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PubMed2006

Observation of family functioning at mealtime: a comparison between families of children with and without overweight.

OBJECTIVE: To examine differences between families of children with and without overweight on parental control and support. METHODS: Twenty-eight families with an overweight child and a control group of 28 families with a normal weight child (age range 7-13 years) participated in the study. Observations and self-reports of mealtime family functioning were administered and analyzed. RESULTS: Parents of children with overweight reported to exert more control on their children's feeding behavior and an equal amount of parental support in comparison with parents of children without overweight. However, observations at mealtime indicated that in families with an overweight child, maladaptive control strategies were twice as prevalent, and less parental support was displayed. CONCLUSIONS: Self-reports and observations provide complementary information on how parents interact with their overweight children. Family-based treatment programs should include discussions on the adequate amount of parental control and support.

Adolescent↗
PubMed2003

Long-term follow-up of overweight children: after training, after a single consultation session, and without treatment.

BACKGROUND: A satisfactory treatment of childhood obesity has not yet been found. An individual consultation session is the usual practice while experts recommend an outpatient training program consisting of a combination of physical exercise, nutrition education, and behavior therapy. METHODS: We analyzed degree of overweight (SDS-BMI) after one and two years in overweight children (aged 6-15 years) who had had a single consultation session (n = 66) and who had finished a one-year, structured outpatient training program consisting of physical exercise, nutrition education, and behavior therapy (n = 81). Furthermore we collected data on changes in weight for a control group of overweight children not receiving any treatment (n = 100) over the same period of time. RESULTS: There was no significant change in the degree of overweight over the period of two years either for the control group or for those having received single consultation. The participants of the training were in mean significantly less overweight than at the beginning of the training (P < 0.001), both after one year (mean change in SDS-BMI -0.38) and after the second year (mean change in SDS-BMI -0.30). CONCLUSIONS: Overweight children not receiving treatment do not reduce in weight. A single consultation session is not sufficient to achieve weight reduction in children. Weight reduction over at least two years can be achieved in part of the participants of a long-term, specialized treatment.

Adolescent↗
PubMed2004

Maternal prepregnancy overweight and obesity and the pattern of labor progression in term nulliparous women.

OBJECTIVE: To examine the effect of maternal overweight and obesity on labor progression. METHODS: We analyzed data from 612 nulliparous women with a term pregnancy that participated in the Pregnancy, Infection, and Nutrition Study from 1995 to 2002. The median duration of labor by each centimeter of cervical dilation was computed for normal-weight (body mass index [BMI] 19.8-26.0 kg/m2), overweight (BMI 26.1-29.0 kg/m2), and obese (BMI > 29.0 kg/m2) women and used as a measurement of labor progression. RESULTS: After adjusting for maternal height, labor induction, membrane rupture, oxytocin use, epidural analgesia, net maternal weight gain, and fetal size, the median duration of labor from 4 to 10 cm was significantly longer for both overweight and obese women, compared with normal-weight women (7.5, 7.9, and 6.2 hours, respectively). For overweight women, the prolongation was concentrated around 4-6 cm, whereas for obese women, their labor was significantly slower before 7 cm. CONCLUSION: Labor progression in overweight and obese women was significantly slower than that of normal-weight women before 6 cm of cervical dilation. Given that nearly one half of women of childbearing age are either overweight or obese, it is critical to consider differences in labor progression by maternal prepregnancy BMI before additional interventions are performed.

Body Mass Index↗
PubMed2005

Early rapid weight gain and current overweight in relation to asthma in adolescents born with very low birth weight.

