Relationship of lead and essential elements in whole blood from school-age children in Nanning,China

ObjectivesThe aim of this study was to investigate blood lead level and its relationship to essential elements (zinc, copper, iron, calcium and magnesium) in school-age children from Nanning, China.MethodsA total of 2457 children aged from 6 to 14 years were enrolled in Nanning, China. The levels of lead (Pb), zinc (Zn), copper (Cu), iron (Fe), calcium (Ca) and magnesium (Mg) were determined by an atomic absorption spectrometer.ResultsThe mean blood lead level (BLL) was 57.21 ± 35.00 μg/L. 188 (7.65%) asymptomatic children had toxic lead level higher than 100 μg/L. The school-age boys had similar lead level among different age groups, while the elder girls had less BLL. The blood Zn and Fe were found to be increased in the boys with elevated BLL, but similar trends were not observed in the girls. Positive correlations between Pb and Fe or Mg (r = 0.112, 0.062, respectively, p < 0.01) and a negative correlation between Pb and Ca (r = −0.047, p < 0.05) were further established in the studied children.ConclusionsLead exposure in school-age children was still prevalent in Nanning. The boys and girls differed in blood levels of lead and other metallic elements. Lead exposure may induce metabolic disorder of other metallic elements in body.     

Association of blood lead levels with neurobehavior and BDNF expression in school going children

BackgroundChildhood Lead (Pb) toxicity has been an ongoing concern for decades; however, its underlying pathogenesis remains unclear. Although its prevalence has come down in developed countries (USA, Europe); it is relatively high in low to middle-income countries of South-East Asia. The current study aimed to evaluate the association of blood lead levels (BLLs) with neurobehavioral alterations and changes in Brain-Derived Neurotropic Factor (BDNF) expression in Indian school children.MethodologySchool going children in age group of 9–15 years (N = 72) were included in the study. Neurobehavioral changes were assessed using Childhood Psychopathological Measurement Schedule (CPMS) and BLL were measured by Graphite Furnace Atomic Absorption Spectrophotometry (GFAAS). BDNF mRNA expression and serum BDNF levels were assessed by Real-Time PCR and ELISA, respectively.ResultsMedian BLL was 4.95 μg/dL (IQR = 4.47), very close to the recommended toxic cut off levels (<5 μg/dL). BLLs had a direct correlation with both CPMS scores and BDNF expression. Depression was found to be significantly higher in boys than in girls with high BLLs. BDNF mRNA expression and serum BDNF levels were higher among children with high BLL, although not to significant levels.ConclusionWe report a significant association of neurobehavioral changes with the prevalence of high Pb levels in Indian children. Additionally significant correlation of BDNF with BLL in these children suggests a causal role of BDNF in Pb induced neurological damage.     

Impact of social class on body fatness among rural pre-school Bengalee Hindu children of Arambagh, West Bengal, India

Body composition is a useful marker for assessing the adiposity of an individual. The amount of body fat (BF) differs with age, sex, environmental conditions and genotype, and is a good indicator of the health and nutritional status of a community. As the subcutaneous fat serves as a reservoir for energy during nutritional deprivation, lower BF in comparison with other studies indicates a lower energy intake by those children, who are affected by their lower socio-economic status. The objective of the present study was to evaluate the impact of socio-economic class, after allowing for sex and age, on body fatness among rural pre-school children of Bengalee Hindu ethnicity of Arambagh, West Bengal, India. The present study was undertaken at 20 Integrated Child Development Services (ICDS) scheme centers in Bali Gram Panchayat, Arambagh, Hooghly District of West Bengal, India. A total of 1012 boys and girls (aged 2-6 years) living in these areas were studied. The children were classified into two groups based on their social class: Schedule Castes (SC) and Non-Schedule Castes (NSC). In general, SC comprise socio-economically and educationally deprived individuals. Three-way analysis of variance was used to assess the effect of ethnicity on mid-upper arm circumference (MUAC) and sum of skinfolds (SS), allowing for age and sex. There was an increasing age trend in both these variables in both sexes in the two groups. All three factors had a significant effect on MUAC, whereas only age and social class had a significant impact on SS. In the case of MUAC, only one second order interaction (sex-age) was significant. In conclusion, we found that after controlling for age and sex, children belonging to the SC group had lower body fatness. These results implied that they were under more nutritional stress. There was also some evidence that at the early ages, girls belonging to the SC group probably received inadequate nutrition and as a result had lower body fat.     

