Trends in overweight and obesity prevalence in Tuscan schoolchildren (2002-2012)

An Ecological Association Between Air Pollution and Adolescent Obesity Study

OBJECTIVES

The purposes of this study were to assess the association between exposure to particulate matter (PM 2.5 ) and adolescent obesity and to identify and visualize the world areas where the problems of adolescent obesity and air pollution by fine PM are more severe.

METHODS

This is an ecological study, based on publicly available data from a World Health Organization site.

RESULTS

For each increase in air pollution there was an increase in the probability of being in the higher prevalence obesity group (OR = 1.18 (95% CI, 1.06-1.31). High prevalence rates for both adolescent obesity and air pollution by PM 2.5 were identified in several countries, including Venezuela, Algeria, Libya, Saudi Arabia, Iraq, and Oceania islands.

CONCLUSIONS

Efforts by local authorities and world organizations should be focused on the countries with the highest prevalence rates for both conditions.

The methodology of the Italian Health Behaviour in School-aged Children (HBSC) 2018 study and its development for the next round

Introduction

The Italian "Health Behaviour in School-aged Children" (HBSC) is a national surveillance system that collects data on health and well-being among adolescents aged 11, 13 and 15 years attending school. It is part of the HBSC Research Network, an international alliance of researchers from 45 European and North American countries and regions started in 1982.

Methods

All countries and regions participating in HBSC must adhere to a common international standard protocol developed and systematically updated by the entire HBSC Network. Data collection occurs every four years. Italy joined the international Network in 2000 and, to date, five waves (in 2002, 2006, 2010, 2014 and 2018) have been carried out. From 2010 the Italian HBSC is representative at regional level and in 2017 the base of the "Surveillance system for risk behaviours in 11-17 year-olds" became part of the Prime Ministerial Decree "Identification of surveillance systems and registries of mortality, tumours and other diseases". Cluster sampling is used, with school class as primary sampling unit, and two validated questionnaires are used to collect the information.

Results

In 2018, the Italian HBSC involved 3,608 classes and 58,976 students. The average response rates were 86% of sampled classes and 97% of students achieving a national and regional representative sample for youths of all age groups (19,504 eleven-year-old, 20,554 thirteen-year-old and 18,918 fifteen-year-old). The national coordination group prepared a standardized format for disseminating the results locally and indicating areas for intervention A national report and some articles have been published. The next round, which will take place in the 2021-2022 school year, will also involve a representative sample of students of grade four of secondary schools (adolescents aged 17 years) and use on line questionnaires.

Conclusions

Over 3 decades at international and 2 decades at national level 35 years have demonstrated that HBSC methodology and its results are useful for monitoring and deepening the knowledge on the most critical issues of adolescents' well-being.

10-Year Changes in Adiposity in Cameroon School-Age Children: Evidence for Increasing Central Adiposity and Higher Adiposity Levels in Tallest-for-Age Children

OBJECTIVE

To examine changes in measures of adiposity and determine the prevalence of excess adiposity in relation to height in school children between 2010 and 2020.

METHODS

5-12-year-old urban school-age children participated in two cross-sectional surveys in 2010 (n = 1274) and 2020 (n = 1550). Standard procedures were used for anthropometric measurements. Changes in BMI, waist circumference (WC), and waist-to-height ratio (WHtR) and the corresponding proportions of children with excess adiposity were analyzed and adjusted for design variables (class and school type) and age. Children were classified according to quartiles of height z-score and prevalence of excess adiposity estimated across each quartile.

RESULTS

There was a 2.4% and 3.3% increase in adjusted mean BMI and WC, respectively, between 2010 and 2020. The prevalence of central overweight/obesity (WC) and WHtR ≥ 0.5 increased by 7.3% (X ² = 27.151, p < 0.001) and 5.3% (X ² = 26.117, p < 0.001), respectively, between the two surveys except BMI overweight/obesity. The odds of excess adiposity significantly increased in 2020 for central overweight/obesity (WC) (OR 2.8, 95% CI 2.0-3.6) and WHtR ≥ 0.5 (OR 1.8, 95% CI 1.3-2.4) and not for BMI overweight/obesity (OR 1.3, 95% CI 0.8-1.7). The prevalence of BMI overweight/obesity significantly increased from 33% in 2010 to 51.5% in 2020 in the fourth quartile of height z-score (X ² = 19.198, p < 0.001). Similarly, the prevalence of central overweight/obesity (WC) significantly increased from 23.5% in 2010 to 42.4% in 2020 in the fourth quartile of height z-score (X ² = 18.733, p < 0.001).

CONCLUSION

Central overweight/obesity has increased more than BMI overweight/obesity over the last decade. Children with a higher height-for-age tend to accumulate more adiposity. Objective monitoring of adiposity levels and height of children is needed in future to identify groups for targeted intervention and prevention of chronic diseases.