Early catch-up growth and subsequent overweight are suggested to be associated with later cardiovascular diseases and later type II diabetes. However, the impact of early catch-up growth and childhood overweight on the development of asthma has been less studied, particularly in children born with very low birth weight (VLBW). A birth cohort of 74 VLBW children (birth weight < or = 1500 g) was followed from birth and investigated on asthma at 12 yr of age. Early rapid weight gain was in one way defined as an increase of weight > or =1 standard deviation score (SDS) at 6 months of corrected postnatal age. Current overweight was defined by body mass index (BMI) exceeding 21.2 and 21.7 kg/m(2), respectively, for boys and girls at 12 yr of age. Current asthma was diagnosed by a pediatrician, according to asthma ever in combination with a positive response to hypertonic saline bronchial provocation test and/or wheeze at physical examination at 12 yr old. Being overweight at 12 yr of age was associated with an increased risk for current asthma in the VLBW children [crude odds ratio (OR): 5.5, 95% confidence interval (CI): 1.3-22.2]. After adjustment for early weight gain and neonatal risk, the OR of overweight increased nearly three times (adjusted OR: 15.3, 95% CI: 2.5-90.6). Early rapid weight gain seemed to be inversely associated with current asthma (adjusted OR: 0.49 for an increase of weight equal to 1 SDS, 95% CI: 0.23-1.02, p = 0.06). In addition, early rapid weight gain was inversely associated with the magnitude of bronchial responsiveness at 12 yr (coefficient -1.15, p < 0.01). There was a strong and positive association between overweight and asthma at 12 yr of age in the VLBW children. This strong association had been reduced by early rapid weight gain, possibly via the reduction of bronchial responsiveness.

Adolescent↗
PubMed2005

Comparison of perioperative spirometric data following spinal or general anaesthesia in normal-weight and overweight gynaecological patients.

BACKGROUND: There is limited data comparing the impact of spinal anaesthesia (SA) and general anaesthesia (GA) on perioperative lung function. Here we assessed the differences of these two anaesthetic techniques on perioperative lung volumes in normal-weight (BMI < 25) and overweight (BMI 25-30) patients using spirometry. METHODS: We prospectively studied 84 consenting patients having operations in the vaginal region receiving either GA (n = 41) or SA (n = 43). Both groups (GA and SA) were further divided into two subgroups each (normal-weight vs. overweight). We measured vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), midexpiratory (MEF25-75) and peak expiratory flow rates (PEFR) at the preoperative assessment (baseline), after premedication, after effective SA, and 20 min, 1 h, 2 h and 3 h after the operation (last measurement after patient mobilization). RESULTS: Premedication was associated with a small but significant decrease in lung volumes in direct correlation with BMI (-5%). Spinal anaesthesia resulted in a significant reduction in lung volumes in overweight as opposed to normal-weight patients. Postoperatively, lung volumes were significantly more reduced following GA than SA as indicated by differences in mean VC (SD) of -12 (6)% vs. -6 (5)% 20 min after the end of the operation in the normal-weight and -18 (5)% vs. -10 (5)% in the overweight patients. There was a significant impact of BMI on postoperative respiratory function, which was significantly more important in the GA group than in the SA group, and recovery of lung volumes was more rapid in the normal-weight patients than in the overweight patients, particularly in the SA group. CONCLUSION: In gynaecological patients undergoing vaginal surgery, the impact of anaesthesia on postoperative lung function as assessed by spirometry was significantly less after SA than GA, particularly in overweight patients.

Adult↗
PubMed2004

Prevalence of overweight and smoking patients with coronary heart disease in rural China.

OBJECTIVE: To investigate the prevalence of overweight and/or smoking patients with coronary artery disease in rural China. DESIGN: A prospective survey with qualitative, open-ended questionnaires. SETTING: Tertiary referral centre. SUBJECTS: 158 hospitalised patients (71 men and 87 women) with established coronary heart disease. MAIN OUTCOME MEASURES: To determine the prevalence of overweight and/or smoking hospitalised patients who had a definitive diagnosis of coronary artery disease and to determine participants understanding of these risk factors. RESULTS: Being overweight and smoking cigarettes were found in 32.7% and 15.2% of the participants, respectively. More than 70% of the overweight participants had neither knowledge nor counselling on their weight before the study. Most smokers believed smoking was harmful to their health and cardiac condition, and had tried unsuccessfully to quit smoking. CONCLUSIONS: There was a high prevalence of overweight and/or smoking patients with coronary heart disease. A systematic approach is urgently required to educate patients and primary care physicians, and to improve the management of being overweight and smoking cigarettes.

Adult↗
PubMed2005

Major differences in prevalence of overweight according to nationality in preschool children living in Germany: determinants and public health implications.

