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PubMed2003

Measures of overweight status in school-age children.

Identifying and intervening with overweight children may decrease their likelihood of developing heart disease later in life. This secondary analysis of 58 children in the 3rd grade examined the prevalence of overweight children, methods for measuring overweight status, and the relationship among these measures and other risk factors for heart disease. Approximately one third of the 58 children were categorized as overweight. Several measures, such as weight, body fat percentage, body mass index (BMI), and skin-fold, are available to school nurses for measuring overweight status. The highest correlations were between BMI and weight and between BMI and body fat. Anthropometric measurements cannot predict cholesterol level, 24-hour diet recall, or family history. Blood pressure can be predicted by weight, body fat percentage, and BMI. BMI and body fat percentage highly correlate; however, body fat percentage is more liberal in identifying children at risk for overweight status. Therefore, body fat percentage is recommended for identification of overweight status in school-age children.

Anthropometry↗
PubMed2003

Relationship between apolipoprotein(a) size polymorphism and coronary heart disease in overweight subjects.

BACKGROUND: Overweight is associated with an increased cardiovascular risk which is only partially explained by conventional risk factors. The objective of this study was to evaluate lipoprotein(a) [Lp(a)] plasma levels and apolipoprotein(a) [apo(a)] phenotypes in relation to coronary heart disease (CHD) in overweight subjects. METHODS: A total of 275 overweight (BMI > or = 27 kg/m2) subjects, of which 155 had experienced a CHD event, 337 normal weight subjects with prior CHD and 103 CHD-free normal weight subjects were enrolled in the study. Lp(a) levels were determined by an ELISA technique and apo(a) isoforms were detected by a high-resolution immunoblotting method. RESULTS: Lp(a) levels were similar in the three study groups. Overweight subjects with CHD had Lp(a) concentrations significantly higher than those without [median (interquartile range): 20 (5-50.3) versus 12.6 (2.6-38.6) mg/dl, P < 0.05]. Furthermore, overweight subjects with CHD showed a higher prevalence of low molecular weight apo(a) isoforms than those without (55.5% versus 40.8%, P < 0.05) and with respect to the control group (55.5% versus 39.8%, P < 0.05). Stepwise regression analysis showed that apo(a) phenotypes, but not Lp(a) levels, entered the model as significant independent predictors of CHD in overweight subjects. CONCLUSIONS: Our data indicate that small-sized apo(a) isoforms are associated with CHD in overweight subjects. The characterization of apo(a) phenotypes might serve as a reliable biomarker to better assess the overall CHD risk of each subject with elevated BMI, leading to more intensive treatment of modifiable cardiovascular risk factors.

Apolipoproteins A↗
PubMed2006

Personal, social and environmental correlates of vegetable intake in normal weight and overweight 9 to 13-year old boys.

BACKGROUND: The first aim of the present study was to investigate differences in correlates of vegetable intake between the normal weight and the overweight boys in the Pro Children Cross Sectional Study. The second aim was to explore whether the association between vegetable intake and potential correlates is different in overweight boys compared with normal weight boys. METHODS: Random samples of mainly 11-year old children were recruited in 9 European countries. The total sample size consisted of 3960 boys (16.5% overweight). A validated self-report questionnaire was used to measure vegetable intake, and personal, social and environmental factors related to vegetable intake in the classroom. Weight and height were reported by the parents of the children in parents' questionnaires. RESULTS: Regression analyses explained 23% to 28% of the variance in vegetable intake by potential correlates. Liking, self-efficacy and bringing vegetables to school were related to intake in both normal weight and overweight boys (beta's>0.10). Active parental encouragement and availability at home was only related to intake in overweight boys (beta's>0.10), whereas knowledge about recommendations was only related to vegetable consumption in normal weight boys (beta>0.10) CONCLUSION: Intervention strategies to increase vegetable intake should focus on increase in liking and preferences, increase in self-efficacy, and increase in bringing vegetables to school in both normal weight and overweight boys. Further research should investigate whether advising parents of overweight boys to encourage their child to eat vegetables every day, to insist as far as possible that their child eats vegetables regularly and to make vegetables easily available at home is effective in changing vegetable intake.

