Factors affecting prevalence of overweight among 12- to 17-year-old urban adolescents in Hyderabad, India

Objective: The problem of overweight and obesity is not confined only to developed countries but is also widely prevalent in developing countries. The objective of this study was to assess the prevalence of overweight and obesity as defined by the International Obesity Task Force (IOTF) among school‐age children in Hyderabad, India, and identify its associated factors. Research Methods and Procedures: A cross‐sectional and institutional study, adopting a multistage stratified cluster sampling procedure, was carried out during 2003 on adolescents 12 to 17 years of age of both sexes from Hyderabad, India. Results: The overall prevalence of overweight was 6.1% [95% confidence interval (CI): 4.2, 8.0] among boys and 8.2% among girls (CI: 6.0, 10.4); 1.6% and 1.0% were obese, respectively. The prevalence was significantly higher (p < 0.05) among adolescents who watched television ≥3 h/d (10.4%) or belonged to a high socioeconomic background (14.9%, p < 0.001), whereas it was significantly lower among those participating regularly in outdoor games ≥6 h/wk (3.1%, p < 0.004) and household activities ≥3 h/d (4.7%, p < 0.001). The logistic regression analysis revealed that the prevalence of overweight was 4 times higher among the adolescents of high socioeconomic status [odds ratio (OR): 4.1; CI: 2.25, 7.52], 3 times higher in those not participating in outdoor games (OR: 2.75; CI: 1.56, 4.72), and 1.92 times higher in those watching television ≥3 h/d (OR: 1.92; CI: 1.16, 3.18). Discussion: This study confirmed the findings of earlier studies carried out in Western countries and emphasizes that regular physical exercise, doing household activities, regulated television viewing, and healthy eating behaviors could contribute to controlling overweight and obesity.     

Trends in Overweight and Obesity among Children and Adolescents in China from 1981 to 2010: A Meta-Analysis

Background

Overweight/obesity is a serious public health problem that affects a large part of the world population across all age and racial/ethnic groups. However, there has not been a meta-analysis of the prevalence of childhood and adolescent overweight/obesity in China during the past 30 years.

Methods

The China National Knowledge Infrastructure and Wanfang DATA, MEDLINE, EMBASE and Cumulative Index to Nursing and Allied Health Literature were searched for relevant studies published between January 1970 and June 2012. The prevalence of overweight/obesity over time was pooled using Stata/SE, version 9. Summary statistics (odds ratios, ORs) were used to compare sex-specific and urban-rural preponderance of overweight/obesity using Review Manager.

Results

After screening 1326 papers, we included 35 papers (41 studies), most of medium quality. The prevalence of overweight/obesity increased from 1.8% (95% confidence interval [CI], 0.4%–3.1%) and 0.4% (95% CI, −0.1% to −0.8%) respectively in 1981–1985 to 13.1% (95% CI, 11.2%–15.0%) and 7.5% (95% CI, 6.6%–8.4%) respectively in 2006–2010. The average annual increase was 8.3% and 12.4% respectively. Boys were more likely to be overweight/obese than girls (OR, 1.36; 95% CI, 1.24–1.49 and OR, 1.68; 95% CI, 1.52–1.86 respectively). The prevalence of overweight/obesity was higher in urban areas than in rural areas (OR, 1.66; 95% CI, 1.54–1.79 and OR, 1.97; 95% CI, 1.68–2.30 respectively). For age-specific subgroup analyses, both overweight and obesity increased more rapidly in the toddler stage than in other developmental stages. Sensitivity analyses showed that sample-size differences, study quality, overweight/obesity criteria and geographical distribution affected overweight/obesity prevalence.

Conclusions

Toddlers and urban boys were at particularly high risk; the prevalence in these groups increased more rapidly than in their counterparts. Public health prevention strategies are urgently needed to modify health behaviors of children and adolescents and control overweight/obesity in China.     

Trends of overweight and obesity among white and american indian school children in south dakota, 1998–2010

Objective:

To investigate the prevalence of overweight and obesity among white and American Indian children in a predominantly rural state.

Design and Methods:

Using a repeated, cross‐sectional design of school children's height and weight, the study sample included 361,352 measures of children who were 5.0–19.9 years, attending school across 13 academic calendar years. Trained staff measured height, weight, and recorded gender, age, and race. Data were voluntarily reported to the State Department of Health.

