The epidemic of obesity in children and adolescents in the world

Nutritional status and obesity in children and young adults with disabilities in Punta Arenas, Patagonia, Chile

Childhood obesity is reaching epidemic proportions throughout the world; however, little is known on the nutritional status of children with disabilities. To address this issue, medical records of 748 children aged 18 years or younger receiving physical therapy during 2004-2005 at a privately sponsored free rehabilitation clinic in Punta Arenas, Patagonia, Chile were abstracted. Data included demographic, clinical, and anthropometric information recorded at the first visit. As a comparison, height and weight were also collected in 215 children attending local schools. Nutritional status was calculated as body mass index (above 6 years of age) or evaluated by growth curves (6 years of age or below) as undernourished, normal, overweight, obese, or morbidly obese. Logistic regression was used to determine risk factors for obesity in these children. Overall, a significant difference in nutritional status between disabled and non-disabled children was found (P<0.001). Children with disabilities had a higher prevalence of both below and above normal weight than non-disabled children. Risk factors for obesity included increasing age and living with a grandparent independent of other socioeconomic factors. Compared with normal children, risk of obesity was doubled for those with developmental delays [odds ratio (OR): 1.96; 95% confidence interval (CI): 1.16-3.34] and neurological disorders (OR: 2.58, 95% CI: 1.26-5.29), whereas individuals with cerebral palsy were less than half as likely to be obese than non-disabled children (OR: 0.46, 95% CI: 0.20-1.03). We conclude that overnutrition continues to be a problem for both disabled and non-disabled children in Patagonia. Programs to increase physical activity and improve nutrition are needed in this isolated part of the world.

Prevalence of non-alcoholic fatty liver disease in children and relationship to metabolic syndrome, insulin resistance, and waist circumference

OBJECTIVES

To investigate the prevalence of non-alcoholic fatty liver disease (NAFLD) in children and its relationship to metabolic syndrome, insulin resistance, and waist circumference (WC).

METHODS

This was a population-based cross-sectional, case-control study. Cases were selected among students of a primary and junior high school, respectively, and age- and sex-matched control subjects were selected randomly (ratio of cases to control subject was 37:113).

RESULTS

Of the 846 students, aged between 6 and 15 years, enrolled in the study and screened by ultrasonography, 37 children were diagnosed as having NAFLD (score >/= 1). There was a significant sex difference in the prevalence of NAFLD(P = 0.003). The trend test revealed a strong dose-response relationship (P < 0.001) between pediatric NAFLD and the number of the proposed components of pediatric metabolic syndrome in Japan (MetS-JC), such as a clustering of the components of MetS-JC. Additionally, the linear trend of the odds ratios (ORs) with increasing percentile of the homeostasis model assessment-insulin resistance (HOMA-IR) was statistically significant (P < 0.001). However, when WC was added to the logistic model, the ORs were no longer significant, whereas WC turned out to be an independent risk factor for NAFLD regardless of the HOMA-IR index.

CONCLUSION

The prevalence of NAFLD in children and adolescents is closely related to metabolic syndrome, insulin resistance, and WC.

Umbilical artery tone in maternal obesity

BACKGROUND

The increasing prevalence of obesity constitutes a major health problem in obstetrics with implications for feto-maternal growth and wellbeing. This study investigated and compared the contractile properties of umbilical arteries excised from obese women, with those excised from women with a normal body mass index (BMI).

METHODS

Sections of umbilical artery were obtained from umbilical cord samples immediately after delivery and mounted for isometric recording in organ tissue baths under physiological conditions. Cumulative additions of 5-Hydroxytryptamine (5-HT) and Prostaglandin F-2alpha (PgF2alpha) were added in the concentration range of 1 nmol/L to 10 micromol/L. Control vessels were exposed to Krebs physiological salt solution (PSS) only. The resultant effects of each drug addition were measured using the Powerlab hardware unit.

RESULTS

5-HT exerted a significant effect on human umbilical artery tone at concentrations of 100 nmol/L, 1 micromol/L, and 10 micromol/L in normal (n = 5; P < 0.05) and obese (n = 5; P < 0.05) women. The contractile effect was significantly greater in vessels from obese women {Mean Maximum Tension (MMT) = 4.2532 g} than in those from women of normal BMI (MMT = 2.97 g; P < 0.05). PgF2alpha exerted a significant contractile effect on vessels at 1 micromol/L and 10 micromol/L concentrations when compared with controls (n = 5; P < 0.05). There was a non-significant trend towards an enhanced tone response in vessels from obese women (MMT = 3.02 g; n = 5), in comparison to vessels from women of a normal BMI (MMT = 2.358 g; n = 5; P > 0.05).

