Childhood obesity: an update

Relationship of body mass index with asthma indicators in head start children

OBJECTIVE

To examine the relationship of body mass index (BMI) and asthma indicators on children with asthma in a Head Start (HS) program.

METHODS

In this cross-sectional study (November 18, 2000, to December 12, 2003) of children aged 3 to 5 years with asthma, we compared the BMI data of HS asthmatic patients (n = 213) with the data of peer control subjects from a sample (n = 816) of the National Health and Nutrition Examination Survey aged 3 to 5 years and with children in prekindergarten in Arkansas public schools (n = 1,024). Parental reports of asthma symptoms, health care use, medication use, school days missed, and quality of life were used as indicators of asthma morbidity. Categorical analysis and chi2 tests were performed to examine the relationship between BMI and asthma morbidity.

RESULTS

The prevalence of overweight (> or =95th percentile) was significantly higher in HS children with asthma compared with the National Health and Nutrition Examination Survey children (P < .001) and Arkansas prekindergarten children (P = .05). Compared with HS asthmatic children with a BMI less than the 85th percentile, HS asthmatic patients with a BMI of the 85th percentile or greater reported significantly more school days missed (P = .02), lifetime hospitalizations (P = .04), emergency department visits (P = .02), and activity limitations (P = .03) and fewer oral corticosteroid bursts (P = .04). There was also a trend for more daytime symptoms (P = .05) and lower quality of life (P = .06). No differences were observed in rescue (P = .28) or controller (P = .47) medications, environmental tobacco smoke exposure (P = .47), positive allergy test results (P = .85), and nighttime symptoms (P > .99).

CONCLUSIONS

Having an increased BMI was associated with more asthma morbidity in this group of HS asthmatic patients. Despite the lack of a clear explanation for the link between asthma and BMI, our data suggest that an increased BMI significantly affects the well-being of young asthmatic patients and should be further addressed.

Dietary approaches to the treatment of the overweight pediatric patient

A review of recently published studies on the dieting practices of children and adolescents examines the impact those practices are having on the overall health of youth who are overweight and those who are not. Recommendations for improving the nutritional quality of children's diets are made based on the food consumption patterns of youngsters ages 2 to 18 years. If implemented, these recommendations would lower calories, fat, saturated fat, and cholesterol, while improving nutrient density. Guidelines for the treatment of childhood overweight from four organizations are presented in chart form.

A social epidemiologic study of obesity among preschool children in Thailand

OBJECTIVE

To describe the prevalence of childhood obesity in a moderately industrialized province in Thailand and examine the influence of socioeconomic status (SES) on childhood obesity.

DESIGN

Cross-sectional study.

SUBJECTS

One thousand one hundred and fifty seven children in the second or third grade of kindergartens in Saraburi Province, Thailand.

MEASUREMENTS

Height and weight were measured and the weight-for-height index with the Thai national standard was used for assessing nutritional status. A questionnaire was used for measuring parents' socioeconomic status.

RESULTS

The prevalence of childhood obesity over 97th percentile for weight-for-height (>p(97)) was 22.7% in urban and 7.4% in rural areas. There were marked relationships between childhood obesity and parents' educational level and household income.

CONCLUSION

Childhood obesity is an emerging health problem in developing countries, especially in urban areas. This study demonstrates a marked correlation between SES and prevalence of childhood obesity in an Asian developing country.

Prevalence and correlates of obesity in preschool children

Obesity, a common nutritional disorder in childhood, is a complex problem that is poorly understood. The purpose of this study was to identify the prevalence of obesity in preschool children, and to examine the relationships between obesity and gender, race, socioeconomic status, and health problems. Data were collected from 309 charts of children enrolled in a Head Start program. Ninety-nine (32%) of the children were obese. Obese children had significantly higher blood pressure readings than those who were not obese. This study represents a beginning effort to learn more about the prevalence of, and factors associated with, obesity in preschoolers.

Body mass index centile charts to assess fatness of British children

Body mass index (BMI) relates weight to height and reflects the shape of a child, but because of age dependency it has not been used conventionally for the estimation of fatness in children. From measurements of Tayside children (n = 34,533) centile charts were constructed for BMI (wt/ht2) from the raw data of height and weight, using Cole's LMS method for normalised growth standards. These data were compared with the only available European BMI charts published from data of French children obtained over a period of 24 years from 1956-79. British children appear to be 'fatter'. Within a subgroup (n = 445) the BMI values were correlated with estimations of body fat, for boys and girls, from skinfold thickness (r = 0.8 and 0.81) and bioelectrical impedance (r = 0.65 and 0.7). The limits of acceptable BMI have yet to be defined.