International Obesity Task Force Research Articles

The Association between Fast Food Outlets and Overweight in Adolescents Is Confounded by Neighbourhood Deprivation: A Longitudinal Analysis of the Millennium Cohort Study.

The aim of our study is to utilise longitudinal data to explore if the association between the retail fast food environment and overweight in adolescents is confounded by neighbourhood deprivation. Data from the Millennium Cohort Study for England were obtained for waves 5 (ages 11/12; 2011/12; n = 13,469) and 6 (ages 14/15; 2014/15; n = 11,884). Our outcome variable was overweight/obesity defined using age and sex-specific International Obesity Task Force cut points. Individuals were linked, based on their residential location, to data on the density of fast food outlets and neighbourhood deprivation. Structural Equation Models were used to model associations and test for observed confounding. A small positive association was initially detected between fast food outlets and overweight (e.g., at age 11/12, Odds Ratio (OR) = 1.0006, 95% Confidence Intervals (CI) = 1.0002–1.0009). Following adjusting for the confounding role of neighbourhood deprivation, this association was non-significant. Individuals who resided in the most deprived neighbourhoods had higher odds of overweight than individuals in the least deprived neighbourhoods (e.g., at age 11/12 OR = 1.95, 95% CIs = 1.64–2.32). Neighbourhood deprivation was also positively associated to the density of fast food outlets (at age 11/12 Incidence Rate Ratio = 3.03, 95% CIs = 2.80–3.28).

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.

Assessing the association between breastfeeding, type of childbirth and family structure with childhood obesity: results from an observational study among 10–12 years old children

This study examined the association between breastfeeding, type of childbirth, and family structure with childhood obesity. During 2014–2016, 1728 Greek students attending primary schools and their parents were enrolled. Children’s weight status was measured and classified according to the International Obesity Task Force criteria. A self-administered questionnaire assessing the type of childbirth, the family structure, and several perinatal and demographic characteristics was used. Factors associated with higher breastfeeding rates were the type of childbirth, high maternal educational level, and nuclear family structure. No association was found between childhood obesity and type of childbirth (p = 0.64) and family structure (p = 0.26). Although the short-term beneficial effects of breastfeeding on childhood obesity are undeniable and it is of great importance to all health professionals to promote breastfeeding, no significant long-term effects on obesity in adolescence were observed. More studies are needed in order to elucidate the role of breastfeeding in obesity status in adolescence.

Prevalence of overweight and obesity among school children and parents: a cross-sectional study.

Obesity, a complex and multifactorial disease causing severe health problems, is still the second most important cause of preventable deaths after smoking. Another risk is that childhood obesity is associated with overweight and obesity in adulthood. This study provides information on the prevalence of overweight and obesity in primary school students and their parents on location (rural v urban) and gender. In this population-based, cross-sectional study, the anthropometric and demographic data of 9786 children and 6855 parents were analyzed. The study was conducted between 1 October 2016 and 30 November 2016 on a sample representing all public and private primary school students aged 6-10 years in Samsun province, Turkey. The multi-stage stratified sampling method was used in selecting the research sample according to the number of district students, the number of public/private primary school students, and the number of rural/urban students. In the BMI values classification, cut-off points in the age- and gender-specific growth charts of the Centers for Disease Control and Prevention were used for students, and the International Obesity Task Force cut-offs were used for parents or guardians. After the data acquisition was completed, a questionnaire form developed by the researchers was sent to the parents through the students. While children's anthropometric measurements were performed in their classrooms, parents or guardians self-reported their weight and height. Statistical Package for the social Sciences v22.0 was used for statistical analysis of the data. The study group consisted of 5005 (51.1%) boys and 4781 (48.9%) girls. The 6855 parents comprised 5258 (76.7%) mothers and 1597 (23.3%) fathers. The mean age was 8.2±1.2 years in children and 36.2±6.7 years in parents. Obesity prevalence was 10.5% in children and 20.2% in their parents. Childhood obesity was more prevalent in boys and in those living in urban areas (12.0% and 12.3%, respectively) than in girls and in those living in rural areas (9.0% and 4.5%, respectively). Conversely, adulthood obesity was more frequent in females and in those living in rural areas (20.4% and 21.8%, respectively) than in males and in those living in urban areas (19.7% and 20.4%, respectively). BMI values were higher among those of male gender and those living in rural areas. Combating obesity requires further multidisciplinary research to reveal the reasons for the differences based on place and gender, especially on nutrition and healthy lifestyle behaviors.

