International Obesity Task Force Reference Research Articles

Assessing Disparities about Overweight and Obesity in Pakistani Youth Using Local and International Standards for Body Mass Index

Background/Objectives: Obesity is currently considered a public health problem in both developed and developing countries. Gender- and age-specific body mass index (BMI) growth standards or references are particularly effective in monitoring the global obesity pandemic. This study aimed to report disparities in age-, gender- and ethnic-specific statistical estimates of overweight and obesity for 2–18 years aged Pakistani children and adolescents using the World Health Organization (WHO), the Center for Disease Control (CDC) 2000 references, the International Obesity Task Force (IOTF) and Pakistani references for BMI. Methods: The study used secondary data of 10,668 pediatric population, aged 2–18 years. Demographic information like age (years), gender, city and anthropometric examinations, i.e., height (cm) and weight (kg) were used in this study. The recommended age- and gender-specific BMI cut-offs of the WHO, CDC 2000 and the IOTF references were used to classify the children sampled as overweight and obese. For the Pakistani reference, overweight and obesity were defined as BMI-for-age ≥ 85th percentile and BMI-for-age ≥ 95th percentile, respectively. Cohen’s κ statistic was used to assess the agreement between the international references and local study population references in the classification of overweight/obesity. Results: The statistical estimates (%) of the participants for overweight and obesity varied according to the reference used: WHO (7.4% and 2.2%), CDC (4.9% and 2.1%), IOTF (5.2% and 2.0%) and Pakistan (8.8% and 6.0%), respectively; suggesting higher levels of overweight and obesity prevalence when local study references are used. The Kappa statistic shows a moderate to excellent agreement (κ ≥ 0.6) among three international references when classifying child overweight and obesity and poor agreement between local references and the WHO (0.45, 0.52), CDC (0.25, 0.50) and IOTF references (0.16, 0.31), for overweight and obesity, respectively. Conclusions: The results of the study showed a visible difference in the estimates of excess body weight after applying the WHO, CDC, IOTF and local BMI references to the study population. Based on the disparity results and poor agreement between international references and the local study reference, this study recommends using local BMI references in identifying children with overweight and obesity.

MULT: An allometric body mass index (ABMI) reference to assess nutritional status of multiethnic children and adolescents.

To develop an allometric body mass index (ABMI) reference that adjusts the weight in relation to height, taking into account the changes during development (MULT ABMI reference), and to compare it with international BMI references. The MULT ABMI reference was constructed through the LMS method, calculated with 65 644 ABMI observations of 17 447 subjects aged 5-22 years, from the United Kingdom, Ethiopia, India, Peru, Vietnam, Portugal, and Brazil. The M, S, and L curves of the MULT ABMI reference were compared with the curves of the MULT, World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), International Obesity Task Force (IOTF), and Dutch Growth Study (DUTCH). The greater differences in the M curve between MULT ABMI and WHO, CDC, IOTF, DUTCH, and MULT BMI references were around puberty (138 to 150 months for boys; 114 to 132 for girls). MULT ABMI presented S values similar to IOTF and DUTCH BMI references for boys 60 to 114 months and then became higher, approaching the MULT BMI S values from 198 to 240 months. For girls the MULT ABMI S values were close to the IOTF, CDC, and DUTCH from 60 to 110 months, and then became higher, approaching the MULT BMI S values until 240 months. MULT ABMI presented an advantage in comparison to the existing BMI references because it takes into account the growth changes during puberty and is a new option to assess the nutritional status of multiethnic populations.

Prevalence of overweight and obesity among saudi children: A comparison of two widely used international standards and the national growth references.