CONCLUSION

These findings support the hypothesis that endogenous regulation of umbilical artery tone is altered in association with maternal obesity. This may be linked to the cardiovascular effects of secretory products of adipose tissue, with implications for the feto-maternal circulation.

Is there a further acceleration in the age at onset of menarche? A cross-sectional study in 1840 school children focusing on age and bodyweight at the onset of menarche

OBJECTIVE

More than 30 years ago Frisch and Revelle proposed a body weight threshold for the onset of menarche. Based on this hypothesis, a further acceleration of age at menarche can be expected in times of childhood obesity.

DESIGN

A cross-sectional study of 1840 healthy school girls (Berlin school children's cohort, BSCOC) within the age groups 10-15 years was conducted in 2006-2007.

METHODS

Median age of menarche was calculated by Kaplan-Meier survival analysis. Bi- and multivariate analyses were performed to analyze the associations between menarche age and weight status. A locally weighted regression was used to analyze the relationship respectively between height, weight, and body mass index (BMI)-SDS and age stratified by menarche status.

RESULTS

Nine hundred and thirty six (50.9%) girls had already experienced menarche at a median age of 12.8 years. Two hundred and thirty six of these girls reached their menarche recently. Obese/overweight girls reached menarche significantly earlier (12.5 years), than normal weight (12.9 years), and underweight girls (13.7 years). The mean total body weight was similar in all girls at menarche irrespective of age (mean 51.1 kg, s.d. 8.1) and height. BMI-SDS remained the only significant factor for onset of menarche within a multiple regression model for early menarche (OR 2.1, 95% confidence interval 1.3-3.3, P=0.002).

CONCLUSIONS

Age at onset of menarche did not accelerate even in a childhood population with more than 10% obesity prevalence. Nevertheless, a negative correlation of BMI-SDS with age at onset of menarche exists.

Growth-curve standards and the assessment of early excess weight gain in infancy

OBJECTIVES

Increasing overweight and obesity are growing problems among children worldwide. Prevention requires an understanding of when excess weight gain begins and the determinants that place children at risk. The aim of our study was to illustrate how the growth curve used to assess growth influences the interpretation of weight gain and the age of onset of higher weight gains in infancy.

METHODS

This was a longitudinal study of Canadian infants from birth to 18 months of age. Infant feeding pattern was recorded monthly, and weight and length of 73 infants were measured at 8 different ages. Weight, length, weight for length, and BMI z scores were compared with the Centers for Disease Control and Prevention 2000 growth curves and World Health Organization growth standard.

RESULTS

Comparison with the Centers for Disease Control and Prevention growth curves showed that Canadian infants grew similarly or slightly slower than their US counterparts. Using the World Health Organization growth standard, an increase in body weight occurred between 6 and 9 months of age, associated with a change from breastfeeding to formula feeding and introduction of solid foods. When compared with the World Health Organization standards, breastfed infants followed the standards, but formula-fed infants deviated with higher weight for age. When compared with the Centers for Disease Control and Prevention charts, breastfed infants showed an apparent decline in weight for age beginning at approximately 6 months.

CONCLUSIONS

The choice of growth curve is important to interpreting infant growth and identifying the onset of excess weight gain. Identification of the prevalence and age of onset of early excess weight gains among Canadian infants will be best achieved by using the World Health Organization growth standards.

Association of central obesity with early Carotid intima-media thickening is independent of that from other risk factors

AIM

We investigated whether anthropometric measurements or metabolic risk factors correlated more with vascular changes associated with obesity.

METHODS

One hundred never smoking subjects (71 women, 29 men) without vascular events, with blood pressure (BP) <140/90 mm Hg, LDL cholesterol <4 mmol/l, glucose <6.2 mmol/l participated. Anthropometric measurements (body mass index (BMI), waist/hip ratio (WHR), waist circumference (WC) and Waist/height ratio WHTR) and metabolic risk factors (glucose, insulin, lipid and uric acid levels plus BP) were assessed. Subjects underwent vascular measurements (Carotid intima-media thickness (IMT) using duplex ultrasonography, vascular stiffness assessment (Augmentation Index) by applanation tonometry and brachial artery reactivity tests).

