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PubMed2004

Overweight postmenopausal women lose bone with moderate weight reduction and 1 g/day calcium intake.

UNLABELLED: Overweight postmenopausal women may be more susceptible to bone loss with weight reduction than previously studied obese women. The influence of energy restriction and Ca intake on BMD was assessed in 66 individuals. Weight reduction resulted in bone loss at several sites in women consuming 1 g Ca/day and was mitigated with higher calcium intake at 1.7 g/day. INTRODUCTION: Bone loss is associated with weight loss in obese postmenopausal women and can be prevented with calcium (Ca) supplementation. However, because bone loss caused by weight loss may be greater in overweight than obese women, it is not clear whether Ca supplementation is also beneficial in overweight women. MATERIALS AND METHODS: We assessed the influence of caloric restriction at two levels of Ca intake on BMD and BMC in 66 overweight postmenopausal women (age, 61 +/- 6 years; body mass index, 27.0 +/- 1.8 kg/m2). Subjects completed either a 6-month energy-restricted diet (WL, n = 47) and lost 9.3 +/- 3.9 % weight or maintained weight (WM; 1 g Ca/day, n = 19). Participants in the WL group were randomly assigned to either normal (1 g/day; WL NL-Ca) or high (1.7 g/day; WL Hi-Ca) Ca intake. Regional BMD and BMC were measured at baseline and after 6 months. RESULTS: During normal Ca intake, trochanter BMD and BMC and total spine BMD were decreased more in WL than WM women (p < 0.05). The WL NL-Ca group lost more trochanter BMD (-4.2 +/- 4.1%) and BMC (-4.8 +/- 7.1%) than the WL Hi-Ca group (-1.4 +/- 5.6% and -1.1 +/- 8.1%, respectively; p < 0.05). There were no significant changes in BMD or BMC at the femoral neck in any group. Weight loss correlated with trochanter BMD loss (r = 0.687, p < 0.001) in the WL NL-Ca group. CONCLUSION: Despite an intake of 1 g Ca/day, bone loss occurred at some sites because of weight loss. Calcium intake of 1.7 g/day will minimize bone loss during weight loss in postmenopausal overweight women.

Aged↗
PubMed2004

Prevalence of overweight and obesity in a provincial population of Canadian preschool children.

BACKGROUND: More and more school-aged children in Canada and elsewhere are becoming overweight or obese. Many countries are now reporting a similar trend among preschool children. However, little information is available on the prevalence of overweight and obesity among preschool children in Canada. In addition, available data are based on reported rather than measured heights and weights. We conducted this study to determine the prevalence of overweight and obesity, using measured heights and weights, in the 1997 cohort of children aged 3-5 years born in Newfoundland and Labrador. METHODS: We calculated the body mass indices (BMIs) using heights and weights measured by public health nurses during the province-wide Preschool Health Check Program conducted between October 2000 and January 2003. Descriptive data on the children's BMIs and prevalence estimates were generated and analyzed by sex and age with the use of the classification system recommended by the International Obesity Task Force. RESULTS: Data were available for 4161 of the 5428 children born in 1997; boys and girls were equally represented (50.1% and 49.9% respectively). Overall, 25.6% of the preschool children in the cohort were overweight or obese. The rates did not differ significantly by sex or age group. INTERPRETATION: These results indicate that a high proportion of children aged 3-5 years in Newfoundland and Labrador are overweight or obese. It appears that prevention measures should begin before the age of 3 years.

Body Mass Index↗
PubMed2004

Prevalence of overweight and obesity in male adolescents in Austria between 1985 and 2000. A population based study.

