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PubMed2004

Parental overweight, socioeconomic status and high birth weight are the major determinants of overweight and obesity in 5-7 y-old children: baseline data of the Kiel Obesity Prevention Study (KOPS).

OBJECTIVES: To identify the major risk factors of overweight and obesity in prepubertal children. DESIGN: Cross-sectional study. SETTING: In all, 32 primary schools in Kiel (248 000 inhabitants), northwest Germany. SUBJECTS: A total of 2631 5-7-y-old German children and their parents. MAIN OUTCOME MEASURES: Weight status, socio-economic status (SES), parental overweight, dietary intake, activity, inactivity and further determinants (birth weight, breast feeding, nutritional status of siblings) of the children. RESULTS: The prevalence of overweight (>/=90th BMI percentile of reference) was 9.2% in boys and 11.2% in girls, respectively. Considered univariately, family-, environment- and development-related determinants showed some relations to overweight and obesity. In multivariate analyses parental overweight, a low SES as well as a high birth weight were the strongest independent risk factors of overweight and obesity in children. Additionally, there were sex-specific risk factors: parental smoking and single households were risk factors in boys, whereas a low activity was associated with obesity in girls. Birth weight was associated with obesity, but not with overweight. The prevalence of obesity reached 29.2% in boys and 33.4% in girls with all the three main risk factors. CONCLUSIONS: Overweight families of low SES have the highest risk of overweight and obese children. Future prevention programmes must also take into account sex-specific risk factors.

Analysis of Variance↗

PubMed2004

Identifying overweight high school students: prevalence of overweight in an ethnically diverse adolescent population in two Connecticut high schools.

BACKGROUND: The Third National Health and Nutritional Examination Survey, 1988-1994 (NHANES III) found that 11.5% of adolescents aged 12-17 years were overweight, and NHANES 1999-2000 found that 15.5% of adolescents aged 12-19 years were overweight. METHODS: Body Mass Indices and percentiles were obtained using medical records from 790 white, black, Hispanic, and Asian 11th-grade students. RESULTS: Contrasted with NHANES 1999-2000, this study found a higher prevalence of overweight among white males, a lower prevalence among blacks (both sexes), a lower prevalence among Hispanics than NHANES 1999-2000 found among Mexican Americans (both sexes), and a lower prevalence among all adolescents sampled. It found overweight in females highest in blacks and at risk of overweight highest among blacks and Hispanics (both sexes). CONCLUSIONS: Public attention should be focused on the high prevalence of overweight and at risk of overweight, particularly among minority high school students. Overweight and at risk of overweight students can be relatively easily identified by utilizing available medical records. Treatment and prevention efforts can then be initiated.

Adolescent↗

PubMed2004

Prevention of mildly overweight children from development of more overweight condition.

BACKGROUND: A follow-up study has reported that not only highly obese but also mildly obese children are becoming heavier during the elementary school children. Then we determined the effect of programs for the screening and treatment of overweight elementary school children whether the programs prevented mildly overweight children from development of more overweight condition. METHODS: Subjects were 40 overweight children who participated in both screening and treatment programs. As controls, only 240 children who participated in the screening program were used. The mean observation periods of the subjects and controls were 14 and 12 months, respectively. RESULTS: In both groups, older and heavier children significantly decreased their indices of overweight (percent relative body weight; %RBW), indicating that mildly obese children worsened their %RBW. However, the incidence of children who worsened their %RBW was significantly lower in the subjects (5 of 40) than in the controls (133 of 240) (P < 0.0001). Finally, the subjects significantly reduced their mean %RBW (P < 0.0001) and the controls significantly worsened it (P = 0.0093). CONCLUSION: The treatment program was found important because it prevents mildly overweight children who may worsen their overweight indices without the program from developing more overweight condition.

Blood Pressure↗

PubMed2006

Relations among multiple peer influences, body dissatisfaction, eating disturbance, and self-esteem: a comparison of average weight, at risk of overweight, and overweight adolescent girls.