Relationship between body mass index and physical fitness in Italian prepubertal schoolchildren

The objective of this study was to investigate the association between physical fitness and body mass index categories (obesity, OB; overweight, OW; normal-weight, NW; and underweight, UW) in prepubertal children. Anthropometric and physical fitness characteristics were collected from a convenience sample of 30472 Italian schoolchildren (6–11 years old). Six field-based tests were used: Léger, agility shuttle, long jump, frontal throw of the basketball, Sit & Reach and standing balance. Significant differences were found in the anthropometric characteristics, physical fitness and weight status prevalence between girls and boys (p<0.05) and, except for flexibility, by age class (p<0.05). Obese children performed worse than their NW counterparts in aerobic capacity (p<0.001), agility (p<0.001), muscular power of the lower limb (p<0.001) and balance (p<0.001). Conversely, children with obesity showed greater upper limb power than NW children (p<0.001). The discrepancy in physical fitness between OB and NW children increased in older girls (flexibility, p = 0.002; muscular power of the lower and upper limb, p = 0.002 and p = 0.005) and boys (aerobic capacity, p = 0.009; agility, p = 0.006; standing balance, p = 0.019; muscular power of the lower and upper limb, p<0.001 and p = 0.011) compared to their younger counterparts. On the other hand, UW children performed worse than NW children mainly in terms of muscular power of the arms (p<0.001). Additionally, there was an increasing disparity in the frontal throw test scores of UW and NW girls (p = 0.003) and boys (p = 0.011) in older children compared to younger children. In conclusion, the effect of body mass index on children’s physical fitness intensifies with age. OB and OW negatively affect aerobic capacity, agility, lower limb power and balance but positively affect upper limb power. UW negatively affects upper limb power. This study underscores the importance of preventing childhood OW, OB, and UW in early life to promote children’s health and proper fitness development.

Young people, young adults and binge drinking

Introduction and purpose

The consumption of alcohol among young people and young adults has undergone, in recent decades, a sharp upsurge with the increasingly frequent intake of large quantities of alcohol. The aim of our study was to investigate socio-demographic, economic and behavioural factors that have a major impact on the voluntary alcohol habit in young people.

Methods

The survey was conducted via administration of an anonymous questionnaire based on “the WHO Alcohol Use Disorders Identification Test”, disseminated on-line, to young people and young adults (aged 18 to 35).

Results

We examined a sample of 365 subjects. Consumption of wine and beer were predominant followed by super-alcohol mixes. We found correlations between alcohol use and the following variables: marital status (p < 0.001), parental education (mother p < 0.05; father p < 0.001), income level (p < 0.05), physical activity (p < 0.05) and voluptuous habits (smoke and coffee: p < 0.001.The 5% of men and 1% of women had car accidents during the previous year due to alcohol use and 15% said they did not remember what happened in an alcoholic evening once or twice a month.

Conclusions

The phenomenon of alcohol consummation is deeply ingrained in our reality, with dangerous episodes of binge drinking in young adults with a higher prevalence in the female sex.

Remarkable Increase in the Prevalence of Overweight and Obesity Among School Age Children in Antalya, Turkey, Between 2003 and 2015

OBJECTIVE

Childhood obesity (OB) is an acknowledged global problem with increasing prevalence reported around the world. We conducted this study with the aim of determining the local trend in OB and overweight (OW) prevalence in the last decade and to observe the alteration of OB and OW prevalence by age group. An additional aim was to construct new age- and gender-specific body mass index (BMI) reference percentile charts for Turkish children living in the city center of Antalya.

METHODS

This cross-sectional study included 1687 school aged children. International Obesity Task Force guidelines were used to determine the OB and OW prevalence. OW was defined as a BMI between 85^th and 95^th percentile, and OB >95^th percentile. The data were compared with a previous study carried out in the same region in 2003. The least mean square method was used to construct the BMI reference percentile charts.

RESULTS

The prevalence rates for OB and OW were 9.8% and 23.2%, respectively, with a combined OW/OB rate of 33%. OB prevalence was higher in boys than girls (p<0.05). The prevalence of combined OW/OB was highest at age 9-10 years. The prevalence of OB has increased 2.9 times during twelve years in this location.

CONCLUSION

Comparing the current findings with rates of OW and OB in the previous decade, childhood OB in Antalya has reached alarming levels. Urgent measures integrated into the national education system should be taken to prevent OB. In addition more surveillance studies should be planned to show the future trend of OB prevalence nationally.

Increased levels of persistent organic pollutants in serum one year after a great weight loss in humans: Are the levels exceeding health based guideline values?

