Persistent Overweight Research Articles

Body mass index status and peripheral airway obstruction in school-age children: a population-based cohort study

BackgroundFew large prospective studies have investigated the impact of body mass index (BMI) on lung function during childhood.MethodsUsing data collected between 2002 and 2013, we analysed associations between BMI status...

Changes in Body Mass Index, Leptin, and Leptin Receptor Polymorphisms and Breast Cancer Risk.

Obesity is a strong risk factor for breast cancer. The polymorphisms of leptin (LEP) and leptin receptor (LEPR) may be associated with breast cancer by regulator of adipose tissue mass and tumor cell growth. A total of 794 cases and 805 matched controls were sequentially enrolled. Time-of-flight mass spectrometry was used to determine the LEPrs7799039, LEPRrs1137100, and LEPRrs1137101 genotypes for each participant. Associations between polymorphisms of these genes, change in body mass index (BMI), and breast cancer risk were assessed by unconditional multivariable logistic regression models. The unconditional logistic regression model showed that persistent overweight (BMI ≥24 kg/m2) over the preceding 10 years was associated with increased breast cancer risk in premenopausal women (odds ratio [OR] = 1.67, 95% confidence interval [CI]: 1.19-2.35). No associations between LEPrs7799039, LEPRrs1137100, or LEPRrs1137101 polymorphisms alone and breast cancer risk were found. Persistent overweight over the preceding 10 years and carrying the LEPrs7799039 AA genotype together increased breast cancer risk in premenopausal women (ORadj = 2.00, 95% CI: 1.26-3.16). Persistent overweight over the preceding 10 years and carrying the LEPRrs1137100 GG genotype increased breast cancer risk in premenopausal women (ORadj = 1.68, 95% CI: 1.06-2.68). In premenopausal women, persistent overweight (BMI ≥24 kg/m2) over the preceding 10 years increases breast cancer risk. Persistent overweight along with LEPrs7799039 AA or LEPRrs1137100 GG genotypes synergistically increase risk of breast cancer among premenopausal women.

Comprehensive determinants of growth trajectories and body composition in school children: A longitudinal cohort study

To fully explain the dynamic and comprehensive etiology of the trajectory associated with adiposity indices. This study involved data of 5572 children, aged 6-11 years, as part of the Taiwan Children Health Study (TCHS). The present study introduced four distinct BMI trajectories, identified previously among children: persistently healthy weight; late-onset overweight or obesity; persistent overweight or obesity; and declining BMI class. Logistic regression was used to examine the effect of non-modifiable factors on BMI trajectory classes. Generalized estimating equations were used to examine the effect of dynamically modifiable factors on either BMI trajectory classes or adiposity indices. Compared with class 1 (persistently healthy weight), class 2 exhibited a significantly increased risk of weight gain and fat mass, affected by lower family incomes and poor-quality sleep. Class 3 had a higher risk of persistent obesity and abdominal obesity, affected by higher birthweight and sedentary lifestyle. Class 4 approached a healthy weight due to increased physical activity, which was associated with a decrease in body fat and central obesity. We found crucially non-modifiable and modifiable factors that could describe each high BMI growth pattern, and calculated their modifiable contributions to adiposity indices. Modifiable factors that focus on those crucially dynamic factors are recommended for preventing obese growth trajectories.

Changes in body mass index during childhood and risk of various asthma phenotypes: a retrospective analysis.

It is known that asthma is related to obesity but also to small birthweight. The objective of this study was to clarify this issue by assessing the putative relationship between the changes in corpulence between birth and childhood as assessed by body mass index (BMI) and asthma phenotypes. The following status in corpulence was assessed in 7781 schoolchildren using quartile of BMI at birth and at around 10 (9-11 years): underweight at birth and at around 10, underweight at birth and overweight at around 10, overweight at birth and underweight at around 10, overweight at birth and at around 10, and the reference group constituted by all the other children in whom corpulence changes were not extreme. Determination of asthma phenotypes (allergic, non-allergic, and exercise-induced asthma) was based on a clinical examination including skin prick tests, an exercise challenge test, and a questionnaire. The risk of allergic asthma was higher in children with persistent underweight, children with persistent overweight, and children becoming markedly more corpulent. In boys, the risk of allergic asthma was significantly higher for the less corpulent children at birth, regardless of whether they remained so or become overweight. In girls, the risk of allergic asthma was significantly higher in those with persistent overweight. There were no significant associations between BMI changes and non-allergic and exercise-induced asthma. We observed that some extreme changes in BMI, persistent underweight, and persistent overweight in childhood increased the risk of allergic asthma.

