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Asif M, Qureshi HAI, Seyal SM, Aslam M, Sultan MT, Elwahab MEA, Matłosz P, Wyszyńska J. Assessing Disparities about Overweight and Obesity in Pakistani Youth Using Local and International Standards for Body Mass Index. J Clin Med 2024; 13:2944. [PMID: 38792484 PMCID: PMC11122011 DOI: 10.3390/jcm13102944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024] Open
Abstract
Background/Objectives: Obesity is currently considered a public health problem in both developed and developing countries. Gender- and age-specific body mass index (BMI) growth standards or references are particularly effective in monitoring the global obesity pandemic. This study aimed to report disparities in age-, gender- and ethnic-specific statistical estimates of overweight and obesity for 2-18 years aged Pakistani children and adolescents using the World Health Organization (WHO), the Center for Disease Control (CDC) 2000 references, the International Obesity Task Force (IOTF) and Pakistani references for BMI. Methods: The study used secondary data of 10,668 pediatric population, aged 2-18 years. Demographic information like age (years), gender, city and anthropometric examinations, i.e., height (cm) and weight (kg) were used in this study. The recommended age- and gender-specific BMI cut-offs of the WHO, CDC 2000 and the IOTF references were used to classify the children sampled as overweight and obese. For the Pakistani reference, overweight and obesity were defined as BMI-for-age ≥ 85th percentile and BMI-for-age ≥ 95th percentile, respectively. Cohen's κ statistic was used to assess the agreement between the international references and local study population references in the classification of overweight/obesity. Results: The statistical estimates (%) of the participants for overweight and obesity varied according to the reference used: WHO (7.4% and 2.2%), CDC (4.9% and 2.1%), IOTF (5.2% and 2.0%) and Pakistan (8.8% and 6.0%), respectively; suggesting higher levels of overweight and obesity prevalence when local study references are used. The Kappa statistic shows a moderate to excellent agreement (κ ≥ 0.6) among three international references when classifying child overweight and obesity and poor agreement between local references and the WHO (0.45, 0.52), CDC (0.25, 0.50) and IOTF references (0.16, 0.31), for overweight and obesity, respectively. Conclusions: The results of the study showed a visible difference in the estimates of excess body weight after applying the WHO, CDC, IOTF and local BMI references to the study population. Based on the disparity results and poor agreement between international references and the local study reference, this study recommends using local BMI references in identifying children with overweight and obesity.
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Affiliation(s)
- Muhammad Asif
- Department of Statistics, Govt. Graduate College Qadir Pur Raan, Multan 60000, Pakistan;
| | | | - Saba Mazhar Seyal
- South City Hospital, District Headquarter (DHQ) Sadar, Multan 60000, Pakistan;
| | - Muhammad Aslam
- Department of Statistics, Bahauddin Zakariya University, Multan 60800, Pakistan;
| | | | - Maysaa Elmahi Abd Elwahab
- Department of Mathematical Sciences, College of Science, Princess Nourah bint Abdulrahman University, Riyadh 11564, Saudi Arabia;
| | - Piotr Matłosz
- Institute of Physical Culture Sciences, Medical College of Rzeszow University, 35-959 Rzeszów, Poland;
| | - Justyna Wyszyńska
- Institute of Health Sciences, Medical College of Rzeszow University, 35-959 Rzeszów, Poland
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Umbraško S, Martinsone-Berzkalne L, Plavina L, Cauce V, Edelmers E, Starikovs A, Vetra J. Longitudinal Analysis of Latvian Child Growth: Anthropometric Parameters Dynamics from Birth to Adolescence. CHILDREN (BASEL, SWITZERLAND) 2024; 11:426. [PMID: 38671644 PMCID: PMC11049447 DOI: 10.3390/children11040426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/21/2024] [Accepted: 04/01/2024] [Indexed: 04/28/2024]
Abstract
This study provides a comprehensive analysis of the physical development patterns from birth to adolescence, utilizing a longitudinal dataset of 70 children monitored from birth until 17 years of age. The research focuses on the variability of growth trajectories, emphasizing the role of genetic and environmental factors in influencing these patterns. Key findings indicate that most children undergo one or two periods of accelerated growth, with significant variability in the timing and magnitude of these growth spurts. The study also highlights the adaptive nature of growth changes over generations, influenced by ecological, nutritional, and socio-economic conditions. The longitudinal approach reveals critical insights into the timing of peak growth velocities, demonstrating that girls reach their growth peak approximately one year earlier than boys. The analysis of intergenerational growth patterns suggests a significant increase in average height over the century, attributed to genetic diversity and changes in lifestyle and nutrition. This study's findings emphasize the importance of updating physical development standards regularly to reflect the changing genetic and environmental landscape. The variability in growth patterns and their correlation with health outcomes in later life highlights the need for targeted public health strategies that address the underlying socio-economic and environmental determinants of health. This research contributes to the understanding of physical development trajectories and provides a foundation for future studies aimed at optimizing health outcomes from early childhood through adolescence. The primary objective of this article is to meticulously analyze the dynamics of height growth and accurately identify the periods of accelerated bodily development within the context of longitudinal research.
