Normal Weight Youth Research Articles

Health profiles of overweight and obese youth attending general practice

BackgroundLiterature suggests that overweight and obese young people use healthcare services more often, but this awaits confirmation in primary care.ObjectiveTo identify health profiles of underweight, overweight and obese young people...

Comparison of body mass index with abdominal obesity for identifying elevated blood pressure in children and adolescents: The SNEC study

Body mass index (BMI) and waist circumference (WC) are two common ways to measure obesity. There is a debate, however, about which of these two measures are more closely associated with elevated blood pressure (BP). The aim of this study is to investigate the prevalence of obesity and whether BMI and WC is better associated with elevated BP in children and adolescents. A representative sample of 8613 Chinese youth aged 7-17 years from seven cities in Northeastern China was selected and measurements of height, weight, WC, BP were taken from 2012 to 2013. The average age of the children was 11.3±2.3years. The prevalence of overweight/obese and abdominal obesity in the subjects was 35% and 44.8%, respectively. We found that both BMI and WC were significantly associated with elevated BP. An increase of 1kgm-2 in BMI was associated with a 1.10 (1.08-1.12, 95% CI) increased risk of an elevated BP diagnosis in boys, and a 1.14 (1.11-1.16, 95% CI) increased risk in girls. Meanwhile, a 1cm increase in WC correlated with a 1.03 (1.02-1.04, 95% CI) and a 1.05 (1.04-1.06, 95% CI) increased risk of higher BP in boys and girls, respectively. Compared to the normal-weight youth, subjects with elevated BMI (BMI>85th) had higher risk of elevated BP (OR: 2.42, 95% CI: 2.13-2.75) than that of in elevated WC participants (OR: 2.00, 95% CI: 1.77-2.27). Therefore, BMI may associate better with elevated BP than WC in Chinese youth in our Seven Northeastern Cities study.

Associations Between Type 2 Diabetes-Related Genetic Scores and Metabolic Traits, in Obese and Normal-Weight Youths.

Young-onset obesity is strongly associated with the early development of type 2 diabetes (T2D). Genetic risk scores (GRSs) related to T2D might help predicting the early impairment of glucose homeostasis in obese youths. Our objective was to investigate the contributions of four GRSs (associated with: T2D [GRS-T2D], beta-cell function [GRS-β], insulin resistance [GRS-IR], and body mass index) to the variation of traits derived from oral glucose tolerance test (OGTT) in obese and normal-weight children and young adults. This was a cross-sectional association study. A total of 1076 obese children/adolescents (age = 11.4 ± 2.8 years) and 1265 normal-weight young volunteers (age = 21.1 ± 4.4 years) of European ancestry were recruited from pediatric obesity clinics and general population, respectively. Standard OGTT was the intervention in this study. Associations between GRSs and OGTT-derived traits including fasting glucose and insulin, insulinogenic index, insulin sensitivity index, disposition index (DI) and associations between GRSs and pre-diabetic conditions were measured. GRS-β significantly associated with fasting glucose (β = 0.019; P = 3.5 × 10-4) and DI (β = -0.031; P = 8.9 × 10-4, last quartile 18% lower than first) in obese children, and nominally associated with fasting glucose (β = 0.009; P = 0.017) and DI (β = -0.030; P = 1.1 × 10-3, last quartile 11% lower than first) in normal-weight youths. GRS-T2D showed weaker contribution to fasting glucose and DI compared to GRS-β, in both obese and normal-weight youths. GRS associated with insulin resistance and GRS associated with body mass index did not associate with any traits. None of the GRSs associated with prediabetes, which affected only 4% of participants overall. Single nucleotide polymorphisms identified by genome-wide association studies to influence beta-cell function were associated with fasting glucose and indices of insulin secretion in youths, especially in obese children.

Physical Activity and Fitness of First Nations Youth in a Remote and Isolated Northern Ontario Community: A Needs Assessment.