RESULTS

Risk factors were in the 'normal distribution'. BMI, WHR, WC, WHTR correlated significantly with triglyceride, HDL, LDL, insulin, glucose, uric acid and systolic BP levels (P<0.001). IMT correlated with WHTR, BMI, WC, Glucose (P<0.001), Homoeostasis Model Assessment (HOMA) and cholesterol levels (P<0.05). Only Age, WHTR or BMI were significant correlates of IMT in a multivariate analysis (P<0.01) including WHTR or BMI, with age, sex, systolic BP, HDLc and HOMA. Augmentation Index correlated with age (P<0.0001), WHTR and WC (P<0.0005) but with age only in a multivariate analysis. Brachial reactivity did not correlate with any anthropometric or metabolic parameters. Anthropometric cutoff points, (BMI > or =25, WC > or =102 cm men, > or =88 cm women, WHR > or =0.9 men, > or =0.8 women and WHTR > or =0.5 men and women) significantly differentiated normal from abnormal metabolic and vascular measurements. The WHTR ratio > or =0.5 was as reliable as the BMI cutoff > or =25 in determining metabolic and vascular abnormalities. BMI and WHTR were strongly associated with 89% agreement (P<0.0001).

CONCLUSION

These results demonstrated that in 'healthy individuals', anthropometric parameters and metabolic risk factors correlated with each other, but anthropometric parameters were the only significant correlates of carotid IMT. A waist/height ratio > or =0.5 predicts both early vascular and metabolic changes. These data support a risk factor independent vasculotrophic effect of obesity.

Calcineurin inhibitor sparing in paediatric solid organ transplantation : managing the efficacy/toxicity conundrum

Despite their efficacy, the calcineurin inhibitors (CNIs) ciclosporin and tacrolimus carry a risk of debilitating adverse effects, especially nephrotoxicity, that affect the long-term outcome and survival of children who are given organ transplants. Simple reduction in dosage of CNI has little or no long-term benefit on their adverse effects, and complete withdrawal without threatening graft outcome may only be possible after liver transplantation. Until the last decade, the only option was to increase corticosteroid and/or azathioprine doses, which imposed additional long-term hazards. Considered here are the emerging generation of new agents offering an opportunity for improving long-term graft survival, minimizing CNI-related adverse events and ensuring patient well-being.A holistic, multifaceted strategy may need to be considered - initial selection and optimized use and monitoring of immunosuppressant regimens, early recognition of indicators of patient and graft dysfunction, and, where applicable, early introduction of CNI-sparing regimens facilitating CNI withdrawal. The evidence reviewed here supports these approaches but remains far from definitive in paediatric solid organ transplantation. Because de novo immunosuppression uses CNI in more than 93% of patients, reduction of CNI-related adverse effects has focused on CNI sparing or withdrawal.A recurring theme where sirolimus and mycophenolate mofetil have been used for this purpose is the importance of their early introduction to limit CNI damage and provide long-term benefit: for example, long-term renal function critically reflects that at 1 year post-transplant. While mycophenolic acid shows advantages over sirolimus in preserving renal function because the latter is associated with proteinuria, sirolimus appears the more potent immunosuppressant but also impairs early wound healing. The use of CNI-free immunosuppressant regimens with depleting or non-depleting antibodies plus sirolimus and mycophenolic acid needs much wider investigation to achieve acceptable rejection rates and conserve renal function. The adverse effects of the alternative immunosuppressants, particularly the dyslipidaemia associated with sirolimus, needs to be minimized to avoid replacing one set of adverse effects (from CNIs) with another. While we can only conjecture that judicious combinations with the second generation of novel immunosuppressants currently in development will provide these solutions, a rationale of low-dose therapy with multiple immunosuppressants acting by complementary mechanisms seems to hold the promise for efficacy with minimal toxicity until the vision of tolerance achieves reality.

Cardiac markers of pre-clinical disease in adolescents with the metabolic syndrome: the strong heart study

OBJECTIVES

Our aim was to evaluate the impact of metabolic syndrome (MetS) on cardiac phenotype in adolescents.

BACKGROUND

A high prevalence of MetS has been reported in adolescents.

METHODS

Four hundred forty-six nondiabetic American Indian adolescents (age 14 to 20 years, 238 girls) underwent clinical evaluation, laboratory testing, and Doppler echocardiography. Age- and gender-specific partition values were used to define obesity and hypertension. Metabolic syndrome was defined according to Adult Treatment Panel III criteria, modified for adolescents. Left ventricular (LV) hypertrophy and left atrial (LA) dilation were identified using age- and gender-specific partition values.

