Obesity, fitness and health in Taiwanese children and adolescents

Genetic Association of LEP Gene Polymorphisms with Obesity in Moroccan Individuals: Case-Control Study and Updated Meta-analysis

Obesity is a global epidemic disease representing the fifth leading cause of death in the world. It was shown that it is caused by the interaction between environmental factors and genes including leptin gene (LEP). This paper aimed to analyze the association between the LEP gene polymorphisms rs7799039 and rs11761556 with obesity in Moroccan individuals as well as to perform an update meta-analysis of this genetic association. Both polymorphisms were genotyped in 146 obesity patients and 104 controls using real-time PCR technique. The genetic association analysis and the comparison of quantitative parameters were carried out using the R language. Moreover, a meta-analysis including 20 genetic association studies was performed using Review Manager 5.3 software. No significant association was found between the polymorphisms rs7799039 and rs11761556 and the risk of obesity. The comparison of biochemical and clinical parameters between the genotypes of the rs7799039 polymorphism, showed a significant increased triglycerides levels in carriers of AA or GA genotypes (P value = 0.040). The meta-analysis showed no significant association between the rs7799039 polymorphism and obesity under all genetic models. In conclusion, the case-control study and meta-analysis demonstrated that the LEP gene polymorphisms rs7799039 and rs11761556 cannot be considered as genetic risk factors for obesity.

Prevalence of Ideal Cardiovascular Health Metrics among Young Asian Adults over 5 Years of Follow-Up

BACKGROUND

Ideal cardiovascular health (CVH) metrics play an important role in preventing cardiovascular disease (CVD). However, there is a lack of cohort studies on CVH metrics among young Asian adults. The aims of this study were to describe early changes in CVH among young Asian adults and to investigate the association between CVH metrics and sociodemographic variables.

METHODS

A total of 10,000 young adults (aged 21-30 years) were recruited between 2000 and 2016. There were two CVH measurements taken from these participants over the study period. One measurement was taken at the beginning, and the other was taken five years later. Subgroup analysis of the changes in CVH metrics was divided by education level and marital status.

RESULTS

The mean age of the participants was 26.8 years. The initial prevalence of ideal CVH metrics was 52.3% and 86.8% and decreased to 43.8% and 81.2% after five years for males and females, respectively. In the subgroup analysis, males with less than a university education had a smaller ideal CVH metric decrease (6.2%) than males with more than a university education (8.9%), while females with more than a university education had a smaller ideal CVH metric decrease (5.4%) than females with less than a university education (7.3%). Married males had a smaller ideal CVH metric decrease (6.1%) than single males (9.1%), while single females had a smaller ideal CVH metric decrease (5.3%) than married females (6.2%).

CONCLUSIONS

The prevalence of ideal CVH metrics among young adults gradually decreased as age increased. Higher educational attainment and unmarried status were associated with a greater prevalence of ideal CVH metrics regardless of sex, but early CVH changes differed by sex, education level, and marital status. The prevalence of CVH changes found early among young adults can be used to monitor CVH changes quickly. Effective health promotion programs are needed to maintain CVH metrics among young adults.

Age-specific trend and birth cohort effect on different histologic types of uterine corpus cancers

To evaluate the uterine corpus cancer incidence rates, age-specific trends, and birth cohort patterns by different histologic types. We conducted a retrospective cohort study of uterine cancer patients (n = 28,769) of all ages from the National Cancer Registry of Taiwan between 1998 and 2017. We estimated the incidence trends, average annual percent changes (AAPCs), and cancer-specific survival (CSS) rate for the two main subtypes (endometrioid and nonendometrioid) of uterine cancer in Taiwan. During the study period, uterine corpus cancer incidence rates increased over time from 5.3 to 15.21 per 100,000 women. Incidence trends for endometrioid carcinoma increased in all age groups (positive AAPCs > 5% for each age group), and the rise was steeper among women aged 50 years and younger. For nonendometrioid carcinomas, incidence rates increased among women over 50 years. The CSS rate improved among women with stage I (hazard ratio [HR] 0.63, 95% confidence interval [CI] 0.49-0.81) and stage III (HR 0.72, 95% CI 0.58-0.90) endometrioid carcinomas after 2013 compared with those during 2009-2012. However, the CSS rate remained unchanged for nonendometrioid carcinomas. Age, diagnostic period, stage and histologic types were significant factors associated with the 5-year CSS rate. We found that the incidences of both endometrioid and nonendometrioid carcinomas continued to increase among contemporary birth cohorts. Etiologic research is needed to explain the causes of these trends.

Association between BMI and health-related physical fitness: A cross-sectional study in Chinese high school students

Background

Existing studies reporting on the levels of physical fitness among high school students use relatively few fitness tests for indicators of physical fitness, thus, incomprehensively evaluating the levels of physical fitness. Therefore, this study investigated the relationship between body mass index (BMI) and physical fitness index (PFI) by investigating five physical fitness indicators and calculating PHI.

Method

Anthropometric measurements and indicators from five measures of physical fitness (50-m sprint, sit and reach, standing long jump, 800/1,000-m run, pull-up/bent-leg sit-up) were assessed. BMI was calculated to classify individuals into underweight, normal weight, overweight, and obese categories. Z-scores based on sex-specific mean and standard deviation were calculated, and the sum of Z-scores from the six fitness tests indicated the PFI. The findings were fitted to a linear regression model to elucidate the potential relationship between BMI and PFI.

Results

In total, 176,655 high school students (male: 88,243, female: 88,412, age: 17.1 ± 1.05 years, height: 168.87 ± 11.1 cm, weight: 62.54 ± 15.15 kg) in Jinan, China, completed the physical fitness tests between 2020 and 2021. The one-way ANOVA models showed that PFI in the normal category was significantly higher as compared to all the other BMI categories within both male and female groups (p < 0.001), and PFI in the obese category was significantly lower as compared to all the other BMI categories for both male and female groups (p < 0.001). The association between PFI and BMI showed an inverted U-shape relationship.

Conclusions

This study demonstrated that BMI affects the PFI in both males and females. As compared to the obese and overweight categories based on BMI, significantly higher scores of PFI were observed for males and females.

Nutritional status, food consumption, lifestyle, and physical fitness in rural and urban elementary school children in Northeast China

Childhood obesity is observed not only in developed countries but also in some developing countries in Asia, where low physical activity and poor physical fitness have been reported. The primary goal of weight loss is to reduce body fat mass, thereby reducing the risk of metabolic syndrome. Unfortunately, a concomitant decrease in lean mass, including muscle mass, is often observed when weight is lost. This study aimed to clarify the nutritional status and physical fitness of local elementary school children and to investigate the factors associated with nutritional status. This study evaluated measures that can reduce the tendency toward obesity and recommends exercise that can reduce weight while maintaining or increasing muscle strength. A total of 911 elementary school children were recruited for this study. All the participants completed anthropometric measurements, dietary surveys, and physical fitness tests. Compared with the Chinese obesity criteria, the proportions of obese and overweight subjects were generally high [22 (rural girls) to 47% (urban boys)], and urban children had a higher obesity rate than rural children. Overall, rural children had better physical fitness test results than urban children did. Skipping rope was correlated with muscle mass. Exercise time (β = −0.31, p < 0.01), skipping rope (β = −0.25, p < 0.01), screen time (β= 0.23, p < 0.01); sit-ups (β = −0.20, p < 0.01); 400-m run (β = −0.19, p < 0.01); urban or rural area (β = 0.18, p < 0.01); oil intake (β = 0.15, p < 0.01), family income (β = 0.11, p < 0.05); and sex (β = −0.10, p < 0.05) were significant predictive factors for overweight and obesity, respectively. The diet of schoolchildren can be improved by reducing the intake of grain and edible oils. Physical fitness of schoolchildren can be improved by increasing exercise time and selecting exercises with higher metabolic equivalents. Rope skipping appears to be the best option because it can ameliorate obesity by increasing muscle strength. The results of this study can provide a reference for the development of obesity intervention methods for children in China and worldwide.