Among a group of First Nations youth, this research aimed to obtain objective measures of anthropometry, physical activity (PA) and fitness; to identify any group-level differences by sex, body mass index, waist circumference and body fat categories; to assess the barriers and supports to PA. Youth participated in anthropometric measures (BMI, waist circumference, body fat percentage), PA assessment (3 days of accelerometry) and fitness testing (guided by the Canadian Physical Activity, Fitness and Lifestyle Approach). Barriers and supports were assessed via environmental scan and focus groups. Descriptive statistics were compared to reference data. Group differences by sex, BMI status, waist circumference and body fat categories were tested using Mann-Whitney U and Chi square tests (p ≤ 0.05). Qualitative data were assembled into one file and coded manually for categories and themes. Seventy-two youth (12.1 ± 1.1 years, 61.1% male) participated in at least one measure; 36 completed the accelerometry. Sixty-three percent were overweight or obese, 51% were abdominally obese and 21% had excess body fat. Most (86.1%) met Canada's PA guidelines. Boys were more active than girls (p = 0.025) and had greater cardiorespiratory endurance (p = 0.003). Overweight, obese, or abdominally obese youth had lower cardiorespiratory endurance than normal weight youth (p < 0.001). Barriers and supports fell under the main themes: motivation, role models, personnel and facilities, environment and programs. Based on this assessment, youth in this community are active, but not sufficiently physically fit, especially among those affected by obesity and abdominal obesity. The findings, in addition to the numerous barriers to PA, support the community's desire for school-based PA programming.

Weight–activity associations with cardiometabolic risk factors among U.S. youth

Research among adult populations suggests that underweight is associated with worse cardiometabolic health and that adequate engagement in moderate-to-vigorous physical activity (MVPA) may help to counteract the cardiometabolic consequences of overweight/obesity. Whether these findings are also true in children and adolescents (hereafter ‘youth’) is unknown. Therefore, the purpose of this study was to determine whether underweight and overweight/obese youth who engage in relatively more MVPA have better or similar cardiometabolic risk factors than normal weight youth who engage in relatively less MVPA. Data were extracted from the 2003–2006 National Health and Nutrition Examination Survey (N=2268). Four cardiometabolic risk factors assessed included C-reactive protein, mean arterial pressure, total cholesterol, and high-density lipoprotein (HDL) cholesterol. Weight status was assessed via dual energy X-ray absorptiometry. MVPA was assessed via accelerometry. Six weight–activity groups were created: 1) Underweight and Inactive; 2) Normal Weight and Inactive; 3) Overweight/Obese and Inactive; 4) Underweight and Active; 5) Normal Weight and Active; and, 6) Overweight/Obese and Active. An overall cardiometabolic risk score was calculated by summing the frequency with which each individual participant scored in the worst quartile for each of the 4 cardiometabolic parameters. Compared to those who were Normal Weight and Inactive, youth who were Underweight and Active (β=−0.05, p=0.78) had a similar overall cardiometabolic risk score. In contrast, Overweight/Obese and Active youth (β=1.1, p<0.001) had a higher overall cardiometabolic risk score when compared to Normal Weight and Inactive youth. These cross-sectional findings suggest that MVPA may not fully counteract the cardiometabolic consequences of overweight/obesity in youth. Rather, maintaining a normal weight may be of a more important factor related to cardiometabolic risk in youth.

Measurement Invariance Across Parent and Self-Ratings of Extremely Low Birth Weight Survivors and Normal Birth Weight Controls in Childhood and Adolescence on the Child Behavior Checklist and Youth Self-Report.

This study examined the measurement invariance of the Child Behavior Checklist (CBCL) and Youth Self-Report (YSR) DSM-oriented scales between extremely low birth weight (ELBW) and normal birth weight (NBW) youth. The sample included 158 ELBW survivors and 145 matched, NBW controls at 8 and 12-16 years of age. Strict invariance was established at 8 years for parent-reported CBCL attention-deficit hyperactivity, conduct, and oppositional defiant scales, though invariance could not be established for affective problems at 8 or 12-16 years. Strict invariance was observed between 12-16-year-old ELBW and NBW groups on attention-deficit hyperactivity, anxiety, and oppositional defiant CBCL and YSR scales. Invariance could not be established for youth-reported conduct problems. While the majority of CBCL/YSR DSM-oriented subscales assess the same concepts in both ELBW and NBW children and adolescents across parent and youth reports, this may not be the case for affective and conduct problems.