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Affiliation(s)
- Silvija Umbraško
- Institute of Anatomy and Anthropology, Rīga Stradiņš University, LV-1010 Riga, Latvia; (S.U.); (L.M.-B.); (L.P.); (A.S.); (J.V.)
| | - Liene Martinsone-Berzkalne
- Institute of Anatomy and Anthropology, Rīga Stradiņš University, LV-1010 Riga, Latvia; (S.U.); (L.M.-B.); (L.P.); (A.S.); (J.V.)
| | - Liana Plavina
- Institute of Anatomy and Anthropology, Rīga Stradiņš University, LV-1010 Riga, Latvia; (S.U.); (L.M.-B.); (L.P.); (A.S.); (J.V.)
| | - Vinita Cauce
- Statistics Unit, Rīga Stradiņš University, LV-1010 Riga, Latvia;
| | - Edgars Edelmers
- Institute of Anatomy and Anthropology, Rīga Stradiņš University, LV-1010 Riga, Latvia; (S.U.); (L.M.-B.); (L.P.); (A.S.); (J.V.)
| | - Aleksandrs Starikovs
- Institute of Anatomy and Anthropology, Rīga Stradiņš University, LV-1010 Riga, Latvia; (S.U.); (L.M.-B.); (L.P.); (A.S.); (J.V.)
| | - Janis Vetra
- Institute of Anatomy and Anthropology, Rīga Stradiņš University, LV-1010 Riga, Latvia; (S.U.); (L.M.-B.); (L.P.); (A.S.); (J.V.)
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Prasad V, Sinha D, Joseph RJ. Global relevance of MGRS growth standards: the case of India. BMJ Paediatr Open 2024; 8:e002472. [PMID: 38490693 PMCID: PMC10946363 DOI: 10.1136/bmjpo-2023-002472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 03/03/2024] [Indexed: 03/17/2024] Open
Abstract
The most common measures of childhood undernutrition are based on anthropometric measures such as height-for-age (stunting/chronic undernutrition) and weight-for-height (wasting/acute undernutrition). It is well recognised that the determinants of undernutrition are multiple, including food intake, dietary diversity, health, sanitation and women's status. Currently, most countries across the world including India use the globally accepted WHO-Multicentre Growth Reference Study (MGRS) growth standards (2006) for the purposes of measurement as well as for evaluating progress on these metrics. However, there is some discussion on the universal relevance of these standards, and in the Indian context, whether these standards overestimate the prevalence of stunting, considering differences in genetic potential for growth. This is especially relevant in the context of increasing burden of obesity and non-communicable diseases in India. Based on a detailed review of literature, policy documents and expert inputs, this review paper discusses the relevance of the WHO growth standards for height/stunting, in the context of India. Issues discussed related to the MGRS methodology include pooling of data and intersite and intrasite variability, opting for standards as opposed to references, and external validity. Other issues related to plasticity of stunting and the influence of maternal heights are also discussed, in the context of analysing the appropriateness of using universal growth standards. Based on the review, it is recommended that the current standards may continue to be used until a newer global standard is established through a similar study.