ObjectiveTo compare three body mass index (BMI) classifications that are used to assess the prevalence of overweight and obesity among Saudi children aged 6–13 years: the International Obesity Task Force (IOTF) age and gender cutoffs, the World Health Organization (WHO) growth references for school-aged children, and the Saudi (KSA) national growth references.MethodsThe sample comprised 2,169 children (52.5% girls) derived from two cross-sectional studies conducted in Riyadh and Jeddah during the 2017 and 2019 school years, respectively. Body weight and height were measured, and BMI was calculated.ResultsThe proportions (%) of the participants who were classified as underweight, overweight, and obese varied according to the reference used: IOTF reference (13.8, 18.4, and 12.7), WHO reference (17.2, 19.1, and 18.9), and KSA reference (7.0, 22.4, and 9.3), respectively, indicating higher values for overweight and obesity prevalence when the WHO references were used. Kappa agreement measures between the three references were found to be high, with the coefficients ranging from 0.936 (between the IOTF and KSA references) to 0.849 (between the IOTF and WHO references). In all three classifications, girls exhibited lower overweight or obesity prevalence than boys. Family income, but not paternal or maternal education, was significantly (p = 0.015) associated with overweight/obesity when using the IOTF standards. In addition, having a small family in the house was significantly (p < 0.05) associated with obesity, irrespective of the classification system.ConclusionInconsistency was observed when estimating the prevalence of underweight, overweight, and obesity among Saudi children. However, when defining the overall prevalence of overweight plus obesity among Saudi children, the IOTF classification system performed in a similar way to the KSA references (31.1% versus 31.7%) compared to the WHO references (38.0%).

BMI status relative to international and national growth references among Pakistani school-age girls

BackgroundA sizable proportion of school-going children from developing countries has abnormal growth parameters, often not standardized with international reference values. We aimed to assess the prevalence of underweight, overweight, and obesity in the schoolgirls of Punjab according to international and local references.MethodsIn this population-based cross-sectional study, 10,050 school-going girls aged 8–16 years from 12 districts of northern, central, and southern Punjab were recruited. Estimates of normal weight, underweight, overweight and obesity were calculated in the girls according to three international BMI references including centers for disease control (CDC) 2000, the international obesity task force (IOTF) 2012 and world health organisation (WHO) 2007 in addition to a local reference for the population under study. We used Cohen’s kappa statistics to analyse the agreement of our data with reference values.ResultsThere was marked overestimation of underweight (23.9%, 14.5%, 15.2% and 4.37%), slight underestimation of overweight (5.3%, 7.3%, 7.9% and 8.97%) and moderate underestimation of obesity (1.9%, 1.5%, 2.2% and 5.67%) according to CDC, IOTF, WHO and local reference, respectively. When the weight status of the study cohort was compared with the local data, we found comparable results in all four weight categories.ConclusionWe recommend population-wide further studies to estimate the prevalence of weight status in school-age girls for devising appropriate references and for planning strategies for public health policy and management.

Sex differences in younger school age children’s body weight categories

The issue of inadequate or excessive children’s body weight, particularly in relation to their health, is also discussed by Czech experts in physical anthropology, auxology, paediatrics, endocrinology, etc. Overweight and obesity occur already at a younger school age, and some domestic and foreign sources report a higher prevalence in boys.&#x0D; The objective of this study was to describe distribution range in body weight categories among Czech children of younger school age (6 to 11 years) taking into account age and sex.&#x0D; Our research was carried out at 23 primary schools in 5 regions of the Czech Republic between 2014 and 2018. The research group consisted of 2,099 children aged 6 to 11 years (boys n = 1,015, 48.4%; girls n = 1,084, 51.6%). Probands were subjected to the standard anthropometric examination with body weight being assessed using the following assessment standards: the Czech national growth references, Nationwide Anthropological Survey of Czech Children and Adolescents (NAS), World Health Organisation (WHO) growth standards, and International Obesity Task Force (IOTF) references were used. Statistical tests were carried out at a significance level of p ≤ 0.05; residual analysis.&#x0D; According to all three assessment standards, the highest prevalence of children with normal body weight was in both sexes; 45.8% of girls and 48.4% of boys, using the Czech assessment reference. Overweight and obesity were more predominant in boys (7.9% and 8.7%) than in girls (7.7% and 7.5%). One point seven percent of boys and girls were equally underweight, whereas the percentage of girls (22.3%) with reduced body weight was higher than in boys (20.3%). A significant difference between boys and girls was found in the category of reduced body weight in nine-year-old children. Using internationally recommended BMI references, more children fell into the category of normal body weight. Significant differences, in accordance with IOTF, between the number of severely underweight boys and girls were observed in 7-year-olds, slightly underweight in 9- and 11-year-olds, and overweight in 7-year-olds. In accordance with the WHO growth standards, significant differences appeared between eight-year-olds and eleven-year-olds obese boys and girls.&#x0D; Our research study revealed the prevalence in younger school age children body weight categories. Different BMI references were used to classify body weight. Significant differences between the number of boys and girls were observed in certain weight categories in seven-year-old, eight-year-old, nine-year-old and eleven-year-old children. Thus, the study confirmed the presence of differences in the number of boys and girls in specific body weight categories.

