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PubMed2006

Physical activity and overweight among adolescents on the Texas-Mexico border.

OBJECTIVE: To investigate differences in associations between physical activity and overweight for students in two adjacent areas on the border between Mexico and the United States of America: students in the city of Matamoros, Mexico, and Mexican-American students in the Lower Rio Grande Valley (LRGV) area of southern Texas. Since the extremely high prevalence of overweight among Mexican-American adolescents is well-recognized, we wanted to determine whether overweight has become a problem among Mexican adolescents as well. METHODS: Students from 6 schools (n = 653), representing 11% of the ninth-grade students in Matamoros during 2002-2003, and students from 13 high schools (n = 4,736), representing 22% of the ninth-grade students in the LRGV during 2000-2001, completed questionnaires. Polytomous logistic regression was performed to estimate the risk of being at risk for overweight (> or = 85th percentile to < 95th percentile of body mass index (BMI) for age and sex) and the risk of being overweight (> or = 95th percentile of BMI-for-age and sex) versus normal weight that were associated with measures of physical activity. For simplicity, the classification of normal weight also included underweight. RESULTS: A higher percentage of adolescents in the LRGV were at risk of overweight (17%) in comparison with adolescents from Matamoros (15%). The percentages of LRGV and Matamoros adolescents who were overweight were identical (17%). LRGV adolescent boys (OR = 0.87, 95% CI = 0.77-0.98) who participated in team sports were less likely to be at or above the 85th percentile of BMI-for-age and sex. Although of borderline significance, Matamoros and LRGV adolescent boys who participated in physical education classes were less likely to be at risk for overweight. Among neither the Matamoros students nor the LRGV students were any of the various other physical activity categories or levels associated with being at risk for overweight or being overweight. CONCLUSIONS: Nearly one-third of the students in both Matamoros and the LRGV are at risk for overweight or are overweight. Implementation of interventions on healthful dietary choices and participation in physical education classes and sports teams are essential for reducing the extremely high prevalence of overweight among students on both sides of the Texas/Mexico border.

Adolescent↗

PubMed2006

Awareness of risks of overweight among rural Australians.

INTRODUCTION: Overweight and obesity are highly prevalent in rural areas and pose significant risks to health. The aim of this study was to investigate whether the rural public in central Queensland are aware of the health risks of overweight and to determine whether their perceptions of weight status and methods used to assess weight status correspond with those of health professionals. METHODS: Adults were randomly selected from shoppers in shopping centres in Central Queensland, Australia, to self-complete a questionnaire that assessed participants' understanding of the health risks of overweight, perception of current weight, methods used to assess current weight and understanding of the concepts of body mass index (BMI) and waist-to-hip ratio (WHR). Participants were also asked to provide demographic details and self-report their height and weight. RESULTS: The majority of participants were appropriately aware that, regardless of their degree of physical activity, overweight is associated with increased risk of heart disease (92%), type 2 diabetes (83%) and stroke (83%). A large proportion were also aware of the association of overweight with sleep apnoea (69%), fertility problems (68%) and arthritis (57%) but few were aware of the link with asthma (35%) and various types of cancer (14-32%). Knowledge of the health risks of overweight did not differ greatly across the BMI spectrum, with similar beliefs expressed by those who were classified overweight or obese (based on self-reported data) and those who were not. Women were more aware of the health risks of overweight for type 2 diabetes and fertility problems, less likely to be overweight, and to more accurately perceive their weight status compared with men. The majority of participants used subjective measures to assess weight status and few used or understood BMI or WHR. CONCLUSIONS: Rural people in central Queensland appear to be well aware of the health risks of overweight but many are unable to identify overweight in themselves and few understand how to accurately gauge their weight status. This exploratory study highlights the need to educate people in these communities about accurate and objective measures to assess overweight and obesity. Further studies are needed to assess how common misperception of weight status is among rural populations in Australia and to determine whether this contributes to a higher prevalence of overweight and obesity in rural communities compared with urban areas.

Adult↗

PubMed2000

High prevalence of overweight children and adolescents in the Practice Partner Research Network.

