International Obesity Task Force Standards Research Articles

Socioeconomic Status and Rate of Poverty in Overweight and Obesity among Spanish Children and Adolescents.

This study aimed to analyze the relationship between socioeconomic status (SES), poverty rate, and the prevalence of overweight/obesity or obesity in children and adolescents aged 2-14. Parents or guardians reported the weight and height of participants, used to calculate body mass index (BMI) and BMI z-scores according to the International Obesity Task Force standards. Participants were categorized into "overweight/obesity" and "no overweight/obesity" and further into "obesity" and "no obesity". The rate of poverty rate was determined using data from the National Statistics Institute of Spain, defining it as the percentage of people with income below 60% of the national median. SES was based on the head of household's occupation and categorized into low, medium, and high levels. Adjusted multilevel models showed participants with medium or high SES had lower odds of overweight/obesity compared to those with low SES (medium SES: odds ratio [OR]: 0.63, 95% confidence interval [CI]: 0.54-0.73; high SES: OR: 0.59, 95% CI: 0.49-0.70). Participants in the high-poverty group had higher odds of having overweight/obesity (OR: 1.40, 95% CI: 1.13-1.74) compared to the low-poverty group. The study highlights significant socioeconomic disparities in childhood overweight/obesity, emphasizing the potential impact of SES and poverty on health outcomes in Spanish children and adolescents.

The effect of public policy on high BMI trends of Mexican children: an interrupted time series analysis

BackgroundMexico declared an obesity epidemic in 2000, and in response, became an early adopter of public policies in the form of natural experiments, which have not been evaluated for their effect on high BMI. We focus on children younger than 5 years due to the long-term outcomes of childhood obesity. MethodsWe used the Global Burden of Disease data to evaluate time trends in high BMI, defined as being overweight or obese based on the International Obesity Task Force standards, between 1990 and 2019. Marginalisation and poverty estimates from Mexico's Government were used to identify differences in socioeconomic groups. The time variable reflects the introduction of policies between 2006 and 2011. Our hypothesis was that poverty and marginalisation modify the effects of public policies. We tested for the change in prevalence of high BMI over time using Wald-type tests, correcting for the effect of repeated measures. We stratified the sample by gender, marginalisation index, and households under the poverty line. Ethics approval was not required. FindingsBetween 1990 and 2019, high BMI in children younger than 5 years increased from 23·5% (95% uncertainty interval 38·6–14·3) to 30·2% (46·0–20·4). After a period of sustained increase to 28·7% (44·8–18·6) in 2005, high BMI decreased to 27·3% (42·4–17·4; p<0·001) in 2011. Afterwards, high BMI increased constantly. We found an average gender gap of 12·2%, with a higher rate in males, in 2006, which remained constant. With respect to marginalisation and poverty, we observed a reduction in high BMI across all strata, except for the uppermost quintile of marginalisation in which high BMI remained flat. InterpretationThe epidemic affected groups across different socioeconomic levels, thus weakening economic explanations for the decrease in high BMI, while gender gaps point to behavioural explanations of consumption. The observed patterns warrant investigation through more granular data and structural models to isolate the effect of the policy from secular trends in the population, including other age groups. FundingTecnológico de Monterrey Challenge-Based Research Funding Program.

The Relationship between Obesity and Childhood Dental Caries in the United States.