Prevention of overweight and obesity in a Norwegian public health care context: a mixed-methods study

BackgroundGreater understanding about the prevention and treatment of overweight and obesity in preschool children within public health care is needed. This study assessed the impact of The First Steps module in routine primary health care including mapping of height/weight and diet followed by parental counselling of healthy habits on overweight and obesity in children aged 2 to 7 years. Further, we explored the experiences of public health nurses (PHNs) with the module.MethodsBody weight and height obtained in 2014 and 2016 were extracted retrospectively for 676 children from the health records of children at 2, 4, or 6 years of age in five child health centers in Southern Norway. Sex- and age-adjusted body mass index (BMI) z-scores and weight status classifications were calculated according to the International Obesity Task Force reference values. Impact was assessed as change in mean BMI z-scores for children with under-, normal-, and overweight, respectively, and as proportion of children with overweight and obesity. In focus groups, PHNs described their experiences with the practical application of the module. Focus group transcripts were analyzed using Braun and Clarke’s thematic analysis.ResultsMean BMI z-scores decreased from 2014 to 2016 in overweight children (− 0.26) and increased in children with under- (0.63) and normal weight (0.06), whereas the proportion of children with overweight and obesity was stable. PHNs believed that the module provides them with new tools that are useful for addressing the intricacies of childhood obesity. They described counseling sessions with families as “moving upstream in a river” and that overweight and obesity may be one of many complex challenges for these families.ConclusionsMean BMI z-score decreased in children with overweight during the 2 years after initiation of The First Steps module. PHNs considered the module as useful for addressing children’s overweight and obesity, which was perceived as one of several complex challenges for most of these families. Specialist and evidence-based support is needed to address overweight and obesity in children in primary care. Further research should focus on integrating the issues relating to overweight and obesity within other family problems.

Aceleración y estabilización: disparidad en la tendencia de obesidad en escolares de la provincia de La Pampa (Argentina) entre 1990 y 2016

A pesar de los esfuerzos de diversos organismos para reducir la obesidad, sólo algunos países desarrollados muestran una desaceleración o estabilización de su prevalencia. Este trabajo presenta las tendencias en el índice de masa corporal (IMC) y las prevalencias de sobrepeso (SP) y obesidad (OB) ocurridas en escolares entre 1990 y 2016, y su distribución socioeconómica. Se compararon tres encuestas transversales realizadas en 1990, 2005/07 y 2015/16 en escolares primarios de Santa Rosa (La Pampa, Argentina). Para estandarizar los valores de IMC y definir las categorías SP y OB se empleó la referencia International Obesity Task Force (IOTF). El tipo de escuela se empleó como medida de nivel socioeconómico (NSE). Para analizar la asociación entre las variables dependientes con año de encuesta, sexo y NSE se aplicaron modelos de regresión lineal (IMC) y logística (SP, OB). El cambio temporal en las prevalencias de SP y OB se evaluó mediante Chi- cuadrado de tendencia entre proporciones. IMC, SP y OB incrementaron significativamente en el periodo 1990-2016, resultando en un tercio de la población con exceso de peso. Entre 2005/07 y 2015/16 sólo hubo incrementos significativos en niños que asistían a escuelas públicas. Las tendencias fueron similares en varones y niñas. Se concluye que el estatus de peso en esta población escolar muestra un patrón de aumento no lineal pero continuo en los últimos 25 años, con una estabilización en los sectores de mayor NSE durante la última década.&#x0D;