Comparison analysis of childhood body mass index cut-offs in predicting adulthood carotid intima media thickness: Tehran lipid and glucose study

BackgroundThe prevalence of obesity among children and adolescences have been increased, which can consequently increase the prevalence of metabolic and cardiovascular diseases later in life. The objective of this study is to compare the ability of different childhood body mass index cut-offs in prediction of carotid intima media thickness (CIMT) as an indicator of subclinical atherosclerosis.MethodsParticipants were categorized into normal weight, overweight and obesity group, based on world health organization (WHO), center for disease control and prevention (CDC), international obesity task force (IOTF) and local IOTF cut-offs. After 18 years of follow up CIMT was measured. Akaike’s information criterion and relative efficiency were measured in order to compare regression models on the role of obesity on CIMT.ResultsIn this prospective cohort study, 1295 subjects aged 3 to 18 years old were enrolled. The overall prevalence of overweight was 15.4, 11.5, 16.3 and 14.1 along with obesity prevalence of 6.6, 8.5, 7.7 and 5.0% based on WHO, CDC, local IOTF and international IOTF criteria, respectively. CIMT was higher in obese compare to normal groups across all classification criteria. After regression analysis, international IOTF was the best to predict adulthood CIMT, followed by local IOTF and WHO. CDC had the least discriminatory ability.ConclusionDue to the results of this study, IOTF could be a better tool in national and international surveillances of children in order to define overweight and obesity, which can help us to intervene more effectively in reducing the burden of cardiovascular diseases.

Foetal tobacco and cannabis exposure, body fat and cardio‐metabolic health in childhood

SummaryBackgroundFoetal tobacco and cannabis exposure may have persistent cardio‐metabolic consequences in the offspring.ObjectiveWe examined the associations of maternal and paternal tobacco and cannabis use during pregnancy with offspring body fat and cardio‐metabolic outcomes.MethodsIn a population‐based prospective cohort study among 4792 mothers, fathers, and children, we assessed parental substance use by questionnaires. Childhood outcomes included body mass index (BMI), body fat, blood pressure, and lipid, glucose and insulin concentrations at 10 years.ResultsChildren exposed to maternal tobacco use during pregnancy had a higher android/gynoid fat mass ratio (difference 0.22 SDS, 95% confidence interval [CI]: 0.13, 0.30), fat mass index (difference 0.20 SDS, 95% CI: 0.12, 0.28), triglyceride concentrations (difference 0.15 SDS, 95% CI: 0.04, 0.26), and a higher risk of overweight (odds ratio [OR] 1.35, 95% CI: 1.07, 1.71), compared to non‐exposed. Children exposed to maternal cannabis during pregnancy had a higher BMI (difference 0.26 SDS, 95% CI: 0.08, 0.44), android/gynoid fat mass ratio (difference 0.21 SDS, 95% CI: 0.04, 0.39), and fat‐free mass index (difference 0.24 SDS, 95% CI: 0.06, 0.41), compared to non‐exposed. The associations for paternal substance use with child cardio‐metabolic health outcomes were similar as those for maternal use.ConclusionsSimilar associations for maternal and paternal substance use during pregnancy suggest that these findings may be explained by shared family‐based social and lifestyle factors, rather than by direct foetal programming.

