International Obesity Task Force Cut-offs Research Articles

Parental marital status and childhood overweight and obesity in Norway: a nationally representative cross-sectional study

ObjectiveSociodemographic changes in Norway and other western industrialised countries, including family structure and an increasing proportion of cohabiting and divorced parents, might affect the prevalence of childhood overweight and obesity...

Prevalence of obesity was related to HLA-DQ in 2-4-year-old children at genetic risk for type 1 diabetes.

OBJECTIVESBody size is postulated to modulate type 1 diabetes as either a trigger of islet autoimmunity or an accelerator to clinical onset after seroconversion. As overweight and obesity continue to rise among children, the aim of this study was to determine whether human leukocyte antigen DQ (HLA-DQ) genotypes may be related to body size among children genetically at risk for type 1 diabetes.METHODSRepeated measures of weight and height were collected from 5 969 children 2–4 years of age enrolled in The Environmental Determinants of Diabetes in the Young prospective study. Overweight and obesity was determined by the International Obesity Task Force cutoff values that correspond to body mass index of 25 and 30 kg/m2 at age 18.RESULTSThe average BMI was comparable across specific HLA genotypes at every age point. The proportion of overweight was not different by HLA, but percent obesity varied by age with a decreasing trend among DQ2/8 carriers (p for trend = 0.0315). A multivariable regression model suggested DQ2/2 was associated with higher obesity risk at age four (OR, 2.41; 95% CI, 1.21–4.80) after adjusting for the development of islet autoantibody and/or type 1 diabetes.CONCLUSIONSThe HLA-DQ2/2 genotype may predispose to obesity among 2–4 year old children with genetic risk for type 1 diabetes.

Dairy consumption with onset of overweight and obesity among U.S. adolescents (370.7)

Background: Current evidence relating dairy intake and long‐term weight status for adolescents is inconclusive and insufficient.Objective: To evaluate the relationships between total dairy and dairy subtypes in childhood and early adolescence with subsequent onset of overweight and obesity through early adulthood.Methods: A total of 6,749 girls and 5,701 boys aged 9 to 14, participants in the U.S. prospective cohort Growing Up Today Study (GUTS), free of obesity at the time of enrollment in 1996 were followed until 2012. Dairy intake was measured using Youth/Adolescent Food Frequency Questionnaires. Participants reported height and weight on each cycle, and Body Mass Index was calculated. We defined overweight and obesity using age‐ and sex‐specific International Obesity Task Force cutoffs. We used Cox proportional hazards models to evaluate the associations with incident overweight and obesity of intake of total dairy, total milk, high fat dairy, low fat dairy, whole milk, 1% milk, skim milk, yogurt and frozen yogurt.Results: During 103,293 person‐years of follow up, 762 girls and 1,029 boys became overweight and 491 girls and 370 boys became obese. The total dairy intake hazard ratio (HR), comparing highest to lowest quintile, for incident obesity onset was 0.83 (95%CI: 0.60‐1.15, p trend=0.20) for girls and 1.34 (95%CI: 0.93‐1.95, p trend=0.14) for boys. The yogurt intake HR comparing the highest to lowest tertile, was 1.06 (95%CI: 0.83‐1.34) for girls and 1.00 (95%CI: 0.77‐1.31) for boys. For incident overweight or obesity, the total dairy intake HR was 1.01 (95%CI: 0.81‐1.25, p trend=0.81) for girls and 0.99 (95%CI: 0.82‐1.2, p trend=0.48) for boys. No significant associations were observed for dairy subtypes.Conclusions: Our results suggest that total dairy intake in childhood and early adolescence was not associated with long‐term risk of overweight and obesity in later adolescence and early adulthood.Funding: The Bell Institute of General Mills.Grant Funding Source: Supported by the Bell Institute of General Mills.

