Trends In Childhood Obesity Research Articles

The method of determining abdominal obesity by waist circumference in Ukrainian children

Background. The prevalence of obesity in children has a trend of constant growth. A third of the pediatric population suffers from excess body weight and obesity, which are associated with such pathological conditions as hypertension, insulin resistance, hyperglycemia, type 2 diabetes, dyslipidemia, metabolic syndrome (MS) and early cardiovascular dysfunction. Waist circumference (WC) measurement is a simple noninvasive screening tool to identify children with abdominal obesity, MS, and increased cardiovascular risk. The purpose of the study was to develop age- and gender-specific WC percentiles for Ukrainian children aged 10–17 years and to determine possible WC cut-offs for detecting abdominal obesity. Materials and methods. 1566 children aged 10–17 were examined, 759 boys and 807 girls. According to the WHO protocol, WC was measured using a flexible centimeter tape in a standing position midway between the lower rib and the upper front edge of the ilium. The threshold point for detecting abdominal obesity was WC ≥ 90th percentile of the distribution according to age and sex (IDF Consensus, 2007). Results. Age and gender percentiles of WC and cut-off at the level of the 90th percentile in Ukrainian children and adolescents are presented. The importance of gender assessment of WC lies in the reliable difference of indicators in children aged 10–12 and 15–17 years and growth of parameters with age in both boys and girls. The need for age assessment of WC is due to increasing the 90th percentile indicators in girls aged 10–17 from 76 to 90.5 cm and in boys from 75.9 to 94 cm. The data obtained can serve as a source for screening and identifying children with abdominal obesity, increased metabolic risk and a better understanding of current trends in childhood obesity. It has been suggested that new WC reference values should be added to clinical examinations to help pediatricians and family physicians reduce cardiovascular risk in children. Conclusions. In the diagnosis of MS in children, it is recommended to use the proposed specific percentiles of WC for sex and age, the values of which ≥ 90th percentile of the distribution should be utilized for detection of abdominal obesity and further diagnosis of MS. Measuring and evaluating WC in routine pediatric examinations is important.

Decade-long Trends in Incidence of Slipped Capital Femoral Epiphysis in the United States: A Nationwide Database Analysis of Over 33 Million Patients.

Slipped capital femoral epiphysis (SCFE) is a prevalent pediatric hip disorder linked to severe complications, with childhood obesity as a crucial risk factor. Despite the rising obesity rates, contemporary data on SCFE's epidemiology remain scarce in the United States. This study examined SCFE incidence trends and demographic risk factors in the United States over a decade. A decade-long (2011 to 2020) retrospective cohort study was undertaken using the Healthcare Cost and Utilization Project National Inpatient Sample. Patients aged younger than 18 years were identified and further analyzed if diagnosed with SCFE through ICD-9 or ICD-10 codes. Key metrics included demographics variables, with multivariate regression assessing demographic factors tied to SCFE, and yearly incidence calculated. Of 33,180,028 pediatric patients, 11,738 (0.04%) were diagnosed with SCFE. The incidence escalated from 2.46 to 5.96 per 10,000 children, from 2011 to 2020, mirroring childhood obesity trends. Lower socioeconomic status children were predominantly affected. Multivariate analysis revealed reduced SCFE risk in female patients, while Black and Hispanic ethnicities, alongside the Western geographic location, had an increased risk. This study underscores a twofold increase in SCFE incidence over the past decade, aligning with childhood obesity upsurge. Moreover, SCFE disproportionately affects lower SES children, with male sex, Black and Hispanic ethnicities amplifying the risk. This calls for targeted interventions to mitigate SCFE's effect, especially amidst the vulnerable populations.

Childhood Obesity Trends among 8-11-Year-Olds: Insights from a School Sample in Vienna, Austria (2017-2023).

In Austria, childhood obesity is a public health concern. This study examined time trends in the percentage of obesity among a sample of schoolchildren from Vienna (2017-2023). The body mass index percentiles of 326 children [9.3 years old (95% CI 8.3-10.5, min-max 8.0-10.9] from the EDDY study were calculated for trend analyses. Trend analysis was performed using a logistic regression using overweight and obesity as dependent binary variables, and study year and age as independent continuous variables. The percentage change over time was calculated, including the first period of the COVID-19 pandemic. Obesity percentages increased from 23.5 (95% CI 15.1-31.9)% in 2017 to 25.0 (95% CI 12.2-37.8)% in 2023. From 2017 to 2023, while overweight/obesity percentages decreased by 25.9 (-59.5-15.6)%, obesity increased by 6.4 (-51.2-94.9)%. A non-significant trend (p ≥ 0.38) was observed. During the first period of the pandemic, the percentage changes in overweight/obesity and obesity were 68.4 (5.6-187.9)% and 29.2 (-37.3-166.8)%, respectively. The current percentage of obesity in this sample is high and peaked in 2020 during the pandemic. These findings emphasize the need for future investigations considering the representativeness of the school-aged population in Austria to gain a broader picture of overweight and obesity trends.

