevalence of at-risk-for-overweight was 35.7% and prevalence of overweight was 19%. CONCLUSION: When compared to an age-matched reference population (NHANES 1999-2002), our estimates indicate that children with ADHD and with ASD have a prevalence of overweight that is similar to children in the general population.

Adolescent↗

PubMedDate not supplied

Breast-feeding history and overweight in Latino preschoolers.

OBJECTIVE: Describe the relationship between breast-feeding history and risk of overweight in the preschool years in a sample of primarily Mexican-origin Latinos. METHODS: Children's breast-feeding history, health history, and demographics were obtained in interviewer-administered questionnaires of a convenience sample of 364 parents of children ages 2-5 in an outpatient clinic waiting room serving a predominantly Mexican immigrant population in a large Midwestern city. Child weight status was determined by weighing and measuring each child and calculating age- and sex-specific body mass index (BMI) percentile using 2000 Centers for Disease Control reference values, with children > or =95th percentile defined as overweight. RESULTS: Seventy-six of 364 children (21%) were overweight. Eighty-seven percent of children had been breast-fed. Increased duration of breast-feeding was associated with a linearly decreased risk of overweight in bivariate analysis, ranging from an overweight prevalence of 35% for those never breast-fed to 12% for those breast-fed for at least a year. This inverse relationship remained significant in the smaller sample for which maternal BMI data were available (n = 127), as each additional month of breast-feeding was associated with a 10% decreased odds ratio (OR) of overweight (adjusted OR = 0.90; 95% CI = 0.81, 0.99) after controlling for child's sex, current age, prematurity, birth-weight category, maternal education level, and maternal weight status. CONCLUSION: This sample of children of Mexican-origin immigrant families had high rates of overweight at very young ages but also very high rates of breast-feeding. Duration of breast-feeding was strongly and inversely related with prevalence of overweight as a preschooler.

Breast Feeding↗

PubMed2006

Household food insecurity and overweight status in young school children: results from the Early Childhood Longitudinal Study.

OBJECTIVE: Recent work on the determinants of obesity has shown a positive association between household food insecurity and overweight status in adult women, yet research exploring this issue in children has been inconclusive. In this study we examine the association between food insecurity and overweight status in young school children by using a large, nationally representative sample. METHODS: Data from the Early Childhood Longitudinal Study-Kindergarten Cohort (ECLS-K) were analyzed. Replicate heights and weights were measured on kindergarten children (N = 16889) in the spring of 1999. Children with a body mass index > or = 95th percentile of their gender-specific BMI-for-age chart were considered overweight. Food-insecurity status was assessed by using the full 18-question US Department of Agriculture Household Food Security Scale. Multivariate logistic regression was used to assess the relationship between overweight and food-insecurity status while controlling for potential demographic, socioeconomic, and behavioral confounders. RESULTS: Overall, 11.2% of the girls and 11.8% of the boys were overweight. Children from food-insecure households were 20% less likely to be overweight than their food-secure counterparts. Similar results on the food-insecurity/overweight link were found across a range of different models and expressions for key variables. Positive predictors of overweight status included low physical activity, television watching for > 2 hours/day, high birth weight, black or Latino ethnicity, and low income. CONCLUSIONS: There are strong arguments for reducing food insecurity among households with young children. This research suggests that these arguments would be based on reasons other than a potential link to obesity. Low activity levels and excessive television watching, however, were strongly related to overweight status, a finding that supports continued efforts to intervene in these areas.

Child↗

PubMedDate not supplied

Environmental and policy factors associated with overweight among adults in Missouri.

PURPOSE: To measure the association between environmental and policy factors (i.e., community perceptions, community infrastructure, and worksite infrastructure) and being overweight. DESIGN: Cross-sectional data from the Missouri Cardiovascular Disease Survey, a one-time random-digit-dialed telephone interview of noninstitutionalized adults. SETTING: Missouri, 1999 to 2000. SUBJECTS: The response rate was 69.6%. A total of 2821 adults completed the interview. The sample was weighted to represent the population of Missouri: 52% female, 71% white, and 59% overweight. MEASURES: The survey comprised 92 closed-ended multiple-choice items. Overweight was defined as a body mass index greater than or equal to 25 kg/m2 on the basis of self-reported height and weight. RESULTS: After adjustment for demographic and behavioral factors, environmental variables associated with being overweight included negative (i.e., unsafe and unpleasant) community perceptions (adjusted odds ratio [OR] = 1.6; 95% confidence interval [CI] = 1.1, 2.3) and the absence of outdoor exercise facilities (OR = 1.2; CI = 1.0, 1.5). Worksite policy variables were not related to the outcome; however, negative community perceptions (OR = 2.8; CI = 1.5, 5.2) and the absence of sidewalks and shoulders (OR = 1.7; CI = 1.3, 2.4) were associated with overweight among employed persons. CONCLUSIONS: An ecological perspective, focusing on the physical and social environment, was adopted to address the subject of overweight and obesity. Results of this study show that negative perceptions of the physical environment and the absence of enabling infrastructure are modestly associated with overweight, in comparison with other known risk factors. Environmental and policy interventions that promote healthier lifestyles by encouraging physical activity and healthy eating may have an effect on reducing the prevalence of overweight and obesity.