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Affiliation(s)
| | - Dipa Sinha
- Dr BR Ambedkar University Delhi, New Delhi, India
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Asif M, Aslam M, Wyszyńska J, Altaf S. Establishing Body Mass Index growth charts for Pakistani children and adolescents using the lambda-mu-sigma (LMS) and quantile regression method. Minerva Pediatr (Torino) 2023; 75:866-875. [PMID: 32508076 DOI: 10.23736/s2724-5276.20.05745-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
BACKGROUND Assessment of growth and nutritional status is an essential part of clinical evaluation and care in pediatrics. Therefore, we aimed to establish age and gender specific smoothed BMI growth reference charts of Pakistani children and adolescents aged 2-18 years and to compare our LMS median percentile values with WHO 2007 international references and with references from other foreign studies. METHODS A representative cross-sectional sample of 10,668 healthy Pakistani subjects aged 2 to 18 years was studied. For calculation of BMI (kg/m2), height (cm) and weight (kg) were measured using standard procedures. Age and gender specific smoothed BMI growth reference values and associated charts were obtained using lambda-mu-sigma (LMS) as well as quantile regression (QR) statistical methods. RESULTS In the sample studied, the mean (±SD) BMI of all subjects was 16.50 (±2.83 kg/m2). Smoothed BMI percentile curves (5th, 10th, 25th, 50th, 75th, 90th and 95th) obtained by using LMS and QR methods, showed that BMI increased with age in both sexes. During pubertal age, girls had larger percentiles than boys. Centile values estimated by the LMS and QR procedure had small variability from the empirical centiles. Comparison of LMS BMI 50th percentile with references from WHO 2007 and data from other countries demonstrated that Pakistani children had substantially lower BMI percentiles than their counterparts in the reference population. CONCLUSIONS This comprehensive study suggests that WHO 2007 references are not suitable for Pakistani children. The QR method should be considered as an alternative method to develop growth charts.
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Affiliation(s)
- Muhammad Asif
- Department of Statistics, Govt. Degree College, Qadir Pur Raan Multan, Pakistan -
| | - Muhammad Aslam
- Department of Statistics, Bahauddin Zakariya University, Multan, Pakistan
| | | | - Saima Altaf
- Department of Statistics, Bahauddin Zakariya University, Multan, Pakistan
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Kozawa Y, Yamamoto A, Nakakuki M, Fujiki K, Kondo S, Okada T, Fukuyasu T, Yamaguchi M, Taniguchi I, Nomura N, Liu L, Higuchi M, Niwa E, Sohma Y, Naruse S, Takeyama Y, Ishiguro H. Clinical and genetic features of cystic fibrosis in Japan. J Hum Genet 2023; 68:671-680. [PMID: 37217688 DOI: 10.1038/s10038-023-01160-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/28/2023] [Accepted: 05/07/2023] [Indexed: 05/24/2023]
Abstract
Cystic fibrosis (CF) is an autosomal recessive disease caused by pathogenic variants in CF transmembrane conductance regulator (CFTR). While CF is the most common hereditary disease in Caucasians, it is rare in East Asia. In the present study, we have examined clinical features and the spectrum of CFTR variants of CF patients in Japan. Clinical data of 132 CF patients were obtained from the national epidemiological survey since 1994 and CF registry. From 2007 to 2022, 46 patients with definite CF were analyzed for CFTR variants. All exons, their boundaries, and part of promoter region of CFTR were sequenced and the presence of large deletion and duplications were examined by multiplex ligation-dependent probe amplification. CF patients in Japan were found to have chronic sinopulmonary disease (85.6%), exocrine pancreatic insufficiency (66.7%), meconium ileus (35.6%), electrolyte imbalance (21.2%), CF-associated liver disease (14.4%), and CF-related diabetes (6.1%). The median survival age was 25.0 years. The mean BMI percentile was 30.3%ile in definite CF patients aged < 18 years whose CFTR genotypes were known. In 70 CF alleles of East Asia/Japan origin, CFTR-dele16-17a-17b was detected in 24 alleles, the other variants were novel or very rare, and no pathogenic variants were detected in 8 alleles. In 22 CF alleles of Europe origin, F508del was detected in 11 alleles. In summary, clinical phenotype of Japanese CF patients is similar to European patients, but the prognosis is worse. The spectrum of CFTR variants in Japanese CF alleles is entirely different from that in European CF alleles.
