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PubMed1999

Overweight, weight concerns, and bulimic behaviors among girls and boys.

OBJECTIVE: To assess the prevalence rates and correlates of overweight, concern with weight, and bulimic behaviors. METHOD: A survey was completed by a population-based sample of 16,114 boys and girls aged 9 to 14 years. RESULTS: Although fewer girls (19%) than boys (26%) were overweight, more girls (25% versus 22%) perceived themselves as overweight (p < .001). The proportion of girls reporting trying to lose weight increased with age (p < .001). The prevalence of binge eating at least monthly increased with age among the girls, but remained stable among the boys. The prevalence of purging was low (< or = 1%) and comparable between genders until age 13. Among the 13- and 14-year-olds, girls were significantly more likely than boys to report using laxatives or vomiting to control weight (p < or = .001). Purging was independently positively associated with stage of pubertal development (girls: odds ratio [OR] = 2.1, 95% confidence interval [CI] 1.6-2.7; boys: OR = 1.5, 95% CI 1.0-2.2) and overweight (girls: OR = 1.9, 95% CI 1.2-3.0; boys: OR = 2.7, 95% CI 1.4-5.1). CONCLUSIONS: Misperception of being overweight and concern with weight were common. Purging was a very rare behavior, but increased with pubertal development. Among the girls, the prevalence increased sharply around the onset of adolescence.

Adolescent↗
PubMed1998

Derivation of prediction equations for RV in overweight men and women.

PURPOSE: The purpose of this research was to derive and compare regression equations for predicting residual volume (RV) in overweight and normal weight adults. METHODS: RV was determined on land, in 311 men and women, following an overnight fast, using the nitrogen-dilution technique. Subjects were then weighed underwater at RV; 5-10 underwater weights were recorded; and the heaviest 3 measurements were averaged as the underwater weight. Percent body fat was calculated using the Siri equation. Group analyses were performed on overweight men (N = 59, body fat > 25%) and women (N = 126, body fat > 30%) compared with normal weight men (N = 68, body fat < or = 25%) and women (N = 58, body fat < or = 30%). A stepwise regression was performed for each group using the Systat Statistical Package (Evanston, IL). RESULTS: When RV was regressed on sex, age (yr), body weight (kg), and height (cm), sex was not found to be a significant predictor variable for RV. Subsequent regressions revealed that prediction equations for the overweight (RV = 0.0277 AGE + 0.0048 WT + 0.0138 HT - 2.3967, F = 44.0, P < 0.0000, SEE = 0.403) were different from those generated for normal weight men and women (RV = 0.0275 AGE + 0.0189 HT - 2.6139, F = 58.6, P < 0.0000, SEE = 0.405). Similar equations were obtained when a cross validation was performed on a separate sample of normal weight (N = 31) and overweight (N = 46) men and women. CONCLUSION: These data suggest that prediction equations for RV are separate and distinct for the overweight and normal weight populations.

Adipose Tissue↗
PubMed2005

Are adolescents who were breast-fed less likely to be overweight? Analyses of sibling pairs to reduce confounding.

BACKGROUND: Cohort analyses suggesting that breast-feeding protects against being overweight have been criticized for inadequately controlling for confounding associated with the self-selection of feeding practices. METHODS: Using nationally representative U.S. data from the National Longitudinal Study of Adolescent Health (1994-1996), we performed traditional cohort analyses (n = 11,998) using logistic regression to estimate the relation between breast-feeding and adolescent overweight (body mass index > or =85 percentile, based on year 2000 CDC growth charts), controlling for known potential confounders. Breast-feeding also was assessed in a subsample of 850 sibling pairs to account for unmeasured genetic and environmental factors. RESULTS: Among girls in the full cohort, the odds of being overweight declined among those who had been breast-fed at least 9 months; odds ratios ranged from 0.90 (95% confidence interval = 0.74-1.09) for <3 months of breast-feeding to 0.78 (0.64-0.96) for > or =9 months. A similar effect was seen in boys, although these trends were less consistent. In contrast, an analysis of sibling pairs provided no evidence of breast-feeding effects on weight within discordant trends. CONCLUSION: Cohort data indicate that odds of being overweight decrease as breast-feeding duration increases, at least among girls. However, sibling analyses suggest that this relationship may not be causal but rather attributable to unmeasured confounding related to mothers' choice to breast-feed, or to other childhood risk factors for overweight. Our results illustrate the utility of sibling analyses in understanding the true effect of early life exposures (such as breast-feeding) on health outcomes over time, independent of confounding factors that may not be satisfactorily controlled using traditional prospective cohort methods.