Sleep hygiene a neglected paediatric identity - A cross-sectional study.

Sleep is the physiological need of any human being; its role in paediatric mental and physical development is irreplaceable. However, in recent days, the rising trend of childhood obesity makes it essential to assess the sleep hygiene of the children to know if there is any adjacent association. 1. To estimate the prevalence of poor sleep quality using Sleep Hygiene Index Scoring. 2. To determine the association of sleep quality with academic performance and body mass index among the school children. The present cross-sectional study was conducted among 322 children aged between 7 and 12 years attending paediatric OPD of a private tertiary care hospital, Puducherry. Using Sleep Hygeine Index scoring with the cut off 16, prevalence of poor sleep quality was assessed and its association with BMI and academic performance was determined. Frequency, proportion, and Chi-square test were used for analysis; P value < 0.05 was considered statistically significant. The mean age of the participants was 8.8 ± 2 years, and most of them were boys. Around 53% of the children had poor quality of sleep, and there was a positive association between poor sleep quality with obesity (P value: 0.0003) and unfavourable academic performance (P value: 0.00001). Sleep hygiene importance should be taught to the parents and periodical assessment helps in predicting the neglected reason for obesity and poor academic performance, which could be managed easily with small lifestyle changes.

Food Environments Within and Outside of Schools Play a Critical Role in Curtailing the Rise in Obesity among School-Aged Children over Time

BackgroundSound evidence for effective community-based strategies is needed to curtail upward trends in childhood obesity in the United States (US). ObjectivesThe aim of the study was to assess the association between school and community food environments and the prevalence of obesity over time. MethodsData were collected from K–12 schools in 4 low-income New Jersey cities in the US. School-level obesity prevalence, calculated from nurse-measured heights and weights at 4 time points, was used as the outcome variable. Data on the school food environment (SFE) measured the healthfulness of school lunch and competitive food offerings annually. The community food environment (CFE), i.e., the number of different types of food outlets within 400 m of schools, was also captured annually. The count and presence of food outlets likely to be frequented by students were calculated. Exposure to composite environment profiles both within schools and in communities around schools was assessed using latent class analysis. Data from 106 schools were analyzed using multilevel linear regression. ResultsThe prevalence of obesity increased from 25% to 29% over the course of the study. Obesity rates were higher in schools that had nearby access to a greater number of limited-service restaurants and lower in schools with access to small grocery stores and upgraded convenience stores participating in initiatives to improve healthful offerings. Interaction analysis showed that schools that offered unhealthier, competitive foods experienced a faster increase in obesity rates over time. Examining composite food environment exposures, schools with unhealthy SFEs and high-density CFEs experienced a steeper time trend (β = 0.018, P < 0.001) in obesity prevalence compared to schools exposed to healthy SFE and low-density CFEs. ConclusionsFood environments within and outside of schools are associated with differential obesity trajectories over time and can play an important role in curtailing the rising trends in childhood obesity.

A secular trend in childhood obesity: Post-COVID statistical analysis

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Nutrient intake and nutritional status of 4-10-year-old Hungarian children

