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Prevalence of overweight and obesity among children and adolescents in Thessaloniki-Greece and Kayseri-Turkey.

The aim of this study was to investigate the prevalence of overweight and obesity among children and adolescents in the city of Thessaloniki, Greece and in the Kayseri area of Turkey and compare the results. For this purpose, data concerning the weight and height of 2458 Greek school children aged 6-17 years (1226 6-10 years, 1232 11-17 years) and 3703 Turks (1032 6-10 years, 2671 11-17 years) were collected. BMI was calculated. The prevalence of overweight Greek schoolchildren was 22.2% while that of Turks was 10.6%. The obesity prevalence was 4.1% and 1.6%, respectively (total overweight and obese children 26.3% and 12.2%, respectively). In the analyses, the estimations of the prevalence of overweight and obesity are based on the international BMI percentile curves and cut-off points in subjects aged 2-18 years recently established. A significant gender difference was found, males being more overweight and obese compared to females. Finally, the prevalences for both Greeks and Turks were higher in children when compared to adolescents. In conclusion, Greece (as represented by the Thessaloniki area) has one of the highest prevalences of overweight schoolchildren recorded in Europe while Turkey (as represented by Kayseri area) one of the lowest recorded among developed and developing countries. Differences in lifestyle and socioeconomic status in the two regions are most probably responsible for these results.

Adolescent↗

[Trends in overweight and obesity in 45-64 year old men and women in Reykjavik 1975-1994.].

OBJECTIVE: The aim of this study was to assess possible changes in the prevalence of overweight and obesity in Iceland during the last decades. Furthermore, the possible effect of dietary changes on the observed trend in obesity prevalence was evaluated. MATERIAL AND METHODS: Participants came from stages III-V in the Reykjavik Health Study and the Reykjavik part of the MONICA studies from the period 1975-1994. The age groups 45-54 years and 55-64 years were examined. Only the information from the first visit of each person was included. The body mass index (BMI) for the participants was calculated and the percentage of those subjects considered overweight and obese according to WHO standards evaluated, using 25BMI<30 kg/m(2) as the cut-off point for overweight and BMI30 kg/m(2) as the cut-off point for obesity. Also, the observed trend in obesity prevalence is compared to changes in diet that have occurred in the same period. RESULTS: The results show that the mean weight and height of both men and women have been increasing during the study period. However, weight has increased more than can be accounted for by increased height, resulting in increased BMI. At the same time, the prevalence of overweight and obesity have increased, the relative increase in obesity far exceeding the relative increase in overweight. The prevalence of obesity more than doubled in both age groups of women during the study period, according to trend analyses. At the end of the period, almost 15% (95% confidence interval (CI), 9-22%) in the younger group of women and 25% (95% CI, 17-34%) in the older group were classified as obese. In the younger group of men, the prevalence of obesity almost doubled, while the observed increase in the older group was not statistically significant, according to trend analyses. The prevalence of obesity in the final period was about 19% (95% CI, 13-27%) and 17% (95% CI, 11-25%) in the younger and older groups of men, respectively. According to the food supply statistics there have been insignificant changes in the consumption of energy nutrients during the period. CONCLUSIONS: Overweight and obesity are becoming more common among middle-aged men and women in Reykjavik, during the period 1975-1994 and the rate of increase being comparable to that observed in many Western countries. It is urgent to respond to this problem by promoting a healthier lifestyle, both with respect to diet and physical activity.

English Abstract↗

[Subfertility in overweight women].

The prevalence of overweight individuals in The Netherlands is increasing sharply as has also been observed in populations worldwide. In addition to the long-term health risks of being overweight, overweight women of reproductive age are more commonly faced with reproductive disorders. Women who are overweight are less fertile than women of normal weight. The chances of both spontaneous conception and conception after ovulation induction and assisted reproduction are lower in women who are overweight. The chance of a live birth is also decreased due to an increased risk of miscarriage. Furthermore pregnancy outcome is compromised by obesity-related complications of pregnancy. Weight loss of 5-15% in subfertile women who are overweight increases the chance of spontaneous conception and conception after fertility treatment and can be achieved through a low-calorie diet, increased exercise and behaviour modification.

Female↗

Common major gene inheritance of extreme overweight.

