High Prevalence Of Childhood Obesity Research Articles

Physical activity guidelines for preschoolers: a call for research to inform public health policy

There are many challenges in developing evidence-based physical activity guidelines for preschoolers that can ensure health benefits for children. Guidelines for the preschool years have recently been developed in several countries, but there are notable inconsistencies in the amount of physical activity regarded as sufficient for this age group. Given the currently high prevalence of childhood obesity, there is an urgent need for evidence-based studies to inform the development of community-targeted programs to ensure healthy levels of physical activity in young children. Our article outlines the global recommendations for physical activity for children ≤ 5years of age. We identify gaps in the literature and suggest recommendations for future research and public health policy.

Fast food consumption and food prices: evidence from panel data on 5th and 8th grade children.

Fast food consumption is a dietary factor associated with higher prevalence of childhood obesity in the United States. The association between food prices and consumption of fast food among 5th and 8th graders was examined using individual-level random effects models utilizing consumption data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-99 (ECLS-K), price data from American Chamber of Commerce Researchers Association (ACCRA), and contextual outlet density data from Dun and Bradstreet (D&B). The results found that contextual factors including the price of fast food, median household income, and fast food restaurant outlet densities were significantly associated with fast food consumption patterns among this age group. Overall, a 10% increase in the price of fast food was associated with 5.7% lower frequency of weekly fast food consumption. These results suggest that public health policy pricing instruments such as taxes may be effective in reducing consumption of energy-dense foods and possibly reducing the prevalence of overweight and obesity among US children and young adolescents.

Trends in obesity among Korean children using four different criteria

This study examined the prevalence of and trends in childhood overweight and obesity among South Korean children using four different criteria. Data for 7 879 subjects, aged 2?19 (4 091 boys and 3 788 girls), were derived from four waves of the Korean National Health and Nutrition Examination Surveys conducted in 1998, 2001, 2005, and 2007. We examined the time trends in obesity measures based on criteria suggested by the International Obesity Taskforce (IOTF), the US Centers for Disease Control and Prevention (US CDC), the World Health Organization (WHO), and the Korea Centers for Disease Control and Prevention (KCDC). Differences in the absolute prevalence of childhood obesity among the criteria were relatively great. There were no criteria that recorded consistently higher or lower prevalence of childhood overweight (including obesity) and obesity in both genders and age groups compared with other criteria. No differences in time trends of the prevalence between criteria were detected. Increases in the prevalence of overweight and obesity among boys aged 10?19 were found between 1998 and 2001 but, thereafter, trends toward stabilization were found. No significant increases in the prevalence of both overweight and obesity were detected among males and females aged 2?9 between 2001 and 2007 and among females aged 10?19 between 1998 and 2007. The prevalence of childhood overweight and obesity in South Korea stabilized in the early 2000s; however, further policy efforts to lower the high prevalence of childhood obesity and overweight should be exercised.

Behavioural and socio-demographic characteristics of Dutch neighbourhoods with high prevalence of childhood obesity

To identify neighbourhoods with increased prevalence of overweight children and to examine whether the association between neighbourhood and overweight can be explained by demographic characteristics and energy-related behaviours. This cross-sectional study was carried out among 4,072 primary schoolchildren in the city of Zwolle, The Netherlands. Data collection consisted of measured height, weight and waist circumference, and a parental questionnaire on socio-demographic characteristics, dietary and (in)activity behaviour of their child. With multivariate logistic regressions, associations between unhealthy behaviours and neighbourhoods (defined by postal code) with high and low prevalence of childhood overweight were investigated. In three neighbourhoods the prevalence of overweight was significantly higher (16.5% vs. 10.6%, p < 0.05). The odds of living in these neighbourhoods were higher among children watching >2 h television/day (OR: 1.57; 95% CI: 1.15-2.14), not eating breakfast daily (OR: 2.86; 95% CI: 1.93-4.23), drinking >3 glasses/day sugared drinks (OR: 1.23; 95% CI: 1.01-1.50) on weekdays and not participating in organized sports (OR: 1.32; 95% CI: 1.09-1.59). This odds was however lower among children eating <2 fruit/day (OR: 0.83; 95% CI: 0.69-1.00) on weekends. The association between neighbourhood and overweight altered slightly after adjustment for socio-demographic and behavioural characteristics during weekdays (OR: 1.42; 95% CI: 1.05-1.92) and weekends (OR: 1.50; 95% CI; 1.11-2.02). Three neighbourhoods with higher prevalence of overweight were identified. A small part of the association between overweight and neighbourhood is explained by socio-demographic factors and unhealthy behaviours measured in this study. Neighbourhoods with higher overweight prevalence are a priority setting for targeted interventions to prevent overweight. The association between neighbourhood and overweight needs to be explored further to understand the role the neighbourhood can play in tackling overweight.