OBJECTIVES: To determine the prevalences of overweight children and adolescents seeking care in 49 Practice Partner Research Network (PPRNet) primary care practices and to compare these rates with national population-based surveys. DESIGN AND SETTING: The prevalence of overweight subjects (>95th percentile for age and sex) and subjects at risk for being overweight (>85th percentile for age and sex) was calculated for 30445 children aged 6 through 19 years visiting PPRNet primary care practices from 1995 through 1997. Prevalences were compared with prevalences from the National Health and Nutrition Examination Surveys. Percentile cutoffs from the National Health Evaluation Survey were used as the baseline standard for the comparisons. MAIN OUTCOME MEASURE: Obesity prevalences. RESULTS: Thirty-six percent of boys aged 6 through 11 years and 35% of boys aged 12 through 17 years were either at risk for being overweight or overweight; 20% and 19% were overweight, respectively. Thirty-five percent of girls aged 6 through 11 years and 34% of girls aged 12 through 17 years were either at risk for being overweight or were overweight; 20% and 18% were overweight, respectively. Prevalences of overweight subjects and subjects at risk for being overweight were much greater in patients of PPRNet primary care practices compared with the most recent national survey, the National Health and Nutrition Examination Surveys III. CONCLUSIONS: One in 3 children and adolescents visiting PPRNet primary care practices is at risk for being overweight or is overweight. The prevalence of obesity in children and adolescents visiting primary care practices is much greater than that observed in national population-based surveys.

Adolescent↗

PubMed1997

Psychosocial concerns and health-compromising behaviors among overweight and nonoverweight adolescents.

OBJECTIVE: To compare weight-specific and global psychosocial concerns and health-compromising behaviors among overweight and nonoverweight youth across gender and ethnicity. METHODS: A cross-sectional school-based survey of 31,122 adolescents in grades 7 to 12. Based on self-reported heights and weights, respondents were categorized as nonoverweight (body mass index (BMI) < 85th percentile), moderately overweight (85th percentile < BMI < 95th percentile), or severely overweight (BMI > 95th percentile). RESULTS: Global psychosocial concerns, such as emotional well-being, suicidal ideation, future job concerns, and peer concerns, did not differ greatly between nonoverweight, moderately overweight, and severely overweight adolescents. Substance abuse behaviors were equally or less prevalent among the overweight group. Overweight girls were significantly less likely to consume alcohol, whereas overweight boys were at lower risk for marijuana use. In contrast, overweight youth were more likely to perceive their health as only fair or poor and were more likely to express weight-specific concerns and engage in behaviors such as chronic dieting and binge eating than nonoverweight youth. Overweight American Indian girls perceived their physical health more positively than nonoverweight American Indian girls. Strong associations were found between overweight status and chronic dieting among African American boys and girls. CONCLUSIONS: Nutritional counseling and educational programs need to address the weight-specific concerns and behaviors of overweight adolescents. However, assumptions regarding global psychosocial concerns and health-compromising behaviors among overweight adolescents of different genders and ethnicities should be avoided. These broad issues need to be explored in more depth at both the research and intervention levels.

Adolescent↗

PubMed2001

Family environmental factors influencing the developing behavioral controls of food intake and childhood overweight.

Although a large body of research has assessed direct genetic links between parent and child weight status, relatively little research has assessed the extent to which parents (particularly parents who are overweight) select environments that promote overweight among their children. Parents provide food environments for their children's early experiences with food and eating. These family eating environments include parents' own eating behaviors and child-feeding practices. Results of the limited research on behavioral mediators of familial patterns of overweight indicate that parents' own eating behaviors and their parenting practices influence the development of children's eating behaviors, mediating familial patterns of overweight. In particular, parents who are overweight, who have problems controlling their own food intake, or who are concerned about their children's risk for overweight may adopt controlling child-feeding practices in an attempt to prevent overweight in their children. Unfortunately, research reveals that these parental control attempts may interact with genetic predispositions to promote the development of problematic eating styles and childhood overweight. Although the authors have argued that behavioral mediators of family resemblances in weight status, such as parents' disinhibited or binge eating and parenting practices are shaped largely by environmental factors, individual differences in these behaviors also have genetic bases. A primary public health goal should be the development of family-based prevention programs for childhood overweight. The findings reviewed here suggest that effective prevention programs must focus on providing anticipatory guidance on parenting to foster patterns of preference and food selection in children more consistent with healthy diets and promote children's ability to self-regulate intake. Guidance for parents should include information on how children develop patterns of food intake in the family context. Practical advice for parents includes how to foster children's preferences for healthy foods and how to promote acceptance of new foods by children. Parents need to understand the costs of coercive feeding practices and be given alternatives to restricting food and pressuring children to eat. Providing parents with easy-to-use information regarding appropriate portion sizes for children is also essential as are suggestions on the timing and frequency of meals and snacks. Especially during early and middle childhood, family environments are the key contents for the development of food preferences, patterns of food intake, eating styles, and the development of activity preferences and patterns that shape children's developing weight status. Designing effective prevention programs will, however, require more complete knowledge than currently available regarding behavioral intermediaries that foster overweight, including the family factors that shape activity patterns, meals taken away from home, the impact of stress on family members' eating styles, food intake, activity patterns, and weight gain. The research presented here provides an example of how ideas regarding the effects of environmental factors and behavioral mediators on childhood overweight can be investigated. Such research requires the development of reliable and valid measures of environmental variables and behaviors. Because childhood overweight is a multifactorial problem, additional research is needed to develop and test theoretic models describing how a wide range of environmental factors and behavioral intermediaries can work in concert with genetic predispositions to promote the development of childhood overweight. The crucial test of these theoretic models will be in preventive interventions.