Background: Childhood obesity and dental caries are prevalent chronic, multifactorial conditions with adverse health consequences and considerable healthcare costs. The aims of this study were: (1) to evaluate the relationship between obesity and dental caries among young children using multiple definitions for both conditions, and (2) to evaluate the role of family socioeconomic status (SES) and the child’s intake of added sugars in explaining this association. Methods: Data from 2775 2−5-year-olds children from the National Health and Nutrition Examination Survey (NHANES) 2011−2018 were analysed. Three different international standards were used to define obesity, namely the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), and the International Obesity Task Force (IOTF). Dental caries was measured during clinical examinations and summarised as counts (dt and dft scores) and prevalence (untreated caries [dt > 0] and caries experience [dft > 0]). The association of obesity with dental caries was assessed in regression models controlling for demographic factors, family SES and child’s intake of added sugars. Results: In crude models, obesity was associated with greater dt scores when using the IOTF standards (RR: 2.43, 95% CI: 1.11, 5.29) but not when using the WHO and CDC standards; obesity was associated with greater dft scores when using the WHO (1.57, 95%CI: 1.11−2.22), CDC (1.70, 95%CI: 1.17−2.46) and IOTF standards (2.43, 95%CI: 1.73−3.42); obesity was associated with lifetime caries prevalence when using the WHO (1.55, 95%CI: 1.05−2.29), CDC (1.73, 95%CI: 1.14−2.62) and IOTF standards (2.45, 95%CI: 1.61−3.71), but not with untreated caries prevalence. These associations were fully attenuated after controlling for demographic factors, family SES and child’s intake of added sugars. Conclusions: The relationship between obesity and dental caries in primary teeth varied based on the definition of obesity and dental caries used. Associations were observed when obesity was defined using the IOTF standards and dental caries was defined using lifetime indicators. Associations were fully attenuated after adjusting for well-known determinants of both conditions.

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%).

Associations between intakes of foods and their relations to overweight/obesity in 16-year-old adolescents

There is limited knowledge about the associations between intakes of different foods and inconsistency in the literature of the relation between the quality of food intake and bodyweight in adolescents. The aim of this study is to explore how healthy self-reported food intakes are associated with each other and with overweight/obesity in adolescents. This is a cross-sectional study of seven cohorts of adolescents (n 13 451) who turned sixteen from 2009/2010 up to 2015/2016 and responded to a health questionnaire used by the School Health Services in southeast Sweden. Associations between intakes of ten self-reported foods as well as between food intakes and weight groups based on the International Obesity Task Force standards (isoBMI) were explored by multivariable logistic regression. Healthy intakes of different foods were mostly associated with each other with the strongest association between a high intake of fruit and a high intake of vegetables (odds ratio (OR) = 25 (95 % confidence interval (CI) 20⋅0-33⋅1)). A low-frequency intake of sweets/snacks (OR = 2⋅35 (95 % CI 1⋅84-3⋅00)) was associated with overweight/obesity as well as a healthy choice of butter/margarine (≤40 % fat) (OR = 1⋅82 (95 % CI 1⋅39 to 2⋅41)), but a high-frequency intake of vegetables was negatively associated with overweight/obesity 0⋅77 (0⋅62-0⋅95). To promote health and achieve a healthy weight among adolescents, it is important to take both diet quality and total food amount into consideration.

Eating Habits Associated with Overweight and Obesity: Case - Control Study in 11-14 year old Adolescents in Hanoi in 2020

Eating Habits Associated with Overweight and Obesity: Case - Control Study in 11-14 year old Adolescents in Hanoi in 2020

Overweight and obesity of children and adolescents in Slovakia

Aim: To compare the national reference percentile values for body height, weight, and body mass index (BMI) of children and adolescents in Slovakia with international standards and to analyze growth trends in this population.Methods: The study was designed as a repeated crosssectional survey. Two nationwide anthropometric surveys (NAS) performed in 2001 and 2011 assessed body weight, height, and BMI of 38 692 children aged 7 to 18 years. Age- and sex-specific smoothed percentiles were generated with the lambda-mu-sigma method. Slovak standards were compared with World Health Organization (WHO) 2007 z-scores and International Obesity Task Force (IOTF) standards.Results: Medians of body height corresponded to the 75th-85th percentile of the WHO 2007 standards. The secular trend of height increase was attenuated, and the final body height did not change between NAS 2001 and NAS 2011. The cut-off BMI values for obesity, set at the 97th percentile for age <14 years, were higher across age ranges than WHO 2007 standards but lower than IOTF standards. Obesity prevalence, relatively low in 2001 (<3%), doubled during the following decade (P<0.001), with the highest values (4.8%-7.6%) observed in children aged up to 13 years.Conclusion: NAS 2001 data were chosen as national growth standards, as these data were not influenced by the obesity rates increase in the period between the surveys. BMI cut-offs were lower than those in most European countries. Obesity proportions in prepubertal and pubertal boys might be overestimated when WHO 2007 cut-offs are used.