Adolescent↗

PubMed2005

[The current prevalence status of body overweight and obesity in China: data from the China National Nutrition and Health Survey].

OBJECTIVE: To study on the prevalence of body overweight and obesity in China and its distribution in age, sex and economic development status. METHODS: A total of 209,849 in all ages from the 2002 China National Nutrition and Health Survey (NNAHS) database were analyzed. The year 2000 population census data was used for age standardization. 1978 WHO criteria using Z scores was applied to age 0-7 years, criteria recommended by the Working Group on Obesity in China was applied to those aged 7-17 years and criteria in the Guidelines for Prevention and Control of Overweight and Obesity in Chinese Adults was applied to those aged 18 years and above. RESULTS: The overall prevalence was 17.6% for overweight and 5.6% for obesity. The combined prevalence of overweight and obesity was 23.2%. The prevalence of overweight was 25.0%, 21.6%, 17.4%, 15.1%, 19.2% and 12.8%, respectively for large city, middle-and-small city, class 1 rural, class 2 rural, class 3 rural and class 4 rural. For obesity, the rate was 10.6%, 7.2%, 6.4%, 4.3%, 6.0% and 2.7%, respectively for large city, middle-and-small city, class 1 rural, class 2 rural, class 3 rural and class 4 rural. By age groups, the prevalence of overweight was 3.4% in children age 0-6, 4.5% in adolescents age 7-17, 22.8% in adults age 18 and above; the prevalence of obesity was 2.0% in children age 0-6, 2.7% in adolescents age 7-17, 7.1% in adults age 18 and above. The sex difference in overweight and obesity differed between urban and rural, and among age groups. CONCLUSION: Overweight and obesity should have affected nearly 1 quarter of the country's total population, and became a threatening hazard to resident's health. As the urbanization progress, obesity might doubly increase. Prevention and control of this hazard should be urgently needed.

Adolescent↗

PubMed2004

Trends in state-specific prevalence of overweight and underweight in 2- through 4-year-old children from low-income families from 1989 through 2000.

OBJECTIVES: To document overweight and underweight state-specific prevalence and examine trends among 2- through 4-year-old children from low-income families. METHODS: State-specific and overall overweight and underweight prevalence for 1989, 1994, and 2000 and trend analyses during the study period are documented. Overweight was defined as a sex-specific body mass index (BMI) for age in the 95th percentile or higher and underweight as a sex-specific BMI for age in less than the fifth percentile on the 2000 Centers for Disease Control and Prevention (CDC) growth charts. These analyses are based on one randomly selected record per child per year for 30 states consistently participating in the CDC Pediatric Nutrition Surveillance System in 1989, 1994, and 2000. Prevalence in 1989 and 1994 is adjusted to state-specific age and race/ethnicity distribution of the population in 2000. Overweight and underweight prevalence were categorized as 5% or less, more than 5% to 10%, more than 10% to 15%, more than 15% to 20%, and more than 20%. RESULTS: The number of states that reported overweight prevalence of more than 10% increased from 11 in 1989 to 28 in 2000. Underweight decreased during the study period: 9 states in 1989 and 23 states in 2000 had a prevalence of 5% or less. No geographic predominance was apparent. Trend analyses showed significant increases in overweight in 30 states (P < .01) and decreases in underweight in 26 states (P < .05). CONCLUSIONS: Overweight is increasing and underweight is decreasing in our study population. We need to expand prevention and intervention efforts to reverse the rising trend of overweight in the United States.

Child, Preschool↗

PubMed2004

Diet, physical activity, and sedentary behaviors as risk factors for overweight in adolescence.