We studied 3925 individuals in 961 families to determine the mode of inheritance of overweight. As an index of overweight, we examined body mass index. Our analyses indicate that the most likely genetic model for susceptibility to overweight included moderate polygenic inheritance (34% of variance resulting from many genes with small effects) and common (21% frequency) recessively expressed major genes (a few genes with large effects on the individuals who possess them). Standard statistical criteria for accepting both polygenic and major gene inheritance were met, including tests of Mendelian transmission. These results suggest that recessive major gene inheritance of overweight may be common and that homozygosity for overweight susceptibility alleles often results in overweight. Clinical, biologic, and empirical observations all suggest genetic heterogeneity, that is, more than one predisposing gene.

Adult↗

[Risk factors in overweight: a survey among female hospital personnel].

The purpose of this study was to explore the eventual relationship between the working conditions, and overweight women working in hospitals. The sample comprised 594 women working in hospitals in Lyon; 34% of them were overweight which is 10% above the theoretical weight. The rate of overweight hospital staff increased with the woman's age, the number of children and when the social level decreased. The analysis showed that being overweight was more frequent in women working in cleaning staff (56%) and in nursing auxiliaries (36%) than in nurses and administrative staff (24% and 27% respectively). After taking the above personal risk factors into account, this relationship remained the same. However, the night work and the length of service in hospitals are not found to be risk factors, after adjustment for the personal risk factors and type of work. Considering the women who were not overweight at the time of commencing employment, the relationship between being overweight and the type of working conditions in the hospitals disappeared.

Adult↗

Overweight and obesity in black women: a review of published data from the National Center for Health Statistics.

Overweight is a major health problem for black women in the United States. The age-adjusted prevalence of overweight was 47.1 percent in 1960-1962, 46.8 percent in 1971-1974, and 48.1 percent in 1976-1980 for black women aged 25 to 74 years, much higher than that of white women or men of either race. Black women born in later decades tended to be more overweight than those born earlier. Black women were first clearly more obese than white women in the third decade of life. Overweight was inversely related to family income and education. Rural and southern women were more overweight than their urban, northern, and western counterparts. More research is needed upon which to base efforts to control and prevent overweight in black women.

Adolescent↗

The pathophysiological role of water-sodium balance and renal dopaminergic activity in overweight patients with essential hypertension.

Studies were conducted to evaluate the role of water-sodium balance and renal dopaminergic activity in the hypertensive mechanisms of overweight patients with essential hypertension (EHT). The body mass index (BMI) was correlated positively with arterial pressure, plasma volume, extracellular fluid volume, or total exchangeable sodium and negatively with plasma noradrenaline concentration or plasma renin activity in patients with EHT. Fractional excretion of sodium (FENa) was significantly lower in overweight patients with EHT than that in normal-weight patients with EHT. Hypotensive effects of sodium restriction or the natriuretic response to infused dopamine was more remarkable in overweight than in normal-weight patients with EHT. Urinary excretion of free dopamine (UDA) was correlated positively with simultaneously measured urinary excretion of sodium or FENa and negatively with the natriuretic response to dopamine infusion. In addition, UDA was positively correlated with the BMI in normal-weight patients with EHT, whereas the relation between UDA and BMI was significantly negative in overweight patients with EHT. These findings suggest that the expansion of body fluid volume and sodium might result from the blunted natriuretic ability due to an attenuation of the renal dopaminergic activity in overweight patients with EHT. The expansion of body fluid volume and sodium may play an important role in the hypertensive mechanisms of overweight patients with EHT.

Adult↗

Normal and overweight adults: perceived weight and health behavior characteristics.

Perceived weight, perceived health status, health conception, and health behavior choices were studied in 33 normal weight and 26 overweight adults. Data were collected by interview and by weighting the 59 participants (25 men and 34 women). Results indicated that 92% of the overweight and 36% of the normal weight participants perceived themselves to be overweight. The two groups did not differ significantly in perceived health status, health conception, or health behavior choice. Health conception and health behavior choice were significantly related in both groups. Perceived health status was not related to either health conception or health behavior choice in the overweight group but was significantly related to health conception in the normal weight group. Although the overweight participants were aware that they were overweight, they did not perceive themselves to be less healthy than the normal weight group. Further, their health conceptions were as complex and their behavior choices as health promoting as those of the normal weight group.

Adult↗

Estimated overweight and obesity in Mexican American school children.