Results:

American Indian children consistently had higher rates of overweight and obesity compared to white children. Across the years, 16.3% of white students were overweight, whereas 19.3% of American Indian students were overweight. In addition, 14.5% of white children were obese and 25.9% of American Indian children were obese. Examining by rural versus urban schools, prevalence of overweight had been increasing among white male and female students and American Indian female students living in rural areas. Obesity is also increasing among rural white females and male and female American Indian children.

Conclusions:

The findings here suggest that although American Indian children are at higher risk, in general, compared to white children, rural populations in general are experiencing increases in childhood overweight and obesity. Targeted rural interventions beginning at an early age are necessary to improve the health of rural children, especially in American Indian communities.     

Metabolic Syndrome in Overweight and Obese Japanese Children

Objective: To determine the prevalence of and sex differences related to the metabolic syndrome among obese and overweight elementary school children. Research Methods and Procedures: Subjects were 471 overweight or obese Japanese children. Children meeting at least three of the following five criteria qualified as having the metabolic syndrome: abdominal obesity, elevated blood pressure, low high‐density lipoprotein‐cholesterol levels, high triglyceride levels, and high fasting glucose levels. Fasting insulin levels were also examined. Results: Japanese obese children were found to have a significantly lower prevalence (17.7%) of the metabolic syndrome than U.S. obese adolescents (28.7%, p = 0.0014). However, Japanese overweight children had a similar incidence (8.7%) of the metabolic syndrome compared with U.S. overweight adolescents (6.8%). Hyperinsulinemia in girls and abdominal obesity in boys are characteristic features of individual metabolic syndrome factors in Japanese children. Discussion: The prevalence of the metabolic syndrome is not lower in preteen Japanese overweight children than in U.S. overweight adolescents, although it is significantly lower in Japanese obese preteen children than in U.S. obese adolescents. Primary and secondary interventions are needed for overweight preteen children in Japan.     

Prevalence and Trends in Obesity among China’s Children and Adolescents, 1985–2010

Objectives

We examined the prevalence of and trends in obesity among children and adolescents in China (1985–2010).

Methods

We used data from the 1985, 1991, 1995, 2000, 2005, and 2010 Chinese National Surveys on Students’ Constitution and Health (CNSSCH). The CNSSCH is a national survey of physical fitness and health status in Chinese students that uses multistage stratified sampling of 31 provinces and municipalities. A subject was considered obese or overweight if weight-for-height exceeded the 20% or 10% of standard weight-for-height. The standard weight-for-height was the 80th percentile for sex- and age-specific growth charts.

Results

The age-adjusted prevalence of obesity and of overweight and obesity combined was 8.1% (95% CI, 8.0–8.3%) and 19.2% (95% CI, 19.1–19.4%) among children and adolescents 7–18 years in age. Obesity was more likely to be present among children or adolescents who were male (RR, 1.93; 95% CI, 1.90–1.97), urban (RR, 1.99; 95% CI, 1.95–2.02), or 10–12 years (RR, 1.43; 95% CI, 1.40–1.46). Trend analyses of the 25-year period revealed a significant increasing trend in males (RR, 1.59; 95% CI, 1.58–1.60) and in females (RR, 1.49; 95% CI, 1.48–1.50). The rate of increase in obese or overweight prevalence was highest in boys from rural areas (9% annual increase).

Conclusions

During 1985–2010, there was a significant and continuous increase in the prevalence of obesity in children and adolescents. Obesity is epidemic in China, but may be reduced with evidence-based interventions (e.g., school intervention programs).     

Overweight Associated with Increased Risk of Erosive Esophagitis in a Non-Obese Taiwanese Population

Objective

To investigate the relationship between overweight and erosive esophagitis (EE) in a non-obese Taiwanese population.

Design and Methods

A total of 7,352 subjects (non-obese, 5,826; obese, 1,526) from a health examination center at National Cheng Kung University Hospital were enrolled. Central obesity was defined by a waist circumference (WC) ≥90 cm in male and 80 cm in female. Overweight was defined as body mass index (BMI) of 24–26.9 kg/m², and general obesity as BMI ≥27 kg/m². The Los Angeles classification was adopted to determine the presence of EE.

