Increasing Weight Status Research Articles

Tracking changes in weight status in primary school children in Birmingham: an analysis of the National Child Measurement Programme – a retrospective cohort study

One-in-four 4–5 years and more than one-in-three 10–11 years have excess weight in England.AimTo identify characteristics associated with (1) having overweight, obesity and severe obesity at 11 years and (2)...

Severe obesity and fitness in New York City public school youth, 2010–2018

BackgroundObesity is associated with poorer youth fitness. However, little research has examined the magnitude of this relationship in youth with severe obesity. Therefore, we sought to determine the relationship between increasing weight status and fitness within a sample of children and adolescents from New York City public schools.MethodsThis study utilized longitudinal data from the NYC Fitnessgram dataset years 2010–2018. Height and weight along with fitness were measured annually during physical education classes. Severity of obesity was defined using body mass index relative to the 95th percentile and then categorized into classes. A composite measure of fitness was calculated based on scores for three fitness tests: aerobic capacity, muscular strength, and muscular endurance. To examine the weight status-fitness relationship, repeated measures mixed models with random-intercepts were constructed. Stratified models examined differences by demographic factors.ResultsThe sample included 917,554 youth (51.8% male, 39.3% Hispanic, 29.9% non-Hispanic Black, 14.0%, 4.6%, and 1.6% class I, II and III obesity, respectively). Compared to youth with healthy weight, increasing severity of obesity was associated with decreased fitness: overweight (β = − 0.28, 95% CI:-0.29;-0.28), class I obesity (β = − 0.60, 95% CI:-0.60; − 0.60), class II obesity (β = − 0.94, 95% CI:-0.94; − 0.93), and class III obesity (β = − 1.28; 95% CI:-1.28; − 1.27). Stratified models showed the association was stronger among male and non-Hispanic White youth.ConclusionFindings revealed that more severe obesity was associated with lower fitness. Future research is needed to develop targeted interventions to improve fitness in youth with obesity.

Longitudinal Association between Weight Status, Aerobic Capacity, Muscular Strength, and Endurance among New York City Youth, 2010-2017.

Background: Child weight status is inversely associated with fitness, but less is known about this relationship across fitness domains. This study examined the longitudinal association between weight status and fitness domains in a large, diverse sample of children. Methods: Data were drawn from the New York City Fitnessgram (2010-2011 to 2017-2018). Height and weight were collected annually and converted to weight status using Centers for Disease Control and Prevention growth charts. Aerobic capacity, muscular strength, and endurance were measured as age and sex standardized z-scores based on the fitness performance tests. Repeated-measures multilevel models were run testing the association between weight status and 1-year lagged fitness domains. Results: The sample included 917,554 children (51.8% male, 39.3% Hispanic, 29.9% non-Hispanic Black, 13.9%, 4.7%, and 1.7% class I, II, and III obesity, respectively). For each fitness domain, fitness scores decreased with increasing weight status across all demographic categories, with the lowest fitness scores observed in children with the most severe obesity, and highest magnitude of effects for aerobic capacity, and particularly among boys, non-Hispanic Whites, and older youth. For example, compared with youth with healthy weight, youth with overweight had 0.28 standard deviation lower aerobic capacity performance [confidence interval (95% CI): -0.29 to -0.28], followed by class 1 obesity (β = -0.57, 95% CI: -0.58 to -0.57), class 2 obesity (β = -0.88, 95% CI: -0.88 to -0.88), and class 3 obesity (β = -1.19, 95% CI: -1.20 to -1.18). Conclusions: Compared with youth with healthy weight, youth at every other weight status had lower subsequent fitness, with the magnitude of the relationship increasing as weight status increased. Future research should examine interventions targeting aerobic capacity to reduce fitness disparities.