OBJECTIVE: The goal of this study was to evaluate peer-related influences on appearance, body dissatisfaction, eating disturbance, and self-esteem in average weight, at risk of overweight, and overweight adolescent girls. METHODS: Three hundred twenty-five adolescent girls from high schools in Florida were assessed. Ninety met criteria for being at risk of overweight or overweight. Logistic and multiple regression analyses were used to evaluate group differences on all variables and to assess the amount of variance accounted for by peer-influence variables in the prediction of body dissatisfaction, eating disturbance, and self-esteem. RESULTS: Overweight and at risk of overweight girls scored higher than average weight girls on body dissatisfaction, dieting, and a peer measure that assessed negative comments and attributions about appearance. They also scored lower than average weight girls on self-report measures that assessed conversations about appearance and anti-dieting advice. How influential friends were in determining one's body image was a unique predictor of body dissatisfaction but only for the overweight and at risk of overweight group. CONCLUSIONS: Possible implications for clinical intervention programs are discussed along with directions for future research.

Adolescent↗

PubMed2001

[Increased prevalence of overweight and obesity in Dutch children, and the detection of overweight and obesity using international criteria and new reference diagrams].

OBJECTIVE: To determine the prevalence of overweight and obesity in Dutch children in 1980 and 1997 according to international criteria, and to design new reference diagrams for overweight and obesity in children. DESIGN: Descriptive. METHOD: The prevalence of overweight and obesity, based on height and weight data from the Fourth Dutch Growth Study (1997), was determined according to international criteria for age and sex. RESULTS: In 1997, the prevalence of overweight and obesity increased in both boys and girls compared to 1980: in 1997, the prevalence of overweight ranged between 7.1 and 15.5% for boys, and between 8.2 and 16.1% for girls. Both the prevalence of overweight and obesity was higher in girls than in boys. CONCLUSION: By applying the international criteria for overweight and obesity and reference growth diagrams based upon the 1997 Dutch growth study, the prevention and detection of overweight and obesity has to be implemented with vigour in Dutch youth health care.

Adolescent↗

PubMed2007

Timing and sequence of the onset of overweight, dieting, and binge eating in overweight patients with binge eating disorder.

OBJECTIVE: To examine the self-reported sequence and timing of onset of overweight, binge eating, and dieting in adult patients diagnosed with binge eating disorder (BED). METHOD: Participants were 284 treatment-seeking adults (73 men and 211 women) who met DSM-IV research criteria for BED. Patients were interviewed with structured diagnostic interviews and were queried regarding history of overweight, dieting, and binge eating behaviors. Questionnaires were also administered to assess current eating disturbances, body dissatisfaction, and general functioning. Participants were classified as Overweight First, Binge First, or Diet First, and the three groups were compared on developmental sequence and using the battery of measures. RESULTS: Sixty-three percent of the 284 participants reported becoming overweight prior to the onset of dieting or binge eating. Participants who reported they were overweight first had significantly greater BMI at the time of assessment. The 16% of the participants who reported binge eating first were significantly younger at the onset of BED diagnosis and reported significantly less dietary restraint. Onset order differed significantly by gender; proportionally more women (25%) than men (11%) reported that dieting preceded overweight or binge eating. CONCLUSION: Weight problems preceded dieting and binge eating behaviors for a majority of treatment-seeking overweight participants diagnosed with BED.

Adaptation, Psychological↗

PubMed2005

Cardiovascular risk factors in overweight German children and adolescents: relation to gender, age and degree of overweight.

OBJECTIVE: So far in Europe, no large studies have been published on the frequencies of the cardiovascular risk factors hypertension and dyslipidaemia in overweight children. METHODS: Diagnosis of hypertension, decreased HDL-cholesterol, increased triglycerides, total and LDL-cholesterol were documented for 1004 overweight children and adolescents (aged 4-8 years, 52% girls, BMI-SDS in median 2.43) referred to four obesity centres. Hypertension and dyslipidaemia were defined by cut off points above the 95th percentile of healthy children. Multivariate linear regression was conducted for the dependent variables systolic and diastolic blood pressure, triglycerides, HDL-, LDL-, and total cholesterol, including gender, degree of overweight (SDS-BMI) and age as independent variables. RESULTS: Thirty-seven percent of the children studied suffered from hypertension, 27% displayed increased total cholesterol, 26% increased LDL-cholesterol, 20% increased triglycerides and 18% decreased HDL-cholesterol. Seventy percent of all children had at least one unfavourable cardiovascular risk factor. Hypertension and dyslipidaemia were observed in any age group and in any degree of overweight at least twofold above the suspected rate of 5%. SDS-BMI was significantly related to blood pressure (systolic: coefficient 7.26, p < 0.001, diastolic: coefficient 3.21, p < 0.001), weakly to triglycerides (coefficient 0.12, p = 0.007), slightly negatively to HDL-cholesterol (coefficient -0.06, p = 0.001) and not related to total and LDL-cholesterol. Age was positively related to blood pressure (systolic: coefficient 2.436, p < 0.001, diastolic: coefficient 0.54, p < 0.001) and negatively to HDL cholesterol (coefficient -0.02, p < 0.001). CONCLUSION: Cardiovascular risk factors were frequently present in a large collective of overweight European children and adolescents. They occurred mostly independently of age, gender and degree of overweight. Therefore, screening for cardiovascular risk factors seems meaningful at any age and degree of overweight in childhood.