Plasma Nutrient Biomarkers are Associated with Waist‐to‐Height Ratio in Youth with Type 1 Diabetes: SEARCH for Diabetes in Youth Nutrition Ancillary Study

BackgroundPlasma nutrient biomarkers may be associated with waist‐to‐height ratio (WHtR) in youth with type 1 diabetes (T1D).Design1,416 youth aged 3‐20 years at diagnosis were included at baseline and 1,178 youth had a follow‐up visit after 23 (range 16‐40) months. Data on plasma phospholipid fatty acids, desaturase activities and vitamins were obtained at baseline. Multiple linear regression was used with adjustment for demographic and diabetes‐related confounders. Findings were stratified by weight status when significant (P&lt;0.05) effect modification was observed.ResultsIn cross‐sectional analysis, palmitic acid (P=0.001), dihomo‐γ‐linolenic acid (DGLA, P=0.003) and Δ6‐desaturase (D6D, P=0.0004) were positively; oleic acid (P=0.014), linoleic acid (LA, P=0.002) and vitamin D (VD, P&lt;0.0001) were negatively associated with WHtR. In normal weight youth, VD (P=0.003) was negatively associated with WHtR. In obese youth, DGLA (P&lt;0.0001) and D6D (P&lt;0.0001) were positively; Δ9‐desaturase‐18 activity (P=0.011) and VD (P&lt;0.0001) were negatively associated with WHtR. In longitudinal analysis, baseline LA (P=0.017), n‐6/n‐3 fatty acid ratio (P=0.017), VD (P=0.003) and vitamin E (P=0.0001) were negatively associated with WHtR at follow‐up only in obese youth.ConclusionsPlasma nutrient biomarkers are associated with WHtR in T1D youth, most commonly among those who are obese.

Estimated Average 24‐h Urine Sodium Excretion in US Children

In 2009–2010, US children aged 6–11 y and 12–19 y consumed an estimated average 2971 mg/d and 3563 mg/d of dietary sodium, respectively, which is above the 2010 Dietary Guideline of 2300 mg/d. To our knowledge, no nationally representative published data exist on urine sodium excretion in youth 6–19 y. We measured sodium levels in 306 spot urine samples of children 6–19 y participating in NHANES 2010. Due to the lack of calibration equations for children, we estimated 24‐h urine sodium (24hUNa) excretion by use of equations validated for adults living in the United States. Mean (SEM) estimated 24hUNa excretion was 2635 (127) mg/d and 2952 (72) mg/d for 6–11 y and 12–19 y old children, respectively. Estimated 24hUNa excretion was significantly higher among boys, 12–19 y olds, and overweight or obese youth, but did not vary by race‐ethnicity. The directions of the patterns in mean 24hUNa excretion by demographic group were the same as mean dietary sodium intake (based on one 24‐h recall). Spearman correlation between 24hUNa excretion and dietary sodium intake was weak (r=0.26, P=0.0001). Mean estimated 24hUNa excretion was &gt;20% lower than mean dietary sodium intake among normal weight youth, non‐Hispanic white youth, 12–19 y olds, and girls. These differences may be a result of problems with the calibration equation or of misreported dietary intake. These 24hUNa excretion estimates from spot urine samples are consistent with dietary data and suggest that on average, US children consume too much sodium in relation to recommendations

Plasma Nutrient Biomarkers Are Associated with Waist-to-Height Ratio in Youth with Type 1 Diabetes1–4

