Cut-offs For Overweight Research Articles

Neck Circumference as A Screening Tool for Obesity in Pre- and Primary School Children in Puducherry India – A Cross-Sectional Study

Introduction: Obesity has become the 21st Century’s greatest challenge and threat. Around 50% of the obese children become obese adolescents, of which 80% become obese adults. Methodology: Cross-sectional analytical study was done on 930 pre- and primary school children. Neck circumference, weight, height, waist and hip circumference was recorded. Overweight/obese identified according to WHO standards. Age-specific percentile charts for boys and girls were drawn with data from the apparently normal children in the study population. Results: The Neck Circumference measurements ranged from 23.64(±1.16) to 28.49(±2.87) in boys and 23.59(±1.63) to 27.6(±2.67) in girls. ROC analysis derived cut-offs for overweight and obesity in each age group/gender were found to have high sensitivity (80-100%) and specificity (60-95.9%). Using the reference percentile data/curves, and the cut –offs obtained by ROC analysis, a neck circumference above the 75th percentile for age and gender can be regarded as overweight and above the 90th percentile as obese in both boys and girls. Conclusion: The study concludes that the Neck circumference is a valid and effective screening tool for overweight/obesity in pre and primary school children.

MULT: A new BMI reference to assess nutritional status of multi-ethnic children and adolescents.

To develop a new Body Mass Index (BMI) reference (MULT) based on longitudinal data of multi-ethnic populations and to compare it to international BMI references. The MULT BMI reference was constructed through the LMS method and the Generalized Additive Models for Location Scale and Shape (GAMLSS), with 81 310 observations of 17 505 subjects aged 0-22 years old, from the United Kingdom, Ethiopia, Peru, India, Vietnam, Brazil, and Portugal. Outlier values were removed based on weight z-scores (population level) and based on BMI z-scores using the linear mixed effects model (individual level). The MULT M, S and L curves were compared to the ones of the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), International Obesity Task Force (IOTF), and Dutch Growth Study (DUTCH). The MULT BMI percentile cutoffs for overweight and obesity were calculated using the adult BMI values of 25 and 30 kg/m2 at 17, 18, 19, and 20 years old. MULT presented the lowest mean BMI values for the ages 102-240 months for boys and 114-220 months for girls. MULT S values were similar to the WHO and IOTF for children under 60 months of age and the highest during puberty, while the L curve showed to be more symmetric than the other BMI references. The MULT BMI reference was constructed based on recent data of populations from 10 countries, being a good option to assess the nutritional status of multi-ethnic populations.

Predictive Performance of Different Diagnostic Criteria for Overweight and Obesity Between 2008–2015 in Adolescents

The reference cut-offs for overweight and obesity have evolved from the use of International obesity task force (IOTF) to extended IOTF and revised Indian Academy of Pediatrics (IAP) growth charts. Secondary analysis of anthropometric data of school-going children from Delhi in the year 2008, 2013 and 2015 was performed. The proportions of children with overweight, obesity, and undernutrition were checked for agreement using different diagnostic cutoffs, and compared at three-time points. Among 8417 adolescents, weighted Kappa statistics showed good agreement between extended IOTF and IAP cutoffs (k=0.933; 95% CI 0.93-0.94), between eIOTF and IOTF (k=0.624; 95% CI 0.619 - 0.629) and between IAP and IOTF (k=0.654; 95% CI 0.645-0.662). A higher proportion of adolescents were diagnosed with obesity with extended IOTF and IAP charts than IOTF charts (P<0.001 for both genders). The mean (SD) BMI showed a rising trend for adolescents overall from 19.61 (3.89) kg/m2 in 2008, 20.44 (4.37) kg/m2 in 2013 and 20.88 (4.60) kg/m2 in 2015 (P<0.001). 158 adolescent (97 girls) were undernourished using combined IAP and extended IOTF criteria. Both extended IOTF and IAP charts showed good agreement for diagnosing overweight and obesity in adolescents. A secular trend in malnutrition was observed in adolescent girls.

Prevalence of overweight and obesity from 5 to 19years of age in Gothenburg, Sweden.

