Trends in a Life Threatening Condition: Morbid Obesity in Dutch,Turkish and Moroccan Children in The Netherlands

Background

Morbid obesity can be a life threatening condition. The aim of our study is to assess the trend in morbid obesity in The Netherlands among children of Dutch origin since 1980, and among children of Turkish and Moroccan origin since 1997.

Methods and Findings

Cross-sectional height and weight data of children of Dutch, Turkish and Moroccan origin aged 2–18 years were selected from three national Dutch Growth Studies performed in 1980, 1997 and 2009 (n = 54,814). Extended international (IOTF) cut-offs in childhood were used to define morbid obesity (obesity class II and III combined). The morbidity index for overweight was calculated as the prevalence of morbid obesity divided by the prevalence of overweight. Our study showed that the prevalence of morbid obesity in children of Dutch origin was 0.59% in boys and 0.53% in girls in 2009. Significant upward trends occurred since 1980 and 1997. The prevalence was three to four fold higher in Turkish children compared to Dutch children. The Turkish children also had an upward trend since 1997, but this was only statistically significant in boys. The prevalence of morbid obesity in Moroccan children was two to three fold higher than in Dutch children, but it remained almost stable between 1997 and 2009. The Dutch and Turkish children showed an upward trend in morbidity index for overweight since respectively 1980 and 1997, while the Moroccan children showed a downward trend since 1997. In 2009, children of low educated parents had the highest prevalence rates of morbid obesity; 1.06% in Dutch, 2.11% in Turkish and 1.41% in Moroccan children.

Conclusions and Significance

An upward trend of morbid obesity in Dutch and Turkish children in The Netherlands occurred. Monitoring and reducing the prevalence of childhood morbid obesity is of high importance for these children, health care and the community.     

To be an immigrant: a risk factor for developing overweight and obesity during childhood and adolescence?

Childhood overweight and obesity, especially among migrant children, are current health problems in several European countries. In the present study the prevalence of overweight and obesity among migrant children from Turkey and the former Yugoslavia was documented and compared with that of Austrian children in Vienna. Anthropometric data from 1,786 children were collected at the ages of 6, 10 and 15 years. Body mass was estimated by means of the body mass index and percentile curves were used to determine weight status. The prevalence of overweight and obesity was found to be significantly higher among migrant children. Children and adolescents from the former Yugoslavia and Turkish girls exhibited especially high rates of overweight and obesity. Biosocial and cultural factors are discussed as causes of these observations.     

Prevalence of obesity in elementary schoolchildren living in Northeast Attica, Greece

Objective: To assess the prevalence of obesity and obesity trend in schoolchildren living in Northeast Attica, Greece. Research Methods and Procedures: Mean (standard deviation) and median weight and BMI were calculated in 4131 (2054 boys and 2077 girls) 6‐ to 11‐year‐old Greek schoolchildren living in Northeast Attica between November 2003 and April 2004. Two hundred thirty‐six (95 boys, 141 girls) immigrant children also participated in the study. The secular trend for obesity was determined comparing our data with those of a similar study performed in 1994. Results: Of boys, 27.8% were overweight, and 12.3% were obese. For girls, the corresponding values were 26.5% for overweight and 9.9% for obesity. There was an increase in the prevalence of overweight and obesity in the last 10 years in both sexes. For boys, overweight increased by 4.2% and obesity by 2.9%, whereas, for girls, overweight increased by 3.8% and obesity by 1.6%. Overweight and obesity were less prevalent in the immigrant children compared with their Greek peers. For immigrant boys, overweight was 15.9% and obesity was 7.9%, and for immigrant girls, overweight was 15.2% and obesity was 8.7%. Discussion: Greek schoolchildren living in Northeast Attica present a high prevalence of overweight and obesity and a positive secular change in the prevalence of obesity.     