Sex-Specific Effect of Obesity on Epiblepharon in Different Age Groups: A Case-Control Study

Obesity has been regarded as a risk factor for several ocular diseases. This study aims to investigate the age- and sex-specific relationship between epiblepharon and obesity in children. A retrospective case-control study was conducted using the Chang Gung Research Database. Children ≤ 18 years of age with epiblepharon were identified from 1 January 2009 to 31 December 2019. Children were classified into three groups: normal, overweight and obese groups. A total of 513 patients and 1026 controls (57.7% males) aged 1 to 18 matched by sex and age were included in the analysis. The median body mass index (BMI) of children with epiblepharon was significantly higher than that of children without epiblepharon (p < 0.001). In the subgroup analysis, among boys aged 4 to 9 years, the BMI in boys with epiblepharon was significantly higher than that in boys without epiblepharon (p < 0.05) and the risk of epiblepahron in overweight/obese boys was significantly higher than in non-overweight boys (OR = 1.74, 95% CI = 1.07-2.82 for age 4 to 6; OR = 3.06, 95% CI = 1.56-6.03 for age 7 to 9). On the other hand, among girls aged 13 to 18 years, the BMI in adolescent girls with epiblepharon was significantly higher than that in the control group (p < 0.05) and overweight/obese girls had a statistically higher risk of persistent epiblepharon than non-overweight girls (OR = 3.70, 95% CI = 1.38-9.97). The association between obesity and epiblepharon varies in strength according to age in a sex-specific manner.

Applicability of the Greulich and Pyle bone age standards to Taiwanese children: A Taipei experience

BACKGROUND

The Greulich and Pyle (GP) method is one of the most common radiographic techniques for bone age (BA) assessment. The applicability of this method to ethnic populations outside of the United States has been investigated in several recent studies worldwide. Currently, limited data are available on the accuracy of the GP method for the Taiwanese population. The purpose of this study was to determine whether the GP standards are applicable to contemporary Taipei children.

METHODS

Clinical data from October 1, 2010, to March 31, 2020, were retrospectively collected from a general hospital in Taipei. BA was determined by a senior pediatrician and was reviewed by a senior pediatric radiologist according to the GP standards. Comparison of BA and chronological age (CA) was performed in children with body weight and height in the 15th to the 85th percentiles of normal children. Ethnic variations in the maturation process in the ulnar bone were investigated. All data were statistically analyzed.

RESULTS

In total, 2465 medical records were collected. After excluding those with diseases and unqualified data, 654 records of boys and 809 of girls were analyzed. In boys, the mean BA was significantly delayed between 6 and 9 years of age compared with the CA. In girls, the mean BA was generally advanced between 7 and 15 years of age. Ulnar bone maturation tended to be delayed in young boys.

CONCLUSION

A significant discrepancy between CA and BA was observed in our population. Delayed ulnar bone maturation in young boys was confirmed. Children in Taipei exhibit a different maturation pattern than children on whom the GP standards were based.

The impact of maternal influences on childhood obesity

There was a lack of detailed information about maternal influences on their children’s body mass index (BMI) in Taiwan. The aim of this study was to find the evidence to describe how mothers’ factors could affect their 2 to 9-year-old children’s BMI, with data collected from May 2021 to June 2021. Anonymous self-administered questionnaires were completed by 1035 participants from Taiwan’s six metropolitan cities and eight counties. After controlling for children’s factors, such as number of children in a family, children’s constitution, children’s age and gender, hierarchical regression models were used to analyze the effects of five maternal factors on their children’s BMI: maternal BMI, age, education level, monthly household income, and marital status (single parent or not). The results were found as follow: maternal BMI [β = .24], maternal educational level [β = −.141], and monthly household income [β = .071], significantly (p < 0.05) influenced their children’s BMI. Higher maternal BMI was associated with a higher children’s BMI. Mothers with lower levels of education background were more likely to have children with a higher BMI. Monthly household income was a positive factor influencing children’s BMI. In conclusion, this study is the first detailed description of maternal influences on their 2–9 years old children’s BMI in Taiwan. Although the study could not cover all of the factors influencing Taiwan’s childhood obesity, we have discovered maternal BMI, education level, and monthly household income were significant factors associated with children’s BMI.

Differences between Sexes in Cardiopulmonary Fitness among Children and Adolescents with Kawasaki Disease

It is known that children and adolescents with Kawasaki disease (KD) can maintain normal cardiopulmonary fitness (CPF) after the disease’s acute stage has subsided. This study aimed to investigate whether gender differences affect CPF in children and adolescents with KD. We retrospectively reviewed a cohort of 204 participants (120 boys and 84 girls) with KD. All participants were instructed to complete a symptom-limited cardiopulmonary exercise test (CPET) adapted to assess their CPF. Based on body mass index (BMI), boys and girls were categorized into groups of underweight (19 boys and 12 girls), normal (62 boys and 59 girls), and overweight (39 boys and 13 girls). Although a similarity in body composition was found among both genders for KD subjects and normal Taiwanese peers, the percentage of overweight subjects was higher in KD boys than the normal Taiwanese boys. When comparing CPF for different BMI groups, the whole KD group showed no discrepancy, but a significantly lower peak VO2 for the overweight KD boys group was observed, representing poorer CPF. In conclusion, girls with KD had better CPF than boys, and gender stereotypes affect sports participation as well as self-efficacy, and may be contributing to poorer CPF in KD boys.

Would foot arch development in children characterize a body maturation process? a prospective longitudinal study

BACKGROUND

Flatfoot (Pes Planus), often regarded as a physiological deviation in children, is of concern to parents because there is no test to predict the development of foot arch. This study aimed to use a new diagnostic flatfoot criterion to determine 1) how the footprint index changes during the development of foot arches, 2) what factors can predict a foot arch development, and 3) whether foot arch development could be a process of body growth.

MATERIALS AND METHODS

572 children were enrolled in a prospective longitudinal study of anthropometrical parameters and physical fitness twice at age of 6.7 and 8.2 years. The bimodal frequency distribution of the Chippaux-Smirak index (CSI) of the footprint was used to define flatfoot as CSI <0.58 and non-flatfoot as CSI >0.61. Body measurements and physical fitness tests were compared between children with flatfeet who developed foot arches and children who did not.

RESULTS

Of 263 children with flatfeet, the CSI significantly changed from 0.72 to 0.46 in 70 children who developed foot arches over 1.5 years and the others had minimal change in the index. Children with foot arch development had a lower initial CSI, improved boys' performance in one-leg balance, and less increase in girls' body height than children who remained flatfooted, whereas sex and weight were similar in both groups.

CONCLUSION

This longitudinal study with the bimodal distribution of the CSI investigated how the development of foot arch advances in children around age 7. A significant and unique pattern in change of the CSI suggests involvement of a maturational stage in foot arch development. Along with the improved performance in one-leg balance, the unidirectional transition from flatfoot to non-flatfoot is associated with improvement in motor control of the ankle.