Adult↗

PubMed2001

Serum leptin and lipid profiles in Thai obese and overweight subjects.

The weight, height, body mass index (BMI), waist/hip ratio, serum leptin and lipid profiles of 48 overweight (BMI > or = 25.00). Thai males and 166 overweight Thai females, compared with 26 males and 81 females in a control group (BMI = 18.5-24.9 kg/m2), were investigated. Subjects for the study were those persons who turned up regularly for physical check-ups at the out-patient department, general practice section of the Rajvithi Hospital, Bangkok. The study was conducted between March-October, 1998. Statistically significantly higher levels of serum leptin, cholesterol, LDL-C, LDL-C/HDL-C ratio and triglyceride were found in the overweight compared with the control subjects. The median serum leptin concentration in overweight subjects was 19.6 (2.0-60.0 ng/ml) compared with 9.0 (range 1.0-30.0 ng/ml) in the control subjects (p < 0.001). The median values of leptin serum concentrations in the overweight and obese males were significantly higher than those of the overweight and obese females. A total of 66.7% (32 out of 48) of the overweight and obese males had elevated leptin levels, while elevated leptin levels were found in 87.3% (145 out of 166) of the overweight and obese females. A total of 18.8% and 21.1% of the overweight and obese males and females respectively had cholesterol concentrations of > or = 6.48 mmol/l. However, the prevalence of low HDL-C (HDL-C < or = 0.91 mmol/l) was found to be 41.7% in the overweight and obese males and 4.2% in the overweight and obese females. Statistically significant associations were found between weight, height, BMI, waist, hip, waist/hip ratio, HDL-C, and serum leptin in both overweight male and female subjects. A negative correlation was found between serum leptin and LDL-C/HDL-C ratio in both the overweight and obese subjects.

Adult↗

PubMed1999

Prevalence of childhood overweight in Northwestern Spain: a comparative study of two periods with a ten year interval.

OBJECTIVE: To determine the prevalence of overweight children and its modifications over a period of 10 y and whether changes in overweight prevalence is similar in the inland and coastal areas in our country. DESIGN: Cross-sectional study in two stages, the initial survey being in 1985 and the second in 1995. SUBJECTS: 1131 children (827 and 304 from coastal and inland areas respectively) in the initial survey, and 903 children (695 and 208 from coastal and inland areas) in the second survey, of both sexes, aged from 6 to 15 y were selected by a random process from the total school population in the Province of Pontevedra, North-western Spain. MEASUREMENTS: Overweight was defined in terms of body mass index (BMI), using Spanish standards. Children having BMI at or above the 85th percentile were classed as overweight and at or above the 95th percentile as very overweight. RESULTS: Overall prevalence of overweight and very overweight were significantly higher in the second survey than in the first, 18.1% vs 11.7%, P<0.05 for overweight prevalence and 6.8% vs 2.7%, P<0.05 for very overweight prevalence respectively. When we compared modifications in overweight prevalence over the period 10 y between the inland and coastal areas of our country, increase prevalence was observed in the inland area 9.8% vs 19.7%, P<0.05 for initial and secondary surveys respectively, whereas in the coastal area overweight prevalence remains stable, 20.2% vs 17.6%, P>0.05. CONCLUSION: An increased prevalence of overweight children of both sexes in over a period of 10 y was observed, however, this increase was particularly caused by an increased prevalence in the inland area whereas in coastal area it remained stable. We speculate that differences in overweight prevalence between both areas might be due to differences in physical activity associated with different degrees in technological development between inland and coastal areas.