Comparison of socioeconomic status of parents and Body Mass Index of their in-school adolescents in Cross River state, Nigeria

Background: Overweight and obesity as well as underweight in adolescence are risk factors of chronic diseases that occur in adulthood. The objective of this research was to assess the Body Mass Index of in-school adolescents and its relationship to socioeconomic status of their parents.Methods: This is a cross-sectional study of 454 adolescents aged 10-19 years selected from five secondary schools using multistage sampling technique. A semi-structured interviewer questionnaire was used to collect relevant information from the adolescents and their anthropometric measurement to determine their Body Mass Index. Their Body Mass Index was categorized into obese, overweight, normal and underweight using the International Obesity Task Force reference. Analysis was done using IBM Statistical Package for Social Sciences, version 20.1. Results: The prevalence of obesity, overweight, and underweight among the adolescents was 7.7%, 1.1% and 32.8% respectively. None of the students in the public schools was obese while 2.1% of the adolescents were obese in the private schools. Adolescents in public schools had a higher percentage of underweight (65.4%) compared to those in private schools (34.5%) and this was found statistically significant (p&lt;0.001). There was an overall higher prevalence of overweight and obesity among the females than found among the males. This was also the case for adolescents from higher socio-economic parents. These differences were found to be statistically significant (p&lt;0.001). Conclusion: The Body Mass Index status of the in-school adolescents studied was found to increase with increased socioeconomic status of their parents. This underscores the need for sensitization of in-school adolescents to see the need of knowing their nutritional status and ways to avoid the consequences of abnormal Body Mass Index.

Breakfast skipping and overweight/obesity in first grade primary school children: A nationwide register-based study in Iceland.

Although several studies have revealed an association between skipping breakfast and overweight (OW) or obesity (OB) in older children and adolescents, less is known about that association in younger children. The purpose of our study was to assess the association between skipping breakfast and OW/OB in children in the first grade. The sample included 4360 children (51.5% boys) aged 5.6 to 7.4 years who participated in the annual health examination in Iceland during 2016 and 2017, completed by 91% of all first graders in Iceland. Binary logistic regression analysis with odds ratios (ORs) and 95% confidence intervals (CIs) was used to assess the association between skipping breakfast and OW/OB. Skipping breakfast was assessed as not eating breakfast on the day of the assessment, whereas OW or OB was based on measured height and weight relative to the International Obesity Task Force reference. The final analyses were adjusted for bedtime, well-being in school, commuting to school and physical activity. 7.2% of the boys (n = 162) and 7.5% of the girls (n = 158) had not eaten breakfast. After multivariable adjustment, a statistically significant association emerged between skipping breakfast and OW/OB in girls (OR 1.66, 95% CI 1.17-2.36) but not in boys (OR 1.02, 95% CI 0.63-1.63). Because the study's results suggest an association between skipping breakfast and OW/OB only in first-grade girls in Iceland, sex-based differences should be further investigated to inform future strategies for preventing OW and OB in young children.

Comparison of International Growth Standards for Assessing Nutritional Status in Cystic Fibrosis: The GreeCF Study.