Internalized weight bias in the relationship between mental health and obesity in UK adolescents

Abstract Background It is crucial to promote mental and physical health during adolescence to protect against lifetime risks of mental health problems and obesity. Internalized weight bias (self-directed stigmatizing attitudes about perceived weight status) and bullying are implicated as potential mechanisms in the relationship between mental health and obesity in adolescence. We examined internalized weight bias and bullying as potential mediators of the relationship between mental health and weight status across adolescence in the United Kingdom (UK). Methods We analysed data on 8,688 adolescents from the UK Millennium Cohort Study. Weight status was defined using sex and age specific International Obesity Taskforce cut points for body-mass index (not overweight/obese; overweight; obese) at 11 and 17 years. Mental health was defined using parental reported emotional (anxiety and depression), and externalizing (aggression and impulsivity) symptoms at 11 and 17 years (low; moderate; high). Self-reported measures of internalized weight bias captured via body-dissatisfaction and self-esteem and bullying at 14 years were tested as mediators. We used Generalized Structural Equation Models to examine longitudinal pathways between weight status and mental health across 11 and 17 years, whilst accounting for concurrent associations and potential confounders. Results Adolescents with high emotional (relative risk (RR) 1.98, 95% CI 1.28 to 3.07) or externalizing symptoms (RR 2.07, 95% CI 1.23 to 3.48) at 11 years were twice as likely to be obese at 17 years compared with those who had low symptoms. The impact of emotional and externalizing symptoms on weight status was found to be partially attributable to internalized weight bias, but not bullying, with significant mediation for body-dissatisfaction and low self-esteem. Conclusions Internalized weight bias partially explains the relationship between mental health and weight status across adolescence. Key messages There is a need for a holistic, early prevention strategy to focus on reducing weight stigma to encourage healthy mental and physical development of children. The relationship between mental health and weight status across adolescence is partly attributable to internalized weight bias.

Parental Adherence to Ideal Cardiovascular Health Status Was Associated With a Substantially Lower Prevalence of Overweight and Obesity in Their Offspring Aged 6-18 Years.

Background: Parental health status had a potential influence on offspring health. This study aimed to investigate the separate associations between paternal and maternal cardiovascular health statuses and the prevalence of childhood overweight and obesity in the offspring.Methods: Data were from a cross-sectional study conducted in seven provinces or cities of China in 2013. A total of 29,317 children aged 6–18 years old and their parents, making up 9,585 father-offspring pairs and 19,732 mother-offspring pairs, were included in the final analysis. Information on parental cardiovascular health status factors (dietary behaviors, body mass index (BMI), smoking, physical activity, hypertension, and diabetes mellitus) was obtained from the structured self-administrated questionnaires. Based on the health status factors, we then generated an ideal cardiovascular health (iCVH) score. The overweight and obesity of children were defined using age- and sex-specific cutoffs based on the International Obesity Task Force criteria. A multilevel log-binomial regression model was used to assess the association between parental cardiovascular health status and prevalence of childhood overweight and obesity in the offspring.Results: The prevalence of pediatric overweight and obesity was 22.0% in the father-offspring subset and 23.8% in the mother-offspring subset, respectively. Fathers with ideal BMI, non-smoking, and absence of hypertension and diabetes, and mothers with ideal BMI, ideal physical activity, and absence of hypertension and diabetes were found to be associated with lower prevalence of overweight and obesity in the offspring. The prevalence of offspring overweight and obesity was significantly decreased with the parental iCVH scores increased. Each additional increase in paternal and maternal iCVH factor was associated with a 30% and 27% lower prevalence of overweight and obesity in the offspring. Compared with children whose parental iCVH scores ≤ 3, offspring whose fathers or mothers met all six iCVH factors had 67% [prevalence ratio (PR): 0.33, 95%CI: 0.25–0.42] and 58% (PR: 0.42, 95%CI: 0.29–0.62) lower prevalence of overweight and obesity, respectively.Conclusions: Parental adherence to iCVH status was associated with a lower prevalence of pediatric overweight and obesity in offspring. Our findings support the intervention strategy that parents should involve in the obesity intervention program for children.

Prevalence of overweight and obesity from 5 to 19years of age in Gothenburg, Sweden.