The aim of this study was to present prevalence data for overweight and obesity across school age in a large, recent, population-based cohort of children in Gothenburg, Sweden. We included 66,807 children (48.5% girls) aged 5-18.9years who had their height and weight measured in school health care 2015-2018. The BMI values were categorised according to the age-dependent cut-offs for overweight and obesity from the International Obesity Task Force (IOTF). Overall, the prevalence of overweight and obesity for girls and boys was 18.1% and 18.0%, respectively. We observed increasing proportions of overweight (girls 11.5-17.1% and boys 8.4-17.4%) and obesity (girls 3.0-4.2% and boys 2.7-6.1%) with increasing age (p<0.001 for trend in both sexes). Moreover, girls had higher prevalence of overweight during ages 5.0 to 8.9years compared with boys (p<0.001), while boys had higher prevalence of obesity 15.0-18.9years compared with girls (p<0.001). In conclusion, we demonstrate increasing prevalence of overweight and obesity across the entire school age range, as well as differences in prevalences between boys and girls, in a population-based sample of 67,000 children in Gothenburg city, Sweden. Continuous monitoring of schoolchildren, together with effective preventive measures, is crucial to curb the obesity epidemic and its consequences.

Overweight, obesity, and thinness among a nationally representative sample of Norwegian adolescents and changes from childhood: Associations with sex, region, and population density.

To estimate the prevalence of overweight, obesity, and thinness among Norwegian 13-year-olds and the changes from childhood (age 8 years) to adolescence (age 13 years); and to explore associations with sex, region, and population density from childhood to adolescence. We used longitudinal, anthropometric data collected by school health nurses conducted in Norway. Weight status was classified according to the International Obesity Task Force cut-offs for overweight, obesity, and thinness, and according to mean body mass index (kg/m2). The Norwegian Youth Growth Study, consisting of a nationally representative sample of Norwegian 13-year-olds (n = 1852; 50.7% girls), which is a part of The Norwegian Growth Cohort. Among 13-year-old Norwegians, the prevalence of overweight (including obesity), obesity, and thinness was 15.8%, 2.5%, and 7.3%, respectively. There was little evidence that these had changed from 8 to 13 years. From 8 to 13 years, the odds of obesity was highest in the Northern region of Norway compared to the South-East (odds ratio (OR): 3.78 (95% confidence interval (CI): 1.13, 12.65; p = 0.036) and in rural areas (OR: 4.76 (95% CI: 1.52, 14.90; p = 0.027). Over the same age period, girls had a trend towards a higher odds of thinness compared to boys (OR: 1.65 (95% CI: 0.98, 2.78; p = 0.057). In Norway, the prevalence of overweight, obesity, and thinness among 13-year-olds seem to be established by age 8 years. The prevalence of obesity was higher in the North and in rural areas. The results indicate the continued need for early prevention and treatment, and targeted interventions to certain areas.

Neck circumference cut-offs for overweight and obesity in a group of Mexican adolescents.

Neck circumference (NC) has been used for screening overweight/obesity for its high correlation with age, weight, body mass index (BMI), and waist circumference (WC). Cut-offs should be population specific. The aim of the study was to obtain cut-offs of NC for overweight/obesity in Mexican adolescents and to correlate them with anthropometric indicators. Weight, height, BMI, NC, WC, and mid-upper arm circumference (MUAC) of 465 12-14-year-old Mexican-mestizo students attending a public school in Mexico City were assessed. Using receiver operating characteristics analyses, neck cut-offs were obtained according to the WHO age and sex criteria for overweight/obesity. NC cut-offs with the highest sensitivity and specificity for males and females, respectively, were as follows: 30.0 and 29.3 cm for 12-year-olds; 31.9 and 30.4 cm for 13-year-olds; and, 33.5 and 30.7 cm for 14-year-old adolescents. Overweight/obesity was identified with NC cut-offs in 80% of males and 86% of females, and showed significant correlations (p < 0.01) in males and females with weight (r = 0.821 and r = 0.840, respectively), BMI (r = 0.649 and r = 0.819, respectively), WC (r = 0.710 and r = 0.813, respectively) and MUAC (r = 0.736 and r = 0.815, respectively). Neck circumference may be used as a first-stage screening tool or jointly with BMI to identify overweight/obesity in 12-14-year-old Mexican adolescents.