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Affiliation(s)
- Yuka Kozawa
- Department of Human Nutrition, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akiko Yamamoto
- Department of Human Nutrition, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Miyuki Nakakuki
- Department of Human Nutrition, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kotoyo Fujiki
- Department of Nutrition, Nagoya University of Arts and Sciences, Nisshin, Japan
| | - Shiho Kondo
- Department of Health and Nutrition, Nagoya Women's University, Nagoya, Japan
| | - Takuto Okada
- Department of Human Nutrition, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomoya Fukuyasu
- Department of Human Nutrition, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Food and Nutrition, Tsu City College, Tsu, Japan
| | - Makoto Yamaguchi
- Department of Human Nutrition, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Itsuka Taniguchi
- Department of Human Nutrition, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nao Nomura
- Department of Human Nutrition, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Libin Liu
- Department of Human Nutrition, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mayuko Higuchi
- Department of Human Nutrition, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Erina Niwa
- Department of Human Nutrition, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshiro Sohma
- Division of Molecular Therapy, Department of Pharmaceutical Sciences, School of Pharmacy and Center for Basic Medical Research, International University of Health and Welfare, Otawara, Japan
| | | | - Yoshifumi Takeyama
- Department of Surgery, Kindai University School of Medicine, Osakasayama, Japan
| | - Hiroshi Ishiguro
- Department of Human Nutrition, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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Asif M, Aslam M, Mazhar I, Ali H, Ismail T, Matłosz P, Wyszyńska J. Establishing Height-for-Age Z-Score Growth Reference Curves and Stunting Prevalence in Children and Adolescents in Pakistan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12630. [PMID: 36231930 PMCID: PMC9566739 DOI: 10.3390/ijerph191912630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
Height-for-age Z-score (HAZ) curves are widely used for detecting children with stunting. The aim of this study was to provide smoothed HAZ growth reference values and their curves for Pakistani children and adolescents aged 2-18 years. The prevalence of stunting in Pakistani children was determined. A total of 10,668 healthy Pakistani participants were included. Information related to age, sex, city of residence and height (cm) was used. Age- and sex-specific smoothed HAZ growth reference values and associated graphs were obtained using the lambda-mu-sigma (LMS) method. The prevalence of stunting was calculated by applying WHO 2007 and USCDC 2000 height-for-age references and local reference of the study population. In both sexes, the smoothed HAZ curves increased with age. For 2 and 3 years of age, the height values of the girls were greater than those of the boys. The boys were then taller than the girls. Comparing our median height (z = 0) growth reference data from WHO, USCDC and corresponding data from other countries, Pakistani children and adolescents have significantly different reference values than their counterparts in the reference group. A marked overestimation of the prevalence of stunting was observed (10.8% and 17.9% according to WHO and USCDC, respectively) compared to the local reference (3.0%). It is recommended that the prevalence of stunting in children and adolescents is determined by applying local height growth references to plan health strategies and treatments in the local population.
