Body Mass Index Percentile For Age Research Articles

Effects of Food Plate Size and Color on Visual Perception of Satiety in Adolescents; a New Strategy toward Weight Management.

Adolescence obesity and its health consequent on adulthood is affected by various environmental factors. Recently, dishware size or color is considered as a probable critical point to manage intake and weight. We investigated visual perception effects of plate size and color on fullness sensation regarding the Body Mass Index (BMI) for age percentiles in Tehran, Iran in 2019. A cross sectional study conducted on 408 students aged 13-18 year from both sexes with different socioeconomic status through convenience sampling method. Anthropometric characteristics were measured to determine BMI for Age categories based on the WHO protocol. Visual analog scale (VAS) was used to assess participants' perceived satiety when faced to images of different plate's size and color with the same food volume. SPSS 21 was used to statistical analyze. 41.2% of student were on >85th percentile of BMI for age. Mean of score of VAS for medium red plate was significantly lower than medium and large white plates in both sexes (P<0.001), while mean of score of VAS for small white plate was significantly lower than large white plates only in girls (P<0.001). The adolescents who were on >85th percentile of BMI for age, gave higher score to large white plate than medium white plate and to medium white plate than medium red plate, significantly (P<0.001), while the scores given by the adolescent on 5th percentile of BMI, were not significant. Considering dramatic trend of obesity in adolescents in Iran, there is an urgent need to make supportive policies. Manipulating food containers seems to be an effective and simple approach to control feeling satiety. It may be a cost-effective approach to prevent obesity in adolescents before progressing to adulthood.

Association of High Normal Body Weight in Youths With Risk of Hypertension

Ample evidence links obesity to hypertension in youths. However, the association of high normal body mass index (BMI) with obesity and the interaction with different weight trajectories are not well understood. To examine the hypertension risk associated with high normal BMI for age and different weight trajectories in youths. This retrospective cohort study assessed 801 019 youths aged 3 to 17 years in an integrated health care system in Southern California from January 1, 2008, to February 28, 2015, with a maximum follow-up of 5 years from January 1, 2008, to February 28, 2020. Data analysis was performed from 2018 to 2022. Youths were compared by first available (baseline) sex-specific BMI for age and change in the distance to the median BMI for age during the 5-year follow-up. Cox proportional hazards regression models with age as a time scale to assess hypertension risk (based on 2017 Blood Pressure Guidelines by the American Academy of Pediatrics from 3 consecutive independent visits), adjusted for sex, race and ethnicity, socioeconomic status, baseline year, and birth year. A total of 801 019 youths (mean [SD] age, 9.4 [4.6] years; 409 167 [51.1%] female]; 59 399 [7.4%] Asian and Pacific Islanders, 65 712 [8.2%] Black, and 427 492 [53.4%] Hispanic) were studied. Compared with youths with a baseline BMI for age in the 40th to 59th percentiles, the adjusted hazard ratio (aHR) for hypertension within a maximum of 5 years was 1.26 (95% CI, 1.20-1.33) for youths between the 60th and 84th percentiles if they maintained their BMI for age. With every 1-unit annual increase in the distance to the median BMI for age, the aHR increased by 1.04 (95% CI, 1.04-1.05). The aHR was 4.94 (95% CI, 4.72-5.18) in youths with a baseline BMI for age in the 97th percentile or higher who maintained their body weight. Weight gain increased the risk associated with baseline BMI for age in the 97th percentile or higher with an aHR of 1.04 (95% CI, 1.04-1.05) per 1-unit annual increase in the distance to the median BMI for age. The risk associated with weight change was higher in youths living with low to high normal weight and overweight than in youths living with severe obesity. In this cohort study of youths, high normal body weight above the 60th percentile of BMI for age was associated with increased risk of hypertension. Weight gain was associated with further increases in hypertension risk. Further research is needed to evaluate the wide range of body weight considered normal in youths and the health risks associated with high normal weight.

Acute asthma management with IV magnesium in obese, overweight and non-overweight inner-city children

Objective IV Magnesium (IV Mg) is increasingly used as adjunctive therapy for asthma exacerbations. In obese patients, delays in recognition of asthma severity may lead to delays in IV Mg administration. Our objective was to examine whether timing of IV Mg administration varied by Body Mass Index (BMI) category and whether this relates to hospitalization course. Methods This is a retrospective chart review of IV Mg use for asthma in children 2–17 years of age hospitalized in an urban children’s hospital. Weight status was categorized by BMI percentile for age. The primary outcome was time to IV Mg administration. Secondary outcomes included admission to the intensive care unit, time to discharge readiness and Length of Stay (LOS). Continuous variables were analyzed using Student’s t-test or Mann-Whitney test, categorical variables with Chi-Square test or Fisher’s exact test, as appropriate. A linear regression model examined factors related to time to IV Mg administration. Results In 2017, 361/698 (52%) of patients admitted with acute asthma received IV Mg. Of these, 210 patients met study criteria. Except for age, baseline characteristics did not vary by BMI category. No differences were found in Time to IV Mg, rates of admission to the intensive care unit, time to discharge readiness, or LOS comparing non-overweight to overweight or obese patients. Conclusions In this sample of inner-city children who received IV Mg there were no differences in timing of IV Mg based on BMI category. Further work is needed to examine whether standardizing timing of IV Mg improves care.