Discriminatory ability of mid-upper arm circumference in identifying overweight and obese adolescents: Findings from the comprehensive national nutrition survey, India.

Overweight and obesity during adolescence is an important public health problem. However, little is known about the age-and sex-specific mid-upper arm circumference (MUAC) cut-offs for identifying overweight and obese adolescents. The present study was planned to assess diagnostic performance of MUAC in identifying overweight and obese adolescents and estimating age specific MUAC cut-offs, separately for males and females, taking body mass index for age Z-score (BAZ) as the gold standard. The present study is secondary data analysis using Comprehensive National Nutrition Survey, India, on 31,471 adolescents. The, area under curve receiver operating characteristic curve (AUC), and Youden Index were used to estimate MUAC cut-offs for overweight (BAZ > +1) and obesity (BAZ > +2). The MUAC cut-offs to identify overweight were: For 10-14 years- 22.9/23.4 cm, for 15-19 years - 27.0/25.6 cm for males and females, respectively; and for obesity were: For 10-14 years - 24.5/25.1, for 15-19 years - 28.5/28.0 cm for males and females, respectively. For overweight, among males, the age-specific cut-off ranged between 21.2 cm (10 years) and 29.8 (19 years), and for females ranged between 21.2 cm (10 years) and 26.7 cm (19 years). For obesity, it ranged between 22.4 cm (10 years) and 31.1 cm (18 years) for males, and 23.9 cm (10 years) to 26.9 cm (19 years) for females. For obesity, AUC ranged between 0.81 and 0.92, indicating good to excellent diagnostic accuracy. Age- and sex-specific MUAC cut-offs could be considered as a screening tool for identifying overweight and obese adolescents.

Adiposity and mortality in Korean adults: a population-based prospective cohort study

The Asia-Pacific obesity classification recommends using lower BMI cutoffs in Asians compared with those in Western populations. However, the supporting evidence is scarce and little is known about the exact shape of the relations between adiposity and mortality in Asians. We investigated the relations of BMI (in kg/m2), waist circumference, and predicted body fat mass with mortality using a population-based prospective cohort of Korean men and women. This analysis included 44,060 Korea National Health and Nutrition Examination Survey 2007-2014 participants who agreed to mortality follow-up through 31 December, 2016. At baseline, height, weight, and waist circumference were measured. Using DXA data, we derived predicted body fat and fat-free mass. Cox proportional hazards models were used to estimate HRs and 95% CIs for the associations with mortality, adjusting for potential confounders. We tested for nonlinearity using the likelihood ratio test comparing nonlinear restricted cubic spline models with linear models. During ≤9.5 y of follow-up, 1682 deaths were identified. The relations of BMI with all-cause and cardiovascular mortality were J-shaped with the nadir at BMI=25.0-29.9 (P-nonlinearity<0.001). Among participants without a history of cancer or cardiovascular disease, waist circumference (≥95 compared with 75.0-79.9 cm: HR: 2.10; 95% CI: 1.54, 2.86) and predicted body fat mass (highest compared with lowest sextiles: 2.55; 95% CI: 1.60, 4.06) were positively associated with all-cause mortality (all P-nonlinearity≤0.03), as well as cancer and cardiovascular mortality. The highest mortality was observed among participants who had both high predicted fat mass and low fat-free mass. Our data suggest a strong positive association between adiposity and mortality in a population without pre-existing disease. We observed the lowest mortality at BMI=25.0-29.9, suggesting that the current cutoff for overweight (BMI ≥23) may require re-evaluation and that BMI alone may not be a useful measure for indicating adiposity in Asians.