The aim of this study was to present prevalence data for overweight and obesity across school age in a large, recent, population-based cohort of children in Gothenburg, Sweden. We included 66,807 children (48.5% girls) aged 5-18.9years who had their height and weight measured in school health care 2015-2018. The BMI values were categorised according to the age-dependent cut-offs for overweight and obesity from the International Obesity Task Force (IOTF). Overall, the prevalence of overweight and obesity for girls and boys was 18.1% and 18.0%, respectively. We observed increasing proportions of overweight (girls 11.5-17.1% and boys 8.4-17.4%) and obesity (girls 3.0-4.2% and boys 2.7-6.1%) with increasing age (p<0.001 for trend in both sexes). Moreover, girls had higher prevalence of overweight during ages 5.0 to 8.9years compared with boys (p<0.001), while boys had higher prevalence of obesity 15.0-18.9years compared with girls (p<0.001). In conclusion, we demonstrate increasing prevalence of overweight and obesity across the entire school age range, as well as differences in prevalences between boys and girls, in a population-based sample of 67,000 children in Gothenburg city, Sweden. Continuous monitoring of schoolchildren, together with effective preventive measures, is crucial to curb the obesity epidemic and its consequences.

Association Between Body Mass Index and Disability in Children With Charcot-Marie-Tooth Disease.

This study examined the association between body mass index (BMI) and disability in children with Charcot-Marie-Tooth disease (CMT). We conducted a cross-sectional analysis of 477 patients with CMT who were 3 to 20 years of age from the Inherited Neuropathy Consortium and 316 age- and sex-matched healthy children from the 1,000 Norms Project. BMI was categorized according to the International Obesity Task Force (IOTF) criteria, and BMI categorization was compared with healthy children. IOTF categories (adult equivalent BMI cut points) were severely underweight (BMI <17 kg/m2), underweight (BMI ≥17-<18.5 kg/m2), healthy weight (BMI ≥18.5-<25 kg/m2), overweight (BMI ≥25-<30 kg/m2), and obese (BMI ≥30 kg/m2). Scores on the 0 to 44-point CMT Pediatric Scale (CMTPedS), a well-validated measure of disability, were examined in relation to BMI. There was a higher proportion of children with CMT categorized as severely underweight (5.7% vs 0.3%), underweight (10.3% vs 5.1%), and obese (7.3% vs 3.8%) (p < 0.05). Fewer children with CMT were categorized as healthy weight (61.8% vs 74.4%) (p < 0.05), and the proportion of overweight (14.9% vs 16.5%) between groups was similar. CMTPedS scores (mean ± SD) for weight categories were as follows: severely underweight 27 ± 9, underweight 20 ± 8, healthy weight 17 ± 9, overweight 17 ± 9, and obese 22 ± 10. Compared to children with a healthy weight with CMT, being severely underweight was associated with being more disabled (p < 0.001), as was being obese (p = 0.015). The proportion of children with CMT who are underweight or obese is higher compared to age- and sex-matched healthy children. In children with CMT, being underweight or obese is associated with greater disability, when compared to children with CMT of healthy weight.

Social mobility by parent education and childhood overweight and obesity: a prospective cohort study.

The association of social mobility, measured by parent education and childhood overweight and obesity (OWOB) has been scarcely reported on. This study evaluated the associations between social mobility measured by parent education and childhood OWOB at child age 6 and 10 years. We analyzed data of 4030 children and parents participating in the Generation R study. We used generalized linear models controlling for potential confounders to determine if social mobility (upward mobility, static-low and static-high based on the change of parent education) was associated with age- and sex-specific standard deviation scores of body mass index (BMI-SDS) or OWOB (the cut-offs of International Obesity Task Force). Mean BMI-SDS of the children was 0.23 ± 0.89 and 0.26 ± 1.03 at child age 6 and 10 years, respectively; the prevalence of OWOB increased from 15.2 to 17.4%. Compared with children from mothers in the upward mobility group, children from mothers in the static-high group had lower BMI-SDS and lower odds of OWOB at both ages (all P < 0.001). Compared with children from fathers in the upward mobility group, children from fathers in static-low group had higher BMI-SDS and higher odds of OWOB at both ages (all P < 0.05). Our study contributes to the literature by showing that the behaviors of parents' obtaining a higher level of education after the child was born may be beneficial to attenuate the odds of the child developing overweight in late childhood.