Determining the impact of body mass index on ultrasound accuracy for diagnosing appendicitis: Is it less useful in obese children?

BackgroundUltrasonography (US) is the preferred imaging for suspected pediatric appendicitis. We hypothesize that children with elevated Body-Mass-Index-for-age percentile (BMIP) may be more likely to have an inaccurate or equivocal (IE) US. MethodsAfter IRB approval, a four-year review was performed on pediatric patients evaluated for appendicitis by US. The CDC BMIP Calculator was used. IE subgroups were analyzed together for comparison against the accurate group. Results1059 patients were included: median age 11.3 years (IQR: 8.2, 14.6), 506 (47.8%) males. Median BMIP was 65.9 (IQR: 33.9, 89.6). US accurately diagnosed 857 (80.9%), incorrectly diagnosed 76 (7.2%), 126 (11.9%) were equivocal. Overall sensitivity was 0.85, specificity 0.96, PPV 0.93 and NPV 0.91. Obese children (BMIP ≥95%), had higher odds of IE US (OR: 1.86, 95% CI: 1.28, 2.70; p = 0.001). When analyzed by sex, risk increased in obese males (OR: 2.55, 95% CI:1.53, 4.24; p = 0.0003) but normalized in obese females (OR: 1.30, 95% CI:0.74, 2.28; p = 0.35). ConclusionsAn elevated BMIP may increase difficulty in visualizing the appendix, resulting in inaccurate or equivocal findings. This risk is seen specifically in obese males. If US findings do not correlate with clinical assessment in obese children with abdominal pain, further evaluation may be warranted.

Relationship between renal dimensions using ultrasonography and body mass index in apparently healthy school children in Port Harcourt, Nigeria

Background: Renal size is an important parameter in evaluation and management of a child with kidney disease. Establishing the normal limits of renal sizes standardized against somatometric parameters will be a useful tool in detecting probable renal diseases in children. Aim: To determine renal sizes in relation to body mass index (BMI) in apparently healthy primary school children in Port Harcourt. Materials and Methods: This was a cross-sectional and multi-staged study involving 450 children aged 6-12 years. Renal ultrasonography was carried out using a portable DP 1100 PLUS real time ultrasound machine fitted with 3.5MHz probe. The length, width and anteroposterior diameter of the kidneys were measured, and renal volume calculated. The BMI percentile for age and sex were obtained. The renal sizes were correlated with somatometric parameters and regression equations derived. Results: The mean renal length and volume percentiles increased from 77.7 ± 5.6 and 49.2 ± 13.7 at 6years to 85.9 ± 5.9 and 60.4 ± 18.4 at 12years respectively. There were no significant differences in the length and volume between the right and left kidneys, and dimensions of the kidneys were not statistically different in males and females. There was a significant positive correlation between BMI and renal dimensions. The renal length and volume increased at a rate of 1.372mm and 1.951cm3 per year and at a rate of 0.067mm and 0.176cm3 per one percentile increase in BMI respectively. The regression model derived for predicting renal length in mm =65.731 + (1.372 Age X) + (0.067 BMI percentile X) while that for renal volume in cm3 =26.386 + (1.951 Age X) + (0.176 BMI percentile X), (Where X is the independent variables: age in years and BMI in percentile). Conclusion: BMI has a significant positive linear relationship with renal dimensions. This study has provided prediction models for deriving renal length and volume from subject's BMI and age.

Assessment of Nutritional Status and Malnutrition Risk at Diagnosis and Over a 6-Month Treatment Period in Pediatric Oncology Patients With Hematologic Malignancies and Solid Tumors.

In total, 74 pediatric oncology patients with hematologic malignancies (n=56) or solid tumors (n=18) and a median age of 78.5 months were included in this prospective study. The aims were to assess malnutrition risks and nutritional status over a 6-month treatment period measured at regular intervals. The rate of patients with high risk for malnutrition at diagnosis was 28.4% by Screening Tool for Risk of Impaired Nutritional Status and Growth tool and 36.5% by Pediatric Yorkhill Malnutrition Score. Body mass index (BMI) z-scores at diagnosis showed 12.3% undernutrition (<-2 SD) and 6.8% overnutrition (>2 SD), which changed to 6.7% and 11.1% at the sixth month, respectively. Malnutrition (BMI<5th age percentile) was detected in 13.7% at diagnosis. Despite an initial deterioration noted in BMI, BMI for age percentile, and z-scores at month 1 in all malignancy subgroups (at month 3 for acute lymphoblastic leukemia), the scores improved later on. There was an increase in weight from baseline in 88.2% of patients over 6 months. This study revealed a decrease in the prevalence of undernutrition and malnutrition over a 6-month treatment period with improved anthropometrics despite an initial deterioration in all malignancy subgroups and even in patients with high risk for malnutrition at baseline screening. Solid tumors and acute lymphoblastic leukemia seem to be associated with higher likelihood of undernutrition and overnutrition, respectively, during treatment.