Association study of common polymorphisms in MSRA, TFAP2B, MC4R, NRXN3, PPARGC1A, TMEM18, SEC16B, HOXB5 and OLFM4 genes with obesity-related traits among Portuguese children

At least 52 genetic loci were associated with obesity-related traits. However, little is known about the genetic basis of obesity among children. This study aims to test whether 10 polymorphisms in obesity-related genes methionine sulfoxide reductase A (MSRA), transcription factor AP-2 beta (TFAP2B), melanocortin 4 receptor (MC4R), neurexin 3 (NRXN3), peroxisome proliferator-activated receptor gamma coactivator 1 alpha (PPARGC1A), transmembrane protein 18 (TMEM18), homolog of S. cerevisiae Sec16 (SEC16B), homeobox B5 (HOXB5) and olfactomedin 4 (OLFM4) are associated with the risk of obesity in Portuguese children. A total of 730 children aging from 6 to 12 years old, recruited randomly from public schools in Portugal, were analysed. Anthropometric measurements were obtained and children were classified into three phenotypic groups, normal weight (n=256), overweight (n=320) and obese (n=154), according to the International Obesity Task Force cutoffs. Polymorphisms were genotyped by allelic discrimination TaqMan assays. The MC4R rs12970134 polymorphism was nominally associated with body mass index (BMI) (P=0.035), BMI Z-score (P=0.043) and waist circumference (P=0.020), and borderline associated with weight (P=0.053). Near nominal associations were also found for the PPARGC1A rs8192678 polymorphism with weight (P=0.061), and for the MSRA rs545854 polymorphism with BMI (P=0.055) and BMI Z-score (P=0.056). Furthermore, logistic regression showed that MC4R rs12970134 and TFAP2B rs987237 were nominally, respectively, associated (P=0.029) and borderline associated (P=0.056) with the obese phenotype. This study highlighted the possible association of MC4R, PPARGC1A, MSRA and TFAP2B polymorphisms with several obesity-related traits in a sample of Portuguese children. The two significant associated TFAP2B rs987237 and MC4R rs12970134 polymorphisms showed an opposite direction of effect to that in the original reports.

Childhood Attention-Deficit/Hyperactivity Disorder Symptoms Are Risk Factors for Obesity and Physical Inactivity in Adolescence

To prospectively investigate the association and directionality between attention-deficit/hyperactivity disorder (ADHD) symptoms and obesity from childhood to adolescence in the general population. We examined whether obesogenic behaviors, namely, physical inactivity and binge eating, underlie the potential ADHD symptom-obesity association. We explored whether childhood conduct disorder (CD) symptoms are related to adolescent obesity/physical inactivity. At 7 to 8 years (n = 8,106), teachers reported ADHD and CD symptoms, and parents reported body mass index (BMI) and physically active play. At 16 years (n= 6,934), parents reported ADHD symptoms; adolescents reported physical activity (transformed to metabolic equivalent of task [MET] hours per week) and binge eating; BMI and waist-hip ratio (WHR) were measured via clinical examination. Obesity was defined using the International Obesity Task Force (IOTF) cut-offs for BMI and the 95th percentile cut-off for WHR. Childhood ADHD symptoms significantly predicted adolescent obesity, rather than the opposite. Inattention-hyperactivity symptoms at 8 years were associated with indices of obesity at 16 years (obese BMI: odds ratio [OR]= 1.91, 95% confidence interval [CI]=1.10-3.33; 95th percentile WHR: OR= 1.71, 95% CI= 1.05-2.78), adjusted for gender, baseline BMI, physical activity, family structure change, and maternal education. Child CD symptoms associated with indices of adolescent obesity. Reduced physically active play in childhood predicted adolescent inattention (OR= 1.61, 95% CI= 1.16-2.24). Childhood ADHD and CD symptoms were linked with physical inactivity in adolescence (inattention-hyperactivity; OR=1.60, 95% CI= 1.20-2.13), but not binge eating. Physical inactivity mediated the associations. Children with ADHD or CD symptoms are at increased risk forbecoming obese and physically inactive adolescents. Physical activity may bebeneficialforbothbehavior problems and obesity.