Adolescent↗
PubMed2004

Unbearable weight: young adult women's experiences of being overweight.

Being overweight is a hazard to health. Overweight people have a very negative image due to the marketing strategies for weight reduction and beauty products. Young women establishing self-image, seeking affirmation of social peers, and looking for potential mates are usually concerned about their weight and figure. To investigate the experience of young women who think they are overweight, how they come to think in this way, and the impact of this thinking, this qualitative pilot study conducted semi-structured interviews with five participants. On the basis of the qualitative method, data was subjected to constant comparison and content analysis. The phenomenon can thus be described in three major categories: (1) Social labeling of the overweight - a slim image is overwhelmingly preferred; (2) Pursuing attractiveness or health - a self-struggling process; (3) Weight reduction and self control - an endless struggle. The result of the study suggests there is a need for a competitive image to counter current obsessions with painfully slender figures in society. To protect the public's mental and physical health, nurses should play an active role in weight education based on a deeper and more dynamic understanding of being overweight.

Adaptation, Psychological↗
PubMed2005

Overweight children and adolescents: a clinical report of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition.

Childhood overweight and obesity are major health problems with immediate and long-term consequences of staggering magnitude. Despite this, there are few preventive and therapeutic strategies of proven effectiveness available to public health and clinical practitioners. Accruing such evidence is currently and appropriately a health policy priority, but there is an urgent need to intervene even before comprehensive solutions are fully established. The aim of this Clinical Report on Overweight Children and Adolescents is to present information on current understanding of pathogenesis and treatment of overweight and obesity. We report on the epidemiology, molecular biology and medical conditions associated with overweight; on dietary, exercise, behavioral, pharmacological and surgical treatments; and on the primary prevention of overweight in children and adolescents.

Adolescent↗
PubMed1989

Leucocyte sodium content and sodium pump activity in overweight and lean hypertensives.

Leucocyte sodium content and sodium pump activity was studied in overweight and lean hypertensive subjects and normotensive controls, all in the fasting state. In lean subjects (body mass index less than 27 kg m-2), hypertensives did not have altered leucocyte sodium content or pump activity. In the overweight (mostly obese) subjects, the leucocyte sodium content was higher in hypertensive than in normotensive subjects (median (range) 56.1 (42.0-84.1) vs 32.0 (18.2-59.4) mmol kg-1, P less than 0.001). This raised sodium content in overweight hypertensives was associated with a lower (ouabain-sensitive) 22Na efflux rate constant (2.25 (1.15-3.01) vs 2.64 (1.98-3.61) h-1, P less than 0.05) and a higher passive (or ouabain-insensitive) 22Na efflux rate constant (0.90(0.53-1.18) vs 0.63 (0.21-1.09) h-1, P less than 0.01). The systolic and diastolic blood pressures were significantly correlated to intracellular Na+ in the overweight group (r = 0.41 and 0.56, P less than 0.02 and 0.001 respectively). Thus, hypertension in the overweight subjects is associated with accumulation of intracellular sodium that may be due to abnormalities of the active sodium pump, though changes in ouabain-insensitive mechanisms also occur.

Biological Transport↗
PubMed2007

How many cases of Type 2 diabetes mellitus are due to being overweight in middle age? Evidence from the Midspan prospective cohort studies using mention of diabetes mellitus on hospital discharge or death records.

AIMS: To relate body mass index (BMI) in middle age to development of diabetes mellitus. METHODS: Participants were 6927 men and 8227 women from the Renfrew/Paisley general population study and 3993 men from the Collaborative occupational study. They were aged 45-64 years and did not have reported diabetes mellitus. Cases who developed diabetes mellitus, identified from acute hospital discharge data and from death certificates in the period from screening in 1970-1976 to 31 March 2004, were related to BMI at screening. RESULTS: Of Renfrew/Paisley study men 5.4%, 4.8% of women and 5% of Collaborative study men developed diabetes mellitus. Odds ratios for diabetes mellitus were higher in the overweight group (BMI 25 to < 30 kg/m(2)) than in the normal weight group (BMI 18.5 to < 25 kg/m(2)) and highest in the obese group (BMI >or= 30 kg/m(2)). Compared with the normal weight group, age-adjusted odds ratios for overweight and obese Renfrew/Paisley men were 2.73 [95% confidence interval (CI) 2.05, 3.64] and 7.26 (95% CI 5.26, 10.04), respectively. Further subdividing the normal, overweight and obese groups showed increasing odds ratios with increasing BMI, even at the higher normal level. Assuming a causal relation, around 60% of cases of diabetes could have been prevented if everyone had been of normal weight. CONCLUSIONS: Overweight and obesity account for a major proportion of diabetes mellitus, as identified from hospital discharge and death records. With recent increases in the prevalence of overweight, the burden of disease related to diabetes mellitus is likely to increase markedly. Primordial prevention of obesity would be a major strategy for reducing the incidence of diabetes mellitus in populations.