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.

Developing Global Standards for Predicting Adult Overweight and Obesity from Childhood Body Mass Index - A Comparison of Estimates Obtained from Follow Up of a Pooled International Longitudinal Cohort to Current Standards Derived from Cross-Sectional Survey Data

Background: Historically, cut-points for childhood and adolescent overweight and obesity have been based on population-specific percentiles derived from cross-sectional data. To obtain cut-points that might better predict overweight and obesity in adulthood, we examined the association between childhood body mass index (BMI) and adult BMI status in a longitudinal cohort. Methods: Using data from the International Childhood Cardiovascular Cohort (i3C) Consortium pooled cohort we determined childhood overweight and obesity cut-points that best predict BMI status at the age of 18. Logistic regression analysis was used to assess the association between BMI in childhood and adult obesity. Area under the Receiver Operating Characteristic curve was used to assess the ability of fitted models to discriminate different BMI status groups in adulthood. The cut-points were then compared to those defined by the International Obesity Task Force (IOTF) using cross-sectional data, and tested for sensitivity and specificity in a separate, independent longitudinal sample with BMI measurements available from both childhood and adulthood. Findings: The cut-points derived from the longitudinal i3C Consortium data were lower than the IOTF cut-points. Consequently, a larger percentage of the sample was classified as overweight or obese when using the i3C cut-points in the independent sample. The i3C cut-points were better than the previously used IOTF cut-points at discriminating those who would later become overweight or obese in early adulthood from those whose BMI was normal when tested in the independent sample. Interpretation: The childhood BMI cut-points based on the i3C Consortium longitudinal data provide better predictors of future risk of adult overweight and obesity than estimates based on cross-sectional data. The result is more specific identification of the childhood population at risk of adult overweight or obesity than the currently used IOTF standards. Funding: Authors Kartiosuo, Ramakrishnan, Lemeshow, Juonala, Daniels, Sabin, Hu, Prineas and Dwyer declare no support from funding organisations for their work. Authors Woo, Jacobs, Steinberger, Urbina, Bazzano and Sinaiko declare their work was supported by the National Institutes of Health (NHLBI) grant no. i3C R01 HL121230. Dr Burns declares the acquisition and management of historic Muscatine Study data was supported by a Specialized Center of Research (SCOR) in Atherosclerosis, Lipids and Thrombosis grant from the National Heart, Lung and Blood Institute (NHLBI) HL-14230; M01-FR59 and RR-00059 from the General Clinical Research Centers Program, NCRR, NIH; and the Lipid Research Clinics Program (NIH-NHLBI-N01-HV-2-2913-L). Dr Raitakari declares The Young Finns Study has been financially supported by the Academy of Finland: grants 286284, 134309 (Eye), 126925, 121584, 124282, 129378 (Salve), 117787 (Gendi), and 41071 (Skidi); the Social Insurance Institution of Finland; Competitive State Research Financing of the Expert Responsibility area of Kuopio, Tampere and Turku University Hospitals (grant X51001); Juho Vainio Foundation; Paavo Nurmi Foundation; Finnish Foundation for Cardiovascular Research ; Finnish Cultural Foundation; The Sigrid Juselius Foundation; Tampere Tuberculosis Foundation; Emil Aaltonen Foundation; Yrjo Jahnsson Foundation; Signe and Ane Gyllenberg Foundation; Diabetes Research Foundation of Finnish Diabetes Association; EU Horizon 2020 (grant 755320 for TAXINOMISIS); European Research Council (grant 742927 for MULTIEPIGEN project); and Tampere University Hospital Supporting Foundation. Dr Venn declares the CDAH follow-up study received grant support from the National Health and Medical Research Council (APP211316). Dr. Bazzano is also supported in part by the following grants from the National Institutes of Health: R01AG041200, R21057983, R01062309, K12HD043451, and P20GM109036. Declaration of Interest: All authors have declared no conflict of interest. Ethical Approval: The following studies used in the work were covered by ethical approval detailed as follows: The protocols for all relevant Muscatine Study data acquisition were approved by the University of Iowa Institutional Review Board. Informed consent was obtained from all parents and adult participants; assent was obtained from participants while they were children/adolescents. The Princeton and NGHS studies were approved by the IRB at Cincinnati Children’s Hospital Medical Center. The NGHS cohort all study participants or their legal guardian if <18 years, provided written informed consent according to local IRB requirements. The Young Finns Study was approved by the institutional ethics committees, and written informed consent was obtained from all the study participants. The CDAH study was approved by the Tasmanian Health and Medical Human Research Ethics Committee. Participants gave informed consent. The Bogalusa Heart Study was approved by the institutional review board at Tulane University.