Effects of early postnatal nutrition on adult-onset insulin resistance in Sprague-Dawley rats

Objective To explore the effects of early postnatal nutrition on adult-onset insulin resistance by an artificial nutrition intervention during the critical period. Methods On postnatal day 2, Sprague-Dawley rats were assigned randomly to overnutrition (SL), normonutrition (NL) and undernutrition (LL) via artificially adjusting the number of pups nursed per dam. Litter size was adjusted to 3 pups/dam, 10 pups/dam and 20 pups/dam for the SL, NL and LL groups, respectively. There were eight litters for each group. All the pups were nursed by their natural dams and fed with a standard rodent laboratory chow. The pups were weaned on postnatal day 21 and three male pups from each litter were separated. After that, all male rats were housed three per cage and fed standard chow until 16 weeks old. At 3 and 16 weeks, rats were killed after overnight fasting and blood was collected. Liver, gastrocnemius muscle and perirenal and epididymal fat pads were dissected and weighed to calculate relative mass after normalization for body weight. Physiological parameters, biochemical values and insulin resistance status, including serum insulin level, homeostasis model assessment for insulin resistance (HOMA-IR) index and intraperitoneal glucose tolerance test (IPGTT), were dynamically monitored. Analysis of variance was used for statistical analysis. Results (1) Before weaning, the body weights of SL rats were significantly heavier than NL rats after postnatal day 10, and weights of LL rats were significantly lower than NL rats after postnatal day 7. After weaning, body weights of SL rats still remained heavier and weights of LL rats continued to be lower than NL rats (P<0.05). (2) At 3 weeks, the weights of liver and perirenal and epididymal fat pads in SL rats were significantly heavier than NL rats, whereas LL rats were lower than NL rats (P<0.05). At 16 weeks, the weights of liver, epididymal fat pads and gastrocnemius muscle in SL rats were significantly heavier than NL rats. Meanwhile, the weights of all detected tissues in LL rats were lower than the NL group. The weights of epididymal fat pads after normalization for body weight in the SL group were heavier than the NL group (P<0.05). (3) At 3 weeks, the fasting serum glucose level of the SL group was significantly higher than the NL and LL groups [(7.77±1.10) vs (6.33±1.20) and (5.80±1.51) mmol/L, respectively, F=13.217, P<0.01]. At 16 weeks of age, the serum insulin level in SL rats significantly increased compared to NL and LL rats [(0.31±0.11) vs (0.16±0.08) and (0.14±0.11) ng/ml, respectively, F=5.369, P=0.017]. For HOMA-IR evaluation, the index was significantly lower in LL rats compared to NL and LL rats at 3 weeks of age [(0.09±0.01) vs (0.25±0.01) and (0.31±0.05), respectively, F=25.923, P=0.005]. At 16 weeks, the index was significantly elevated in SL rats compared to NL and LL rats [(1.77±0.53) vs (0.84±0.44) and (0.83±0.67), respectively, F=5.765, P=0.015]. Furthermore, IPGTT was performed in all groups at 14 weeks of age. SL rats had significantly higher serum glucose levels at 60 min and a significantly increased area under the curve when compared to NL and LL rats (all P<0.05). (4) Serum from 16 week old SL rats was found to contain significantly higher levels of albumin, triglycerides and free fatty acids compared to NL rats (all P<0.05). Conclusions Early postnatal overnutrition induces persistent overweight and visceral white adipose accumulation in rats, while early postnatal undernutrition show the opposite effects. Early postnatal overnutrition may lead to adult-onset insulin resistance in rats. Avoiding overnutrition during the early postnatal period, a critical window for growth and development, may prevent or decrease later metabolic risks. Key words: Nutritional status; Insulin resistance; Overnutrition; Rats, Sprague-Dawley

Effect of childhood adiposity on long-term risks of carotid atherosclerosis and arterial stiffness in adulthood