The growing trend of childhood obesity is a major public health issue. Collaborations between medical and healthcare professionals, preventive and health preservative programs, dietary habit and nutrient intake studies are indispensable. A representative study has been performed among 4-10-year-old Hungarian children by gender, age, size of settlement and region. The study included 733 assessable questionnaires and 666 dietary records. Data on children's eating habits were collected by using the internationally recommended three-day dietary record method. Body weight and height measurements were taken for each child to determine nutritional status. Data were analyzed with statistical methods. The rate of overweight and obesity is 23%. Energy intake differs significantly between body mass index groups. The children's fat intake is excessive (34.2 energy%), the saturated fatty acid intake exceeds the recommended 10 energy%, omega fatty acid ratio is disadvantageous and the children's cholesterol intake is high. The average energy from carbohydrates is below the recommended 57 energy%, from added sugar it is 11%, which affects 52% of the children. Their low fibre intake (19.4 g/day) is due to low fruit, vegetable (263 g/day) and whole grain consumption. Of the micronutrients, sodium intake is 3-4 times higher than the recommended. In 35% of the children, the calcium intake is below the critical threshold, due to unfavourable milk and milk product consumption (290 g/day). Vitamin D intake was low in 98-100% of the children. Compared to the results of other European and national studies performed among children, adolescent and adults, the nutritional status and nutrient intake of our sample is unfavourable. Comprehensive intervention, education of the children with the involvement of their parents is essential to reduce obesity. Orv Hetil. 2023; 164(14): 533-540.

Comparison of the ability of HOMA-IR, VAI, and TyG indexes to predict metabolic syndrome in children with obesity: a cross-sectional study

BackgroundThe increasing trend in childhood obesity needs to be closely monitored and intervened due to long-term health issues such as metabolic syndrome, cardiovascular diseases, hypertension, and type 2 diabetes. We aimed to determine and compare the cut-off values for the visceral adiposity index (VAI), triglyceride-glucose index (TyG), and HOMA-IR for predicting metabolic syndrome (MetS).MethodsThis population-based cross-sectional study was conducted in May 2019 in Samsun, Turkey. The study included 169 children with obesity aged 9 and 10 years. After anthropometric and clinical evaluation, fasting blood samples were collected from the children. The areas under the curve of the visceral adiposity index, triglyceride-glucose index, and HOMA-IR were compared by receiver-operating-characteristic (ROC) analysis in predicting the MetS.ResultsThe total prevalence of MetS was 21.3% in children with obesity, and it was two times higher in girls than in boys. The mean values of TyG and VAI were significantly different in those who have and have not MetS in both genders. However, the HOMA-IR index was higher only in girls with MetS and did not differ in boys by having MetS. The VAI and the TyG index both had statistically significant cut-off values in both sexes and a larger ROC area than the HOMA-IR index in predicting MetS.ConclusionsThe VAI and TyG index are effective indicators in assessing the MetS risk in children with obesity. Both indexes can be considered useful tools in pediatric research and the evaluation of interventions. However, the HOMA-IR index formula needs to be developed taking into account age, gender, and ethnicity.

Obesity and glucose metabolism abnormalities by post-disaster evacuation.

The objectives of this study were to determine the longer-term trends in childhood obesity and glucose metabolism abnormalities among residents of Fukushima Prefecture 5 years after the Great East Japan Earthquake. We evaluated the changes for height, weight, body mass index (BMI), BMI SD score, fasting plasma glucose (FPG) concentration, and hemoglobin A1c (HbA1c) in elementary and junior high school residents who had lived in the evacuation zone between 2011 and 2015. 1) Of the Residents, 11,112 received health checks, while in 2012, 2013, 2014 and 2015, 5,737, 4,522, 4,297 and 3,405 received health checks, respectively. 2) The mean BMI SD score for all participants in 2011 was 0.149, and this score gradually decreased from 2011 to 2015. 3) FPG levels and HbA1c levels for all participants with a BMI value≧+2SD in 2011 were higher than those in residents with a BMI value < +2SD. 4) The frequency of participants with a FPG level ≧126 mg/dl and the frequency of participants with a HbA1c level ≧6.5 % in 2011 were higher than those in 2012, 2013, and 2015. These results suggest that a number of pediatric residents suffered from obesity and glucose metabolism abnormalities. Furthermore, the longer-term observations indicated an improvement in obesity and glucose metabolism abnormalities. There was a strong association observed between obesity and glucose metabolism, thus, it is considered important to continue with health checks for children with obesity and strive to improve their health.

Childhood obesity trends: Association with same-day hospital admission in a National Outpatient Surgical Population.