Results

There were significant differences in the prevalence of central obesity and different BMI status between subjects with and without EE in total and non-obese population. In total population, multivariate analyses revealed central obesity (OR, 1.17, 95% CI, 1.02–1.34, p = 0.021) and being obese (OR, 1.28, 95% CI, 1.07–1.52, p = 0.007)/overweight (OR, 1.25, 95% CI, 1.08–1.45, p = 0.003) had positive associations with EE in different model, respectively. When considering the joint effect of central obesity and BMI status, overweight (OR, 1.22; 95% CI, 1.04–1.44; p = 0.016) remained as an independent associated factor of EE but central obesity (OR, 1.06; 95% CI, 0.89–1.26; p = 0.549)/being obese (OR, 1.22; 95% CI, 0.98–1.53; p = 0.082) did not. As for non-obese group, separate model showed central obesity (OR, 1.19, 95% CI, 1.00–1.40, p = 0.046) and overweight (OR, 1.24; 95% CI, 1.07–1.44, p = 0.005) was positively associated with EE, respectively. However, being overweight (OR, 1.20; 95% CI, 1.02–1.42, p = 0.030) but not central obesity (OR, 1.08; 95% CI, 0.90–1.31; p = 0.398) was positively related to EE with considering the effect of overweight and central obesity simultaneously.

Conclusion

Overweight effect on EE was more detrimental than central obesity in non-obese subjects. In addition, male gender, hiatus hernia and alcohol use were also associated with increased risk of EE.     

Prevalence and determinants of obesity in children in public schools of Sintra, Portugal

Objective: To assess the prevalence of and the factors related to overweight and obesity in a sample of children from the region of Sintra, Portugal. Methods and Procedures: Cross‐sectional study, stratified for freguesia with random selection of schools. Height, weight, triceps skinfold, upper arm and waist circumferences were measured, and overweight/obesity defined according to international criteria. Breast‐feeding, number of daily meals and parents' height and weight data were also collected. Results: One thousand two hundred and twenty‐five children aged 6–10 years were assessed. Overall prevalence of overweight and obesity was 35.6% (23% overweight and 12.6% obesity). Overweight or obese children had higher triceps skinfold, upper arm circumference, arm muscle area, and waist circumference than their normal weight counterparts (P < 0.001). On multivariate analysis, relatively to a child without obese progenitors, a child with one obese progenitor had an obesity risk multiplied by 2.78 (95% confidence interval (CI): 1.76–4.38), while a child with two obese progenitors had a risk multiplied by 6.47 (95% CI: 5.59–16.19). Conversely, being picky was significantly related with a smaller risk of obesity: for boys, odds ratio (OR) = 0.15 (95% CI: 0.04–0.63); for girls, OR = 0.19 (95% CI: 0.06–0.64). Finally, no relationships were found between obesity, birth weight, birth height or breast‐feeding. Discussion: Prevalence of overweight and obesity are elevated among children of the Sintra region in Portugal compared to most other regions of Europe. The relationship with the parents' nutritional state stresses the need to target families for preventing obesity.     

Racial/Ethnic Differences in Weight Perception

The objective of this research was to estimate the prevalence of weight misperception among adults using the most recent nationally representative data, according to measured weight category and to assess the relationship between weight misperception and race/ethnicity. Height and weight were measured as part of the 1999–2006 National Health and Nutrition Examination Survey. The study sample consisted of 17,270 adults aged ≥20 years. BMI was categorized as underweight (BMI < 18.5), healthy weight (18.5 ≤ BMI < 25), overweight (25 ≤ BMI < 30), and obese (BMI ≥ 30). Subjects reported self‐perception of weight status. Among study subjects, 31.7% of healthy weight adults, 38.1% of overweight adults, and 8.1% of obese adults incorrectly perceived their weight category. Among obese men, the odds of weight misperception were higher for non‐Hispanic blacks (odds ratio (OR) = 3.0; 95% confidence interval (CI) = 2.0–4.5) compared to non‐Hispanic whites and for persons with less than a high school education (OR = 2.1; 95% CI = 1.3–2.1), compared to those with some college education. Among obese women, the odds of weight misperception were higher for non‐Hispanic blacks (OR = 3.4; 95% CI = 1.4, 3.1) and Mexican Americans (OR = 1.9; 95% CI = 1.2, 3.2) compared to non‐Hispanic whites and for persons with less than high school education compared to those with some college education (OR = 5.5; 95% CI = 3.3–9.3). Weight misperception is highly prevalent in the US population, and more frequent in racial/ethnic minorities, males, and in persons with lower educational levels. Addressing the issue of weight misperception may help address the problem of obesity in the United States by increasing awareness of healthy weight levels, which may subsequently have an impact on weight‐related behavior change.     