BACKGROUND: The proportion of overweight adolescents has increased, but the behavioral risk factors for overweight youth are not well understood. OBJECTIVE: To examine how diet, physical activity, and sedentary behaviors relate to overweight status in adolescents. DESIGN AND SETTING: Baseline data from the Patient-Centered Assessment and Counseling for Exercise Plus Nutrition Project, a randomized controlled trial of adolescents to determine the effects of a clinic-based intervention on physical activity and dietary behaviors. PARTICIPANTS: A total of 878 adolescents aged 11 to 15 years, 42% of whom were from minority backgrounds. MAIN OUTCOME MEASURE: Centers for Disease Control and Prevention body mass index-for-age percentiles divided into 2 categories: normal weight (<85th percentile) and at risk for overweight plus overweight (AR + O) (>or=85th percentile). RESULTS: Overall, 45.7% of the sample was classified as AR + O with a body mass index for age at the 85th percentile or higher. More girls from minority backgrounds (54.8%) were AR + O compared with non-Hispanic white girls (42%) (chi(2)(1) = 7.6; P =.006). Bivariate analyses indicated that girls and boys in the AR + O group did fewer minutes per day of vigorous physical activity, consumed fewer total kilojoules per day, and had fewer total grams of fiber per day than those in the normal-weight group. Boys in the AR + O group also did fewer minutes per day of moderate physical activity and watched more minutes per day of television on nonschool days than normal-weight boys. Final multivariate models indicated that independent of socioeconomic status (as assessed by household education level), girls had a greater risk of being AR + O if they were Hispanic or from another minority background (odds ratio [OR] = 1.65; 95% confidence interval [CI], 1.09-2.49) and a reduced risk of being AR + O as minutes per day of vigorous physical activity increased (OR = 0.93; 95% CI, 0.89-0.97). A low level of vigorous physical activity was the only significant risk factor for boys being AR + O (OR = 0.92; 95% CI, 0.89-0.95). Analyses based on meeting behavioral guidelines supported these findings and showed that failing to meet the 60 min/d moderate to vigorous physical activity guideline was associated with overweight status for both girls and boys. In addition, boys who failed to meet sedentary behavior and dietary fiber guidelines were more likely to be overweight. CONCLUSIONS: Of the 7 dietary and physical activity variables examined in this cross-sectional study, insufficient vigorous physical activity was the only risk factor for higher body mass index for adolescent boys and girls. Prospective studies are needed to clarify the relative importance of dietary and physical activity behaviors on overweight in adolescence.

Adolescent↗

PubMed2002

Prevalence and trends in overweight among US children and adolescents, 1999-2000.

CONTEXT: The prevalence of overweight among children in the United States increased between 1976-1980 and 1988-1994, but estimates for the current decade are unknown. OBJECTIVE: To determine the prevalence of overweight in US children using the most recent national data with measured weights and heights and to examine trends in overweight prevalence. DESIGN, SETTING, AND PARTICIPANTS: Survey of 4722 children from birth through 19 years of age with weight and height measurements obtained in 1999-2000 as part of the National Health and Nutrition Examination Survey (NHANES), a cross-sectional, stratified, multistage probability sample of the US population. MAIN OUTCOME MEASURE: Prevalence of overweight among US children by sex, age group, and race/ethnicity. Overweight among those aged 2 through 19 years was defined as at or above the 95th percentile of the sex-specific body mass index (BMI) for age growth charts. RESULTS: The prevalence of overweight was 15.5% among 12- through 19-year-olds, 15.3% among 6- through 11-year-olds, and 10.4% among 2- through 5-year-olds, compared with 10.5%, 11.3%, and 7.2%, respectively, in 1988-1994 (NHANES III). The prevalence of overweight among non-Hispanic black and Mexican-American adolescents increased more than 10 percentage points between 1988-1994 and 1999-2000. CONCLUSION: The prevalence of overweight among children in the United States is continuing to increase, especially among Mexican-American and non-Hispanic black adolescents.

Adolescent↗

PubMed2004

Compensation for energy intake from fast food among overweight and lean adolescents.

CONTEXT: Fast food consumption has increased greatly among children in recent years, in tandem with the obesity epidemic. Fast food tends to promote a positive energy balance and, for this reason, may result in weight gain. However, if fast food and obesity are causally related, the question arises of why some children who frequently eat fast food do not become overweight. OBJECTIVE: To test the hypothesis that overweight adolescents are more susceptible to the adverse effects of fast food than lean adolescents. DESIGN AND SETTING: In study 1, we fed participants an "extra large" fast food meal in a naturalistic setting (a food court). The participants were instructed to eat as much or little as desired during this 1-hour meal. In study 2, we assessed energy intake under free-living conditions for 2 days when fast food was consumed and 2 days when it was not consumed. Data were collected in Boston, Mass, between July 2002 and March 2003. PARTICIPANTS: Overweight (n = 26) and lean (n = 28) adolescents aged 13 to 17 years. Overweight was defined as a body mass index exceeding sex- and age-specific 85th percentiles based on the 2000 Centers for Disease Control and Prevention growth charts. MAIN OUTCOME MEASURES: Energy intake determined by direct observation in study 1 and by unannounced 24-hour dietary recalls, administered by telephone, in study 2. RESULTS: In study 1, mean (SEM) energy intake from the fast food meal among all participants was extremely large (1652 [87] kcal), accounting for 61.6% (2.2%) of estimated daily energy requirements. Overweight participants ate more than lean participants whether energy was expressed in absolute terms (1860 [129] vs 1458 [107] kcal, P =.02) or relative to estimated daily energy requirements (66.5% [3.1%] vs 57.0% [2.9%], P =.03). In study 2, overweight participants consumed significantly more total energy on fast food days than non-fast food days (2703 [226] vs 2295 [162] kcal/d; +409 [142] kcal/d; P =.02), an effect that was not observed among lean participants (2575 [157] vs 2622 [191] kcal/d; -47 [173] kcal/d; P =.76). CONCLUSIONS: In this study, adolescents overconsumed fast food regardless of body weight, although this phenomenon was especially pronounced in overweight participants. Moreover, overweight adolescents were less likely to compensate for the energy in fast food, by adjusting energy intake throughout the day, than their lean counterparts.