Weight-based victimization, eating behaviors, and weight-related health in Sexual and Gender Minority Adolescents

Weight-based victimization (WBV) is a common form of bullying associated with maladaptive eating, and poor weight-related health. Although sexual and gender minority (SGM) youth experience a number of eating and weight-related health disparities, the link between WBV and these outcomes has not been investigated in this vulnerable population. Data came from the LGBTQ Teen Study, a national survey of SGM adolescents. Participants provided data to assess body mass index (BMI), WBV, sexual identity, gender identity, dieting, binge eating, eating to cope with stress, weight control behaviors, exercise, and stress (N = 9679). The sample was 66% White, with a mean age of 15.6 years; 58.5% had healthy weight, and 37.2% had overweight or obesity. Over half of participants reported WBV from family members and peers. WBV from family members was associated with maladaptive eating (i.e., binge-eating, unhealthy weight-control behaviors), dieting, and poor weight-related health (i.e., stress, exercise avoidance, less physical activity and poorer sleep); relationships remained significant after accounting for participants’ age, BMI percentile for age and sex, race, gender identity, and sexual identity. Higher frequency of WBV at school, but not history of peer weight-based victimization, was associated with more maladaptive eating, dieting, and poorer weight-related health on all outcomes except physical activity. This is the first large-scale study that examined links between WBV, maladaptive eating behaviors, and weight-related health in SGM adolescents. These results suggest the need for increased awareness that WBV may play a role in maladaptive eating, and weight-related health of SGM youth, and may contribute to both elevated levels of eating disorders and obesity in this population.

How Does Obesity Impact Pediatric Anterior Cruciate Ligament Reconstruction?

To assess the relationship of elevated body mass index (BMI) on postoperative outcomes, including graft rupture, contralateral anterior cruciate ligament (ACL) tear, new meniscus injuries, isokinetic strength testing, and range of motion (ROM) in a large group of pediatric patients. We also sought to calculate the risk of graft rupture in overweight patients with small femoral or tibial tunnels. The secondary objective was to evaluate the association between BMI and concurrent meniscus tears and the need for meniscectomy at the time of primary ACL reconstruction. We retrospectively reviewed all pediatric patients undergoing primary ACL reconstruction at our institution. BMI percentile for age was used to categorize children as having normal BMI or being overweight or obese per Centers for Disease Control and Prevention guidelines. Demographic data, intraoperative findings and techniques, postoperative complications (including graft rupture, contralateral ACL tear, and meniscus injuries), ROM, and isokinetic strength testing were recorded. Univariate analysis was followed by stepwise, logistic regression to control for confounders. Of the 1,056 patients included, 535 (50.7%) were male and 521 were (49.3%) female, with a mean age of 15.1 ± 2.4years. The average BMI was 23.1 ± 4.7. There were 675 (63.9%) children with normal BMI, 228 (21.6%) who were overweight, and 153 (14.5%) who were obese. In multivariate analysis, children with elevated BMI had a higher rate of concurrent meniscus tears compared with those with normal BMI (76.3% vs 70.2%; P= .02) and 1.6 times higher odds of requiring a meniscectomy (95% confidence interval, 1.2-2.2; P < .01). The 723 patients included in the analysis of postoperative complications had a mean follow-up duration of 26.2 ± 3.3months Postoperatively, BMI did not impact the rate of graft rupture, contralateral ACL injury, or new meniscus tears. There was no increased risk of graft failure in overweight children with smaller graft size (≤8mm). There was no clinically relevant difference in postoperative ROM or isokinetic strength testing. After ACL rupture, overweight and obese children sustained more overall meniscus tears and more irreparable meniscus tears than those with normal BMI. Graft size did not impact the risk of early graft failure in overweight patients. With an appropriate rehabilitation protocol, there was no increased risk of graft rupture, contralateral ACL injury, or new meniscus tear in early follow-up. Level III, retrospective comparative study.