AIMS: To investigate the prevalence of overweight according to nationality in preschool children living in Germany, and to establish the determinants responsible for differences in body mass index. METHODS: The study was performed within the context of the 2001/2002 obligatory health examination before school entry in the city of Aachen, Germany. Of 2020 eligible children 1979 children were recruited (participation rate: 98%). Children's height and weight were measured using a standardised protocol. The parents completed a standardised questionnaire on sociodemographic factors and possible determinants of nutritional status. Being overweight was defined according to age and sex specific reference values for German children as well as according to international reference values. RESULTS: The study population included 452 (22.9%) children with other than German nationality. Among these children the prevalence of overweight was twice as high than among German children (14.8% v 7.2%). Prevalence of most known risk factors for overweight, such as low physical activity, high consumption of soft drinks, and frequent visits to fast-food restaurants was higher in the children with other nationalities than in the German children. Multivariate analyses revealed that most of the difference in prevalence of obesity by nationality is explained by known risk factors of overweight, especially education of mother and watching TV. CONCLUSIONS: The apparent ethnic differences could be explained by two non-ethnic but socioeconomic factors. In preventing overweight in children, there is the need to identify and deal with high risk environments rather than high risk ethnic groups.

Body Mass Index↗
PubMed2000

Relation of weight gain and weight loss on subsequent diabetes risk in overweight adults.

STUDY OBJECTIVE: To determine whether long term weight gain and weight loss are associated with subsequent risk of type 2 diabetes in overweight, non-diabetic adults. DESIGN: Prospective cohort. Baseline overweight was defined as BMI>/=27.3 for women and BMI>/=27. 8 for men. Annual weight change (kg/year) over 10 years was calculated using measured weight at subjects' baseline and first follow up examinations. In the 10 years after measurement of weight change, incident cases of diabetes were ascertained by self report, hospital discharge records, and death certificates. SETTING: Community. PARTICIPANTS: 1929 overweight, non-diabetic adults. MAIN RESULTS: Incident diabetes was ascertained in 251 subjects. Age adjusted cumulative incidence increased from 9.6% for BMI<29 to 26. 2% for BMI>/=37. Annual weight change over 10 years was higher in subjects who become diabetic compared with those who did not for all BMI<35. Relative to overweight people with stable weight, each kg of weight gained annually over 10 years was associated with a 49% increase in risk of developing diabetes in the subsequent 10 years. Each kg of weight lost annually over 10 years was associated with a 33% lower risk of diabetes in the subsequent 10 years. CONCLUSIONS: Weight gain was associated with substantially increased risk of diabetes among overweight adults, and even modest weight loss was associated with significantly reduced diabetes risk. Minor weight reductions may have major beneficial effects on subsequent diabetes risk in overweight adults at high risk of developing diabetes.

Adult↗
PubMed2003

Positive correlation of skeletal muscle UCP3 mRNA levels with overweight in male, but not in female, rats.

The objective of this study was to investigate the sex-dependent regulation of skeletal muscle uncoupling protein (UCP)3 mRNA expression in response to overweight and its relationship with serum levels of free fatty acids, leptin, and insulin. Two obesity models were used: rats made obese by feeding them with a cafeteria diet for 14 wk, and postcafeteria overweight rats fed a chow diet for 10 wk after consuming the cafeteria diet for 14 wk. The effects of 24-h fasting were studied in postcafeteria rats and their age-matched controls. The cafeteria rats ate a high-fat diet and attained an excess body weight that was higher in females (+59%) than in males (+39%). A trend to higher induction of abdominal muscle UCP3 mRNA in male rats than in females after cafeteria diet was apparent (+116% increase vs. +26% increase). Postcafeteria male but not female rats still showed the tendency to have increased UCP3 mRNA levels relative to their age-matched controls. A linear regression analysis showed a significant positive correlation of the UCP3 mRNA levels with overweight and with serum levels of leptin and insulin in males, but not in females, and no correlation with serum free fatty acid levels. A subsequent correlation analysis and a multiple linear regression analysis showed that overweight was the only parameter actually related to UCP3 mRNA levels in males. Fasting-induced upregulation of muscle UCP3 mRNA levels was higher in males (5- to 7-fold) than in females (3- to 4-fold). Our results point to the existence of sex-associated differences in the control of muscle UCP3 expression in response to overweight and fasting, with an impaired induction in female rats under both conditions. The correlation of abdominal muscle UCP3 mRNA expression with overweight in males could be related to their relative resistance to gain weight after chronic overeating of a cafeteria diet, by the purported role of UCP3 in the regulation of lipid utilization.