A national study on weight classes among children in Greenland at school entry

ObjectivesTo estimate the proportion of gender-specific thinness, overweight and obesity among children born in 2005 at school entry in Greenland and to compare figures between the capital, Nuuk, with the rest of Greenland.Study design A cross-sectional study based on data from Electronic Medical Records (EMR).MethodsAll children born in 2005 with permanent address in Greenland at the time of data extraction with a registered weight and height in EMR from January 1st 2011 to January 31st 2013 were included in the study. Information about height without shoes and weight in light indoor clothing was obtained. Body Mass Index (BMI) was calculated. Participants were categorized into age and gender-specific weight classes based on the International Obesity Task Force (IOTF) cut-offs for child overweight, obesity and thinness.ResultsA total of 842 children born in 2005 were identified. Of those, 72% (N=607, 308 boys and 299 girls) had a recorded weight and height in the study period. In total, 74.6% (71.2–78.1) were categorized as of normal weight. The proportion of children with overweight was 15.8% (12.9–18.7) while 6.8% (4.8–8.8) were obese. In all, 2.9% were categorized as thin. The proportion of overweight among boys (12.7%) was lower (p=0.031) than among girls (19.1%), and boys in Nuuk had a lower median BMI compared to the rest of Greenland. No differences in distribution of age and gender-specific overweight and obesity were observed between the capital and the rest of Greenland.ConclusionNearly 1 quarter of Greenlandic children are overweight or obese at school entry. No differences were observed between Nuuk and the rest of Greenland. Information about weight and height is available in the EMR for the majority of all children at school entry in Greenland. Continuous monitoring of the proportion of overweight and obesity among children using data from the EMR in Greenland is recommended.

Prevalence of Overweight and Obesity among 6- to 9-Year-Old Schoolchildren in Cuenca, Ecuador: Relationship with Physical Activity, Poverty, and Eating Habits

The high prevalence of childhood overweight and obesity is a health problem worldwide. In developing countries, we lack information on the extent of the problem and the risk factors involved. To determine the prevalence rates of overweight and obesity and of abdominal obesity, and their relationship with physical activity, poverty, and eating habits in schoolchildren in Cuenca, Ecuador. A cross-sectional survey in a representative sample (n = 743) schoolchildren aged 6 to 9 years was conducted. Overweight and obesity were detected using the International Obesity Task Force cutoffs according to body mass index (BMI), and abdominal obesity was detected according to waist circumference. Poverty, physical activity, and eating habits were assessed with validated questionnaires. The prevalence rates of overweight and obesity and of abdominal obesity were 26.0% and 10.6%, respectively. There were no differences between the sexes, but the prevalence of overweight and obesity was 1.5- to 2-fold higher in 9-year-old than in 6-year-old children (p < .05). Multivariate models demonstrated that higher BMI and waist circumference were significantly related to low physical activity and nonpoverty. Insufficient physical activity (in 75% of children) was associated with a 13% to 18% increased risk of overweight and obesity and abdominal obesity. Eating breakfast and eating more than three meals per day (in 96.7% and 85.9% of children, respectively) were not related to the prevalence of overweight and obesity. Eating fruits during school break was associated with a lower BMI.L CONCLUSIONS: The high prevalence of overweight and obesity observed in schoolchildren increased from the ages of 6 to 9 years and was associated with insufficient physical activity and nonpoverty. Promoting physical activity and fruit consumption in school snacks should be explored as intervention measures to prevent and reduce overweight and obesity in Cuenca schoolchildren.

Underweight, overweight and obesity in paediatric dialysis and renal transplant patients

The prevalence of childhood overweight is rising worldwide, but in children on renal replacement therapy (RRT) a poor nutritional status is still the primary concern. We aimed to study the prevalence of, and factors associated with, underweight and overweight/obesity in the European paediatric RRT population. Moreover, we assessed the evolution of body mass index (BMI) after the start of RRT. We included 4474 patients younger than 16 years from 25 countries of whom BMI data, obtained between 1995 and 2010, were available within the European Society for Paediatric Nephrology/European Renal Association-European Dialysis and Transplant Association Registry. Prevalence estimates for under- and overweight/obesity were calculated using age and sex-specific criteria of the World Health Organization (WHO, 0-1 year olds) and the International Obesity Task Force cut-offs (2-15 year olds). The prevalence of underweight was 3.5%, whereas 20.8% of the patients were overweight and 12.5% obese. Factors associated with being underweight were receiving dialysis treatment and infant age. Among transplanted recipients, a very short stature (OR: 1.64, 95% CI: 1.40-1.92) and glucocorticoid treatment (OR: 1.23, 95% CI: 1.03-1.47) were associated with a higher risk of being overweight/obese. BMI increased post-transplant, and a lower BMI and a higher age at the start of RRT were associated with greater BMI changes during RRT treatment. Overweight and obesity, rather than underweight, are highly prevalent in European children on RRT. Short stature among graft recipients had a strong association with overweight, while underweight appears to be only a problem in infants. Our findings suggest that nutritional management in children receiving RRT should focus as much on the prevention and treatment of overweight as on preventing malnutrition.