Adolescent↗

PubMed2004

Association of reduction in parental overweight with reduction in children's overweight with a 3-year follow-up.

BACKGROUND: Parental overweight has been reported to be a risk factor predicting obesity of their children. However, the effect of changes in parental overweight on the changes in children's overweight is not yet characterized. METHODS: Six hundred five children of 9-10 years underwent physical examinations and a survey concerning parents' body mass index (BMI) with a 3-year follow-up. RESULTS: In families where both parents' BMI was above 25 at baseline, when either parents' BMI decreased to less than 25 kg/m(2), children improved their adiposity, atherosclerosis index (AI), and systolic blood pressure (SBP). No such improvement was observed in children both of whose parents maintained BMI > or =25 kg/m(2). CONCLUSIONS: Improving parental overweight possibly reduced the risk of overweight in their children. Changes in parental overweight status were associated with changes in overweight status of their children.

Alanine Transaminase↗

PubMed2007

The B'Active programme for overweight primary school children in Glasgow: determining the prevalence of overweight and obesity and piloting an activity intervention.

The aim of this study was to determine the prevalence of overweight and obesity in primary school children in Glasgow and to evaluate a pilot activity programme for overweight and obese children. BMI was measured in 1548 children. Overweight, obesity and severe obesity were defined as BMI > or =85th, 95th and 98th centile, respectively. Overweight and obese children were then invited to participate in a 10-week school-based activity programme. The programme was evaluated by recording weekly attendance, intensity (using the Children's Effort Rating Scale) and enjoyment (scale 1-10). Focus groups were used to explore the experiences and views of the children, teachers, coaches and parents. Of the 1548 children, 31.4% were overweight, 19.1% were obese and 12.4% were severely obese; 38% of those invited attended the activity programme. Weekly programme attendance was 83% (range 56-99%). Mean enjoyment rating (scale 1-10) was 8 for boys and 9 for girls. The intensity of activity sessions were rated 'very easy' by boys and 'just feeling a strain' by girls. Common themes emerging from the focus groups related to perceived positive and negative aspects of the programme (fun, concerns about stigmatising children); physical and psychological outcomes (fitter, more confident); and future recommendations (involve parents). In summary, the prevalence of overweight and obesity was high. The activity programme was successful in terms of attendance and enjoyment, and overall views of the initiative were positive and there was compelling support for its continuation.

Black People↗

PubMed2006

Increases in overweight after adenotonsillectomy in overweight children with obstructive sleep-disordered breathing are associated with decreases in motor activity and hyperactivity.

OBJECTIVE: To examine the effect of adenotonsillectomy (T&A) in children with obstructive sleep-disordered breathing on growth, hyperactivity, and sleep and waking motor activity. METHODS: We studied 54 children who were aged 6 to 12 years and had adenotonsillar hypertrophy and an obstructive apnea-hypopnea index of > or =1 before and 12 months after they all received adenotonsillectomy (T&A). We measured their height, weight, percentage overweight (patient BMI - BMI at 50th percentile)/BMI at 50th percentile x 100) and obtained a hyperactivity score from parent report on a standardized behavior questionnaire scale. A subset of 21 of these children were also studied for motor activity by wrist actigraphy for 7 consecutive days and nights before and 12 months after T&A. RESULTS: After T&A, mean obstructive apnea-hypopnea index decreased from 7.6 to 0.6. Height percentile did not change, but weight percentile increased; as a consequence, percentage overweight increased from 32.0% to 36.3%. Hyperactivity scores and total daily motor activity were reduced after T&A. From linear regression, the reduction in hyperactivity scores predicted an increase in percentage overweight. Reduced motor activity was correlated with increased percentage overweight. CONCLUSIONS: An increase in percentage overweight after T&A in children with obstructive sleep-disordered breathing is correlated to decreased child hyperactivity scores and to decreased measured motor activity in the subset studied. These associations suggest that the increase in overweight may be attributable to reductions in physical activity and fidgeting energy expenditure.

