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PubMed2006

Influence of overweight on surgical complications for gastric cancer: results from a randomized control trial comparing D2 and extended para-aortic D3 lymphadenectomy (JCOG9501).

BACKGROUND: The impact of overweight on the outcome of gastrectomy with lymphadenectomy is controversial, and data from a well-controlled, randomized study are needed to identify a possible relationship. METHODS: We used data from 523 patients registered for a prospective randomized trial comparing D2 and extended para-aortic D3 lymphadenectomy to compare the effects of body mass index (BMI) and the extent of lymphadenectomy for the development of general or major surgical complications (anastomotic leakage, abdominal abscess, and pancreatic fistula). RESULTS: Seventy-seven patients were classified as overweight with BMI >or= 25, and 38 and 39 of these patients underwent a D2 or D3 lymphadenectomy, respectively. Among the 446 patients classified as nonoverweight with BMI < 25, 225 received D2 and 221 received D3 lymphadenectomy. Surgical complications, operation time, and blood loss were statistically significantly associated with BMI, and logistic regression analysis revealed that overweight directly affected the occurrence of surgical complications even after considering operation time and blood loss as intermediate factors instead of outcome variables. Among patients undergoing D2 lymphadenectomy, being overweight increased the risk for surgical complications and blood loss, whereas overweight was associated with only blood loss and operation time among patients receiving D3 lymphadenectomy. CONCLUSIONS: Overweight increased the risk of surgical complications in patients undergoing gastrectomy both directly and indirectly through operation time and blood loss. The impact of overweight on surgical complications was more evident in patients undergoing a D2 dissection.

Aged↗

PubMed2007

Physician advice about being overweight: association with self-reported weight loss, dietary, and physical activity behaviors of US adolescents in the National Health and Nutrition Examination Survey, 1999-2002.

OBJECTIVE: The goal was to examine the association of physician counseling about being overweight with attempted weight loss, dietary, and physical activity/inactivity behaviors of US teens. METHODS: We used data from the National Health and Nutrition Examination Surveys 1999-2000 and 2001-2002 for 16- to 19-year-old subjects with BMI for age of > or = 85th percentile (n = 716). Regression methods were used to examine the association of physician advice about teen weight status with covariate-adjusted differences in reported weight loss, dietary, and physical activity behaviors. RESULTS: Approximately 51% of overweight teens (BMI for age of > or = 95th percentile) but only 17% of at-risk teens (BMI for age of 85th to < 95th percentile) reported that they had been informed by a doctor about being overweight. More than 60% of those told by a doctor about being overweight had attempted weight loss in the past year, relative to 41% of those who did not receive this advice. Teens informed of their overweight status reported significantly smaller amounts of all foods and beverages and lower energy intake per kilogram of body weight in the 24-hour recall, relative to the comparison group. Physical activity and inactivity behaviors were unrelated to professional counseling about overweight status. CONCLUSION: Physician counseling regarding adolescent overweight status was associated with a positive impact on attempted weight loss and moderate dietary behaviors.

Adolescent↗

PubMed2006

The relationship between asthma and overweight in urban minority children.

BACKGROUND: This study was performed to determine the relationship between overweight [body mass index (BMI) > or = 85th percentile] and asthma as determined by spirometry. METHOD: Spirometry was performed according to the American Thoracic Society guidelines, and BMI was calculated. Asthma was defined as a forced expiratory volume in 1 second (FEV1) <80% predicted and FEV1/forced vital capacity (FVC) >5% lower than predicted for age and sex. RESULTS: One-hundred-nine children (age 14.7 +/- 1.6 years) were enrolled. Eighty children (73%) were African-American, and 29 children (27%) were white. Fifty-eight (53%) children were overweight. Twelve (11%) children, of whom nine (75%) were overweight, met the criteria for asthma. Baseline FEV1 percent predicted (87 +/- 6% vs. 83 +/- 7%, p=0.03), FEV1/FVC (93 +/- 6 vs. 87 +/- 8, p<0.001), and FEV1 percent predicted following albuterol administration (94 +/- 7 vs. 89 +/- 7%, p=0.03) were all lower in overweight children. Children with asthma were almost 1.5 times more likely to be overweight compared with children without asthma (relative risk: 1.49, 95% confidence interval: 1.015-2.17). CONCLUSIONS: Inner-city children are more likely to be overweight compared to the general population. Asthma is a risk factor for overweight in these children.