Trends in the prevalence of overweight and obesity among young Australians, 1985, 1997, and 2004

Objective: To determine secular trends in overweight/obesity among 7‐ to 15‐year‐olds for the periods 1985, 1997, and 2004. Research Method and Procedures: Data from representative surveys conducted in New South Wales, Australia, in 1985, 1997, and 2004 were analyzed. Height and weight were measured, and BMI categories were created using International Obesity Task Force definitions. Students were grouped as Grades 2 + 4 + 6 and 8 + 10. Results: The prevalences of overweight/obesity for 1985, 1997, and 2004 were 10.9%, 20.6%, and 25.7% among the younger boys and 10.6%, 19.5%, and 26.1% among the older boys. The average annual rate of increase for 1985 to 1997 was 0.81% and for 1997 to 2004 was 0.73% among the younger boys and was 0.74% and 0.94% for the two periods among the older boys. The prevalences of overweight/obesity in 1985, 1997, and 2004 were 14.0%, 22.0%, and 24.8% among the younger girls and 8.3%, 17.9%, and 19.8% among the older girls, respectively. The average annual rates of increase for the two periods were 0.8% and 0.4% among the younger girls and 0.80% and 0.27% among the older girls. Change in the prevalence of overweight/obesity and socioeconomic status were not associated. Discussion: Over the period 1985 to 1997, the prevalence of overweight and obesity increased significantly among the younger and older boys and the younger girls. The prevalence of overweight, but not obesity, increased among the older girls over this period. Over the period 1997 to 2004, the prevalence of overweight/obesity combined increased significantly among boys of both age groups but not among girls.     

Prevalence of overweight and obesity among the affluent adolescent school children of Amritsar, Punjab

In the present study, an attempt has been made to assess the prevalence of overweight and obesity in adolescent children (between 10-15 years of age) of the affluent families of Amritsar district of Punjab, a state in rapid economic and epidemiological transition. A total of 640 children (323 boys and 317girls) were measured for height and weight. Overweight and obesity were assessed using age and sex-specific body mass index (BMI) cut-off points. 9.91% boys and 11.99% girls were overweight, and 4.95% boys and 6.31% girls were obese. The prevalence of overweight and obesity among the affluent children in Amritsar was as high or higher as in some industrialized countries.     

Geographic and Demographic Variation in the Prevalence of Overweight Canadian Children

Objective : To examine the geographic and demographic variation in the prevalence of overweight Canadian children. Research Methods and Procedures : Using BMI data from the 1981 Canada Fitness Survey and the 1996 National Longitudinal Survey of Children and Youth, this study assessed: 1) the prevalence of overweight and obesity among Canadian boys and girls ages 7 to 13 years; 2) secular trends in the prevalence of overweight from 1981 to 1996, by province and adjusted for age and sex; and 3) provincial variation in the prevalence of overweight, before and after adjusting for socioeconomic and demographic characteristics. Results : The prevalence of boys and girls classified as overweight in 1996 was 33% and 26%, respectively. The corresponding figures for obesity were 10% for boys and 9% for girls. Provincial variation was observed with a trend of increasing risk of being overweight from west to east. Socioeconomic status was inversely related to the prevalence of overweight regardless of geographic region. The risk of being overweight was more related to geography (province) than demographic variables (income and family background); however, the effect of secular trends (1981 to 1996) exceeded the effect of geographic or demographic variables. Discussion : The prevalence of childhood overweight and obesity is increasing in all areas of Canada and can be explained only partially by geographic or demographic characteristics.     

Biocultural aspects of gender differences in body composition and obesity during childhood and adolescence

Gender differences in body composition, the prevalence in overweight and obesity as well as in physical activity patterns were tested among 3003 children and adolescents aging between 6 and 18 years (x = 12.1 +/- 3.6) in Vienna and rural parts of Eastern Austria. As to be expected, the absolute and relative amount of body fat was significantly higher among girls of nearly all age groups, while boys exhibited a significantly higher amount of lean or fat free body mass. The prevalence of overweight and obesity was markedly higher among prepubertal girls, however significantly lower among younger and older adolescent girls aging 11 years and older in comparison to their male counterparts. This was however only true of adolescents originating from Austria. Considering adolescents with a background of migration originating from Turkey or the Near East, a significantly higher amount of overweight and/or obesity was found among girls. Therefore, biocultural factors have to be considered to explain gender differences in obesity during childhood and adolescence.     