OBJECTIVE: To analyse the prevalence of overweight and obesity in young Austrian men, to describe a possible time trend during the observation period 1985-2000 and to define regional differences within the country. DESIGN: Epidemiological population based investigation (conscript health investigation) comparing aggregated data of four cross-sectional studies. SUBJECTS: Four cohorts of 18 year-old males (1985: n = 50,475, 1990: n = 47,463, 1995: n 39,275, 2000: n = 43,503), in total n = 180,716. METHODS: Measurements of height and weight were performed during the nationwide conscript health investigation. BMI was calculated and overweight was defined as BMI > or = 25.00 kg/m2 and obesity as BMI > or = 30.00 kg/m2. Besides height and weight data, information on place of residence of the young men was used for the study. Chi-squared and Student's t-test were calculated to test group differences with respect to their statistical significance. RESULTS: The prevalence of overweight increased from 10.9% to 15.5% and of obesity from 1.8% to 4.9% during the observation period. A significant regional trend was found with the highest prevalence of overweight and obesity in the Eastern part of Austria (p < 0.001). BMI was 22.12 +/- 0.34 kg/m2 (mean +/- SD) in 1985 and showed a significant increase (p < 0.001) during the study period to 22.71 +/- 0.25 kg/m2. CONCLUSION: Overweight and obesity increased remarkably in young males in Austria between the years 1985 and 2000. The steepest increase was found in the prevalence of obesity and in the Western part of Austria. A significant regional difference could be documented during the whole study period.

Adolescent↗
PubMed1998

Increasing prevalence of overweight among US low-income preschool children: the Centers for Disease Control and Prevention pediatric nutrition surveillance, 1983 to 1995.

OBJECTIVE: To determine whether the prevalence of overweight in preschool children has increased among the US low-income population. DESIGN: Analysis using weight-for-height percentiles of surveillance data adjusted for age, sex, and race or ethnicity. SETTING: Data from 18 states and the District of Columbia were examined. SUBJECTS: Low-income children <5 years of age who were included in the Centers for Disease Control and Prevention Pediatric Nutrition Surveillance System. RESULTS: The prevalence of overweight increased from 18.6% in 1983 to 21.6% in 1995 based on the 85th percentile cutoff point for weight-for-height, and from 8.5% to 10.2% for the same period based on the 95th percentile cutoff point. Analyses by single age, sex, and race or ethnic group (non-Hispanic white, non-Hispanic black, and Hispanic) all showed increases in the prevalence of overweight, although changes are greatest for older preschool children. CONCLUSION: Overweight is an increasing public health problem among preschool children in the US low-income population. Additional research is needed to explore the cause of the trend observed and to find effective strategies for overweight prevention beginning in the preschool years.

Body Height↗
PubMed2002

Infant weight gain and childhood overweight status in a multicenter, cohort study.

OBJECTIVE: To determine whether a rapid rate of weight gain in early infancy is associated with overweight status in childhood. DESIGN: Prospective, cohort study from birth to age 7 years. SETTING: Twelve sites across the United States. PARTICIPANTS: Twenty-seven thousand, eight hundred ninety-nine (27 899) eligible participants born at full term between 1959 and 1965. MAIN OUTCOME MEASURE: Overweight status at age 7 years, defined by a body mass index above the 95th percentile of the Centers for Disease Control and Prevention reference data. RESULTS: In the 19 397 participants with complete data (69.6%), the prevalence of overweight status at age 7 years was 5.4%. The rate of weight gain during the first 4 months of life (as 100 g/month) was associated with being overweight at age 7 years, after adjustment for several confounding factors: odds ratio: 1.38; 95% confidence interval: 1.32-1.44. This association was present in each birth weight quintile, and remained significant after adjustment for the weight attained at age 1 year (odds ratio: 1.17; 95% confidence interval: 1.11-1.24). CONCLUSIONS: A pattern of rapid weight gain during the first 4 months of life was associated with an increased risk of overweight status at age 7 years, independent of birth weight and weight attained at age 1 year. These findings may lead to new hypotheses regarding the cause of childhood obesity, which may contribute to our understanding of this increasing public health problem in the United States.

Adult↗
PubMed2004

Does breastfeeding protect against pediatric overweight? Analysis of longitudinal data from the Centers for Disease Control and Prevention Pediatric Nutrition Surveillance System.