CARDIOVASCULAR PARAMETERS IN OBESE AND NORMAL WEIGHT PEOPLE: A COMPARATIVE STUDY

Introduction: Obesity can be classified as generalized obesity (GO) and abdominal obesity (AO) and obese population have higher rates of mortality and morbidity compared to non-obese individuals. World Health Organization (WHO) has defined overweight and obesity as abnormal or excessive fat accumulation that presents a risk to health. A commonly used simple measure to classify overweight and obesity in adults is body mass index (BMI). BMI is defined as a person's weight in kilograms divided by the square of his height in meters (kg/m2). WHO defines overweight when BMI is greater than or equal to 25; and obesity when BMI is greater or equal to 30 but in Asians, the cut-offs for overweight (≥23.0kg/m2) and obesity (≥25.0kg/m2) are lower than WHO criteria due to risk factors and morbidities MATERIAL AND methods: A sample of 50 male and 50 female obese patients with body Mass Index &gt; 30 kg/m2 and also 50 male and 50 female non obese patients with body Mass Index of 18.50 – 24.99 kg/m2 were selected. Sample was randomly selected. A pilot study was carried out on 20 patients to ensure feasibility, and time needed for completing the study.&#x0D; Results: A total of 200 participants were included in the study of which 100 were obese and 100 were non obese subject. Comparison of cardiac paramenters between obese and non obese individual was done like hrart rate, systolic and diastolic blood pressure, mean arterial pressure and pulse pressure. Demographic variables were also compared. Conclusion: The strong association of obesity with cardiovascular disease necessitates the importance of prevention and control of obesity and it should begin in early child hood also proper diet and regular medical check-up should be carried out to cope up with the problem of obesity.

Exploring the STOP-BANG questionnaire for obstructive sleep apnea screening in seniors.

The accuracy of obstructive sleep apnea (OSA) screening instruments in seniors may change as the predictive role of sex, age, and body mass index (BMI) changes with aging. We investigated the diagnostic performance of the STOP-BANG questionnaire in older individuals with aging-adapted scores and thresholds. Independent community-dwelling adults aged 65 years or older were screened for OSA. The STOP-BANG questionnaire was tested with different configurations and compared to the apnea-hypopnea index (AHI) obtained from home sleep apnea testing (HSAT). Epworth Sleepiness Scale (ESS) and Athens Insomnia Scale (AIS) were tested as possible supplementary screening criteria. We recruited 458 individuals with a mean age of 71 ± 5 years, 41% men, BMI of 28.5 ± 4.6 kg/m². Mild, moderate, and severe OSA were present in, respectively, 34%, 30%, and 19% of the sample. The STOP questions had an area under the curve (AUC) of the receiver operating characteristic curve significantly lower than the STOP-BANG and the STOP+BMI > 28 kg/m² (STOP-B28). Both STOP-BANG and STOP-B28 had high sensitivity and low specificity in all OSA levels with similar AUC to predict AHI ≥ 5 events/h, 0.64. ESS and AIS were nonsignificant as adjunctive instruments. Novel modifications of a standard instrument created the STOP-B28, a simpler-to-obtain and similarly performing variation of the STOP-BANG using fewer inputs, and useful to exclude OSA. Screening seniors via questionnaires to detect OSA is problematic. Considering the 83% OSA prevalence in this age group, it may be a sensible option to indicate objective tests, oximetry, HSAT, or even polysomnography, as a first step in OSA investigation.

Body composition-derived BMI cut-offs for overweight and obesity in ethnic Indian and Creole urban children of Mauritius.

It is increasingly recognised that the use of BMI cut-off points for diagnosing obesity (OB) and proxy measures for body fatness in a given population needs to take into account the potential impact of ethnicity on the BMI-fat % relationship in order to avoid adiposity status misclassification. This relationship was studied here in 377 Mauritian schoolchildren (200 boys and 177 girls, aged 7-13 years) belonging to the two main ethnic groups: Indian (South Asian descent) and Creole (African/Malagasy descent), with body composition assessed using an isotopic 2H dilution technique as reference. The results indicate that for the same BMI, Indians have more body fat (and less lean mass) than Creoles among both boys and girls: linear regression analysis revealed significantly higher body fat % by 4-5 units (P < 0·001) in Indians than in Creoles across a wide range of BMI (11·6-34·2 kg/m2) and body fat % (5-52 %). By applying Deurenberg's Caucasian-based equation to predict body fat % from WHO-defined BMI thresholds for overweight (OW) and OB, and by recalculating the equivalent BMI values using a Mauritian-specific equation, it is shown that the WHO BMI cut-offs for OB and OW would need to be lowered by 4·6-5·9 units in Indian and 2·0-3·7 units in Creole children in the 7-13-year-old age group. These results have major implications for ethnic-based population research towards improving the early diagnosis of excess adiposity in this multi-ethnic population known to be at high risk for later development of type 2 diabetes and CVD.