达斡尔族学生皮下脂肪发育的研究

作者内蒙古莫力达瓦达斡尔族自治旗１７５９例中小学生项项皮褶厚度及体脂发育情况进行了调查研究。结果表明：（１）达斡尔族学生进入青春期后,随着年龄的增长,男性躯干部皮变厚,四肢部皮褶变薄,女性躯干、四肢部皮褶均增厚。（２）１２岁后,女性皮褶厚度显著大于男性。（３）青春发育早期,男性体脂逐渐有下降,女性于１２－１４岁体脂迅速增加。（４）总体说来,达斡尔族学生并不偏于肥胖。     

Development of subcutaneous fat in Spanish and Latin American children and adolescents: Reference values for biceps,triceps, subscapular and suprailiac skinfolds

Subcutaneous fat skinfolds represent a reliable assessment instrument of adiposity status. This study provides current percentile references for four subcutaneous skinfolds (biceps, triceps, subscapular, suprailiac) applicable to children and adolescents in Spain and in Latin American countries where data are scarce.The design consisted of a cross-sectional multicenter study performed with identical methods in 5 countries (Argentina, Cuba, Mexico, Spain and Venezuela). Total sample comprised 9163 children and youths (boys 4615 - girls 4548) aged 6–18 years, healthy and without apparent pathologies. Percentiles 3, 5, 10, 25, 50, 75, 90, 95 and 97 were calculated by the LMS method. Sexual dimorphism was assessed using the t-test and age differences with ANOVA. Normalized growth percentile references were obtained according to sex and age for each skinfold. The mean values of four skinfolds were significantly greater in girls than boys (p < 0.001) and, in both sexes, all skinfolds show statistical differences through age (p < 0.001) with different magnitudes.Except triceps in girls, peaks between 11 and 12 years of age are more noticeable in boys than in girls. Although the general model of growth is known, the skinfold measurements show variability among populations and differences of magnitude are presented according to the analyzed population. Therefore, these age and sex-specific reference percentile values for biceps, triceps, subscapular and suprailiac skinfolds, derived from a large sample of Spanish and Latin American children and adolescents, are a useful tool for adiposity diagnosis in this population for which no reference values were available.     

Relation between blood levels of heavy metals and some markers of oxidative stress among boys with neuropathic bladder and posterior urethral valve

BackgroundThe status of heavy metals in children with lower urinary tract pathology that may harm the upper tract, e.g., neuropathic bladder and posterior urethral valve and its relationship with oxidative stress has not been adequately investigated. Therefore, the object of the current work was to evaluate the concentrations of copper, zinc, cadmium and lead and their relations with levels of catalase (CAT), malondialdehyde (MDA) and glutathione (GSH) in boys with neuropathic bladder and posterior urethral valve.MethodsThirty-six children with neuropathic bladder, 35 children with posterior urethral valve and 33 health controls were included in the study. In addition to routine laboratory tests, blood samples were collected from patients and controls to assess levels of Cu, Zn, Cd and Pb in addition to plasma concentrations of CAT, MDA and GSH.ResultsSignificantly elevated levels of Cu, Pb, CAT, MDA and GSH and significantly lower concentration of blood Zn were found in the studied groups compared to the controls. In the posterior urethral valve group, blood level of Cu was positively correlated with GSH while a significantly negative relation was observed between blood Zn and CAT activity among the neuropathic bladder patients.ConclusionNeuropathic bladder and posterior urethral valve may lead to abnormalities in the blood levels of heavy metals (i.e. Cu, Pb and Zn) and markers of oxidative stress (CAT, MDA and GSH). Therefore, the levels of theses metal ions should be monitored during the treatment course of neuropathic bladder and posterior urethral valve patients to prevent or minimize long-term oxidative injury.     