Prevalence of metabolic syndrome in children and adolescents who consult with obesity

The higher prevalence of childhood obesity has led to search for metabolic syndrome (MS) in this age group. To study the prevalence of MS in obese children and adolescents. Cross sectional study of 255 obese children and adolescents aged 11.3 ± 2.4 years, 45% males, 60% pubertal, with a body mass index (BMI) z score of 2.7 ± 0.6, who were evaluated for obesity. MS was defined as the presence of at least three of the following criteria, according to Ferranti: fasting glucose (FG) ≥ 100 mg/dl, triglycerides (TG) ≥ 100 mg/dl, HDL < 50 mg/dl, waist circumference (WC) > percentile (p) 75 and blood pressure (BP) > p90. Patients were also classified using Cook criteria: FG ≥ 100 mg/dl, TG ≥ 110 mg/dl, HDL < 40 mg/dl, WC > p 90, BP > p 90. MS was observed in 45 and 22.7% of patients, according to Ferranti and Cook definitions, respectively. WC was the most frequent criteria and glucose was the most uncommon. Males had higher body mass index, WC and TG levels than females. According to Ferranti and Cook definitions, MS prevalence was 53.5 and 28% in males and 37.6 and l8.4% in females (p < 0.05). Fifty and 26.1% of pubertal patients exhibited MS vs 36.9 and 17.5% in pre-pubertal subjects (p < 0.05) using Ferranti and Cook criteria, respectively. The frequency of MS increased along with a higher BMI. MS is a prevalent condition in obese children and adolescents, especially in males and pubertal children. It is necessary to have a better and universal definition for MS in pediatrics including all ages, in order to be focused in obesity prevention and treatment.

TigerKids

The high prevalence of childhood obesity necessitates broadly effective prevention measures. A behavioral program for children in daycare settings was developed, and its effects were assessed in a 2-year cluster randomized controlled trial. A total of 64daycare settings were cluster randomized in a 2:1 ratio to intervention and control in order to assess the effects of the program. Samples of 1318 and 1340 children were assessed after 5.7±2.6 and 17.6±2.3months. Main outcome measures were prevalence of high fruit and vegetable consumption and of low consumption of high caloric drinks at home assessed by parental questionnaires. TigerKids achieved a significantly higher prevalence of high home consumption of fruits (66.6 vs. 55.7%, p<0.0001) and vegetables (42.7 vs. 33.6%, p=0.001) as well as a lower frequency of high consumption of energy rich beverages (47.7 vs. 60.4%, p<0.0001). The TigerKids group tended to show a lower prevalence of overweight (13.9 vs. 18.0%, p=0.05) and obesity (3.4 vs. 5.4%, p=0.07) in the first year. TigerKids is a low cost program applied in daycare settings which achieves significant behavioral changes in the home environment.

Childhood obesity in the Middle East: a review

Accurate and comprehensive data on the extent of the problem of childhood obesity is lacking in countries of the Middle East. This review, based on a Medline search, summarizes the prevalence of obesity among children and adolescents in the region during 1990-2007. The highest rates of obesity and overweight were reported from Bahrain and the lowest from the Islamic Republic of Iran. Studies from Saudi Arabia, Islamic Republic of Iran and Kuwait showed an upwards trend in childhood obesity compared with a decade ago. Lack of uniformity in reference standards and reporting systems renders comparisons difficult. Nevertheless, the I high prevalence of childhood obesity in the Middle East should stimulate policy-makers in the region to set up effective national and regional surveillance systems.