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.

Thinness, overweight and obesity among 6- to 17-year-old Malaysians: secular trends and sociodemographic determinants from 2006 to 2015.

To examine secular trends and sociodemographic determinants of thinness, overweight and obesity among Malaysian children and adolescents from 2006 to 2015. We used cross-sectional data from the National Health and Morbidity Surveys 2006, 2011 and 2015. Individuals were classified into pre- (6-9 years), early (10-13 years) and mid- (14-17 years) adolescence. BMI status was determined according to the International Obesity Task Force (IOTF) and WHO criteria, using measured height and weight. We analysed trends using log-binomial regression, by sex-age groups, stratified by sociodemographic factors (ethnicity, residential area, household size and household income), and accounting for the complex survey design. Associations between sociodemographic factors and prevalence of thinness and overweight (obesity included) in 2015 were assessed using log-Poisson regression. Nationwide population-based surveys, Malaysia. Eligible 6-17-year-olds from urban and rural residential areas (n 28094). The prevalence of thinness decreased from 2006 to 2015 (IOTF: boys from 22 % to 18 %, girls from 23 % to 19 %; WHO: boys from 9 % to 7 %, girls from 8 % to 6 %), while the prevalence of overweight increased (IOTF: boys from 20 % to 26 %, girls from 19 % to 24 %; WHO: boys from 25 % to 31 %, girls from 22 % to 27 %). These changes were statistically significant in most sex-age groups. Thinness and overweight co-existed in all sociodemographic subgroups, with variation in the prevalence estimates, but similar secular changes in most subgroups. Malaysia is facing a double burden of malnutrition at population level with a secular increase in overweight and obesity and a gradual decrease in thinness among 6-17-year-olds from varying sociodemographic backgrounds.

Time trends of overweight and obesity among schoolchildren in Kuwait over a 13-year period (2007-2019): repeated cross-sectional study.

This study aimed to examine age-specific trends in the prevalence of overweight and obesity in schoolchildren in Kuwait over a 13-year period (2007 to 2019) using the WHO, the Centers for Disease Control and Prevention (CDC) and the International Obesity Taskforce (IOTF) definitions. Using cross-sectional approach, Kuwait Nutrition Surveillance System (KNSS) objectively measured weight and height of schoolchildren over a 13-year period. Log-binomial regression models were used to examine age-specific trends of obesity and overweight over the study period. Public primary, middle and high schools in all provinces of Kuwait. Schoolchildren aged 5-19 years (n 172 603). According to the WHO definition, the prevalence of overweight and obesity in schoolchildren, respectively, increased from 17·73 % and 21·37 % in 2007 to 20·19 % and 28·39 % in 2019 (Pfor trend < 0·001). There is evidence that the obesity in females (but not males) has levelled off in the period 2014-2019 according to the three definitions of obesity, which is corroborated by a similar trend in the mean of BMI-for-age Z-score. The prevalence of obesity and overweight in schoolchildren in Kuwait has risen over the last 13 years and trends are similar across all definitions. Obesity is no longer increasing at the same pace and there is evidence that the prevalence of obesity in females has plateaued. The current level of childhood overweight and obesity is too high and requires community-based and school-based interventions.

Overweight, obesity, and thinness among a nationally representative sample of Norwegian adolescents and changes from childhood: Associations with sex, region, and population density.