Age Factors↗
PubMed2006

Prevalence of overweight, obesity, and associated psychological problems in Qatari's female population.

Dissatisfaction with body weight and the use of unhealthy weight reduction practices have been reported among adolescents. It is important to conduct rigorous studies using large representative samples of female adolescents to assess accurately the frequency of dieting, overweight and eating disorders and accompanying attitudes. The aim of the present study was to examine the severity of dieting and its association with obesity, body satisfaction and psychological problems in female adolescents. A representative sample of 800 girls aged 14-19 years were approached during the period of October to December 2004, and 566 girls gave consent and participated in the study, thus giving a response rate of 70.8%. Self-reports were obtained from 566 teenage girls using the Adolescent Dieting Scale and the Self-Reporting Questionnaire (SRQ-20) for psychopathology. Subjects were classified into three categories: acceptable weight (BMI < 25 kg m(-2)); overweight (BMI 25-29.9 kg m(-2)); and obese (BMI > 30 kg m(-2)). The prevalence of overweight and obesity for female adolescents were 13.4% vs. 1.8%; 39.9% were intermediate dieters, and 8.3% were extreme dieters. Dieting was not associated with age but was significantly associated with body mass index (BMI) (P = 0.045). Extreme dieting was strongly associated with peer perception of respondent's figure (P < 0.001) and self-perception of figure (P = 0.016). Additionally, in adult Qatari population overweight and obesity for males were (34.4% vs. 34.6%) and for females were (33.0% vs. 45.3%). This is significantly higher than adolescent girls. (P < 0.01). The SRQ score was significantly highest in the extreme dieters group (P = 0.005). The extreme dieters get most of their education about dieting from school (14.0%) and TV (43.6%). The present study revealed strong evidence for the association between frequent dieting and overweight, body image dissatisfaction and psychological problems among adolescent females.

Adolescent↗
PubMed1997

Cause and effect beliefs and self-esteem of overweight children.

In this study, beliefs of the cause and effect of weight were examined in a sample of 9- to 11-year-old clinically overweight children. Lower self-esteem was found in the children who believed they are responsible for their overweight as compared to those who attributed their overweight to an external cause. Lower self-esteem was also found in the children who believed that their overweight hinders their social interaction. Other evidence gathered here lends some support to the view that the overweight child is more vulnerable to low self-esteem. The negative experiences in school and at home that the children reported and the premise that childhood obesity is a stigmatising condition is discussed.

Body Mass Index↗
PubMed2005

Infant and child feeding practices and childhood overweight: the role of restriction.

This review addresses the association between restrictive feeding practices by parents and the development of overweight in children. To date, only one parent feeding domain--feeding restriction--has been consistently linked to variations in child eating patterns or weight status. Despite challenges to unravelling causal pathways, the most current data suggest that restrictive feeding practices are elicited by child characteristics (e.g. weight status or obesity risk) and depend on parent characteristics as well. Restriction, in turn, may maintain or exacerbate child overweight. There remain important questions to be addressed in this literature, pertinent both to the development of childhood overweight and clinically to overweight prevention. Two areas of importance are the roles of cultural differences, as well as genes that confer risk for overweight, on the relationship between restriction and child weight status.

Caloric Restriction↗
PubMed2002

Television viewing and its associations with overweight, sedentary lifestyle, and insufficient consumption of fruits and vegetables among US high school students: differences by race, ethnicity, and gender.

