Nature versus nurture in childhood obesity: a familiar old conundrum

The effect of birth weight on low-energy diet-induced changes in body composition and substrate-energy metabolism in obese women

OBJECTIVE

The objective of this study was to examine the association of birth weight (BW) with body composition, resting metabolic rate (RMR), nonprotein respiratory quotient (NPRQ), and insulin sensitivity changes after a 12-week diet intervention program.

METHODS

A total of 78 obese (body mass index [BMI] 34.0 ± 2.8) women aged 36.7 ± 7 years volunteered to participate in a 12-week diet intervention program. We assessed body fat mass (FM), lean mass (LM), and bone mass (BM; measured by dual energy x-ray absorptiometry), RMR (measured by indirect calorimetry), fasting plasma glucose, and insulin before and after the intervention. We calculated BMI, FM to LM ratio (FM/LM), and HOMA-IR. BW and gestational age were self-reported, and the BW Z-score was calculated.

RESULTS

At baseline, the BW Z-score was positively associated with LM (p < 0.01) and RMR (p < 0.05). The BW Z-score was significantly associated with diet-induced FM (p < 0.05) and FM/LM ratio changes (p < 0.01) independently of potential confounders including weight loss. The BW Z-score was not associated with diet-induced RMR or insulin resistance changes.

CONCLUSIONS

Lower birth weight is associated with lower LM and RMR in obese women and could program a lower FM loss achievement after an energy-restriction diet intervention.

Obesity in Turkish children and adolescents: prevalence and non-nutritional correlates in an urban sample

OBJECTIVES

The aim of the present study was to identify the prevalence and non-nutritional correlates of childhood obesity in primary school children and adolescents living in a representative sample of an urban area in western Anatolia.

METHODS

The study was designed as a cross-sectional, population-based study. A representative sample of primary school children in Aydin was randomly selected according to age, gender and socio-economic status. Body mass index (BMI) was calculated after weight and height measurement. Centres for Disease Control 2000 growth charts for children and adolescents were used to identify BMI percentiles. Weight and height percentiles were obtained from charts of growth curves for Turkish children.

RESULTS

The age range of children was 6-16 years. A total of 924 children and 424 adolescents were screened for obesity. Overweight and obesity prevalence in primary school children living in Aydin was 12.2% and 3.7%, respectively. High socio-economic status was found to be associated with childhood obesity. There was no association between obesity and gender, adolescence, educational status of parents and occupation of father.

CONCLUSION

In the present study, we focused on some of the non-nutritional correlates of obesity in a representative population of an urban area in a developing country. Obesity prevalence rate in Turkish children living in Aydin was higher in children from a higher socio-economic group in contrast to reports from many developed countries.

Obesity among male adolescent migrants in Vienna, Austria

Childhood overweight and obesity--especially among migrant children--are health problems in several European countries. The prevalence rates of overweight and obesity among 936 migrant boys of low socio-economic status from Turkey and former Yugoslavia were compared with those of Austrian boys in Vienna. In the longitudinal study, children were measured at the ages of 6, 10 and 15 years. Weight status was estimated by means of the body mass index and percentile curves were used for weight status classification. The prevalence of overweight and obesity was high among migrant boys as well as Austrian boys at all age groups. Ten-year-old boys from Yugoslavia exhibited the highest percentage of overweight (nearly 38%). The lowest percentage of overweight was among 6-year-old Austrian boys (17.2%). Being overweight or obese at the age of 6 years increased the risk of being overweight at 10 and 15 years significantly (p<0.001). This was true of all groups independent of migrant status. The impact of migrant status on weight status at the ages of 10 and 15 was not significant. Therefore, although migrant boys from former Yugoslavia exhibited the highest rates of overweight and obesity, migrant status is not associated significantly with an increased prevalence of obesity in this sample characterized by a generally low socio-economic status. Prevention should start as early as possible for all children, since overweight tends to persist from childhood into adolescence independent of migrant status.

Resting energy expenditure in females with cystic fibrosis: Is it affected by puberty?

OBJECTIVE

The aims of this study were to determine the effect of puberty and the menstrual cycle on resting energy expenditure (REE) in females with cystic fibrosis (CF).

DESIGN

Cross-sectional study. All participants had measurements of REE, anthropometry and pubertal staging. The measurements in the postmenarche group were carried out both in the follicular and luteal phases of their menstrual cycle.

SETTING

CF outpatient clinic at the Children's Hospital at Westmead.

SUBJECTS

Fifty-six females with CF and pancreatic insufficiency (13 postmenarche) were recruited from the hospital clinic and 63 controls (21 postmenarche) were recruited through families and friends of hospital staff.

RESULTS

Females with CF had a higher REE than controls (111.6+/-12.8% of predicted from controls P<0.001). There was a significant effect of menarche on REE with a decrease in the postmenarche -470 kJ/24 h compared with premenarche after adjustment for fat-free mass, fat mass and group (control or CF). There was no difference in REE between the follicular and luteal phases for either CF or controls.

CONCLUSIONS

Females with CF had raised REE that appeared to be independent of menarche. This study implies all females with CF and pancreatic insufficiency may need more intensive dietary management, owing to raised REE, to maintain growth and nutritional status, and possibly improve survival.

Obesity among female adolescents in Vienna, Austria--the impact of childhood weight status and ethnicity

OBJECTIVE

The objective of the study was to analyse prevalence of overweight and obesity among migrant girls in Vienna, Austria, starting at the age of 6 years up to the age of 15 years.

DESIGN

In a longitudinal study, the prevalence of overweight and obesity among migrant girls from Turkey and former Yugoslavia was documented and compared with that among Austrian girls in Vienna.

SETTING

Medical investigation of medical school authority in Viennese schools.

SAMPLE

Seven hundred and ninety girls of low socio-economic status were included in the study.

METHODS

Anthropometric data were collected at the age of 6, 10 and 15 years. Body mass was estimated by means of the body mass index (BMI), and percentile curves were used for determining the weight status.

MAIN OUTCOME MEASURE

Stature, body weight, BMI, weight status.

RESULTS

The prevalence of overweight and obesity was significantly higher among migrant girls at all age groups. The highest percentage of overweight was found among 10-year-old girls from Yugoslavia (nearly 35%) and the lowest percentage of overweight was exhibited in 6-year-old Austrian girls (20%). Being overweight or obese at the age of 6 years increased the risk of being overweight at 10 and 15 years significantly (P < 0.001). Among migrants, this risk was significantly higher than among Austrian girls (P < 0.001). Only 64.8% of Austrian girls, who were overweight/obese at the age of 6 years, were still classified as overweight at the age of 15 years. Among migrant girls, who were overweight at the age of 6 years, 72.0% (Turkish girls) and 78.3% (Yugoslavian girls) remained overweight until the age of 15 years.

CONCLUSIONS

Especially girls from former Yugoslavia but also Turkish girls exhibited high rates of overweight and obesity. Prevention should start as early as possible since overweight tends to persist from childhood into adolescence.