School Vending Machine Purchasing Behavior: Results From the 2005 YouthStyles Survey

Competitive foods are often available in school vending machines. Providing youth with access to school vending machines, and thus competitive foods, is of concern, considering the continued high prevalence of childhood obesity: competitive foods tend to be energy dense and nutrient poor and can contribute to increased energy intake in children and adolescents. To evaluate the relationship between school vending machine purchasing behavior and school vending machine access and individual-level dietary characteristics, we used population-level YouthStyles 2005 survey data to compare nutrition-related policy and behavioral characteristics by the number of weekly vending machine purchases made by public school children and adolescents (N = 869). Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were computed using age- and race/ethnicity-adjusted logistic regression models that were weighted on age and sex of child, annual household income, head of household age, and race/ethnicity of the adult in study. Data were collected in 2005 and analyzed in 2008. Compared to participants who did not purchase from a vending machine, participants who purchased >or=3 days/week were more likely to (1) have unrestricted access to a school vending machine (OR = 1.71; 95% CI = 1.13-2.59); (2) consume regular soda and chocolate candy >or=1 time/day (OR = 3.21; 95% CI = 1.87-5.51 and OR = 2.71; 95% CI = 1.34-5.46, respectively); and (3) purchase pizza or fried foods from a school cafeteria >or=1 day/week (OR = 5.05; 95% CI = 3.10-8.22). Future studies are needed to establish the contribution that the school-nutrition environment makes on overall youth dietary intake behavior, paying special attention to health disparities between whites and nonwhites.

Training in childhood obesity management in the United States: a survey of pediatric, internal medicine-pediatrics and family medicine residency program directors

BackgroundInformation about the availability and effectiveness of childhood obesity training during residency is limited.MethodsWe surveyed residency program directors from pediatric, internal medicine-pediatrics (IM-Peds), and family medicine residency programs between September 2007 and January 2008 about childhood obesity training offered in their programs.ResultsThe response rate was 42.2% (299/709) and ranged by specialty from 40.1% to 45.4%. Overall, 52.5% of respondents felt that childhood obesity training in residency was extremely important, and the majority of programs offered training in aspects of childhood obesity management including prevention (N = 240, 80.3%), diagnosis (N = 282, 94.3%), diagnosis of complications (N = 249, 83.3%), and treatment (N = 242, 80.9%). However, only 18.1% (N = 54) of programs had a formal childhood obesity curriculum with variability across specialties. Specifically, 35.5% of IM-Peds programs had a formal curriculum compared to only 22.6% of pediatric and 13.9% of family medicine programs (p < 0.01). Didactic instruction was the most commonly used training method but was rated as only somewhat effective by 67.9% of respondents using this method. The most frequently cited significant barrier to implementing childhood obesity training was competing curricular demands (58.5%).ConclusionsWhile most residents receive training in aspects of childhood obesity management, deficits may exist in training quality with a minority of programs offering a formal childhood obesity curriculum. Given the high prevalence of childhood obesity, a greater emphasis should be placed on development and use of effective training strategies suitable for all specialties training physicians to care for children.

Physical activity evaluation in Yugoslav Study of the Precursors of Atherosclerosis in School Children – YUSAD study

IntroductionIt is observed that there is a lack of physical activity and exercise in children, stressing higher prevalence of childhood obesity. The purpose of the study was to evaluate duration of physical activity in a child population and correlation of dynamics in physical activity during 5 years of follow-up in the same population.Material and methodsWe evaluated 3243 school children from 12 regional centres across Serbia. The first examination was done when the children were 10 years old (baseline group), while the second examination was done on the same population when children were 15 years old. Physical activity was classified as recreational activity after school. We analysed 3 groups regarding physical activity: a group of children who were physically active less than 1 hour per day (group I), a second group active from 1 hour to < 3 hours per day (group II), and a third group active ≥ 3 hours per day (group III).ResultsIn our study we have found on examination that the majority of children were physically active between 1 and 3 hours per day. Our results indicate that there is significant movement from groups I and III toward group II on the second examination regarding the proportion in the baseline group. There is a significant increase in the number of children in group I as they get older.ConclusionsSchool children in Serbia are physically active predominantly between 1 and 3 hours per day at the age between 10 and 15 years.