RESULTS

One hundred eleven participants met criteria for MetS. They had a similar age and gender distribution as non-MetS participants. Analysis of covariance, controlling for relevant confounders, demonstrated that participants with MetS had higher LV, LA, and aortic root diameters, higher LV relative wall thickness, and greater LV mass index. Accordingly, MetS participants showed higher prevalences of LV hypertrophy (43.2% vs. 11.7%) and LA dilation (63.1% vs. 21.9%, both p < 0.001) compared with non-MetS participants. In addition, MetS was associated with a reduction in midwall shortening, lower transmitral mitral early to atrial peak velocity ratio, and mildly prolonged mitral early deceleration time (all p < 0.05). In multiple regression analysis, independently of demographics, obesity, blood pressure, and single metabolic components of MetS, clustered MetS was associated with a 2.6-fold higher likelihood of LV hypertrophy and a 2.3-fold higher likelihood of LA dilation (both p < or = 0.02).

CONCLUSIONS

In a population sample of adolescents, MetS is associated with higher prevalences of LV hypertrophy and LA dilation and with reduced LV systolic and diastolic function, independently of individual MetS components.

Sucrose exposure in early life alters adult motivation and weight gain

The cause of the current increase in obesity in westernized nations is poorly understood but is frequently attributed to a 'thrifty genotype,' an evolutionary predisposition to store calories in times of plenty to protect against future scarcity. In modern, industrialized environments that provide a ready, uninterrupted supply of energy-rich foods at low cost, this genetic predisposition is hypothesized to lead to obesity. Children are also exposed to this 'obesogenic' environment; however, whether such early dietary experience has developmental effects and contributes to adult vulnerability to obesity is unknown. Using mice, we tested the hypothesis that dietary experience during childhood and adolescence affects adult obesity risk. We gave mice unlimited or no access to sucrose for a short period post-weaning and measured sucrose-seeking, food consumption, and weight gain in adulthood. Unlimited access to sucrose early in life reduced sucrose-seeking when work was required to obtain it. When high-sugar/high-fat dietary options were made freely-available, however, the sucrose-exposed mice gained more weight than mice without early sucrose exposure. These results suggest that early, unlimited exposure to sucrose reduces motivation to acquire sucrose but promotes weight gain in adulthood when the cost of acquiring palatable, energy dense foods is low. This study demonstrates that early post-weaning experience can modify the expression of a 'thrifty genotype' and alter an adult animal's response to its environment, a finding consistent with evidence of pre- and peri-natal programming of adult obesity risk by maternal nutritional status. Our findings suggest the window for developmental effects of diet may extend into childhood, an observation with potentially important implications for both research and public policy in addressing the rising incidence of obesity.

Impact on weight dynamics and general growth of the common FTO rs9939609: a longitudinal Danish cohort study

OBJECTIVE AND DESIGN

We investigated the impact of the fatness-related FTO rs9939609 A-allele on cross-sectional and longitudinal measures of body mass index (BMI), height and lean body mass (LBM) in a unique cohort representing a broad range of BMI.

SUBJECTS AND MEASUREMENTS

A random sample of all men attending the Danish draft boards during 1943-1977 plus all men with a BMI>or=31.0 kg/m(2) (assuring representation of the right end of the distribution) was taken. Anthropometric measures were available at up to eight points in time from birth to adulthood in 1629 genotyped men. The odds ratio (OR) for being a carrier of FTO rs9939609 according to (1) one unit alteration in z-scores for BMI, height and LBM at given ages and (2) longitudinal changes in BMI and height z-scores were assessed by logistic regression.

RESULTS

Except at birth, the AA genotype was associated with increased BMI z-scores at all point during the monitored lifespan, starting at the age of 7 years. This effect remained stable until early adulthood, where further weight gain occurred. The AA genotype was also--mainly through the effect on fatness--associated with accelerated linear growth in childhood (age 7 years; OR, 1.36; 95% confidence interval (CI), 1.06-1.74) and increased LBM in adulthood (OR, 1.24; 95% CI, 1.14-1.35).

CONCLUSION

Fatness induced by FTO rs9939609 in early childhood is sustained until early adulthood, where further weight gain may occur. FTO rs9939609 may, however, also be associated with linear growth and LBM mainly through the effect on fat mass.