Blood lead in children and associations with trace elements and sociodemographic factors

BackgroundNo safe blood lead concentration in children has been identified. Lead can affect nearly every system in the body and is especially harmful to the developing central nervous system of children.The aim of this study is to analyze blood lead in a population of children and its association with sociodemographic variables, biochemical parameters, copper, iron, selenium and zinc.MethodsWe recruited 155 children (86 boys and 69 girls) with a mean age of 7.3 (SD:4.1). Blood lead and serum selenium concentrations were measured by electrothermal atomic absorption spectrometry. Serum copper and zinc concentrations were measured by flame atomic absorption spectrometry. Serum iron levels were determined by colorimetric assay. A risk exposure questionnaire for lead was administered to the participants.ResultsThe median blood lead level was 1.1 (IQR 0.7–1.6) μg/dL. Regarding risk exposure factors, the youngest children (<2 years) who played outdoors presented a median blood lead concentration of 1.1 μg/dL IQR: 0.48–1.48, compared to the median of 0.3 μg/dL IQR:0.2-0.48 in the children who stated they played at home (p = 0.024). Significant differences were also found when taking into account those parents who smoked (median 1.3 IQR 0.8–1.9 μg/dL vs 0.9 IQR 0.5–1.4 μg/dL of non-smokers, p = 0.002). Children who drank tap water had higher blood lead levels (median 1.2 IQR 0.7–1.6 μg/dL) than those who drank bottled water (median 0.7 IQR 0.2–1.3 μg/dL p = 0.014). In addition, children whose mothers had not finished school had higher blood lead levels (median 1.7 IQR 1.2–2.3 μg/dL) than those whose mothers had finished school (median 1.2 IQR 0.7–1.7 μg/dL) and those whose mothers had gone to university (median 0.9 IQR 0.5–1.4 μg/dL) p = 0.034. In the multivariate lineal regression analysis we continue to observe the association between mother’s higher level of education and lower blood levels (p = 0.04) and the interaction between age and outdoor play (p = 0.0145).ConclusionsIn spite of the decline in blood lead concentrations, associated risk factors continue to exist in vulnerable populations such as children.     

Malnutrition,anemia, micronutrient deficiency and parasitic infections among schoolchildren in rural Tanzania

BackgroundMalnutrition, anemia, micronutrient deficiency and parasitic infections continue to impact the nutritional status and health of children in lower-income countries. However, not enough data concerning this issue is available. The aim of this study was to assess the distribution of nutritional indicators, anemia and micronutrient deficiency and their underlying risk factors among schoolchildren in south-eastern Tanzania.Methodology/Principal findingsThis cross-sectional study enrolled primary schoolchildren aged 6–12 years from Kikwawila and Kiberege wards, Tanzania. In total, 471 schoolchildren underwent a physical examination and provided blood, stool and urine samples for an assessment of the levels of different micronutrients, nutritional and anemia status, and parasitic infection status. We employed bivariate and multivariate logistic regression to determine the association between nutritional statuses, anemia, micronutrient deficiency and parasitic infections. We found that 23.90%, 12.60% and 16.20% of schoolchildren were stunted, underweight and wasted, respectively. About 14.0% of schoolchildren were found to be anemic. Children diagnosed with Plasmodium falciparum infection were more likely to have low levels of ferritin (aOR: 10.40, 95% CI: 2.88-40.53) and elevated levels of serum soluble transferrin receptor (aOR: 3.59, 95% CI: 1.27-11.23), respectively. Vitamin A (34.71%) and vitamin B12 (8.79%) were the most prevalent micronutrients found to be deficient in diagnosed children. Finally, we found that schoolchildren attending the most rural schools were five times more likely to be diagnosed with at least one micronutrient deficiency (aOR: 5.04, 95% CI: 2.38–11.44).Conclusions/SignificanceMalnutrition, anemia and micronutrient deficiency still pose a significant health burden among schoolchildren living in rural Tanzania. To effectively tackle this burden, health interventions such as deworming, micronutrient supplementation, vector control, health education and access to clean water and improved sanitation should be strengthened and made sustainable.     

High Prevalence of Enterobius vermicularis Infection among Schoolchildren in Three Townships around Yangon,Myanmar

In order to determine the status of Enterobius vermicularis infection among schoolchildren in suburban areas of Myanmar, 761 primary schoolchildren in 3 different townships around Yangon City were subjected to a survey using cello-tape anal swabs. The subjected schoolchildren were 383 boys and 378 girls who were 5-7 years of age. Only 1 anal swab was obtained from each child. The overall egg positive rate of E. vermicularis was 47.2% (359 positives), and sex difference was not remarkable (48.6% in boys and 45.8% in girls). However, the positive rate was the highest in South Dagon (54.6%) followed by Hlaing Thayar (43.8%) and North Dagon (34.8%). This difference was highly correlated with the living standards of the people in each township. Nucleotide sequence of the 5S rDNA from the eggs on the cello-tape (2 children) revealed 99.7% identity with that of E. vermicularis reported in GenBank. The results indicated that E. vermicularis infection is highly prevalent among primary schoolchildren around Yangon, Myanmar.     

