Identification and follow-up of obesity in ten-year-old school children

Abstract

Growth surveillance of children in school health services is a routine in Sweden. We describe the effect at follow-up of an overt identification of obesity in school children. Follow-up data were collected in two populations of ten-year-old children with obesity. Children in the study group belonged to a cohort born in 1990. Here the presence of obesity had been identified at the routine growth screening, and intervention activities against obesity had been actively offered. Controls belonged to a cohort born in 1989. Of the 176 children with obesity, 91 were in the study group (41 girls) and 85 (44 girls) in the control group. No differences were found between the groups in age, gender or body mass index at baseline. At follow-up, after one to two years, children in the study group had a modest but significantly more pronounced decrease in the relative body mass index, compared with controls. The mean difference between the populations in body mass index standard deviation score (z-score) after adjustment for baseline body mass index and follow-up time was -0.14 (95% confidence interval: -0.25 to -0.02; P=0.027). Socioeconomic status, gender, follow-up time and group were independent predictors for change in body mass index z-score. To identify children with obesity in a routine school health survey may be a crucial initial step in the management of childhood obesity.