Correlates of childhood obesity in Athens, Greece

OBJECTIVE

Childhood obesity is a growing public health problem. We have examined the association between sociodemographic profile and eating and physical activity patterns with overweight among primary-school students in Athens, Greece.

DESIGN

Cross-sectional study.

SETTING

Eleven primary schools in the greater Athens area, Greece.

SUBJECTS

A total of 633 children aged 10-12 years (50 % boys, 50 % girls) were interviewed in person during spring 2003. Multivariate logistic regression was used to investigate the association between eating and physical activity patterns and overweight (> or =85th sex- and age-specific BMI centile). Results are presented as odds ratios and 95 % confidence intervals.

RESULTS

Overweight was more common among girls than among boys (OR=1.73; 95% CI 1.11, 2.69) and substantially less common among children born outside Greece (OR=0.46; CI 0.22, 0.95). Reported physical activity (per 1.5 h per day) was unrelated to overweight (OR=0.97; CI 0.85, 1.12) but patent physical inactivity, operationalised as time spent watching television or working/playing with the computer (per 1.5 h per day) was a highly significant predictor of overweight (OR=1.20; CI 1.05, 1.36). Composition of diet was unrelated to overweight but the daily number of eating occasions, controlling for total energy intake, was significantly inversely associated with overweight (OR=0.61; CI 0.48, 0.76).

CONCLUSIONS

The principal factor underlying overweight among children in Athens appears to be the extended inactivity imposed by modern childhood lifestyles. An intriguing finding is that spreading a given energy intake over several eating occasions was inversely associated with the likelihood of childhood obesity.

Musculoskeletal pain in obese children and adolescents

AIM

To determine whether bodyweight is associated with musculoskeletal pain within a population of obese children and adolescents.

METHODS

A descriptive, cross-sectional study of subjects evaluated at a tertiary care medical centre for the management of obesity. Analyses were conducted using both a person-specific model, and then again, using a joint site model in order to account for correlations between joints within children.

RESULTS

We evaluated 135 children and adolescents (68 girls, 67 boys) with a mean age of 12.3 years (range: 3-18). The study population was racially and ethnically diverse--Hispanic (51%), non-Hispanic white (26%), non-Hispanic black (13%), other (10%). The majority of subjects (61%) complained of at least one joint hurting more than once per month. Back pain was the most common complaint (39%), followed by foot (26%) and knee (24%) pain. After adjustment for age, pain in the knees and hips were associated with increased weight and/or body mass index (BMI).

CONCLUSIONS

In this cross-sectional analysis of obese children and adolescents, musculoskeletal pain was common and, in the knee and hip joints, was positively associated with extra bodyweight. Clinicians may want to ask about musculoskeletal pain when recommending physical activity for weight management counselling.

Efeito do exercício físico sobre peso corporal em crianças com excesso de peso: ensaio clínico comunitário randomizado em uma favela no Brasil

Associação da obesidade com doenças crônicas tem se mostrado mais intensa nas áreas carentes. Examinamos o efeito de um programa de exercício físico para crianças com excesso de peso, em uma favela do Recife, Pernambuco, Brasil, por meio de um ensaio comunitário, randomizado, com 78 crianças. Um grupo (n = 39) recebeu três aulas semanais de exercícios físicos durante seis meses. Não foi realizada nenhuma intervenção em relação à alimentação. A análise por intenção de tratamento demonstrou que todas as crianças apresentaram aumento significativo de peso. Entretanto, esse aumento foi menor no grupo que sofreu a intervenção (diferença média entre os grupos; -1.37; IC95%: -2,00; -0,74). Em relação ao índice de massa corporal (IMC), também foi verificada uma diferença significativa (p = 0,049) entre os dois grupos (diferença média entre os grupos; -0,53; IC95%: -1,06; -0,002). Na análise restrita às crianças que completaram o estudo (intervenção = 30 e controle = 38), os resultados foram similares. Concluímos que um programa regular de exercícios físicos para crianças com excesso de peso em áreas carentes seja eficaz, sem a necessidade de intervenções dietéticas, na redução do ganho ponderal e do IMC.

Fasting nonesterified fatty acid profiles in childhood and their relationship with adiposity, insulin sensitivity, and lipid levels

OBJECTIVE

The objective of this study was to examine the major constituent of nonesterified fatty acids in children with respect to auxologic parameters, insulin sensitivity, and lipid levels, because nonesterified fatty acid levels are elevated in obesity and are important in the development of comorbidities.