Television (TV) viewing has been associated with overweight, decreased physical activity, and unhealthy dietary behavior among children and adolescents, and may represent a modifiable cause of childhood obesity. This study examined race, ethnic, and gender-specific differences in these associations among high school students in the United States. The study analyzed data from the 1999 national Youth Risk Behavior Survey, a representative sample (N = 15,349) of US high school students. Logistic regression tested for significant associations. TV viewing on an average school day exceeded 2 hours/day among 43% of students; it was greater among Black (74%) and Hispanic (52%) than White (34%) students. Overall, 11% of students were overweight, 31% of students were sedentary (i.e., did not participate in moderate or vigorous physical activity at recommended levels), and 76% ate less than five servings/day of fruits and vegetables. Watching TV more than 2 hours/day was associated with being overweight, being sedentary, and eating insufficient fruits and vegetables among White females, and with being overweight among Hispanic females. No significant associations were found among Black females. TV viewing was associated with being overweight and eating insufficient fruits and vegetables among White males. No significant associations were found among Hispanic males. Among Black males, TV viewing was associated with greater participation in physical activity. These findings suggest the presence of cultural factors to consider when developing interventions to promote physical activity, healthy eating, and healthy weight through reduced TV viewing among adolescents.

Adolescent↗
PubMed1990

Effects of overweight on lung function.

Spirometric data from 1586 healthy children, who did not smoke, were analysed to examine the effects of overweight as measured by the body mass index (weight/height2) on lung function. Overweight (72 boys, 88 girls) was defined as on or above the 90th percentile weight for height. After having controlled for the confounding variables of height and age, there were positive partial correlations between body mass index and lung function in girls whose weight was normal, in overweight girls, and in boys whose weight was normal, but not in overweight boys. In contrast to adults, body mass index has a positive effect on lung function in girls, whatever their weight. No such correlation between body mass index and lung function was seen in overweight boys. The observations may be accounted for by distinct sex dependent patterns of fat distribution in children.

Adolescent↗
PubMed1991

Overweight and stroke in the Whitehall study.

STUDY OBJECTIVE: The aim was to examine the risk of increasing overweight for death from stroke. DESIGN: This was a prospective cohort study, in which the main outcome measure was the mortality ratio for stroke with increasing body mass index. SETTING: Civil service departments, Whitehall, London. SUBJECTS: Participants were 17,753 men aged 40 to 64 years. MEASUREMENTS AND MAIN RESULTS: 208 stroke deaths were recorded. Men aged 40 to 54 in the most overweight quintile of body mass index had a mortality ratio of 2.01 (95% confidence interval 0.9 to 4.7) compared to the thinnest quintile. The mortality ratio was 1.19 (95% CI 0.7 to 2.0) in men aged 55 to 64. The increase in risk was more apparent in non-smokers: age adjusted mortality ratio 2.58 (95% CI 1.2 to 5.7). When smoking status and overweight were considered in combination a gradient of the age adjusted mortality ratio was observed, from 1.0 in thinner/non-smokers up to 3.15 in fatter/current smokers. On the assumption that smoking and obesity cause strokes, an estimated 60% of strokes could be prevented if these two easily identifiable risk factors could be avoided. CONCLUSIONS: The risks of overweight for death from stroke were more apparent in younger subjects and non-smokers. A substantial proportion of stroke deaths occurring under the age of 80 years would probably be prevented if cigarette smoking and overweight could be avoided.

Adult↗
PubMedDate not supplied

Overweight hypothesis in asthma and eczema in young adolescents.

BACKGROUND: A positive association between body mass index (BMI) and allergic diseases has recently been suggested; however the sex-dependence of this association remains controversial. The aim of the present study was to explore the relationship between BMI and asthma and eczema, as well as its sex-dependence in young adolescents. METHODS: Self-reported data obtained through the standardized International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three written questionnaires of 2926 young adolescents aged 13-14 years old from randomly selected schools in Skopje (Republic of Macedonia) were used. The BMI for each individual was calculated and used-both unadjusted and adjusted for confounding factors-as a variable for analysis. The international cut-off points for BMI for overweight and obesity by sex and age were used. Because of the very low prevalence of obesity (1.5 %), obese respondents were included in the overweight group. The data were statistically analyzed by the chi-square test, the t-test for independent samples and odds ratios (OR, 95 % CI) in binary logistic regression. RESULTS: Being overweight was significantly associated with an increased risk of having a dry night cough without a cold or chest infection (adjusted OR: 1.54; 95 % CI: 1.09-2.16; p = 0.01) and with having had self-reported asthma at some time (adjusted OR: 2.36; 95 % CI: 1.02-5.44; p = 0.04) in boys only. A significant association between overweight and other symptoms of asthma or atopic eczema was not established. CONCLUSION: These findings suggest a male-specific positive association between overweight and a current dry night cough and having received a diagnosis of asthma at some time. No association was found with other asthma symptoms or atopic eczema in young adolescents.

