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PubMed1996

Use of weight-for-height indices in children to predict adult overweight: the Bogalusa Heart Study.

OBJECTIVE: To compare the body mass index (BMI) (weight/height2) and the Ponderal index (PI) (weight/height3) in childhood as predictors of adult overweight in a biracial group of children. DESIGN: Prospective, 15-y follow-up. SUBJECTS: 835 children aged 10-15 y at baseline. MEASUREMENTS: Weight in kg and height in m. OUTCOME VARIABLE: Overweight, defined as a BMI greater than 27 kg/m2 in young adults. RESULTS: Overall, the BMI and the PI at baseline were identically correlated with the BMI at follow-up (r = 0.64, p < 0.001). However, the predictions of overweight based on each index were distinctively affected by age, sex and race. The probability of adult overweight among 10-year old children was greater than 0.5 (50% overweight threshold) if their BMI exceeded 17 kg/m2 in black girls, 20 in white girls and 18 in boys of either race. Similarly, the 50% BMI overweight thresholds among 15-year-old children were 23 kg/m2 for black girls, 25 for white girls and 22 for boys of either race. The 50% PI overweight thresholds (in kg/m2) were 12 and 14 for 10-year-old black girls and white girls, respectively; and 14 and 16 for 15-year-old black girls and white girls, respectively. Among boys, the 50% PI threshold was 13 kg/m3 regardless of age or race. CONCLUSION: The BMI and the PI in childhood were both useful in assessing sex-and race-specific risks of adult overweight. However, assessments based on the Ponderal index were less affected by age and race than those based on the BMI, particularly among boys. Hence, to establish general weight goals for children, aimed at preventing adult obesity, the PI could be a much better choice than the BMI.

Adolescent↗
PubMed1998

[Body composition in overweight children, healthy children as well as children with mucoviscidosis, measured by multifrequency impedance].

The body composition of a total of 90 children (aged 5-18) were subjected to multifrequency impedance measurement with a Human IM Scan impedance analyser. We compared data of 30 overweight children (17 boys, 13 girls; mean age 11.47 yrs, range: 4-17 yrs), 30 children with cystic fibrosis (12 boys, 18 girls; mean age 12.8 yrs, range: 3-24 yrs) and 30 healthy children (12 boys, 18 girls; mean age 13.4 yrs, range 7-18 yrs). The percentage of fat mass was found to be inversely proportional to total body water. Extracellular water expressed as a percentage of the total body water was significantly higher in overweight children than in the other two groups: (p < 0.01) between children with cystic fibrosis and overweight children, (p < 0.05) between healthy children and overweight children. Extracellular water expressed as a percentage of total body water was lower in children with cystic fibrosis than in healthy children (p < 0.05). The ratios of extracellular mass and body cell mass to body weight were significantly lower in overweight children than in healthy children (p < 0.01) or in children with cystic fibrosis (p < 0.01). The ratio of exchangeable sodium and potassium was lower in all three groups than the normal value given for adults (> 0.87), but in overweight children it was significantly higher than in the other two groups; (p < 0.01) between children with cystic fibrosis and overweight children, (p < 0.05) between healthy children and overweight children. Multifrequency impedance measurement is reliable, fast, non-invasive, easy to carry out, therefore we consider it very useful in determining the body composition of children in various pathological conditions.

Adolescent↗
PubMed2006

Television exposure and overweight risk in preschoolers.