Dietary behaviors as associated factors for overweight and obesity in a sample of adolescents from Aquitaine, France

This study aimed to identify dietary behaviors that might be considered as associated factors for overweight or obesity among French adolescents. Forty-nine of the 536 middle and high schools in Aquitaine (southwest of France) were invited to take part in the study. For each school, participating adolescents were selected using stratification by grade. A self-report questionnaire, including information about sex, age, dietary behaviors, physical and sedentary activities, and parental socioeconomic status (SES), was filled in by adolescents during class. Overweight and obesity were defined according to the age- and sex-specific body mass index cutoff points of the International Obesity Task Force. Multivariate analysis (logistic regression) was used to identify independent dietary factors associated with overweight including obesity and obesity alone (adjustment on sex, age, parental SES, and weight status and adolescents' sedentary activity). In addition to parental SES and weight status and adolescents' sedentary activity, some dietary behaviors are also independently and significantly associated with a higher prevalence of overweight including obesity: absence (OR 1.43, 0.91–2.23) or rare (OR 1.57, 1.23–2.01) breakfast intake (p?<?0.01) and absence (OR 5.03, 3.19–7.92) or rare (OR 1.90, 1.46–2.47) light afternoon meal intake (p?<?0.001). All variables were also significantly and independently associated with obesity alone. This study shows that socioeconomic factors and individual behaviors are associated with overweight or obesity. These results confirm the importance to carry out multifaceted educational actions among adolescents, by promoting physical activity and healthy food choices in order to prevent overweight and promote healthy lifestyle behaviors.     

Trends in obesity and associations with education and urban or rural residence in Thailand

Objective: To measure trends in the prevalence of overweight and obesity and the relationship with urban or rural residence and education in Thailand. Research Methods and Procedures: Data were from two nationally representative surveys of 38,323 individuals ≥18 years old (19,156 were 18 to 59 years old) in 2004 and 3375 individuals 18 to 59 years old in 1997. Overweight and obesity were defined using the World Health Organization's Asian criteria. Results: Among those ≥18 years old in 2004, 17.8% of men (95% confidence interval, 16.6% to 19.0%) were overweight, 18.4% (17.3% to 19.5%) had Class I obesity, 4.8% (4.1% to 5.5%) had Class II obesity, and 15.9% (14.6% to 17.1%) had abdominal obesity. In women, 18.2% (17.1% to 19.2%) were overweight, 26.1% (24.9% to 27.3%) had Class I obesity, 9.3% (8.6% to 10.0%) had Class II obesity, and 37.3% (35.3% to 39.2%) had abdominal obesity. In those 18 to 59 years old, the prevalence of Class I obesity in men and all four categories in women significantly increased between 1997 and 2004. There was an inverse relationship in women but a positive relationship in men between education and the odds of being overweight or obese. In 2004, there were significantly lower odds of being overweight or obese in rural compared with urban men but similar odds between urban and rural women. Discussion: The prevalence of overweight and obesity in Thailand is high and increasing. Although the transition of overweight and obesity to those of lower socioeconomic status is not complete, it is well on the way.     