Prevalence and related factors of hyperuricaemia in Chinese children and adolescents: a pooled analysis of 11 population-based studies

Background and aims Hyperuricaemia can lead to gout and is associated with an increased risk of cardiometabolic disease. We aimed to investigate the prevalence of hyperuricaemia and its related factors in Chinese children and adolescents. Methods We pooled data from 11 population-based studies comprising 54,580 participants aged 3–19 years. The sex- and age-standardized prevalence of hyperuricaemia was estimated overall and by sex, age, weight status, geographic region and survey year. Results Serum uric acid (SUA) increased gradually from 3 to 11 years with no significant sex difference, and then increased dramatically during 11–15 years. The estimated overall prevalence of hyperuricaemia was 23.3% (26.6% in boys and 19.8% in girls, p < .001). The prevalence increased with growing age (3.7, 9.8, 15.8, 35.5 and 31.7% among children aged 3–5, 6–8, 9–11, 12–15 and 16–19 years, respectively, p for trend < .001) and with increasing weight status (18.2, 37.6, 50.6 and 64.5% among children with non-overweight, overweight, obesity and extreme obesity, respectively, p for trend < .001). The prevalence was higher in North than in South (24.2 vs. 19.7%, p < .001), and increased markedly from 16.7% during 2009–2015 to 24.8% during 2016–2019. In multivariable regression analyses, sex, age, obesity, region and survey year were independently associated with odds of hyperuricaemia. Conclusions The prevalence of hyperuricaemia in Chinese children and adolescents is unexpectedly high. The findings suggest an urgent need to implement effective interventions to reduce risk of hyperuricaemia in Chinese youths. KEY MESSAGES Question: What is the prevalence of hyperuricaemia in Chinese children and adolescents? Findings: In this large pooled cross-sectional study comprising >50,000 children and adolescents aged 3–19 years, we found that the prevalence of hyperuricaemia was high in overall population and subgroups of sex, age, obesity, region and survey year. Meaning: Our findings indicate that hyperuricaemia is an important health problem in Chinese children and adolescents, and effective intervention strategies are needed to reduce its burden.

Food Sales and Adult Weight Status: Results of a Cross-Sectional Study in England

Ecological studies often use supermarket location as a proxy measure of the food environment. In this study, we used data on sales at a leading mainstream supermarket chain to explore how area-level supermarket use is associated with overweight and obesity in English adults. Sales data were aggregated to local authority level and joined to a national dataset describing self-reported height and weight and fruit and vegetable consumption. Regression models showed a modest association between higher levels of unhealthy food sales relative to health food sales and increased odds of being overweight and obese. Although effect sizes were small, they persisted after adjustment for area-level deprivation. Supermarket sales data provide additional understanding in the study of food environments and their impact on increasing weight status. Future health policies should consider using ‘big data’ combined with other research methods to address the increasing consumption of unhealthy and highly processed foods.

The association between obesity and quality of life: a retrospective analysis of a large-scale population-based cohort study

BackgroundThe relationship between obesity and health-related quality of life (HRQoL) may be confounded by factors such as multimorbidity. The aim of the study was to explore this relationship, controlling for long-term conditions and other health, lifestyle and demographic factors in a general adult population. There was specific interest in the impact of high weight status, measured by body mass index (BMI) levels (obesity, morbid obesity) compared with individuals of normal weight.MethodsHealth, lifestyle and demographic data were collected from 64,631 individuals aged 16 years and over registered in the Yorkshire Health Study; a long-term cohort study. Data were collected in 2 waves: from patients attending GP surgeries in the South Yorkshire region; and using online recruitment across the entire Yorkshire and Humber area. Univariable and multivariable regression methods were utilised to identify factors associated with HRQoL as measured by the EQ-5D summary score. Long-term conditions were tested as both covariates and mediating factors on the causal pathway between obesity and HRQoL.ResultsIncreasing levels of obesity are associated with reduced HRQoL, although this difference is negligible between those of normal weight and those who are overweight. Individuals with obesity and morbid obesity score 4.9 and 11.3 percentage points less on the EQ-5D summary scale respectively than those of normal weight. Concurrent physical, and particularly mental health-related long-term conditions are substantively related to HRQoL: those with 3 or more reported mental or physical health conditions score 29.8 and 14.6 percentage points less on the EQ-5D summary scale respectively than those with fewer conditions. Long-term conditions can be conceptualised as lying on the causal path between obesity and HRQoL, but there is weak evidence for a partial mediating relationship only.ConclusionsTo conclude, in agreement with the established literature we have found a clear inverse relationship between increasing weight status and decreasing HRQoL and confirmed the mediating role of long-term conditions in the reduction of HRQoL in people with obesity. Nevertheless, a high BMI remains independently related to HRQoL, suggesting that ‘healthy people with obesity’ may be in transition to an unhealthy future.