The aim of the study was to compare 3 international growth references and explore their differences in assessing growth in Greek school-aged patients with cystic fibrosis (CF). Sample included 114 patients (50 boys, age 11.5 ± 3.9 years), provided care at Aghia Sofia Children's Hospital, Greece. Anthropometrics and predicted forced expiratory volume in 1 second (FEV1%) were measured. Body mass index (BMI) and height z scores were computed according to the Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), and International Obesity Task Force (IOTF) references. Agreement between methods was analyzed with kappa statistics, repeated-measures analysis of variance, and Bland-Altman analysis. The relationship between FEV1% and BMI was explored with linear regression. Mean CDC BMI z score was the lowest (0.06 ± 1.08), followed by WHO (0.17 ± 1.14) and IOTF (0.35 ± 1.05) (P ≤ 0.001 for all). The CDC and WHO growth references highly agreed for most weight status strata and stunting; all other comparisons produced lower agreements. Except for CDC and IOTF BMI z scores, all other comparisons produced wide levels of agreement and proportional bias. CDC reference classified more children as attaining low or normal weight, against WHO or IOTF (P ≤ 0.001 for all). Lowest prevalence of ideal and excess weight was recorded by CDC, compared to all other standards (P ≤ 0.001 for all). All BMI z scores provided moderate associations with FEV1%. Large variations across weight status classification were present when employing 3 growth standards in school-aged patients . Given than BMI z-scores from all references provided comparable associations with pulmonary function, our data indicate that no studied reference is better than others in assessing growth in CF.

Severity of obesity is associated with worse cardiometabolic risk profile in adolescents: Findings from a Brazilian national study (ERICA).

The prevalence of obesity and severe obesity among adolescents has increased dramatically in developing countries. However, the distribution of cardiometabolic risk factors through the severity of obesity continuum is relatively unknown among youth. The aim of this study was to evaluate the association of weight categories with cardiometabolic risk factors among Brazilian adolescents. ERICA (The Study of Cardiovascular Risk in Adolescents) was a multicenter, school-based, cross-sectional study composed of Brazilian adolescents (12-17 y of age). Severity of obesity was classified according to the International Obesity Task Force reference values for body mass index (BMI) and several cardiometabolic risk factors were measured after clinical and biochemical exams and categorized using standard definitions of abnormal values. Among the 37 892 adolescents enrolled, 8708 had excess weight, being classified with overweight (17.2%), obesity (5.6%), and severe obesity (1.3%). Increasing severity of obesity was associated with a worse cardiometabolic profile in the overall sample. Multivariable models that controlled for age, sex, skin color, socioeconomic status, physical activity, and total energy intake, showed that individuals in higher categories of severity of obesity tended to have higher prevalence ratios of most cardiometabolic risk factors compared with the other weight groups, except for high fasting blood glucose among boys. Progressive degrees of excess weight are positively associated with cardiometabolic risk factors in youth from a middle-income country, indicating the importance in classifying the severity of weight excess among adolescents and considering this to plan prevention programs against early development of obesity-related diseases.

Procjena saglasnosti tri različita klasifikaciona sistema za određivanje uhranjenosti učenika

The aim of this paper is to determine the agreement in assessing the nutritional status of adolescents using the classification systems of the US Centers for Disease Control and Prevention (CDC), the International Obesity Task Force (IOTF) and the World Health Organization (WHO). Non-experimental observation was performed on a sample of 213 first grade high school students from Banja Luka, Republika Srpska, Bosnia and Herzegovina, with an average age of 15.67 years, of which 89 (41.8%) were male and 124 female (58.2%). Each of the subjects was categorized according to a unique scale, as underweight, normal weight, overweight or obese, using IOTF, CDC and WHO reference values. The Cohen kappa coefficient (k) was used to estimate the agreement of the three classification systems in determining nutritional status. The prevalence of underweight was found to be highest according to IOTF standards in both sexes, while the prevalence of overweight was highest according to WHO references. The differences between analyzed three systems are not large for the obese category, especially in girls. In boys, CDC references show a slightly higher percentage of obese compared to the other two systems. The agreement between the classification systems ranges from 0.83 to 0.86 on the total sample of respondents based on all nutritional status categories, which can be considered a reliable parameter for further monitoring, comparison and prescribing of measures.

Accuracy of anthropometric measurements and weight status perceptions reported by parents of 4-year-old children.