Journal Article↗
PubMed2006

Increasing body mass index z-score is continuously associated with complications of overweight in children, even in the healthy weight range.

CONTEXT: Overweight/obesity in children is increasing. Incidence data for medical complications use arbitrary cutoff values for categories of overweight and obesity. Continuous relationships are seldom reported. OBJECTIVES: The objective of this study is to report relationships of child body mass index (BMI) z-score as a continuous variable with the medical complications of overweight. DESIGN: This study is a part of the larger, prospective cohort Growth and Development Study. SETTING: Children were recruited from the community through randomly selected primary schools. Overweight children seeking treatment were recruited through tertiary centers. PARTICIPANTS: Children aged 6-13 yr were community-recruited normal weight (n = 73), community-recruited overweight (n = 53), and overweight treatment-seeking (n = 51). Medical history, family history, and symptoms of complications of overweight were collected by interview, and physical examination was performed. Investigations included oral glucose tolerance tests, fasting lipids, and liver function tests. MAIN OUTCOME MEASURE: Adjusted regression was used to model each complication of obesity with age- and sex-specific child BMI z-scores entered as a continuous dependent variable. RESULTS: Adjusted logistic regression showed the proportion of children with musculoskeletal pain, obstructive sleep apnea symptoms, headaches, depression, anxiety, bullying, and acanthosis nigricans increased with child BMI z-score. Adjusted linear regression showed BMI z-score was significantly related to systolic and diastolic blood pressure, insulin during oral glucose tolerance test, total cholesterol, high-density lipoprotein, triglycerides, and alanine aminotransferase. CONCLUSION: Child's BMI z-score is independently related to complications of overweight and obesity in a linear or curvilinear fashion. Children's risks of most complications increase across the entire range of BMI values and are not defined by thresholds.

Adolescent↗
PubMed2005

Prevalence of and risk factors for childhood overweight and obesity.

BACKGROUND: Increases in childhood overweight and obesity have become an important public health problem in industrialized nations. Preventive public health action is required, but more research of risk factors is required before evidence-based initiatives can be developed and targeted effectively. We investigated the association between childhood overweight and obesity and risk factors relating to dietary habits, activities, parents and schools. METHODS: In 2003 we surveyed grade 5 students and their parents and school principals in Nova Scotia. We measured height and weight and assessed dietary habits (using Harvard's Youth/Adolescent Food Frequency Questionnaire), physical and sedentary activities, and parental and school-based risk factors. We estimated neighbourhood income by averaging, per school, the postal-code level means of household income of residential addresses of children attending that school. We used multilevel logistic regression to evaluate the significance of these risk factors for overweight and obesity. RESULTS: On the basis of measurements taken of 4298 grade 5 students, we estimated the provincial prevalence of overweight to be 32.9% and of obesity to be 9.9%. Children who bought lunch at school were at increased risk of overweight (fully adjusted odds ratio [OR] 1.39, 95% confidence interval [CI] 1.16-1.67), whereas those who ate supper together with their family 3 or more times a week were at decreased risk (OR 0.68, 95% CI 0.52-0.88). Physical education classes 2 or more times a week at school were associated with a decreased risk of overweight (OR 0.61, 95% CI 0.43-0.87) and obesity (OR 0.54, 95% CI 0.33-0.88). Children in high-income neighbourhoods were half as likely to be obese as their peers living in low-income neighbourhoods (OR 0.50, 95% CI 0.36-0.70). INTERPRETATION: Parents and schools provide important opportunities for public health initiatives for reducing childhood overweight and obesity. Children and schools in low-income neighbourhoods should receive priority in public health initiatives to reduce future socioeconomic inequalities in health.

Body Weight↗
PubMed2004

Gender diversity in developing overweight over 35 years of Westernization in an Inuit hunter cohort and ethno-specific body mass index for evaluation of body-weight abnormalities.