Fast food intake and excess weight gain over a 1-year period among preschool-age children.

Fast food is cross-sectionally associated with having overweight and obesity in young children. To examine whether fast food intake independently contributes to the development of overweight and obesity among preschool-age children. Prospective cohort of 3- to 5-year-old children (n = 541) followed for 1 year. Children's height and weight were objectively measured at baseline and study end. Parents reported their child's fast food intake frequency in the past week from 11 chain fast food restaurants in six online follow-up surveys, completed approximately 8 weeks apart. Poisson regression with robust standard errors modelled the risk of a child increasing in weight status (ie, transitioning from a having a healthy weight to having overweight or from having overweight to having obesity) over the study period in relation to their average weekly fast food intake, adjusted for sociodemographics, child obesogenic behaviours, and parent weight status. At baseline, 18.1% of children had overweight and 9.8% had obesity; 8.1% of children transitioned to a greater weight status over the 1-year period. Mean fast food intake frequency among consumers was 2.1 (SD: 1.4) times per week. The risk of increasing in weight status increased linearly with each additional time fast food was consumed in an average week over the study year (RR: 1.38; 95% CI, 1.13-1.67; P < .01). Greater fast food intake over 1 year was associated with increasing weight status during that time in this preschool-age cohort.

Demographic differences in and correlates of perceived body image discrepancy among urban adolescent girls: a cross-sectional study

BackgroundUnderstanding factors related to girls’ body image discrepancy, which is the difference between self-perceived current or actual and ideal body size, is important for addressing body-related issues and preventing adverse sequelae. Two aims were to: 1) examine demographic differences in body image discrepancy; and 2) determine the association of body image discrepancy with weight status, percent body fat, physical activity, sedentary behavior, and cardiovascular (CV) fitness among young adolescent girls.MethodsThe cross-sectional study included a secondary analysis of baseline data from a group randomized controlled trial including 1519 5th–8th grade girls in 24 U.S. schools. Girls completed physical activity and sedentary behavior surveys. To indicate perceived current/actual and ideal body image, girls selected from nine body figures the one that represented how they look now and another showing how they want to look. Girls wore accelerometers measuring physical activity. Height, weight, and percent body fat were assessed. The Progressive Aerobic CV Endurance Run was used to estimate CV fitness. Independent t-test, one- and two-way ANOVA, correlational analyses, and hierarchical linear regressions were performed.ResultsThe majority (67.5%; n = 1023) chose a smaller ideal than current/actual figure. White girls had higher body image discrepancy than Black girls (p = .035). Body image discrepancy increased with increasing weight status (F3,1506 = 171.32, p < .001). Moderate-to-vigorous physical activity (MVPA) and vigorous physical activity were negatively correlated with body image discrepancy (r = −.10, p < .001; r = −.14, p < .001, respectively), but correlations were not significant after adjusting for race and body mass index (BMI), respectively. Body image discrepancy was moderately correlated with CV fitness (r = −.55, p < .001). After adjusting for demographics, percent body fat, but not CV fitness or MVPA, influenced body image discrepancy. Girls with higher percent body fat had higher body image discrepancy (p < .001).ConclusionThis study provided important information to guide interventions for promoting a positive body image among girls.Trial registrationClinicalTrials.gov Identifier NCT01503333, registration date: January 4, 2012.

Pain Response after Maximal Aerobic Exercise in Adolescents across Weight Status.