To observe the effect of childhood excessive adiposity on long-term risk of adult carotid atherosclerosis and arterial stiffness. At baseline, in 1987, by using stratified cluster sampling design, 3 198 healthy children aged 6-18 were recruited from six primary schools and six middle schools from three districts (Chaoyang, Xicheng, and Haidian) in Beijing, with blood pressure, weight, height and left scapular skinfold thickness (LSSF) measured. From April 2010 to July 2012, 1 225 subjects were followed from childhood to adulthood. Questionnaire, biochemistry parameters, carotid-femoral pulse wave velocity (cfPWV), and carotid intima media thickness (cIMT) were measured at follow-up. Based on weight statuses in childhood and adulthood, subjects were classified into four groups (persistent non-overweight from childhood to adulthood, overweight in childhood but non-overweight in adulthood, non-overweight in childhood but overweight in adulthood, persistent overweight from childhood to adulthood). Multiple logistic regression model was used to analyze the association between weight statuses changing from childhood to adulthood and adult high cfPWV and high cIMT. The prevalence of overweight (including obesity) at adulthood was 52.2% (639). Males had higher prevalence of smoking (62.5%(422/675) vs 29.4%(160/550), χ(2)=133.21, P<0.001), drinking (52.1%(353/675) vs 26.1%(140/550), χ(2)=87.13, P<0.001), overweight (including obesity) (69.3% (468/675) vs 31.1% (171/550), χ(2)=182.18, P< 0.001) than females. With adjusting for gender, age, and length of follow-up, the risk of high cfPWV and high cIMT increased by 26% and 58% for 1 units increase in BMI, and by 30% and 36% for 1 units increase in LSSF. Compared to subjects with persistent non-overweight from childhood to adulthood, subjects with overweight in childhood but non-overweight in adulthood had similar risks of high cfPWV (OR=1.59, 95%CI: 0.77-3.30)and high cIMT (OR=1.47, 95%CI:0.65-3.31). The risks of high cfPWV and high cIMT increased among subjects with non-overweight in childhood but overweight in adulthood (OR=1.92, 95%CI:1.37-2.68; OR=3.69, 95% CI:2.61- 5.23) and among subjects with persistent overweight from childhood to adulthood (OR=2.53, 95%CI:1.70-3.76; OR=5.37, 95%CI:3.62-7.97). We concluded that a overweight children changed to a healthy weight adult, the risks of adult subclinical atherosclerosis and arterial stiffness would not be increased.

Overweight patterns throughout childhood and cardiometabolic markers in early adolescence.

Risk of cardiovascular and metabolic disease is higher in adults who were relatively thin at birth and had subsequent accelerated weight gain. This specific pattern of weight gain may relate to unfavorable cardiometabolic markers already in childhood. We prospectively assessed whether children with different patterns of overweight development from age 3 months to 11 years had distinct levels of cardiometabolic markers at age 12 years. We used data of 1500 children participating in the PIAMA birth cohort that started in 1996/1997. Parents reported height and weight during 10 waves of follow-up from age 3 months to 11 years. Four distinct overweight development patterns were derived using longitudinal latent class analysis; 'never'; 'early transient'; 'gradually developing' and 'persistent' overweight. Cardiometabolic markers (total-to-high-density lipoprotein cholesterol (TC/HDLC) ratio, blood pressure (BP), glycated hemoglobin (HbA1c)) were assessed at age 12 years in 1500 children. Children who developed overweight gradually and children with persistent overweight throughout childhood, at age 12 years had a 2-3-fold higher risk of having high (>90th centile) TC/HDLC ratio, systolic and diastolic BP, compared with children who were never overweight. In children who gradually developed overweight, TC/HDLC ratio was 0.75 higher (95% confidence interval (CI) 0.54-0.96); systolic BP 4.90 mmHg higher (95% CI 2.45-7.36) and diastolic BP 1.78 mmHg higher (95% CI 0.07-3.49) than in children who never had overweight. Estimates for children with persistent overweight were similar. Children with gradually developing overweight, and those with persistent overweight had unfavorable cholesterol and blood pressure levels already at age 12 years, whereas children with early transient overweight avoided these unfavorable outcomes. Our results support the hypothesis that specific overweight patterns predispose to an adverse cardiometabolic profile, which is already apparent in early adolescence before progressing to adult cardiometabolic disease.

Predictors for Persistent Overweight, Deteriorated Weight Status, and Improved Weight Status During 18 Months in a School-Based Longitudinal Cohort.