OBJECTIVE: To establish an Inuit body mass index (BMI) norm from a healthy, not malnourished, pure Inuit population and to investigate the development of overweight in the Inuit in Greenland. DESIGN: Longitudinal study with 35 years follow-up on overweight among Inuit in Greenland. METHODS: The heights and weights of 97% of all inhabitants in Eastgreenland in 1963 (n=1852) were recovered recently and BMI calculated. We obtained similar data in 96% of the 50-69-year-old population in Eastgreenland in 1998 and in a random sample of 25% of individuals aged 50-69 years in the capital Nuuk (n=535). RESULTS: Overweight or obesity, as defined by the World Health Organization (WHO), was found in 30% of all men and 22% of all women in Eastgreenland in 1963, and in 31% of young Inuit hunters in 1963. Such high rates were incompatible with a hunter's way of living. Inuit-specific BMI norms from data on healthy Inuit aged 20-29 years in 1963 were computed: men, 20.2-27.9; women, 17.9-27.7. These differed from the WHO classification (P<0.001). Using the Inuit-specific BMI norm for the classification of 50-69-year-old Inuit in 1963 and 1998, the fraction of overweight men increased by over six times (4.0 to 25.6%; P<0.001), and overweight increased with Westernization (P=0.001). The fraction of overweight women by the Inuit BMI norm doubled from 1963 to 1998 (14.0 to 30.7%; P<0.001) while median BMI remained unaltered (P=0.22) because the fraction of slim women more than doubled (3.5 to 9.0%; P<0.001). CONCLUSION: A steep increase in the fraction of overweight Inuit men and women calls for intervention. Westernization predicted increased BMI. In women the increased number of obese people was accompanied by an increased fraction of slim people. This illustrates that transition can be modified and indicates that monitoring of populations in transition should observe gender differences. Finally, the historical data argue against the global applicability of the WHO delineation of normal BMI.

Adult↗
PubMed2001

Low-grade systemic inflammation in overweight children.

OBJECTIVE: Human adipose tissue expresses and releases the proinflammatory cytokine interleukin-6, potentially inducing low-grade systemic inflammation in persons with excess body fat. To limit potential confounding by inflammation-related diseases and subclinical cardiovascular disease, we tested the hypothesis that overweight is associated with low-grade systemic inflammation in children. DESIGN AND SETTING: The third National Health and Nutrition Examination Survey, 1988-1994, a representative sample of the US population. PARTICIPANTS: A total of 3512 children 8 to 16 years of age. OUTCOME MEASURES: Elevated serum C-reactive protein concentration (CRP; >/=.22 mg/dL) and white blood cell count (10(9) cells/L). RESULTS: Elevated CRP was present in 7.1% of the boys and 6.1% of the girls. Overweight children (defined as having a body mass index or a sum of 3 skinfolds (triceps, subscapula, and supra-iliac) above the gender-specific 85th percentile) were more likely to have elevated CRP than were their normal-weight counterparts. After adjustment for potential confounders, including smoking and health status, the odds ratio (OR) was 3.74 (95% confidence interval [CI]: 1.66-8.43) for overweight boys and the OR was 3.17 (95% CI: 1.60-6.28) for overweight girls, based on the body mass index. Based on the sum of 3 skinfolds, these ORs were 5.11 (95% CI: 2.36-11.06) and 2.89 (95% CI: 1.49-5.59) for boys and girls, respectively. Overweight was also associated with statistically significant higher white blood cell counts. The results were similar when restricted to healthy, nonsmoking, nonestrogen-using children. CONCLUSIONS: In children 8 to 16 years of age, overweight is associated with higher CRP concentrations and higher white blood cell counts. These findings suggest a state of low-grade systemic inflammation in overweight children. inflammation, obesity, children.

Adipose Tissue↗
PubMed2003

Association between clinically meaningful behavior problems and overweight in children.