Adolescent↗

PubMed2006

[Insulin ultradian pulse model of individuals with overweight and impaired glucose tolerance].

OBJECTIVE: To study the characteristics of insulin ultradian pulses of individuals with normal glucose tolerance, overweight, and impaired glucose tolerance (IGT). METHODS: Blood samples were taken every 15 minutes from 10 individuals with normal glucose tolerance, 6 individuals with overweight and 3 individuals with IGT for 24 hours. Blood glucose, insulin, and C-peptide of every time point were measured. Standard diet was used in the study. The 24 h-ISR profile was submitted to time series analysis. RESULTS: (1) As given standard diet, 2 to 4 pulses occurred after each meal, 3 to 4 pulses occurred during the night, and 12 to 15 pulses occurred in the whole 24-hour period. The first insulin pulse always occurs 30 to 60 minutes after meal. The maximum amplitude of pulse occurred 45 to 90 minutes after meal. These characteristics were not significantly different among the 3 groups. (2) The average amplitude of 24-hour insulin secretion rate (ISR) of the normal group was 357 pmol/min +/- 11 pmol/min, significantly lower than those of the overweight and IGT groups (820 pmol/min +/- 37 pmol/min and 666 pmol/min +/- 53 pmol/min respectively, both P < 0.05). (3) The average periodicity of insulin ultradian pulse were 75 min and 75 - 90 min in the control group and overweight group respectively. The periodicity of insulin ultradian pulse in the IGT group was undefined. (4) The cross-correlation function were 0.72 +/- 0.11, 0.80 +/- 0.11 and 0.51 +/- 0.11 respectively in the normal, overweight, and IGT groups. CONCLUSION: (1) As given standard diet, the occurring numbers and time of insulin ultradian oscillations are not statistically significantly different among the normal, overweight, and IGT groups. (2) The insulin secretion amplitude is increased in the overweight and IGT groups. (3) The rhythm and concomitance coefficient of the ISR and glucose are low in the individuals with IGT.

Adult↗

PubMed2006

Overweight and hypertension: longitudinal study in school-aged children.

AIM: A continuous increase in overweight has been documented in the paediatric population. The increase occurred in many developed and also developing countries. In the United States prevalence of overweight is 21.5% among African-Americans, 21.8% among Hispanics, and 12.3% among non-Hispanic whites; in Europe, from 10% to 20% in Northern Europe and 20% to as high as 36% in parts of Southern Italy (International Obesity Task Force data). The association between overweight and hypertension in children has been reported. This longitudinal study assessed the prevalence of hypertension and the relationships between gender, overweight, and blood pressure. METHODS: School-based screening was performed in 1.563 children (3-16 years). Age, gender, height, weight and blood pressure were registered every year for 3 subsequent years, in the period 1997-2000. Body mass index (BMI, kg/m2) was calculated and overweight was defined as centile corresponding to BMI = or >25 at 18 years. Blood pressure > 95th centile defined hypertension. RESULTS: The prevalence of elevated blood pressure at first, second and third screenings was 35.1%, 33.8% and 23.9% in males, and 41%, 40.2% and 31.2% in females. The relative risk was significant for overweight subjects. CONCLUSIONS: These results confirm an increasing epidemic of cardiovascular risk in children, as evidenced by an increase in the prevalence of overweight and hypertension. This increase in association with other cardiovascular risk factors that include dyslipidemia, insulin resistance, glucose intolerance, type II diabetes mellitus, suggest the necessity of accurate prevention strategies.

Adolescent↗

PubMed2006

Detecting overweight children in primary care: do national data reflect the typical urban practice?