Marching to the Beet: The effect of dietary nitrate supplementation on high altitude exercise performance and adaptation during a military trekking expedition

PURPOSE

The aim was to investigate the effect of dietary nitrate supplementation (in the form of beetroot juice, BRJ) for 20 days on salivary nitrite (a potential precursor of bioactive nitric oxide), exercise performance and high altitude (HA) acclimatisation in field conditions (hypobaric hypoxia).

METHODS

This was a single-blinded randomised control study of 22 healthy adult participants (12 men, 10 women, mean age 28 ± 12 years) across a HA military expedition. Participants were randomised pre-ascent to receive two 70 ml dose per day of either BRJ (~12.5 mmol nitrate per day; n = 11) or non-nitrate calorie matched control (n = 11). Participants ingested supplement doses daily, beginning 3 days prior to departure and continued until the highest sleeping altitude (4800 m) reached on day 17 of the expedition. Data were collected at baseline (44 m altitude), at 2350 m (day 9), 3400 m (day 12) and 4800 m (day 17).

RESULTS

BRJ enhanced the salivary levels of nitrite (p = 0.007). There was a significant decrease in peripheral oxygen saturation and there were increases in heart rate, diastolic blood pressure, and rating of perceived exertion with increasing altitude (p=<0.001). Harvard Step Test fitness scores significantly declined at 4800 m in the control group (p = 0.003) compared with baseline. In contrast, there was no decline in fitness scores at 4800 m compared with baseline (p = 0.26) in the BRJ group. Heart rate recovery speed following exercise at 4800 m was significantly prolonged in the control group (p=<0.01) but was unchanged in the BRJ group (p = 0.61). BRJ did not affect the burden of HA illness (p = 1.00).

CONCLUSIONS

BRJ increases salivary nitrite levels and ameliorates the decline in fitness at altitude but does not affect the occurrence of HA illness.

Sex-Specific Temporal Trends in Overweight and Obese Among Schoolchildren From 2009 to 2018: An Age Period Cohort Analysis

Background: Our study examined the age, period, and cohort effects on overweight and obesity in children using a 10-year dataset collected from schoolchildren in Hualien, Taiwan. Methods: We used data from the annual health checkup of a total of 94,661 schoolchildren in primary schools and junior high schools in Hualien from 2009 to 2018. Children were defined as overweight or obese by the gender- and age-specific norm of the body mass index. We conducted the age-period-cohort (APC) analysis in boys and girls separately. Results: From 2009 to 2018, the rates of children overweight and obese were 12.78 and 14.23%, respectively. Boys had higher rates of overweight and obesity than girls (29.73 vs. 24.03%, P < 0.001). Based on APC analysis results, positive age effect existed regardless of gender. The risk of overweight or obesity of children aged 9 or 12 years was significantly higher compared to the average rate. As for period effect, a fluctuating downward trend in overweight was evident in 2016, and a similar trend in obesity was seen in 2017 across gender groups. The birth cohort of 2007 to 2009 had a significant higher proportion of overweight and obese than other birth cohorts. This indicated that the proportion of children overweight and obese in the young generation is higher than that in the old generation. Conclusion: An increased risk of children overweight or obese was associated with age and later birth cohort. For the period effect, the trend in the prevalence of overweight and obesity fluctuated downward slowly from 2016 to 2017.

Comparison of Growth Velocity Among School Age Children With Different Body Mass Index From Childhood Into Early Adolescence in Hualien County, Taiwan: A Retrospective Cohort Study

Objective: This study aimed to investigate the contribution of high body mass index (BMI) to growth velocity among school-aged children who remained in the same BMI categories for a 6-year period. Methods: This retrospective cohort study included children who enrolled in the school year 2009 and remained in the same BMI categories during their 1st, 4th, and 7th grades (6-7, 9-10, 12-13 years of age). Annual linear growth velocity and weight gain were calculated and compared between sexes, BMI groups, and different times. Risk analysis and repeated measures analysis of variance were performed to identify the impact of BMI on growth velocity. Results: Of the 1,637 subjects, 53.0% were male, and 2.5% and 10.9% belonged to BMI groups of overweight and obese, respectively. In students between 6 and 13 years of age, obesity was associated with higher annual weight gain and height gain. Risk analysis showed that obese subjects had higher linear growth velocity than normal BMI groups of both sexes between 6 and 9 years of age. Unexpectedly, overweight and obese girls between 9 and 13 years of age had less linear growth velocity than underweight girls at the same interval. Repeated measures analysis of variance in both sexes showed a significant statistical association between BMI and different times of growth. However, the effect was less in girls between 9 and 13 years of age. Conclusion: Puberty may dominate over BMI as the main contributor to high growth velocity in girls with underweight BMI emerging into pubertal age.

A study on the perception of hand washing and health status in Korean adults

ABSTRACT

This study aimed to investigate the perception about hand washing and health status among Koreans using the data from the Community Health Survey.We examined the differences in the perceptions about hand washing and health statuses of 220,440 participants of the 2017 community health survey. The sample was divided into groups based on demographic variables, perceptions about hand washing, and prevalence of metabolic diseases. Participants' demographic characteristics were analyzed using frequency, and perceptions about hand washing and subjective health status-related parameters were analyzed using t tests. The prevalence of metabolic disorder was analyzed with χ2 tests.There were significant differences in subjective health status, subjective oral health status, and perceived obesity in the positive and negative hand washing perception groups (P < .01). The prevalence rate of hypertension and diabetes mellitus significantly differed in the positive and negative hand washing perception groups (P < .01), but no differences were observed for hyperlipidemia (P < .01).This study showed that positive hand washing perception is associated with good health care practices. The perceptions of hand washing, which are formed during early childhood, were closely associated with health status. This finding could be useful evidence for developing programs focusing on major health behaviors and levels of health.

The Associations Between Physical Performance and Anthropometric Characteristics in Obese and Non-obese Schoolchild Handball Players

This study investigated the relationship of body fat and fitness measures in schoolchild handball players. Twenty-eight young male handball players from handball first youth league volunteered for the present investigation (age: 10.9 ± 0.72 years; body mass: 54.8 ± 22.9 kg; height: 1.48 ± 0.10 m; body fat: 27.6 ± 9.23%). Measures included the Yo-Yo Intermittent Recovery Test level 1 (Yo-Yo IR1), jumping ability [squat and counter-movement jumps (SJ, CMJ)], and sprint tests (10 m, 15 m). Anthropometry was assessed by body mass, body mass index (BMI), and fat percentage (%BF). The power of the upper limb was measured as the total distance thrown overhead using a 2 kg medicine ball. Intrarater reliability for all parameters showed a coefficient of variation (CV) below 10% and an intraclass correlation coefficient (ICC) above 0.75. All ICC were excellent (ICC ≥ 0.96). Reliability as shown by the CV differed between 1.0 (sprint 15 m) and 5.6 (sprint 10 m). With the exception of medicine ball throw, we found significant differences between non-obese and obese in all performance parameters. The differences ranged from η _p ² = 0.47 (sprint 10 m) to η _p ² = 0.09 (medicine ball throw). The two-step-linear regression analysis using the predictors body height and body weight (step 1) and body fat (step 2) showed a marked increase of explained variance by adding body fat. The largest r² changes were calculated for sprint 10 m (0.54), CMJ (0.49), and sprint 15 m (0.42). The lowest influence of the predictors was observed for medicine ball throw (step 1: r ² = 0.03, step 2: r ² = 0.07). With the exception of sprint parameters (β-coefficient sprint 10 m: -0.74; β-coefficient sprint 20: -0.66), a decrease of %BF leads to a higher performance in all parameters. %BF in youth handball players should be an important concern for practitioners working in this team sport in contrast to the frequently used BMI. It seems sensible and appropriate to engage very young children in physical activities such as team handball in order to improve their physical fitness. Decrease in% body fat could be considered both as a training and nutritional target to enhance and optimize sport performance-related outcomes.