OBJECTIVE: To determine whether there is a relationship between clinically meaningful behavior problems and concurrent and future overweight in 8- to 11-year-old children. METHODS: 1998 National Longitudinal Survey of Youth interview data for 8- to 11-year-old children and their mothers were analyzed. A Behavior Problems Index score >90th percentile was considered clinically meaningful. Child overweight was defined as a body mass index (BMI) >or=95th percentile for age and sex. Multiple logistic regression was used to control for potential confounders (selected a priori): child's sex, race, use of behavior-modifying medication, history of academic retention, and hours of television per day; maternal obesity, smoking status, marital status, education, and depressive symptoms; family poverty status; and Home Observation for Measurement of the Environment-Short Form (HOME-SF) cognitive stimulation score. In an attempt to elucidate temporal sequence, a second analysis was conducted with a subsample of normal-weight children who became overweight between 1996 and 1998 while controlling for BMI z score in 1996. RESULTS: The sample included 755 mother-child pairs. Of the potential confounding variables, race, maternal obesity, academic grade retention, maternal education, poverty status, and HOME-SF cognitive stimulation score acted as joint confounders, altering the relationship between behavior problems and overweight in the multiple logistic regression model. With these covariates in the final model, behavior problems were independently associated with concurrent child overweight (adjusted odds ratio: 2.95; 95% confidence interval: 1.34-6.49). The relationship was strengthened in the subsample of previously normal-weight children, with race, maternal obesity, HOME-SF cognitive stimulation score, and 1996 BMI z score acting as confounders (adjusted odds ratio: 5.23; 95% confidence interval: 1.37-19.9). CONCLUSIONS: Clinically meaningful behavior problems in 8- to 11-year-old children were independently associated with an increased risk of concurrent overweight and becoming overweight in previously normal-weight children.

Body Mass Index↗
PubMed2004

Overweight, ethnicity, and the prevalence of hypertension in school-aged children.

OBJECTIVES: To describe the current prevalence of pediatric hypertension and the relationships between gender, ethnicity, overweight, and blood pressure. METHODS: School-based screening was performed in 5102 children (13.5 +/- 1.7 years) from May through November 2002. Age, gender, ethnicity, weight, and height were ascertained, and body mass index (BMI) was calculated as weight (kg)/height (m2). Overweight was defined as BMI > or =95th percentile. Students with blood pressure >95th percentile on the first screening underwent a second screening 1 to 2 weeks later, and then a third screening if blood pressure was >95th percentile at the second screening. RESULTS: Ethnicity distribution was 44% white, 25% Hispanic, 22% African American, and 7% Asian. Overall, overweight prevalence was 20%, which varied significantly by ethnicity (31% Hispanic, 20% African American, 15% white, and 11% Asian). The prevalence of elevated blood pressure after first, second, and third screenings was 19.4%, 9.5%, and 4.5%, respectively. Elevated blood pressure on first screening was highest among Hispanics (25%) and lowest among Asians (14%). Ethnic differences in the prevalence of hypertension (elevated blood pressure on 3 screenings) were not significant after controlling for overweight. The prevalence of hypertension increased progressively as the BMI percentile increased from < or =5th percentile (2%) to > or =95th percentile (11%). After adjustment for gender, ethnicity, overweight, and age, the relative risk of hypertension was significant for gender (relative risk: 1.50; confidence interval: 1.15, 1.95) and overweight (relative risk: 3.26; confidence interval: 2.50, 4.24). CONCLUSIONS: These results confirm an evolving epidemic of cardiovascular risk in youth, as evidenced by an increase in the prevalence of overweight and hypertension, notably among ethnic minority children.

Adolescent↗
PubMed2004

Associations between overweight and obesity with bullying behaviors in school-aged children.

OBJECTIVE: The prevalence of overweight and obesity in children is rising. Childhood obesity is associated with many negative social and psychological ramifications such as peer aggression. However, the relationship between overweight and obesity status with different forms of bullying behaviors remains unclear. The purpose of this article is to examine these relationships. METHODS: We examined associations between bullying behaviors (physical, verbal, relational, and sexual harassment) with overweight and obesity status in a representative sample of 5749 boys and girls (11-16 years old). The results were based on the Canadian records from the 2001/2002 World Health Organization Health Behaviour in School-Aged Children Survey. Body mass index (BMI) and bullying behaviors were determined from self-reports. RESULTS: With the exception of 15- to 16-year-old boys, relationships were observed between BMI category and peer victimization, such that overweight and obese youth were at greater relative odds of being victims of aggression than normal-weight youth. Strong and significant associations were seen for relational (eg, withdrawing friendship or spreading rumors or lies) and overt (eg, name-calling or teasing or hitting, kicking, or pushing) victimization but not for sexual harassment. Independent of gender, there were no associations between BMI category and bully-perpetrating in 11- to 14-year-olds. However, there were relationships between BMI category and bully-perpetrating in 15- to 16-year-old boys and girls such that the overweight and obese 15- to 16-year-olds were more likely to perpetrate bullying than their normal-weight classmates. Associations were seen for relational (boys only) and overt (both genders) forms of bully-perpetrating but not for sexual harassment. CONCLUSIONS: Overweight and obese school-aged children are more likely to be the victims and perpetrators of bullying behaviors than their normal-weight peers. These tendencies may hinder the short- and long-term social and psychological development of overweight and obese youth.