Pain reports are greater with increasing weight status, and exercise can reduce pain perception. It is unknown, however, whether exercise can relieve pain in adolescents of varying weight status. The purpose of this study was to determine whether adolescents across weight status report pain relief after high-intensity aerobic exercise (exercise-induced hypoalgesia (EIH)). Sixty-two adolescents (15.1 ± 1.8 yr, 29 males) participated in the following three sessions: 1) pressure pain thresholds (PPT) before and after quiet rest, clinical pain (McGill Pain Questionnaire), and physical activity levels (self-report and ActiSleep Plus Monitors) were measured, 2) PPT were measured with a computerized algometer at the fourth finger's nailbed, middle deltoid muscle, and quadriceps muscle before and after maximal oxygen uptake test (V˙O2max Bruce Treadmill Protocol), and 3) body composition was measured with dual-energy x-ray absorptiometry. All adolescents met criteria for V˙O2max. On the basis of body mass index z-score, adolescents were categorized as having normal weight (n = 33) or being overweight/obese (n = 29). PPT increased after exercise (EIH) and were unchanged with quiet rest (trial × session, P = 0.02). EIH was similar across the three sites and between normal-weight and overweight/obese adolescents. Physical activity and clinical pain were not correlated with EIH. Overweight/obese adolescents had similar absolute V˙O2max (L·min(-1)) but lower relative V˙O2max (mL·kg(-1)·min(-1)) compared with normal-weight adolescents. When adolescents were categorized using FitnessGram standards as unfit (n = 15) and fit (n = 46), the EIH response was similar between fitness levels. This study is the first to establish that both overweight and normal-weight adolescents experience EIH. EIH after high-intensity aerobic exercise was robust in adolescents regardless of weight status and not influenced by physical fitness.

Pes planus and paediatric obesity: a systematic review of the literature.

Children with obesity report musculoskeletal pain more than normal-weight children; this may be linked with literature suggesting children with obesity have higher prevalence of pes planus (flatfoot). To further elucidate whether this relation occurs, we conducted a systematic literature review on the co-occurrence of pes planus and paediatric obesity. Empirical articles published until September 2013 were obtained through an electronic search of MEDLINE and SPORTDiscus; included articles examined the association between body weight and pes planus in children. Thirteen cross-sectional studies of varied designs were identified. Methods used to diagnose pes planus varied between studies: imaging modalities, anthropometric measurements and clinical examination. Across all studies, pes planus prevalence among children with obesity ranged widely from 14 to 67%. Nearly all studies indicated increasing pes planus in children with increasing weight. No studies evaluated pain/complications related to pes planus. Our review suggests increased prevalence of pes planus among children with obesity or increasing weight status. Because of differing methodologies, lack of consensus regarding the pes planus definition, the dearth of investigation into pain/complications and the few existing studies, more research is needed to determine a relation between children's body weight, pes planus and associated effects on pain and function.

Strength and body weight in US children and adolescents.

Regular aerobic and muscle-strengthening physical activity in youth has been positively associated with health and may help prevent obesity. The purpose of this study is to provide reference values on 4 core, upper, and lower body measures of muscle strength among US children and adolescents and to investigate the association between these measures of strength and weight status. We assessed muscular strength using 4 different tests (plank, modified pull-up, knee extension, and grip strength) in 1224 youth aged 6 to 15 years collected during the 2012 National Health and Nutrition Examination Survey National Youth Fitness Survey. Mean and median estimates are provided by gender, age, and weight status. Weight status was defined based on standard categories of obesity, overweight, normal weight, and underweight using the gender-specific BMI-for-age Centers for Disease Control and Prevention growth charts. There were significant positive trends with age for each of the strength tests (P < .001) except the modified pull-up among girls. The length of time the plank was held decreased as weight status increased for both girls and boys (P < .001). As weight status increased the number of modified pull-ups decreased (P < .001 boys and girls). Scores on the knee extension increased as weight status increased (P < .01). Grip strength increased as weight status increased (P < .01). Increasing weight status had a negative association with measures of strength that involved lifting the body, but was associated with improved performances on tests that did not involve lifting the body.

Weight status in young adulthood and survival after cardiovascular diseases and cancer.