Lead and cadmium in the hair and blood of children from a highly industrial area in Poland

The study covered the children living in Miasteczko ?lcaskie, near the largest Zn plant in Poland. This is one of the areas highly contaminated with heavy metals. The subjects were 158 children aged from 8 to 15 (98 boys and 60 girls). The average Pb and Cd levels in the hair of the entire children population was 8.21 ± 5.59 μg/g, and 0.91 ± 0.61 μg/g, and the average Pb and Cd levels in their blood were 14.32 ± 3.98 and 0.52 ± 0.24 μg/dL^-1, respectively. The children population under investigation was divided according to their sex. The hair of the girls contained, on the average, 5.06 ± 2.81 μg/g of Pb and 0.74 ± 0.48 ug/g of Cd and the hair of the boys 10.14 ± 6.0 μg/g of Pb and 1.01 ± 0.65 ug/g of Cd. The blood of the girls contained, on the average, 13.23 ± 4.23 μg/dL of Pb and 0.48 ± 0.21 μg/dL of Cd, and the blood of the boys 14.99 ± 3.68 μg/dL of Pb and 0.55 ± 0.24 μg/dL of Cd. Thus, both the hair and blood of the boys accumulated more Pb and Cd than those of the girls. A correlation between the concentrations of these metals was confirmed.     

Selenium Deficiency as a Possible Contributor of Goiter in Schoolchildren of Isfahan, Iran

The prevalence of goiter still remains high in some areas of Iran in spite of iodine supplementation. In the present study, we investigated the role of selenium (Se) deficiency in the etiology of goiter in Isfahan. Two thousand three hundred thirty-one schoolchildren were selected by multistage random sampling. Thyroid size was estimated in each child by inspection and palpation. Urinary iodine concentration (UIC) and plasma Se were measured. Overall, 32.9% of the 2,331 children had goiter. The median UIC was 19.55 µg/dl. Plasma Se was measured in 96 goitrous and 72 nongoitrous children. The mean?±?SD of plasma Se in goitrous and nongoitrous children was 66.86?±?21.82 and 76.67?±?23.33 µg/l, respectively (P?=?0.006). Goitrous girls had lower plasma Se level than nongoitrous girls (65.62?±?21.64 vs. 76.51?±?22.61 µg/dl, P?=?0.02). Goitrous boys had lower plasma Se level than nongoitrous boys (68.45?±?22.21 vs. 76.91?±?24.76 μg/l, P?=?0.14). The prevalence of Se deficiency was significantly higher in goitrous boys and girls than nongoitrous children. Se deficiency is among the contributors of goiter in Isfahan goitrous schoolchildren. However, the role of other micronutrient deficiencies or goitrogens should be investigated in this region.     

Growth pattern of the Kamars--a primitive tribe of Chhattisgarh,India

A cross sectional study of the physical growth status was made on 655 Kamar children (341 boys and 314 girls), aged 5 to 18 years, in the Raipur district of Chhattisgarh. The study aimed to find out the growth pattern of the Kamar children, which is considered to be a primitive tribe of Chhattisgarh, India and was compared with another Indian tribe and the official data for all India (ICMR). Anthropometric measurements included height, weight, sitting height, biacromial diameter, biilliocrystal diameter, upper arm circumference, calf circumference and measurements of the triceps and subscapular skinfolds. All anthropometric measurements except skinfold thickness exhibit uniform increase with age in both sexes. However, when height and weight of the Kamar boys and girls were compared with the data for other tribes and for all India, the Kamar children (both boys and girls) indicated lower weight and height and the difference showed to be significant, for almost all ages. Kamar boys showed higher anthropometric values than girls in almost all measurements except in biilliocrystal diameter and in measured skinfolds. Poor socio-economic status of this primitive tribe may be one of the reasons for this poor growth pattern. However, in-depth study is necessary in order to arrive at any basic conclusions and to recommend any policy and interventions.     

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.     