Adolescent↗

PubMed2002

Secular trends in overweight and obesity among Finnish adolescents in 1977-1999.

OBJECTIVE: To study the trends in overweight and obesity among Finnish adolescents in 1977-1999. DESIGN: Mailed surveys every other year. SUBJECTS: Nationally representative samples of 12, 14, 16 and 18-y-olds (n = 64,147, response rate 78.9%). METHODS: Overweight and obesity were measured by body mass index (BMI) and relative weight (RW) based on self-reported height and weight. BMI > or = the 85th percentile cut-off point for BMI in each age- and sex-specific group in the entire data set was considered as overweight, and BMI > or = 95th percentile cut-off point as obesity. RW > or = 110% and > or = 120%, calculated as the individual's weight divided by the mean weight in each age- and sex-specific height percentile group in the entire data set, were considered as overweight and obesity, respectively. The trends in overweight and obesity are described by the change in the 85th and 95th percentile cut-off points of BMI over time. The prevalence of overweight and obesity is also reported using BMI reference values recommended for international comparisons. Because of the similarity of the BMI and the RW criteria in classifying adolescents as overweight and obese, only results based on BMI are presented. RESULTS: Overweight and obesity increased linearly in all sex and age groups from 1977 to 1999. Depending on the age group, the average increase in the 85th percentile cut-off point of the BMI per 10 y was 0.6-1.1 kg/m2 in boys and 0.3-0.7 kg/m2 in girls. The 95th percentile cut-off point of the BMI for boys and girls increased by 1.1-1.6 kg/m2 and by 0.6-1.0 kg/m2 per 10 y, respectively. In boys, the increase in overweight and obesity was largest in the two youngest age groups. In girls, the increase in overweight was largest in the oldest age group, and that of obesity both in the 14 and 18-y-olds. Overweight and obesity increased more in boys than in girls in all age groups except in the 18-y-olds among whom the increase was similar in both sexes. Examination of the entire BMI distribution showed that there was little or no change over time at the lower (5th, 15th) and middle (50th) percentiles, but increasing differences at the upper end of the distribution, the increases in the 95th percentile being even more marked than those in the 85th percentile curves. According to international reference values, the age-standardized prevalence of overweight increased in boys from 7.2 to 16.7%, and in girls from 4.0 to 9.8%, between 1977 and 1999. The prevalence of obesity in boys was 1.1% in 1977 and 2.7% in 1999, and in girls 0.4 and 1.4%, respectively. CONCLUSION: Overweight and obesity increased remarkably among Finnish adolescents from 1977 to 1999. The changes concentrated at the upper end of the BMI distribution, suggesting that factors behind this development have influenced only a part of the adolescent population.

Adolescent↗

PubMed2002

Social class differences in overweight of prepubertal children in northwest Germany.

OBJECTIVES: To assess social class differences in overweight and health-related behaviours in 5-7-y-old German children. DESIGN: Cross-sectional study. SETTING: Twenty-nine primary schools in Kiel (inhabitants: 248000), northwest Germany. SUBJECTS: A total of 1350 German 5-7-y-old children and their parents. MAIN OUTCOME MEASURES: Body mass index (BMI), fat mass and health-related behaviours of the children. Self-reported height and weight of their parents, parental school education as a measure of social class. RESULTS: The prevalence of overweight (> or = 90th percentile of reference) was 18.5%. There was an inverse social gradient (P < 0.01): the highest fat mass was observed in children from low social class. The odds ratios for overweight reached 3.1 (CI 1.7-5.4) in boys and 2.3 (CI 1.2-4.3) in girls, respectively (low vs high social class). Overweight parents (BMI > or = 25 kg/m2) were more likely to have overweight children. Parental overweight enhanced the inverse social gradient. The prevalence of overweight was 37.5% (low social class) vs 22.9% (high social class) in children from overweight parents, respectively. There was an inverse social gradient in unhealthy behaviours. Parental BMI and physical inactivity were independent risk factors of overweight in children. CONCLUSIONS: In 5 to 7-y-old children overweight and health-related behaviours are inversely related to social class. Parental overweight enhanced the risk of childhood overweight. The familial effect on body weight is most pronounced in children with low social class. Preventive measures should specifically tackle 'overweight families' from low social class.

Behavior↗

PubMed2002

Who is becoming overweight during the elementary school years?