Assessing Social Contagion in Body Mass Index, Overweight, and Obesity Using a Natural Experiment

Little is known about whether the substantial clustering of obesity and overweight within social and geographic networks results from causal pathways, such as social contagion and shared environments, or from self-selection. This study aimed to determine whether exposure to communities with higher rates of obesity increases the body mass index (BMI) of individuals, calculated as weight in kilograms divided by height in meters squared, and their risk of being overweight or obese, and whether social contagion, shared environments, or self-selection can account for identified differences. This natural experiment study used the routine assignment of military service members to installations as a source of exogenous variation in exposure to communities with higher vs lower rates of obesity. The study, which used data collected by the Military Teenagers' Environments, Exercise, and Nutrition Study, examined families from 38 military installations around the United States to determine if individuals had higher BMI and greater odds of overweight and obesity when assigned to installations in counties with higher rates of obesity. The study also examined if the relationship persisted after controlling for shared built environments. The participants included 1 parent and 1 child aged 12 or 13 years from 1519 families of Army-enlisted personnel. Data analysis was completed from November 2016 to October 2017. Adult obesity rate in the county where the assigned installation of the service member was located. Time at installation and location of residence (on-installation vs off-installation) were used to measure the degree of exposure. For parents, outcomes were BMI, overweight/obesity (BMI, ≥25) and obesity (BMI, ≥30). For children, outcomes were BMI z score, overweight/obesity (BMI percentile for age and sex, ≥85), and obesity (BMI percentile for age and sex, ≥95). These outcomes were based on self-reports for parents, self-reports and parent reports for all children, and anthropometric measurements for a subsample of children. Members of 1519 families participated, including 1314 adults (of whom 740, or 56%, were fathers) and 1111 children (of whom 576, or 52%, were boys); anthropometric measurements were performed on 458 children. The sample was 40% white, 22% black, 24% Hispanic, and 14% other races/ethnicities. A 1-percentage point higher county obesity rate was associated with a higher BMI (a difference of 0.08; 95% CI, 0.02-0.13) and greater odds of obesity (adjusted odds ratio [aOR], 1.05; 95% CI, 1.02-1.08) in parents, and a higher BMI z score (0.01; 95% CI, 0.003-0.02) and greater odds of overweight/obesity (aOR, 1.04; 95% CI, 1.01-1.06) in children. The evidence supported stronger associations among families with more time at installation and off-installation residence. Associations persisted even after controlling for shared built environments. Exposure to counties with higher rates of obesity was associated with higher BMI and higher odds of overweight and/or obesity in parents and children. There was no evidence to support self-selection or shared built environments as possible explanations, which suggests the presence of social contagion in obesity.

Parental Views of Promoting Fruit and Vegetable Intake Among Overweight Preschoolers and School-Aged Children

Given the importance of parental influence on children’s eating habits, we explored perceptions of parents of overweight (body mass index–for-age percentile ≥85%) preschoolers (3-5 years) and overweight school-aged children (6-12 years) regarding challenges in promoting fruit and vegetable intake and how they and other family members influence their overweight children’s dietary habits. Focus groups were conducted with 13 parents of overweight preschoolers and 14 parents of overweight school-aged children. Codes and themes were developed by inductive data analysis. Four common themes were identified: short shelf life of fresh fruits and vegetables prohibiting parents from purchasing, children’s taste changes in fruits and vegetables, parents having the primary influence on children’s dietary intake, and wanting fruits and vegetables “ready to go.” Parents of school-aged children were more concerned about their children’s weight, and extended family members negatively influenced children’s dietary intake compared with parents of preschoolers. Our findings provide valuable insight for nutrition/health educators when developing family-based interventions for weight management.

Growth in children with pulmonary arterial hypertension: a longitudinal retrospective multiregistry study

To enable adequate interpretation of growth measurements in the management of children with pulmonary arterial hypertension (PAH), we assessed growth and its associated determinants in children with PAH. We did a retrospective longitudinal study of height and body-mass index in reference to WHO growth standards by pooling data from four contemporary prospective registries of paediatric PAH representing 53 centres in 19 countries. The main outcome measures were median height for age and body-mass index for age percentiles and longitudinal deviation of height for age and body-mass index for age Z scores from WHO standards. 601 children were followed up for a median of 2·9 years (IQR 1·5-4·4). Baseline median height for age percentile was 26 (IQR 4-54) and baseline median body-mass index for age percentile was 41 (IQR 12-79). Mean height for age Z score was significantly lower than the reference (-0·81, 95% CI -0·93 to -0·69; p<0·0001), as was body-mass index for age Z score (-0·12, -0·25 to -0·01; p=0·047). Height for age Z score was particularly decreased in young patients (aged ≤5 years) with idiopathic or hereditary PAH and in all patients with PAH associated with congenital heart disease. Although Z scores increased in some patients and decreased in others, we detected no significant trend in height for age Z score (p=0·57) or body-mass index for age Z score (p=0·48) before taking account of covariates. Multivariable linear mixed effects modelling showed that age, cause of PAH, ex-prematurity, WHO functional class, trisomy 21, and time since diagnosis were associated with height for age Z score, whereas age, ethnicity, and trisomy 21 were associated with body-mass index for age Z score. A favourable WHO functional class course was independently associated with increases in height for age Z score. PAH is associated with impaired growth, especially in younger children and those with pulmonary arterial hypertension associated with congenital heart disease. The degree of impairment is independently associated with cause of PAH and comorbidities, but also with disease severity and duration. Because a favourable clinical course was associated with catch-up growth, height for age could serve as an additional and globally available clinical parameter to monitor patients' clinical condition. Actelion Pharmaceuticals.