Obesity and Overweight Prevalence in Polish 7‐ to 9‐Year‐Old Children

Objective: Secular trend in childhood obesity is a well‐known phenomenon, and it is important to monitor it in cross‐sectional studies. The study aim was to estimate prevalence of obesity and overweight in Polish 7‐ to 9‐year‐old children and to compare the results with a French study based on the same protocol. Research Methods and Procedures: The study was conducted in 2001 according to the protocol of the European Childhood Obesity Group. Height and weight were measured, and BMI was calculated to define nutritional status in a randomly selected group of 2916 (1445 girls and 1471 boys) primary school children. Obesity and overweight were estimated according to International Obesity Task Force references with curve for obesity and overweight passing through 30 and 25 kg/m² at age 18, respectively. Results: Overweight (including obesity) was found in 15.4% of Polish children (in 15.8% of girls and 15.0% of boys) and obesity in 3.6% (3.7% of girls and 3.6% of boys) compared with 18.1% of overweight and 3.8% of obese children in French study. There was no significant difference in nutrition status between Polish and French children except for higher frequency of overweight in French 9‐year‐old boys. The same trend of decreasing overweight through age classes was observed in both populations. Discussion: The prevalence of obesity and overweight (including obesity) in prepubertal children estimated in two European countries according to the same protocol and using the same references showed little differences between the two populations despite higher prevalence of obesity in Polish than French adults.     

Overweight in Swiss children and associations with children's and parents' characteristics

Objective: The objective was to assess the prevalence of overweight and obesity in children in a canton of Switzerland and the association with various characteristics of the parents and the children. Research Methods and Procedures: A cross‐sectional survey was conducted in all children of the sixth school grade of the canton of Vaud, Switzerland. Weight and height were measured, and selected lifestyle variables were assessed with a self‐administered semiquantitative questionnaire. Information on children's parents was gathered through a mailed structured questionnaire. Overweight and obesity were based on the International Obesity Task Force criteria. Results: Of 6873 eligible children, 5207 (76%) participated (2621 boys, 2586 girls; mean age, 12.3 years; standard deviation, 0.5 year). The prevalence of overweight (including obesity) was 15.0% (95% confidence interval, 13.7% to 16.4%) in boys and 12.4% (11.1% to 13.7%) in girls, and the prevalence of obesity was 1.8% (1.3% to 2.3%) and 1.7% (1.2% to 2.2%), respectively. In both univariate and multivariate analyses, overweight was strongly associated with high television viewing time and selected characteristics of the parents (overweight, low educational level, and foreign nationality). Discussion: The prevalence of pediatric overweight and obesity was lower in this region of Switzerland than in several European countries. The correlates of overweight found in this region suggest areas for potential interventions.     

Obesity and Malnutrition in a Shantytown Population in the City of São Paulo,Brazil