Comparison of Slovak reference values for anthropometric parameters in children and adolescents with international growth standards: implications for the assessment of overweight and obesity

AimTo compare the national reference percentile values for body height, weight, and body mass index (BMI) of children and adolescents in Slovakia with international standards and to analyze growth trends in this population.MethodsThe study was designed as a repeated cross-sectional survey. Two nationwide anthropometric surveys (NAS) performed in 2001 and 2011 assessed body weight, height, and BMI of 38 692 children aged 7 to 18 years. Age- and sex-specifıc smoothed percentiles were generated with the lambda-mu-sigma method. Slovak standards were compared with World Health Organization (WHO) 2007 z-scores and International Obesity Task Force (IOTF) standards.ResultsMedians of body height corresponded to the 75th-85th percentile of the WHO 2007 standards. The secular trend of height increase was attenuated, and the final body height did not change between NAS 2001 and NAS 2011. The cut-off BMI values for obesity, set at the 97th percentile for age <14 years, were higher across age ranges than WHO 2007 standards but lower than IOTF standards. Obesity prevalence, relatively low in 2001 (<3%), doubled during the following decade (P < 0.001), with the highest values (4.8%-7.6%) observed in children aged up to 13 years.ConclusionNAS 2001 data were chosen as national growth standards, as these data were not influenced by the obesity rates increase in the period between the surveys. BMI cut-offs were lower than those in most European countries. Obesity proportions in prepubertal and pubertal boys might be overestimated when WHO 2007 cut-offs are used.

Weighing in on international growth standards: testing the case in Australian preschool children.

Overweight and obesity in preschool-aged children are major health concerns. Accurate and reliable estimates of prevalence are necessary to direct public health and clinical interventions. There are currently three international growth standards used to determine prevalence of overweight and obesity, each using different methodologies: Center for Disease Control (CDC), World Health Organization (WHO) and International Obesity Task Force (IOTF). Adoption and use of each method were examined through a systematic review of Australian population studies (2006-2017). For this period, systematically identified population studies (N=20) reported prevalence of overweight and obesity ranging between 15 and 38% with most (n=16) applying the IOTF standards. To demonstrate the differences in prevalence estimates yielded by the IOTF in comparison to the WHO and CDC standards, methods were applied to a sample of N=1,926 Australian children, aged 3-5years. As expected, the three standards yielded significantly different estimates when applied to this single population. Prevalence of overweight/obesity was WHO - 9.3%, IOTF - 21.7% and CDC - 33.1%. Judicious selection of growth standards, taking account of their underpinning methodologies and provisions of access to study data sets to allow prevalence comparisons, is recommended.