OBJECTIVE: To test the independent effect of television exposure in preschool-aged children on overweight risk. DESIGN: Cross-sectional and longitudinal analysis of the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. SETTING: Ten US sites. PARTICIPANTS: One thousand sixteen children selected via conditional random sampling. MAIN EXPOSURE: Being awake in the room with the television on for 2 hours or more per day, by maternal report at age 36 months. MAIN OUTCOME MEASURES: Child overweight (body mass index [calculated as weight in kilograms divided by the square of height in meters] > or =95th percentile) calculated from measured anthropometrics at ages 36 and 54 months. Covariates tested included child sex and race; maternal marital status, education, age, and depressive symptoms; income-needs ratio, child behavior problems; Home Observation for Measurement of the Environment total score; hours per week in nonparental care; and proportion of television exposure that was educational. RESULTS: At age 36 months, 5.8% of children were overweight; at age 54 months, 10.0% were overweight. Exposure to 2 or more hours of television per day was associated with an increased risk of overweight at both age 36 months (odds ratio, 2.92; 95% confidence interval, 1.36-6.24) and age 54 months (odds ratio, 1.71; 95% confidence interval, 1.03-2.83) in unadjusted analyses. Only maternal age altered the concurrent relationship, and the effect of television remained significant (odds ratio, 2.61; 95% confidence interval, 1.21-5.62). Television exposure at age 36 months was no longer a significant predictor of overweight at age 54 months when controlling for covariates. CONCLUSION: Excessive television exposure is a risk factor for overweight in preschoolers independent of a number of potential confounders associated with the quality of the home environment.

Analysis of Variance↗
PubMed2006

Prenatal programming of childhood overweight and obesity.

OBJECTIVE: To review the scientific evidence for prenatal programming of childhood overweight and obesity, and discuss its implications for MCH research, practice, and policy. METHODS: A systematic review of observational studies examining the relationship between prenatal exposures and childhood overweight and obesity was conducted using MOOSE guidelines. The review included literature posted on PubMed and MDConsult and published between January 1975 and December 2005. Prenatal exposures to maternal diabetes, malnutrition, and cigarette smoking were examined, and primary study outcome was childhood overweight or obesity as measured by body mass index (BMI) for children ages 5 to 21. RESULTS: Four of six included studies of prenatal exposure to maternal diabetes found higher prevalence of childhood overweight or obesity among offspring of diabetic mothers, with the highest quality study reporting an odds ratio of adolescent overweight of 1.4 (95% CI 1.0-1.9). The Dutch famine study found that exposure to maternal malnutrition in early, but not late, gestation was associated with increased odds of childhood obesity (OR 1.9, 95% CI 1.5-2.4). All eight included studies of prenatal exposure to maternal smoking showed significantly increased odds of childhood overweight and obesity, with most odds ratios clustering around 1.5 to 2.0. The biological mechanisms mediating these relationships are unknown but may be partially related to programming of insulin, leptin, and glucocorticoid resistance in utero. CONCLUSION: Our review supports prenatal programming of childhood overweight and obesity. MCH research, practice, and policy need to consider the prenatal period a window of opportunity for obesity prevention.

Adolescent↗
PubMed2006

The College Health and Wellness Study: baseline correlates of overweight among African Americans.

Overweight and obesity are epidemic in the United States, particularly among minority populations. This epidemic contributes to the development of chronic conditions that occur later in life such as type 2 diabetes and hypertension. Therefore, it is important to identify factors associated with the development of obesity during young adulthood. We conducted a cross-sectional survey among students graduating from a Historically Black College or University (HBCU) in the Mid-Atlantic region. Participants were 392 predominantly African American seniors graduating in the spring of 2003. Data were collected using a self-administered paper and pencil questionnaire which focused on weight, weight management activities, individual and familial weight history, and health status indicators. Participants were on average 24 +/- 5 years of age and 69% female; over 90% identified as African American or Black. According to NIH guidelines, about 30% of males and 28% of females were considered overweight, 12% of males and 7% of females were considered obese, and 7% of males and females were considered extremely obese. Significant correlates of being more overweight were being married, having children, lower socio-economic status, weight-loss attempts, personal and family history of overweight, and poorer health status. These data suggest that among this sample, the prevalence of overweight and obesity is similar to other populations of young African American adults. Familial factors such as socio-economic status and family weight history were important correlates of overweight. Overweight is a significant problem in this population, and these data should be useful for developing weight loss interventions aimed at young adults.

Adult↗
PubMed2006

Socio-demographic and cultural comparison of overweight and obesity risk and prevalence in adolescents in Southern California and Wuhan, China.