The Relationship between Body Mass Index and Physical Fitness among Chinese University Students: Results of a Longitudinal Study

Over the past few decades, a gradual increase in sedentary lifestyles along with the increased consumption of a modern, hypercaloric diet has resulted in a substantial increase in the number of those classified as overweight or obese in China. The prevalence of overweight and obesity has become a key public health issue. However, it is important to be cautious when interpreting the literature as the majority of studies apply cross-sectional data to assess and subjectively compare the relationship between physical fitness and being overweight and obese. In the present study, longitudinal data were collected from 3066 students (enrolled in 2014) at a university in China at the beginning of each academic year throughout their four-year university program. The aim of this study was to analyze the various associations between BMI, explosive power, flexibility, and cardiorespiratory endurance, and a random-intercept panel model (RIPM) was separately employed on male and female participants to identify between- and within-person variations. In this way, the associations for between-person physical fitness and normal/overweight/obese weight ranges, and for within-person physical fitness and normal/overweight/obese weight ranges could be observed. The results of this study revealed that every physical fitness test chosen for evaluation (such as the standing long jump for explosive power or the distance run for cardiorespiratory endurance) was negatively related to the BMI results, irrespective of sex, with the notable exception of the flexibility results. In addition, this study showed that both males and females exhibited positively correlated results in both between-person BMI and flexibility as well as within-person BMI and flexibility. Furthermore, the relationships between and within persons of cardiorespiratory endurance, explosive power, and flexibility all showed positive correlations across both sexes. The dynamics between physical fitness and BMI identified in this study could prove useful to practitioners and researchers investigating such relationships in the future.

Correlation of physical fitness with psychological well-being, stress, and depression in Korean adults

The purpose of this study was to examine the relationship between physical fitness and psychological well-being, stress, and depression in Korean adults. Participants were 160 adults aged 40-70 years living in the metropolitan area of Incheon. Results were collected from random sample of main measurements from Incheon fitness center of National Fitness Award Project (2019). We assessed participants using physical fitness test (national fitness award), Psychosocial well-being index short form, Perceived Stress Scale, Geriatric Depression Scale. The data were analyzed Pearson and Spearman rank correlation analysis, and linear was conducted using IBM SPSS Statistics ver. 25.0. The re-sults indicated there were statistically significant associations between psychological well-being and agility, quick response; stress and flexibil-ity; depression and strength endurance strength, body fat. In addition, analysis showed that strength, endurance strength, body fat of physical fitness factors could significantly predict depression, flexibility could significantly predict stress, agility and quick response could significant-ly predict psychological well-being.

Age, period and birth cohort effects on the prevalence of overweight and obesity among Taiwanese adolescents: a national population-based study

BACKGROUND

The age-period-cohort effects on youth overweight and obesity among junior and senior high school students in Taiwan is not clear.

METHODS

We utilized the 2006-14 nationally representative School Physical Fitness Dataset. Based on the International Obesity Task Force cut-off criteria, a log-linear age-period-cohort analysis was performed to determine the influence of age, period and cohort on the trend in being overweight, obese and severely obese for both sexes.

RESULTS

The final dataset included 1073173 individuals (n = 520 382 boys and 552 791 girls). For girls, the prevalence of overweight and obesity declined with age, and the prevalence of overweight declined over time. For boys, the prevalence of overweight and obesity declined with age and over time from 2006 to 2014. The prevalence of severe obesity declined over time and increased with age for the boys. The younger birth cohorts had greater odds of being overweight, obese and severely obese than the older birth cohorts.

CONCLUSIONS

After differentiating the age-period-cohort effects, the data suggested a decreasing temporal trend in overweight and obesity among adolescents in Taiwan from 2006 to 2014. Among the birth cohorts of the 1990s, the younger cohorts had greater odds of being overweight and obese than the older cohorts when they reached adolescence.

[Tracking of physical fitness during chilhood: Longitudinal findings from the Diagnoform program]

BACKGROUND

A high level of physical fitness is associated with cardiovascular health in adolescents. We describe change in physical fitness levels assessed at two time points over 3 years.

METHODS

The study presents a longitudinal design, with the first phase data collection at 8 years and the second phase carried out at 11 years. A total of 516 children (254 boys) aged to 7.7±0.4 years (in 2010) and 10.9±0.4 years (in 2010) and 10.9 ± 0.4 years (in 2013) participated to the study. Cardiorespiratory fitness, muscular strength, speed, and agility were assessed in this study. For each physical fitness test, determination of the situation (in terms of percentiles) of each child in 2010 and then in 2013 compared to national standards. The 2010 and 2013 percentiles are then compared using the Wilcoxon signed rank test.

RESULTS

Muscular strength, agility and cardiorespiratory fitness decrease in both sex (p<0.01). A significant decrease was also found for all physical fitness components in normal weight children (p<0.05). For normal weight children in 2010 who became overweight or obese in 2013, there was a significant decrease in scores of cardiorespiratory fitness and agility tests (p<0.05). For overweight children in 2010 becoming from to normal weight status in 2013, only the agility test decreased significantly (p<0.05). Children being overweight or obese in 2010 and remaining in 2013, had a significant decrease in their physical fitness levels (p<0.05).

CONCLUSIONS

Our results indicate that the physical fitness of French youth decrease between childhood and early adolescence. Developing and introducing a health promotion curriculum in the French schools is suggested to improve health and physical fitness.

The Federated Practice of Soccer Influences Hamstring Flexibility in Healthy Adolescents: Role of Age and Weight Status

The aim of this study was to compare the hamstring flexibility between federated soccer and non-federated adolescents, and also to evaluate the effect of age and weight status on hamstring flexibility. The participants were 234 students (11–18 years old) divided into: (i) G1: non-federated (n = 127), and (ii) G2: federated in soccer (n = 107). The deep flexion of the trunk (DF) test and the sit and reach test (SRT) were performed. G2 showed higher values for the DF and SRT compared to G1 (p < 0.05). Both flexibility tests correlated positively (r = 0.4, p < 0.001). Body mass index (BMI) was negatively correlated with the DF test (r = −0.3, p < 0.001), but not with the SRT. Divided by BMI, the underweight and normal weight groups had higher scores in the DF test compared with the overweight and obese groups (p < 0.001). BMI was negatively correlated with hamstring flexibility. Federated soccer students present higher scores of hamstring flexibility.