Adolescent↗
PubMed2004

Prepregnant overweight and obesity diminish the prolactin response to suckling in the first week postpartum.

OBJECTIVE: The population subgroups with the highest proportion of overweight and obese women often are characterized by the lowest rates of initiation and shortest durations of breastfeeding. We previously documented that these 2 population-level trends may be related. In a population of white women who lived in a rural area, we observed that prepregnant overweight and obesity were associated with failure to initiate and also to sustain lactation. The means by which being overweight or obese negatively affect lactational performance is unknown and likely to be multifactorial in origin, including the simple mechanical difficulties of latching on and proper positioning of the infant. In addition, we have shown that prepregnant body mass index (BMI) is negatively associated with the timing of lactogenesis II, the onset of copious milk secretion. Although the effects of obesity on the prolactin response to infant suckling have never been studied, we postulated that maternal obesity could compromise this important response. We proposed that this might occur because obesity alters the 24-hour spontaneous release of prolactin and also because prolactin secretion is blunted in response to various stimuli among obese subjects. The fall in progesterone concentration that occurs immediately postpartum is the trigger for the onset of copious milk secretion, but maintenance of prolactin and cortisol concentrations is necessary for this trigger to be effective. Adipose tissue concentrates progesterone. We proposed that this additional source of progesterone would lead to consistently higher progesterone concentrations among obese compared with normal-weight women. This, in turn, would lead to a delay in reaching the appropriate concentration to trigger the onset of lactogenesis II. We tested the hypotheses that a reduced prolactin response to suckling and higher-than-normal progesterone concentration in the first week after delivery might be among the means by which maternal overweight could compromise early lactation. METHODS: We enrolled 40 mothers of term infants from the same population that we studied previously. We measured serum prolactin and progesterone concentrations by radioimmunoassay before and 30 minutes after the beginning of a suckling episode at 48 hours and 7 days after delivery. We used path analysis to develop a parsimonious multivariate prediction of the prolactin response to suckling at 48 hours and 7 days postpartum. RESULTS: As expected, prolactin values decreased from 48 hours to 7 days postpartum. Women who were overweight or obese (using the Institute of Medicine's cutoff for women of a BMI >26 kg/m2) before conception had a lower prolactin response to suckling than normal-weight women at 48 hours but not at day 7. In multivariate analyses, overweight/obesity, primiparity, and birth weight were negatively associated with the prolactin response to suckling at 48 hours. After adjustment for confounding by time since delivery and the duration of the nursing episode, only overweight/obesity remained a significant negative predictor of prolactin response to suckling at day 7. Concentrations of progesterone decreased dramatically from 48 hours to 7 days postpartum but did not differ between normal-weight and overweight/obese women at either time. In addition, the decreases in progesterone concentrations from 48 hours to 7 days postpartum did not differ between the prepregnant BMI groups. CONCLUSION: The unique and important finding from this study is that overweight/obese women had a lower prolactin response to suckling. This would be expected to compromise the ability of overweight/obese women to produce milk and, over time, could lead to premature cessation of lactation. These findings are important because, during our observation period (just before and after lactogenesis II, the time of onset of copious milk secretion), the prolactin response to suckling is more important for milk production than it is later in lactation. We have previously shown that a high proportion of the overweight and obese women in women in this population who give up on breastfeeding do so at this time. This finding thus provides evidence of a biological basis for this association, and additional study of it is likely to be informative. We postulated that there would be consistently higher progesterone concentrations in the early postpartum period among obese compared with normal-weight women because adipose tissue is an extraplacental source of this hormone. This hypothesis was not supported in this study because there were no significant differences between normal-weight and overweight/obese women in progesterone concentrations at either 48 hours or 7 days postpartum. The values that we observed at these times were similar to those reported by others in the early postpartum period. The findings from this study add plausibility to our observation that initiation, not just duration of breastfeeding, is negatively affected by maternal overweight/obesity. Although women should begin pregnancy at a healthy weight and gain reasonably during gestation, not all will. Pediatricians can help overweight/obese women to succeed at breastfeeding by targeting them for contact with a lactation consultant before discharge from the hospital to be sure that they have received optimal advice on breastfeeding techniques. In addition, early contact with the mother after discharge--by calling her at home to offer her support and counseling for breastfeeding, by scheduling the first pediatric visit earlier than for other patients, or by enlisting the assistance of public health nurses for a home visit if this is possible--would help overweight/obese women to continue to breastfeed. Being overweight or obese is negatively associated with the prolactin response to suckling in the first week postpartum and, thus, may contribute to early lactation failure.