To investigate the prevalence of obesity and malnutrition in the poor Brazilian population we conducted a survey on the socioeconomic and nutritional status of 535 families (comprising 2 411 individuals) living in shanty towns in the city of São Paulo. There was a 30% prevalence of malnutrition in the children, with chronic malnutrition as the most predominant problem. The prevalence of obesity was 6.4% in boys and 8.7% in girls. Overweight and obesity associated with stunting was found in 5.8% of boys and 6.8% girls. Adolescents showed a higher prevalence of malnutrition when weight-for-age distribution was used (boys 46.4%, girls 40.2%), but a right deviation in the distribution was observed with an increase in obesity and a decrease of malnutrition was observed (obesity was 21% in girls and 8.8% in boys; malnutrition was 15.5% in boys and 12.6% in girls) when the weight-for-height adjustment was made. Stunting was the most predominant type of malnutrition in both sexes. Obesity associated with stunting was more common than obesity without stunting, both in younger children and adolescents. Adults had a higher prevalence of obesity than malnutrition according to both the Metropolitan Life Insurance tables (1.7% of undernutrition, 16.7% of overweight, and 14.1% of obesity) and Body Mass Index (8.5% of undernutrition, 21.9% of overweight, and 14.6% of obesity). There was an increase in the percentage of obese children when at least one adult in the family was obese and an increased percentage of malnourished children when undernourished adults were present in the family. Obesity among the adults of the family decreased the occurrence of malnutrition among the children. In 9% of families there was a coexistence of obesity in the adults and malnutrition in the children. These results demonstrate a coexistence of malnutrition and obesity in poor urban Brazilian communities.     

Increase in prevalence of overweight in Dutch children and adolescents: a comparison of nationwide growth studies in 1980, 1997 and 2009

Objective

To assess the prevalence of overweight and obesity among Dutch children and adolescents, to examine the 30-years trend, and to create new body mass index reference charts.

Design

Nationwide cross-sectional data collection by trained health care professionals.Participants: 10,129 children of Dutch origin aged 0–21 years.

Main Outcome Measures

Overweight (including obesity) and obesity prevalences for Dutch children, defined by the cut-off values on body mass index references according to the International Obesity Task Force.

Results

In 2009, 12.8% of the Dutch boys and 14.8% of the Dutch girls aged 2–21 years were overweight and 1.8% of the boys and 2.2% of the girls were classified as obese. This is a two to three fold higher prevalence in overweight and four to six fold increase in obesity since 1980. Since 1997, a substantial rise took place, especially in obesity, which increased 1.4 times in girls and doubled in boys. There was no increase in mean BMI SDS in the major cities since 1997.

Conclusions

Overweight and obesity prevalences in 2009 were substantially higher than in 1980 and 1997. However, the overweight prevalence stabilized in the major cities. This might be an indication that the rising trend in overweight in the Netherlands is starting to turn.     

Longitudinal study of body weight changes in children: who is gaining and who is losing weight

Cross-sectional studies have reported significant temporal increases in prevalence of childhood obesity in both genders and various racial groups, but recently the rise has subsided. Childhood obesity prevention trials suggest that, on average, overweight/obese children lose body weight and nonoverweight children gain weight. This investigation tested the hypothesis that overweight children lose body weight/fat and nonoverweight children gain body weight/fat using a longitudinal research design that did not include an obesity prevention program. The participants were 451 children in 4th to 6th grades at baseline. Height, weight, and body fat were measured at month 0 and month 28. Each child's BMI percentile score was calculated specific for their age, gender and height. Higher BMI percentile scores and percent body fat at baseline were associated with larger decreases in BMI and percent body fat after 28 months. The BMI percentile mean for African-American girls increased whereas BMI percentile means for white boys and girls and African-American boys were stable over the 28-month study period. Estimates of obesity and overweight prevalence were stable because incidence and remission were similar. These findings support the hypothesis that overweight children tend to lose body weight and nonoverweight children tend to gain body weight.     

Eleven‐year Prevalence Trends of Obesity in Greek Children: First Evidence that Prevalence of Obesity Is Leveling Off