To assess the validity of self-reported height and weight by parents of 4-year-old children and subjective weight perception. Descriptive cross-sectional study. Paediatric population living in the Autonomous Community of Madrid. Children born in 2008-2009 examined at 47-59 months of age. Data were collected by paediatricians of the Madrid Primary Care Physicians Sentinel Network. Parents reported weight and height data. Prevalence of weight status categories was calculated using WHO and International Obesity Task Force (IOTF) reference criteria. Sensitivity, specificity and positive predictive value (PPV) were estimated. The appraisal of their child's weight perception and parental misperception were assessed. For 2914 children, reported height was underestimated by -1·38 cm, weight by -0·25 kg and BMI was overestimated by +0·41 kg/m2 on average. The prevalence of obesity estimated with reported data was 2·7 times higher than that calculated with measured data (16·2 v. 6·0 %) according to WHO classification, and 3·6 times higher with IOTF classification. Sensitivity to identify obesity was 70·5 %, specificity was 87·3 % and PPV was 26·2 % (WHO classification). Half of the parents of pre-schoolers with obesity failed to identify their child's weight status. Parental misperception among children classified as having overweight or obesity reached 93·0 and 58·8 %, respectively. Parents underestimated children's height and weight, leading to an overestimation of the prevalence of obesity. Small inaccuracies in reported measures have an important effect for the estimation of population prevalences. Parents' report of child weight status is unreliable. Parental awareness and acknowledgement of child weight status should be improved.

Lifestyle and cardiometabolic risk among primary school children of Oran

The increase in the prevalence of overweight and obesity among young people led to a surge in several risk factors, such as high blood pressure, dyslipidemia and abdominal adiposity, leading to metabolic syndrome and atherosclerosis. The aim of the study was to assess food consumption and physical activity level (PAL), in children on the one hand, and to evaluate the cardio-metabolic risk on the other hand. Children ( n = 222, sex-ratio F/M = 106/116) in the city of Oran, 7 to 10 years old were recruited. Dietary survey was carried out by 24 hours recall, followed by 3-day record. PAL, anthropometric parameters, and blood pressure (BP) were measured. Glycaemia, lipid profile, uric acid, albumin, creatinine, urea, leptin and adiponectin were determined in serum. Children were classified according to the body mass index (BMI) into four groups, according to the International Obesity Task Force (IOTF) references: normal-weight (NW) 63%, overweight (OW) 19%, obesity (O) 8.5%, and underweight (UW) 9.5%. Increased BMI, waist circumference ( P = 0.01) and weight ( P < 0.05) were observed in OW and O groups, compared to NW. PAL study revealed that OW were sedentary (1.40 < PAL < 1.69) and O were extremely inactive (PAL < 1.40). Dietary survey revealed a total energy intake (TEE) of 2008, 2211, 2567 and 1780 Kcal/dayfor NW, OW, O and UW, respectively. Qualitatively, lipids consumption, in particular saturated fatty acids, was high at the expense of complex carbohydrates in O. Systolic and diastolic BP were increased in OW and O groups, compared to NW ( P < 0.05) group. An increase in total cholesterol, LDL-cholesterol, triglycerides and uric acid values was observed in OW and O compared to NW groups ( P < 0.05). A positive correlation was noted between BMI and serum leptin levels ( r = 0.89: P < 0.001) on the one hand, and an inverse relationship was observed between BMI and serum adiponectin values ( r = −0.49; P < 0.01). This study highlights the presence of increased cardio-metabolic risk in overweight and obese children, requiring nutritional education, and a monitoring of their health status.

The prevalence of malnutrition and growth percentiles for urban South African children