Comparison of Anthropometric Measures in US Military Personnel in the Classification of Overweight and Obesity.

This study aimed to determine (1) the level of agreement between BMI, circumference-based equation (CBE) measures, waist circumference (WC), and bioelectrical impedance analysis (BIA) measures and (2) whether BMI, CBE measures, or WC alone or in combination adequately reflects adiposity in military personnel compared with BIA. BMI from measured height and weight (using military overweight cutoffs in men [BMI ≥ 27.5 kg/m2 ] and World Health Organization overweight cutoffs [BMI ≥ 25.0 kg/m2 ]), BMI body fat percentage (BF%), WC, CBE BF%, and BIA BF% were collected. Respondents (N = 389, 78% men) were categorized with normal fat versus overweight, obesity, or overfat. Levels of agreement and standard screening performance measures were compared between anthropometric measures and BIA. World Health Organization BMI and BIA BF% classified the most men and women with overweight/obesity; WC with BMI (BMI + WC) and WC alone classified the fewest men and women with overweight/obesity. Levels of agreement were all statistically significant and highest for BMI (men: Cohen's κ = 0.711; women: Cohen's κ = 0.814) and lowest for WC and BMI + WC (all Cohen's κ ≤ 0.270). BMI + CBE performed best overall (sensitivity = 50.9%, false discovery rate = 5.4%). Our findings support BMI + CBE as an easy-to-implement combination to assess adiposity in the military.

The Impact of Body-Mass Index on Cardiopulmonary Fitness in Chinese Heart Failure Patients

Introduction Body-mass index (BMI) and cardiopulmonary fitness measured by peak oxygen consumption (VO2peak) are inversely related among healthy Caucasians. However, knowledge of Chinese heart failure patients remains scant because they experience significant impaired cardiopulmonary fitness, and Asians have lower BMI cut-offs than whites. Hypothesis Evaluate whether Asian-specific BMI cut-offs for overweight (23 kg/m2) and obese (27.5 kg/m2) reflect significant VO2peak changes, and BMI's impact on VO2peak in Chinese heart failure patients. Methods In this cross-sessional study, data was collected from 70 heart failure patients with NYHA class I∼IV (83% II) and mean ejection fraction of 46.3% in Guangdong Provincial Hospital of Chinese Medicine. Height and weight were measured to calculate BMI; and VO2peak was measured via symptom-limited bicycle exercise test. Participants were categorized as healthy (BMI 18.5-22.9 kg/m2), overweight (BMI 23-27.4 kg/m2), or obese (BMI ≥27.5 kg/m2). Those with BMI below 18.5 kg/m2 were excluded. Between-group differences were identified by one-way ANOVA and post-hoc analysi. Spearman's correlation coefficients and binary linear regression evaluated the relationship between BMI and VO2peak. p Results Among 70 patients, 24 (34%) were classified healthy (BMI >18 kg/m2), 34 (49%) overweight (BMI 23-27.4 kg/m2), and 12 (17%) obese (BMI ≥27.5 kg/m2). VO2peak differed between the three BMI groups (p=0.017); and the obese group had significantly lower VO2peak than the heathy group (-3.9 mL/kg/min, 95%CI: -6.6, -1.2). When patients were sex-age stratified (young: Conclusion Asian-specific BMI cut-offs are useful clinical instruments for detecting statistically relevant decreases in VO2peak among heart failure patients. A negative association exists between BMI and VO2peak, especially in those under 60. For each 1.5 unit increase in BMI, reducing VO2peak showed a clinically significant 1 mL/kg/min decrease among heart failure patients. Larger sample-size research could reveal robust quantitative relationships between BMI and cardiopulmonary fitness.