OBJECTIVE: To determine the risk of becoming overweight for every first grader during the elementary school years and to determine whether the overall risk of becoming overweight for first graders is increasing. STUDY DESIGN: A descriptive study using school-based surveys of 12,588 boys and 12,264 girls who entered elementary school between 1989 and 1994. Six years later, the follow-up survey was conducted. Overweight was defined using the BMI percentile cut-off points. MEASUREMENTS: For every 5th percentile rank of first graders, the odds ratio for becoming overweight at seventh grade was calculated. A hockey stick regression analysis and the yearly trend of the risk for becoming overweight at 7th grade were also investigated. RESULTS: For overweight children in first grade, the odds ratio for staying at the same level was extremely high in both boys (35.0) and girls (63.9). The threshold effects of the BMI percentile value at first grade for becoming overweight were the 81st and 87th percentiles for boys and girls, respectively, according to the hockey stick model. The overall risk for becoming overweight significantly increased in boys during the study period (P=0.009). CONCLUSION: The present study determined the exact level of the risk for becoming overweight for every first grader at a different BMI percentile rank. The risk of overweight children in first grade who stayed at the same level at seventh grade was higher in girls than in boys. On the other hand, the trend of the entire population for becoming overweight presents only in boys. The different pattern of the trend of population for becoming overweight by sex during elementary school period may provide evidence to understand and predict overweight in adolescents and adults.

Age Factors↗

PubMed2005

Family and early life factors associated with changes in overweight status between ages 5 and 14 years: findings from the Mater University Study of Pregnancy and its outcomes.

OBJECTIVE: To describe different patterns of overweight status between ages 5 and 14 y and examine the role of modifiable family and early life characteristics in explaining different patterns of change between these two ages. DESIGN: A population-based prospective birth cohort. SUBJECTS: A total of 2934 children (52% males) who were participants in the Mater-University study of pregnancy, Brisbane, and who were examined at ages 5 and 14 y. MAIN OUTCOME MEASURES: Four patterns of change in overweight/obesity status between ages 5 and 14 y: (i) normal at both ages; (ii) normal at 5 y and overweight/obese at 14 y; (iii) overweight/obese at 5 y and normal at 14 y; (iv) overweight/obese at both ages. RESULTS: Of the 2934 participants, 2018 (68.8%) had a normal body mass index (BMI) at ages 5 and 14 y, 425 (14.5%) changed from a normal BMI at age 5 y to overweight or obese at age 14 y, 175 (6.0%) changed from being overweight or obese at age 5 y to normal weight at age 14 y and 316 (10.8%) were overweight or obese at both ages 5 and 14 y. Girls were more likely to make the transition from overweight or obese at age 5 y to normal at 14 y than their boy counterparts. Children whose parents were overweight or obese were more likely to change from having a normal BMI at age 5 y to being overweight at 14 y (fully adjusted RR: 6.17 (95% CI: 3.97, 9.59)) and were more likely to be overweight at both ages (7.44 (95% CI: 4.60, 12.02)). Birth weight and increase in weight over the first 6 months of life were both positively associated with being overweight at both ages. Other explanatory factors were not associated with the different overweight status transitions. CONCLUSIONS: Parental overweight status is an important determinant of whether a child is overweight at either stage or changes from being not overweight at 5 y to becoming so at 14 y.

Adolescent↗

PubMed2004

Leptin and asthma in overweight children at 12 years of age.

Obesity is suggested as a risk factor for asthma, but the mechanisms are unclear. The relationship between obesity and asthma has not been considered in children born with very low-birth weight (VLBW). We hypothesized that overweight was a contributing factor for asthma in VLBW children, and that leptin and leptin-associated cytokines might play roles in overweight-related asthma. Seventy-four VLBW and 64 normal birth weight (NBW) children participated in a 12-yr follow up study assessing asthma and allergy. Twenty-seven (12 VLBW) of the 138 children were overweight according to the proposed international definition. The diagnosis of current asthma was made by a pediatrician. Serum levels of leptin and interferon (IFN)-gamma were analyzed by enzyme-linked immunosorbent assay (ELISA). Leptin levels were considerably higher in the overweight than in the non-overweight children (median value: 18.1 vs. 2.8 ng/ml, p < 0.001). In the overweight children, current asthmatics had twice as high levels of leptin as children without current asthma (median value: 30.8 vs. 14.3 ng/ml, p = 0.14), but this was not the case in the non-overweight children. IFN-gamma was more often detected in the overweight than in the non-overweight children (61% vs. 12%, p < 0.001), and there was a positive correlation between the levels of leptin and the levels of IFN-gamma (Rho = 0.40, p < 0.001). In the VLBW group, the overweight children had a significantly increased risk for current asthma compared with the non-overweight children after adjustment for the neonatal risk factors [adjusted odds ratio (OR) 5.8, 95% confidence interval (CI): 1.2-27]. Thus, overweight was associated with asthma in the VLBW children. Our hypothesis remained that leptin might be involved in the pathogenesis of asthma in the overweight children, and IFN-gamma might be a pathway in the process of leptin-induced inflammation.