Plasma fatty acids (FAs) and micronutrients have been associated with central obesity in adults; however, previous studies of these associations in adults have yielded mixed results. In addition, no comparable research has been conducted among youth with type 1 diabetes (T1D). We investigated the cross-sectional and longitudinal associations between plasma nutrient biomarkers and waist-to-height ratio (WHtR) in youth with T1D. These analyses included 1324 youth aged 3-20 y at T1D diagnosis with a baseline visit in the SEARCH (Search for Diabetes in Youth) Study and a subset of 1178 of these youth with a follow-up visit an average of 23 mo (range: 16-40 mo) after their baseline visit. Plasma phospholipid FAs and vitamins were measured, and estimated desaturase activities were calculated at baseline. Anthropometric measurements and diabetes-related assessments were collected at each visit. Multiple linear regression was used to examine the association between plasma nutrient biomarkers and WHtR. In cross-sectional analysis, plasma palmitic acid (P = 0.004), dihomo-γ-linolenic acid (DGLA; P = 0.017) and Δ6 desaturase (D6D; P = 0.006) were positively correlated with WHtR after adjustment of confounders. Oleic acid (OA; P = 0.002), linoleic acid (LA; P = 0.015), Δ9 desaturase 18 (D9D-18; P = 0.027), and vitamin D (P < 0.0001) were negatively correlated with WHtR after adjustment. Weight status was an effect modifier (P < 0.05). In normal-weight youth, vitamin D (P = 0.003) was negatively associated with WHtR. In obese youth, stearic acid (P = 0.037), DGLA (P < 0.0001), and D6D (P < 0.0001) were positively associated and OA (P = 0.0008), D9D-18 (P = 0.0006), and vitamin D (P < 0.0001) were negatively associated with WHtR. In longitudinal analysis, baseline linoleic acid (P = 0.018), n-6:n-3 (ω-3:ω-6) FA ratio (P = 0.029), vitamin D (P = 0.003), and vitamin E (P < 0.0001) were negatively correlated with WHtR at follow-up only in obese participants. In T1D youth, plasma FAs and vitamins are associated with WHtR and are modified by weight status. These associations are particularly marked in obese youth.

Perceived health status and cardiometabolic risk among a sample of youth in Mexico.

To examine differences in self-reported perceived mental and physical health status, as well as known cardiometabolic risk factors in a sample of normal weight, overweight, and obese Mexican youths. Cross-sectional analysis of 164 youths aged 11-18 years recruited in Cuernavaca, Mexico. Participants completed a self-administered questionnaire that included measures of generic and weight-specific quality of life, perceived health, physical function, depressive symptoms, and body shape satisfaction. Height, weight, and waist circumference were measured, and body mass index (BMI) was determined. Fasting blood samples from participants yielded levels of glucose, triglycerides, and cholesterol (total, HDL, and LDL). Nearly 50 % of participants were female, 21 % had a normal BMI, 39 % were overweight, and 40 % were obese. Obese youths reported significantly lower measures of perceived health status (PHS) and showed an increase in cardiometabolic risk, compared with normal weight youths. Physical functioning, generic and weight-specific QoL were inversely associated with BMI, waist circumference, and glucose. Depressive symptoms were positively correlated with BMI, waist circumference, glucose levels, and HDL cholesterol. No correlation was found between PHS and cardiometabolic risk measures after controlling for BMI. In this sample of Mexican youths, obesity was associated with a significantly lower PHS and increased cardiometabolic risk.

Delayed skeletal muscle mitochondrial ADP recovery in youth with type 1 diabetes relates to muscle insulin resistance.