Animal Feed↗
PubMed1989

Overweight and obesity in Kuwait.

The aim of this study was to determine the prevalence of overweight and obesity among adult females. A multistage stratified sample of 2999 adult females was examined. 52.5% were found to be overweight (10-20% above reference weight tables) and 42% obese (more than 20% above reference standards). The numbers increased with age. There were fewer obese and more overweight the higher the standard of education, with a similar pattern with the husbands' standard of education. Obesity was more prevalent (46.8%) in non-working women, 36.8% among those in management and 32.9% among those in technical work, while the corresponding figures for those overweight were 47.7%, 56.9% and 62.2%. The prevalence of obesity increased with family size while that of overweight fell. A similar pattern was found with the number of children. Family income was inversely related to the prevalence of obesity and positively related to overweight.

Adolescent↗
PubMed2006

Prevalence of obesity, overweight, and underweight in Qatari adolescents.

BACKGROUND: Overweight and obesity have reached epidemic proportions in Arabian oil-rich countries and are threatening to become a global epidemic. Excess weight has a great impact on the health and quality of life of individuals. However, prevalence of underweight in the developing world has shown a decline during the last decade. OBJECTIVE: The aim of this cross-sectional study was to determine the prevalence of underweight, overweight, and obesity, as measured by body-mass index, in a representative sample of adolescents aged 12 to 17 years in the State of Qatar. METHODS: Qatari schoolchildren (n = 3,923) from 30 schools in urban and semiurban districts responded to a sociodemographic questionnaire. Body-mass index was calculated and the prevalence of overweight and obesity was determined on the basis of cutoff points of the International Obesity Task Force (IOTF) values (above the 85th and 95th percentiles, respectively, for overweight and obesity). Underweight was defined on the basis of CDC (Centers for Disease Control and Prevention) less than 5th percentile of BMI for age. RESULTS: The final sample consisted of 1,968 boys and 1,955 girls. The prevalence of underweight, overweight, and obesity was 8.6%, 28.6%, and 7.9%, respectively, among adolescent boys and 5.8%, 18.9%, and 4.7% among girls. The prevalence of underweight was highest at 16 years of age among boys (10.5%) and at 17 years among girls (8.9%). The prevalence of obesity was highest at 12 years of age among boys (11.7%) and at 13 years among girls (6.4%). The 95th percentile curve for boys was above the IOTF standard curve; the 95th percentile curve for girls was below the IOTF curve. CONCLUSIONS: Adolescents living in the State of Qatar are at high risk for overweight and obesity. There is a need to establish a national program for the prevention and treatment of obesity and related complications.

Adolescent↗
PubMed2006

Dieting practices, weight perceptions, and body composition: a comparison of normal weight, overweight, and obese college females.

BACKGROUND: Of concern to health educators is the suggestion that college females practice diet and health behaviors that contradict the 2005 dietary guidelines for Americans. In this regard, there remain gaps in the research related to dieting among college females. Namely, do normal weight individuals diet differently from those who are overweight or obese, and are there dieting practices used by females that can be adapted to promote a healthy body weight? Since it is well recognized that females diet, this study seeks to determine the dieting practices used among normal, overweight, and obese college females (do they diet differently) and identify dieting practices that could be pursued to help these females more appropriately achieve and maintain a healthy body weight. METHODS: A total of 185 female college students aged 18 to 24 years participated in this study. Height, weight, waist and hip circumferences, and skinfold thickness were measured to assess body composition. Surveys included a dieting practices questionnaire and a 30-day physical activity recall. Participants were classified according to body mass index (BMI) as normal weight (n = 113), overweight (n = 35), or obese (n = 21). Data were analyzed using JMP IN(R) software. Descriptive statistics included means, standard deviations, and frequency. Subsequent data analysis involved Pearson X2 and one-way analysis of variance with comparison for all pairs that were significantly different using Tukey-Kramer honestly significant difference test. RESULTS: Outcomes of this study indicate the majority of participants (83%) used dieting for weight loss and believed they would be 2% to 6% greater than current weight if they did not diet; normal weight, overweight, and obese groups perceived attractive weight to be 94%, 85%, and 74%, respectively, of current weight; 80% of participants reported using physical activity to control weight, although only 19% exercised at a level that would promote weight loss; only two of 15 dieting behaviors assessed differed in terms of prevalence of use among groups, which were consciously eating less than you want (44% normal weight, 57% overweight, 81% obese) and using artificial sweeteners (31% normal weight and overweight, 5% obese); and the most prevalent explicit maladaptive weight loss behavior was smoking cigarettes (used by 9% of participants) and most unhealthy was skipping breakfast (32%). CONCLUSION: Collectively, results indicate female college students, regardless of weight status, would benefit from open discussions with health educators regarding healthy and effective dieting practices to achieve/maintain a healthy body weight. The results are subject to replication among high school, middle-aged, and older females.