Primary care physicians can easily identify overweight in children aged < 2 years using body-mass index. There is no consensus on the appropriate way of identifying overweight before age 2 years. However, the primary care physician should be alert if the body-mass index of a child < 2 years of age is significantly higher then those published (as a guideline) in this paper. Overweight is occurring early. Thus it is essential that primary care physicians focus on identifying overweight as early as preschool age. Primary care physicians have to pay particular attention to identifying overweight in non-Hispanic black children aged 2 to 11 years, who may have a higher prevalence of being at risk for overweight compared with 1999-2002 national data. Children seen for a sick-child visit may be at higher risk for overweight; thus, we recommend that height and weight measurements be obtained during these visits.

Body Mass Index↗

PubMed2001

Low family income and food insufficiency in relation to overweight in US children: is there a paradox?

OBJECTIVES: To investigate associations between family income, food insufficiency, and being overweight in US children aged 2 to 7 and 8 to 16 years, to discuss mechanisms that may explain these associations, and to propose design and data requirements for further research that could effectively examine this issue. METHODS: Data from the Third National Health and Nutrition Examination Survey were analyzed. Children were classified as food insufficient if the family respondents reported that their family sometimes or often did not get enough food to eat. The prevalence of overweight was compared by family income category and food sufficiency status within age-, sex-, and race-ethnic-specific groups. Odds ratios for food insufficiency are reported, adjusted for family income and other potential confounding factors. RESULTS: Among older non-Hispanic white children, children in families with low income were significantly more likely to be overweight than children in families with high income. There were no significant differences by family income for younger non-Hispanic white children, non-Hispanic black children, or Mexican American children. After adjusting for confounding variables, there were no differences in overweight by food sufficiency status, except that younger food-insufficient girls were less likely to be overweight, and non-Hispanic white older food-insufficient girls were more likely to be overweight than food-sufficient girls (P<.10). CONCLUSION: Further research to evaluate whether food insecurity causes overweight in American children requires longitudinal quantitative and in-depth qualitative methods.

Adolescent↗

PubMed2004

Childhood overweight and parent- and teacher-reported behavior problems: evidence from a prospective study of kindergartners.

OBJECTIVES: To determine if there is a relationship between overweight and behavior problems among children as young as 5 years old by studying the association between overweight and behavioral health at entry into kindergarten and to determine whether overweight status is a risk factor for the onset of new behavior problems during the first 2 years in school. DESIGN: We use data from a nationally representative sample of kindergartners in the United States-the Early Childhood Longitudinal Study-Kindergarten class. Data on height, weight, and parent- and teacher-reported behavior problems were collected 3 times during their first 2 years in school for 9949 children. We use a multivariate regression analysis that controls for sociodemographic characteristics, parent-child interaction, birth weight, and mother's mental health. RESULTS: Among girls, but not boys, there is a significant association between overweight and teacher-reported externalizing behavior problems (odds ratio [OR], 1.81; 95% confidence interval [CI], 1.23-2.68), teacher-reported internalizing behavior problems (OR, 1.54; 95% CI, 1.09-2.17), and parent-reported internalizing behavior problems (OR, 1.49; 95% CI, 1.08-2.06) at the beginning of kindergarten. However, overweight status was not a risk factor for the onset of new behavior problems over time for either girls (teacher-reported externalizing behavior problems: OR, 0.58 [95% CI, 0.25-1.33]; teacher-reported internalizing behavior problems: OR, 1.34 [95% CI, 0.88-2.03]; and parent-reported internalizing behavior problems: OR, 1.29 [95% CI, 0.82-2.01]) or boys (teacher-reported externalizing behavior problems: OR, 1.02 [95% CI, 0.67-1.57]; teacher-reported internalizing behavior problems: OR, 1.02 [95% CI, 0.68-1.52]; and parent-reported internalizing behavior problems: OR, 1.42 [95% CI, 0.94-2.15]), whereas low family income and maternal depression were strong predictors of such problems. CONCLUSIONS: Childhood overweight is already associated with behavior problems when girls start school, but not boys. In contrast to common belief, overweight status does not predict the onset of new internalizing or externalizing behavior problems during the first 2 years of school.