Some studies have suggested that overweight is associated with lower mortality, but these results may be affected by reverse causality. We analysed how body mass index (BMI) in young adulthood is associated with mortality in the general population and after the diagnoses of coronary heart disease (CHD), stroke and cancer. BMI was measured at an average age of 18 years in 734 438 Swedish men born in 1950-65. Diagnoses of CHD, stroke and cancer as well as all-cause mortality were derived from registers covering the whole population, up to 31 December 2010. The follow-up of 24.56 million person-years included 33 067 cases of mortality and 19 843 CHD, 13 578 stroke and 27 365 cancer diagnoses. Hazard ratios (HR) [with 95% confidence intervals (CI)] were estimated by the Cox proportional hazards model. Higher mortality in the whole cohort (HR = 1.26, 1.21-1.32) as well as after the diagnosis of CHD (HR = 1.33, 1.09-1.63) or cancer (HR = 1.13, 1.01-1.25) was found in moderately overweight men (BMI 25.0-27.4 kg/m(2)) as compared with normal weight men (BMI 20.1-22.4 kg/m(2)); for stroke patients the result for the same BMI categories was not statistically significant (HR = 1.17, 0.94-1.45). Mortality increased with increasing weight status and was highest in obese men (BMI >30 kg/m(2)): HR = 2.17 (2.02-2.34) for the whole cohort, 2.35 (1.81-3.05) after the diagnosis of CHD, 2.08 (1.56-2.77) after stroke and 1.68 (1.40-2.01) after cancer. Even moderate overweight in young adulthood increases all-cause mortality and mortality after the diagnosis of CHD, stroke and cancer in men. Preventing overweight in young adulthood remains as an important public health issue.

Obesity negatively impacts lung function in children and adolescents

To investigate the relationship between weight status (body mass index [BMI] percentile and BMI z-score) and lung volumes in healthy children and adolescents. We hypothesized that: (a) there would be a significant inverse relationship between age- and sex-specific BMI distribution and functional residual capacity (FRC), and expiratory reserve volume (ERV), respectively; and (b) obese children would have significantly reduced FRC and ERV compared to their non-obese peers. The medical records of all individuals who successfully performed pulmonary function testing between 2000 and 2007 at two university children's hospitals were reviewed. Participants were excluded if they had cardiopulmonary, neuromuscular, or chest wall disease. Of 1,469 record reviewed, 327 subjects met study criteria. Percent predicted ERV was lowest in the obese group (P < 0.001) while residual volume (RV) was lowest in the overweight and obese groups (P < 0.001). Underweight participants had a lower percent predicted forced vital capacity (FVC) (P = 0.027) and vital capacity (VC; P = 0.039). Obese participants had the lowest FEV1 /FVC (P < 0.001). A positive linear relationship existed between BMI z-score and percent predicted FVC, VC, and diffusing capacity of carbon monoxide (DLCO ). A negative linear relationship was found between BMI z-score and percent predicted FRC, ERV, RV, and absolute FEV1 /FVC. Our results show that increasing weight status in children and adolescents is associated with a general reduction in lung volume measurements, which may reflect impaired lung function, increased respiratory symptoms, and decreased functional status.

Overweight Physicians During Residency: A Cross-Sectional and Longitudinal Study

Resident physicians are at risk for increasing weight status given their changes in environment, resources, and stress level. To describe body mass index (BMI), blood pressure, eating habits, and physical activity during postgraduate training and to compare the findings to data for nationally matched controls. This was a combined cross-sectional study and longitudinal cohort, with a comparison to matched controls in 2 academic hospital centers in the eastern and western United States. BMI and blood pressure were objectively measured, and an eating and exercise habits recall was obtained for 375 enrolled medical and surgical residents (93 longitudinally) at the onset of each postgraduate year (PGY) in 2006, 2007, and 2008. Nearly half (43%) of overweight residents described themselves as normal weight. Residents were more likely to be overweight (BMI ≥25) at the beginning of PGY-3 than at the beginning of PGY-1 (49% versus 30%; odds ratio 2.26; 95% confidence interval 1.19-4.28). The average BMI of residents at PGY-1 was lower than that of their matched controls, but the magnitude of this difference decreased with increasing PGY (P = .02). Overweight status is underacknowledged by overweight residents and increases by PGY of training. These changes differ significantly from that of controls and may affect overweight physicians' long-term health.