We examined 11‐year (1997–2007) trends in underweight, overweight, and obesity in Greek children. Population data derived from a yearly, school‐based health survey carried out between 1997 and 2007 in >80% of all Greek schools. Height and weight measurements from 651,582 children, aged 8–9 years (boys: 51.2%) were analyzed. The gender‐ and age‐specific BMI cutoff points by the International Obesity Task Force (IOTF) were used in order to define underweight, normal weight, overweight, and obesity. Trend analysis showed an increase in the prevalence of obesity from 7.2 ± 0.2% in 1997 to 11.3 ± 0.2% in 2004 for girls (P < 0.001) and from 8.1 ± 0.2% in 1997 to 12.3 ± 0.2% in 2004 for boys (P < 0.001). An apparent leveling off in obesity rates was observed during 2004–2007 for both boys and girls. The prevalence of overweight rose between 1997 and 2007 from 20.2 ± 0.2% to 26.7 ± 0.2% for girls (P < 0.001) and from 19.6 ± 0.2% to 26.5 ± 0.2% for boys (P < 0.001). The overall prevalence of thinness in the same period remained constant in both sexes. The presented population‐based data revealed that the prevalence of overweight and obesity among 8‐ to 9‐year‐old Greek children is alarmingly elevated, with the overweight rates rising continuously. However, an apparent leveling off in obesity rates for the past 4 consecutive years was documented for the first time in both genders.     

Association between obesity and hyperlipidemia among children.

BACKGROUND: This study was undertaken to show the association between obesity and hyperlipidemia among the children. METHODS: In March 2000, while conducting a comprehensive health examination, we analyzed 2011 children from the first grade of primary schools in Taichung City in Taiwan. To study the association between obesity and hyperlipidemia, the t test, chi-square analysis, and multivariate logistic regression were used. RESULTS: There were 1057 boys (52.56 percent) and 954 girls (47.44 percent). The mean age was 7.27 +/- 0.46 years. The proportion of overweight was 11.07 percent in boys and 11.64 percent in girls. The proportion of obesity was 14.19 percent in boys and 12.89 percent in girls. After controlling the other covariates, the multivariate logistic regression analysis showed that overweight was associated with a low level of high density lipoprotein cholesterol. Obesity was associated with hypertriglyceridemia, a high level of low density lipoprotein cholesterol, and a low level of high density lipoprotein cholesterol. CONCLUSIONS: Our findings disclosed that the prevalence of overweight and obesity was high in childhood. Early intervention to control and prevent childhood obesity might be warranted. Obesity was associated with hyperlipidemia in children. A wide-scale survey will be suggested in the future to establish causal-effect issues between obesiyy and hyperlipidemia.     

California and federal school nutrition policies and obesity among children of Pacific Islander,American Indian/Alaska Native,and Filipino origins: Interrupted time series analysis

BackgroundObesity prevalence remains high among children of Pacific Islander (PI) origin, Filipino (FI), and American Indian/Alaska Native (AIAN) origins in the United States. While school nutrition policies may help prevent and reduce childhood obesity, their influences specifically among PI, FI, and AIAN children remain understudied. We evaluated the association of the California (CA) state school nutrition policies for competitive food and beverages and the federal policy for school meals (Healthy, Hunger-Free Kids Act of 2010 (HHFKA 2010)) with overweight/obesity among PI, FI, and AIAN students.Methods and findingsWe used an interrupted time series (ITS) design with FitnessGram data from 2002 to 2016 for PI (78,841), FI (328,667), AIAN (97,129), and White (3,309,982) students in fifth and seventh grades who attended CA public schools. Multilevel logistic regression models estimated the associations of the CA school nutrition policies (in effect beginning in academic year 2004 to 2005) and HHFKA 2010 (from academic year 2012 to 2013) with overweight/obesity prevalence (above the 85 percentile of the age- and sex-specific body mass index (BMI) distribution). The models were constructed separately for each grade and sex combination and adjusted for school district-, school-, and student-level characteristics such as percentage of students eligible for free and reduced price meals, neighborhood income and education levels, and age. Across the study period, the crude prevalence of overweight/obesity was higher among PI (39.5% to 52.5%), FI (32.9% to 36.7%), and AIAN (37.7% to 45.6%) children, compared to White (26.8% to 30.2%) students. The results generally showed favorable association of the CA nutrition policies with overweight/obesity prevalence trends, although the magnitudes of associations and strengths of evidence varied among racial/ethnic subgroups. Before the CA policies went into effect (2002 to 2004), overweight/obesity prevalence increased for White, PI, and AIAN students in both grades and sex groups as well as FI girls in seventh grade. After the CA policies took place (2005 to 2012), the overweight/obesity rates decreased for almost all subgroups who experienced increasing trends before the policies, with the largest decrease seen among PI girls in fifth grade (before: log odds ratio = 0.149 (95% CI 0.108 to 0.189; p < 0.001); after: 0.010 (−0.005 to 0.025; 0.178)). When both the CA nutrition policies and HHFKA 2010 were in effect (2013 to 2016), declines in the overweight/obesity prevalence were seen among White girls and FI boys in fifth grade. Despite the evidence of the favorable association of the school nutrition policies with overweight/obesity prevalence trends, disparities between PI and AIAN students and their White peers remained large after the policies took place. As these policies went into effect for all public schools in CA, without a clear comparison group, we cannot conclude that the changes in prevalence trends were solely attributable to these policies.ConclusionsThe current study found evidence of favorable associations of the state and federal school nutrition policies with overweight/obesity prevalence trends. However, the prevalence of overweight/obesity continued to be high among PI and AIAN students and FI boys. There remain wide racial/ethnic disparities between these racial/ethnic minority subgroups and their White peers. Additional strategies are needed to reduce childhood obesity and related disparities among these understudied racial/ethnic populations.