PURPOSE: This study performed parallel analyses on two large samples of seventh graders living in Los Angeles, California and in Wuhan, China to make direct comparisons of overweight and obesity risks in Western and Eastern cultural environments. METHODS: Two representative samples of 1772 and 1896 seventh grade students were randomly selected from the public or parochial middle schools in the greater Los Angeles area of Southern California in the United States, and public schools in Wuhan city of China. Two body mass index (BMI) references recently established by the U.S. National Center for Health Statistics (NCHS) and the International Obesity Task Force (IOTF), respectively, were used to define overweight (85th < or = BMI < 95th percentile) and obesity (BMI > or = 95th percentile). Logistic regressions were conducted to examine relationships between socioeconomic status (SES) and obesity risk. RESULTS: The prevalence rates of combined overweight and obesity in Los Angeles and in Wuhan were 43.1% and 12.1%, respectively, by the US-NCHS reference, and 45.8% and 11.9%, respectively, by the IOTF reference. Chinese-American adolescents had higher prevalence rates for overweight and obesity than those from China. SES was positively related to the risk of overweight and obesity in the Chinese sample, whereas a negative association was found in Southern California adolescents. Urbanicity was significantly positively related to higher overweight and obesity prevalence. CONCLUSION: Different overweight and obesity prevalence estimates and SES effects were observed for American and Chinese adolescent samples. Research on the underlying mechanisms is needed to help us to set up a tailored program for obesity prevention in Eastern and Western cultural environments.

Adolescent↗
PubMed2006

The prevalence of overweight and obesity in pediatric survivors of cancer.

OBJECTIVE: To compare the prevalence of overweight in a cohort of pediatric survivors of cancer with that in the general population. STUDY DESIGN: We reviewed the charts of 441 cancer survivors followed at a Canadian tertiary care pediatric hospital and calculated their most recent body mass index. We compared this cohort with population data generated from the Canadian Community Health Survey. RESULTS: At a median age of 14.7 years (range, 3.4 to 19.5 years) and a median time from diagnosis of 9.7 years (range, 3.4 to 19.2 years), 140 of 441 patients (31.7%) were overweight or obese. Only 12 of the 441 patients (2.7%) were underweight. Males age 6 to 11 years (odds ratio [OR] = 2.29; 95% confidence interval [CI] = 1.36 to 3.86; P < .001) and male survivors of acute lymphoblastic leukemia (OR = 1.55; 95% CI = 1.03 to 2.52; P = .04) were more likely to be overweight than the general population. No other age or diagnostic group had an increased risk of overweight. CONCLUSIONS: The prevalence of overweight was not increased in this cohort compared with the general population. However, almost 1/3 of these patients are overweight, necessitating a clinical and research focus on preventing and combating overweight in childhood cancer survivors.

Adolescent↗
PubMed2006

Sib-size, birth order and risk of overweight in junior high school students in Japan: results of the Toyama Birth Cohort Study.

OBJECTIVE: To investigate whether there is a relationship between sib-size, birth order and the risk of overweight in junior high school students. METHOD: Sib-size, birth order, height and weight of subjects and their parents, and other lifestyle factors were obtained through a questionnaire survey conducted between June and July 2002 from 7,959 junior high students in Toyama prefecture, Japan. Logistic regression analysis was performed to examine the associations. Boys and girls were analyzed separately. RESULTS: Boys from three-child families showed a significantly lower risk of overweight than only boys (odds ratio (OR)=0.66, p=0.010), and girls from larger families have a significantly lower risk than only girls (p for trend=0.001). Compared to middle-born girls, only girls have a significantly higher risk of overweight (OR=2.22, p<0.001). The risk of overweight in boys was significantly lower with increasing number of elder sibling or sister. However, increasing of any one sibling almost had the same risk reduction effect on the risk of overweight in girls (OR ranged from 0.74 to 0.76, p<=0.001). CONCLUSION: Children without siblings are the ones most at risk for overweight, especially in girls. Birth order and sib-size are possible risk factors for the development of overweight and obesity.

Adolescent↗
PubMed2006

Who benefits from intervention in, as opposed to screening of, overweight and obese children?