Ethnic Differences in Subcutaneous Adiposity and Waist Girth in Children and Adolescents

The purpose of this study was to examine ethnic differences in adiposity as measured by sum of skinfolds (SKF) and waist circumference (WC) in children and adolescents, after statistical adjustment for the BMI and age. A cross sectional sample of 3,218 (55% white, 49% male) children and adolescents aged 5–18 years who participated in the Bogalusa Heart Study (1992–1994) were included in these analyses. Sex‐specific ANOVAs, adjusted for BMI and age, for each 2‐year age group compared measures of adiposity (SKF and WC) between ethnic groups. No significant differences in the proportions of children and adolescents who were overweight and obese by ethnicity or sex were found. Mean SKF in normal weight (P < 0.0001) and overweight (P < 0.0001) categories was higher for white than black children of both sexes. Across most age categories, white boys and girls had significantly higher SKF than black boys and girls, respectively (P ≤ 0.05). Across most age categories, white boys had significantly higher WC than black boys (P ≤ 0.05) with no difference in the girls, when adjusted for BMI and age. Measures of adiposity in childhood and adolescence were significantly higher in white children compared to black children, when adjusted for BMI and age. Throughout childhood and adolescence, white boys and girls had higher SKF and white boys had higher WC. Differences in adiposity between ethnic groups should be considered in disease risk assessment and stratification as they are observed even for a given BMI level.     

Resting Heart Rate Is Not a Good Predictor of a Clustered Cardiovascular Risk Score in Adolescents: The HELENA Study

BackgroundResting heart rate (RHR) reflects sympathetic nerve activity a significant association between RHR and all-cause and cardiovascular mortality has been reported in some epidemiologic studies.MethodsTo analyze the predictive power and accuracy of RHR as a screening measure for individual and clustered cardiovascular risk in adolescents. The study comprised 769 European adolescents (376 boys) participating in the HELENA cross-sectional study (2006–2008) were included in this study. Measurements on systolic blood pressure, HOMA index, triglycerides, TC/HDL-c, VO₂máx and the sum of four skinfolds were obtained, and a clustered cardiovascular disease (CVD) risk index was computed. The receiver operating characteristics curve was applied to calculate the power and accuracy of RHR to predict individual and clustered CVD risk factors.ResultsRHR showed low accuracy for screening CVD risk factors in both sexes (range 38.5%–54.4% in boys and 45.5%–54.3% in girls). Low specificity’s (15.6%–19.7% in boys; 18.1%–20.0% in girls) were also found. Nevertheless, the sensitivities were moderate-to-high (61.4%–89.1% in boys; 72.9%–90.3% in girls).ConclusionRHR is a poor predictor of individual CVD risk factors and of clustered CVD and the estimates based on RHR are not accurate. The use of RHR as an indicator of CVD risk in adolescents may produce a biased screening of cardiovascular health in both sexes.     

Increased oxidative stress in children with attention deficit hyperactivity disorder

Objectives: The purpose of this study was to investigate oxidative stress in children with attention deficit hyperactivity disorder (ADHD).

Methods: Total oxidant status (TOS), total antioxidant status (TAS), paraxonase-1 (PON-1) and arylesterase (ARE) activity were measured in 76 children (44 boys, 32 girls) diagnosed with ADHD according to the DSM-IV and 78 healthy children (46 boys, 32 girls).

Results: Age and sex were similar between the groups (P?>?0.05). TOS and the oxidative stress index (OSI) were higher in the patient group than the control group (P?<?0.001). PON-1 (P?=?0.002), ARE (P?=?0.010) activity and TAS (P?<?0.001) were lower in the patient group than the control group.

Discussion: We found decreased PON-1, ARE activity and TAS, and increased TOS and OSI in children with ADHD. Our study showed that there is significantly increased oxidative stress in children with ADHD.     

Heavy metals and trace elements in scalp hair samples of children with severe autism spectrum disorder: A case-control study on Jordanian children

BackgroundElemental analysis has been increasingly used for biomonitoring heavy metals and trace elements.MethodsThis study monitored the levels of two heavy metals (Al and Pb), and seven trace elements (Macroelements Mg, K, P and Ca; Microelements Zn, Cu, Fe) in scalp hair of 57 children with severe autism spectrum disorder (ASD) and 50 age-matched controls, using Inductively Coupled Plasma Atomic Emission Spectrophotometry (ICP-AES).ResultsCompared to controls, significantly higher levels of Al (p = 0.001), Pb (p = 0.001) and K (p = 0.021), with lower levels of Mg and Zn (p = 0.038) were observed for the ASD group. ASD boys had higher levels of Al (p = 0.001), Pb (p = 0.001) and K (p = 0.017) than control boys, while ASD girls had higher Pb levels (p = 0.005) than control girls. The ASD subgroup exposed to passive smokers had higher levels of Al (p = 0.033) and Pb (p = 0.001, and the ASD subgroup not exposed to passive smoke had higher levels of Al (p = 0.011), Pb (p = 0.001), K (p = 0.003); and lower levels of Mg (p = 0.011) than their controls. Other confounding factors and the correlation between these elements were also investigated.ConclusionThis data suggests that exposure to Al and Pb, increase intake of K, and decreased intake of magnesium and zinc, may contribute to ASD etiology.     