Secular trends in the prevalence of overweight and obesity in Sicilian schoolchildren aged 11-13 years during the last decade

The present study evaluates trends in the prevalence of overweight and obesity in relation to gender and area of residence between two cohorts of students aged 11–13 years in Sicily. The analysis was performed on 1,839 schoolchildren, with 924 and 915 children being studied in 1999–2001 and 2009–2010, respectively. The children who were enrolled during 2009–2010 had significantly higher body mass indexes (BMI), BMI z-scores, and waist circumferences than the children who were studied during 1999–2001 (p<0.0001 for all); these differences was also observed when the cohort was subdivided according to gender or residence area The prevalence of obesity increased significantly from 7.9% in 1999–2001 to 13.7% in 2009–2010 (p<0.0001), whereas thinness decreased significantly from 10.1% to 2.3% (p<0.0001) in the same periods. The increase of trends in the prevalence of obesity was significantly higher in males (9.7% vs. 17.6%, p = 0.0006) than in females (6.3% vs. 9.8%, p = 0.04) and was slightly higher in urban areas (8.8% vs. 14.3%, p = 0.002) than in rural areas (7.8% vs. 13.0%, p = 0.012). The male gender was associated with a higher risk of being overweight or obese (odds ratio: 1.63; 95% confidence intervals: 1.24–2.15; p = 0.0005) in 2009–2010 than in 1999–2001, after adjusting for age and the residence area. In conclusion, this study showed an increasing trend in the prevalence of overweight and obesity in Sicilian schoolchildren during the last decade and that this trend was related to gender, age and the area of residence. More specifically, our data indicated that the prevalence of obesity increased by 5.8%, the prevalence of thinness decreased by 7.8% and the prevalence of normal-weight children did not change over the course of a decade. These results suggest a shift in the body weights of Sicilian children toward the upper percentiles.     

Four-year follow-up of school-based intervention on overweight children: the KOPS study

Objective: To evaluate the 4‐year outcome of a school‐based health promotion on weight status as part of the Kiel Obesity Prevention Study (KOPS). Research Methods and Procedures: Within a cluster‐sampled quasi‐randomized controlled trial, 1764 children at 6 and 10 years of age were assessed between 1996 and 2005 in 32 primary schools in Kiel, North Germany. Six nutrition units followed by 20‐minute running games were performed within the first year at school. Prevalence, incidence, and remission of overweight were main outcome measures. Results: The 4‐year change in BMI was +11.6%, with increases in prevalence of overweight and obesity from 5.2% to 11.1% and 3.9% to 5.1%, respectively. Cumulative 4‐year incidence of overweight and obesity was 9.2% and 3.1%, respectively. Intervention had no effect on mean BMI. The effect on prevalence was significant in children from families with high socioeconomic status [odds ratio (OR), 0.35; 95% confidence interval (CI), 0.14 to 0.91] and marginally significant in children of normal‐weight mothers (OR, 0.57; 95% CI, 0.33 to 1.00). Cumulative 4‐year incidence of overweight was lower only in intervention children from families with high socioeconomic status (OR, 0.26; 95% CI, 0.07 to 0.87). Remission of overweight was most pronounced in children of normal‐weight mothers (OR, 5.43; 95% CI, 1.28 to 23.01). Prevalence of underweight was unchanged. The intervention had minor but favorable effects on lifestyle. Discussion: A school‐based health promotion has sustainable effects on remission and incidence of overweight; it was most pronounced in children of normal‐weight mothers and children from families with high socioeconomic status. There was no effect on obesity. The data argue in favor of additional measures of prevention.     

A pilot study on the prevalence of maternal obesity in selected Greek counties

ObjectiveTo report a pilot prevalence of maternal overweight, obesity and underweight in selected Greek counties.MethodsA total of 441 adult childbearing women were recruited from maternity clinics in 6 Greek counties for this cross-sectional study. Pre-gravid weight status was defined according to the WHO cut-offs and gravid weight status was diagnosed with the Mardones and Rosso weight gain chart.ResultsDuring gestation the majority of the participants were of normal body weight (BW) (34.0%), obesity was apparent in 25.6% of the sample, 23.8% of the participants were underweight, and the remaining 16.6% were overweight. Overall, pregnancy tripled the prevalence of underweight, increased the prevalence of obesity (by 388.0%) and decreased the number of participants in the normal BW category (p ≤ 0.001 for all). The majority of participants classified in each pre-gravid weight-category remained in the same weight category during their gestation. All the pre-gravidly obese women were also obese during pregnancy. Underweight was more prevalent in Kavala (37.5%) and obesity was more frequent in Thessaloniki (30.8%). Women who were overweight prior to conception were highly likely to be overweight/obese during pregnancy (OR: 23.8, CI: 11.1–51.0).ConclusionsThe results indicate a high prevalence of overweight, obesity and underweight among pregnant women in Greece.     