Adolescent↗
PubMed1998

Explanatory models of overweight among African American, Euro-American, and Mexican American women.

Ethnographic interviewing methods were used to explore women's explanatory models (EMs) of overweight and the congruence of these models with professional models and professionally recommended treatments for overweight. Through community-based snowball and theoretical sampling, 40 African American, 40 Euro-American, and 40 Mexican American women of varying social status and weight participated in multiple ethnographic interviews, which were subsequently interpreted using domain analysis and constant comparison. Study participants' EMs of overweight ranged from simple to complex, were generally similar across the three study groups, and only partially congruent with professional EMs of obesity. Major differences in EMs between the study groups were found in the dimensions of etiologies and consequences of overweight. There was partial congruence between participants' EMs and professionally recommended treatments for overweight.

Adult↗
PubMed1998

Factors associated with overweight and obesity among Kuwaiti college women.

A random sample of 585 Kuwaiti college women was studied in 1997 for factors associated with overweight and obesity. Weight and height were measured. The index of adiposity used was the body mass index (BMI), which is the weight in kilograms divided by the height squared (W/H2). The women were classified as overweight or obese (BMI > 25 or > 30 Kg/m2). The associated factors obtained through questionnaires included age, marital status, area of residence, number of siblings, (brothers, sisters, total), suffering from a chronic disease, obesity among parents, parents' education and occupation, number of major meals eaten, eating between meals, family income, number of servants, number of people living at home, exercising, last dental and physical checkup, dieting, year of study, highest desired degree, countries prefer visiting, and socioeconomic status (SES). The results of the study revealed that 27.2 and 7.2% of the students were overweight (BMI > 25 Kg/m2) and obese (BMI > 30 Kg/m2), respectively. Factors that were found to be significantly associated with overweight and obesity among the women included number of brothers, having a chronic disease, obesity among parents, dieting and countries prefer visiting. Logistic regression analysis of significant associated factors revealed that the same factors contributed to the development of overweight and obesity except number of brothers and having a chronic disease.

Adolescent↗
PubMed2005

Arkansas school nurses' role in statewide assessment of body mass index to screen for overweight children and adolescents.

National surveys that have tracked weight and physical activity in the United States for more than 40 years have shown a continuing increase in the number of overweight children and adolescents. Overweight children and adolescents are showing an increase in diseases related to overweight: Type II diabetes, cardiovascular disease, hypertension, and orthopedic and respiratory conditions. Overweight children are also likely to become obese adults. This article describes Arkansas's efforts to connect with families through schools to prevent or reduce overweight in children. Arkansas school nurses measured the heights and weights of more than 400,000 public school students during the 2003-2004 school year. A detailed protocol for accurate measurement of students is provided.

Adolescent↗
PubMed2004

Failure of mathematical indices to accurately assess insulin resistance in lean, overweight, or obese women with polycystic ovary syndrome.

Insulin resistance is a common metabolic feature of polycystic ovary syndrome (PCOS). In this study, we examined the validity of the mathematical indices [the quantitative insulin sensitivity check index (QUICKI) and the homeostasis model of assessment (HOMA)] that calculate insulin sensitivity and their correlation to glucose utilization with the insulin infusion rate in 40 mU/m(2).min by the euglycemic clamp (M) in women with PCOS. We studied 59 women with PCOS (20 lean, 16 overweight, and 23 obese subjects). Euglycemic clamp testing was performed, and QUICKI, HOMA, total testosterone, fasting insulin, fasting glucose, and glucose-to-insulin ratio were estimated. No difference was found in testosterone and glucose levels among the three groups. Lean or overweight women compared with obese women differed in insulin levels, glucose-to-insulin ratio, QUICKI, and HOMA (P < 0.01). No statistical difference was found between lean and overweight women in the above parameters. M differed when lean women were compared with overweight (P < 0.002) or obese women (P < 0.0001); however, no statistical difference was observed between overweight and obese women. No significant correlation was found between M and QUICKI or HOMA. We conclude that mathematical indices should be applied with caution in different insulin-resistant populations and should not be considered a priori equivalent to the euglycemic clamp technique.

Adult↗