To examine predictors for persistent overweight/obesity, deteriorated weight status, and improved weight status among students who participated in a school-based obesity prevention intervention from fall 2009 to spring 2011. Longitudinal assessment of a school-based cohort was conducted to determine the characteristics of students who remained overweight/obese, improved their weight status, or showed deteriorated weight status during an 18-month period. Eleven schools in southern Indiana, northwestern Kentucky, and southeastern Illinois. N = 5309 students in 4th through 12th grade. Weight, height, and self-reported physical activity and nutrition behaviors of students were measured at baseline and 6, 12, and 18 months. SAS 9.3 was employed to examine predictors for the three different weight categories using logistic regression. Low socioeconomic status (SES) (adjusted odds ratio [AOR] = 1.56 and p < .001, AOR = 1.35 and p = .0069, respectively) and higher soda intake (AOR = 1.07 and p = .0016, AOR = 1.08 and p = .0278, respectively) increased the odds of belonging to persistent overweight/obesity (30.6%) and deteriorated weight status (6.9%), compared to the persistent nonoverweight status group. While SES is an important determinant of weight category change, students' screen time and soda consumption may be important factors. Schools and families may be able to successfully focus on these modifiable risk factors, decreasing the burden of childhood obesity.

Overweight in Infancy: Which Pre- and Perinatal Factors Determine Overweight Persistence or Reduction A Birth Cohort Followed for 11 Years

Background: A considerable proportion of children with early-life overweight attain a normal weight. To recognize infants at risk of persistent overweight, we compared early-life factors of children with a longitudinal pattern of persistent overweight to children with a pattern of overweight in early but not in later childhood. Methods: In 3,550 children participating in a birth cohort that started in 1996/1997 in the Netherlands, body mass index was repeatedly assessed until age 11 and dichotomized into with/without overweight. Latent class growth modeling was used to distinguish trajectories. Our analysis was focused on the comparison of early-life factors in children in a persistent overweight pattern with those in an overweight reduction pattern using multivariable log-binomial regression analyses. Results: Children (n = 133) in the persistent overweight pattern were more likely to have overweight parents [relative risk (RR)_mother: 1.85, 95% CI: 1.37-2.49: RR_father: 1.75, 95% CI: 1.21-2.55] than children in the overweight reduction pattern (n = 303). Maternal education, child's gender, ethnicity, birth weight, breast-feeding and maternal smoking during pregnancy did not differ between the trajectories. Conclusion: Health care practitioners should focus on high-weight infants with overweight parents, as these children are less likely to resolve their overweight.

Abstract P103: Patterns of Childhood Obesity and Relation to Middle-Age Sleep Apnea Risk: The Bogalusa Heart Study

Background: Patients with obesity have high risk of obstructive sleep apnea (OSA); however, the relationship between childhood obesity and later OSA risk is unknown. Methods: We prospectively examined the association between changes in overweight/obesity status in childhood and subsequent OSA in 823 middle-aged adults free of cardiovascular diseases at baseline and who had at least 2 measures of body mass index (BMI) between 4 and 18 yrs old (1974-) and responded to the Berlin Questionnaire in 2010. Childhood overweight/obesity was defined as age and gender specific BMI ≥85 th percentile based on 2000 CDC Growth Charts. Four groups were generated based on change in obesity status from the earliest to most recent visit in childhood: persistent normal weight, incident overweight (from normal to overweight), weight loss (from overweight to normal), and persistent overweight. Based on Berlin Questionnaire, high-risk OSA was defined as any 2 of the following: obesity or hypertension, persistent snoring symptoms, and persistent daytime sleepiness. Persistent snoring was defined as snoring on ≥3 nights/week, snoring louder than talking or very loud, and breathing pauses on ≥3 nights/week; and persistent daytime sleepiness was defined as feeling tired ≥3 days/week after sleeping, feeling tired during time awake ≥3 days/week, and falling asleep while driving. Results: Mean age was 42 yrs and mean BMI was 31.0 kg/m 2 in adulthood. Of the total, 43% were male, and 34% were African-American. There were 604, 68, 39, and 112 persons in the persistent normal weight, incident overweight, weight loss, and persistent overweight groups, respectively. Median time between measures of BMI in childhood was 5 yrs (IQR: 5 yrs) across the 4 groups. Over an average of 35 years follow-up from childhood to adulthood (IQR: 1 yr), 326 (38%) participants had high-risk of OSA. In multivariate log-linear regression models, compared to participants in persistent normal weight group, those in persistent overweight, incident overweight, and weight loss groups had 1.80 (95% CI: 1.48, 2.19), 1.61 (1.22, 2.12), and 1.28 (0.89, 1.87) times higher risk of OSA, after adjustment for age, gender, race, educational level, leisure-time physical activity, regular drinking, and current smoking. The persistent overweight group had significantly higher risk of persistent snoring symptoms than persistent normal group (RR: 1.39; 95% CI: 1.12, 1.73). Results were not statistically significant for persistent daytime sleepiness among the groups. Conclusions: Persistent overweight or change from normal weight to overweight in childhood was associated with a higher risk of OSA in middle age, while weight loss during childhood did not have higher risk of OSA in adulthood compared to their counterparts in the persistent normal weight group.