BACKGROUND

With the growing prevalence of obesity, an increased number of bariatric surgeries are being performed. Lipophilic persistent organic pollutants (POPs) are stored in adipose tissue, and an increased release of lipophilic POPs into the blood circulation may occur following rapid weight loss such as after bariatric surgery.

OBJECTIVES

To evaluate and compare POP levels in serum before and after bariatric surgery, and to assess if the POP levels exceeded health based guideline values, with particular focus on women of childbearing age (WCBA).

METHODS

Serum samples from 63 patients before and one year after bariatric surgery were analysed for organochlorine pesticides (OCPs); polychlorinated biphenyls (PCBs); and brominated flame retardants (BFRs).

RESULTS

Mean weight loss one year after surgery was 32.1kg. The levels of all the analysed POPs in serum increased during the study period. Median levels of dichlorodiphenyldichloroethylene (p,p'-DDE), hexachlorobenzen (HCB) and PCB-153 increased from 90.2ng/g lipid weight (lw) to 158.5ng/glw, from 21.1ng/glw to 36.4ng/glw and from 48.7ng/glw to 71.5ng/glw, respectively. The highest percentage increase was observed for PCB -138, with 83.1%. BFRs were detected in low sample numbers and at low levels. Guideline values for ΣPCB₆ in serum were exceeded for 5% of the participants.

CONCLUSIONS

Weight loss after bariatric surgery resulted in increases of POPs levels in serum between 46.7%-83.1%. Guideline values for ΣPCB₆ in serum were exceeded for 5% of the participants. For WCBA, the possible transfer of comparable levels to infants warrants further attention.

Prevalence of obesity in Italian adolescents: does the use of different growth charts make the difference?

BACKGROUND

Since populations are becoming increasingly multi-ethnic, the use of local or international charts is a matter of debate. This study aimed to evaluate how the choice of cut-off thresholds affected prevalence of underweight (UW), overweight (OW), obesity (OB) in 1200 11-12-year Italian adolescents, and how their somatic growth depended on parental origin.

METHODS

The height, weight and body mass index were expressed as standard deviation score (SDS) using Italian (ISPED-2006) and UK (UK-1990) charts. The classification of UW/OW/OB was computed with the IOTF international cut-offs, and thresholds were identified as centiles corresponding to BMI values of 18.5/25.0/30.0 kg/m² at 18-year in ISPED-2006 or UK-1990 references.

RESULTS

About 30% participants had non-Italian parents, above all from North-Africa and Romania. Referring to the UK-1990 charts, all groups showed negative mean SDS for height, and positive SDS for weight and BMI. Referring to the ISPED-2006 charts, all mean SDS were negative. Percentage of UW individuals was higher in accordance with ISPED-2006 than with UK-1990 charts, whereas percentages of OW/OB were higher with UK-1990 than ISPED-2006 charts. The results obtained using IOFT cut-offs were similar to UK-1990 cut-offs. These results were due to the different shape of age-dependent cut-off centiles. Independently by the parental origin, the percentages of adolescents classified as OW/OB were closer to the expected values using the ISPED-2006 then the UK-1990 cut-offs. The results suggested the use of the Italian references for adolescents with immigrant parents.

CONCLUSION

The use of local charts seems more appropriate at least in Italian adolescents in the age range studied.

Prevalence and incidence of overweight and obesity among Vietnamese preschool children: a longitudinal cohort study

Background

A plateau in childhood overweight and obesity has been reported in some developed countries while in almost all developing countries this problem is on the rise. The aim of this paper is to describe the changes in prevalence of overweight and obesity within a cohort of preschool children followed for 3 years, and to estimate and compare the incidences in urban and rural children of Hanoi, Vietnam.

Methods

A longitudinal study of a cohort of 2677 children aged 3 to 6 years old at the beginning of the study was conducted in urban DodaLab and rural FilaBavi, Hanoi, Vietnam. Overall, 2602 children, 1311 urban and 1291 rural, were followed for 3 years with identical measurements of weight and height in 2013, 2014 and 2016. Standard methods were used to estimate prevalence and incidence as well as confidence intervals.

Results

During the three-year follow-up, the overall estimated prevalence of overweight increased from 9.1% to 16.7%. For the urban children, the increase was considerably higher. The overall prevalence of obesity decreased from 6.4% to 4.5% with less decrease in the urban children. In the group of children who were overweight and obese at the start of the study, 41.4% and 30.7%, respectively, remained in the same state three years later. The incidence of overweight and obesity during the three years were 12.4% and 2.7%, respectively. Boys were more likely to develop obesity than girls.

Conclusions

Already in preschool age, the prevalence of overweight is high and it continues to increase with age, especially in the urban area. Prevention and intervention programs need to start at early preschool age and actions in urban areas deserve priority.