Adolescent↗
PubMed1998

Overweight prevalence in persons with Down syndrome.

Prevalence of overweight among the general population has been reported to be 33% for males and 36% for females. We undertook this study to establish overweight prevalence data in a cohort with Down syndrome and to stratify the incidence of overweight by living arrangement. We measured Body Mass Index (BMI) in 283 persons with Down syndrome and found a higher prevalence of overweight in this group compared to the general population. Individuals with Down syndrome living in a family setting had a higher incidence of overweight than did those living in a group home setting. Overweight prevalence among persons with Down syndrome should be considered a major public health concern that warrants further attention from researchers, practitioners, family members, and individuals with Down syndrome.

Adolescent↗
PubMed2005

Overweight, obesity, and health-related quality of life among adolescents: the National Longitudinal Study of Adolescent Health.

OBJECTIVE: Childhood and adolescent overweight and obesity have increased substantially in the past 2 decades, raising concerns about the physical and psychosocial consequences of childhood obesity. We investigated the association between obesity and health-related quality of life in a nationally representative sample of adolescents. METHODS: A cross-sectional analysis was conducted using the 1996 National Longitudinal Study of Adolescent Health, a nationally representative sample of adolescents in grades 7 to 12 during the 1994-1995 school year, and 4743 adolescents with direct measures of height and weight. Using Centers for Disease Control and Prevention growth charts to determine percentiles, we used 5 body mass categories. Underweight was at or below the 5th percentile, normal BMI was between the 5th and 85th percentiles, at risk for overweight was between the 85th and 95th percentiles, overweight was between the 95th and 97th percentiles + 2 BMI units, and obese was at or above the 97th percentile + 2 BMI units. Four dimensions of health-related quality of life were measured: general health (self-reported general health), physical health (absence or presence of functional limitations and illness symptoms), emotional health (the Center for Epidemiologic Studies Depression Scale and Rosenberg's self-esteem scale), and a school and social functioning scale. RESULTS: We found a statistically significant relationship between BMI and general and physical health but not psychosocial outcomes. Adolescents who were overweight had significantly worse self-reported health (odds ratio [OR]: 2.17; 95% confidence interval [CI]: 1.34-3.51), as did obese adolescents (OR: 4.49; 95% CI: 2.87-7.03). Overweight (OR: 1.81; 95% CI: 1.22-2.68) and obese (OR: 1.91; 95% CI: 1.24-1.95) adolescents were also more likely to have a functional limitation. Only among the youngest adolescents (ages 12-14) did we find a significant deleterious impact of overweight and obesity on depression, self-esteem, and school/social functioning. CONCLUSIONS: Using a nationally representative sample, we found that obesity in adolescence is linked with poor physical quality of life. However, in the general population, adolescents with above normal body mass did not report poorer emotional, school, or social functioning.

Activities of Daily Living↗
PubMed2003

Factors associated with overweight and obesity in Mexican school-age children: results from the National Nutrition Survey 1999.