Child↗

PubMed2005

Health-related quality of life of overweight and obese children.

CONTEXT: The negative effects of childhood overweight and obesity on quality of life (QOL) have been shown in clinical samples but not yet in population-based community samples. OBJECTIVE: To determine relationships between weight and health-related QOL reported by parent-proxy and child self-report in a population sample of elementary school children. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional data collected in 2000 within the Health of Young Victorians Study, a longitudinal cohort study commenced in 1997. Individuals were recruited via a random 2-stage sampling design from primary schools in Victoria, Australia. Of the 1943 children in the original cohort, 1569 (80.8%) were resurveyed 3 years later at a mean age of 10.4 years. MAIN OUTCOME MEASURES: Health-related QOL using the PedsQL 4.0 survey completed by both parent-proxy and by child self-report. Summary scores for children's total, physical, and psychosocial health and subscale scores for emotional, social, and school functioning were compared by weight category based on International Obesity Task Force cut points. RESULTS: Of 1456 participants, 1099 (75.5%) children were classified as not overweight; 294 (20.2%) overweight; and 63 (4.3%) obese. Parent-proxy and child self-reported PedsQL scores decreased with increasing child weight. The parent-proxy total PedsQL mean (SD) score for children who were not overweight was 83.1 (12.5); overweight, 80.0 (13.6); and obese, 75.0 (14.5); P<.001. The respective child self-reported total PedsQL mean (SD) scores were 80.5 (12.2), 79.3 (12.8), and 74.0 (14.2); P<.001. At the subscale level, child and parent-proxy reported scores were similar, showing decreases in physical and social functioning for obese children compared with children who were not overweight (all P<.001). Decreases in emotional and school functioning scores by weight category were not significant. CONCLUSION: The effects of child overweight and obesity on health-related QOL in this community-based sample were significant but smaller than in a clinical sample using the same measure.

Australia↗

PubMed2002

Changes in the prevalence of overweight and obesity and their risk factors in Spain, 1987-1997.

BACKGROUND: The aim of this study was to examine the relationship of the changes in the prevalence of overweight and obesity with the changes in some of their risk factors in Spain from 1987 to 1997. METHODS: Data were obtained from three interview-based health surveys, covering representative samples of the noninstitutionalized Spanish population aged 16 years and over and undertaken in 1987 (n = 17,434), 1995 (n = 4,736), and 1997 (n = 4,678). To compensate for the different sample sizes, the 1995 and 1997 surveys were combined. Risk factors for obesity and overweight considered in this study were age, educational level, physical activity at work, physical activity during leisure time, tobacco use, alcohol consumption, and civil status. Data analysis was performed with logistic regression. RESULTS: The prevalence of overweight and obesity (body mass index >or= 25 kg/m(2)) rose from 35.6% in 1987 to 40.9% in 1995/1997 among women and from 47.1 to 56.2% among men. In the period 1987-1995/1997, the proportion of persons with secondary or university education increased by 11.3% in women and 10.8% in men. Similarly, the prevalence of intense or regular leisure-time physical activity increased by 5.7 and 6.2% in women and men, respectively. The remaining risk factors for overweight and obesity registered no substantial change in prevalence over the study period. The prevalence of overweight and obesity expected in 1995/1997, had educational level and leisure-time physical activity been the same as in 1987, is higher than the observed figures; for educational level, expected figures are 7.3 and 1.4% higher than those observed among women and men, respectively, while for leisure-time physical activity corresponding values are 2.8 and 1.6%. CONCLUSIONS: The rise in the prevalence of overweight and obesity in Spain from 1987 to 1997 may have been attenuated by an increase in leisure-time physical activity and by an improvement in educational level, particularly among women. The contribution to overweight and obesity trends attributable to physical activity at work or to tobacco and alcohol consumption appears to be small or null.