To estimate the prevalence of overweight, obesity, and thinness among Norwegian 13-year-olds and the changes from childhood (age 8 years) to adolescence (age 13 years); and to explore associations with sex, region, and population density from childhood to adolescence. We used longitudinal, anthropometric data collected by school health nurses conducted in Norway. Weight status was classified according to the International Obesity Task Force cut-offs for overweight, obesity, and thinness, and according to mean body mass index (kg/m2). The Norwegian Youth Growth Study, consisting of a nationally representative sample of Norwegian 13-year-olds (n = 1852; 50.7% girls), which is a part of The Norwegian Growth Cohort. Among 13-year-old Norwegians, the prevalence of overweight (including obesity), obesity, and thinness was 15.8%, 2.5%, and 7.3%, respectively. There was little evidence that these had changed from 8 to 13 years. From 8 to 13 years, the odds of obesity was highest in the Northern region of Norway compared to the South-East (odds ratio (OR): 3.78 (95% confidence interval (CI): 1.13, 12.65; p = 0.036) and in rural areas (OR: 4.76 (95% CI: 1.52, 14.90; p = 0.027). Over the same age period, girls had a trend towards a higher odds of thinness compared to boys (OR: 1.65 (95% CI: 0.98, 2.78; p = 0.057). In Norway, the prevalence of overweight, obesity, and thinness among 13-year-olds seem to be established by age 8 years. The prevalence of obesity was higher in the North and in rural areas. The results indicate the continued need for early prevention and treatment, and targeted interventions to certain areas.

Dietary Patterns, Weight Perception and Obesity Status, among 10-12-Year-Old Children; an Epidemiological Study in Greece.

Adherence to certain dietary patterns influences obesity status in both children and adults. Weight perception influences dietary habits. The aim of this study was to examine children’s dietary habits and obesity status, in relation to weight perception. One thousand seven hundred Greek students enrolled in this study during 2014–2016. Children’s characteristics were assessed through validated questionnaires, and weight status was classified according to the criteria of the International Obesity Task Force. Dietary patterns were assessed through exploratory factor analysis. Overall, 52.2% of children characterized themselves as normal weight, 34.5% as low weight, and 13.3% as overweight/obese; 52.5% of children were in accordance with their actual weight status, with girls being more likely to overestimate their weight. Children followed three dietary patterns, i.e., starchy and protein foods, unhealthy/high-fat foods, and healthy foods. Children who followed the healthy dietary pattern and had accurate weight perception (in accordance with their actual weight), had lower odds of being overweight/obese (p < 0.001). Accurate weight perception in conjunction with healthy dietary habits may play a determinant role in the prevention of obesity. From a public health perspective, early identification of children’s weight misperception along with healthy dietary habit promotion shape a crucial role in childhood obesity confrontation.

Relationship of Overweight and Obesity with Body Self-Image Dissatisfaction in Urban Mediterranean Adolescents.

The aim of this study was to analyze whether weight status has a relationship with the prevalence of body self-image dissatisfaction in Mediterranean urban teenagers. A series of 809 adolescents aged 11 to 17 years underwent anthropometric measurements according to ISAK protocols and completed the Body Shape Questionnaire (BSQ). The overall overweight prevalence according to International Obesity Task Force (IOTF) criteria was 11.5%, and 2.7% for obesity. Girls showed higher overweight prevalence than boys (18.4% vs. 12.9%; p < 0.05). At the late adolescence period (16–17 y), obesity was observed in the boys but not in the girls (8.7% vs. 0%; p < 0.01). There was a relative low prevalence of body image (BI) dissatisfaction among participants (boys 17.3%; girls 22.7%). In the late adolescence period, the girls were more often classified as being dissatisfied (31%). A weak correlation between the BSQ scores and all the anthropometric variables related to the adiposity profile was detected only in the boys. A logistic regression confirmed that female adolescents and the late pubertal period had a significant association with body dissatisfaction, regardless of their weight status. As BI are not related to weight status measured by body mass index (BMI) percentiles, other factors beyond anthropometry deserve further research to explain BI concerns specifically in girls.

Obesity in Pediatric-Onset Multiple Sclerosis: A French Cohort Study.