OBJECTIVE: To examine whether increasing duration of breastfeeding is associated with a lower risk of overweight in a low-income population of 4-year-olds in the United States. METHODS: Visit data were linked to determine prospectively the duration of breastfeeding (up to 2 years of age) and weight status at 4 years of age. Overweight among 4-year-old children was defined as a body mass index (BMI)-for-age at or above the 95th percentile based on the 2000 Centers for Disease Control and Prevention growth charts. Logistic regression was performed, controlling for gender, race/ethnicity, and birth weight. In a subset of states, links to maternal pregnancy records also permitted regression analysis controlling for mother's age, education, prepregnancy BMI, weight gain during pregnancy, and postpartum smoking. Data from the Pediatric Nutrition Surveillance System, which extracts breastfeeding, height, and weight data from child visits to public health programs, were analyzed. In 7 states, data were linked to Pregnancy Nutrition Surveillance System data. A total of 177 304 children up to 60 months of age were included in our final pediatric-only analysis, and 12 587 were included in the pregnancy-pediatric linked analysis. RESULTS: The duration of breastfeeding showed a dose-response, protective relationship with the risk of overweight only among non-Hispanic whites; no significant association was found among non-Hispanic blacks or Hispanics. Among non-Hispanic whites, the adjusted odds ratio of overweight by breastfeeding for 6 to 12 months versus never breastfeeding was 0.70 (95% confidence interval: 0.50-0.99) and for >12 months versus never was 0.49 (95% confidence interval: 0.25-0.95). Breastfeeding for any duration was also protective against underweight (BMI-for-age below the 5th percentile). CONCLUSION: Prolonged breastfeeding is associated with a reduced risk of overweight among non-Hispanic white children. Breastfeeding longer than 6 months provides health benefits to children well beyond the period of breastfeeding.

Adult↗
PubMed1996

Trends in overweight among US adults from 1987 to 1993: a multistate telephone survey.

OBJECTIVES: Using data from the Behavioral Risk Factor Surveillance System, this study describes trends in the prevalence of overweight between 1987 and 1993. METHODS: Data were examined from 33 states participating in an ongoing telephone survey of health behaviors of adults (n = 387,704). Self-reported weights and heights were used to calculate sex-specific prevalence estimates of overweight for each year from 1987 to 1993. Time trends were evaluated with the use of linear regression. RESULTS: Between 1987 and 1993, the age-adjusted prevalence of overweight increased by 0.9% per year for both sexes (from 21.9% to 26.7% among men and from 20.6% to 25.4% among women). The increasing linear trend was observed in all subgroups of the population but was most notable for Black men (1.5% per year) and men living in the Northeast (1.4% per year). Secular changes in smoking and leisure-time physical activity did not entirely account for the increase in overweight. CONCLUSIONS: The prevalence of overweight among American adults increased by 5% between 1987 and 1993. Efforts are needed to explore the causes of this adverse trend and to find effective strategies to prevent obesity.

Adult↗
PubMed2001

Maturational timing and overweight prevalence in US adolescent girls.

OBJECTIVES: This study examined the relation of age at menarche to overweight in US adolescent girls. METHODS: Effects of age at menarche and race/ethnicity on overweight were estimated via logistic regression, after adjustment for sociodemographic characteristics, in a sample of 6507 Hispanic, Black, White, and Asian American girls who participated in wave 2 of the National Longitudinal Study of Adolescent Health. RESULTS: Overweight prevalence rates were significantly higher in early maturing adolescents of all racial/ethnic groups but highest (57.5%) among early maturing Black girls. Early maturation nearly doubled the odds of being overweight (body mass index at or above the 85th percentile). CONCLUSIONS: Greater public health attention should be focused on the high prevalence of overweight, particularly among minority female adolescents.

Adolescent↗
PubMed2006

Overweight in urban schoolchildren assessed by body mass index and body fat mass in Dalian, China.

In order to assess overweight in urban schoolchildren (298 boys and 298 girls) aged 9-16 years in Dalian, China, their body height, weight, skinfolds at triceps, biceps, subscapular and suprailiac, and body circumferences of mid-upper arm, waist and hip were measured. The results showed that the prevalence of overweight, based on the United States Centers for Disease Control 2000 reference values using body mass index (BMI), was 22.9% in boys and 10.4% in girls, which was higher than that of indicated in Chinese national surveys of recent decades. More boys were overweight than girls due to excessive increase in body fat, although the prevalence of overweight in girls prevalence increased from 13 years. Discussion here focuses on the effects of behavioral patterns on overweight in Dalian schoolchildren, paying attention to gender difference.

Adolescent↗
PubMed1999

Weight change and duration of overweight and obesity in the incidence of type 2 diabetes.