Adult↗
PubMed2003

[Overweight and obesity prevalence in Northeast and Southeast Regions of Brazil].

OBJECTIVE: to evaluate the prevalence of overweight and obesity in children, adolescents, adults and elderlies from Northeast and Southeast regions of Brazil. METHODS: anthropometric evaluation of 17.184 people, studied in Life Pattern Research conducted by Brazilian Institute of Geographic and Statistics in 1996/97, by body mass index. Overweight and obesity definitions according to body mass index values proposed by Cole et al. which are related to adult definition. RESULTS: It was studied a little more females in this study (53.1%). Average age was 29 years and five months ( +/- 20 years), median was 25 years and six months. Overweight prevalence was 10.8% in children, 9.9% in adolescents and 28.3% among adults and obesity was 7.3%, 1.8% and 9.7% respectively. It was noticed a gradual increase in overweight or obesity prevalence since infancy through adult age with decrease among the elderly. CONCLUSION: Prevalence of overweight and obesity joined is higher among females. More than half of the women among 50 and 69 years old, from Northeast and Southeast regions of Brazil have overweight or obesity. There are few studies of overweight and obesity among children and adolescents and a lot of definition for obesity in children which makes more difficult the comparison of studies of prevalence among children.

Adolescent↗
PubMed2006

Racial and ethnic differentials in overweight and obesity among 3-year-old children.

OBJECTIVES: We estimated racial/ethnic differences in overweight and obesity in a national sample of 3-year-olds from urban, low-income families and assessed possible determinants of differences. METHODS: Survey, in-home observation, and interview data were collected at birth, 1 year, and 3 years. We used logistic regression analyses and adjusted for a range of covariates in examining overweight and obesity differentials according to race/ethnicity. RESULTS: Thirty-five percent of the study children were overweight or obese. Hispanic children were twice as likely as either Black or White children to be overweight or obese. Although we controlled for a wide variety of characteristics, we were unable to explain either White-Hispanic or Black-Hispanic differences in overweight and obesity. However, birthweight, taking a bottle to bed, and mother's weight status were important predictors of children's overweight or obesity at age 3 years. CONCLUSIONS: Children's problems with overweight and obesity begin as early as age 3, and Hispanic children and those with obese mothers are especially at risk.

Adult↗
PubMed1986

The relation between overweight and subjective health according to age, social class, slimming behavior and smoking habits in Dutch adults.

Subjective health status was assessed in relation to overweight by administering a list of 51 health complaints to adult men and women who were either chronically overweight as defined by Body Mass Index (BMI) or not overweight, in a continuous morbidity registration in four general practices during the period 1967-83. Responses were received from 455 men (182 overweight) and 790 women (386 overweight), ages 26-66 years. Response rate (71 per cent) and age distribution (mean age 48) were similar in overweight and non-overweight groups of both sexes. BMI was correlated with the total number of complaints in women (r = 0.15) but not in men (r = 0.07). Multiple regression analysis revealed, however, that age was an effect modifier in this relation, there being a negative association between BMI and subjective health in younger men and a positive association in older men, whereas in women the association between BMI and subjective health was much more pronounced at younger ages than at older ages. In addition, current smoking habits and social class (in men and women) and reported slimming behavior (in women) had an independent relation to the total number of health complaints. BMI was also related to specific complaints and groups of complaints, particularly in women.