ObjectiveTo study the link between a high body mass index (BMI) in childhood and the occurrence of pediatric-onset multiple sclerosis (POMS) and to compare, within the MS population, the clinical-radiologic-biological characteristics, according to BMI.MethodsA case-control study comparing BMI data of 60 patients with POMS (39 girls and 21 boys) at Bicêtre Hospital with that of 113 non-neurologic controls NNCs (68 girls and 45 boys) and 18,614 healthy controls HCs (9,271 girls and 9,343 boys) was performed. Crude BMI (cBMI), residual BMI (rBMI = measured BMI − expected BMI for age), z-score (rBMI/SD), and adult equivalent categories (International Obesity Task Force ≥25 = overweight, ≥30 = obese) were assessed.ResultsIn boys, cBMI and rBMI were significantly higher in patients with POMS compared with NNCs (cBMI: +2.9; rBMI: +2.95, p < 0.01) and HCs (cBMI: +2.04, p < 0.01). In girls, cBMI or rBMI did not differ between POMS and NNCs patients (cBMI p = 0.4; rBMI p = 0.44) but with HCs (cBMI +0.99, p < 0.01). CSF inflammatory markers increased with BMI in prepubertal patients (p < 0.01), whereas vitamin D level at diagnosis was lower in boys with higher BMI (p = 0.016). Increased BMI was not associated with clinical and radiologic disease characteristics.ConclusionsOverweight and obesity are more frequently observed at diagnosis, particularly in boys with POMS compared with non-neurologic controls and French HCs. Moreover, BMI is related to initial inflammation in the CSF in prepubertal patients with POMS suggesting an interaction between excess body fat, sexual hormones, and POMS occurrence.

Adapting pediatric obesity care to better suit adolescent patients: Design of a treatment platform and results compared with standard care in the national patient quality register.

BackgroundObesity constitutes a critical risk for adolescent health. This study aimed at identifying youth‐friendly components of obesity treatment.MethodsIn this feasibility study, an adolescent obesity treatment platform was implemented at two Pediatric outpatient clinics in Sweden. Body mass index (BMI), BMI z‐score, and the category of obesity (International Obesity Task Force) were compared before and after the intervention and with data on standard care from the Swedish Childhood Obesity Treatment Register.ResultsThe study included 99 participants (49 females) aged 13–18 years from 1 September 2014, to 31 December 2016. A pediatric nurse met the participants on average 6.5 times in the average inclusion period of 15 months. Physical activity sessions attracted 63 participants. Acceptance Commitment Therapy and In Real Life groups attracted 24 participants. At inclusion, 62 participants had obesity and 37 severe obesity, and 71/99 (72%) remained in the same category. The mean BMI increased from 32.0 to 33.4 kg/m2 (p < 0.01), but 56/94 (60%) participants lowered their BMI or increased less than 1 kg/m2 and 73% stayed to the end of the study. Participants who were new to treatment and participants coming for more than eight visits to the nurse did not increase in BMI. BMI did not change for the 221 out of 641 register patients who had two recordings of BMI in the study period.ConclusionsThe platform was successful in increasing retention, and 60% of participants lowered or maintained their BMI. Still, seven out of ten adolescents with obesity or severe obesity remained in the same weight category.

Dietary Patterns and Weight Status of Primary School Children in Serbia.

The purpose of the present cross-sectional study was to examine dietary patterns and the prevalence of underweight, overweight, and obesity among Serbian children. Furthermore, the study analyzed the association between dietary patterns and weight status. A nationally representative sample of 6–9-year-old children (n = 3,067) was evaluated as part of the Fifth Round World Health Organization European Childhood Obesity Surveillance Initiative. The children's height and weight were measured by trained field examiners, while their parents or guardians filled paper versions of the food frequency questionnaire to collect information related to the child's breakfast habits and food and beverage intake. According to the International Obesity Task Force cut-off points, the overall prevalence of overweight (including obesity) and underweight were 28.9 and 8.1%, respectively. The majority of parents reported that their children (84.5%) had breakfast every day, while only 39.5 and 37% of children had daily fruit and vegetable consumption, respectively. The children who do not eat breakfast every day are more likely to be obese (OR = 1.50), while a higher intake frequency of nutrient-poor beverages such as soft drinks increases the risk of being not only overweight (OR = 1.32) but also underweight (OR = 1.39). Regular monitoring and understanding of dietary patterns and weight status is crucial to inform, design, and implement strategies to reduce national and global diet and obesity-related diseases. Urgent actions need to be taken from public policymakers to stop and reverse the increasing trend of overweight (including obesity) among Serbian children.