Major Increase in Prevalence of Overweight and Obesity between 1987 and 2001 among Danish Adults

Objective: The aim of the study was to examine the secular trends in the prevalence of obesity (BMI ≥ 30.0 kg/m²) and overweight (25.0 ≤ BMI < 30.0 kg/m²) in Danish adults between 1987 and 2001. Research Methods and Procedures: The study included self‐reported weight and height of 10, 094 men and 9897 women 16 to 98 years old, collected in a series of seven independent cross‐sectional surveys. Prevalence and changes in prevalence of obesity and overweight stratified by sex and age groups were determined Results: The prevalence of obesity more than doubled between 1987 and 2001, in men from 5.6% to 11.8% [odds ratio (OR) = 2.3, 95% confidence interval (CI) = 1.9 to 2.8, p < 0.0001] and in women from 5.4% to 12.5% (OR = 2.6, 95% CI = 2.1 to 3.2, p < 0.0001), with the largest increase among the 16‐ to 29‐year‐old subjects (men, from 0.8% to 7.5%, OR = 10.2, 95% CI = 4.1 to 25.3, p < 0.0001; women, from 1.4% to 9.0% OR = 7.0, 95% CI = 3.5 to 14.1, p < 0.0001). Between 1987 and 2001, the prevalence of overweight increased from 34% to 40% in men and from 17% to 27% in women. Discussion: The prevalence of overweight and obesity in Denmark has increased substantially between 1987 and 2001, particularly among young adults, a development that resembles that of other countries. There is clearly a need for early preventive efforts in childhood to limit the number of obesity‐related complications in young adults.     

Additive Interactions of Maternal Prepregnancy BMI and Breast‐feeding on Childhood Overweight

Objective: To examine the interactions of maternal prepregnancy BMI and breast‐feeding on the risk of overweight among children 2 to 14 years of age. Research Methods and Procedures: The 1996 National Longitudinal Survey of Youth, Child and Young Adult data in the United States were analyzed (n = 2636). The weighted sample represented 51.3% boys, 78.0% whites, 15.0% blacks, and 7.0% Hispanics. Childhood overweight was defined as BMI ≥95th percentile for age and sex. Maternal prepregnancy obesity was determined as BMI ≥30 kg/m². The duration of breast‐feeding was measured as the weeks of age from birth when breast‐feeding ended. Results: After adjusting for potential confounders, children whose mothers were obese before pregnancy were at a greater risk of becoming overweight [adjusted odds ratio (OR), 4.1; 95% confidence interval (CI), 2.6, 6.4] than children whose mothers had normal BMI (<25 kg/m²; p < 0.001 for linear trend). Breast‐feeding for ≥4 months was associated with a lower risk of childhood overweight (OR, 0.6; 95% CI, 0.4, 1.0; p = 0.06 for linear trend). The additive interaction between maternal prepregnancy obesity and lack of breast‐feeding was detected (p < 0.05), such that children whose mothers were obese and who were never breast‐fed had the greatest risk of becoming overweight (OR, 6.1; 95% CI, 2.9, 13.1). Discussion: The combination of maternal prepregnancy obesity and lack of breast‐feeding may be associated with a greater risk of childhood overweight. Special attention may be needed for children with obese mothers and lack of breast‐feeding in developing childhood obesity intervention programs.     

Association of macro-level determinants with adolescent overweight and suicidal ideation with planning: A cross-sectional study of 21 Latin American and Caribbean Countries