The Impact of Long-Term Body Mass Index Patterns on Health-Related Quality of Life

Overweight is associated with a reduced health-related quality of life (QOL), but less is known about the impact of long-term body mass index (BMI, calculated as weight (kg)/height (m)(2)) patterns on QOL in adults. In the Dutch Doetinchem Cohort Study (1989-2009) that included 1,677 men and 1,731 women aged 20-66 years, 6 BMI patterns were defined by using 4 measurements over a 15-year period: 1) persistent healthy weight (18.5-24.9, reference pattern); 2) persistent overweight (25.0-29.9); 3) persistent obesity (≥30.0); 4) developing overweight; 5) developing obesity; and 6) switching between BMI categories. For each BMI pattern, adjusted QOL (measured on a 0-100 scale) was estimated at the end of this period. The lowest QOL was observed for persistent obesity of all BMI patterns. It was 5.0 points (P = 0.02) lower for 1 mental dimension in men and 6.2-11.6 points (P < 0.05) lower for 5 (mainly physical) dimensions in women. Developing overweight or obesity scored 1.8-6.3 points (P < 0.05) lower on 2-5 (mainly physical) dimensions. Persistent overweight hardly differed from a persistent healthy weight. In women, switching between BMI categories resulted in a lower QOL on the mental dimensions. Studying long-term BMI patterns over a 15-year period showed that persistent obesity, developing overweight, and developing obesity resulted in a lower QOL-particularly on the physical dimensions-compared with a persistent healthy weight.

Association Between Overweight and Low Back Pain

A prospective cohort study in adolescents aged 7 to 19 years. To evaluate whether persistent overweight increases the risk of low back pain (LBP) among adolescents. Overweight and LBP are common health problems in adolescents. Their relationship is still controversial among adolescents, as well as among adults. The study population, the Oulu Back Study, was drawn from the Northern Finland Birth Cohort 1986. The final study sample included 1660 adolescents (56% females). The subcohort of 786 subjects (57% females) was used in the analysis of waist circumference. The association between the area under the curve of body mass index from 7 to 16 years, and from 16 to 18 years, and area under the curve of waist circumference from 16 to 19 years, and LBP during the past 6 months was evaluated separately for incident (reporting LBP at 18 or 19 yr but not at 16 yr) and persistent LBP (reporting LBP at 16 and 18 yr or 19 yr). Relative risks (RR) and their 95% confidence intervals (95% CI) were adjusted for smoking, leisure time physical activity, and family socioeconomic status at 16 years and stratified by sex. Body mass index from 16 to 18 years among girls and body mass index from 7 to 16 years among boys predicted incident LBP at 18 years (girls: RR, 1.09; 95% CI, 1.01-1.18; boys: RR, 1.15; 95% CI, 1.00-1.32). Among boys, waist circumference from 16 to 19 years was also associated with incident LBP (RR, 1.16; 95% CI, 1.02-1.32). Overweight was not associated with persistent LBP. In this population-based cohort study, persistent overweight slightly increased the risk of incident LBP, but the time period during which overweight was related to incident LBP differed between sexes. 2.

Body weight at early and middle adulthood, weight gain and persistent overweight from early adulthood are predictors of the risk of total knee and hip replacement for osteoarthritis