The prevalence of overweight and obesity in Mexican American children 6 to 17 years of age was estimated in 1972 (n = 1269) and 1983 (n = 868). Children were classified as overweight or obese on the basis of the body mass index (weight/stature2), the triceps skinfold, or both, relative to reference data for white children in NHANES-1. Overweight was defined as greater than or equal to 90th percentiles, while obesity was defined as greater than or equal to 95th percentiles of age- and sex-specific reference data. Over the entire age range, there was a significant increase in the prevalence of overweight and obesity between 1972 and 1983, but there was variation with age and sex. Fewer children were classified as overweight or obese when the two criteria were used together than when they were used individually. The results suggest that the body mass index and the triceps skinfold may vary in sensitivity as indicators of overweight and obesity particularly in 10- to 17-year-old children. Children classified as obese by the body mass index had significantly larger estimated midarm muscle circumferences than those classified as obese by the triceps skinfold or by both the body mass index and the triceps skinfold.

Adolescent↗

Overweight in women--metabolic aspects. The population study of women in Göteborg 1968--1969.

In a population sample of 1462 women aged 38--60 years, those with overweight were studied separately and compared with the women in the total population sample. Overweight was defined as the upper 5% of a weight index in the various ages studied and the weight index as (formula: see text). Significant differences, with higher values in the overweight women, were found for serum triglycerides, serum uric acid and arterial BP. Smoking was significantly less common in the overweight women. Serum cholesterol was similar in overweight women and in women in the total sample. Higher values for some risk factors for ischaemic heart disease in the overweight group of women thus seemed to be compensated to some extent by a lower number of smokers in this group.

Adult↗

Update: prevalence of overweight among children, adolescents, and adults--United States, 1988-1994.

Overweight and obese adults are at increased risk for morbidity and mortality associated with many acute and chronic medical conditions, including hypertension, dyslipidemia, coronary heart disease, diabetes mellitus, gallbladder disease, respiratory disease, some types of cancer, gout, and arthritis. In addition, overweight during childhood and adolescence is associated with overweight during adulthood, and previous reports have documented an increase in the prevalence of overweight among children, adolescents, and adults from 1976-1980 to 1988-1991. This report presents data from CDC's Third National Health and Nutrition Examination Survey (NHANES III) (1988-1994) to provide the most recent national estimates of overweight among children (ages 6-11 years), adolescents (aged 12-17 years), and adults (aged > or = 20 years) in the United States. The findings indicate that the prevalence of overweight in the United States has continued to increase.

Adolescent↗

Prevalence and characteristics of the polycystic ovary syndrome in overweight and obese women.

BACKGROUND: Surprisingly, the prevalence of polycystic ovary syndrome (PCOS) in otherwise unselected overweight or obese women is unknown, despite obesity being frequent in patients with PCOS. We conducted the present study to obtain an unbiased estimate of the prevalence of PCOS in unselected overweight and obese premenopausal women from Spain. METHODS: All premenopausal women reporting to the Department of Endocrinology, Hospital Universitario Ramón y Cajal, for dietary treatment of overweight or obesity from May 2002 to December 2005 were prospectively recruited. Women referred for any other reason were automatically excluded to avoid selection bias. Diagnosis of PCOS relied on the presence of clinical and/or biochemical hyperandrogenism, oligo-ovulation, and exclusion of secondary causes. Anthropometric measurements, hirsutism scores, and androgen, gonadotropin, metabolic, and lipid profiles were obtained. RESULTS: Of a total of 113 consecutive women recruited, 32 (28.3%) were diagnosed as having PCOS (95% confidence interval, 20.0%-36.6%). The prevalence of PCOS was not different when considering the degree of obesity. Another 3 women presented with hyperandrogenemia without oligo-ovulation, 2 had idiopathic hirsutism, 2 had chronic oligomenorrhea without clinical or biochemical hyperandrogenism, and 2 had oligomenorrhea with hyperprolactinemia, precluding the diagnosis of PCOS. The remaining 72 women (63.7%) had no evidence of hyperandrogenism or reproductive abnormalities. CONCLUSIONS: Our results demonstrate a 28.3% prevalence of PCOS in overweight and obese women from Spain, which is markedly increased compared with the 5.5% prevalence of PCOS in lean women of our country. Therefore, PCOS must be routinely ruled out in overweight and obese premenopausal women seeking advice for weight loss.

Adult↗

Parental weight status as a moderator of the relationship between television viewing and childhood overweight.