Adolescent↗

PubMed2001

Trends in overweight and physical activity among U.S. military personnel, 1995-1998.

BACKGROUND: The purpose of this study was to deter mine whether changes in physical activity patterns account for the increasing prevalence of obesity, utilizing a large, representative sample of male and female U.S. military personnel. METHODS: Data from the 1995 and 1998 waves of the Department of Defense Survey of Health Related Behaviors among Military Personnel were utilized. Overweight was defined as body mass index > or =25. Respondents were classified as physically active if they reported > or =3 days/week of vigorous activity. Three sequential multivariate logistic regression models were analyzed separately for males and females with overweight regressed on year of study (1995 or 1998), demographic characteristics, and physical activity. RESULTS: Some 50% of military personnel in 1995 and 54% in 1998 were classified as overweight, representing a significant increase in overweight over the 3-year period for both males and females. Overweight military personnel were more likely to be male, older, African American or Hispanic, married, and enlisted personnel. Physical activity levels were high, with around 67% of the sample engaging in regular, vigorous physical activity. Although physical activity levels increased among male personnel between 1995 and 1998, there was not an independent association between physical activity and overweight, and changing physical activity patterns did not account for the increase in over weight from 1995 to 1998. CONCLUSIONS: The U.S. military is experiencing a trend toward increasing overweight that mirrors the pattern among the general population. The results of this study suggest that the rise in overweight among the military is not explained by a decrease in physical activity.

Adult↗

PubMed2002

Use of BMI as a measure of overweight and obesity in a field study on 5-7 year old children.

OBJECTIVE: The present field study examines the use of BMI in comparison with estimates of percent fat mass to screen for overweight and obesity in children. DESIGN: Cross-sectional field study. SETTING: Four waves of children 1996-1999 at Kiel, North West Germany. SUBJECTS: A representative large sample of 2,286 5-7 year old children representing 40% of the total child population examined by school physicians within the same period in Kiel. MAIN OUTCOME MEASURES: BMI was compared with anthropometric measures (TSF, BSF, SIF, SSF) and bioelectrical impedance analysis (BIA). The 90th and 97th BMI percentiles were used as cut offs for overweight and obesity, respectively. RESULTS: BMI reached a low sensitivity to identify overweight children when compared with the two estimates of % FM (0.60 to 0.78 for girls, 0.71 to 0.82 for boys, respectively). The specificity of BMI was 93 to 95 %. By contrast, BMI reached higher sensitivity to screen for obese children of 0.83 to 0.85 for boys and 0.62 to 0.80 for girls at a concomitant specificity of 0.95 to 0.98 for boys and 0.96 to 0.97 for girls as defined by assessment of body fat mass. Comparing nutritional status of overweight children classified as overweight or non overweight by BMI shows that BMI only identified obese but not-overweight children. CONCLUSION: BMI can be used to screen for obese children. In contrast BMI has a poor sensitivity to screen for overweight children. Body composition analysis should be used to screen for children at risk of becoming obese.

Adipose Tissue↗

PubMed1990

Interrelationships between psychological factors, overweight, and blood pressure in adolescents.

Relationships between psychological factors and physical factors such as body mass, overweight, and blood pressure were examined in a sample of black and white adolescents enrolled in health science courses. Black female adolescents were significantly more overweight and obese than either other group. Psychological factors were not significantly associated with body mass (weight/height) for females. A small percentage of the variance in body mass for black (6%) and white (4%) males was explained by Trait Anger, the frequent experience of anger and the intensity of anger (S-Anger-Reaction/TP) in pressure situations. Trait Anger also significantly (p less than 0.01) discriminated between black male adolescents who were normal weight and those 20% overweight for age and height. The relationships between traditional risk factors and blood pressure among adolescents who were 20% underweight, normal weight, and 20% overweight for age and height suggest that few traditional risk factors contribute significantly to the prediction of blood pressure in overweight adolescents. In contrast, psychological measures of suppressed anger (Anger-In, Anger Expression) were significantly (p less than 0.001) associated with blood pressure among overweight adolescents. The findings regarding the associations between overweight and psychological factors are complex. Prospective studies using better measures of overweight are needed to clarify the processes involved.

Adolescent↗