Gradska buka i krvni pritisak stanovništva - sistematski pregled istraživanja u Beogradu

The Belgrade team for biological effects of noise, comprising experts in the fields of hygiene and cardiology, has carried out population studies in Belgrade on the sample of 2503 adults, 328 preschool children and 1113 schoolchildren to investigate the effects of urban noise on blood pressure. In the first phase of investigation acoustic measurements were performed on 115 streets of the central municipality "Stari grad" as a typical urban environment. Blood pressure measurements were performed using mercury sphygmomanometer in those subjects who did not have a diagnosed hypertension and were not under antihypertensive therapy. Among adults living in the streets with equivalent noise level (Leq) exceeding 45 dB (A) there was a significantly higher number of people with hypertension compared to areas with Leq ≤ 45 dB (A) (23.6% vs.17.5%). After statistical adjustments according to family history of hypertension, age, body mass index (BMI), smoking habits, physical activity and alcohol consumption among males, we found 58% increased odds for obtaining hypertension if they lived in noisy environments for more than 10 years (OR = 1.58; 95 CI = 1.03-2.42; p = 0.038). In females noise exposure and hypertension were not significantly related. In preschool children aged 3-7 and living in areas with night Leq &gt; 45 dB (A) and attending kindergartens in the streets with daytime Leq &gt; 60 dB (A) the prevalence of hypertensive values of blood pressure was higher compared to children from quiet streets (5,7 % vs. 1,5 %; p = 0,054). Systolic blood pressure was significantly higher (5 mmHg on average) in children from noisy streets and kindergartens compared to children from quiet environments (p &lt; 0,01). Multiple regression after adjustments according to age, sex, BMI percentile-forage , family history of hypertension, and socioeconomic status revealed a significant positive correlation between the exposure to urban noise and systolic blood pressure (p = 0,009). In schoolchildren aged 7-11 and attending schools in streets with public transport we found a higher systolic blood pressure (1.3 mmHg on average) compared to children from schools without public transport, after adjustments according to age, sex, BMI, family history of hypertension, living conditions and health related behavioral habits (p &lt; 0.05).

Childhood obesity and in-hospital asthma resource utilization.

To examine the relationship between pediatric obesity and inpatient length of stay (LOS), resource utilization, readmission rates, and total billed charges for in-hospital status asthmaticus. We conducted a cross-sectional study of patients 5 to 17 years old hospitalized with status asthmaticus to 1 free-standing children's hospital system over 12 months. Only hospitalized patients initially treated in the hospital's emergency department were included to ensure all therapies/charges were examined. Patients with complex chronic conditions, pneumonia, or lacking recorded body mass index (BMI) were excluded. The primary exposure was BMI percentile for age. The primary outcome was LOS (in hours). Secondary outcomes were 90-day readmission rate, billed charges, and resource utilization: number of albuterol treatments, chest radiographs, intravenous fluids, intravenous or intramuscular steroids, and intensive care unit admission. Bivariate, adjusted Poisson and logistic regression model analyses were performed. Five hundred eighteen patients met inclusion criteria. Most had a normal BMI (59.7%); 36.7% were overweight or obese. LOS, readmissions, and resource utilization outcomes were not associated with BMI category on bivariate analyses. After adjustment for demographic/clinical characteristics, LOS decreased by 2% for each decile increase in BMI percentile for age. BMI percentile for age was not associated with billed charges, readmissions, or other measures of resource utilization. Although BMI decile for age is inversely associated with LOS for in-hospital pediatric status asthmaticus, the effect likely is not clinically meaningful.

Association between obesity and eczema prevalence, severity and poorer health in US adolescents.