Prevalence and comparison of obesity, overweight, and thinness by different growth standards among affluent schoolchildren (8–18 years) in Rajkot

Background: The aim of the study was to estimate the prevalence of obesity, overweight, and thinness and compare it using different growth standards among schoolchildren and adolescents. Material and Methods: Anthropometric measurements of all students of four schools from 3rd to 12th standards were taken. Prevalence of overweight, obesity, and thinness was measured and compared using four standards – Agarwal 2001 standards, revised Indian Association of Paediatrics (IAP) 2015, World Health Organization (WHO) 2007, and International Obesity Task Force (IOTF) standards. Results: A total of 1496 children including 79.1% boys and 20.9% girls participated. Prevalence of obesity was reported 9.1% by Agarwal standards, 14% by IAP standards, 11.1% by WHO standards, and 5.1% by IOTF standards. Overweight children prevalence was reported more (19.1%) with IAP standards, followed by 17% with Agarwal standards, 15.8% with IOTF standards, and 15.3% by WHO standards. Prevalence of obesity and overweight was high among boys than girls in all three standards. A good level of agreement found among IAP 2015 standards with Agarwal and WHO 2007 standards considering four categories. The agreement was improved further up to 0.90 when compared to two combined categories – overweight/obese versus normal weight/thinness. Conclusion: High prevalence of obesity and overweight was reported with IAP 2015, Agarwal, and WHO 2007 standards in the age group of 8–18 years. Good agreement was found for revised IAP 2015 with Agarwal and WHO 2007 standards for measuring obesity and overweight. There was an underestimation of obesity with IOTF standards.

Beverage intake and obesity in early childhood: evidence form primary health care clients in Northwest Argentina.

Sugar sweetened beverages (SSB) are thought to play an important role in weight gain. We examined the relationship between the intake of caloric and noncaloric beverages (SSB and water) and the nutritional status of children. In 2014, we randomly selected 16 public health clinics in four cities of Northwest Argentina and conducted a survey among mothers of children 0-6 years of age. Children's beverage intake was ascertained by 24-h dietary recall provided by the mothers. Children's weight and height measures were obtained from clinic's registries. We calculated the body mass index using the International Obesity Task Force standards. The analysis included 562 children 25 months to 6 years of age with normal or above normal nutritional status. Children's beverage consumption was as follows, water 81.8%, carbonated soft drinks (CSD) 49.7%, coffee/tea/cocoa 44.0%, artificial fruit drinks 35.6%, flavored water 17.9%, natural fruit juice 14.5%. In multivariate logistic regression models the likelihood of being obese v. being overweight or having normal weight doubled with an intake of one to five glasses of CSD (OR=2.2) and increased by more than three-fold with an intake of more than five glasses (OR=3.5). Drinking more than five glasses of water decreased the likelihood of being obese by less than half (OR=0.3). The percentage of children drinking more than five glasses of other beverages was low (3.3-0.9%) and regression models did not yield significant results. The study contributed evidence for reducing children's CSD intake and for promoting water consumption, together with the implementation of comprehensive regulatory public health policies.

Weight perceptions in a population sample of English adolescents: cause for celebration or concern?