OBJECTIVE: To examine the relationship between weight change and duration of overweight and obesity and the incidence of type 2 diabetes in a cohort of middle-aged British men. RESEARCH DESIGN AND METHODS: We carried out a prospective study of cardiovascular disease in men aged 40-59 years at screening (1978-1980), drawn from one general practice in 24 British towns, who completed a postal questionnaire 5 years later (Q5) and for whom data on BMI at year 1 (Q1) and Q5 were available (n = 7,100). Men with diabetes at Q1 or Q5 and men with hyperglycemia at Q1 were excluded from the study (n = 184). The main outcome measure was type 2 diabetes (physician-diagnosed) during a mean follow-up period of 12 years starting at Q5 (1983-1985). RESULTS: In the 6,916 men with no history or evidence of diabetes, there were 237 incident cases of type 2 diabetes during the mean follow-up period of 12 years, a rate of 3.2/1,000 person-years. Substantial weight gain (>10%) was associated with a significant increase in risk of type 2 diabetes compared with that in men with stable weight (relative risk [RR] 1.61 [95% CI 1.01-2.56]) after adjustment for age, initial BMI, and other risk factors. Excluding men who developed diabetes within 4 years after the period of weight change increased the risk further (1.81 [1.09-3.00]). After adjustment and exclusion of men who developed diabetes early in the follow-up, weight loss (> or =4%) was associated with a reduction in the risk of type 2 diabetes, compared with that in the stable group, that reached marginal significance (0.65 [0.42-1.03], P = 0.07). A test for trend that fitted weight change as a continuous covariate showed the risk of diabetes to increase significantly from maximum weight loss to maximum weight gain (P = 0.0009). The lower risk associated with weight loss was seen in obese (> or =28 kg/m2) and nonobese subjects and in men with normal (<6.1 mmol/l) and high (> or =6.1 mmol/l) nonfasting blood glucose levels. Although not statistically significant, this is consistent with a benefit from weight loss. Risk of type 2 diabetes increased progressively and significantly with increasing levels of initial BMI and also with the duration of overweight and obesity (P<0.0001). CONCLUSIONS: This study confirms the critical importance of overweight and obesity, particularly of long duration, in the development of type 2 diabetes. The data support current public health recommendations to reduce the risk of type 2 diabetes by preventing weight gain in middle-aged men who are not overweight and by encouraging weight loss in overweight and obese men.

Adult↗
PubMed2005

Overweight and effect of hormone replacement therapy on lipid profiles in postmenopausal women.

BACKGROUND: Many experimental and observational studies have suggested that hormone replacement therapy (HRT) in postmenopausal women is cardioprotective. However, the results of randomized controlled trials have been discouraging. We attempted to evaluate the influence of overweight, a frequent risk factor for coronary artery disease, on the lipid-modifying effects of HRT. METHODS: A total of 345 postmenopausal women were divided into 2 groups according to body mass index (BMI): the control group; BMI <25 Kg/m2 (n=248) and the overweight group; BMI > or =25 Kg/m2 (n=97). All women received either 0.625 mg conjugated equine estrogen (CEE)(n=139), CEE plus 5 mg medroxyprogesterone acetate (MPA)(n=97) or CEE plus 10 mg MPA (n=109). Lipid profiles were measured before and 12 months after HRT. RESULTS: In both the control and overweight groups, HRT reduced low density lipoprotein cholesterol (LDL-C) (p = 0.000 and p = 0.000 respectively) and lipoprotein (a) [Lp(a)] levels (p = 0.000 and p = 0.000 respectively) and raised high density lipoprotein cholesterol (HDL-C) levels (p = 0.000 and p = 0.002 respectively). However, the elevation of the HDL-C level was higher in the control group than in overweight group (17.5% vs. 10.4%, p = 0.015), and this was significant after adjusting for changes in body weights (p = 0.016). There were no differences in the reduction of LDL-C (p = 0.20) and Lp(a) (p = 0.09) levels between the two groups. CONCLUSION: HRT had less favorable effects on HDL-C levels in overweight postmenopausal women than in women with normal body weight. This finding may be partially associated with no cardioprotective effect of HRT in postmenopausal patients at a high risk due to multiple risk factors including obesity.

Contraceptive Agents, Female↗
PubMed2004

Risk evaluation in pediatric practice aids in prevention of childhood overweight.