Summer effects on body mass index (BMI) gain and growth patterns of American Indian children from kindergarten to first grade: a prospective study

BackgroundOverweight and obesity are highly prevalent among American Indian children, especially those living on reservations. There is little scientific evidence about the effects of summer vacation on obesity development in children. The purpose of this study was to investigate the effects of summer vacation between kindergarten and first grade on growth in height, weight, and body mass index (BMI) for a sample of American Indian children.MethodsChildren had their height and weight measured in four rounds of data collection (yielded three intervals: kindergarten, summer vacation, and first grade) as part of a school-based obesity prevention trial (Bright Start) in a Northern Plains Indian Reservation. Demographic variables were collected at baseline from parent surveys. Growth velocities (Z-score units/year) for BMI, weight, and height were estimated and compared for each interval using generalized linear mixed models.ResultsThe children were taller and heavier than median of same age counterparts. Height Z-scores were positively associated with increasing weight status category. The mean weight velocity during summer was significantly less than during the school year. More rapid growth velocity in height during summer than during school year was observed. Obese children gained less adjusted-BMI in the first grade after gaining more than their counterparts during the previous two intervals. No statistically significant interval effects were found for height and BMI velocities.ConclusionsThere was no indication of a significant summer effect on children's BMI. Rather than seasonal or school-related patterns, the predominant pattern indicated by weight-Z and BMI-Z velocities might be related to age or maturation.Trial registrationBright Start: Obesity Prevention in American Indian Children Clinical Trial Govt ID# NCT00123032

Multiple Markers of Inflammation and Weight Status: Cross-sectional Analyses Throughout Childhood

Inflammatory markers such as C-reactive protein (CRP) are related to obesity in adults, but the association is less clear in children. Our objective was to examine relationships between multiple markers of inflammation and children's weight status; we hypothesized that the prevalence of inflammatory markers would increase as weight status increased. We conducted a cross-sectional analysis of children in the United States aged 1 to 17 years in the National Health and Nutrition Examination Survey, 1999-2006. Children were categorized using weight-for-length when age <2 years and BMI for > or =2 years, as very obese (> or =99th percentile), obese (<99th and > or =95th percentile), overweight (<95th and > or =85th percentile), and healthy weight (>5th to < or =85th percentile) according to expert consensus. Our main outcome measures were high-sensitivity CRP and absolute neutrophil count, in addition to a novel third measure: ferritin controlled for iron status using a ferritin/transferrin ratio. We used Cox proportional hazards models to examine risk of abnormal values of inflammatory markers according to weight. Increased risk of a CRP level of >1.0 mg/L was evident among very obese children from ages 3 to 5 years (hazard ratio [HR]: 2.29; P < .01) through 15 to 17 years (HR: 4.73; P < .01). Increased risk of abnormal neutrophil count among very obese children began at 6 to 8 years (HR: 2.00; P = .049), and increased prevalence of abnormal ferritin/transferrin ratio began at 9 to 11 years (HR: 7.06; P < .001). Multiple inflammatory markers are strongly and positively associated with increasing weight status in children, and this relationship starts as young as age 3. Elevated inflammatory markers in very young obese children are particularly concerning, because inflammation may cause long-term, cumulative vascular damage. This deserves additional research via longitudinal design.

Self-reported dietary energy intake of normal weight, overweight and obese adolescents

The purpose of the present paper was to assess dietary energy reporting as a function of sex and weight status among Ontario and Alberta adolescents, using the ratio of energy intake (EI) to estimated BMR (BMRest). Data were collected using the FBQ, a validated web-based dietary assessment tool (including a 24 h dietary recall, FFQ, and food and physical activity behavioural questions). BMI was calculated from self-reported height and weight and participants were classified as normal weight, overweight or obese. BMR was calculated using the WHO equations (based on weight). Reporting status was identified using the ratio EI:BMRest. Data were collected in public, Catholic and private schools in Ontario and Alberta, Canada. A total of 1917 (n 876 male and n 1041 female) students (n 934 grade 9 and n 984 grade 10) participated. The mean EI:BMRest ratio across all participants was 1.4 (sd 0.6), providing evidence of under-reporting for the total sample. Females under-reported more than males (t = 6.27, P < 0.001), and under-reporting increased with increasing weight status for both males (F = 33.21, P < 0.001) and females (F = 14.28, P < 0.001). After removing those who reported eating less to lose weight, the EI:BMRest was 1.56 (sd 0.6) for males and 1.4 (sd 0.6) for females. The present study highlights methodological challenges associated with self-reported dietary data. Systematic differences in under-reporting of dietary intake by gender and weight status were observed using a web-based survey, similar to observations made using paper-based 24 h recalls and dietitian interviews.