Although the prevalence of obesity in the general population and its perioperative implications among children undergoing inpatient surgeries are well known, little is known about obesity prevalence among children scheduled for ambulatory surgery. Here, we report the trends of obesity and severe obesity among children who underwent ambulatory surgery across multiple centers in the United States and explore the association of obesity status with admission following elective ambulatory surgery. Using data from the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (2012-2019), we selected children 2-18 years old who underwent outpatient surgical procedures under general anesthesia and had documented height, weight, and body mass index (BMI) data. We estimated the prevalence of overweight, obesity (class 1), and severe obesity (class 2 and class 3) patients and explored their association with same-day hospital admission, defined as hospital length of stay ≥1day. Data from 152 918 children (mean age: 9.7 ± 4.7 years) were analyzed. Of these, 16.4% (n=25 007) were overweight, 13.8% (n=21 085) were class 1 obese, 5.2% (n=7879) were class 2 obese, and 3.0% (n=4623) were class 3 obese. From 2012 to 2019, class 2 or 3 obesity prevalence increased by 26.7% and 32.5%, respectively. Overweight and obese children had relatively higher odds of same-day hospital admission compared to healthy weight children (overweight odds ratio [95% confidence interval]: 1.05 [1.02, 1.08]; class 1 obesity: 1.04 [1.00, 1.07]; class 2 obesity: 1.09 [1.02, 1.16]; class 3 obesity: 1.20 [1.11, 1.30]). The burden of obesity continues to increase in children scheduled for ambulatory surgery. Children with class 2 and class 3 obesity have higher rates of same-day hospital admission following elective ambulatory surgery compared to healthy weight children, a factor that should be considered in scheduling these patients.

Quantifying the Impact of Supermarket Distance on Childhood Obesity in Greater London, United Kingdom: Exploring Different Access Measures and Modification Effects of Transportation.

Background: Healthy food access may be relevant for predicting trends in childhood obesity. The goal was to determine associations between childhood overweight (including obesity) and distance to three nearest supermarkets stratified by transportation modes (walking, cycling, driving). Methods: Bivariate and multivariate linear regressions examine the relationship with obesity, including interacting active and inactive modes. Results: Proximity to at least three supermarkets shows small but significant positive association with obesity. Walking mode showed higher obesity rates than driving, and distance was not related to the mode of travel. Conclusions: Disparities in healthy food access may not contribute meaningfully to childhood obesity, as other individual factors may be largely at play.

Healthcare professionals\u2019 perceptions of childhood obesity in Iquitos, Peru: a qualitative study

BackgroundChildhood obesity is an urgent worldwide concern associated with increased morbidity in adulthood. Healthcare professionals (HCPs) are well placed to influence childhood obesity trends and implement interventions. English-language studies regarding HCPs’ perceptions of childhood obesity are limited to high-income countries. Peru is an upper-middle-income country with regional disparities in childhood obesity prevalence. This qualitative study aims to explore HCPs’ perceptions of childhood obesity in Iquitos, Peru, where prevalence is relatively low.MethodsTwenty-one HCPs with child healthcare experience were purposively recruited from two primary healthcare centres. Semi-structured, individual interviews were conducted with a translator and audio recorded. Transcribed data were analysed using thematic analysis.ResultsEight themes were identified and divided into four categories: (1) HCPs’ perceptions and attitudes towards childhood obesity (level of concern regarding childhood obesity, perceived consequences of childhood obesity); (2) Factors which HCPs perceive to be important in the development of childhood obesity (parental factors, contextual factors); (3) HCPs’ perceptions of their role in childhood obesity prevention and management (educating parents about childhood obesity, regular monitoring of child growth); and (4) Barriers and facilitators in childhood obesity prevention and management (in healthcare, in schools).ConclusionsHCPs had a low level of concern regarding childhood obesity in Iquitos and prioritised undernutrition. Parental factors were perceived to be the most influential in the development of childhood obesity. HCPs perceived themselves to have minimal influence due to prevailing positive views of excess weight and difficulties engaging parents. Educating parents about childhood obesity was felt to be essential to prevention and management although regular monitoring of child growth and home healthcare visits were viewed as useful additional measures. This study can help to inform the development of targeted public health strategies which are sensitive to local contexts and could prevent the upward childhood obesity trends evident elsewhere in Peru.

Prevention of childhood obesity through appropriate food labeling.