Comparison of blood pressure levels among children and adolescents with different body mass index and waist circumference: study in a large sample in Shandong, China

Several anthropometric indicators [such as body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR)] have been used to investigate the association between adiposity and high blood pressure (BP) in both adults and children. The present study compared the BP levels among children and adolescents with different BMI and WC in a large population in Shandong, China. A total of 38,822 students (19,456 boys and 19,366 girls) aged 7-17 years participated in this study. Height, weight, WC, and BP of all subjects were measured, and BMI was calculated. The prevalence of overweight and obesity was obtained according to the International Obesity Task Force (IOTF) cutoffs; central obesity was defined as WC ≥ 90th percentile (P 90); relatively high BP status was defined as systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) ≥ 95th percentile for age and gender. Within each BMI categories (normal weight, overweight, and obesity), children and adolescents with WC ≥ P 90 had higher BP levels than those with WC < P 90 (p < 0.01). When BMI and WC were combined, the highest and lowest prevalences of relatively high BP were noted in obese with WC ≥ P 90 group (54.52% for boys and 48.71% for girls) and normal weight with WC < P 90 group (17.00% for boys and 14.13% for girls). Children and adolescents with high BMI and high WC might have an increased risk of elevated BP. Our results suggest that the additional measurement of WC is better than BMI alone to help identify high BP risks.

Thinness, overweight and obesity in indigenous youth in Oaxaca, 1970 and 2007

To evaluate change in body mass index (BMI) and weight status of indigenous youth in Oaxaca between the 1970s and 2007. Heights and weights were measured in cross-sectional samples of school children 6-14 years in the 1970s (2 897) and 2007 (4 305); BMI was calculated. International Obesity Task Force cutoffs for weight status were used. BMI and prevalence of severe and moderate thinness, overweight and obesity were compared by year. BMI increased significantly across time. Primary change in weight status occurred in overweight, 1970s, <2%; 2007, 7 to 12%. Little change occurred in thinness (<2%) and obesity (≤ 1%) in both surveys, except in children 6-9 years (obesity=4% in 2007). BMI and prevalence of overweight increased across all ages from the 1970s to 2007, but children 6-9 years appeared to be more at risk for obesity than youth 10-14 years. Prevalence of thinness was unchanged.

Relative Contribution of Physical Activity, Sedentary Behaviors, and Dietary Habits to the Prevalence of Obesity among Kuwaiti Adolescents

The increasing rate of obesity among Kuwaiti adolescents is associated with immediate and long term-risks to their health and well-being. To update data on the prevalence of overweight and obesity among Kuwaiti adolescents and to examine the relative contribution of selected lifestyle factors to overweight and obesity in this population. The present study is part of the Arab Teens Lifestyle Study (ATLS). A total of 906 adolescents (463 boys and 443 girls) aged between 14 and 19 years were selected from Kuwaiti schools by a multistage stratified randomization process. A validated questionnaire was used to collect data on physical activity, sedentary lifestyle, and eating habits. The International Obesity Task Force (IOTF) cutoff values for adolescents under 18 years of age were used to define overweight and obesity. Total energy expenditure was calculated using metabolic equivalent-minutes per week. A general linear model was used to establish the proportion of the variance (expressed in partial eta squared) in excess weight attributable to differences in eating habits and physical activity. The prevalence of overweight and obesity was 50.5% in boys and 46.5% in girls. Among boys, moderate and vigorous activities were found to be significantly negatively associated with overweight and obesity (p < .05), whereas in girls, only those with not less than moderate activities were negatively associated with overweight and obesity (p < .05). Sedentary behaviors, time spent watching television, and time spent working on the computer were not significantly associated with obesity in either sex. Consumption of breakfast, vegetables, and fast foods (boys and girls) and potatoes, cakes and doughnuts, and sweets (girls only) was significantly associated with overweight and obesity (p < .05). In general, the partial eta square explained by physical activity was less than 3.6% in boys compared with less than 1.0% in girls, and eating habits explained less than 1.8% in boys compared with 2.5% in girls. Physical activity explains a greater proportion of variation in body mass index than do eating habits, particularly in boys. Eating habits explain a greater proportion of variation in body mass index than does physical activity in girls. Prospective studies are needed to clarify the relative effects of sedentary behaviors on overweight in adolescents.