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Affiliation(s)
- Muhammad Asif
- Department of Statistics, Government Associate College, Qadir Pur Raan 60000, Pakistan
| | - Muhammad Aslam
- Department of Statistics, Bahauddin Zakariya University, Multan 60000, Pakistan
| | - Iqra Mazhar
- Department of Preventive Pediatrics, The Children Hospital and Institute of Child Health, Multan 60000, Pakistan
| | - Hamza Ali
- Department of Biology, Government Associate College, Qadir Pur Raan 60000, Pakistan
| | - Tariq Ismail
- Department of Food Sciences and Technology, Bahauddin Zakariya University, Multan 60000, Pakistan
| | - Piotr Matłosz
- Institute of Physical Culture Sciences, Medical College, University of Rzeszów, 35-959 Rzeszów, Poland
| | - Justyna Wyszyńska
- Institute of Health Sciences, Medical College, Rzeszów University, 35-959 Rzeszów, Poland
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Tanveer M, Hohmann A, Roy N, Zeba A, Tanveer U, Siener M. The Current Prevalence of Underweight, Overweight, and Obesity Associated with Demographic Factors among Pakistan School-Aged Children and Adolescents-An Empirical Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11619. [PMID: 36141896 PMCID: PMC9517235 DOI: 10.3390/ijerph191811619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/26/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
Purpose: This study investigated the most recent estimates of underweight, overweight, and obesity prevalence in Pakistani school-aged children and adolescents. Methods: A cross-sectional study was conducted using a convenience random clustered sampling approach with 3,551 Pakistani school children aged 9 to 17 years from 52 schools throughout seven districts in central Punjab province. The CDC US 2000 was used to define underweight (BMI < 5th percentile), overweight (85th ≤ BMI < 95th percentile), and obesity (95th percentile ≤ BMI) for different school grade cohorts (primary, middle, secondary, and higher secondary schools). As a trend test, the Chi-square test was used. A Spearman correlation analysis (r) was used to determine the correlations between demographic variables and weight status. A regression analysis was conducted to explore the predictive power of demographic factors in relation to body weight. Results: In Pakistani school-aged children and adolescents, the prevalence of underweight, normal weight, overweight, and obesity was 21.9%, 66.9%, 5.8%, and 5.4%, respectively. Significant correlations with body weight status were shown for individual demographic parameters (age, gender, school type, and school grade). Children in urban areas were more likely to be underweight, overweight, or obese than those in rural areas. Boys were found to have a lower BMI than girls. Accordingly, more boys than girls were underweight (odds ratio (OR) = 1.57, 95% CI: 1.33-1.85) and more girls had a higher risk of obesity than boys (OR = 1.39, 95% CI: 1.03-1.86). Lower grades showed more underweight (OR = 1.66, 95% CI: 1.39-1.99) whereas higher grades showed a higher risk of obesity (OR = 1.91, 95% CI: 1.41-2.57). Conclusions: In Pakistani school-aged children and adolescents, underweight, overweight, and obesity were prevalent. Compared with studies from 2011, the risk of overweight and obesity in Pakistan has decreased. However, this may also be due to the fact that students in Pakistan have a lower BMI compared to other countries. This issue has also been seen in the present study and is confirmed here by the high number of cases of underweight students. Future research studies should look into additional weight status correlates and factors. To evaluate the association between weight status and behavioral and other health variables, future research should use longitudinal or interventional designs.