OBJECTIVE: To examine whether and to what extent the relationship between television viewing and children's weight status differs according to parental weight status. DESIGN: Population-level survey including in-home and telephone interview components. SETTING: United States. PARTICIPANTS: Representative sample of children aged 6 to 19 years in 2002 (n = 1483). MAIN EXPOSURE: Hours of television viewing. MAIN OUTCOME MEASURES: Child weight status (normal weight, at risk for overweight, overweight) as defined by current Centers for Disease Control and Prevention standards. RESULTS: Parental obesity increased the risk of child overweight for all of the children except boys aged 6 to 9 years. There were significant interactions between television viewing hours and parental obesity among boys aged 14 to 19 years and girls aged 10 to 13 years. For these 2 groups, the odds of overweight status increased with viewing hours for children with at least 1 obese parent but not at all for children of normal-weight parents. CONCLUSIONS: Results indicate that when parental obesity is taken into account, television viewing hours do not significantly relate to increased odds of childhood overweight, and parental body mass index may serve to moderate the relationship between television viewing and child weight status among adolescents (but not among younger children). Further examination of the moderating effect of parental body mass index on the relationship between television viewing and child weight status is warranted.

Adolescent↗

Rimonabant for overweight or obesity.

BACKGROUND: Worldwide, the prevalence of obesity and overweight in industrialized countries and in a substantial number of developing countries is increasing at an alarming rate. Rimonabant is a selective cannabinoid-1 receptor antagonist that has been investigated for its efficacy in reducing body weight and associated risk factors in obese people. Phase III trials are now under way to test the use of rimonabant for long-term weight-loss. Given the prevalence of overweight and obesity, it is important to establish the efficacy and safety of rimonabant. OBJECTIVES: To assess the effects of rimonabant in overweight and obese people. SEARCH STRATEGY: MEDLINE, EMBASE, The Cochrane Library, LILACS, databases of ongoing trials and reference lists were used to identify relevant trials. The last search was conducted in June 2006. SELECTION CRITERIA: Randomised controlled trials comparing rimonabant with placebo or other weight loss interventions in overweight or obese adults. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed all potentially relevant citations for inclusion and methodological quality. The primary outcome measures were weight loss change, morbidity and adverse effects occurrence. MAIN RESULTS: Four studies evaluating rimonabant 20 mg versus rimonabant 5 mg versus placebo in addition to a hypocaloric diet lasting at least one year were included. Compared with placebo, rimonabant 20 mg produced a 4.9 kg greater reduction in body weight in trials with one-year results. Improvements in waist circumference, high-density lipoprotein cholesterol, triglyceride levels and systolic and diastolic blood pressure were also seen. However, the results with rimonabant 5 mg demonstrated a weight reduction which was only 1.3 kg greater when compared with placebo. No clinically relevant effects on plasma lipids and blood pressure were found. Rimonabant 20 mg caused significant more adverse effects both of general and serious nature, especially of nervous system, psychiatric or gastro-intestinal origin. Attrition rates were approximately 40% at the end of one year. AUTHORS' CONCLUSIONS: The use of rimonabant after one year produces modest weight loss of approximately 5%. Even modest amounts of weight loss may be potentially beneficial. The observed results should be interpreted with some caution, though, since the evaluated studies presented some deficiencies in methodological quality. Studies with longer follow-ups after the end of treatment and of more rigorous quality should be done before definitive recommendations can be made regarding the role of this new medication in the management of overweight or obese patients.

Adult↗

Attitudes Regarding Overweight, Exercise, and Health among Blacks (United States).

OBJECTIVE: To investigate Blacks'views regarding the connections among overweight, exercise, and health. METHODS: A national randomized telephone survey of 986 US Blacks, conducted between 6 July 2004 and 15 July 2004. RESULTS: The majority (65%) of respondents reported their weight as average or underweight. Most participants also reported being regularly physically active in the last month (84.5%). The majority of participants reported believing that it is possible to be overweight and healthy. Most acknowledged the connection between exercise and health, and just over half of respondents identified the association between overweight and cancer risk. There was little sociodemographic variation in responses, although findings differed by self-reported overweight and physical activity. CONCLUSIONS: Some Blacks may underestimate the extent of their overweight, perhaps resulting from the high prevalence of the condition in the population. Gaps exist in Blacks' recognition of the connection between weight and health, although the importance of exercise for health promotion was widely acknowledged. These data may highlight an important target for intervention attention.