Objectives:To examine the proportion of normal-weight adolescents who consider themselves to be too heavy (size overestimation), and the proportion of overweight or obese adolescents who consider themselves to be about the right weight or too light (size underestimation), in large population-based samples collected over 8 years in England.Methods:Data were from the Health Survey for England between 2005 and 2012: an annual survey of households representative of the English population. We analysed data from 4979 adolescents (2668 boys, 2311 girls) aged 13 to 15 years old whose weight status was defined as normal weight or overweight/obese based on body mass index standard deviation scores (BMI-SDS) derived from objective measurements of height and weight and using International Obesity Task Force standards. Weight perception was based on the adolescent's choice from the following descriptors: ‘about the right weight', ‘too heavy' or ‘too light'.Results:The majority of normal-weight adolescents (83% of boys, 84% of girls) correctly identified themselves as ‘about the right weight'. Overestimation was uncommon, with only 7% of normal-weight teens (4% of boys, 11% of girls) identifying themselves as ‘too heavy'. In contrast, only 60% of overweight/obese adolescents (53% of boys, 68% of girls) correctly identified themselves as ‘too heavy', whereas 39% (47% of boys, 32% of girls) underestimated, identifying themselves as ‘about the right weight' or ‘too light'. There were no significant changes in BMI-SDS or body size estimation over time (2005–2012).Conclusions:Overestimation of body weight among normal-weight adolescents is relatively uncommon; potentially a cause for celebration. However, almost half of boys and a third of girls with a BMI placing them in the overweight or obese BMI range perceived themselves to be about the right weight. Lack of awareness of excess weight among overweight and obese adolescents could be a cause for concern.

Agreement and Diagnostic Performance of FITNESSGRAM®, International Obesity Task Force, and Hungarian National BMI Standards

Purpose: This study examined agreement between all 3 standards (as well as relative diagnostic associations with metabolic syndrome) using a representative sample of youth from the Hungarian National Youth Fitness Study. Method: Body mass index (BMI) was assessed in a field sample of 2,352 adolescents (ages 10–18.5 years) and metabolic syndrome status was assessed in a laboratory subsample of 373 youth. All youth were categorized into weight status groups based on the FITNESSGRAM®, International Obesity Task Force (IOTF), and Hungarian growth standards. Classification agreement was compared between all pairs of standards via cross-tabulation. Logistic regression was used to estimate the odds of metabolic syndrome by weight status. Results: The 3 BMI standards agreed on ≥ 88% of cases, with better agreement on girls’ standards than boys’ standards. Kappa values ranged from .65 to .89. Using the Hungarian standards over the Fitnessgram or IOTF standards resulted in 5% to 10% more youth being classified as normal weight. The overweight/obesity groups were 4 times to 6 times more likely to have metabolic syndrome than those classified as normal weight regardless of the classification standards. These odds ratios increased to 8 times to 17 times when comparing the normal-weight/overweight groups to the obesity category. Odds ratios for boys tended to be slightly larger than those for girls. Conclusions: All 3 standards provide similar information about weight status and metabolic syndrome classification. To more easily facilitate international comparisons, it may be of greater benefit to use the IOTF standards, which also had better agreement with the U.S. Fitnessgram thresholds.

Prevalence of Overweight and Obesity among Students in the Kumasi Metropolis.

The aim was to determine the prevalence of obesity and overweight among students in the Kumasi metropolis. In a descriptive cross-sectional study, 500 students aged 10 to 20 years were examined from two junior high schools selected by multistage sampling technique and three randomly selected senior high schools. Height and weight were measured in all participants and the body mass index (BMI) of each individual was calculated. Body mass index classes were calculated according to the International Obesity Task Force standards. Out of the 500 students, 290 (58.00%) were males and 210 (42.00%) were females. The prevalence of underweight, normal weight, overweight, and obesity was 7.40%, 79.60%, 12.20%, and 0.80%, respectively. Overweight was more prevalent among students than obesity. There is therefore the need to establish effective public health promotion campaigns among students in order to curtail future implications on health.

Overweight and obesity in 4-5-year-old children in New Zealand: results from the first 4 years (2009-2012) of the B4School Check programme.