AIMS: StEP TWO is a school- and family-based intervention consisting of extra lessons, healthy nutrition and physical education for overweight and obese children in primary schools, aimed at reducing body mass index by maintenance or reduction of weight, and improving motor abilities. We analysed differences in changes in anthropometric, cardiovascular and obesity parameters between children who underwent intervention, non-participants in intervention, and controls. METHODS: Anthropometric data and waist circumference were recorded for 1678 children; body mass index and body mass index-standard deviation score were calculated. Blood pressure was measured after 5 minutes at rest. 121 overweight and obese children enrolled at 3 schools involved in programmes of intervention were invited to take part; 40 of them completed the programme from November 2003 to July 2004. Of these overweight children, 74 were invited, but did not take part. As controls, we enrolled 155 overweight and obese children from 4 other schools. RESULTS: After the programme, the children involved in intervention showed a lower increase in the body mass index (0.3 plus or minus 1.3 versus 0.7 plus or minus 1.2 kilograms per metre squared) and an approximately three times higher diminution of the body mass index-standard deviation score in comparison with their controls (-0.15 plus or minus 0.26 versus 0.05 plus or minus 0.27). Systolic blood pressure was significantly lowered by 9.5 plus or minus 19.6 millimetres of mercury in those involved in intervention, but increased in the control group by 0.5 plus or minus 16.5 millimetres of mercury. Among those invited but not participating, the increase of the body mass index (0.5 plus or minus 1.3 kilograms per metre squared) was less, and the reduction of the body mass index-standard deviation score (-0.09 plus or minus 0.31) and systolic blood pressure (-5.3 plus or minus 15.6 millimetres of mercury) was higher than in the control group. Overweight but not obese children seem to benefit from a screening examination alone. CONCLUSIONS: Early preventive measures in schools are necessary and effective for overweight and obese primary school children. The screening itself seems also to have a minor positive effect, especially for overweight children. Sustainability of the observed improvements over a longer period remains to be confirmed.

Blood Pressure↗
PubMed2006

Soda consumption and overweight status of 2-year-old mexican-american children in california.

OBJECTIVE: The prevalence of overweight in United States children, 2 to 5 years old, has increased 2-fold since 1975, with the highest prevalence in Mexican Americans. The objective of this study was to determine the association between current soda consumption and overweight in 2-year-old Mexican-American children. RESEARCH METHODS AND PROCEDURES: The Center for the Health Assessment of Mothers and Children of Salinas study is a longitudinal study of the health of low-income Latino pregnant women and their children living in the Salinas Valley, CA. Six hundred pregnant women were enrolled (October 1999 to October 2000), and their children were followed until 2 years of age. This cross-sectional analysis includes the 354 children who completed the 2-year follow-up interview. Standing height (centimeters) and weight (grams) were measured at 2 years. Overweight was defined as > or =95th percentile of the sex-specific BMI for each child's age. RESULTS: Fifty-five (15.5%) children were overweight. Over half (56%) reported consuming any soda in the last week. After covariate adjustment, compared with no soda consumption, <1 soda/d was not related to overweight (adjusted odds ratio, 0.97; 95% confidence interval, 0.47, 1.99), but > or =1 soda/d was significantly associated with overweight (adjusted odds ratio, 3.39; 95% confidence interval, 1.43, 8.07), and the test for trend was significant (p = 0.02). DISCUSSION: At 2 years of age, the prevalence of overweight among the Center for the Health Assessment of Mothers and Children of Salinas cohort is higher than the national prevalence estimate for Mexican-American 2- to 5-year-old children and is significantly associated with current soda consumption. Interventions to reduce consumption of soda in young Mexican-American children should be considered.

Adult↗
PubMed2006

Overweight with concurrent stunting in very young children from rural Mexico: prevalence and associated factors.