Normative health-related fitness values for French children: The Diagnoform Programme

The primary objective of this study was to establish sex- and age-specific physical fitness percentiles for French children. The secondary aim was to assess sex, weight status, and age differences for physical fitness levels in French children. A sample of 31 484 children (16 023 boys, 15 461 girls) aged 6-11 years participated in the Diagnoform programme. Cardiorespiratory fitness, muscular endurance, speed, flexibility, and agility were assessed in this national programme. Percentile values were estimated as a function of age stratified by sex using a parametric method providing smooth centile curves and explicit formulae for the centile estimates. Values from the 10th to the 90th percentile are reported. The influence of body weight according to sex on the physical fitness level was also examined using an analysis of covariance adjusted for age. Physical fitness levels were slightly better in boys, except for agility and flexibility, in which girls performed better (Cohen's coefficient, 0.20-0.45; P < .001). All physical fitness tests were significantly associated with age (P < .0001). In general, overweight and obese children had a significantly poorer physical fitness level compared with their normal-weight counterparts (P < .05). No difference was found between thin and normal-weight boys and girls, except for agility (P < .05). Reference values provide normative data for French children, and these data should be useful for identifying special needs for appropriate intervention programmes.

Investigating the relationship between district-level socioeconomic status and individual obesity in Taiwanese adolescents: A large-scale cross-sectional analysis

The current study aimed to assess the prevalence of obesity and to explore the relationship between socioeconomic status and obesity among adolescents in Taiwan, a transitioning country. Data from the Taiwan School Physical Fitness Database on 1,875,627 Taiwanese adolescents aged 10-18 years were analyzed. The average family income per household in each district was collected from the national statistical institutional database. Descriptive statistics, Chi-square tests, Pearson correlation analysis, and mixed model analyses were used. The overall prevalence of combined overweight and obesity was 28.1%. The prevalence of overweight/obesity significantly differed according to gender and age. Furthermore, the average family income per household was negatively associated with the district-level prevalence of obesity. Additionally, when controlling for physical fitness, the average family income per household remained negatively associated with adolescent obesity. In addition, multilevel analysis was also applied to explore the relationship between district-level socioeconomic status and individual-level obesity to prevent the nested data structure from affecting the results. The results revealed that the average family income per household negatively correlated with individual obesity. These findings provide insight for public health officials into preventing and managing adolescent obesity.

Profiles of Physical Fitness Risk Behaviours in School Adolescents from the ASSO Project: A Latent Class Analysis

The aim of the present investigation was to describe profiles of adolescents’ fitness level, identify latent classes of fitness-related risk behaviours, and describe their sociodemographic and environmental predictors. In total, 883 adolescents (16.4 ± 1.4 years; 167.3 ± 10.4 cm; 62.8 ± 13.5 kg; 62.2% males) were assessed for personal and lifestyle information and for physical fitness components. Eleven possible fitness determinants and seven predictors were included. Latent class analysis (LCA) was used to determine fitness-related risk behaviours. Logistic regressions predicted class membership and assessed associations with fitness levels and fitness components. Five latent classes were recognised: 1—virtuous, 30.7% of respondents; 2—low physical activity/sport, 18.8%; 3—incorrect alcohol/food habits, 25.8%; 4—health risk/overweight, 15.9%; 5—malaise/diseases, 8.8%. Sex, age, parents’ overweightness/obesity and education, and school type predicted most classes significantly. Compared to class 1, class 2 had higher odds of having all poor fitness components except upper body maximal strength; class 4 had higher risk of low muscular endurance; and class 5 was likely to have lower maximal strength, muscular endurance, and speed/agility. Educating adolescents to reach a sufficient practice of PA/sport could help decreasing the risk of low health-related fitness more than discouraging them from using alcohol, addressing proper food behaviours and habits, and helping them understand their psychophysical malaise symptoms.

Associations of serum leptin, ghrelin and peptide YY levels with physical activity and cardiorespiratory fitness in adolescent boys with different BMI values

The aim of this study was to investigate the differences in associations of serum acylated and des-acylated ghrelin, peptide YY (PYY) and leptin levels with physical activity (PA) and cardiorespiratory fitness (CReF) in adolescent boys (mean age of 14.0 years) with overweight (OWB; n=55) and with normal weight (NWB; n=154).

METHODS

Total PA was measured by 7-day accelerometry (counts/min) and CReF by peak oxygen consumption (VO²peak/kg).

RESULTS

No differences were found in serum PYY, acylated ghrelin or des-acyl ghrelin levels, whereas mean leptin (11.6±10.6 vs. 2.0±2.7 ng/ml; p<0.05) and insulin (18.1±8.7 vs. 11.0±6.2 mU/l; p<0.05) levels were significantly higher in OWB compared to NWB. Mean CReF was significantly lower in OWB compared to NWB (39.7±8.7 vs. 50.5±6.8 ml/min/kg; p<0.05). Leptin was negatively correlated with CReF in both groups (r=-0.43; p<0.05), des-acylated ghrelin with CReF only in OWB (r =-0.36; p<0.05). In OWB leptin was negatively correlated with total PA (r=-0.32; p<0.05) and positively with sedentary time of PA (r=0.35; p<0.05). In NWB 28.1% of the variability of CReF was determined by leptin and insulin resistance index (HOMA-IR), whereas in OWB 71.9% was determined by trunk FM and BMI.

CONCLUSIONS

Leptin concentration was inversely associated with CReF in adolescent boys independently of BMI in both groups, while des-acylated ghrelin was associated with CReF only in OWB. Low PA in OWB was associated with high serum leptin level.

Novel Ultrasonographic Fatty Liver Indicator Can Predict Hepatitis in Children With Non-alcoholic Fatty Liver Disease

Background: Childhood non-alcoholic fatty liver disease (NAFLD) is a public health issue worldwide. To date, liver biopsy remains the gold standard for diagnosing the severity of NAFLD. However, this invasive procedure might contribute to complications. Owing to this reason, a good non-invasive tool to estimate NAFLD in children is urgently needed. We sought to investigate whether a non-invasive semi-quantitative ultrasonographic fatty liver indicator (US-FLI) can estimate NAFLD in children. Methods: Children aged between 10 and 18 years were enrolled prospectively. Abdominal ultrasonography was performed by a single experienced pediatric gastroenterologist and the non-invasive semi-quantitative US-FLI score were used. Patients were diagnosed with NAFLD if they had a US-FLI score ≥2. The anthropometric measures, obesity-related biochemical results, and levels of tumor necrosis factor-α, interleukin-6, caspase-cleaved cytokeratin fragment of cytokeratin 18 (M30), and adiponectin were also checked. Results: Overall, 117 children aged 10-18 years were enrolled. The anthropometric measures and obesity-related biochemical parameters (hsCRP, triglyceride, uric acid, AST, ALT, γ-GT, homeostatic model assessment insulin resistance (HOMA-IR), and M30) were significantly higher in the obesity group than in the non-obesity group (p < 0.05). Similarly, the US-FLI score was significantly higher in the obesity group than that in the non-obesity group (p < 0.001). Multiple linear regression showed that the US-FLI score was significantly associated with the waist-to-height ratio, uric acid, adiponectin, and M30 levels (all p < 0.05) in children with obesity. The US-FLI score ≥6 was the optimal cut-off point for predicting the hepatitis in children with NAFLD. The area under the receiver operating characteristic curve was 0.710 (95% CI: 0.572-0.847; p = 0.005). Conclusions: The non-invasive US-FLI score can predict hepatitis in children with NAFLD without mandatory liver biopsy. Moreover, the waist-to-height ratio, uric acid, adiponectin, and M30 levels were significantly associated with US-FLI score in children with obesity.