Insulin resistance (IR) increases cardiovascular morbidity and is associated with mitochondrial dysfunction. IR is now recognized to be present in type 1 diabetes; however, its relationship with mitochondrial function is unknown. We determined the relationship between IR and muscle mitochondrial function in type 1 diabetes using the hyperinsulinemic-euglycemic clamp and 31P-MRS before, during, and after near-maximal isometric calf exercise. Volunteers included 21 nonobese adolescents with type 1 diabetes and 17 nondiabetic control subjects with similar age, sex, BMI, Tanner stage, and activity levels. We found that youths with type 1 diabetes were more insulin resistant (median glucose infusion rate 10.1 vs. 18.9 mg/kglean/min; P < 0.0001) and had a longer time constant of the curve of ADP conversion to ATP (23.4 ± 5.3 vs. 18.8 ± 3.9 s, P < 0.001) and a lower rate of oxidative phosphorylation (median 0.09 vs. 0.21 mmol/L/s, P < 0.001). The ADP time constant (β = −0.36, P = 0.026) and oxidative phosphorylation (β = 0.02, P < 0.038) were related to IR but not HbA1c. Normal-weight youths with type 1 diabetes demonstrated slowed postexercise ATP resynthesis and were more insulin resistant than control subjects. The correlation between skeletal muscle mitochondrial dysfunction in type 1 diabetes and IR suggests a relationship between mitochondrial dysfunction and IR in type 1 diabetes.

Are overweight and obese youths more often bullied by their peers? A meta-analysis on the correlation between weight status and bullying.

Research suggests that overweight and obese youths are stigmatized in contemporary society, and are more likely than normal-weight youths to become the victims of bullying. In the current study, meta-analyses were performed to analyze to what extent overweight and obese youths are more likely than normal-weight youths to be the victims of bullying. The databases Psychinfo, ERIC and Medline were searched for relevant articles. Retrieved articles were scanned to find further articles. Language was not used as an exclusion criterion. A total of 14 articles (N=55 231) were included in a meta-analysis on bullying and overweight youths, and a total of 16 articles (N=58 520) were included in a meta-analysis on bullying and obese youths. The results suggested that both overweight and obese youths were more likely to be victims of bullying. The results were not moderated by gender, overweight and obese boys and girls were equally likely to be victimized. Results remained significant after adjustment for publication bias. Both overweight and obesity are risk factors for being a victim of bullying.

The Role of Poverty Status and Obesity on School Attendance in the United States

PurposeSeveral studies have shown that obesity influences school performance. Little is known about the joint effect of poverty and obesity associated with school attendance. MethodsData are from the National Survey of Children's Health (N = 93,151), a nationally representative sample of U.S. youth aged 10–17 years. Our dependent variable was ≥11 days of school days missed per year. Body mass index was classified as normal, overweight, and obese using age- and sex-specific criteria. Federal poverty level (FPL) was classified as <200%, 200%–399%, and ≥400% (high income). Covariates included gender, age, child's race or ethnicity, maternal physical and mental health, child's health, family composition, and household tobacco use. Logistic regression models and prevalence ratios were estimated, accounting for the complex survey design. ResultsThe odds of missing ≥11 days of school among overweight youth was 1.5 times that of normal-weight youth (95% confidence interval (CI) = 1.22–1.85) and 1.7 (95% CI = 1.35–2.13) times among obese youth in fully adjusted models. In joint effects models, the probability of missing school was significantly greater for obese youth in both the <200% FPL group (prevalence ratio = 1.78, CI = 1.36–2.34) and the ≥400% FPL group (prevalence ratio = 2.88, CI = 1.91–4.35), when compared with their normal-weight, higher income peers. Predicted probabilities revealed sharper gradients for higher income youth. ConclusionsObesity influences school absenteeism across all income categories. Nonetheless, there may be distinct reasons for missing school for lower and higher income youth, and the long-term consequences of school absences may also differ for these populations.

Lifetime Direct Medical Costs of Childhood Obesity

An estimate of the lifetime medical costs of an obese child provides a benchmark of the potential per capita savings that could accrue from successful childhood obesity prevention efforts. We reviewed the literature to identify the best current estimate of the incremental lifetime per capita medical cost of an obese child in the United States today relative to a normal weight child. We searched PubMed and Web of Science for US-based studies published within the 15 years preceding May 2013 from which lifetime medical cost estimates can be extracted or imputed. Two reviewers independently screened search results and extracted data from eligible articles. All estimates were inflated to 2012 dollars and discounted to reflect costs from the perspective of a 10-year-old child today. We identified 6 studies. The incremental lifetime direct medical cost from the perspective of a 10-year-old obese child relative to a 10-year-old normal weight child ranges from $12 660 to $19 630 when weight gain through adulthood among normal weight children is accounted for and from $16 310 to $39 080 when this adjustment is not made. We recommend use of an estimate of $19 000 as the incremental lifetime medical cost of an obese child relative to a normal weight child who maintains normal weight throughout adulthood. The alternative estimate, which considers the reality of eventual weight gain among normal weight youth, is $12 660. Additional research is needed to include estimates of indirect costs of childhood obesity.