A Comparison of Anthropometric Measures with Bioelectrical Impedance Analysis in the Classification of Overweight and Obesity in U.S. Military Personnel (P21-050-19)

ObjectivesGiven that the prevalence of obesity in the military is a growing national security concern, we sought to determine: 1) the level of agreement between body mass index (BMI), circumference-based equation (CBE), waist circumference (WC), and bioelectrical impedance analysis (BIA) measures, and 2) if BMI, CBE, or WC measures alone or in combination adequately reflect adiposity in military personnel compared to BIA measures. MethodsMeasurements taken by trained personnel were used to estimate BMI (using overweight cut-offs in males from the military (BMI, ≥27.5 kg/m2) and World Health Organization (WHO BMI, ≥25.0 kg/m2)), BMI % body fat (BF%), WC, CBE BF%, and BIA BF%. Respondents were categorized as normal vs. overweight/obese or overfat. Anthropometric measures were compared to BIA to examine levels of agreement and standard screening performance measures. ResultsAmong the 389 participants (78% male), WHO BMI and BIA BF% classified the most males (61.1% and 42.6%, respectively) and females (both 51.2%) as overweight/obese, whereas WC with BMI (BMI + WC) and WC alone were the least likely to classify males (10.9% and 11.6%, respectively) and females (both 9.3%) as overweight/obese. The levels of agreement were all statistically significant and highest for BMI (males Cohen’s kappa (Ck) = 0.711, females Ck = 0.814) and WHO BMI (males Ck = 0.578, females Ck = 0.814); moderate for BMI + CBE (males Ck = 0.447, females Ck = 0.676); and lowest for WC and WC + BMI (all Ck ≤ 0.270). To maximize sensitivity and minimize false discovery rate, BMI + CBE performed best overall (sensitivity = 50.9%, false discovery rate = 5.4%). ConclusionsValid measures of adiposity are needed to ensure that military recruitment and job security are not jeopardized by inaccurate body fat standards. Our findings support BMI + CBE as an easy-to-implement combination to assess adiposity in the military. Future studies need to consider overall goals, including associated health risks, before expanding on these findings. Funding SourcesAll authors contributed their efforts without receiving funding or salary support. The research study was supported by a Grant to the Consortium for Health and Military Performance at the Uniformed Services University from the US Army’s Comprehensive Soldier and Family Fitness program.

Overweight and obesity standards and subjective well-being: Evidence from China

The adult BMI cutoffs for overweight and obesity standards set by the Working Group on Obesity in China are exerting growing influence over daily life. Using the regression discontinuity design method, this paper confirms the existence of a statistically significant discontinuity in subjective well-being at the overweight and obesity cutoffs, respectively. The overweight standard causes a significant decrease in subjective well-being (SWB) by approximate 0.10 units, and the obesity standard by 0.14 units, both sizable. Thus the standard setting has profound social, economic and welfare impacts beyond the health scope.

Childhood BMI is inversely associated with pubertal timing in normal-weight but not overweight boys

ABSTRACTBackgroundAn inverse association between childhood body mass index (BMI; in kg/m2) and pubertal timing is well established for girls. Among boys, studies are scarce and the results inconclusive.ObjectiveWe aimed to determine the association between childhood BMI and age at peak height velocity (PHV) in boys.DesignWe collected height and weight measurements between 6.5 and 22 y of age for boys born 1945–1961 (original cohort; n = 31,971; mean ± SD childhood BMI: 15.74 ± 1.41; age at PHV: 14.06 ± 1.11 y) and 1981–1996 (replication cohort; n = 1465; childhood BMI: 16.47 ± 2.06; age at PHV: 13.71 ± 1.08 y) attending schools in Gothenburg, Sweden, and examined at mandatory military conscription. Age at PHV was obtained from curve-fitting of measured heights with the use of a modified Infancy-Childhood-Puberty model.ResultsIn the original cohort, childhood BMI was inversely associated with age at PHV (P < 0.001) and a significant quadratic term for childhood BMI (P < 0.001) indicated the nonlinearity of this association. Via piecewise linear regression, we identified a threshold for the association at a childhood BMI of 18.42. A significant inverse association was observed below (β: −0.17 y/BMI unit; 95% CI: −0.18, −0.16 y/BMI unit) but not above (β: 0.02 y/BMI unit; 95% CI: −0.03, 0.06 y/BMI unit) this childhood BMI threshold. For every unit increase in childhood BMI, age at PHV was ∼2 mo earlier up to the childhood BMI threshold. Similar results were observed in the replication cohort, demonstrating a significant inverse association below (β: −0.16; 95% CI: −0.21, −0.11) but not above (β: −0.03; 95% CI: −0.11, 0.05) the childhood BMI threshold. The identified threshold was close to the cutoffs for overweight at 8 y of age, and childhood BMI was inversely associated with age at PHV below but not above the overweight cutoffs.ConclusionsThe present findings establish an inverse association between childhood BMI and pubertal timing in normal-weight but not overweight boys.