Adolescent↗

PubMed1993

Overweight among Mexican Americans and its relationship to life style behavioral risk factors.

The hypothesis positing differences between Mexican Americans and whites regarding attitudes and behaviors concerning obesity and other health issues was tested. A random sample of 1171 whites and 155 Mexican Americans aged 18 to 65 was selected. Two analyses were carried out. First, overweight Mexican Americans were compared with overweight whites. Second, overweight individuals were compared with normal weight counterparts within each ethnic group. Differences between overweight Mexican Americans and overweight whites disappeared after adjusting for the effects of sex, income, educational status, and marital status. Among whites, several factors remained significantly different when comparing overweight with normal weight individuals. Among Mexican Americans, however, all but one of the significant differences between overweight and normal weight individuals disappeared after adjusting for other variables. The implications of these results as they relate to the implementation of public health programs to deal with the prevention and treatment of obesity among Mexican Americans are discussed.

Adolescent↗

PubMed2003

Alarming trends in pediatric overweight in the United States.

OBJECTIVES: A comprehensive review of the pediatric overweight literature was undertaken to examine secular changes in the prevalence of pediatric overweight, the current magnitude and scope of pediatric overweight, and the identity of high-risk groups in the U.S. METHODS: Articles published in the last two decades and studies of nationally representative numbers of children were highlighted. RESULTS: An unprecedented three-fold increase in the prevalence of pediatric overweight has occurred in recent decades in the U.S. and evidence suggests that this trend is continuing unabated. While no sociodemographic or racial group has escaped this trend, particularly at risk are African American girls, Hispanic girls and boys, and children from low-income house-holds. CONCLUSION: The rising prevalence of pediatric overweight in the U.S. is a harbinger of increases in diabetes, cardiovascular disease and numerous other health problems. Furthermore, disparities in pediatric overweight along ethnic and socio-economic lines are expected to further exacerbate current disparities in rates of chronic disease. Strategies and programs to prevent overweight among children are urgently needed.

Adolescent↗

PubMed2006

Impact of overweight and pneumoperitoneum on hemodynamics and oxygenation during prolonged laparoscopic surgery.

BACKGROUND: Anesthesia adversely affects respiratory function and hemodynamics in obese patients. Although many studies have been performed in morbidly obese patients, data are limited concerning overweight patients [BMI 25-29.9 kg m(-2)]. The aim of this study was to evaluate the effects of prolonged pneumoperitoneum in Trendelenburg position on hemodynamics and gas exchange in normal and overweight patients. METHODS: We studied 15 overweight and 15 non-obese [BMI 18.5-24.9 kg m(-2)] patients who underwent totally endoscopic robot-assisted radical prostatectomy under general anesthesia with an inspired oxygen fraction of 0.5. A standardized anesthetic regimen was used, and patients were examined at standard times: after induction of anesthesia and Trendelenburg posture, every 30 minutes after establishing pneumoperitoneum, and after the release of the pneumoperitoneum with the patient still in Trendelenburg position. RESULTS: After induction of anesthesia and Trendelenburg positioning arterial oxygen pressure [P(a)O2] and alveolar-arterial difference in oxygen tension [A(a)DO2] differed significantly between both groups with lower P(a)O2 [235 +/- 27 versus 164 +/- 51 mmHg] and higher A(a)DO2 [149 +/- 48 versus 76 +/- 28 mmHg] values in overweight patients. During pneumoperitoneum, P(a)O2 transient increased above baseline values in overweight patients, whereas A(a)DO2 decreased. Hemodynamic parameters [HR, MAP, and CVP] did not differ significantly between groups. CONCLUSIONS: Arterial oxygenation and A(a)DO2 are significantly impaired in overweight patients under general anesthesia in Trendelenburg posture. In overweight patients pneumoperitoneum transient reduced the impairment of arterial oxygenation and lead to a decrease in A(a)DO2. Hemodynamic parameters were not affected by body weight.