Childhood obesity and elevated blood pressure in a rural population of northern Greece

The objective of this study was to determine the prevalence of childhood obesity and elevated blood pressure (BP) in a rural population of northern Greece. In total, 572 schoolchildren between the age of 4 and 10 years were examined. Obesity was defined using three different standards: (1) body mass index (BMI) charts of the French society of Paediatrics (FR), selected because of the low cardiovascular risk profile and low prevalence of obesity in France; (2) United States BMI CDC charts (US), selected because of the high prevalence of childhood obesity in the USA; and the reference curves of the International Obesity Task Force (IOTF). Children with elevated BP were defined as BP > or = 95th percentile for age, gender and height, according to the Greek national charts. The prevalence of obesity for boys was 13.6% (IOTF), 23.7% (US) and 31.7% (FR); for girls 14.4% (IOTF), 21.1% (US) and 35.1% (FR). The prevalence of elevated BP was 7.9% (45 children). It was 5 to 6 times more common for obese than non-obese children to have elevated BP (relative risk of 5.2 to 6.2 and odds ratio 6.3 to 7.7). The results confirm the high prevalence of childhood obesity in Greece, in this study found to be more prevalent in rural than urban Greece. The IOTF criteria tend to underestimate obesity and may not be optimal for use in a primary clinical care setting where the approach is for health education and patient treatment, rather than purely epidemiological. The study also confirms a strong relationship between high BP and increased BMI.

Influence of Race, Ethnicity, and Culture on Childhood Obesity: Implications for Prevention and Treatment

Influence of Race, Ethnicity, and Culture on Childhood Obesity: Implications for Prevention and Treatment

Active play and screen time in US children aged 4 to 11 years in relation to sociodemographic and weight status characteristics: a nationally representative cross-sectional analysis.

BackgroundThe high prevalence of childhood obesity underscores the importance of monitoring population trends in children's activity and screen time, and describing associations with child age, gender, race/ethnicity, and weight status. Our objective was to estimate the proportion of young children in the US who have low levels of active play or high levels of screen time, or who have both these behaviors, and to describe associations with age, gender, race/ethnicity, and weight status.MethodsWe analyzed data collected during the National Health and Nutrition Examination Surveys 2001–2004, a US nationally representative cross-sectional study. We studied 2964 children aged 4.00 to 11.99 years. Our main outcomes were reported weekly times that the child played or exercised hard enough to sweat or breathe hard (active play), daily hours the child watched television/videos, used computers, or played computer games (screen time), and the combination of low active play and high screen time. Low active play was defined as active play 6 times or less per week. High screen time was defined as more than 2 hours per day. We accounted for the complex survey design in analyses and report proportions and 95% confidence intervals. We used Wald Chi-square to test for differences between proportions. To identify factors associated with low active play and high screen time, we used multivariate logistic regression.ResultsOf US children aged 4 to 11 years, 37.3% (95% confidence interval, 34.1% to 40.4%) had low levels of active play, 65.0% (95% CI, 61.4% to 68.5%) had high screen time, and 26.3% (95% CI, 23.8% to 28.9%) had both these behaviors. Characteristics associated with a higher probability of simultaneously having low active play and high screen time were older age, female gender, non-Hispanic black race/ethnicity, and having a BMI-for-age ≥95th percentile of the CDC growth reference.ConclusionMany young children in the US are reported to have physical activity and screen time behaviors that are inconsistent with recommendations for healthy pediatric development. Children who are overweight, approaching adolescence, girls, and non-Hispanic blacks may benefit most from public health policies and programs aimed at these behaviors.

Higher prevalence of childhood overweight and obesity in association with gender and socioeconomic status in the Hunter region of New South Wales

AbstractObjective: To determine the prevalence of overweight and obesity in primary school‐aged children in the Hunter region and examine associations with gender, age, socioeconomic status (SES) and geographical location.Design: Cross‐sectional survey of a stratified sample of randomly selected government primary schools in the Hunter region with SES defined by Socio‐Economic Index For Areas index and geographical location based on school education areas.Subjects: A total of 2224 out of 5206 (42.7%) primary school children from randomly selected government primary schools representing year 1 to year 6 (x = 9.61 ± 1.7).Setting: Sixteen government primary schools in the Hunter Region of New South Wales.Main outcome measures: Overweight and obesity were assessed using the international body mass index cut points, standardised for both age and gender as defined by Cole.Data analyses: Chi square (α = 0.05) was used to compare prevalence across categories of gender, age, SES or geographical location.Results: Of the 2224 children who had their height and weight measured, 28.35% (n = 606) were either overweight (n = 415, 19.3%) or obese (n = 191, 9.06%). Significant differences in the prevalence of combined overweight and obesity were observed between children residing in high and low socioeconomic areas, by ages and between boys and girls.Conclusion or application: The prevalence of childhood obesity is high and appears more prevalent in girls, in children residing in low‐income areas and at specific ages. Determinants of the observed differences will need to be investigated in order to address the higher prevalence of childhood obesity in high‐risk population groups.