Higher maternal education is associated with favourable growth of young children in different countries

BackgroundChildhood growth affects long-term health and could contribute to health inequalities that persist throughout life.MethodsWe compared growth data of 4-year-old to 6-year-old children born 1997–2002 in UK (n=15 168), Sweden...

High prevalence of overweight among adolescents in Ho Chi Minh City, Vietnam.

BackgroundTwo previous surveys conducted in Ho Chi Minh City revealed an increasing prevalence of overweight and obese adolescents, from 5.9% in 2002 to 11.7% in 2004. From 2004 to 2010, the government set up and implemented health promotion programs to promote physical activity and good nutritional habits in order to prevent overweight and obesity in children and adolescents. Our study aimed to estimate the prevalence of overweight and obesity among adolescents in urban areas of Ho Chi Minh City in 2010.MethodsA representative sample of 1,989 students aged 11–14 years was selected using a multistage cluster sampling method. 23 schools were randomly selected from the full list of all public junior high schools. In each selected school, 2 classes were chosen at random and all students from the class were examined. Age- and sex-adjusted overweight and obesity were defined using International Obesity Taskforce cut-offs.ResultsThe prevalences of overweight and obesity were 17.8% and 3.2%, respectively. Prevalences of overweight and obesity were significantly higher in boys (22%, 5.4% ) than in girls (13.3%, 1.3%, p<0.001) and higher in children from districts with a high economic level (20.5% , 3.8% ) than in those from districts with a low economic level (12.1%, 3.8%, p<0.001). Additionally, children living in wealthier families were more overweight and obese than those living in less wealthy families. When using WHO cutoffs, the overall prevalences of overweight and obesity reached 19.6% and 7.9%, respectively.ConclusionOur study’s findings suggest that the prevalence of overweight and obesity among secondary school students remains high, especially among boys living in wealthier families. Public health programs should therefore be developed or improved in order to promote good eating habits and physical activity among youth in HCMC.

Defining Body Fatness in Adolescents: A Proposal of the Afad-A Classification

AimsBody mass index (BMI) shows several limitations as indicator of fatness. Using the International Obesity Task Force (IOTF) reference and the World Health Organization (WHO) standard 2007 on the same dataset yielded widely different rates. At higher levels, BMI and the BMI cut-offs may be help in informing a clinical judgement, but at levels near the norm additional criteria may be needed. This study compares the prevalence of overweight and obesity using IOTF and WHO-2007 references and interprets body composition by comparing measures of BMI and body fatness (fat mass index, FMI; and waist-to-height ratio, WHtR) among an adolescent population.Methods and ResultsA random sample (n = 1231) of adolescent population (12–17 years old) was interviewed. Weight, height, waist circumference, triceps and subscapular skinfolds were used to calculate BMI, FMI, and WHtR. The prevalence of overweight and obesity were 12.3% and 15.4% (WHO standards) and 18.6% and 6.1% (IOTF definition). Despite that IOTF cut-offs misclassified less often than WHO standards, BMI categories were combined with FMI and WHtR resulting in the Adiposity & Fat Distribution for adolescents (AFAD-A) classification, which identified the following groups normal-weight normal-fat (73.2%), normal-weight overfat (2.1%), overweight normal-fat (6.7%), overweight overfat (11.9%) and obesity (6.1%), and also classified overweight at risk and obese adolescents into type-I (9.5% and 1.3%, respectively) and type-II (2.3% and 4.9%, respectively) depending if they had or not abdominal fatness.ConclusionsThere are differences between IOTF and WHO-2007 international references and there is a misclassification when adiposity is considered. The BMI limitations, especially for overweight identification, could be reduced by adding an estimate of both adiposity (FMI) and fat distribution (WHtR). The AFAD-A classification could be useful in clinical and population health to identify overfat adolescent and those who have greater risk of developing weight-related cardiovascular diseases according to the BMI category.