Aged↗

PubMed2004

Duration of overweight and metabolic health risk in American men and women.

PURPOSE: To investigate the association between overweight duration and metabolic health risk. METHODS: Subjects consisted of 4,874 participants, aged 30 to 64 years, from the Third National Health and Nutrition Examination Survey. Duration of overweight was determined from recalled weights from 10 years prior to the survey. Metabolic health risk was determined from a fasting blood sample and blood pressure measurements. RESULTS: After adjusting for current body mass index, the relative odds for obesity-related comorbidities were not higher in men who had been overweight for < 10 years compared with men with a normal weight. However, the likelihood [odds ratios (95% confidence intervals)] of hypertriglyceridemia [2.39 (1.34-4.27)] and the metabolic syndrome [2.15 (1.01-4.57)] were increased in men who had been overweight for > or = 10 years compared with normal weight men. In women there was a graded increase (p < 0.001) in the likelihood of numerous metabolic disorders when moving from the normal weight to overweight < 10 year to overweight > or = 10 year categories. CONCLUSIONS: The duration of overweight has a significant effect on obesity-related comorbidities in men and women.

Adult↗

PubMed2004

Overweight and obesity in patients with established coronary heart disease: are we meeting the challenge?

AIMS: Several epidemiological studies have reported increasing obesity rates in the general population during last decades. We studied the prevalence of overweight and obesity in the high priority group of patients with established coronary heart disease (CHD) and the therapeutic control of manageable coronary risk factors in relation to body mass index. METHODS: Data from a representative sample of patients having experienced a recent cardiac event before the age of 71 years from 15 European centres participating in the EUROASPIRE II study, were gathered in the period 1999-2000 through standardized methods. In total, 5535 coronary patients with valid height and weight measurements were included. RESULTS: About one in three patients (31%) was diagnosed as obese with additionally half of the patient population being overweight (48%). Obesity was 10% more prevalent among women and significantly less smokers were observed among overweight and obese subjects, twice as many diabetics and more people with low education. Overweight and obese patients had more frequently raised blood pressure and elevated cholesterol after adjustment for age, gender, education, diabetes and centre. In patients using blood pressure lowering agents, 56% of obese and 51% of overweight patients were still having raised blood pressure compared to 42% in normal weight patients. A similar result was observed for the therapeutic control of total cholesterol. Since their hospital discharge, obese and overweight patients did not alter lifestyles regarding fat intake and physical activity. In the period between coronary event and interview, body weight had increased with at least five kilograms in a quarter of all patients. CONCLUSIONS: These results suggest that the growing population of overweight and obese coronary patients is at particularly high risk for further cardiovascular complications due to elevated risk factor levels on the one hand and their insufficient therapeuticcontrol on the other hand. Our results also confirm the considerable weight gain seen in a high proportion of patients following their cardiac event.

Adult↗

PubMed2004

Relationship of child-feeding practices to overweight in low-income Mexican-American preschool-aged children.

OBJECTIVE: The purpose of this research was to examine the relationship of child-feeding practices and other factors to overweight in low-income Mexican-American preschool-aged children. DESIGN: Cross-sectional survey with anthropometric measurements of mothers and target children. Trained bilingual staff interviewed the parents to collect data on child-feeding strategies, food patterns, child's health history, parental acculturation level, food insecurity, and other household characteristics. Subjects and setting Complete data were available from 204 low-income Mexican-American parents residing in California with at least one child aged 3 to 5 years. Outcomes measured Risk of overweight was defined as body mass index (BMI) (measured as weight [in kilograms]/height [in meters](2)) >/=85th percentile and overweight was defined as BMI >/=95th percentile. The Student t test, chi(2) test, and logistic regression were used. RESULTS: Three variables were positively related to risk of overweight: birth weight (odds ratio [OR], 2.31; 95% confidence interval [CI], 1.11 to 4.82), mother's BMI >/=30 (OR, 2.05; 95% CI, 1.11 to 3.79), and juice intake (OR, 2.33; 95% CI, 1.09 to 4.98). Being enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children was negatively related to risk of overweight (OR, 0.40; 95% CI, 0.21 to 0.75). Additional variables related to overweight were monthly income >$1,500 (OR, 2.33; 95% CI, 1.00 to 5.42) and child takes food from the refrigerator between meals (OR, 0.32; 95% CI, 0.13 to 0.76). CONCLUSIONS: The results of this study suggest that biological and socioeconomic factors are more associated with overweight in Mexican-American preschool-aged children than most of the self-reported child-feeding strategies.