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Affiliation(s)
- Moazzam Tanveer
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China
| | - Andreas Hohmann
- Department of Training and Movement Science, BaySpo—Bayreuth Center of Sport Science, University of Bayreuth, 95447 Bayreuth, Germany
| | - Nadeem Roy
- School of Physical Education, Shanxi University, Taiyuan 030006, China
| | - Asifa Zeba
- Department of Education, International Islamic University, Islamabad 44000, Pakistan
| | - Umar Tanveer
- Department of Mass Communication, University of Lahore, Lahore 54000, Pakistan
| | - Maximilian Siener
- Department of Training and Movement Science, BaySpo—Bayreuth Center of Sport Science, University of Bayreuth, 95447 Bayreuth, Germany
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Al-Hazzaa HM, Alrasheedi AA, Alsulaimani RA, Jabri L, Alhowikan AM, Alhussain MH, Bawaked RA, Alqahtani SA. Prevalence of overweight and obesity among saudi children: A comparison of two widely used international standards and the national growth references. Front Endocrinol (Lausanne) 2022; 13:954755. [PMID: 36004353 PMCID: PMC9393362 DOI: 10.3389/fendo.2022.954755] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/18/2022] [Indexed: 11/15/2022] Open
Abstract
Objective To compare three body mass index (BMI) classifications that are used to assess the prevalence of overweight and obesity among Saudi children aged 6-13 years: the International Obesity Task Force (IOTF) age and gender cutoffs, the World Health Organization (WHO) growth references for school-aged children, and the Saudi (KSA) national growth references. Methods The sample comprised 2,169 children (52.5% girls) derived from two cross-sectional studies conducted in Riyadh and Jeddah during the 2017 and 2019 school years, respectively. Body weight and height were measured, and BMI was calculated. Results The proportions (%) of the participants who were classified as underweight, overweight, and obese varied according to the reference used: IOTF reference (13.8, 18.4, and 12.7), WHO reference (17.2, 19.1, and 18.9), and KSA reference (7.0, 22.4, and 9.3), respectively, indicating higher values for overweight and obesity prevalence when the WHO references were used. Kappa agreement measures between the three references were found to be high, with the coefficients ranging from 0.936 (between the IOTF and KSA references) to 0.849 (between the IOTF and WHO references). In all three classifications, girls exhibited lower overweight or obesity prevalence than boys. Family income, but not paternal or maternal education, was significantly (p = 0.015) associated with overweight/obesity when using the IOTF standards. In addition, having a small family in the house was significantly (p < 0.05) associated with obesity, irrespective of the classification system. Conclusion Inconsistency was observed when estimating the prevalence of underweight, overweight, and obesity among Saudi children. However, when defining the overall prevalence of overweight plus obesity among Saudi children, the IOTF classification system performed in a similar way to the KSA references (31.1% versus 31.7%) compared to the WHO references (38.0%).
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Affiliation(s)
- Hazzaa M. Al-Hazzaa
- Lifestyle and Health Research Center, Health Sciences Research Center, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Amani A. Alrasheedi
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rayan A. Alsulaimani
- Department of Pharmacology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Laura Jabri
- American International School of Jeddah, Jeddah, Saudi Arabia
| | | | - Maha H. Alhussain
- Department of Food Science & Nutrition, College of Foods & Agricultural Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Rowaedh A. Bawaked
- Department of Public Health, College of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia
| | - Saleh A. Alqahtani
- Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, United States
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
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Shahid M, Ahmed F, Ameer W, Guo J, Raza S, Fatima S, Qureshi MG. Prevalence of child malnutrition and household socioeconomic deprivation: A case study of marginalized district in Punjab, Pakistan. PLoS One 2022; 17:e0263470. [PMID: 35271578 PMCID: PMC8912173 DOI: 10.1371/journal.pone.0263470] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 01/20/2022] [Indexed: 11/18/2022] Open
Abstract
Better socioeconomic status and well-being in households decrease malnutrition and health risks in children. The objective of the present study is to assess the current nutritional status of pre-school children and to correlate the prevalence of malnutrition with Household Deprivation Status (HDS) in one of the deprived districts of the Punjab province in Pakistan. Using primary data collected from 384 households through a proportional purposive random sampling technique, this study calculates the z-scores of weight-for-age (WAZ), weight-for-height (WHZ), and height-for-age (HAZ). The study has used a cut-off point which is -2 standard deviations below the median of the WHO/NCHS reference population for each anthropometric indicator. The results indicate that the underweight, stunting, and wasting prevalence rates are 46.1%, 34.83%, and 15.49% respectively in district Rahimyar Khan. Also, the expected tendency of malnutrition is worst for HDS-1 and HDS-2 which are the most deprived segments of the population. As the household shifts from HDS-1 to HDS-2 and further to HDS-3, the rates of stunting (HAZ) and underweight (WAZ) decreases but wasting (WHZ) does not. The study concludes that the high prevalence of malnutrition in the district is correlated with overall socio-economic deprivation.