Physical Fitness Reference Standards in French Youth: The BOUGE Program

The aim of this study was to establish sex- and age-specific physical fitness percentiles in French youth. A sample of 11,186 children and adolescents (5,546 boys and 5,640 girls), aged between 10 and 15 years, was assessed in the French national BOUGE study. Participants were tested for their cardiorespiratory fitness, muscular endurance, speed, flexibility, and agility using the following tests: 20-m shuttle run tests, curl-ups test, 50-m sprint test, back-saver sit and reach test, and 10 × 5-m shuttle run test. Percentile values were estimated for French youth as a function of age stratified by sex using the generalized additive model for location, scale, and shape (GAMLSS). In general, physical fitness was better in boys than in girls, except for the back-saver sit and reach test, in which girls performed better. Except for the back-saver sit and reach test and 10 × 5-m shuttle run test, physical fitness performance was significantly associated with age. Sex- and age-specific normative values for physical fitness tests in French youth expressed as percentiles from the fifth to the 95th are provided. Reference values provide normative data for French youth. The data are useful in identifying special needs for appropriate intervention programs.

Laparoscopic sleeve gastrectomy for morbidly obese adolescents in Singapore

INTRODUCTION

Laparoscopic sleeve gastrectomy (LSG) outcomes among adolescents and factors associated with adolescent obesity in Singapore were evaluated.

METHODS

Prospectively collected data of patients aged 16-19 years who underwent LSG was retrospectively reviewed. A lifestyle questionnaire, Berlin and Epworth scores, and Patient Health Questionnaire-9 scores were collected. Preoperative anthropometrics, comorbidities, weight loss and body composition outcomes were recorded.

RESULTS

Among 208 LSGs, 13 (6.3%) were performed on obese adolescents. Mean age and body mass index (BMI) at first presentation were 19.1 ± 0.9 (range 16.8-19.8) years and 46.2 ± 6.3 (range 36-57) kg/m², respectively. There was family history of obesity (n = 7) and regular consumption of high-calorie drinks (n = 12). Most patients had comorbidities (n = 12), including hypertension (n = 5), asthma (n = 4), diabetes mellitus (n = 3), hernia (n = 3) and obstructive sleep apnoea requiring continuous positive airway pressure support (n = 3). At one year, excess weight loss was 64.3% ± 34.7% (range 21.8%-101.5%), while BMI and fat mass dropped to 31.2 ± 7.6 (range 23-40) kg/m² and 17.4 kg, respectively. Pain score was 2/10 at 24 hours after surgery. Mean postoperative stay was 2.7 days. No complications or readmissions occurred. Remission of diabetes mellitus and hypertension was reported in two of three and four of five adolescents, respectively, within one year of surgery.

CONCLUSION

LSG is a safe option for adolescents with good short-term weight loss outcomes and remission of metabolic comorbid conditions.

Association of School Environment and After-School Physical Activity with Health-Related Physical Fitness among Junior High School Students in Taiwan

The relationship between students’ school environment and exercise habits is complex, and is affected by numerous factors. However, the few studies that have been conducted on this relationship have reported inconsistent results, especially regarding Taiwanese students. We conducted this cross-sectional study to investigate the association of school environment and after-school physical activity with health-related physical fitness in Taiwanese adolescents. Data were drawn from a national survey conducted by the Ministry of Education in Taiwan in 2008 of health-related physical fitness measurements among junior high school students (649,442 total) in grades seven to nine. School environment (level of urbanization, school size, presence of sports field or gymnasium) and after-school physical activity were assessed for their association with adolescents’ physical fitness measurements (body mass index (BMI), bent-leg sit-ups, 800-/1600-m run, sit-and-reach, standing long jump). Urban boys and girls perform significantly better in muscle strength and endurance, cardiorespiratory endurance, flexibility, and explosive power; girls from rural areas exhibited significantly worse scores in body composition. Boys from large-size schools performed the worst in cardiorespiratory endurance, flexibility, and explosive power; whereas girls from large-size schools performed the worst in muscle strength, muscle endurance, and explosive power, but had the best score for body composition. However, the differences in body composition of boys from large-, medium-, and small- size schools did not reach a statistically significant level. Adolescents of both genders in schools with a sports field or gymnasium exhibited significantly better in muscle strength and endurance, cardiorespiratory endurance, and explosive power. Boys in schools with a sports field or gymnasium had significantly better body composition; girls in schools with sports field or gymnasium differed significantly in flexibility. Adolescents of both genders who participated in physical activity after school had significantly better body composition, cardiorespiratory endurance, and flexibility. Boys who participated in physical activity after school significantly differed in explosive power, whereas girls who participated in physical activity after school exhibited significantly better flexibility. Thus, the current study demonstrated that some factors, including urbanization (school location in rural or urban areas), school size, school facility provision (school with or without sports fields or gymnasiums), and after-school physical activity participation are more important than others in shaping adolescents’ physical fitness in Taiwan; meanwhile, these association patterns differed by gender.

[Physical fitness levels in French adolescents: The BOUGE program]

BACKGROUND

A high level of physical fitness is associated with cardiovascular health in adolescents. The aims of this study were to assess the levels of physical fitness of French adolescents and to determine the prevalence of these adolescents below the minimum level of cardiorespiratory fitness needed to guarantee future favorable cardiovascular profile.

METHODS

Participants were 12,082 French children and adolescents (5975 boys, 6107 girls) aged to 9 from 16 years. Cardiorespiratory fitness, muscular endurance, speed, flexibility and speed agility were tested. The associations of physical fitness measures with adolescent's characteristics were analyzed using Student t test, one-way ANOVA, or Pearson correlations as appropriate.

RESULTS

Boys were physically fitter than girls, expected for flexibility (P<0.0001). Subjects of normal weight adolescents had significantly better results than overweight or obese adolescents (P<0.05 for all comparisons), but also in comparison with underweight adolescents for muscular endurance, flexibility, cardiorespiratory fitness test (P<0.05). Our findings indicate that, on the basis of cardiorespiratory fitness, 16% of French boys and 7.7% of French girls have a risk of future cardiovascular disease (P<0.0001). This subgroup also performed poorly in all other tests of physical fitness used (P<0.0001). Aerobic fitness decreased significantly with the age (r=-0.168 for boys; r=-0.261 for girls).

CONCLUSIONS

Our results indicate that the physical fitness of French adolescents must be improved to help protect against cardiovascular disease in adulthood, especially in boys. The study showed also a dramatically decrease of the cardiorespiratory fitness during the adolescence period. Developing and introducing a health promotion curriculum in the French schools is suggested to improve health and physical fitness.

Relation of body mass index (BMI) to the prevalence of hypertension in children: A 3years' school-based prospective study in Suzhou, China

BACKGROUND

The prevalence of hypertension has been increasing in children and adolescents in China, which is considered to be accompanied with the epidemic of childhood overweight and obesity, but limited prospective studies have investigated the effect of body mass index (BMI) change on blood pressure among children, especially in China.

METHODS

This school-based prospective study compared the blood pressure and prevalence of hypertension in students with different patterns of change in BMI between two periods (childhood and adolescence). 5465 children were followed-up since 2011(childhood) in Suzhou, China and had weight, height and blood pressure measured in 2011(childhood) and 2014(adolescence).

RESULTS

Those who changed from being overweight in childhood to having normal BMI in adolescence had similar mean blood pressures to those who had a normal BMI at both two periods. In contrast, those who were overweight at both two periods or who had a normal BMI in childhood and were overweight in adolescence had higher blood pressure in adolescence than those who had a normal BMI at both two periods. Compared with students who had a normal BMI at both periods, those with combination of abnormal BMI in childhood and adolescence have higher ORs of hypertension (4.83 in boys, 3.44 in girls and 3.73 in total).