Asthma↗

PubMed2003

The relationships between anthropometric measurements, serum vitamin A and E concentrations and lipid profiles in overweight and obese subjects.

The weight, height, body mass index (BMI), waist/hip ratio, serum retinol and alpha-tocopherol and lipid profiles of 16 overweight (BMI > or = 25.0 kg/m2) Thai males and 56 overweight females, compared with 14 males and 58 females in a control group (BMI 18.5-24.9 kg/m2), were investigated. Subjects for the study were those persons who turned up regularly for physical check-up at the Outpatient Department, General Practice Section of Rajvithi Hospital, Bangkok. The study was conducted between December 2000-March 2001. Higher levels of cholesterol, LDL-C, LDL-C/HDL-C ratio were found in the overweight compared with the control subjects. Statistically significant higher triglyceride levels were found in the overweight compared with the control subjects. The median serum retinol concentration in overweight subjects was 2.80 mumol/L (range 0.53-4.62 mumol/L) compared with 2.97 mumol/L (range 1.21-4.12 mumol/L) in control subjects (p = 0.0736). The median serum alpha-tocopherol concentration in overweight subjects was 17.30 mumol/L (range 6.29-28.65 mumol/L) compared with 18.75 mumol/L (range 5.30-30.28 mumol/L) in control subjects (P < 0.05). The median values of retinol and alpha-tocopherol serum concentrations in the overweight and obese males were lower than those of the overweight and obese females. A total of 6.3% (1 out of 16) and 12.5% (2 out of 16) of the overweight/obese males had decreased retinol and alpha-tocopherol levels, while the overweight/obese females had decreased retinol and alpha-tocopherol level of 1.8% (1 out of 56) and 10.7% (6 out of 56), respectively. A total of 12.5% and 39.3% of the overweight/obese males and females had cholesterol concentrations of > or = 6.48 mmol/l. However, the prevalence of low HDL-C (HDL-C < or = 0.91 mmol/l) was found to be 50% in the overweight and obese males and 10.7% in the overweight and obese females. Statistically significant associations were found between age, cholesterol, LDL-C, and serum alpha-tocopherol in the overweight and obese male and female subjects. A negative correlation was found between weight, BMI, AC, MAMC, hip circumference and serum retinol in both the overweight and obese subjects. A negative correlation was found between weight, BMI, MAMC, waist, hip circumferences and serum alpha-tocopherol in both the overweight and obese subjects.

Adolescent↗

PubMed2004

[Dynamic analysis on the prevalence of obesity and overweight school-age children and adolescents in recent 15 years in China].