The Impact of Overweight and Obesity on Pediatric Medical Expenditures

Published studies do not consistently find overweight and obesity to be associated with higher medical expenditures for US children. Previous analyses use varying samples and methods, making results difficult to compare. To examine whether methodological choices or temporal trends are driving differences in estimates of the association between weight and pediatric medical expenditures. We analyzed the medical expenditures and use of 6- to 17-year-old individuals in the 2006-2010 US Medical Expenditure Panel Surveys. The impact of overweight and obesity on annual medical expenditures and use was assessed, controlling for age, income, race, sex, geographic region, urban/rural residency, insurance status, and survey year. A two-part regression model, in which part one estimated the likelihood of incurring any expenditure and part two estimated non-zero expenditures, was used to predict total expenditures. Expenditures were inflated to 2012 dollars using the medical care component of the Consumer Price Index. Poisson and logistic regression models were used to predict differences in healthcare use between normal weight, overweight, and obese youth. We found that overweight and obese youth have higher, but not significantly higher medical expenditures than normal weight youth. Conclusions were robust to various methodological assumptions. We found that obese adolescents have a higher use of prescriptions drugs and healthcare visits compared with normal weight youth (0.04-1.3 visits), but differences in use only translated into marginally higher expenditures. These findings may reflect new trends in healthcare use among obese youth. Future research should assess whether services are being underused by obese youth and the impact of persistent obesity on long-term medical expenditures.

Diagnostic Performance of BMI Percentiles to Identify Adolescents With Metabolic Syndrome

To compare the diagnostic performance of the Centers for Disease Control and Prevention (CDC) and FITNESSGRAM (FGram) BMI standards for quantifying metabolic risk in youth. Adolescents in the NHANES (n = 3385) were measured for anthropometric variables and metabolic risk factors. BMI percentiles were calculated, and youth were categorized by weight status (using CDC and FGram thresholds). Participants were also categorized by presence or absence of metabolic syndrome. The CDC and FGram standards were compared by prevalence of metabolic abnormalities, various diagnostic criteria, and odds of metabolic syndrome. Receiver operating characteristic curves were also created to identify optimal BMI percentiles to detect metabolic syndrome. The prevalence of metabolic syndrome in obese youth was 19% to 35%, compared with <2% in the normal-weight groups. The odds of metabolic syndrome for obese boys and girls were 46 to 67 and 19 to 22 times greater, respectively, than for normal-weight youth. The receiver operating characteristic analyses identified optimal thresholds similar to the CDC standards for boys and the FGram standards for girls. Overall, BMI thresholds were more strongly associated with metabolic syndrome in boys than in girls. Both the CDC and FGram standards are predictive of metabolic syndrome. The diagnostic utility of the CDC thresholds outperformed the FGram values for boys, whereas FGram standards were slightly better thresholds for girls. The use of a common set of thresholds for school and clinical applications would provide advantages for public health and clinical research and practice.