Identification of modifiable risk factors for the development of eczema is of major public health significance. This study aimed to determine the effects of obesity in adolescence on the prevalence, severity, and quality of life of patients with eczema. We used the 2007-2008 National Survey of Children's Health, including a nationally representative sample of 45,897 adolescents aged 10 to 17 years. Caregiver report of eczema, health status, height, weight, number of health conditions, use of health services, and sociodemographics were assessed. The prevalences of overweight (20.3% vs 15.4%) and obesity (16.8% vs 15.4%) were increased in adolescents with eczema compared with adolescents without eczema (Rao-Scott χ, P < 0.0001). A body mass index for-age-percentile (BMIP) of 50 to 94 (logistic regression, odds ratio [OR], 1.61 [95% confidence interval (CI), 1.32-1.97]) and greater than or equal to 95 (1.46 [1.15-1.86]) was associated with higher odds of eczema compared with 5% to 49%. Moderate to severe eczema was higher with BMIP of 50 to 94 (41.2%; OR, 2.46 [95% CI, 1.73-3.51]) and greater than or equal to 95 (45.7%; 2.95 [1.73-3.51]) compared with 5 to 49 (22.2%). There was a significant interaction between race/ethnicity and BMIP in multivariate regression models of eczema severity, such that BMIP remained significant in Hispanics (OR, 3.24 [95% CI, 1.56-6.71]), non-Hispanic whites (3.64 [1.93-6.84]), Asians (57.17 [4.02-813.10]), Pacific Islanders/Alaskan Natives (90,336.3 [11,963.80-682,111.0]), and multiracial/other (3.99 [1.23-12.98]) but not in non-Hispanic blacks (1.88 [0.91-3.91]) and American Indians (2.12 [0.11-42.33]). Obese adolescents with eczema had higher odds of having only good (OR, 2.67 [95% CI, 1.56-4.56]) or fair (2.60 [1.35-5.03]) health compared with excellent overall health, had higher number of chronic health conditions (34.6% vs 18.0% with ≥2 conditions; P ≤ 0.003), and used more health services than most children of the same age compared with nonobese children (31.2% vs 21.5%; P = 0.01). Obesity in adolescence is associated with increased eczema prevalence and severity, poorer overall health, and increased chronic health conditions and health care utilization.

Effects of KidQuest on body mass index, lean body mass and body fat percentage among children ages 11 to 14 years in Nebraska (808.14)

Objective: Promoting healthy eating and physical activity are key to the prevention of childhood obesity which continues to increase in the U.S. Our study examined the changes in body mass index (BMI), total lean body mass (LBM) and total body fat mass (FM)) in children ages 11 to 14 years after receiving a 6‐week nutrition and physical activity curriculum (KidQuest).Methods: KidQuest was implemented in after school programs in Nebraska. BMI, LBM, and FM were measured before and after the program in 42 children who had both parental and youth consents. Paired t‐test was used to assess the baseline and post intervention differences in the above measurements.Results: No significant differences in BMI were observed before and after the intervention. Based on BMI for age percentile, 10% of the children were overweight and 20% were obese at baseline. There were significant increases in LBM after the intervention (pre, 33.1kg, post, 42.0kg, P&lt;0.0001). Decreases in FM were also observed after the program (pre, 15.1kg, post, 13.8kg, P=0.13).Conclusions: Our observations for changes in LBM and possible FM need to be confirmed with a larger sample size.Grant Funding Source: USDA (AFRI) Grant No. 2011‐67002‐30202

Associations between the neighborhood and home environments and weight status in pre‐kindergarten children (390.6)

AIM: To determine if parent perceptions of the neighborhood environment, parenting style and household food purchasing patterns are associated with weight status in pre‐kindergarten children. METHODS: Parents of 114 pre‐kindergarten children, participants in the West Virginia Early Childhood Obesity Prevention Project, completed surveys to assess behavioral and environmental contributors to child weight. Neighborhood and home environments were assessed using the Twin Cities Walking Survey and the Family Food Environment Survey. Household food expenditures over the past 30 days, parent health status and that of the study child and household socio‐demographic characteristics were also reported. Children were weighed and height measured at a home visit or school screening by study staff. Linear regression was used to identify survey items significantly associated with child body mass index (BMI) percentile. RESULTS: Indicators of neighborhood cohesion, walkability and safety, percent of household food purchases made at stores not considered grocery stores, parent feeding style and history of overweight, and child birth weight accounted for about 50% of the variance in BMI percentile for age and gender. CONCLUSION: Characteristics of the neighborhood and home environments may be important contributors to weight status and should be considered in early childhood obesity prevention initiatives.Grant Funding Source: This project was supported by USDA AFRI grant #2011‐68001‐30049.

Abstract 2523: Anthropometric factors and insulin related biomarkers in adolescent girls: Results from the Dietary Intervention Study in Children (DISC).