Pediatric providers and the pediatric support staff play important roles in the primary prevention of child overweight (Sidebar 3, page 28). Beliefs and values concerning overweight children must be examined so that biases and misunderstandings can be rectified. Early prevention of pediatric overweight begins with recognition of children who are predisposed to becoming overweight. BMI is the standard of care for screening pediatric weight status beginning at age 2. Office staff need to be knowledgeable about all aspects of BMI, including application and sensitive discussion with parents concerning the weight of their children. Pediatric providers should organize the office environment to support the staff in the screening process. Provision of age-appropriate anticipatory guidelines for the family to help with the prevention of childhood overweight needs to be provided at each well-child visit.

Child↗
PubMedDate not supplied

Environmental and lifestyle factors associated with overweight and obesity in Perth, Australia.

PURPOSE: To examine associations between environmental and lifestyle factors and overweight or obesity. DESIGN: A cross-sectional survey and an environmental scan of recreational facilities. SETTING: Metropolitan Perth, Western Australia. SUBJECTS: Healthy sedentary workers and homemakers aged 18 to 59 years (n = 1803) living in areas within the top and bottom quintiles of social disadvantage. MEASURES: Four lifestyle factors, one social environmental factor, and five physical environment factors (three objectively measured). RESULTS: After adjustment for demographic factors and other variables in the model, overweight was associated with living on a highway (odds ratio [OR], 4.24; 95% confidence interval [CI], 1.62-11.09) or streets with no sidewalks or sidewalks on one side only (OR, 1.35; 95% CI, 1.03-1.78) and perceiving no paths within walking distance (OR, 1.42; 95% CI, 1.08-1.86). Poor access to four or more recreational facilities (OR, 1.68; 95% CI, 1.11-2.55) and sidewalks (OR, 1.62; 95% CI, .98-2.68) and perceiving no shop within walking distance (OR, 1.84; 95% CI, 1.01-3.36) were associated with obesity. Conversely, access to a motor vehicle all the time was negatively associated with obesity (OR, .56; 95% CI, .32-.99). Watching 3 or more hours of television daily (ORs, 1.92 and 1.85, respectively) and rating oneself as less active than others (ORs, 1.66 and 4.05, respectively) were associated with both overweight and obesity. After adjustment for individual demographic factors and all other variables in the model, socioeconomic status of area of residence and leisure-time physical activity were not associated with overweight or obesity. CONCLUSION: Factors that influence overweight and obesity appear to differ, but aspects of the physical environment may be important. Objectively measured neighborhood environment factors warrant further investigation.

Adolescent↗
PubMed1985

Overweight and cancer.

In a prospective study, mortality ratios were computed in relation to overweight, cancer, and other diseases. The study included 750 000 men and women followed for 12 years. Each person was given a weight index. Death rates for overweight and underweight persons were compared with rates for persons of average weight. Men who were 40% or more overweight had a mortality ratio for cancer of 1.33; women, 1.55. This ratio was much lower than that for coronary heart disease (men, 1.95; and women, 2.07); diabetes (5.19 and 7.90), and digestive diseases (3.99 and 2.29). Overweight men had significantly higher mortality ratios for colorectal and prostate cancer; overweight women had much higher rates for cancer of the endometrium, gall bladder, and cervix; and also significantly higher rates for ovary and breast cancer.

Adult↗
PubMed1998

The relationship between overweight and psychological problems in adult Czech population.

Overweight is often mentioned in causal relationship with various psychological problems and a lack of self-control. 438 randomly chosen subjects (selected from electoral registers or by random walk method)--men and women from Prague and the countryside--were divided according to their body weight into two groups, one with BMI equal or lower that 25, the other one with BMI higher than 25. 92.2 per cent of the subjects were overweight, 8 per cent had BMI higher than 30. Comparison of the two groups with lower and higher body weight based on a self-report questionnaire (GHQ, CAGE and some other items) showed differences between men and women. In men, with growing body weight the self-control in food intake decreased and problems related to lack of self-control increased significantly (smoking, problems with alcohol). On the contrary, women with overweight reported higher self-control in food intake (dieting) and had less problems with alcohol. The relationship between psychological problems (depression, anxiety) and overweight was not unequivocally proved. Men with higher body weight reported significantly less somatic problems in the GHQ. They also suffered comparatively less from depression and anxiety. The overweight women showed slightly more anxiety and significantly higher social dysfunction than women with normal body weight.