BackgroundAdolescents and young people (10–24 years old) in the Latin America and the Caribbean (LAC) region represent approximately 25% of the region’s population. Since the 2008 global economic crisis, the pace of reduction in poverty and income inequality in the LAC region has stalled. The region is characterised by high levels of inequities and is also vulnerable to many natural disasters. Food systems are changing with increased availability and marketing of packaged and fast foods and sugar-sweetened drinks. Adolescence is a formative phase of the life course with multiple physical, emotional and social changes which can make them vulnerable to health problems. We assess the potential impact of macro-determinants, human and economic development as well as income inequality, on 2 top-ranking regional priorities for adolescent nutrition and mental health, using measures of overweight and suicidal ideation and planning which some have shown to be associated.Methods and findingsThe Global School-based Health Survey (GSHS) is a nationally representative self-administered, school-based survey. We examined overweight/obesity and suicidal ideation with planning by gross domestic product (GDP) per capita or human development index (HDI) in 10–19-year-old adolescents from 21 LAC countries between 2009 and 2013. Sample sizes varied from 943 in Anguilla to 27,988 in Argentina. A total of 55,295 adolescents had a measure of overweight/obesity status, and 59,061 adolescents reported about suicidal ideation with planning. There was equal representation by sex in the surveys (52% girls and 48% boys). A total of 28.8% of boys and 28.1% of girls had overweight/obesity, and 7.5% of boys and 17.5% of girls reported suicidal ideation with planning over the last 12 months. Adjusted for individual socioeconomic and risk behaviours, and relative to the highest GDP per capita tertile, the middle tertile was associated with 42% (95% confidence interval (CI) 59% to 17%, p = 0.003) and 32% (95% CI 60% to 5%, p = 0.023), and the lowest tertile with 40% (95% CI 55% to 19%, p = 0.001) and 46% (95% CI 59% to 29%, p < 0.001) lower chances of overweight/obesity for girls and boys, respectively. A similar positive effect was seen with HDI, with lowest chances of overweight in the lowest tertile compared with the highest tertile for both sexes. Overweight/obesity was positively related with suicidal ideation with planning for girls (odds ratio (OR) 1.12, 95% CI 1.02 to 1.22, p = 0.009) and weakly related for boys (OR 1.09, 95% CI 0.96 to 1.24, p = 0.182). In contrast to overweight/obesity status, suicidal ideation with planning was not related to macro-level indices despite both outcomes sharing common individual socioeconomic and risk behaviour correlates. Limitations include the dominance of Argentinians in the sample (40%), the exclusion of vulnerable adolescents who dropped out of school, and reporting bias due to stigma of mental health–related issues.ConclusionsThis study shows that economic and human development were positively associated with adolescent overweight/obesity but not with suicidal ideation with planning. We also observed an interconnectedness between overweight/obesity and suicide ideation with planning among girls. These findings highlight the importance of strategies that engage with both upstream and downstream determinants to improve adolescent nutrition and mental health.     

High childhood obesity in an Australian population

Objective: The objective was to determine the prevalences of overweight and obesity in regional Australian children and to examine the association between BMI and indicators of socioeconomic status (SES). Research Methods and Procedures: Regionally representative cross‐sectional survey of 2184 children, 4 to 12 years of age, was conducted, and the socio‐demographic characteristics of their parents from regional Victoria, Australia, 2003 to 2004, were obtained. Results: The prevalences of overweight and obesity were 19.3 ± 0.8% (proportion ± standard error) and 7.6 ± 0.6%, respectively, using international criteria, and the proportion of overweight/obese girls was significantly higher than that of boys (29.6 ± 1.4% vs. 23.9 ± 1.3%, χ² = 9.01, p = 0.003). Children from households of lower SES had higher odds of being overweight/obese; lower SES was defined by lower paternal education (adjusted odds ratio, 1.18; 95% confidence interval, 1.08 to 1.30) and lower area‐level SES (adjusted odds ratio, 1.13; 95% confidence interval, 1.02 to 1.25), adjusted for age, gender, height, and clustering by school. Discussion: The prevalences of overweight and obesity are increasing in Australian children by about one percentage point per year. This equates to ～40,000 more overweight children each year, placing Australian children among those at highest risk around the world. In addition, girls are more likely to be overweight, and there is a general trend for children of lower SES to be at even greater risk of overweight and obesity.     

Obesity and Aerobic Fitness among Urban Public School Students in Elementary,Middle, and High School

Aims and Objectives

To assess the prevalence of cardiovascular disease risk among urban public school students through a collaborative school district and university partnership.