Abstract Background: Higher adiposity during childhood has been reported to be associated with reduced breast cancer risk. We hypothesize that adiposity may play a role in later breast cancer development through its influence on the insulin pathway. Objectives: To prospectively examine associations between baseline childhood adiposity and longitudinal measures of serum insulin related biomarkers (IRBS) (insulin, C-peptide, glucose, homeostasis model assessment of insulin resistance [HOMA]) among girls in the DISC. Methods: The present study includes 270 of the 301 girls who participated in the DISC (median follow-up: 7 yrs). Among these girls, 224 girls had premenarcheal fasting blood samples and 203 girls had postmenarcheal fasting blood samples collected on at least one of four visits: baseline, years 3, 5 and last visit. Weight, height and waist circumference (WC) were measured at multiple visits. General and central adiposity were assessed as body mass index (BMI)-for-age percentile (BMIPCT) and WC, respectively. Adjusted geometric means of IRBS were calculated within quintiles of baseline BMIPCT and WC. Baseline BMIPCT and WC were also modeled as continuous variables to estimate their associations with longitudinal measures of IRBS, using multivariable linear mixed-effect models. All adjusted analyses included age, age2, treatment group, baseline height, and physical activity. Results: Premenarcheal girls in the lowest quintile of baseline BMIPCT had the lowest geometric mean of all four IRBS. Both pre- and post-menarcheal girls in the lowest quintile of baseline WC had the lowest geometric mean of insulin, C-peptide and HOMA. Results from continuous analyses of the associations between baseline BMIPCT/WC and IRBS are shown in Table 1. Conclusion: Results show higher BMIPCT in girls at baseline is associated with higher levels of IRBS premenarche, while higher WC is associated with higher IRBS both pre- and postmenarche. Table 1. Percent change in concentrations of IRBS based on baseline BMIPCT and WC in adolescent girl % Change (95% CI) per 10% increment in baseline BMIPCT ptrend bmipct % Change (95% CI) per 1cm increment in baseline waist circumference ptrend WC Pre-menarcheal Insulin (uU/mL) 3.9% (2.1%, 5.7%) &amp;lt;0.0001 2.6% (1.6%, 3.6%) &amp;lt;0.0001 C-peptide (pmol/L) 4.2% (1.4%, 7.1%) 0.003 3.1% (1.6%, 4.7%) 0.0001 Glucose (mg/dL) 0.5% (0.007%, 1.1%) 0.05 0.1% (-0.2%, 0.4%) 0.45 HOMA 4.4% (2.4%, 6.5%) &amp;lt;0.0001 2.8% (1.7%, 3.9%) &amp;lt;0.0001 Post-menarcheal Insulin (uU/mL) 1.8% (−0.5%, 4.2%) 0.12 2.0% (0.8%, 3.2%) 0.0009 C-peptide (pmol/L) 0.7% (−1.9%, 3.2%) 0.61 1.5% (0.1%, 2.8%) 0.03 Glucose (mg/dL) −0.1% (−0.5%, 0.3%) 0.55 0.02% (−0.2%, 0.2%) 0.82 HOMA 1.7% (−0.8%, 4.3%) 0.17 2.1% (0.8%, 3.4%) 0.0015 Citation Format: Zhenzhen Zhang, Jean M. Kerver, Joseph C. Gardiner, Joanne F. Dorgan, Ellen M. Velie. Anthropometric factors and insulin related biomarkers in adolescent girls: Results from the Dietary Intervention Study in Children (DISC). [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 2523. doi:10.1158/1538-7445.AM2013-2523 Note: This abstract was not presented at the AACR Annual Meeting 2013 because the presenter was unable to attend.

Diabetes, pre-diabetes and insulin resistance screening in Native American children and youth

Early identification of pre-diabetes and insulin resistance (IR) provides an important window of opportunity for diabetes prevention. Little is known about the prevalence of pre-diabetes and IR in Native American (NA) youth. We designed a cross-sectional, community-based study of NA children to estimate the prevalence of diabetes, pre-diabetes and IR and their association with other diabetes risk factors. NA children (5-18 years) were screened with body mass index (BMI), blood pressure, oral glucose tolerance test (OGTT), lipids, insulin and highly sensitive C-reactive protein (hsCRP), and calculated homeostatic model assessment of IR (HOMA-IR). Mean age of the cohort (n=201) was 10.8 ± 3.8 years (± s.d.; 94/107 M/F). BMI percentile for age and sex (BMI%) was elevated (≥ 85 th percentile) in 58.6% of 5-11 years and 51.1% of 12-18 years, and positively correlated with HOMA-IR, blood pressure, triglycerides and hsCRP (P<0.05). The prevalence rate for pre-diabetes and diabetes were 6.5% (3.5-10.8%) and 1.0% (0.1-3.6%), respectively. Mean HOMA-IR was greater in the older than younger age group while prevalence of pre-diabetes was the same. Those with pre-diabetes and diabetes had a greater HOMA-IR, abdominal circumference and BMI% than normal youth. In the first prospective, community-based screening for pre-diabetes, IR and diabetes in United States NA youth using OGTT, while the number of diabetes cases was low, pre-diabetes was found in a significant number of youth, particularly in those with BMI ≥ 95 th%. As proportions of pre-diabetes were similar in 5-11 and 12-18 year olds, diabetes risk begins early in NA youth.