Adolescent↗
PubMed2001

Prevalence of overweight and obesity in children and adolescents in a county in Sweden.

UNLABELLED: Overweight among young people in Sweden is increasing. The aim of the present study was to investigate the frequency of overweight and obesity based on body mass index (BMI) values among children and adolescents. Overweight was defined as a BMI value > or = 91st percentile and obesity as a BMI value > 98th percentile on an international reference BMI curve. The study population included boys and girls from four age groups: 9, 12, 15 and 18 y. The data consisted of self-reported measures of height and weight that were obtained from questionnaires used in a cross-sectional study in December 1997. A validation study was performed using a part of the study population. A total of 7011 (81.7%) participants completed the questionnaire. The correlation between self-reported estimations and objective measures of height and weight was high in the oldest age groups (0.88-0.98), but lower in the 9-y-old age groups (0.37-0.72). These self-reported estimations in the 9-y-olds were excluded from further analysis. It was found that 12.3%, 11.6% and 11.4% of the boys in the 12-, 15- and 18-y-old age groups and 6.8%, 5.5% and 4.8% of the girls in the same age groups were overweight and 7.9%, 8.9% and 7.3% of the boys and 5.1%, 4.2% and 3.9% of the girls were obese. CONCLUSION: The prevalence of overweight and obesity was found to be high in the study population and is a serious public health problem. The prevalence of obesity was significantly higher (p < 0.05) in 15-y-old boys living in rural areas than in city and town dwellers of the same age.

Adolescent↗
PubMed2001

[Evaluation of protein, fat and carbohydrate contents in daily dietary allowance of overweight and obese students from the Medical Academy in Białystok].

The major causes of primary obesity include dietary errors (e.g. high-fat, high-energy diets) and low physical activity. Therefore, the aim of the present study was the quantitative evaluation of daily dietary allowances of students with overweight and obesity in the Medical Academy of Białystok. Questionnaire investigations were conducted in the years 1997-1999 and included 1050 students (701 women and 349 men). Basing on BMI overweight was revealed in 22 women (3.14%) and 82 men (23.5%). Obesity was found in only 2 women (0.3%) and 4 men (1.2%). The 24-hour dietary history of the preceding day was the method used for quantitative analysis. Low physical activity and low-energy food intake (below the recommended safe norm) were the characteristic features found in the majority of students with overweight or obesity. Their daily dietary allowances showed high protein content (above the safe norm in 75% of women and 87.2% of men) and low content of carbohydrates (below the safe norm in over 70% of those examined). Fat content above the safe norm was found in approximately 55% of men with overweight and obesity, the rest consumed low-fat foods. The incidence of overweight or obesity was higher in young men than women studying in the Medical Academy of Białystok. In some of them, this may be caused by a disturbed proportion in the consumption of the major food components (protein, fat, carbohydrates).

Adult↗
PubMed2001

[The management of labor overweight women with intrapartum fetal oxygen saturation monitoring].

OBJECTIVE: Overweight is one of the most common problems that occurs in pregnancy. The aim of this study was to evaluate the usefulness of fetal pulse oximetry during labour and to compare fetal oxygen saturation between cases with pregravid overweight and normal weight. MATERIAL AND METHODS: Fetal oxygen saturation was continuously recorded with use of Nellcor N-400 fetal pulse oximeter in 20 cases of pregravid overweight and 30 control cases of normal weight. Distribution of fetal oxygen saturation values during 4 periods of labour was analyzed and compared between the examined groups together with neonatal umbilical artery pH values, Apgar score, birth weight and percentage of ceasarian sections performed. RESULTS: We noticed statistically important differences in fetal oxygen saturation between analyzed groups. Mean oxygen saturation value was lower in the overweight group, at the end of first stages of the labour (47% vs 52%) and at the second stages (42% vs 46%) We noticed differences in birth weight too. No significant differences in neonatal umbilical artery pH, ceasarian sections, newborns mean 1 minute Apgar score were observed between analyzed groups. CONCLUSION: Fetal pulse oximetry is a a useful method for intensive surveillance of the fetus at risk of hypoxemia during the labour. A lower fetal oxygen saturation value during labor by pregravid overweight were observed.

Adult↗