METHODS

Fasting blood samples were obtained from 73 children (43 girls; 49 obese; median [range] age: 11.4 [0.9-17.6] years). Concentrations of the major circulating nonesterified fatty acids (myristate, palmitate, oleate, stearate, and arachidate) were determined by gas chromatography mass spectrometry, alongside measurement of insulin, adiponectin, and lipid profiles.

RESULTS

The sum of all nonesterified fatty acids was significantly higher in obese versus normal-weight children, although gender (but not age or puberty) was an important determinant, with the difference remaining significant only in boys. Overall, obese children had higher concentrations of myristate, palmitate, and oleate but not stearate or arachidate. Age was an important determinant of myristate and arachidate, whereas gender proved more important for palmitate and stearate. Fasting insulin concentrations were not associated with either total nonesterified fatty acid concentrations or any of the individual nonesterified fatty acids, although a positive correlation was found between adiponectin and total nonesterified fatty acid concentrations that was independent of obesity status and that seemed mediated by changes in palmitate and stearate. Serum total cholesterol and low-density lipoprotein (but not high-density lipoprotein) levels seemed to correlate positively with circulating concentrations of palmitate, oleate, and stearate, whereas serum triacylglycerols correlated with myristate, palmitate, and oleate concentrations.

CONCLUSIONS

Nonesterified fatty acid concentrations are elevated in obese children, primarily as a result of increases in myristate, palmitate, and oleate. Independent effects of nonesterified fatty acids on circulating adiponectin levels and lipid parameters were observed, although we found no relationship between nonesterified fatty acid concentrations and the insulin resistance identified with obesity.

BMI-based obesity cutoffs and excess adiposity in a Caribbean adolescent population of African origin

OBJECTIVE

To evaluate the diagnostic utility of recommended body mass index (BMI)-based classification systems in detecting excess body fat (BF) in an Afro-Caribbean adolescent population.

SUBJECTS

All adolescents aged 12-18 years were invited to participate in the study. A total of 3749 persons participated fully in the study.

RESULT

Males (12.2%) (95% confidence interval (CI): 10.7, 13.9) and females (43.6%) (95% CI: 41.5, 45.7) had excess adiposity. Specificities were high for all cutoff values (range 90.1-99.7%). Sensitivities ranged from 25.7 to 86.4% and from 15.6 to 54.4% for Centre for Disease Control (CDC) and International Obesity Task Force (IOTF) cutoff values, respectively. The mean areas under the receiver-operating characteristic curves ranged from 62.7 to 88.2% in males and 57.7 to 75.1% in females, while positive likelihood ratios ranged from 8.7 to 90.9 for the recommended BMI cutoff values.

CONCLUSIONS

Overall, the CDC cutoffs had a higher sensitivity than the IOTF cutoffs in screening for excess fat. Specificities were high for cutoff values in both systems and would produce fewer false negatives.

Physical activity patterns and sedentary behaviors of children from urban and rural areas of Cyprus

BACKGROUND

A sedentary lifestyle among children is becoming increasingly common and has been linked to future risk of degenerative diseases. Urban residence has been suggested to be a contributing factor to a less active lifestyle; however, not all available studies support this link. In the present study we examined the physical activity patterns and sedentary behaviours of children living in urban and rural areas of Cyprus, where major demographic shifts have occurred the last decades.

METHODS

We studied 1140 children (531 boys; 609 girls), aged 10-12 years, registered in 24 selected elementary public schools from five urban and rural districts of Cyprus. Children completed a semi-quantitative physical activity questionnaire regarding frequency and duration of everyday physical and sedentary activities. Weight and height of the children, as well as demographic and socioeconomic information was collected from children and their guardians.

RESULTS

Rural children reported being slightly more active after school and occupied weekly with outdoors chores compared to urban children, who on the other hand reported engaging in sports on a weekly basis more than their rural peers (all p < 0.10). However, the average weekly time spent by urban and rural children on vigorous (8.6 +/- 4.7 and 9.1 +/- 4.8 h/w, respectively; p = 0.193) or moderate-to-vigorous (14.9 +/- 7.6 and 15.2 +/- 7.6 h/w, respectively; p = 0.612) activities, as well as total screen time, were not different. The distribution of children with regards to most other physical activity and inactivity pursuits was similar between urban and rural areas.