Association between parental perceptions of residential neighbourhood environments and childhood obesity in Porto, Portugal

Portugal has one of the highest rates of childhood obesity in Europe. Few studies have explored the relationship between parents' perceptions of their residential neighbourhood (safety concerns and amenities of the built environment) and their children's weight status. This study aims to examine the associations between parents' perceptions of their residential neighbourhood and overweight/obesity among their children. Anthropometric measures of height and weight were taken for 2690 children in preschools and elementary schools in Porto. Body mass index (kg/m(2)) was calculated, and the International Obesity Taskforce (IOTF) cut-offs were used. Parents completed the 'Environmental Module' standard questionnaire of the International Physical Activity Prevalence Study. Chi-square tests and the logistic regression model adjusted for age, gender, maternal education and school cluster were used to examine the associations between parents' perceptions of their residential neighbourhood and overweight/obesity among their children. In this sample, 31.8% of the children were overweight (including obese). Significant associations were found between child obesity and the following residential environmental characteristics: the odds of children being obese were lower if their parents believed that it was safe (low/no crime rate) to walk/cycle at night (OR = 0.65, 95% CI = 0.54-0.79) and during the day (OR = 0.70, 95% CI = 0.55-0.86) and that it was easy and pleasant (pedestrian safety) to walk in their neighbourhoods (OR = 0.73, 95% CI = 0.58-0.90) and when local sidewalks were well maintained and unobstructed (OR = 1.18, 95% CI = 1.01-1.40). Parental perceptions of neighbourhood safety and the quality of local sidewalks are significantly associated with obesity values.

The lactase persistence ‐13910C&gt;T polymorphism shows indication of association with abdominal obesity among Portuguese children

The -13910C>T single nucleotide polymorphism located upstream of the lactase gene (LCT) was found tightly associated with lactase persistence in European populations. Recently, it was also associated with body mass index (BMI) and obesity in European adults. The aim of this study was to test the association of -13910C>T polymorphism with obesity-related traits and risk of obesity in children. We genotyped 580 Portuguese children (6-12-year-olds) for the -13910C>T polymorphism using TaqMan probes by real-time PCR. Anthropometric measurements were assessed in all children. Obesity was defined according to the International Obesity Task Force (IOTF) cut-offs and abdominal obesity using the sex and age-specific ≥90th waist circumference percentile. We found indication for an association between the-13910*T allele and children abdominal obesity (odds ratio [OR] = 1.41; 95% confidence intervals [CI]: 1.03-1.94; p = 0.030). Under the dominant model, the indicative association was observed between the LCT-13910 CT/TT genotypes and abdominal obesity, remaining significant after adjustment for age and gender (OR = 1.65; 95% CI: 1.04-2.60; p = 0.029). No association was detected with the risk of obesity (p = 0.350). Our results suggest that the -13910C>T polymorphism may predispose to abdominal obesity in Portuguese children. The association with BMI or risk of obesity, previously observed in adults, was not confirmed.

Comparison on physical activity among adolescents with different weight status in Shandong, China

The present study examined the prevalence of underweight, overweight and obesity among adolescents and compared the attitudes and behaviors of physical activity (PA) among adolescents with different weight status in Shandong, China. A total of 19 523 students (9784 boys and 9739 girls) aged 13-18 years participated in this study. Height and weight of all subjects were measured, body mass index of adolescents was calculated from their height and weight, and the prevalence of overweight and obesity were obtained according to the International Obesity Task Force cut-offs. The prevalence of underweight were also obtained by the international cut-offs. PA status was assessed by a standardized questionnaire. The overall prevalence rates of underweight, overweight and obesity were 2.0, 13.9 and 4.7% in boys and 3.3, 8.3 and 1.2% in girls, respectively. Overweight/obese adolescents had a poor PA status compared with underweight/normal-weight adolescents. These observations highlight the importance of PA in the prevention of overweight and obesity in adolescents.