Dr. Mika Matsuzaki and co-authors found evidence of favorable associations between state and federal school nutrition policies with overweight/obesity prevalence trends among children of Pacific Islander origin, Filipino, and American Indian/Alaska Native origins in the United States.     

Prevalence of obesity in British children born in 1946 and 1958.

The prevalence of overweight at ages 7 and 11 years and in late adolescence was compared in two nationally representative cohorts of British children born in 1946 and 1958. Overweight was defined as weight that exceeded the standard weight for height, age, and sex by more than 20% (relative weight greater than 120%). The prevalence of overweight among 7 year olds born in 1958 was nearly twice that among those born in 1946. Changes in infant feeding practices, food supply, and level of physical activity might be responsible for this difference. By adolescence the prevalence of obesity in both cohorts had increased but the difference between cohorts had almost disappeared. Around 9% of adolescent girls and 7% of adolescent boys were overweight. If infant feeding practices have an influence on prevalence of overweight at 7 years the data from the two cohorts suggest that such an effect does not persist. In neither cohort was there a significant relation between the prevalence of obesity and social class in boys, but in girls the prevalence was higher among those from the lower socioeconomic groups. Correlation coefficients showing the strength of the relation between relative weights at different ages were remarkably similar for both cohorts. The risk of being obese later in childhood for those who had not been obese at the age of 7 was less than one in 10, whereas for those with a relative weight greater than 130% the risk exceeded six in 10.     

Trends in body mass index, prevalence of overweight and obesity in preschool Lithuanian children, 1986-2006

The study provides the body mass index (BMI), the prevalence of overweight and obesity in preschool Lithuanian children, 1986-2006. In the 2003-2006 more than 1000 preschool 3-6 year old children from Vilnius (the capital of Lithuania) were investigated according to the standard anthropometric methods. The prevalence of overweight (OW) and obesity (OB) was estimated according to the cut-off points recommended by the International Obesity Task Force (IOTF). Recent data were compared with the data of preschool children from the 1986 Vilnius study and with the data from the other countries. The BMI of preschool children did not change significantly during the last 20 years, except for the statistically significant BMI increment in 6 years old girls. The prevalence of OB among preschool Lithuanian children was low (0.8%-3.7% in boys, and 0-1.9% in girls) and did not change significantly during 1986-2006. The prevalence of OW was higher in preschool girls (10.7%-18.2%) in comparison with preschool boys (6.5%-12.4%). The significant increment of the prevalence of OW was observed among the 6-year-old girls from the 2006 study in comparison with the 1986 study. The possible socio-economic reasons of the defined trend in the BMI and prevalence of OW and OB among preschool Lithuanian children are discussed in the paper.     