Adenoidectomy↗

PubMed2006

Anthropometric determinants of a clustering of lipid-related metabolic risk factors in overweight and non-overweight adolescents--influence of cardiorespiratory fitness. The Avena study.

BACKGROUND/AIMS: To explore in adolescents the associations between simple anthropometric variables with a continuously distributed summary score for lipid-related metabolic risk in both overweight and non-overweight adolescents, and to test whether these associations are modified by the level of cardiorespiratory fitness. METHODS: Cardiorespiratory fitness, BMI, skinfold thicknesses, body circumferences, and a continuously distributed clustering of lipid- related metabolic risk (calculated from LDL and HDL cholesterol, triglycerides, and glucose) were measured in 524 adolescents (265 males, 259 females, 15.3 +/- 1.4 years) from the cross-sectional multicentric AVENA study. Participants were classified as overweight (including obesity) or non-overweight. RESULTS: Most anthropometric parameters were univariately related to the continuous lipid-related metabolic risk. However, after multicollinear analysis and generalized linear modelling, suprailiac skinfold thickness in males (p < 0.001, explained variance 12.2%) and waist-to-height ratio in females (p < 0.001, explained variance 10.0%) were the best determinants of the continuous metabolic risk score, after adjustment for age, sexual maturation, and economic status. These associations were slightly weakened in overweight males (p = 0.034) and females (p = 0.087), and did not interact with cardiorespiratory fitness. CONCLUSION: Our data emphasize the usefulness of suprailiac skinfold thickness in males and waist-to-height ratio in females as simple anthropometric measurements associated to an overall lipid-related metabolic risk, mainly in non-overweight adolescents and regardless their cardiorespiratory status.

Adolescent↗

PubMed2002

Overweight and risk of overweight in schoolchildren in the city of Rio de Janeiro, Brazil: prevalence and characteristics.

The association of overweight and risk of overweight with socio-economic and demographic variables was investigated among schoolchildren in the city of Rio de Janeiro, Brazil between 1995 and 1996. Data were obtained by direct interview and physical examination of boys and girls aged between 6 and 11 years in a two-stage, random sample, population-based survey. Univariate analysis was performed on the association between socio-economic and demographic predictors of overweight/risk of overweight and the dependent variables, i.e. body mass index (BMI), triceps skinfold and subscapular skinfold. Based on this analysis, logistic regression models were developed. The prevalence of overweight and risk of overweight was 37.8% in girls and 36.4% in boys. For the BMI model, the variables retained were age and number of persons per household; for the triceps skinfold model, the variables were age, gender and area of residence; and age, gender and persons/household were the variables for the subscapular skinfold model. The results suggest that both BMI and skinfold indicators should be used to assess overweight/risk of overweight and that public health programmes for schoolchildren should be developed to combat the alarming increase in obesity.

Age Factors↗

PubMed1994

A 40-year history of overweight children in Stockholm: life-time overweight, morbidity, and mortality.

We describe the 40-year weight history and adult morbidity and mortality in a cohort of 504 overweight children, aged 2 months to 16 years, who were admitted for investigation of their overweight to four children's hospitals in Stockholm between 1921 and 1947. Follow-up information was gathered by questionnaire at 10-year intervals, most recently in 1980-1983 (n = 458), on weight history (based on the body mass index (BMI = kg/m2)), as well as prevalence of cardiovascular disease (n = 143), diabetes (n = 39), and cancer (all types (n = 20)), reported during the 40 years of follow-up, and mortality from all causes (n = 55), determined from death certificate. The sample of overweight children remained overweight as adults; after age 55 years, the BMI began to decline for both genders. Female subjects were heavier than their male counterparts from postpuberty onward. Subjects who died by the 40-year follow-up and those reporting cardiovascular disease were significantly (P < or = 0.05) heavier at puberty and in adulthood than were healthier subjects. There was a marked increase in the BMI between postpuberty and age 25 among those who subsequently died, those who developed cardiovascular disease, and particularly among those who developed diabetes (P < or = 0.001). In contrast, those reporting cancer had a lower BMI throughout adulthood than those who did not. We conclude that overweight in adolescence may continue into adulthood and may be associated with subsequent adverse health outcomes.

Adolescent↗

PubMed2006

Factors related to overweight and risk for overweight status among low-income Hispanic children.