We describe the prevalence of overweight and obesity in four-year-old children in New Zealand, variations with ethnicity and socio-economic status, and changes over the study duration using body mass index (BMI) measurements collected as part of the B4School Check programme. Demographic and BMI data were extracted for all children measured between 2009 and 2012. Overweight and obesity rates were estimated using International Obesity Task Force (IOTF) 2012 standards and the 85th (overweight) and 95th (obese) percentiles for BMI-for-age of the World Health Organization (WHO) 2006, Centers for Disease Control and Prevention 2000 and UK 1990 reference standards. A total of 168,744 BMI measurements were included in the analysis with a coverage rate of 66.5%. Mean BMI was 16.30 kg/m(2) in girls and 16.44 kg/m(2) in boys. Mean BMI z-score (WHO 2006 standards) was 0.601 in girls and 0.785 in boys. Using WHO 2006 standards, 16.9% of girls and 19.6% of boys were overweight and 13.8% of girls and 18.7% of boys were obese. Using IOTF standards, 18.3% of girls and 16.2% of boys were overweight and 5.7% of girls and 4.7% of boys were found obese. Prevalence of overweight and obesity was higher in Pacific and Maori children and those living in more socio-economically deprived areas than other children. No definite time-trends were observed over the study duration. The study reaffirms the high prevalence of overweight and obesity in pre-school children in New Zealand, and demonstrates the variations in prevalence when using different reference standards.

Association between self-reported physical activity and indicators of body composition in Malaysian adolescents

BackgroundObesity and lack of physical activity are fast becoming a concern among Malaysian adolescents. ObjectiveThis study aims to assess physical activity levels among Malaysian adolescents and investigate the association between physical activity levels and body composition such as body mass index (BMI), waist circumference (WC) and percentage of body fat. Subjects and methods1361 school-going 13year old multi-ethnic adolescents from population representative samples in Malaysia were involved in our study. Self-reported physical activity levels were assessed using the validated Malay version of the Physical Activity Questionnaire for Older Children (PAQ-C). Height, weight, body fat composition and waist circumference (WC) were measured. Data collection period was from March to May 2012. Results10.8% of the males and 7.4% of the females were obese according to the International Obesity Task Force standards. A majority of the adolescents (63.9%) were physically inactive. There is a weak but significant correlation between physical activity scores and the indicators of obesity. The adjusted coefficient for body fatness was relatively more closely correlated to physical activity scores followed by waist circumference and lastly BMI. ConclusionThis study demonstrates that high physical activity scores were associated with the decreased precursor risk factors of obesity.

Prevalence of obesity among 10–11‐year‐old Maltese children using four established standards

The objective of this study was to establish, through measured height and weight, the prevalence of overweight and obesity in a representative sample of Maltese children aged 10-11 years. Height and weight were measured in a sample, stratified by sex, region and type of school, of 874 year 6 children and their body mass index classified as normal weight, overweight, and obese using International Obesity Task Force (IOTF), World Health Organization (WHO), US Centre for Disease Control and U.K. Department of Health standards. IOTF standards indicated 20.4% overweight and 14.2% obese, while WHO standards indicated 23.1% overweight and 20.9% obese. All four standards reported significant sex differences, classifying more boys in the overweight and obesity categories. The prevalence of overweight and obesity among 10-11-year-old Maltese children are higher than previously estimated through self-reported height and weight and all other countries in the world except Greece. These high rates confirm the urgent need to identify causes and tackle childhood obesity in Malta.

Association between food intake frequency and obesity among adolescent girls in Saudi Arabia

The main objective of this study was to discover the association between the intake of certain foods and the occurrence of obesity among adolescent girls in Saudi Arabia. A cross-sectional multistage sampling method was conducted among girls aged 12-19 years in Jeddah, Saudi Arabia. The total sample was 512. Obesity was calculated based on the International Obesity Task Force standards. Findings revealed that obese girls were less likely to eat fruit, vegetables, meat, chicken and dairy products than non-obese girls, but the differences were not statistically significant. However, the risk of being obese was greater for those who consumed chocolates and sweets (odds ratio=1.57) and fast foods (odds ratio=1.35) more than three times a week. Thus, programs to promote a healthy lifestyle for schoolchildren should include appropriate intervention on changing dietary habits.