30-year trends in overweight, obesity and waist-to-height ratio by socioeconomic status in Australian children, 1985 to 2015

BACKGROUND/OBJECTIVE

To report 30-year (1985-2015) prevalence trends in overweight, obesity and abdominal obesity among children by school level and socioeconomic status (SES).

SUBJECTS/METHODS

Five cross-sectional, population child surveys (age 4-18 years; n=27 808) conducted in 1985-1997-2004-2010-2015 in New South Wales, Australia. Outcomes were prevalence of measured overweight, obesity and waist-to-height ratio (WHtR⩾0.5) by sex, school level (children (primary) and adolescents (high)) and SES tertile.

RESULTS

In 2015, the prevalences of overweight, obesity and WHtR⩾0.5 in children were 16.4%, 7.0% and 14.6%, respectively, and in adolescents 21.9%, 17.2% and 4.6%, respectively. Obesity prevalence has not significantly changed in children or adolescents since 1997, nor since 2010 (children, P=0.681; adolescents, P=0.21). Overweight has not significantly changed in children since 1997, but has in adolescents since 1985, with a relative increase of 16 percentage points (P<0.001) between 2010 and 2015. WHtR⩾0.5 prevalence has significantly changed since 1985, except in adolescent girls between 2010 and 2015. Between 2010 and 2015 the relative increase in WHtR⩾0.5 was 17 and 40 percentage points in children and adolescent boys, respectively. Significant disparities in prevalence rates between children and adolescents from low and high SES backgrounds began in 2010 for overweight, since 1997 for obesity and since 2004 for WHtR⩾0.5. Differences between SES groups have become larger over the past 18 years.

CONCLUSIONS

Since 1997, obesity has remained stable, and overweight has stabilized in children, not in adolescents. WHtR⩾0.5 significantly increased between 1985 and 2015, with prevalence rates at each survey around twice the obesity prevalence. Compared with high SES children and adolescents, the risk of overweight, obesity and WHtR⩾0.5 was significantly higher for low SES children and adolescents. The findings are highly relevant to policy makers involved in child obesity prevention interventions and highlight the need for better targeted interventions among children and adolescents from low SES backgrounds, and adolescents in particular.

Secular Trends in Growth and Nutritional Outcomes of Children under Five Years Old in Xiamen, China

The purpose of this study was to examine secular changes in growth and nutritional outcomes of Chinese urban children under five years old, in 2009, 2012, and 2015. Cluster random sampling methods were used to select children under five years old in Xiamen, one of five special economic zones in China. Subjects (N = 71,229) under five years old (39,413 boys, 31,816 girls) were examined at three different times (22,576 in 2009, 24,816 in 2012, and 23,837 in 2015). Significant differences in the boys’ height and weight (p < 0.05) were found across the three time points; subjects in the 2015 sample were the heaviest and tallest, and they had the highest BMI (2009 < 2015; 2012 < 2015). Among the girls, those in the 2015 sample were similar to the boys (2009 < 2012; 2012 < 2015). In general, similar patterns were observed when mean values were analyzed by age. An increasing trend was found in the prevalence of overweight and obesity and a decreasing trend for stunting, underweight, and wasting. The results revealed that the burden of childhood under- and over-nutrition might constitute a public health concern in modern China.

Prevalence of grade 1, 2 and 3 thinness is associated with lower socio-economic status in children in Shanghai, China

Objective

We aimed to investigate the prevalence of grade 1, 2 and 3 thinness among Chinese children and to explore their associations with socio-economic status (SES).

Design

A population, school-based cross-sectional study using multistage, stratified cluster random sampling. Grade 1, 2 and 3 thinness, overweight, obesity and severe obesity were defined by the International Obesity Task Force BMI cut-offs.

Setting

Seven districts of Shanghai, China.

Subjects

Chinese children aged 3–12 years (n 84 075).

Results

In boys and girls, respectively, the prevalence of grade 1 thinness was 8·89 % and 11·78 %, of grade 2 thinness was 2·80 % and 3·74 %, and of grade 3 thinness was 2·23 % and 2·93 %. Compared with urban children, suburban children had higher prevalence of thinness. Children whose parent had low education had higher prevalence of grade 1, 2 and 3 thinness than those whose parent had high education. The prevalence of grade 2 and 3 thinness, obesity and severe obesity in low-SES children was higher than that in high-SES children, and the prevalence of grade 1 thinness was lower than that in high-SES children. Particular patterns of prevalence of grade 1, 2 and 3 thinness appeared in low-, middle- and high-SES children.

Conclusions

The study describes associations of SES with grade 1, 2 and 3 thinness, overweight, obesity and severe obesity in Shanghai children. The patterns of thinness and obesity in Shanghai provide further insights into BMI patterns in mega-cities in developing countries.