Racial Differences in the Tracking of Childhood BMI to Adulthood

Objective: The possibility that there are racial differences in the patterns of BMI (kilograms per meter squared) change throughout life has not been examined. For example, the high prevalence of obesity among black women could result from a higher prevalence of obesity among black girls or because normal‐weight black girls experience larger BMI increases in adolescence or adulthood than do their white counterparts. Therefore, we examined the tracking of childhood BMI into adulthood in a biracial (36% black) sample. Research Methods and Procedures: Five‐ to 14‐year‐old children (2392) were followed for (mean) 17 years. Childhood overweight was defined as BMI ≥ 95th percentile, and adult obesity was defined as BMI ≥ 30 kg/m². Results: The tracking of childhood BMI differed between whites and blacks. Among overweight children, 65% of white girls vs. 84% of black girls became obese adults, and predictive values among boys were 71% (whites) vs. 82% (blacks). These racial differences reflected contrasting patterns in the rate of BMI change. Although the initial BMI of black children was not higher than that of white children, BMI increases with age were larger among black girls and overweight black boys than among their white counterparts. In contrast, relatively thin (BMI < 50th percentile) white boys were more likely to become overweight adults than were their black counterparts. Discussion: These findings emphasize the black/white differences in BMI changes with age. Because of the adult health consequences of childhood‐onset obesity, early prevention should be given additional emphasis.     

Changes in BMI and the prevalence of overweight and obesity in children and adolescents in Cracow, Poland, 1971-2000.

The aim of this study is to examine changes in prevalence of overweight and obesity, using International Obesity Task Force criteria, in three cohorts of children and youth living in Cracow, Poland, in 1971, 1983 and 2000. Rates of overweight and obesity doubled among boys and girls, from 7.5% and 6.5% in 1971, to 15.2% and 11.8% in the year 2000. The greatest increases in prevalence occurred in the youngest age groups (7-12 years for boys and 7-10 years for girls), increases being less extensive among adolescents, and lowest of all in the oldest age groups (16-18 years in boys and 14-18 years in girls). The absence of a positive secular trend in BMI among adolescent females relative to males may be due to sociocultural pressures associated with transition to a free market economy in Poland. The extent to which girls attempt to achieve the ideal body, as portrayed by media and society more generally, increases across adolescence.     

The extent of overweight index in children and adolescents from Cracow,Poland (1971–2000)

Obesity indices describe the percentage of overweight and obese children in a given population but they do not show the extent to which the norms have been exceeded. The aim of this work was to determine the extent of overweight index (EOW), suggested by Jolliffe, 2004a, Jolliffe, 2004b, by examining children and adolescents from Cracow in order to obtain information on overweight and obesity prevalence and on the amounts by which the BMI age- and sex-specific norms are exceeded, emphasising usefulness of EOW in population studies.The study material comprises three randomly selected groups, representative for Cracow: (1) measured in 1971 which includes 4090 individuals of both sexes and aged 7–19 years, (2) measured in 1983 with 6542 individuals aged 3–19 years and (3) measured in 2000 with 4524 boys and girls aged 3–19 years. The EOW index of overweight is a mean relative deviation from BMI threshold, assuming that for values lower than the threshold ones, the deviation amounts to zero.The EOW index values in boys increased from 0.9 in 1971 up to 2.2 in 2000 i.e. by 144%, indicating an increase of both prevalence of overweight and obesity and an increase of the amount by which the limits of overweight are exceeded. In girls the index also increased, though less dramatically, from 0.7 in 1971 to 1.5 in 2000 i.e. by 114%.An analysis of the results showed that the increasing prevalence of overweight and obesity in children and adolescents is accompanied by an increase of the amount by which the BMI threshold values are exceeded.