Teesside Schools Health Study: Body mass index surveillance in special needs and mainstream school children

Prevalence of overweight and obesity in children and adolescents with intellectual disabilities in China

BACKGROUND

Overweight and obesity in children and adolescents has become a worldwide epidemic. There are several studies that have concentrated on the prevalence rate of children and adolescents with intellectual disabilities (ID), whereas data on such a population on the mainland of China remain unclear. The purpose of this study was to investigate the prevalence rate of overweight and obesity among school-aged children and adolescents with ID on China's mainland.

METHODS

This study employed a cross-sectional design to examine the body weight status of 1873 children and adolescents (ages 6-18 years old) with ID in 35 special education schools. Body mass index was calculated, and the concepts of overweight and obesity were defined according to the standard of the Working Group for Obesity in China.

RESULTS

Data indicated that 18.2% (95% CI: 16.5%-20.0%) of children and adolescents with ID were overweight and 14.4% (95% CI: 12.8%-16.0%) were obese. Boys with ID were more likely to be overweight than girls with ID (OR = 1.48[95% CI: 1.13-1.94], P < 0.05). Children and adolescents with Down syndrome or autism spectrum disorder had a trend to be classified as overweight (OR = 1.76[95% CI: 1.22-2.54], P < 0.05; OR = 1.57[95% CI: 1.17-2.09], P < 0.05, respectively) or obesity (OR = 1.82[95% CI: 1.23-2.69], P < 0.05; OR = 1.40 [95% CI: 1.02-1.93], P < 0.05, respectively) compared with those with ID without these conditions. Moreover, children and teenagers with ID living in urban areas had a predisposition to be overweight (OR = 2.16[95% CI: 1.14-4.09], P < 0.05) or obese (OR = 3.25[95% CI: 1.41-7.50], P < 0.05) relative to those who lived in rural areas.

CONCLUSION

Results indicated that in China, the prevalence rate of overweight and obesity among school-aged children and adolescents with ID was remarkably high. Therefore, future research should make every effort to focus on reducing and preventing overweight and obesity of this population in China.

Children with Intellectual Disability Are Vulnerable to Overweight and Obesity: A Cross-Sectional Study among Chinese Children

BACKGROUND

The epidemic of childhood obesity has been well documented in typically developing child populations, while situations among children with intellectual disabilities (ID) remain unclear.

METHODS

A cross-sectional study was conducted among 524 Chinese children with ID (males: 68.9%, mean age: 12.2 years) in Hong Kong in 2015. Children's height and weight were measured at school. Parents, in the presence of their children, completed a self-administered questionnaire at home about the children's physical activity (PA), eating habits, and sleep duration in a typical week as well as parenting practices regarding children's eating, PA, and their sociodemographic characteristics.

RESULTS

Of the participants, 31.3% were overweight or obese, which was higher than their typical counterparts (18.7%-19.9%). Multivariate logistic regression analyses revealed that overweight and obesity in children with ID were linked to their comorbidity with autism, maternal overweight and obesity, parenting practices with less pressure to eat more, children having shorter sleep duration, longer periods of sedentary behavior, and higher intake frequencies of sweetened beverages, fried food, meats, fish, and eggs.

CONCLUSIONS

Children with ID are vulnerable to being overweight or obese. Identified risk factors in this study highlight a multifaceted approach to the involvement of parents as well as the modification of some children's questionable behaviors to help them achieve a healthy weight.

Obesity and overweight in intellectual and non-intellectually disabled children

BACKGROUND

Few studies have compared overweight and obesity in intellectually disabled (ID) and non-intellectually disabled (N-ID) children. This research compared the prevalence of overweight and obesity between a sample of 218 ID and 229 N-ID school pupils in Northern Ireland (NI). Comparison of the physical activity and dietary behaviour of the two groups of school pupils were also undertaken.

METHODS

Each pupil completed (assisted if required) a food intake and physical activity questionnaire. Following this body mass index (BMI) and waist circumference were measured and recorded.

RESULTS

Significantly more ID pupils (72, 33%) were overweight/obese compared with 55 (24%) of the N-ID pupils in accordance with their BMI. ID pupils also had significantly higher waist circumferences. Over a quarter of foods consumed by the pupils were fatty and sugary foods and close to 30% of these foods were eaten by the ID children. Pupils spent most of their time engaging in low levels of activity such as reading, watching TV, on games consoles and listening to music. Pupils with an ID spent fewer hours on moderate and high levels of activities compared with those children with N-ID.

CONCLUSIONS

Results of this study found higher levels of overweight and obesity in this sample than in international published research. Additionally significantly higher numbers of ID pupils were overweight and obese indicating the need for future research and public health to focus on this issue.

Health inequalities experienced by children and young people with intellectual disabilities: a review of literature from the United Kingdom

This literature review aimed to synthesize evidence on the prevalence and determinants of health conditions and impairments among children and young people with intellectual disability in the United Kingdom. Several databases were systematically searched for studies conducted with children under the age of 18 living in the United Kingdom and published in 2010-11. Evidence from a 2002 and a 2010 literature review on health inequalities among individuals of all ages with intellectual disability was also reviewed. We conclude there is an increased prevalence of a number of health conditions and impairments among children with intellectual disability and evidence that these health inequalities are associated with several preventable environmental determinants.

Prevalence and risk factors of overweight and obesity among children and adolescents with intellectual disabilities

Recent literature reviews showed that overweight and obesity represent a major health threat in adults with intellectual disability (ID). However, the current evidence around the prevalence and risk factors associated with overweight and obesity in children and adolescents with ID remains unclear. The objective of this article was thus to review the available English- and French-language studies examining the prevalence and risk factors associated with overweight and obesity in youths with ID. Ten studies providing original data on this topic were identified and included in this review. Results demonstrated that (i) overweight and obesity represent a significant secondary health problem in youths with ID; and (ii) obesity risk significantly increases with age. Considering all of the limitations of the reviewed studies (i.e. heterogeneity in sample size and in overweight and obesity classification criteria; lack of comparison group; restrictive number of risk factors examined, etc.), these findings remain preliminary and highlight the need for future research in this area.

High prevalence of obesity in ambulatory children and adolescents with intellectual disability

BACKGROUND

Obesity prevalence is unusually high among adults with intellectual disability (ID). There is limited and conflicting evidence on obesity prevalence among ambulatory children and adolescents with ID. The present study aimed to estimate obesity prevalence in this group and to compare with population prevalence.

METHODS

Survey of nine schools (n = 206, 150 boys) for ambulatory children and adolescents with mild-moderate ID in Scotland in 2007. Obesity was defined as measured body mass index (BMI) at or above the 95th percentile relative to UK 1990 reference data, and using the international definition based on BMI. Obesity prevalence observed was compared against Scottish population data on obesity prevalence from the most recent nationally representative survey.

RESULTS

Obesity prevalence (at or above 95th percentile for BMI) was 36%, and was significantly higher among those attending secondary schools compared with primary schools (P < 0.01). Prevalence of obesity was significantly higher than in the general paediatric population in both boys and girls (P < 0.01).

CONCLUSIONS

The present study suggests that that obesity may be very prevalent among ambulatory children and adolescents with ID, and that increased obesity risk may begin in childhood.