To examine the relationships between weight at early and middle adulthood and adult weight gain and the risk of total knee and hip replacement for OA. At baseline interview during 1990-94, 38,149 participants [mean age 54.9 (S.D. 8.6) years] of the Melbourne Collaborative Cohort Study were asked to recall their weight at age 18-21 years and had their middle age height and weight measured. Total knee and hip replacement for OA between 2001 and 2009 was determined by linking the cohort records to the Australian Orthopaedic Association National Joint Replacement Registry. Greater weight and BMI at age 18-21 years and middle age, weight gain and persistent overweight during this time were associated with an increased risk of total knee and hip replacement. Middle age weight [hazard ratio (HR) per 5 kg 1.25 (95% CI 1.23, 1.27) for knee vs 1.11 (1.09, 1.14) for hip] and BMI [HR per 5 kg/m(2) 1.80 (1.72, 1.89) vs 1.29 (1.21, 1.37)] and adult weight gain [HR per 5 kg 1.25 (1.23, 1.28) vs 1.10 (1.07, 1.13)] were more strongly associated with the risk of total knee replacement than total hip replacement (P for heterogeneity of HRs <0.0001). Greater body weight and BMI at early and middle adulthood, weight gain and persistent overweight from early to middle adulthood are risk factors for knee and hip OA. Adult weight gain confers stronger risk on knee OA than hip OA. Weight control from early adulthood and avoiding weight gain are important for the prevention of OA.

45 Effect of a Multimodal Intervention Program to Prevent Obesity in Early Childhood

Background and aimEstablished overweight is difficult to reverse. Our aim was to examine the effect of a family oriented intervention program on prevention of persistent overweight in young children at...

Factors Involved in the Persistence of Overweight among Children Enrolled in the Supplemental Food Program for Women, Infants, and Children

To investigate differences between children ages 2 and 5 years enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Texas whose overweight persisted and those whose overweight resolved. The study involved administration of a survey to a randomly selected stratified sample of parents and guardians of WIC children residing in the 11 public health regions in Texas. Subjects volunteered to complete the survey during a scheduled WIC appointment. A total of 445 surveys were completed, 206 by parents/guardians of children classified as having persistent overweight, and 239 by those with children classified as having non-persistent overweight. A higher percentage of children in the non-persistent group were male, younger, white, consumed more dairy products, had a mother living in the household, and a family member who participated in physical activity with the child. A higher percentage of parents of children in the persistent group reported that they had been told their child was overweight and received information about overweight in children from the WIC staff. A higher percentage also felt their child was overweight, that their child's weight could be improved, that their child's weight did not improve in the last year and were concerned about their child's weight. This study identified several variables associated with overweight persistence. WIC personnel and other public health educators can utilize these findings to identify overweight children who are at higher risk for non-improvement and to plan more effective intervention strategies for the population studied.

Parent-Reported Appetite of a Child and the Child’s Weight Status Over a 2-Year Period in Korean Children

This study sought to examine the association between the parent-reported appetite of a child and the child’s weight status after 2 years. The design was a 2-year prospective study. A total of 531 Korean children aged 11 to 12 years were followed up for change in weight status (persistent overweight, persistent nonoverweight, recently overweight, recently nonoverweight) between 2001 and 2003 after the measurement of their appetite (low, moderate, and high) using a questionnaire administered to their parents in 2001. Weight status of each child was determined based on the criteria of body mass index (BMI) recommended by the International Obesity Task Force reference. The statistical analyses performed were multiple logistic regression analysis with adjustment for parental factors (parents’ weight and height, education level, and income) and the child’s characteristics (baseline BMI, physical activity, and television viewing). Main outcome measures were child’s mean BMI and weight status, and the proportions of overweight children at the baseline and at the end of the follow-up were greater among those children whose parents reported that they had high appetites ( P<0.001). Compared with the children with a low appetite, the odds ratio for overweight at the end of follow-up was 3.7 (95% confidence interval 1.2 to 11.7) in children with a high appetite. Subgroup analysis of overweight children at baseline showed that the risk of being persistently overweight over the 2-year follow-up was 5.5 times (95% confidence interval 1.1 to 27.5) higher in children with a high appetite than in those with a low appetite. There was a strong association between the parent-reported appetite of a child and being overweight after 2 years. Identifying children with higher appetites and targeting them for lifestyle modification may provide an effective way of reducing the incidence of childhood overweight.