Predicting obesity in early adulthood from childhood and parental obesity.

To determine the degree of tracking of adiposity from childhood to early adulthood, and the risk of overweight in early adulthood associated with overweight in childhood and parental weight status in a cohort of children born in the mid-1970s. Longitudinal observational study. Approximately 155 healthy boys and girls born in Adelaide, South Australia, 1975-1976 and their parents. Height and weight of subjects at 2 y, annually from 4 to 8 y, biennially from 11 to 15 y and at 20 y, and of parents when subjects were aged 8 y. Body mass index (BMI) of subjects converted to standard deviation scores and prevalence of overweight and obesity determined using worldwide definitions. Parents classified as overweight if BMI> or =25 kg/m(2). Tracking estimated as Pearson's correlation coefficient. Risk ratio used to describe the association between weight status at each age and parental weight status and weight status at 20 y and weight status at each earlier age, both unadjusted and adjusted for parental weight status. The prevalence of overweight/obesity increased with age and was higher than that reported in international reference populations. Tracking of BMI was established from 6 y onwards to 20 y at r-values >0.6, suggesting that BMI from 6 y is a good indicator of later BMI. Tracking was stronger for shorter intervals and for those subjects with both parents overweight compared with those with only one or neither parent overweight. Weight status at an earlier age was a more important predictor of weight status at 20 y than parental weight status, and risk of overweight at 20 y increased further with increasing weight status of parents. Strategies for prevention of overweight and targeted interventions for prevention of the progression of overweight to obesity are urgently required in school-aged children in order to stem the epidemic of overweight in the adult population.

Overweight, Obesity, and Associated Disease Burden in the Veterans Affairs Ambulatory Care Population

This report describes the prevalence of overweight and obesity and estimates the disease burden associated with excess weight in ambulatory Veterans Affairs (VA) patients. Height and weight were measured, and self-reported age and self-reported morbidities were obtained for 1,731 patients. Prevalence odds ratios explain the association of self-reported disease on increasing weight status category using body mass index. Seventy-five percent of the participants were overweight or obese. Obesity was significantly higher in the younger patients. Graded increases in odds ratios were observed with increasing severity of overweight and obesity for all morbidities, except heart disease. Overweight, obesity, and associated disease burden are prevalent in the VA health care system, particularly in younger VA patients, which may contribute to the higher prevalence of certain morbidities observed in VA populations compared with private sector outpatients. Department of Veterans Affairs should emphasize obesity prevention and treatment during the design and implementation of ambulatory care services.

Significance of body weight status for bone density in the elderly and very old

Reduced bone density and osteoporosis are significant health problems and contributors to disability and mortality among older women and men. Therefore the decline of bone mineral content (BMC) and bone mineral density (BMD) are aspects of ageing with great medical and social significance. In recent years a low body weight was declared to be an important risk factor for the development of osteoporosis. In the present study the impact of weight status, defined by the categories of the WHO, on BMC of the whole body and BMD of the proximal femur end, determined by dual energy x-ray absorptiometry (DEXA), were studied in 77 female and 62 male probands aged between 60 and 92 years (x = 71.7 yrs). With increasing weight status (BMI categories), BMC and BMD increased significantly (p < 0.001). This was true of both sexes. Even moderate overweight women and men (BMI 25.0-29.99) showed a significantly higher bone density than their normal weight counterparts (BMI < 25.0). In the present study a marked positive impact of body weight on bone density of old-aged women and men could be shown.