Physical Activity in Nonoverweight and Overweight Hispanic Children and Adolescents

Despite the high prevalence of childhood obesity among U.S. Hispanic children and adolescents, quantitative, objective data on their patterns and levels of physical activity are scarce. 1) To describe qualitatively the types of physical activities in which nonoverweight and overweight Hispanic children and adolescents participate; 2) to use accelerometry to quantitatively describe the duration, intensity, and frequency of physical activity; 3) to examine the influence of age, gender, and BMI status on physical activity levels; and 4) to determine the relationships between physical activity and adiposity, fitness, and risk for the metabolic syndrome. Cross-sectional assessment of physical activity using accelerometers was made for three continuous days in 897 nonoverweight and overweight Hispanic children, ages 4-19 yr. Ancillary measurements included blood pressure, anthropometry, body composition by dual-energy x-ray absorptiometry, fitness by VO2peak test, and metabolic risk factors, using standard clinical and biochemical methods. Types and levels of physical activity were influenced by age, gender, and body mass index (BMI) status. Total physical activity counts declined markedly with increasing age (P = 0.001) and were consistently higher in boys than in girls (P = 0.001). Total activity counts were lower (P = 0.002) and sedentary activity counts were higher in overweight than in nonoverweight children (P = 0.001). Sleep duration (min.d(-1)) was slightly lower in overweight compared with nonoverweight children, ages 4-8 yr (P = 0.03). Physical activity levels were significantly associated with percent FM, VO2peak, fasting serum insulin, and waist circumference, although the strength of the associations were generally low. Efforts should be made to shift the time in sedentary activity to light activity, and to increase the time spent in moderate to vigorous activity in U.S. Hispanic children and adolescents, with special attention given to the overweight, girls, and adolescents.

Fitness levels of Greek primary schoolchildren in relationship to overweight and obesity

The aim of the present cross-sectional study was to provide estimates for overweight and obesity in a sample of Greek schoolchildren and to determine their possible relation with selected motor and health-related fitness parameters. The study sample consisted of 709 healthy children (328 girls, 381 boys, mean age = 8.9+/-1.6 years), living in the towns of Agios Stefanos (approximately 12,000 citizens) and Alexandroupolis (approximately 60,000 citizens), Greece. All pupils underwent anthropometric, motor and cardiovascular fitness assessments (Eurofit test battery). The body mass index (BMI) cut-off points adopted by the International Obesity Task Force were utilized for the assessment of overweight and obesity. 59.4% of the participants had a normal BMI, 25.8% were overweight and 14.8% were obese, without significant differences between genders. In general, the higher BMI categories were strongly associated with inferior performances in all fitness tests, except flexibility. This graded relationship was consistent for both boys and girls, although the statistical relationship between BMI categories and fitness performance varied by gender. In conclusion, the findings of the current study offer some support to the reported high prevalence of childhood obesity in Greece and suggest that overweight and obesity are limiting factors for fitness performance in primary schoolchildren. The present data suggest that interventions promoting children's health should, ideally, begin early in life and involve measures that simultaneously improve fitness and lower fatness.

The prognosis in childhood obesity

Childhood obesity is increasing throughout the world. It is associated with a wide spectrum of complications that may affect short- and long-term physical and mental health. With no proven effective prevention or treatment strategies available, there are increasing numbers of obese children who face a significant risk of developing Type II diabetes and/or cardiovascular disease as well as many other medical complications. Furthermore, the social implications of such a high prevalence of childhood obesity cannot be underestimated. Time will tell whether we are able to change a situation such as this, requiring a focussed and co-operative approach from many organisations, before the children of today become the morbidity and mortality figures of tomorrow.