OBJECTIVE: To document the prevalence of overweight or obesity concurrent with stunting in rural low-income Mexican children and to identify demographic and socio-economic characteristics that could help identify families at risk of having an overweight/obese and stunted young child in this population. DESIGN: Cross-sectional analysis of the nutritional status of very young children, using primary data from a rural community-based survey conducted in 2003. Overweight, obesity and stunting were documented along with several maternal, household and community characteristics. SETTING: Impoverished areas of rural Mexico. SUBJECTS: Pre-school children (n=7555), aged 24-72 months. RESULTS: The combined prevalence of overweight and obesity was equal to or greater than 20% in all children, as was the prevalence of stunting. The prevalence of concurrent overweight or obesity and stunting was approximately 5% in non-indigenous children, and over 10% in indigenous children 24-60 months. A multinomial logistic analysis revealed that the factors associated with coexisting stunting and overweight/obesity were lower socio-economic status (SES), lower maternal age, education, intelligence (vocabulary) and perceived social status, shorter maternal height, and larger household size. Among only stunted children, the risk of also being overweight or obese was associated with younger maternal age (relative risk ratios (RRR): 0.98, P=0.05), lower maternal perceived social status (RRR: 0.95, P<0.01) and maternal obesity (RRR: 2.93, P<0.0001) or overweight (RRR: 1.50, P=0.002). CONCLUSIONS: These analyses highlight that concurrent overweight or obesity and stunting is an important public health issue in low-income areas of rural Mexico beginning in early childhood. Even within this impoverished population, children living in households with low relative SES are the most vulnerable. SPONSORSHIP: Financial support for this research was provided by the National Institutes of Child Health and Human Development, the Fogarty International Center at NIH, the John D and Catherine T MacArthur Foundation 'Research Network on Socioeconomic Status and Health' and the Mexican Government.

Body Height↗
PubMed2006

Driving to work and overweight and obesity: findings from the 2003 New South Wales Health Survey, Australia.

OBJECTIVES: To examine possible associations between driving to work, physical activity and overweight and obesity. DESIGN: Secondary analysis of cross-sectional data from a representative sample of the 2003 New South Wales Adult Health Survey, Australia. SUBJECTS: A total of 6810 respondents aged 16 years or over. MEASUREMENTS: Self-reported height and weight, modes of transport to work, level of physical activity, fruit and vegetable intake and social-economic status. RESULTS: Almost half of the respondents (49%) were overweight. The main mode of transport to work was driving a car (69%), 15% used public transport, 7% walked, 2% cycled and 6% worked at home. People who drove to work were less likely to achieve recommended levels of physical activity compared to non-car users (56.3 vs 44.3%, chi2 = 82.5, P<0.0001). Driving to work was associated with being overweight or obese (adjusted odds ratio = 1.13 (95% CI 1.01-1.27), P = 0.047). Inadequate level of physical activity was independently associated with overweight or obesity. Socially and economically disadvantaged people were also more likely to be overweight and obese. In addition, being female or never married or having higher level of education was associated with a significantly reduced odds ratio of being overweight or obese, as was speaking a language other than English at home. No association was found between weight status and recommended vegetable or fruit intake. CONCLUSIONS: Driving to work is the dominant mode of commuting in a modern society and its impact on health requires scrutiny. The association found in this study between driving to work and overweight and obesity warrants further investigation to establish whether this relationship is causal. If proved as such, then promoting active transport modes such as walking, cycling and public transport should form a key component of global obesity prevention efforts.

Adolescent↗
PubMed2006

Children with a TV in their bedroom at higher risk for being overweight.

OBJECTIVE: We examined having a TV in the bedroom as a risk factor for child overweight. DESIGN: Cross-sectional study. SETTING: School- and telephone-based surveys in New Hampshire and Vermont between 2002 and 2004. PARTICIPANTS: Two thousand three hundred and forty-three children enrolled in public schools, aged 9-12 years, and one of their parents. MAIN EXPOSURES: The child having a TV in the bedroom. MAIN OUTCOME MEASURES: Age- and gender-standardized child body mass index (zBMI). Overweight was defined as equal to or above the 95th percentile for zBMI. RESULTS: Overall, 22.3% (N=523) of the children were overweight, and almost half of all children (48.2%, N=1130) had a TV in their bedroom. Children with a TV in their bedroom had a higher zBMI and were significantly more likely to be overweight compared to those without a TV in their bedroom (27.3 versus 17.7%, respectively; P<0.05). After controlling for sociodemographics, physical activity, frequency of TV or movie watching and internet use, children with a TV in their bedroom who watched at least one session of TV or movies per day were more likely to be overweight compared to those without a TV in their bedroom (odds ratio=1.32, 95% confidence interval: 1.03, 1.70). CONCLUSIONS: Having a TV in the bedroom is a risk factor for child overweight, independent of reported physical activity, participation in team sports, TV or movie watching time and internet use at home. Further study is needed to fully understand the mechanism by which having a TV in the bedroom increases children's risk for overweight.