Adult↗
PubMed1986

Associations of moderate and severe overweight with self-reported illness and medical care in Dutch adults.

Data on height, weight, illness, medical care consumption, and demographic variables for 19,126 Dutch adults aged 20 years or older were obtained from three annual Health Interview Surveys. Data on severely overweight (Body Mass Index 30.0-40.0 kg/m2) and moderately overweight (BMI 25.0-29.9 kg/m2) subjects were compared with those on non-overweight persons (BMI 20.0-24.9 kg/m2), taking into account effects of sex, age, and educational level. In men, severe overweight was associated with hypertension, especially in men under 50 years of age. In women, severe overweight was associated with hypertension, diabetes, varicose veins, asthma/bronchitis, and hemorrhoids. Increased utilization of medical care and medications were also associated with severe overweight. For moderately overweight subjects, these associations were less clear or absent.

Adult↗
PubMed2003

The association of race, socioeconomic status, and health insurance status with the prevalence of overweight among children and adolescents.

OBJECTIVES: We examined the effect of race, socioeconomic status, and health insurance status on the prevalence of overweight among children and adolescents. METHODS: We studied an observational cohort from the 1996 Medical Expenditure Panel Survey Household Component. RESULTS: In the younger group, both Black and Latino children had a greater likelihood of being overweight compared with White children. Among the adolescent group, Latinos and Asian/Pacific Islanders were more likely to be overweight. Among adolescents, lacking health insurance and having public insurance were both positively associated with the prevalence of overweight. A relationship between insurance status and overweight was not observed for younger children. CONCLUSIONS: There are substantial racial differences in the prevalence of overweight for children and adolescents. Health insurance status is associated with the prevalence of overweight among adolescents.

Adolescent↗
PubMed2004

Childhood overweight in a New York City WIC population.

OBJECTIVES: We estimated the prevalence of overweight in a population of young children enrolled in a New York City Special Supplemental Nutrition Program for Women, Infants, and Children. METHODS: Administrative and survey data were collected from a sample of enrolled families. Body mass index (BMI) of 557 children aged 2, 3, and 4 years was compared by sociodemographic and nutrition characteristics. RESULTS: Forty percent of the children were overweight or at risk for overweight (BMI >/= 85th percentile). Compared with other racial/ethnic groups combined, Hispanic children were more than twice as likely (odds ratio = 2.6; 95% confidence interval = 1.8, 3.8) to be overweight or at risk for overweight. Two-year-olds were less likely to be overweight than 3- and 4-year-olds. CONCLUSIONS: Interventions to address childhood overweight should be culturally specific and target very young children.

Aid to Families with Dependent Children↗
PubMedDate not supplied

[Overweight and obesity prevalence in children and adolescents from a private school in Recife]

OBJECTIVES: To determine the prevalence of overweight and obesity in students from a private school in Recife; compare the prevalence rates of overweight and obesity in boys and girls and in different age groups (children and adolescents) and verify the correlation between body mass index and triceps skinfold thickness in this population. METHODS: Cross-sectional study with 762 students (332 children and 430 adolescents) from a middle/upper class school in Recife, in 1999. Overweight was defined as body mass index equal or above the 85th percentile for age and gender. Obesity was defined as body mass index and triceps skinfold thickness equal or above the 85th percentile. RESULTS: The prevalence rates were 26.2% (95%CI = 23 to 29%) for overweight, and 8.5% (CI95% = 6.5 to 10.5%) for obesity. Overweight was more prevalent among children (34.3%) than among adolescents (20.0%) (P<0.001). Obesity was more frequent among children (14.2%) than among adolescents (4.2%) (P<0.001). The prevalence of overweight in boys (34.6%) was higher than in girls (20.6%) (P<0.001). The prevalence of obesity was also higher in boys (14.7%) than in girls (4.4%) (P<0.001). The correlation coefficient between body mass index and triceps skinfold thickness was equal to 0.64 (95%CI = 0.60 to 0.68). CONCLUSIONS: The prevalence of overweight in our study population was as high as that found in industrialized countries; obesity, however, was less frequent.

Journal Article↗