Methods

Children and adolescents in grades K-12 from 24 urban public schools participated in measurements of height, weight, and other health metrics during the 2009–2010 school year. Body mass index (BMI) percentiles and z-scores were computed for 4673 students. President’s Challenge 1-mile endurance run was completed by 1075 students ages 9–19 years. Maximal oxygen consumption (⩒O₂max) was predicted using an age-, sex-, and BMI-specific formula to determine health-related fitness. Resting blood pressure (BP) was assessed in 1467 students. Regression analyses were used to compare BMI z-scores, fitness, and age- and sex-specific BP percentiles across grade levels. Chi-square tests were used to explore the effect of sex and grade-level on health-related outcomes.

Results

Based on BMI, 19.8% were categorized as overweight and 24.4% were obese. Included in the obese category were 454 students (9.7% of sample) classified with severe obesity. Using FITNESSGRAM criteria, 50.2% of students did not achieve the Healthy Fitness Zone (HFZ); the proportion of students in the Needs Improvement categories increased from elementary to middle school to high school. Male students demonstrated higher fitness than female students, with 61.4% of boys and only 35.4% of girls meeting HFZ standards. Elevated BP was observed among 24% of 1467 students assessed. Systolic and diastolic BP z-scores revealed low correlation with BMI z-scores.

Conclusions

A community-university collaboration identified obesity, severe obesity, overweight, and low aerobic fitness to be common risk factors among urban public school students.     

Bright Start: Description and Main Outcomes From a Group‐Randomized Obesity Prevention Trial in American Indian Children

The aim of the Bright Start study was to develop and test the effectiveness of a school environment intervention, supplemented with family involvement, to reduce excessive weight gain by increasing physical activity and healthy eating practices among kindergarten and first‐grade American Indian children. Bright Start was a group‐randomized, school‐based trial involving 454 children attending 14 schools on the Pine Ridge Reservation in South Dakota. Children were followed from the beginning of their kindergarten year through the end of first grade. Main outcome variables were mean BMI, mean percent body fat, and prevalence of overweight/obese children. The goals of the intervention were to: increase physical activity at school to at least 60 min/day; modify school meals and snacks; and involve families in making behavioral and environmental changes at home. At baseline, 32% of boys and 25% of girls were overweight/obese. Although the intervention was not associated with statistically significant change in mean levels of BMI, BMI‐Z, skinfolds or percentage body fat, the intervention was associated with a statistically significant net decrease of 10% in the prevalence of overweight. Intervention children experienced a 13.4% incidence of overweight, whereas the control children experienced a corresponding incidence of 24.8%; a difference of ?11.4% (P = 0.033). The intervention significantly reduced parent‐reported mean child intakes of sugar‐sweetened beverages, whole milk, and chocolate milk. Changes in duration of school physical activity were not significant. Because obesity is the most daunting health challenge facing American Indian children today, more intervention research is needed to identify effective approaches.     

Higher prevalence of obesity among children with asthma

The aim of this study is to investigate the association between childhood obesity and asthma, and whether this relationship varies by race/ethnicity. For this population-based, cross-sectional study, measured weight and height, and asthma diagnoses were extracted from electronic medical records of 681,122 patients aged 6-19 years who were enrolled in an integrated health plan 2007-2009. Weight class was assigned based on BMI-for-age. Overall, 18.4% of youth had a history of asthma and 10.9% had current asthma. Adjusted odds of current asthma for overweight, moderately obese, and extremely obese youth relative to those of normal weight were 1.22 (95% confidence interval (CI): 1.20, 1.24), 1.37 (95% CI: 1.34, 1.40), and 1.68 (95% CI: 1.64, 1.73), respectively (P trend < 0.001). Black youth are nearly twice as likely (adjusted odds ratio (OR) = 1.93, 95% CI: 1.89, 1.99), and Hispanic youth are 25% less likely (adjusted OR = 0.75, 95% CI: 0.74, 0.77), to have current asthma than to non-Hispanic white youth. However, the relationship between BMI and asthma was strongest in Hispanic and weakest in black youth. Among youth with asthma, increasing body mass was associated with more frequent ambulatory and emergency department visits, as well as increased inhaled and oral corticosteroid use. In conclusion, overweight, moderate, and extreme obesity are associated with higher odds of asthma in children and adolescents, although the association varies widely with race/ethnicity. Increasing BMI among youth with asthma is associated with higher consumption of corticosteroids and emergency department visits.