CONCLUSION

We found no substantial differences in the physical activity habits and sedentary behaviours among children living in urban and rural areas of Cyprus. Hence public health awareness directed to enhance physical activity and decrease sedentary lifestyle among youngsters should focus equally to urban and rural children.

Neonatal immune challenge does not affect body weight regulation in rats

The perinatal environment plays a crucial role in programming many aspects of adult physiology. Myriad stressors during pregnancy, from maternal immune challenge to nutritional deficiency, can alter long-term body weight set points of the offspring. In light of the increasing concern over body weight issues, such as obesity and anorexia, in modern societies and accumulating evidence that developmental stressors have long-lasting effects on other aspects of physiology (e.g., fever, pain), we explored the role of immune system activation during neonatal development and its impact on body weight regulation in adulthood. Here we present a thorough evaluation of the effects of immune system activation (LPS, 100 microg/kg ip) at postnatal days 3, 7, or 14 on long-term body weight, adiposity, and body weight regulation after a further LPS injection (50 microg/kg ip) or fasting and basal and LPS-induced circulating levels of the appetite-regulating proinflammatory cytokine leptin. We show that neonatal exposure to LPS at various times during the neonatal period has no long-term effects on growth, body weight, or adiposity. We also observed no effects on body weight regulation in response to a short fasting period or a further exposure to LPS. Despite reductions in circulating leptin levels in response to LPS during the neonatal period, no long-term effects on leptin were seen. These results convincingly demonstrate that adult body weight and weight regulation are, unlike many other aspects of adult physiology, resistant to programming by a febrile-dose neonatal immune challenge.

Prevalência de sobrepeso e obesidade em adolescentes escolares do município de Fortaleza, Brasil

OBJETIVOS: determinar a prevalência de sobrepeso e obesidade em adolescentes escolares do Município de Fortaleza, Brasil, e estimar a diferença entre a prevalência nas escolas públicas e privadas segundo sexo e faixa etária (adolescência precoce e tardia). MÉTODOS: estudo de corte transversal realizado no período de março a maio de 2003 com 1158 adolescentes, sendo 571 de escolas públicas e 587 de escolas privadas. Sobrepeso foi definido como indice de massa corporal (IMC) igual ou superior ao percentil 85 e inferior ao percentil 95; obesidade, IMC igual ou maior ao percentil 95, ambos para idade e sexo. RESULTADOS: a prevalência total de sobrepeso e obesidade foi 19,5%. Nas escolas privadas, sobrepeso/obesidade alcançou 23,9%, freqüência maior do que nas públicas (18,0%) (p = 0,018). A prevalência de sobrepeso/obesidade encontrada no sexo masculino (19,6%) foi semelhante ao do feminino (19,0%) (p = 0,80); na adolescência precoce, a prevalência foi (24,1 %) maior do que a encontrada na adolescência tardia (15,0 %) (p < 0,0001). CONCLUSÕES: a prevalência de sobrepeso e obesidade em adolescentes escolares do município de Fortaleza mostrou-se elevada, sendo maior nas escolas privadas e na adolescência precoce, não ocorrendo diferença entre os sexos.

Fat storage is partially dependent on vagal activity and insulin secretion of hypothalamic obese rat

Hypothalamic MSG-obese rats show hyperinsulinemia and tissue insulin resistance, and they display intense parasympathetic activity. Current analysis investigates whether early subdiaphragmatic vagotomy prevents tissue insulin sensitivity impairment in adult obese MSG-rats. Hypothalamic obesity was induced by MSG (4 mg/g BW), daily, from birth up to 5 days. Control animals receiving saline solution. On the 30th day rats underwent bilateral subdiaphragmatic vagotomy or sham surgery. An intravenous glucose tolerance test (i.v.GTT) was performed when rats turned 90 days old. Total white fat tissue (WAT) from rat carcass was extracted and isolated; the interscapular brown fat tissue (IBAT) was weighed. Rather than blocking obesity, vagotomy reduced WAT and IBAT in MSG-obese rats when the latter were compared to sham MSG-rats. High blood fasting insulin and normal glucose levels were also observed in MSG-obese rats. Although glucose intolerance, high insulin secretion, and significant insulin resistance were recorded, vagotomy improved fasting insulinemia, glucose tolerance and insulin tissue sensitivity in MSG-obese rats. Results suggest that increased fat accumulation is caused, at least in part, by high blood insulin concentration, and enhanced parasympathetic activity on MSG-obese rats.