High Blood Pressure in Overweight and Obese Youth: Implications for Screening

In the absence of evidence‐based guidelines for high blood pressure screening in asymptomatic youth, a reasonable strategy is to screen those who are at high risk. The present study aimed to identify optimal body mass index (BMI) thresholds as a marker for high‐risk youth to predict hypertension prevalence. In a cross‐sectional study, youth aged 6 to 17 years (n=237,248) enrolled in an integrated prepaid health plan in 2007 to 2009 were classified according to their BMI and hypertension status. In moderately and extremely obese youth, the prevalence of hypertension was 3.8% and 9.2%, respectively, compared with 0.9% in normal weight youth. The adjusted prevalence ratios (95% confidence intervals) of hypertension for normal weight, overweight, moderate obesity, and extreme obesity were 1.00 (Reference), 2.27 (2.08–2.47), 4.43 (4.10–4.79), and 10.76 (9.99–11.59), respectively. The prevalence of hypertension was best predicted by a BMI‐for‐age ≥94th percentile. These results suggest that all obese youth should be screened for hypertension.

Increased asthma risk and asthma-related health care complications associated with childhood obesity.

Asthma is the most common chronic condition of childhood, yet the relationship between obesity and asthma risk and the impact of obesity on clinical asthma outcomes are not well understood. For this population-based, longitudinal study, demographic and clinical data were extracted from administrative and electronic health records of 623,358 patients aged 6-19 years who were enrolled in the Kaiser Permanente Southern California health plan in 2007-2011. Crude asthma incidence ranged from 16.9 per 1,000 person-years among normal-weight youth to 22.3 per 1,000 person-years among extremely obese youth. The adjusted risks of asthma for overweight, moderately obese, and extremely obese youth relative to those of normal weight youth were 1.16 (95% confidence interval: 1.13, 1.20), 1.23 (95% confidence interval: 1.19, 1.28), and 1.37 (95% confidence interval: 1.32, 1.42), respectively (Ptrend < 0.0001). The relationship between obesity and asthma risk was strongest in Asian/Pacific Islanders and in the youngest girls (aged 6-10 years), compared with other groups. Among youth who developed asthma, those who were moderately or extremely obese had more frequent asthma exacerbations requiring emergency department services and/or treatment with oral corticosteroids. In conclusion, obese youth are not only more likely to develop asthma, but they may be more likely to have severe asthma, resulting in a greater need for health care utilization and aggressive asthma treatment.

Do depression, self-esteem, body-esteem, and eating attitudes vary by BMI among African American adolescents?

To examine how psychosocial factors vary by body weight and gender among African-American adolescents. A community sample of 235 low-income, predominantly African-American adolescents completed measures of depression, self-esteem, body-esteem, and eating attitudes. Measured weight and height were converted to body mass index (kg/m(2)) age and gender-adjusted z-scores. Data were analyzed using 2-factor multivariate analysis of variance. Obese youths had significantly worse scores on all psychosocial domains than normal weight youths, with no differences between overweight and normal weight youths. Obese youths had significantly worse scores than overweight youths on body-esteem and self-esteem. Female adolescents had significantly worse scores than males on depressed mood, body-esteem, and eating attitudes. Among a community sample of predominantly African-American adolescents, obesity, not overweight, was associated with poor psychosocial health. Findings suggest that overweight may be perceived as normative, and that weight-related programs consider adolescents' psychosocial functioning.

Nutritional status and its association with physical fitness, physical activity and parasitological indicators in youths from rural mozambique

Little information exists about the relationship of nutritional status and motor performance conditional on asymptomatic parasitemia in rural African children. The aims of this study were to (1) determine if malnourished youths from rural African areas have lower levels of physical fitness (PF) and physical activity (PA) compared to normal weight youths, (2) verify the biological relevance of anthropometric criteria used to classify nutritional status in youth, and (3) determine the prevalence of parasitological indicators, and its association with nutritional status and PF. The sample comprised 794 youths (6-17 years) from Calanga, a rural community in Mozambique. PF tests were selected from standardized test batteries, and PA was estimated by accelerometry. Nutritional status was defined according to WHO recommendations for stunting, wasting and normal weight. Parasitological indicators were determined based on stool specimens' analysis. In general terms the normal group out-performed the other nutritional groups (stunted and wasted) for PF. However, no significant differences were found for PA among nutritional groups. There were also no significant differences in prevalence of intestinal parasites. Nutritional status was not associated with PA levels or the prevalence of parasitological indicators in youth, but was related to physical performance.