OBJECTIVE: The objective of the study was to measure the prevalence of overweight and obesity in Mexican school-age children (5-11 years) in the National Nutrition Survey 1999 (NNS-1999). MATERIAL AND METHODS: Overweight and obesity (defined as an excess of adipose tissue in the body) were evaluated through the Body Mass Index (BMI) in 10,901 children, using the standard proposed by the International Obesity Task Force. Sociodemographic variables were obtained using a questionnaire administered to the children's mothers. RESULTS: The national prevalence of overweight and obesity was reported to be 19.5%. The highest prevalence figures were found in Mexico City (26.6%) and the North region (25.6%). When adjusting by region, rural or urban area, sex, maternal schooling, socioeconomic status, indigenous ethnicity and age, the highest prevalences of overweight and obesity were found among girls. The risks of overweight and obesity were positively associated with maternal schooling, children's age and socioeconomic status. CONCLUSIONS: Overweight and obesity are prevalent health problems in Mexican school-age children, particularly among girls, and positively associated with socioeconomic status, age, and maternal schooling. This is a major public health problem requiring preventive interventions to avoid future health consequences. The English version of this paper is available too at: http://www.insp.mx/salud/index.html.

Child↗
PubMed2003

[Risk factors for overweight in children from Southern Brazil].

Risk factors for overweight were investigated in a cross-sectional survey of children aged 12-59 months in the Southern Brazilian city of Porto Alegre (n = 2,660). Odds ratios (OR) for overweight, defined by weight/height > 2 z-scores of the NCHS standards, were estimated for socioeconomic and demographic conditions, social environment, and childhood health events. Prevalence of overweight was 6.5%. In the multivariate model, the odds of overweight were positively associated with maternal education (schooling > 12 years, OR = 2.36; 95%CI: 1.21-4.60; 9-11 years, OR = 2.07; 95%CI: 1.16-3.70) and family income per capita > 2 times the minimum wage (OR = 1.86; 95%CI: 1.13-3.08) and negatively associated with maternal work (OR = 0.72; 95%CI: 0.52-0.99). Odds were higher for children born large-for-gestational-age (OR = 2.29; 95%CI: 1.36-3.85) and lower for children born small (OR = 0.57; 95%CI: 0.33-0.99), as compared to those born with adequate birth weight for gestational age. Paternal schooling, parental occupation, and maternal age at the child's birth were associated with overweight in the unadjusted model only. Programs are needed to prevent overweight during childhood, with special attention to families and children at increased risk.

Body Weight↗
PubMed1984

Prevalence of overweight and weight loss behavior in a metropolitan adult population: the Minnesota Heart Survey experience.

Data from two major surveys, conducted in the Minneapolis-St. Paul metropolitan area in 1973-74 and 1980-81, were used to estimate the prevalence of overweight. In 1980-81, weight history and the prevalence of dieting behaviors were also obtained. The prevalence of overweight was greater in the 1980-81 survey than in 1973-74. Increases were observed in all ages in women, but only in the 40-59 year age ranges in men. In 1980-81, dieting to control weight was widely reported by both sexes, even among those who had never been overweight. Of those who reported having been overweight, approximately one-third reported they had successfully reduced. More men than women reported having been overweight, but more women reported having dieted to lose weight. Formal weight reduction programs were used much more by women than men. Although most dieting attempts consisted of balanced, reduced calorie regimens, a significant percentage were "fad" types, whose nutritional safety may be questioned. Overall, contrary to findings based on clinical populations, weight reducing efforts often appear to be successful. Nevertheless, overweight remains a significant public health problem in this community.

Adult↗
PubMed1988

Ethnic differences in female overweight: data from the 1985 National Health Interview Survey.

Ethnic differences in female overweight were analyzed using data from the 1985 National Health Interview Survey. The sample consisted of approximately 17,000 women, ages 18 and over. After adjusting for age and poverty status, there were clear differences in the proportions of women 20 per cent or more overweight among Black, Hispanic and other White women (35, 26 and 20 per cent, respectively). Black women were less likely than White women to perceive themselves as overweight when categorized by actual weight relative to ideal weight; however, within categories of weight relative to other women of the same ethnic group, all women not Hispanic were equally likely to consider themselves overweight. There was no difference by ethnicity in the proportion of women trying to lose weight among those who perceived themselves as overweight. These findings have implications for programs designed to modify weight, since they suggest that women use ethnic-specific standards in assessing overweight.

Adolescent↗