OBJECTIVE: In order to develop strategies on prevention and cure for obesity, a study regarding dynamic analyses on the prevalence of obesity and overweight of Chinese children and adolescents was carried out. METHODS: Data of more than 980 thousands students of Han nationality, aged 7 through 18 years old were collected from National Surveys on Chinese Students' Constitution and Health which were carried out in 1985, 1991, 1995 and 2000. Samples were divided into four groups as "metropolis", "medium and small sized cities", "prosperous village" and "below-averaged village". Study targets were screened using the new criterion-the "Reference Norm for Screening Overweight and Obesity in Chinese Children and Adolescents" which was set up by the Working Group on Obesity in China. The prevalence of overweight and obesity in various groups in different years were compared and analyzed. RESULTS: The prevalence rates of obesity in 1985 including from the metropolis area, were only 0.2% and 0.1% for boys and girls, and the prevalence of overweight was between 1% and 2% indicating that was no trend of obesity epidemic then. However, a rapid increase of overweight prevalence has been noticed since the early 1990s, and the increments were more seen in the urban than in the rural areas and more in boys than in girls. In the most developed cities including Beijing, the prevalence rates of obesity appeared to be 4.7%, 3.8% and 3.2%, among three groups with higher risk: the 7 - 9, 10 - 12 year-old boys and 7 - 9 year-old girls, respectively. Both high prevalence rates of malnutrition and overweight were also found in that period. Around 1995, a large scale of increments of overweight were found both in the urban and rural groups. In the most developed metropolis, the prevalence of overweight was two to three folds more than that of 10 years ago. The prevalence of obesity were 6% - 8% for boys and 4% - 6% for girls, respectively. Since 2000, most of the Chinese metropolis have started the so called 'overall increment period' of obesity. The prevalence rates of obesity plus overweight had reached 25.4%, 25.5%, 17.0% and 14.3% for boys aged 7 - 9 years and 10 - 12 years, and girls aged 7 - 9 years and 10 - 12 years, respectively. Among them, the prevalence rates of obesity were 12.9% and 9.1% for boys aged 7 - 9 and 10 - 12 years, which had already reached the average level seen in the medium-developed countries in the world. Although the increments of overweight were high, the prevalence of obesity was still low in most of the other groups: 4.8% for boys and 2.6% for girls in the "medium sized" group, 1.5% for boys and 1.7% for girls in the "prosperous village" group, and 0.9% for boys and 1.2% for girls in the "below-averaged village" group, respectively. CONCLUSIONS: The prevalence of obesity in Chinese children and adolescents was considered to be still relatively low. However, the rapid increasing of both obesity and overweight, in both urban and rural areas would arouse special attention. Comprehensive strategies of intervention should include periodical monitoring, education on pattern of nutrition, oxygen-consuming physical exercises and healthy dietary behavior. Two areas on obesity prevention to protect the child from becoming overweight in early ages, and to control the tendency of obesity from overweight, should be emphasized in order to improve the health status and life quality of the Chinese children and adolescents.

Adolescent↗

PubMed2007

Television watching and frequency of family meals are predictive of overweight onset and persistence in a national sample of school-aged children.

OBJECTIVE: To identify eating and activity factors associated with school-aged children's onset of overweight and persistent overweight. DESIGN: Data were gathered at four time points between kindergarten entry and spring of third grade. Children were directly weighed and measured and categorized as not overweight (<95th percentile of body mass index) or overweight (> or =95th percentile body mass index); parents were interviewed by telephone or in person. SUBJECTS/SETTING: Subjects were participants in the Early Childhood Longitudinal Study-Kindergarten Cohort, a nationally representative sample of children who entered kindergarten during 1998-1999. Children who weighed <2,000 g at birth, received therapeutic services before kindergarten, skipped or repeated a grade, or without complete height and weight data were excluded, resulting in 8,459 participants. Children with intermittent overweight were not examined (n=459); analyses addressed 8,000 children. MAIN OUTCOME MEASURES: Three mutually exclusive groups of children were identified: never overweight, overweight onset, and persistent overweight. STATISTICAL ANALYSES PERFORMED: Multilevel, multivariate logistic regression analyses estimated the effects of eating and activity factors on the odds of overweight onset and persistent overweight above child sex, race, and family socioeconomic status. RESULTS: Children who watched more television (odds ratio [OR] 1.02) and ate fewer family meals (OR 1.08) were more likely to be overweight for the first time at spring semester of third grade. Children who watched more television (OR 1.03), ate fewer family meals (OR 1.08), and lived in neighborhoods perceived by parents as less safe for outdoor play (OR 1.32) were more likely to be persistently overweight. Child aerobic exercise and opportunities for activity were not associated with a greater likelihood of weight problems. CONCLUSIONS: This study supports theories regarding the contributions of television watching, family meals, and neighborhood safety to childhood weight status. When working with families to prevent and treat childhood weight problems, food and nutrition professionals should attend to children's time spent with screen media, the frequency of family mealtimes, and parents' perceptions of neighborhood safety for children's outdoor play.