Body Mass Index↗
PubMed2005

The Trp64Arg beta3-adrenergic receptor amino-acid variant is not associated with overweight and type 2 diabetes mellitus in Polish population.

The Trp64Arg amino-acid variant of the beta3 adrenoreceptor gene may be associated with a genetic predisposition to human obesity and related disorders, including type 2 diabetes mellitus. This relationship has been reported in various ethnic groups, however it was not extensively studied in Polish population. Therefore, the aim of the study was to investigate the association of Trp64Arg polymorphism of the beta3 adrenergic receptor gene with overweight and type 2 diabetes mellitus in polish subjects. The Trp64Arg polymorphism was determined by PCR-based MspI restriction fragment length polymorphism (PCR-RFLP). The study population consisted of 358 subjects, among whom 200 were diagnosed as overweight (BMI > 27 kg/m (2)). Among overweight subjects 111 presented with type 2 diabetes mellitus and 89 with normal glucose metabolism. All study participants were unrelated Caucasians and inhabited the city of Lodz, Poland. The frequency of the Arg allele did not differ significantly between overweight and normal weight patients (13 % vs. 11 %, OR 1.17, CI 0.74 - 1.85). The same applied to overweight diabetic patients vs. overweight patients without diabetes mellitus (13 % vs. 13 %, OR 0.97, CI 0.54 - 1.76). The obtained results suggest no association between Trp64Arg polymorphism of the beta3-AR gene and the incidence of overweight and type 2 diabetes mellitus in Polish population.

Aged↗
PubMed2006

Asthma and overweight are associated with symptoms of gastro-oesophageal reflux.

AIM: To explore the prevalence of symptoms suggestive of gastro-oesophageal reflux disease (GERD) in asthmatics and controls, and to control for the possible effect of overweight. METHODS: The prevalence of GERD symptoms was assessed using a questionnaire about reflux symptoms in children with asthma (n=872, mean age 10.4 y, 65% males) compared to non-asthmatic controls (n=264, mean age 10.8 y, 48% males), and a symptom score was calculated. The association between GERD symptoms and overweight (age-adjusted BMI > 25) was assessed independently. RESULTS: A positive reflux symptom score was found in 19.7% of the asthmatics compared to 8.5% of the non-asthmatic control group (odds ratio (OR) 2.6, 95% CI 1.7-4.2). Overweight children reported GERD symptoms more frequently than children with normal weight (OR 1.8, 95% CI 1.2-2.6). Asthma and obesity remained significant predictors when analysed simultaneously by logistic regression analysis. One hundred and fifty-two children with asthma consented to an oesophageal pH study, and an abnormal pH study result (reflux index > 5.0) correlated positively with overweight (OR 4.9, 95% CI 2.2-11.0). CONCLUSION: The prevalence of symptoms associated with gastro-oesophageal reflux was increased in children with asthma and in overweight children. Overweight and asthma were independently associated with GERD symptoms, and overweight did not explain the higher frequency of GERD in asthma patients.

Adolescent↗
PubMed2006

Are American children and adolescents of low socioeconomic status at increased risk of obesity? Changes in the association between overweight and family income between 1971 and 2002.