Adolescent↗

Development of relative weight, overweight and obesity from childhood to young adulthood. A longitudinal analysis of individual change of height and weight.

BACKGROUND: To investigate individual longitudinal change of relative weight, overweight and obesity from age 5 to 25 years by gender. METHODS: A cohort was imbedded in four surveys conducted 1992/1993, 1995/1996, 1998/1999 and 2004/2005 in three areas in Germany. Twelve-year-follow-up of 2183 children initially aged 5-13 years at baseline. Main measurements are body mass index (BMI) and international obesity task force (IOTF)-cut point defined overweight and obesity. A special longitudinal random effects model for cohort data was applied, which uses age as meta-meter of follow-up time and takes age at study entry into account. RESULTS: BMI, overweight and obesity increases with linear and squared age. Girls have a significant higher growth rate than boys in BMI (BMI: 0.89 vs. 0.75 kg/m(2) per 1 year age increment), whereas there is no statistical significant gender difference for overweight [odds ratio (OR) = 1.08 per 1 year] or obesity (OR = 1.11 per 1 year). Longitudinal change rates of BMI vary substantially between individuals [95% reference range (beta +/- 1.96 x SD) for linear change per 1 year is -0.14 to 1.98 in females and -0.29 to 1.83 in males; the 95% range of quadratic change rates are -0.09 to 0.04 in females and -0.08 to 0.05 in males]. Moreover, a steeper increase in BMI over time is observed for children with a higher baseline relative weight. CONCLUSION: Increases in BMI and the propensity of overweight and obesity follow a quadratic growth curve with the steepest increase before and during puberty. However, the substantial variability of relative weight gain within individuals indicate, that more research in individual change patterns is needed.

Adolescent↗

The big five and self-esteem among overweight dieting and non-dieting women.

Overweight is one of the most frequent phenomena, which poses serious health risks, emotional disturbances and esthetic and social problems in the Western world. This study investigated personality differences between women with normal weight, dieting overweight women and non-dieting overweight women. Thirty women with normal weight (NW), 30 overweight women who participated in diet groups (OWD), and 30 overweight women who did not participate in such groups (OWND) filled in a demographic questionnaire, Costa and McCrae's [Costa, P. T. Jr., & McCrae, R. R. (1992). NEO PI-R: Professional manual. Odessa, FL: Psychological Assessment Resources.] NEO-FFI, and Rosenberg's [Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, NJ: Princeton University Press.] Self-Esteem questionnaire. The results indicate that the OWND are significantly more neurotic and less open, conscientious, agreeable, and extravert than the other two groups. Self-esteem of the OWND is also lower than both OWD and NW. Contrary to hypothesis, OWD and NW do not significantly differ from each other with respect to both the Big Five and self-esteem.

Adult↗

Position of the American Dietetic Association: individual-, family-, school-, and community-based interventions for pediatric overweight.

The American Dietetic Association (ADA), recognizing that overweight is a significant problem for children and adolescents in the United States, takes the position that pediatric overweight intervention requires a combination of family-based and school-based multi-component programs that include the promotion of physical activity, parent training/modeling, behavioral counseling, and nutrition education. Furthermore, although not yet evidence-based, community-based and environmental interventions are recommended as among the most feasible ways to support healthful lifestyles for the greatest numbers of children and their families. ADA supports the commitment of resources for programs, policy development, and research for the efficacious promotion of healthful eating habits and increased physical activity in all children and adolescents, regardless of weight status. This is the first position paper of ADA to be based on a rigorous systematic evidence-based analysis of the pediatric overweight literature on intervention programs. The research showed positive effects of two specific kinds of overweight interventions: a) multicomponent, family-based programs for children between the ages of 5 and 12 years, and b) multicomponent, school-based programs for adolescents. Multicomponent programs include behavioral counseling, promotion of physical activity, parent training/modeling, dietary counseling, and nutrition education. Analysis of the literature to date points to the need for further investigation of promising strategies not yet adequately evaluated. Furthermore, this review highlights the need for research to develop effective and innovative overweight prevention programs for various sectors of the population, including those of varying ethnicities, young children, and adolescents. To support and enhance the efficacy of family- and school-based weight interventions, community-wide interventions should be undertaken; few such interventions have been conducted and even fewer evaluated.

Adolescent↗