The prevalence of childhood obesity has increased across the globe and millions of the school children are either obese or overweight. This has happened due to rapid nutritional transition over the past few decades. As childhood obesity is multi-factorial in origin and unhealthy foods, packaged foods, high calorie foods are considered as important behavioral risk factors. The aim of this article is to opine whether appropriate food labeling is one of the preventable methods in prevention of childhood obesity. A thorough literature search on childhood obesity articles on well-known search engines like Cochrane Library, PubMed, Google Scholar and Embase electronic data base was done to reach an opinion and derive a conclusion. Among many interventions to prevent NCDs, it is evident that effective FPL can reduce the burden of NCDs, including childhood obesity. Additionally, it was found that during purchasing any food items, consumer knowledge/information plays a crucial role for food purchasing which is commonly recognized by food labels. The problems with the existing food labels are-these are misleading/not completely understandable/not clearly visible to the consumers due to multiple reasons like low literacy levels, diverse languages, small font size and many more. Globally, there exists multiple food labeling system which are consumer friendly. It is the right time for us to join other countries in experimenting with creative food labelling systems. The Chilean system being the gold standard in this regard. It is evident that good food labeling can effectively reduce the burden of non-communicable disease/childhood obesity (indirect evidence) by empowering customers to buy the right/healthy foods. In a country like India, where literacy among consumers is competitively high and languages are diverse, the same approach should be replicated in order to prevent or halt the rising trend of childhood obesity.

Pediatric data from the All of Us research program: demonstration of pediatric obesity over time.

To describe and demonstrate use of pediatric data collected by the All of Us Research Program. All of Us participant physical measurements and electronic health record (EHR) data were analyzed including investigation of trends in childhood obesity and correlation with adult body mass index (BMI). We identified 19729 participants with legacy pediatric EHR data including diagnoses, prescriptions, visits, procedures, and measurements gathered since 1980. We found an increase in pediatric obesity diagnosis over time that correlates with BMI measurements recorded in participants' adult EHRs and those physical measurements taken at enrollment in the research program. We highlight the availability of retrospective pediatric EHR data for nearly 20000 All of Us participants. These data are relevant to current issues such as the rise in pediatric obesity. All of Us contains a rich resource of retrospective pediatric EHR data to accelerate pediatric research studies.

Mechanoadaptation of the bones of mice with high fat diet induced obesity in response to cyclical loading

An upward trend in childhood obesity implies a great need to determine its effects, both immediate and long-term. Obesity is osteoprotective in adults, but we know very little about the effects of obesity on the growing skeleton, particularly its ability to adapt to load. The objective of this research is to assess bone mechanoadaptation in adolescent obese mice. Ten mice were fed a high-fat diet (HFD) from 4 to 16 weeks of age, while a control group of the same size received a normal diet (ND). At 14 weeks of age, right tibiae were cyclically loaded with a 12 N peak load for HFD mice and a 9 N peak load for ND mice three times a week for two weeks, resulting in equal peak strains of about 2500 microstrain. At 16 weeks of age, mice were sacrificed, and tibiae and gonadal fat pads were dissected. Fat pads were weighed as an obesity indicator, and tibiae were imaged with microCT to measure bone structure. The left tibiae (nonloaded) were subsequently decalcified, stained with osmium, and scanned to quantify marrow fat. Results showed that HFD mice had larger tibial cross-sectional areas compared to ND mice, as well as greater marrow adiposity. However, there was no significant difference in the amount of bone adaptation in the cortical or trabecular bone between the two groups. This indicates that the bones of HFD and ND mice adapt equally well to loading.

Prevalence of Childhood Obesity in the United States 1999 - 2018: A 20-Year Analysis

Introduction: Obesity is a public health crisis in the US. Childhood obesity is associated with multiple comorbidities in the adulthood, including metabolic syndrome, cardiovascular diseases, and premature death. A recent study found that the prevalence of childhood obesity varied according to age and ethnicity. This study aims to evaluate the long-term trends and the underexplored socioeconomic factors associated with childhood obesity. Method: From the US National Health and Nutrition Examination Survey from 1999 to 2018, 35 907 children aged 2–19 with body mass index (BMI) data were included. Prevalence of obesity and severe obesity, defined as BMI ≥95th percentile and ≥120% of 95th percentile of US Centers for Disease Control and Prevention growth charts, respectively. Trends in prevalence of obesity and subgroup analyses according to age group, sex, ethnicity, language used in interview, household education level, and household income level, were analyzed. Data analysis was performed using the R statistical package “survey” (version 3.6.3). Results: The prevalence of obesity and severe obesity increased from 14.7 [95% CI: 12.9–17.0] % to 19.2 [17.2–21.0] % and 3.9 [2.9–5.0] % to 6.1 [4.8–8.0] % in 1999–2018, respectively (p=0.001 and p=0.014 for obesity and severe obesity, respectively). In 2017–8, the prevalence of obesity among children from Spanish-speaking households was 24.4 [22.4–27.0] %, higher than children from English-speaking households (p=0.027). Children from households with high education level and high income level had a lower prevalence of obesity compared to those with low education level and low income level (p=0.003 and p=0.002 for education level and income level, respectively). Compared to girls, boys had higher prevalence of obesity (p=0.002) and severe obesity (p=0.004). Conclusion: The prevalence of childhood obesity in America kept increasing during the period 1999–2018 despite various public health initiatives. The problem is worse in children with lower socioeconomic status, and in children from Spanish-speaking households. Public health interventions are urgently needed to halt the rising trend of childhood obesity, and measures specifically catering to children from Spanish-speaking families should be put in place.