The associations between nighttime sleep duration, bedtime and preschool children's obesity

Objective: To examine the relationship of nighttime sleep duration and bedtime with preschool children's obesity, and to explore possible early life risk factors for childhood obesity. Methods: A total of 14 946 valid children from 16 439 pre-school children aged 3-6 years in 91 kindergartens in Ma'anshan city participated in the study. The body mass index cut-offs for overweight and obesity in Chinese children and adolescents aged 2-18 years was used as the criterion for judging overweight and obesity, and pathological and secondary causes of obesity were excluded. The associations of nighttime sleep duration and bedtime with preschool children's obesity was analyzed by using non-conditional multivariate binary logistic regression model. Results: Among the preschool children, 22.4% (n=3 345) had shorter sleep duration. 9.5% (n=1 415) had bedtimes after 22:00 on weekdays and 21.8% (n=3 260) had bedtimes after 22:00 on weekends. The prevalence of overweight and obesity were 16.5% (n=2 466) and 10.5% (n=1 562), respectively. After the adjustent of age, gender, whether or not only child, residence in the last six months, parents' body mass index parents' educational level, diet preference, outdoor activities, TV viewing duration, sleep duration, bedtime on weekdays and weekends, only the shorter sleep duration (OR=1.25, 95%CI: 1.03-1.51) was still positively associated with the prevalence of obesity in preschool children. Conclusion: Shorter sleep duration was positively associated with the prevalence of obesity among preschool children.

Comparative Analysis of Local CDC and IOTF Criteria for Detecting Cardiovascular Risk Factors in Children from Tehran

Background: To develop body mass index (BMI) cut-offs for overweight and obesity based on international obesity task force (IOTF) definition, in children in Tehran, and to compare these values with those of center for disease control (CDC) for local pediatric subjects in discriminating cardiometabolic risk factors. Methods: Anthropometric and biochemical information of 1555 participants, aged 5 - 18 years, from phase IV of the Tehran lipid and glucose study (TLGS), were used to obtain local IOTF and CDC cut-offs. We used the LMS method to develop BMI curves matching the adult cut-offs at the age of 18 years for defining obesity and overweight based on the IOTF definition. Using the CDC growth curves, overweight was defined as 85th ≤ BMI < 95th percentile, and obesity as a BMI ≥ 95th percentile. Results: The overall prevalence of overweight was 22.2, 23.9 and 10.5%; and that of obesity was 7.8, 9.0 and 4.2% using international IOTF, local IOTF and local CDC criteria, respectively. IOTF curves better discriminated the presence of all cardiometabolic risk factors, compared with local CDC curves. Conclusions: Local IOTF cut-offs for children in Tehran are in agreement with international IOTF values and better discriminate the cardiometabolic risk factors in children compared with local CDC cut-offs.

Obstacles and Impediments of Overweight and Obesity

Obstacles and Impediments of Overweight and Obesity

Joining Parents' Bed at Night and Overweight among 2- to 6-Year-Old Children - Results from the ‘Healthy Start' Randomized Intervention

Objective: Parental and child co-sleeping has been suggested as a risk factor for short sleep duration and poor sleep quality that may lead to overweight. We examined if joining parent's bed during night was associated with child overweight. Methods: Cross-sectional data from the ‘Healthy Start' study including 635 2- to 6-year-old Danish children, who were all considered obesity prone. Of these, 496 children had complete information on BMI and whether the child joined parents' bed during night and if so, how frequently. International cut-offs for overweight according to age and gender were applied, and logistic regression was used to estimate odds ratio (OR) and 95% Confidence Intervals (CI). Analyses were adjusted for the child's age and gender, overall family stress, parental educational level, and parental BMI. Results: Children who did not join their parent's bed were more likely to be overweight compared to children who did (OR 1.75 (95% CI 0.99-3.10)). Children who rarely joined their parents' bed had OR 2.74 of being overweight (95% CI 1.01-7.44) compared to children who joined every night. Conclusion: Children who rarely joined parents' bed during night were almost three times more likely to be overweight than those who joined every night.