CONCLUSION

These results suggest that obesity is a key determinant of blood pressure during childhood, and weight reduction may have important beneficial effects on blood pressure.

Relationship of body mass status with running and jumping performances in young basketball players

PURPOSE

the main purpose of this study was to examine the relationship of body mass (BM) status with running and jumping performances in young male basketball players.

METHODS

basketball players (n=72, age 12.9±2.8 yrs), who were grouped into U-12 (9-12 yrs), U-15 (12-15 yrs) and U-18 (15-18 yrs), performed a battery of anthropometric, running and jumping tests. We examined differences among age groups, and between normal weight and overweight players.

RESULTS

the results indicated significant and large differences among age groups in BM, height, body mass index (BMI), fat mass (FM), fat-free mass, speed, endurance, standing long jump, countermovement jump (CMJ), mean power in 30 s jumping test (Pmean) (p<0.001, η(2)≥0.23) with older players presenting higher values. Within each age group, overweight players had higher BM, BMI, body fat percentage and FM (p<0.05) than their normal weight counterparts. Overweight players had worst performance in running (sprint and endurance) and jumping (CMJ and Pmean) in U-12, and worst endurance in U-18 (p<0.05, |d|≥0.82) than normal-weight players, whereas there was no difference in U-15.

CONCLUSIONS

it was concluded that the relationship of BMI with running and jumping performances varied according to age. Based on these findings, trainers and coaches should focus on special intervention exercise and nutrition programs targeting optimal body mass especially in young basketball players, where the excess of body mass seemed to have the most detrimental effect on running and jumping performances.

The health benefits of muscular fitness for children and adolescents: a systematic review and meta-analysis

BACKGROUND

Physical fitness during childhood and adolescence has been identified as an important determinant of current and future health status. While research has traditionally focused on the association between cardio-respiratory fitness and health outcomes, the association between muscular fitness (MF) and health status has recently received increased attention.

OBJECTIVE

The aim of this systematic review and meta-analysis was to evaluate the potential physiological and psychological benefits associated with MF among children and adolescents.

METHODS

A systematic search of six electronic databases (PubMed, SPORTDiscus, Scopus, EMBASE, PsycINFO and OVID MEDLINE) was performed on the 20th May, 2013. Cross-sectional, longitudinal and experimental studies that quantitatively examined the association between MF and potential health benefits among children and adolescents were included. The search yielded 110 eligible studies, encompassing six health outcomes (i.e., adiposity, bone health, cardiovascular disease [CVD] and metabolic risk factors, musculoskeletal pain, psychological health and cognitive ability). The percentage of studies reporting statistically significant associations between MF and the outcome of interest was used to determine the strength of the evidence for an association and additional coding was conducted to account for risk of bias. Meta-analyses were also performed to determine the pooled effect size if there were at least three studies providing standardised coefficients.

RESULTS

Strong evidence was found for an inverse association between MF and total and central adiposity, and CVD and metabolic risk factors. The pooled effect size for the relationship between MF and adiposity was r = -0.25 (95% CI -0.41 to -0.08). Strong evidence was also found for a positive association between MF and bone health and self-esteem. The pooled effect size for the relationship between MF and perceived sports competence was r = 0.39 (95% CI 0.34-0.45). The evidence for an association between MF and musculoskeletal pain and cognitive ability was inconsistent/uncertain. Where evidence of an association was found, the associations were generally low to moderate.

CONCLUSION

The findings of this review highlight the importance of developing MF in youth for a number of health-related benefits.

The Duration of Breastfeeding and Its Association with Metabolic Syndrome among Obese Children

Objective. The objective of this study was to evaluate whether duration of breastfeeding is associated with a lower prevalence of metabolic syndrome in obese children. Methods. A retrospective analysis of obese children aged 3 to 18 years followed at a pediatric outpatient clinic at a single center between the years 2008 and 2012. The children were divided according to their breastfeeding duration: no breastfeeding, a short period of breastfeeding, and a long term breastfeeding. Also, they were divided into metabolic and nonmetabolic syndrome groups, based on physical examination and laboratory tests. Results. Out of 4642 children who visited the clinic, 123 were obese and were included in the study. About half of them matched the metabolic syndrome criteria. There was no correlation between the prevalence of metabolic syndrome and the duration of breastfeeding. Hypertension, abnormal low levels of HDL, high levels of HbA1c, and high fasting triglyceride levels were very common in our study population, yet no statistical significance was noted among the different breastfeeding groups. Conclusion. In this study, breastfeeding was not associated with a reduced risk for metabolic syndrome, compared with formula feeding, in children who are obese.

Fitness level and body composition indices: cross-sectional study among Malaysian adolescent

BACKGROUND

The importance of fitness level on the well-being of children and adolescent has long been recognised. The aim of this study was to investigate the fitness level of school-going Malaysian adolescent, and its association with body composition indices.

METHODS

1071 healthy secondary school students participated in the fitness assessment for the Malaysian Health and Adolescents Longitudinal Research Team (MyHEART) study. Body composition indices such as body mass index for age, waist circumference and waist height ratio were measured. Fitness level was assessed with Modified Harvard Step Test. Physical Fitness Score was calculated using total time of step test exercise and resting heart rates. Fitness levels were divided into 3 categories - unacceptable, marginally acceptable, and acceptable. Partial correlation analysis was used to determine the association between fitness score and body composition, by controlling age, gender, locality, ethnicity, smoking status and sexual maturation. Multiple regression analysis was conducted to determine which body composition was the strongest predictor for fitness.

RESULTS

43.3% of the participants were categorised into the unacceptable fitness group, 47.1% were considered marginally acceptable, and 9.6% were acceptable. There was a significant moderate inverse association (p < 0.001) between body composition with fitness score (r = -0.360, -0.413 and -0.403 for body mass index for age, waist circumference and waist height ratio, respectively). Waist circumference was the strongest and significant predictor for fitness (ß = -0.318, p = 0.002).

CONCLUSION

Only 9.6% of the students were fit. There was also an inverse association between body composition and fitness score among apparently healthy adolescents, with waist circumference indicated as the strongest predictor. The low fitness level among the Malaysian adolescent should necessitate the value of healthy lifestyle starting at a young age.

A cross-sectional study to examine the association between dietary patterns and risk of overweight and obesity in Hong Kong Chinese adolescents aged 10-12 years

OBJECTIVE

To describe the dietary patterns and examine the associations of these patterns with risk of overweight and obesity in Chinese adolescents.

METHODS

Baseline data collected between November 2003 and October 2004 from 171 boys and 180 girls aged 10-12 years who participated in the Hong Kong Adolescent Bone Health Cohort Study were analyzed. Dietary intake was assessed using a food frequency questionnaire and dietary pattern calculated using factor analysis. Data on demographic characteristics, weight, height, and Tanner stage were collected. Overweight and obesity were defined using The International Obesity Task Force cutoff values. Cardiovascular fitness expressed as peak oxygen consumption was predicted using the postexercise heart rate by the 3-minute step test and was used as an objective measure of physical activity. Association between dietary patterns and risk of overweight and obesity was examined using multivariate logistic regression with adjustment for demographics, puberty, and physical activity.