BACKGROUND: A good understanding of the association between obesity and socioeconomic status (SES) has many important public health and policies implications, particularly for the prevention and management of obesity. OBJECTIVE: The objective was to examine secular trends in the relations between overweight (body mass index > or = 95th percentile) and SES. DESIGN: We examined secular trends in the relation between overweight and SES using nationally representative data collected in the National Health and Nutrition Examination Surveys (NHANES) between 1971 and 2002 for 30 417 US children aged 2-18 y. Poverty income ratio tertiles at each survey were used to indicate low, middle, and high SES. RESULTS: Considerable race, sex, and age differences were observed in the association between overweight and SES. A reverse association only existed in white girls; African American children with a high SES were at increased risk. Socioeconomic disparities in overweight have changed over time, with an overall trend of weakening. Compared with the medium-SES group, the adjusted odds ratios and 95% CIs were 0.79 (0.47, 1.33), 1.08 (0.73, 1.61), 1.24 (0.73, 2.09), and 1.04 (0.82, 1.33) in NHANES I, II, and III and in the 1999-2002 NHANES for the low-SES group and 0.66 (0.43, 1.00), 0.60 (0.35, 1.03), 0.42 (0.23, 0.76), and 0.99 (0.68, 1.43) for the high-SES group, respectively. Between 1988-1994 and 1999-2002, the ratio in the prevalence of overweight between adolescent boys with a low or high SES decreased from 2.5 to 1.1 and from 3.1 to 1.6 in girls. Consistently across almost all SES groups, the prevalence of overweight was much higher in blacks than in whites. CONCLUSIONS: Complex patterns in the association between SES and overweight exist. Efforts solely targeting reductions in income disparities probably cannot effectively reduce racial disparities in obesity.

Adolescent↗
PubMed2006

Determinants of overweight in a cohort of Dutch children.

BACKGROUND: To improve the effective prevention and treatment of obesity, it is important to focus on body weight (BW) development and its determinants during childhood. OBJECTIVE: The aim of the present study was to investigate the effects of early development, parental and genetic variables, and behavioral determinants on overweight at 12 y. DESIGN: In a Dutch cohort of 105 children, anthropometric measurements were conducted from birth until age 7 y. At age 12 y, anthropometric measurements were obtained again, as were measurements of body composition, leptin concentration, 3 polymorphisms, and physical activity, and the Three-Factor Eating Questionnaire was conducted. In addition, parental body mass indexes (BMIs, in kg/m2) and Three-Factor Eating Questionnaire scores were determined. RESULTS: The children's mean (+/-SD) BMI at 12 y was 19.0 +/- 2.6, and 15.2% were classified as overweight. From the first year of life, BMI tracked significantly with BMI at age 12 y (r = 0.24, P < 0.05). Linear regression analyses showed that a rapid increase in BW during the first year of life, a high BMI of the father, and a high dietary restraint score of the mother were significantly associated with overweight at age 12 y (P < 0.05). No significant genetic relation was observed. In addition, overweight was positively associated with dietary restraint of the child, and percentage body fat was negatively associated with the child's activity score (P < 0.05). CONCLUSIONS: In this homogeneous cohort of normal-weight to moderately overweight children, tracking of BMI during childhood took place from the first year of life. Overweight at age 12 y was predicted by an early rapid increase in BW and parental influences. Overweight during childhood may be maintained or even promoted by a high dietary restraint score and low physical activity.

Body Composition↗
PubMed2006

Childhood overweight and orthodontists: results of a survey.

OBJECTIVES: A survey among orthodontists to assess clinical procedures of overweight screening and nutrition intervention among youth was conducted. METHODS: Orthodontists identified through professional society membership were invited to participate via email. The web-based survey collected information regarding overweight screening, nutrition counseling, and referral habits. RESULTS: 91% of 111 respondents reported counseling children and families on nutrition recommendations. Referral of overweight youth to a dietitian or pediatrician was sporadic. Orthodontists who felt that overweight had a severe negative impact on dental health were more likely to screen patients for overweight and perform dietary counseling for all patients than orthodontists who felt the impact of overweight on dental health was less severe. CONCLUSIONS: Orthodontists report regularly engaging in dietary discussions with their pediatric patients and may serve as important clinical advocates for healthy dietary choices among youth. Overweight screening and referral practices among orthodontists to appropriate health professionals should be further evaluated as interventions for pediatric obesity.

Attitude of Health Personnel↗