Acculturation↗

PubMed2006

Overweight adolescent African-American mothers gain weight in spite of intentions to lose weight.

OBJECTIVE: This study sought to determine how dietary patterns, self-esteem, depressive symptoms, and intention to lose weight were associated with body size among adolescent African-American mothers 1 year after delivery and with changes in body size over the next year. DESIGN: Cross-sectional and longitudinal self-reported measures were collected 1 year after delivery. Weight and height were collected 1 and 2 years after delivery. SUBJECTS: The subjects were 118 low-income, African-American adolescent mothers recruited after the birth of their first child. STATISTICAL ANALYSES: Multivariate analysis of covariance and multivariate regression analysis were conducted to examine predictors of body size 1 year after delivery and changes in body size over the next year. Analyses were adjusted for maternal age, education, breastfeeding history, and intervention. RESULTS: One year after delivery, 33.0% of mothers were overweight (body mass index [BMI] > or =95th percentile) and 23.7% were at risk for overweight (BMI > or =85th and <95th percentile). Mothers consumed a daily average of 2,527 kcal and 4.1 high-fat snacks. A total of 11% of normal-weight mothers, 22% of mothers at risk for overweight, and 44% of overweight mothers reported intention to lose weight, chi(2)=10.8, P<.01. Average maternal BMI z score increased 0.13 (3.9 kg) between 1 and 2 years after delivery, P<.01. Dietary patterns, self-esteem, depressive symptoms, and intention to lose weight were not related to body size or increase in body size. CONCLUSIONS: One year after delivery, overweight among adolescent mothers was common and increased over time. Although nearly half of overweight mothers reported an intention to lose weight, their weight gain did not differ from that of other mothers, suggesting that they lack effective weight-loss behaviors, and may be good candidates for intervention. African-American adolescent mothers have high rates of overweight and snack consumption and may benefit from strategies to identify nutritious, palatable, affordable, and accessible alternatives to high-fat snack food.

Adolescent↗

PubMed2004

Neighborhood playgrounds, fast food restaurants, and crime: relationships to overweight in low-income preschool children.

BACKGROUND: We examined the relationship between overweight in preschool children and three environmental factors--the proximity of the children's residences to playgrounds and to fast food restaurants and the safety of the children's neighborhoods. We hypothesized that children who lived farther from playgrounds, closer to fast food restaurants, and in unsafe neighborhoods were more likely to be overweight. METHODS: This was a cross-sectional study of 7,020 low-income children, 36 through 59 months of age living in Cincinnati, OH. Overweight was defined as a measured body mass index > or =95th percentile. The distance between each child's residence and the nearest public playground and fast food restaurant was determined with geographic information systems. Neighborhood safety was defined by the number of police-reported crimes per 1,000 residents per year in each of 46 city neighborhoods. RESULTS: Overall, 9.2% of the children were overweight, 76% black, and 23% white. The mean (+/- SD) distances from a child's home to the nearest playground and fast food restaurant were 0.31 (+/- 0.22) and 0.70 (+/- 0.38) miles, respectively. There was no association between child overweight and proximity to playgrounds, proximity to fast food restaurants, or level of neighborhood crime. The association between child overweight and playground proximity did not differ by neighborhood crime level. CONCLUSIONS: Within a population of urban low-income preschoolers, overweight was not associated with proximity to playgrounds and fast food restaurants or with the level of neighborhood crime.

Child, Preschool↗