Television Watching and Frequency of Family Meals Are Predictive of Overweight Onset and Persistence in a National Sample of School-Aged Children

Objective To identify eating and activity factors associated with school-aged children’s onset of overweight and persistent overweight. Design Data were gathered at four time points between kindergarten entry and spring of third grade. Children were directly weighed and measured and categorized as not overweight (<95th percentile of body mass index) or overweight (≥95th percentile body mass index); parents were interviewed by telephone or in person. Subjects/Setting Subjects were participants in the Early Childhood Longitudinal Study–Kindergarten Cohort, a nationally representative sample of children who entered kindergarten during 1998-1999. Children who weighed <2,000 g at birth, received therapeutic services before kindergarten, skipped or repeated a grade, or without complete height and weight data were excluded, resulting in 8,459 participants. Children with intermittent overweight were not examined (n=459); analyses addressed 8,000 children. Main Outcome Measures Three mutually exclusive groups of children were identified: never overweight, overweight onset, and persistent overweight. Statistical Analyses Performed Multilevel, multivariate logistic regression analyses estimated the effects of eating and activity factors on the odds of overweight onset and persistent overweight above child sex, race, and family socioeconomic status. Results Children who watched more television (odds ratio [OR] 1.02) and ate fewer family meals (OR 1.08) were more likely to be overweight for the first time at spring semester of third grade. Children who watched more television (OR 1.03), ate fewer family meals (OR 1.08), and lived in neighborhoods perceived by parents as less safe for outdoor play (OR 1.32) were more likely to be persistently overweight. Child aerobic exercise and opportunities for activity were not associated with a greater likelihood of weight problems. Conclusions This study supports theories regarding the contributions of television watching, family meals, and neighborhood safety to childhood weight status. When working with families to prevent and treat childhood weight problems, food and nutrition professionals should attend to children’s time spent with screen media, the frequency of family mealtimes, and parents’ perceptions of neighborhood safety for children’s outdoor play.

Disc degeneration of the lumbar spine in relation to overweight

To study the association between overweight and lumbar disc degeneration. Population-based 4-y follow-up magnetic resonance imaging (MRI) study. The subjects were 129 working middle-aged men selected to the baseline magnetic resonance imaging (MRI) study from a cohort of 1832 men representing three occupations: machine drivers, construction carpenters, and office workers. The selection was based on the paticipants' age (40-45 y) and place of residence. MR images of the lumbar spines were obtained at baseline and at 4-y follow-up. Signal intensity of the nucleus pulposus of the discs L2/L3-L4/L5 was visually assessed by two readers using the adjacent cerebrospinal fluid as an intensity reference. The weight (at age 25 and 40-45 y) and height of the subjects, history of car driving, smoking, and back injuries were assessed by questionnaire. Multiple regression analyses allowing for occupation, history of car driving, smoking, and back injuries showed that persistent overweight (body mass index (BMI) > or =25 kg/m(2) at both ages) associated strongly with an increased risk of the number of lumbar discs with decreased signal intensity of nucleus pulposus at follow-up, adjusted odds ratio (OR) being 4.3 (95% confidence intervals (95% CIs) 1.3-14.3). Overweight at young age (risk ratio (RR) 3.8; 95% CI 1.4-10.4) was a stronger predictor of an increase in the number of degenerated discs during follow-up than overweight in middle age (RR 1.3; 95% CI 0.7-2.7). The study provides evidence that the BMI above 25 kg/m(2) increases the risk of lumbar disc degeneration. Overweight at young age seems to be particularly detrimental.

Different responses of ventromedial hypothalamic neurons to leptin in normal and early postnatally overfed rats

Leptin is crucially involved in the central nervous regulation of body weight. Neurons of the ventromedial hypothalamic nucleus (VMH) express leptin receptors and signal satiety with increase in their firing. Normally, leptin mainly activates VMH neurons. Rats grown up in small litters (SL) develop persistent hyperphagia and obesity throughout life. We studied single unit activity in hypothalamic brain slices of juvenile SL rats overweight due to early postnatal overfeeding (Mann–Whitney U-test, P<0.001). VMH neurons of normal rats were mainly activated by leptin (Wilcoxon test, P<0.05, n=39), whereas neurons of overweight SL rats were mainly inhibited (Wt, P<0.001, n=33). This clearly altered response to leptin in neonatally overnourished rats might contribute to their persistent overweight throughout life.

Hemorheological parameters and body weight loss in obese children

(Received 30.7.1993; accepted 7.12.1993) Hemorheological parameters were analyzed on 50 simple type obese children after 12 months of an adequate diet and physical training. According to the changes of body weight, the subjects were divided into three groups. The hyperviscosity condition disappeared in obese children with a real weight loss, while it remained in the groups of subjects with persistent overweight and with increased weight. A decrease of erythrocyte membrane lipid peroxidation, expressed as malondialdehyde (MDA) , was observed only in the children with a real weight loss, suggesting that the persistent trend toward lipid peroxidation may be considered a significant risk factor for atherosclerosis.