The purpose of this research was to investigate the agent, host, and environmental factors that are related to overweight status in a sample of low-income Hispanic toddlers who were enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children in a large southwestern city in the United States. Among children at risk for overweight status, the mothers' body mass index (BMI) and the number of servings of fat in the children's daily diet were positively associated with their weight/height percentiles whereas servings of protein in the daily diet and the children's reporting of hunger were negatively associated with their weight/height percentiles. Among overweight children, age was positively associated with their weight/height percentiles. No other variable in the ecological model was associated with normal weight or overweight children and their weight/height percentiles. Different approaches to dietary counseling and health promotion may be indicated based on a child's weight/height percentile or BMI.

Analysis of Variance↗

PubMed2006

Psychological status and weight-related distress in overweight or at-risk-for-overweight children.

OBJECTIVE: To associate psychological status, weight-related distress, and weight status during childhood in overweight or at-risk-for-overweight children. RESEARCH METHODS AND PROCEDURES: We associated self-report of depression, trait anxiety, and weight-related distress (body size dissatisfaction and weight-related peer teasing after controlling for the effects of weight) in 164 children (black 35%; age 11.9 +/- 2.5 years; girls 51%) who were overweight or at-high-risk-for-overweight and were not seeking weight loss. RESULTS: Overall, heavier children reported more psychological and weight-related distress. Black children reported more anxiety and body size dissatisfaction than white children, despite equivalent weights. However, psychological distress was not significantly associated with weight in white children. Girls reported more weight-related distress than boys. Depression was associated with weight-related teasing in all predictive models, except in the model using only black subjects. Trait anxiety was associated with report of peer teasing when using all subjects. Depression was also significantly associated with children's report of body size dissatisfaction in models using all subjects, only girls, or white subjects, but not in analyses using only boys or black subjects. For boys peer teasing was associated with body size dissatisfaction. In models including only black children, depression and trait anxiety were not significantly associated with either report of peer teasing or body size dissatisfaction. DISCUSSION: Regardless of race or sex, increasing weight is associated with emotional and weight-related distress in children. However, associations of psychological status, weight, and weight-related distress differ for girls and boys, and for black and white children.

Black or African American↗

PubMed1994

Guidelines for overweight in adolescent preventive services: recommendations from an expert committee. The Expert Committee on Clinical Guidelines for Overweight in Adolescent Preventive Services.

An expert committee was convened to determine specific criteria for overweight to be integrated into routine preventive screening of adolescents. Body mass index (BMI) should be used routinely to screen for overweight adolescents. Youth with BMIs > or = 95th percentile for age and sex, or > 30 (in kg/m2) should be considered overweight and referred for indepth medical follow-up to determine underlying diagnoses. Adolescents with BMIs > or = 85th percentile but < 95th percentile or < or = 30, should be considered at risk of overweight, and should be referred to a second-level screen. The second-level screen includes family history, blood pressure, total cholesterol, large prior increment in BMI, and concern about weight. If youths are positive for any of the items on the second-level screen they should be referred for further medical assessment.

Adolescent↗

PubMed1999

Tracking of body mass index in children in relation to overweight in adulthood.

Body mass index (BMI; in kg/m2) values at or above the 75th percentile are associated with increased morbidity and mortality in adulthood, and there are significant correlations between BMI values in childhood and in adulthood. The present study addresses the predictive value of childhood BMI for overweight at 35 +/- 5 y, defined as BMI >28 for men and BMI >26 for women. Analyses of data from 555 white children showed that overweight at age 35 y could be predicted from BMI at younger ages. The prediction is excellent at age 18 y, good at age 13 y, but only moderate at ages <13 y. For 18-y-olds with BMIs above the 60th percentile, the probability of overweight at age 35 y is 34% for men and 37% for women. A clinically applicable method is provided to assign an overweight child to a group with a known probability of high BMI values in adulthood.

Journal Article↗

PubMedDate not supplied

[Nutritional status of adolescents: "risk of overweight" and "overweight" in a public school in São Paulo].

This study aimed to assess the nutritional status of adolescents. A cross-sectional study was taken in a public high school in São Paulo, Brazil, with 92 students ages 11 to 17 years. The sample was performed using systematic statistical selection. Nutritional status of adolescents was assessed using body mass index (BMI), compared to WHO (1995) standards. Prevalence rates for "risk of overweight" and "overweight" were 27.9% and 4.6%, respectively, for boys, as compared to 10.2% and 16.3% for girls. Prevalence of "risk of overweight" and "overweight" was thus high for both sexes; the results were similar in comparison to other studies. In addition, the difference in nutritional status between genders was significant (p < 0.05).

Adolescent↗