Comparison of body shape and physical activity among adolescents with normotensive and elevated blood pressure in Shandong, China

Background: Several studies have provided ample evidence that hypertension in adults has its onset in childhood; children and adolescents with elevated blood pressure (BP) are more likely to become hypertensive adults. Shandong province is one of the areas of China with higher prevalence of hypertension. However, no studies on the relationship between physique and BP have been reported in Shandong Province, China.Aim: The present study examined the difference in body shape and physical activity (PA) between adolescents with normotensive and elevated BP in Shandong, China.Subjects and methods: Data for this study were obtained from a large cross-sectional survey of schoolchildren carried out in 2010.A total of 28 039 students (14 084 boys and 13 955 girls) aged 10–17 years participated in this study. Height, weight, waist circumference (WC), BP, triceps and subscapular skinfolds of all subjects were measured and the sum of triceps and subscapular skinfold thickness was applied. Body mass index (BMI) of adolescents was calculated from their height and weight and the prevalence of overweight and obesity were obtained according to the International Obesity Task Force (IOTF) cut-offs. Elevated BP was defined as systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) ≥ 95th percentile for age and gender. PA attitudes and behaviours were assessed by a standardized questionnaire.Results: The mean values of BMI, WC and SFT for both boys and girls were all significantly higher in the elevated BP group than in the normal BP group in all age categories (p < 0.01). More adolescents with elevated BP were overweight or obese compared with normal BP subjects. Significant differences in PA were observed between the elevated and normal BP group, adolescents with elevated BP had poor PA attitudes and behaviours compared with normal BP subjects.Conclusion: Adolescents with elevated BP had high levels of BMI, WC, SFT and poor PA attitudes and behaviours. These findings reinforce the importance of preventing overweight and obesity and improving their attitudes towards physical activity.

Prevalence and regional distribution of childhood overweight and obesity in Shandong Province, China

The rising prevalence of childhood obesity was observed in China. This study assessed the prevalence and district distribution of childhood obesity in Shandong Province, China. A cross-sectional study was conducted in the province. A total of 42 275 students (21 222 boys and 21 053 girls) aged 7-18 years from 16 districts participated in this study. Height and body weight of all subjects were measured, and the body mass index (BMI) was calculated. The prevalence of overweight and obesity was obtained according to the International Obesity Task Force (IOTF) cut-offs. In 2010, the prevalence rates of combined overweight and obesity reached 26.86% in urban boys, 18.32% in rural boys, 14.36% in urban girls, and 11.31% in rural girls, respectively. An increasing trend was observed in the prevalence of overweight and obesity from the low socioeconomic status (SES) group to the moderate and high SES groups. The prevalence rates of combined overweight and obesity in the three SES groups were 18.46%, 21.08% and 27.31% in boys and 10.43%, 12.42% and 15.18% in girls, respectively. There is a high level of overweight and obesity among children and adolescents in Shandong Province, China. The distribution of childhood obesity is positively associated with the regional SES.

Correlates of weight status among Norwegian 11-year-olds: The HEIA study

BackgroundThe underlying mechanisms of overweight and obesity in adolescents are still not fully understood. The aim of this study was to investigate modifiable and non-modifiable correlates of weight status among 1103 Norwegian 11-year-old adolescents in the HEalth in Adolescents (HEIA) study, including demographic factors such as gender and parental education, and behavioral factors such as intake of sugar-sweetened beverages, snacks and breakfast consumption, watching TV and playing computer games, physical activity and sedentary time.MethodsWeight and height were measured objectively, body mass index (BMI) was calculated and International Obesity Task Force cut-offs were used to define weight status. Physical activity and sedentary time were measured by accelerometers. Other behavioral correlates and pubertal status were self-reported by questionnaires. Parental education was reported by the parents on the consent form for their child. Associations were investigated using logistic regressions.ResultsThere were gender differences in behavioral correlates of weight status but not for weight status itself. Adolescents with parents in the highest education category had a 46% reduced odds of being overweight compared to adolescents with parents in the lowest education category. Adolescents with parents with medium education had 42% lower odds of being overweight than adolescents with parents with the lowest education category. Level of parental education, breakfast consumption and moderate to vigorous physical activity were positively associated with being normal weight, and time watching TV was positively associated with being overweight for the total sample. Gender differences were detected; boys had a doubled risk of being overweight for every additional hour of watching TV per week, while for girls there was no association.ConclusionsThe present study showed a social gradient in weight status in 11-year-olds. Both breakfast consumption and moderate to vigorous physical activity were inversely associated with weight status. No associations were found between intake of sugar-sweetened beverages and snacks, playing computer games and weight status. Watching TV was positively associated with weight status for boys but not for girls. Interventions are needed to gain more insight into the correlates of change in weight status.