Body Mass Index↗

PubMed2006

Diet, activity, and overweight among preschool-age children enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

INTRODUCTION: Overweight is affecting children at younger ages and in increasing numbers, putting them at risk for a lifetime of chronic disease. Consumption of unhealthy foods and time spent watching television have increased concurrently. METHODS: Parents of 526 children aged 2 to 4 years old enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) answered questions about their children's food and beverage consumption, television-viewing and computer time, and physical activity. The children's height and weight measurements were collected from administrative records. Crude and adjusted odds ratios were calculated to test for associations between demographic, consumption, and activity variables and overweight or at risk of overweight (body mass index > or =85th percentile for age and sex). RESULTS: Of the participants, 38% of the children were overweight or at risk of overweight. Hispanic and white children were twice as likely as black children to be overweight or at risk of overweight. Fifty-eight percent of the children drank more than one and 30% drank more than two 8-oz servings of fruit juice per day. The children who drank more than one serving of nonjuice fruit drink per day (30%) had increased odds of being overweight or at risk of overweight. On average, the children spent more than twice as much time watching television and using computers as they did engaging in physical activity. In multivariate analyses, race and ethnicity as well as physical activity were associated with being overweight or at risk of overweight. CONCLUSION: Efforts to improve nutrition and prevent overweight in children should focus on the parents of infants and toddlers and provide them with anticipatory guidance on physical activity for young children and nutrition and food transitions.

Black or African American↗

PubMed2006

[Prevalence of overweight and obesity and its associated risk factors in students aged 11-17 in Xi'an in 2004].

OBJECTIVE: To assess the magnitude of overweight and obesity and its associated sociodemographic factors in adolescents attending junior high schools in Xi'an, Shanxi province. METHODS: A total of 1 804 adolescents attending junior high schools in Xi'an (age: 11-17 years) were enrolled randomly from 30 schools in 6 districts in Xi'an. Overweight and obesity was categorized with body mass index (BMI) cutoffs from Working Group of Obesity in China (WGOC). Underweight was defined by BMI-Z < or = -2 s. Sociodemographic information was collected from the parents of the survey participants using self-administered, structured and precoded questionnaires. RESULTS: Overall 17.4% of adolescents were overweight or obese (overweight 11.2%; obesity 6.2%), but there was a marked gender difference in the prevalence with 20.2% of boys versus 14.4% of the girls being overweight or obese. The prevalence of underweight was 2.7%. In a multivariate model, age, residence, household wealth, and parents' BMI were significantly associated with overweight and obesity (P < 0.05). After having been adjusted for age and gender, the odds ratio of an adolescent being overweight and obese was 2.7 (95% CI: 1.8-4.0) folds higher in urban areas than in rural areas, and was 1.6 (95% CI: 1.04-2.5) folds higher for adolescents from rich families than those from poor families. An adolescent with one or both parents overweight was 1.8 (95% CI: 1.3-2.5) more likely to be overweight themselves compared to those with normal weight parents. CONCLUSIONS: Overweight and obesity is a major public health problem in adolescents in Xi'an. Overweight and obesity is more prevalent in younger boys from richer families living in urban districts and those whose parents were either overweight or obese.

Adolescent↗

PubMed2003

Social marginalization of overweight children.

BACKGROUND: Overweight is the most common health problem that faces children and adolescents. Although the correlation among overweight, low self-esteem, and depression is well known, social isolation among overweight children and adolescents has not been studied. OBJECTIVE: To investigate social networks of overweight and normal-weight adolescents in a large, nationally representative sample. DESIGN: Cross-sectional, nationally representative cohort study. Population A total of 90 118 adolescents aged 13 to 18 years who were enrolled in the National Longitudinal Study of Adolescent Health, of which a 1:5 subsample was selected for detailed in-home assessment, including height and weight measurements (n = 17 557). Overweight was defined according to body mass index (>95th percentile for age and sex). MAIN OUTCOME MEASURES: This analysis focuses on the number of friendship nominations each adolescent received from other adolescents. The number of friendship nominations and other social network measures were calculated using statistical software. RESULTS: Overweight adolescents were more likely to be socially isolated and to be peripheral to social networks than were normal-weight adolescents. Although overweight adolescents listed similar numbers of friends as normal-weight adolescents, overweight adolescents received significantly fewer friendship nominations from others than were received by normal-weight adolescents (mean [SE] number of friendship nominations, 3.39 [0.08] vs 4.79 [0.04]; P<.001). Overweight adolescents were also more likely to receive no friendship nominations than were normal-weight adolescents (odds ratio, 1.71; 95% confidence interval, 1.39-2.20). Decreased television viewing (P<.001), increased levels of sports participation (P<.001), and increased participation in school clubs (P<.001) were associated with significantly more friendship nominations and higher network centrality scores among both overweight and normal-weight adolescents. CONCLUSIONS: Many overweight adolescents are socially marginalized. Such isolation may aggravate the social and emotional consequences of overweight in this age group.

Adolescent↗