BackgroundLow- and middle-income countries (LMIC) are experiencing a double-burden of malnutrition characterised by high prevalence of both under- and over-nutrition. We set out using data from the mixed-longitudinal Birth-to-Twenty Plus (Bt20+) birth cohort, to evaluate the patterns of malnutrition and growth in a large South African (SA) city by; (i) assessing the prevalence of undernutrition from birth to 5 years of age and overweight and obesity from ages 2 to 21 years in black and white, male and female children, and (ii) determining percentiles for height, weight, BMI, waist and hip circumferences and comparing the centiles to American and Dutch references.MethodsHeight, weight, waist and hip circumferences were measured on urban black and white SA children from the Bt20+. A total of 3273 children born between April and June 1990 in the Greater Johannesburg Metropolitan area were included in the cohort. Z-scores were derived using the WHO 2006 child growth standards (0–5 years), for defining stunting, underweight and wasting. The International Obesity Task Force (IOTF) references were used to define overweight and obesity. Percentiles were developed using the lambda mu sigma (LMS) method and compared to American and Dutch references.ResultsBlack children were consistently shorter and black males lighter than white children and American references. The prevalence of stunting peaked at 2 years and was significantly higher in males than females and in black than white children. Black females had a greater prevalence of overweight and obesity than black males from 10 to 17 years. The percentiles for black females for weight and BMI were similar to those of South African white and American references but both black and white South African females had lower waist circumferences than American references.ConclusionThe growth percentiles show that young South African urban black females are experiencing general but not central obesity due to a secular change which is faster in weight than height. High levels of undernutrition persist alongside high levels of over-nutrition with adolescence being a critical period for the upsurge in obesity in females. Early intervention is needed to combat the rise in obesity.

Prevalence of obesity in Iranian children: Systematic review and meta-analysis

Background of the Study: Childhood obesity, in addition to the likelihood of its continuation in adulthood, is associated with an increase in mortality and various diseases. Purpose of the Study: This meta-analytic study aimed at determining the prevalence of obesity among Iranian children. Methodology: Two researchers independently searched national and international databases using MeSH, Scopus, PubMed, Science Direct, Web of Science, Springer, Magiran, Iranmedex, SID, Medlib, and the Google Scholar search engine. The heterogeneity between studies was evaluated using the I2 index. Data were analyzed using STATA software. This study was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Results: Among 93 studies with a sample size of 3,845,768, the prevalence of obesity in Iranian children was 7% (girls 8% and boys 10%), and the prevalence of overweight was 12% (girls 17% and boys 15%). The incidence rate of obesity in children was 13% based on US centers for disease control and prevention (CDC) 2000 reference, 11% on international obesity task force (IOTF) reference, 9% on World Health Organization reference, 9% on Iranian reference, 5% on CDC reference, and 3% on national center for health statistics (NCHS) reference. Meta-regression diagram also showed that the prevalence of obesity in children was not dependent on sample size. However, the prevalence of obesity declined during the years 1999–2016, which was statistically significant. Conclusion: The prevalence of obesity in Iranian children was less than of their overweight. On the other hand, the prevalence of childhood obesity in girls was lower than that of boys, and the prevalence of child overweight among girls was higher than that of boys.

Substantial variation across geographic regions in the obesity prevalence among 6\u20138\xa0years old Hungarian children (COSI Hungary 2016)

BackgroundThere have been previous representative nutritional status surveys conducted in Hungary, but this is the first one that examines overweight and obesity prevalence according to the level of urbanization and in different geographic regions among 6–8-year-old children. We also assessed whether these variations were different by sex.MethodsThis survey was part of the fourth data collection round of World Health Organization (WHO) Childhood Obesity Surveillance Initiative which took place during the academic year 2016/2017. The representative sample was determined by two-stage cluster sampling. A total of 5332 children (48.4% boys; age 7.54 ± 0.64 years) were measured from all seven geographic regions including urban (at least 500 inhabitants per square kilometer; n = 1598), semi-urban (100 to 500 inhabitants per square kilometer; n = 1932) and rural (less than 100 inhabitants per square kilometer; n = 1802) areas.ResultsUsing the WHO reference, prevalence of overweight and obesity within the whole sample were 14.2, and 12.7%, respectively. According to the International Obesity Task Force (IOTF) reference, rates were 12.6 and 8.6%. Northern Hungary and Southern Transdanubia were the regions with the highest obesity prevalence of 11.0 and 12.0%, while Central Hungary was the one with the lowest obesity rate (6.1%). The prevalence of overweight and obesity tended to be higher in rural areas (13.0 and 9.8%) than in urban areas (11.9 and 7.0%). Concerning differences in sex, girls had higher obesity risk in rural areas (OR = 2.0) but boys did not. Odds ratios were 2.0–3.4 in different regions for obesity compared to Central Hungary, but only among boys.ConclusionsOverweight and obesity are emerging problems in Hungary. Remarkable differences were observed in the prevalence of obesity by geographic regions. These variations can only be partly explained by geographic characteristics.Trial registrationStudy protocol was approved by the Scientific and Research Ethics Committee of the Medical Research Council (61158–2/2016/EKU).