Abstract B78: Adiposity and the IGF-axis in girls during pubertal development

Abstract Background: Increased childhood adiposity has been associated with decreased breast cancer risk, but the biologic mechanisms underlying this association are not well understood. Pubertal growth is in part driven by the insulin-like growth factor (IGF) system and adult measures of IGF have been associated with breast cancer. We hypothesize that childhood adiposity is associated with the IGF-axis and that levels set in childhood affect later breast cancer risk. We prospectively examine associations between childhood adiposity, as measured by body mass index (BMI)-for-age percentile (BMIPCT), and serum IGF-axis biomarkers (IGF-I, IGF binding protein 1(IGFBP-1), and IGF binding protein 3 (IGFBP-3)) among girls in the Dietary Intervention Study in Children (DISC). Methods: Data are from an ancillary hormone study of 268 of the 301 girls who participated in the DISC. Girls were 8-10 years old at baseline with a median follow-up of 7 years. Data from intervention and control groups were combined and intervention status was included in adjusted analyses. Fasting blood samples (n=563) collected at baseline, years 3, 5 and last visit were available for 219 premenarcheal and 201 postmenarcheal girls. Levels of IGF-I, IGFBP-1, and IGFBP-3 were determined using radioimmunoassays. Weight and height measurements were taken at baseline and subsequent visits by trained interviewers. BMI (weight/height2)–for-age percentiles were determined using the CDC growth chart. To mitigate skewness, biomarkers were log transformed. Adjusted geometric means of IGF biomarkers were calculated by quintiles of baseline BMIPCT. All adjusted analyses included age, age2, treatment group, baseline height, and physical activity. Associations of longitudinal BMIPCT with IGF biomarkers were estimated using multivariable linear mixed-effect models, accounting for repeated BMIPCT and IGF measurements within each girl across follow-up visits. Trend tests were performed on continuous BMIPCT using adjusted mixed-effect models to estimate percentage changes in IGF biomarkers during follow-up. Results: In adjusted analyses, premenarcheal girls in the lowest quintile of baseline BMIPCT had lower geometric mean IGF-I levels than all other quintiles (Q1= 236 ng/mL (95% confidence interval (CI): 211, 264) vs. Q5 mean=271 ng/ml (95% CI: 240, 307)). Girls in the lowest quintile of BMIPCT had higher IGFBP-1 levels that decreased linearly with BMIPCT quintile (Ptrend &amp;lt;0.0001). In continuous analyses, each 10 percentile increment in baseline BMIPCT was associated with a 2.4% increase (95% CI: 0.5%, 4.2%) in IGF-I (Ptrend=0.01) and a 7.2% decrease (95% CI: 4.9%, 9.6%) in IGFBP-1 (Ptrend&amp;lt;0.0001). There was no significant association between IGFBP-3 and BMIPCT. In post-menarcheal girls, each 10 percentile increment in baseline BMIPCT was associated with a 12.0% decrease (95% CI: 8.4 %,15.6%) in IGFBP-1 (Ptrend&amp;lt;0.0001), but no significant association with IGF-I or IGFBP-3. Conclusion: This study suggests that premenarcheal girls in the lowest quintile of BMI-for-age have lower IGF-I levels than in all other quintiles. Results also show increased adiposity, as measured by BMI-for-age, is significantly associated with decreased IGFBP-1 in both pre- and postmenarcheal girls. Further research is needed to confirm these findings, as well as to explore possible associations with breast development and potentially breast cancer risk. Citation Format: Ellen M. Velie, Zhenzhen Zhang, Jean M. Kerver, Joseph C. Gardiner, Clifford J. Rosen, Joanne F. Dorgan. Adiposity and the IGF-axis in girls during pubertal development. [abstract]. In: Proceedings of the Eleventh Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2012 Oct 16-19; Anaheim, CA. Philadelphia (PA): AACR; Cancer Prev Res 2012;5(11 Suppl):Abstract nr B78.

SNAP Participation in Preschool‐Aged Children and Prevalence of Overweight and Obesity

An increased prevalence of overweight and obesity for adults on government-funded nutrition assistance, such as the Supplemental Nutrition Assistance Program (SNAP), has been observed; however, this association among preschool-aged children is not well understood. Longitudinal research designs tracking changes in body mass index-for-age (BMI) in children of low-income households may provide a clearer picture of the association between SNAP participation and overweight and obesity among this age group. To determine if there is a relationship between SNAP participation and overweight and obesity prevalence in low-income, preschool children, we conducted a cross-sectional analysis of children in a Head Start program, and a longitudinal analysis of those children who were enrolled for 2 years. Height and weight data and SNAP participation of 386 students (207 male, 179 female, 4.2 ± 0.5 years) enrolled in a Head Start program were analyzed; data for 2 years were available for 167 of the students. Height and weight measures were used to determine BMI percentile per Centers for Disease Control and Prevention guidelines. SNAP participation was obtained through a nutritional questionnaire given to parents at time of Head Start Program enrollment. No significant differences were found between SNAP and non-SNAP participants for BMI percentile in either the cross-sectional or longitudinal analysis. BMI percentile increased for both groups over time, but failed to reach significance (p = .13). Future studies are warranted with an inclusion of a larger and more geographically diverse sample to further determine the association between SNAP participation and overweight and obesity in preschool-aged children.