Overweight in urban schoolchildren assessed by body mass index and body fat mass in Dalian, China

In order to assess overweight in urban schoolchildren (298 boys and 298 girls) aged 9-16 years in Dalian, China, their body height, weight, skinfolds at triceps, biceps, subscapular and suprailiac, and body circumferences of mid-upper arm, waist and hip were measured. The results showed that the prevalence of overweight, based on the United States Centers for Disease Control 2000 reference values using body mass index (BMI), was 22.9% in boys and 10.4% in girls, which was higher than that of indicated in Chinese national surveys of recent decades. More boys were overweight than girls due to excessive increase in body fat, although the prevalence of overweight in girls prevalence increased from 13 years. Discussion here focuses on the effects of behavioral patterns on overweight in Dalian schoolchildren, paying attention to gender difference.     

Secular growth trends among children in Beijing (1955–2010)

ObjectivesTo analyze the growth trends of children in Beijing from 1955 to 2010.MethodsData for the period 1955–1975 were derived from published records. Data for the period 1985–2010 were derived from the Chinese National Survey on Students’ Constitution and Health (CNSSCH). Since 1985, the overall sampling and measurement methods have been consistent. The mean, the standard deviation, and the variance (ANOVA) of height, weight, and BMI by age and sex of students aged 7–17 were calculated and analyzed.ResultsBetween 1955 and 2010, the average height and weight of children in Beijing has increased. The average increments per decade for boys and girls were 2.45 cm and 2.03 cm in height and 2.68 kg and 1.68 kg in weight, respectively. The largest height increase per decade occurred between 1975 and 1985: 4.51 cm and 3.23 cm for boys and girls, respectively. The largest height increase for the entire 55-year period under study occurred among boys at age 13 (17.85 cm) and among girls at age 11 (15.90 cm.)ConclusionsDuring the period 1955–2010, growth trends among children in Beijing were positive. The health and nutritional status of these children improved significantly. Since 2007, might be related to government intervention, childhood obesity has been curbed.     

Predicting maintenance or achievement of healthy weight in children: the impact of changes in physical fitness

Physical fitness is often inversely associated with adiposity in children cross-sectionally, but the effect of becoming fit or maintaining fitness over time on changes in weight status has not been well studied in children. We investigated the impact of changes in fitness over 1-4 years of follow-up on the maintenance or achievement of healthy weight among 2,793 schoolchildren who were first measured as 1st to 7th graders. Students were classified as "fit" or "underfit" according to age- and gender-specific norms in five fitness domains: endurance, agility, flexibility, upper body strength, and abdominal strength. Weight status was dichotomized by BMI percentile: "healthy weight" (<85th percentile) or "overweight/obese" (≥85th percentile). At baseline, of the 38.3% overweight/obese children, 81.9% (N = 875) were underfit. Underfit overweight students were more likely to achieve healthy weight if they achieved fitness (boys: odds ratio (OR) = 2.68, 95% confidence interval (CI) = 1.24-5.77; girls: OR = 4.67, 95%CI = 2.09-10.45). Initially fit overweight children (N = 194) were more likely to achieve healthy weight if they maintained fitness (boys: OR = 11.99, 95%CI = 2.18-65.89; girls: OR = 2.46, 95%CI = 1.04-5.83). Similarly, initially fit healthy-weight children (N = 717) were more likely to maintain healthy weight if they maintained fitness (boys: OR 3.70, 95%CI = 1.40-9.78; girls: OR = 4.14, 95%CI = 1.95-8.78). Overweight schoolchildren who achieve or maintain physical fitness are more likely to achieve healthy weight, and healthy-weight children who maintain fitness are more likely to maintain healthy weight. School-based policies/practices that support physical fitness may contribute to obesity reduction and maintenance of healthy weight among schoolchildren.