Prevalence and complications of obesity and overweight among Algerian adolescents

OBJECTIVE: To determine the prevalence of overweight and obesity in Algerian adolescents and investigate the associated cardiometabolic complications. METHODS: The study was conducted in the city of Constantine (Algeria). The population included 1100 schooled adolescent, aged 12–18 years, randomly selected. All had anthropometric measurements, and 989 had blood tests. The BMI was calculated and the prevalence of overweight and obesity was determined using the International Obesity Task Force reference values. RESULTS: 179 (16.3%) adolescents were overweight including 74 boys (13.8%) and 105 girls (18.6%), 51 (4.6%) adolescents were obese including 25 (4.6%) boys vs 26 (4.6%) girls (p = 0.09). Overweight and obese adolescents had higher systolic blood pressure/diastolic blood pressure (p = 0.001/p &lt; 0.0001) and abnormal blood lipid levels. Furthermore, the HOMA index was higher in overweight and obese adolescents (p &lt; 0.0001). CONCLUSION: These findings show a high prevalence of overweight and obesity in a population of Algerian adolescents leading to significant cardiometabolic abnormalities.

Maternal smoking during pregnancy and offspring overweight: is there a dose-response relationship? An individual patient data meta-analysis.

A number of meta-analyses suggest an association between any maternal smoking in pregnancy and offspring overweight obesity. Whether there is a dose-response relationship across number of cigarettes and whether this differs by sex remains unclear. Studies reporting number of cigarettes smoked during pregnancy and offspring BMI published up to May 2015 were searched. An individual patient data meta-analysis of association between the number of cigarettes smoked during pregnancy and offspring overweight (defined according to the International Obesity Task Force reference) was computed using a generalized additive mixed model with non-linear effects and adjustment for confounders (maternal weight status, breastfeeding, and maternal education) and stratification for sex. Of 26 identified studies, 16 authors provided data on a total of 238,340 mother-child-pairs. A linear positive association was observed between the number of cigarettes smoked and offspring overweight for up to 15 cigarettes per day with an OR increase per cigarette of 1.03, 95% CI = [1.02-1.03]. The OR flattened with higher cigarette use. Associations were similar in males and females. Sensitivity analyses supported these results. A linear dose-response relationship of maternal smoking was observed in the range of 1-15 cigarettes per day equally in boys and girls with no further risk increase for doses above 15 cigarettes.

The prevalence of underweight, overweight and obesity in children and adolescents from Ukraine

The aim of this study was to evaluate the prevalence of overweight, obesity and underweight in children from Ukraine. A cross-sectional study was performed on data collected from a representative sample of Ukraine children (13,739 children (boys 48%, girls 52%) aged 6.0–18.9 years). The measurement of body weight was performed with medical scales and height was measured using a stadiometer. Based on the results obtained, body mass index (BMI) was calculated. Three criteria were used to define childhood underweight, overweight and obesity: The International Obesity Task Force (IOTF) reference, World Health Organization (WHO) child growth standard and The US Center for Disease Control and Prevention (CDC). The combined prevalence of obesity and overweight among children aged 6–18 years old was 12.1%, 17.6%, and 12.6% based on the IOTF reference, WHO growth standard, and the CDC, respectively. Obesity was 2.1%, 4.2%, and 3.6% respectively. Significantly more girls were underweight than boys. Furthermore, a higher prevalence of overweight and obesity was diagnosed in younger that older Ukrainian population.