High‐fat diet alters body composition and serum cytokines before the overt onset of obesity

Rising trends in childhood obesity are related, in part, to increased dietary fat intake. Accelerated bone growth, a hallmark of juvenile obesity but one of its most overlooked complications, can lead to irreversible skeletal damage and chronic adult disability. Paradoxically, obese children typically have low to normal levels of the growth promoting hormone insulin-like growth factor-1 (IGF-1), despite their accelerated growth rate. Obesity is characterized by chronic inflammation driven by cytokines such as interleukin-6 (IL-6) which can suppress bone elongation by inhibiting IGF-1. We previously found that a high-fat diet increases bone growth and alters serum cytokines in young male and female mice before significant changes in body mass were evident. Our goal here was to determine whether excess body fat could explain the increase in bone elongation rate when overall body mass remains similar. We tested the hypothesis that mice on a high-fat diet exhibit changes in body composition along with higher levels of inflammatory cytokines before they develop overt obesity. Methods Male 3-week-old C57BL/6 mice (N=6/diet) were put on high-fat (60% kCal fat) or control (10% kCal fat) diet for 2 weeks after weaning. Serum cytokines (Leptin, TNF-α, IGF-1, IL-6, VEGF, IL-1α, IL-1β, MCP-1) were measured by ELISA. Skinfold thickness in the rump region was measured in a separate group of mice using a dial micrometer to estimate body fat. Statistical significance (p<0.05) was determined in SPSS using Mann-Whitney and t-tests. Results After only 2 weeks, tibial elongation rate was over 10% higher in mice on a high-fat diet (t=2.1, p<0.05), but had no difference in body mass (t=0.5, p=0.62). Among the cytokines measured, TNF-α (z=2.9, p<0.01) and IL-6 (z=2.7, p<0.01) were both decreased in the high-fat diet group, while VEGF (z=2.7, p<0.01) was increased. Rump skinfold was nearly 7% greater (t=2.6, p<0.05) in the high-fat diet group, indicating a higher proportion of body fat. Discussion Our results support the hypothesis that a high-fat diet alters body composition and inflammatory cytokines before overt signs of obesity. Unexpectedly, the most robust change was a 1.5-fold decrease in IL-6, rather than the increase that we had predicted. Since elevated levels of IL-6 suppress growth, our findings of decreased IL-6 are consistent with accelerated bone lengthening. IL-6 also has a role in energy metabolism, and so the changes in body composition that we observed (increased subcutaneous fat) might play a role in altering serum cytokines. Significance These results are relevant for understanding the development of obesity-related skeletal complications. Reduced inflammatory cytokines such as IL-6 could serve as a useful biomarker of potential adverse effects, providing the opportunity to implement interventions to mitigate long-term skeletal damage before it might otherwise be recognized.

Economic growth as an underlying probable systemic driver for childhood obesity in South Africa: A Joinpoint regression and ecological analysis over 10 years.