RESULTS

The mean (SD) age of the study sample was 11.2 (0.6) years and there were 57 (16.2%) participants who were overweight/obese. Three dietary patterns were identified, namely, vegetables-fruits, snacks-beverages, and animal foods, fats, and condiments dominated. There was no significant linear association between each dietary pattern and the risk of overweight and obesity in this sample. Instead, the risk of overweight and obesity in this sample was positively associated with pubertal stage and inversely associated with physical activity.

CONCLUSIONS

Pubertal stage and physical activity, but not dietary patterns, were important factors contributing to the risk of overweight and obesity in this population.

The association between obesity and blood pressure in Thai public school children

BACKGROUND

The prevalence of obesity has substantially increased in the past 3 decades in both developed and developing countries and may lead to an increase in high blood pressure (BP) at an early age. This study aimed to determine the prevalence of obesity and its association with blood pressure among primary school children in central Thailand.

METHODS

A cross-sectional study was conducted in two public schools in Bangkok in 2012. A total of 693 students (317 boys and 376 girls) aged 8-12 years participated voluntarily. Anthropometric measurements of weight, height, waist circumference (WC) and BP were collected. Fasting venous blood samples were obtained for biochemical analysis of fasting plasma glucose (FPG) and lipid parameters. Child nutritional status was defined by body mass index (BMI) for age based on the 2000 Center for Diseases Control and Prevention growth charts. The cutoff for abdominal obesity was WC at the 75 percentile or greater. Hypertension was defined according to the 2004 Pediatrics US blood pressure reference. Multinomial logistic regression was used to examine the relationship between high BP and obesity after controlling for other covariates.

RESULTS

The prevalence of obese children was 30.6% for boys and 12.8% for girls (mean prevalence 20.9%). Pre-hypertension (Pre-HT) was 5.7% and 2.7% for boys and girls and hypertension (HT) was 4.7% for boys and 3.2% for girls, respectively. Children with pre-HT and HT had significantly higher body weight, height, WC, BMI, SBP, DBP, TG, and TC/HDL-C levels but lower HDL-C levels than those children with normotension. After controlling for age, sex, glucose and lipid parameters, child obesity was significantly associated with pre-HT and HT (odds rations (ORs) = 9.00, 95% CI: 3.20-25.31 for pre-HT and ORs = 10.60, 95% CI: 3.75-30.00 for HT). So also was WC (abdominal obesity) when considered alone (ORs = 6.20, 95% CI: 2.60-14.81 for pre-HT and ORs = 13.73, 95% CI: 4.85-38.83 for HT) (p-value < 0.001).

CONCLUSIONS

Obesity among school children was positively associated with higher BP. Prevention of childhood obesity should be strengthened to prevent the risk of early high BP including cardiovascular risk factors.

Effect of living area and sports club participation on physical fitness in children: a 4 year longitudinal study

Background

Cross-sectional studies detected associations between physical fitness, living area, and sports participation in children. Yet, their scientific value is limited because the identification of cause-and-effect relationships is not possible. In a longitudinal approach, we examined the effects of living area and sports club participation on physical fitness development in primary school children from classes 3 to 6.

Methods

One-hundred and seventy-two children (age: 9–12 years; sex: 69 girls, 103 boys) were tested for their physical fitness (i.e., endurance [9-min run], speed [50-m sprint], lower- [triple hop] and upper-extremity muscle strength [1-kg ball push], flexibility [stand-and-reach], and coordination [star coordination run]). Living area (i.e., urban or rural) and sports club participation were assessed using parent questionnaire.

Results

Over the 4 year study period, urban compared to rural children showed significantly better performance development for upper- (p = 0.009, ES = 0.16) and lower-extremity strength (p < 0.001, ES = 0.22). Further, significantly better performance development were found for endurance (p = 0.08, ES = 0.19) and lower-extremity strength (p = 0.024, ES = 0.23) for children continuously participating in sports clubs compared to their non-participating peers.

Conclusions

Our findings suggest that sport club programs with appealing arrangements appear to represent a good means to promote physical fitness in children living in rural areas.

Modelling the vicious circle between obesity and physical activity in children and adolescents using a bivariate probit model with endogenous regressors

The increasing prevalence of obesity in children and adolescents has become one of the most important public health issues around the world. Lack of physical activity is a risk factor for obesity, while being obese could reduce the likelihood of participating in physical activity. Failing to account for the endogeneity between obesity and physical activity would result in biased estimation. This study investigates the relationship between overweight and physical activity by taking endogeneity into consideration. It develops an endogenous bivariate probit model estimated by the maximum likelihood method. The data included 4008 boys and 4197 girls in the 5th-9th grades in Taiwan in 2007-2008. The relationship between overweight and physical activity is significantly negative in the endogenous model, but insignificant in the comparative exogenous model. This endogenous relationship presents a vicious circle in which lower levels of physical activity lead to overweight, while those who are already overweight engage in less physical activity. The results not only reveal the importance of endogenous treatment, but also demonstrate the robust negative relationship between these two factors. An emphasis should be put on overweight and obese children and adolescents in order to break the vicious circle. Promotion of physical activity by appropriate counselling programmes and peer support could be effective in reducing the prevalence of obesity in children and adolescents.

Factors associated with being overweight among Inner Mongolia medical students in China

OBJECTIVES

A major goal of our study was to identify the associations between lifestyle factors and obesity in adolescents and young adults at risk by surveying students in Inner Mongolia Medical University. A second goal was to determine these factors differed by gender.

DESIGN

Cross-sectional study.

SETTING

Students grade 1-3 in Inner Mongolia Medical University.

PARTICIPANTS

5471 grade 1-3 medical students, composed of 3891 female and 1580 male students. Students with body mass index (BMI) ≥25 were defined as overweight.

RESULTS

BMI for male students was 22.1±2.9 and 21.2±2.2 for female students. The prevalence of overweight was 7.6%, with the prevalence being higher for male students compared with females, urban higher than rural and being an only child higher than having sibling children. For male students, urban residence was a risk factor, while for female students being an only child and staying up at night were risk factors, with physical activity a protective factor. A dose-dependency relationship was found between physical fitness and overweight prevalence.

CONCLUSIONS

This study shows that being an only child and resident in an urban area are risk factors; staying up late and lack of physical activities increased the risk of being overweight. BMI was associated with declines in physical fitness. Our study provides more insight into adolescent obesity problems.

Associations between health-related physical fitness and obesity in Taiwanese youth

This study examined associations between four health-related physical fitness measures and obesity in Taiwanese youth aged 10-18 years. Data from 13,500 school-aged youth were randomly selected from the "School Physical Fitness Database" of Taiwan by sex and age. Variables examined were height, body mass and performance on modified sit-and-reach (flexibility), bent-leg sit-up (abdominal muscular strength/endurance), standing long jump (lower body explosive strength) and distance run/walk (cardiorespiratory endurance). Adjusted logistic regression analyses were performed. Increased odds of being obese with decreased fitness levels were observed for lower body explosive strength and cardiorespiratory endurance in both sexes. The highest odds of being obese was found in the least fit quintile of cardiorespiratory endurance compared with the most fit quintile both in boys (Odds ratio, OR = 10.44; 95% confidence interval (CI), 7.94-13.73) and girls (OR = 5.40; 95% CI, 3.90-7.47). These findings suggest that in addition to cardiorespiratory fitness, lower body explosive strength is also associated with childhood and adolescent obesity.