Childhood obesity has become a global public health problem and is a known risk factor for type 2 diabetes, cardiovascular disease, hypertension, stroke, myocardial infarction and various cancers in later adulthood.Associations between adult obesity and economic growth, technological changes, socioeconomic status and economic inequities have been reported, but limited data are available for children and adolescents in countries that are undergoing an epidemiological health transition exhibiting both under- and overnutrition. To demonstrate childhood obesity trends and explore their associations with economic growth in South Africa (SA). This was a retrospective review and analysis of obesity and economic growth trends in SA. Data for obesity levels were obtained from national surveys conducted in SA youths in 2002, 2008 and 2012. Economic growth indicators (EGIs), namely gross domestic product (GDP) per capita, household final consumption expenditure and Gini coefficient, were obtained from the World Bank and IHS Global Insight databases. Obesity trends for 2002 - 2012 are presented by gender and ethnicity. Annual percentage changes (APCs) in obesity prevalence were computed to assess obesity trends using the linear Joinpoint regression. An overall increase in obesity prevalence over time from 3.8% to 6.0% was observed. Females had higher levels across all time points. APCs in both males (7.8%; 95% confidence interval (CI) 0.3 - 15.9; p=0.01) and females (3.1%; 95% CI -14.7 - 24.7; p=0.30) were observed. Among black Africans, coloureds and whites, females had higher obesity levels than males for the three time points. For males, the prevalence of obesity was highest in whites and Asians/Indians, whereas coloureds and blacks had lower levels across all time points. However, the black male population had the highest APC increase (9.4%; 95% CI -23.0 - 55.3; p=0.20). The prevalence of obesity was positively and inversely associated with GDP per capita and the Gini coefficient, respectively. An increase in childhood and adolescent obesity over time was observed, while trend associations between obesity and EGIs exist.

Optimizing the impact of health and related programmes / policies to address the issue of Childhood Obesity in India----A narrative review.

Non-communicable diseases are already acknowledged as a double burden, and now childhood obesity is putting extra strain on our health system. The current paper aimed to analyze the ongoing health and related programmes/policies in India, and we discussed the existing opportunities in the programmes to address the issue of childhood obesity in India. We searched the “MEDLINE,” “PsycINFO,” “Scopus,” “Web of Science,” and “Google Scholar” databases using the following keywords: (“overweight”) and (“obesity”), (“childhood obesity”), (“nutritional programmes in India”), (“Health policies in India”), (“malnourished children in India”) in combination with each other and in truncated form. All the relevant articles and policy documents (MOHFW, INDIA) available in the public domain were included to support the argument for this narrative review. We found that we have programme gaps like guidelines issues by Food Safety Standards Authority of India to tackle childhood obesity and it has not been strictly implemented due to multiple reasons. School health programme has an opportunity to address the issue of childhood obesity, but at the ground level the outcomes are not very promising. The National Nutrition Mission have only focussed on undernutrition and anemia problem, ignoring the overweight/childhood obesity. Primary care physicians are key players in the treatment of childhood obesity, yet rates of obesity management in the primary care setting are low. National Programme for prevention & Control of Cancer, Diabetes, Cardiovascular Diseases & stroke is dealing with health promotion and prevention, early diagnosis, and management of all ages, except children. Diet provided in Integrated Child Development Scheme is calculated based on calories, not by the quality which is a concern to us. The breastfeeding promotion programme named Mothers Absolute Affection programme has not been implemented with letter and spirit. Other than health programmes, we assume that Ministry of Urban Planning, Foreign Direct Investment policy, Advertisement Council of India and many more sector/policy/programme are indirectly responsible for the increasing burden of childhood obesity in India. Lack of awareness and wrong perception also responsible for the development of childhood obesity. We have multiple National Health Programmes and Policies to address the childhood malnutrition, but are focussing the undernutrition component only, ignoring overnutrition problem in the children, which is emerging as quadruple burden to our health system. Appropriate actions and inclusion of suggestions provided in this study for the improvement of the programmes at the practical level needs to be considered by the policy makers to halt the ever-rising trend of childhood obesity and primary care physicians should play a leadership role.

Less obesity but higher inequalities in Portuguese children: Trends of childhood obesity between 2002–2016

To observe the trends of overweight and obesity among Portuguese children from 2002 to 2016, before and during the years of the economic crisis, and compare these trends according to family's socio-economic position (SEP). Prevalence rates were calculated using data from six studies providing comparable estimates from 2002, 2009, 2011, 2013 and 2016 for children aged 6-10-years living in the Portuguese Midlands (n=7192; 50.2% girls). Height and weight were objectively measured; children and family characteristics were collected by standard questionnaires. A logistic regression was used to test the association between variables. Between 2002 and 2016, there was a decrease in the prevalence of overweight and obesity, which reached a statistical significance for girls. The prevalence of overweight, including obesity, was high (low-SEP=30.5%; high-SEP=20.5%) and a widening of socio-economic inequalities was found. Socio-economically disadvantaged children had more than 2 times the odds of having obesity than children from higher-SEP, even after adjusting for sex, physical activity and screen-time. While a decrease in overall rates of overweight and obesity was observed from 2002 to 2016, the social inequalities have been widened which suggest the need for public efforts to promote healthy weight at a population level, especially in lower socio-economic classes.