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Affiliation(s)
| | - Farooq Ahmed
- Department of Anthropology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Waqar Ameer
- Department of Economics, Shandong Technology and Business University, Yantai, China
- * E-mail:
| | - Jing Guo
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Saqlain Raza
- Respiratory Care Department, College of Applied Medical Sciences in Jubail, Imam Abdulrahman bin Faisal University, Jubail, Saudi Arabia
| | - Saireen Fatima
- Fazaia Medical College, Air University, Islamabad, Pakistan
| | - Madeeha Gohar Qureshi
- Department of Economics, Pakistan Institute of Development Economics, Islamabad, Pakistan
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Joulaei H, Keshani P, Ashourpour M, Bemani P, Amiri S, Rahimi J, Aliakbarpour M, Salehi-Abargouei A. The prevalence of stunting among children and adolescents living in the Middle East and North Africa region (MENA): A systematic review and meta-analysis. J Glob Health 2022; 11:04070. [PMID: 35003712 PMCID: PMC8711751 DOI: 10.7189/jogh.11.04070] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Given the strategic importance of the MENA, the state of war and inequity in the region and its effect on malnutrition which leads to mortality and reduced economic development in this region, the current study purposed to examine the prevalence of stunting as an indicator of chronic malnutrition in the MENA region, with consideration given HDI, rural/urban area, and war-involved countries. Methods The electronic databases of PubMed, SCOPUS, Web of science, and Embase were systematically searched, and English-language articles published between January 1, 2009 and December 31, 2019 were included in this study. The POLIS (population, outcome, location, indicator, study design) criteria were used to perform the systematic review, and studies involving children 2 to 18 years of age were selected. Results Fifty-eight (n = 2 202 869) were included based on the study's inclusion criteria. The prevalence of stunting in children in the total MENA region was 22.0% (95% confidence interval (CI) = 20.4-23.6; I2 = 99.92%, P < 0.0001). The studies included in the meta-analysis were analyzed by subgroups. The pooled prevalence of stunting in children aged 2-5 years old and children aged 6 and older was 25.7% and 16.5%, respectively. The pooled prevalence of stunting was 34.1% in rural and 12.4% in urban areas. The pooled prevalence of stunting according to HDI was 30.1%, 28.5%, 13.1%, in low, medium, and high HDI countries, respectively. Furthermore, the pooled prevalence of stunting according to war status was 28.5% in war-involved countries vs 20.6% in others. Conclusions High prevalence of malnutrition was seen based on stunting indicator in the meta-analysis study in the MENA region, and this issue became more pronounced when the data was divided into subgroups based on age, residential area, and HDI. Inequality regarding social, economic, and political factors leads to significant malnutrition in the mentioned region.
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Affiliation(s)
- Hassan Joulaei
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parisa Keshani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahkameh Ashourpour
- Department of Nutrition Sciences, School of Health, Larestan University of Medical Sciences, Larestan, Iran.Emam Reza Teaching Hospital, Larestan University of Medical Sciences, Larestan, Iran
| | - Peyman Bemani
- Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sanaz Amiri
- Department of Epidemiology, Health School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Jamileh Rahimi
- Department of Epidemiology and Biostatistics, School of Public Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Mohsen Aliakbarpour
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amin Salehi-Abargouei
- Nutrition and Food Security Research Center, Department of nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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11
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Shehzad MA, Khurram H, Iqbal Z, Parveen M, Shabbir MN. Nutritional status and growth centiles using anthropometric measures of school-aged children and adolescents from Multan district. Arch Pediatr 2021; 29:133-139. [PMID: 34955308 DOI: 10.1016/j.arcped.2021.11.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/21/2021] [Accepted: 11/30/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Nutritional status among children and adolescents is assessed using growth rates. The aim of this study was to assess age- and gender-specific height, weight, and body mass index (BMI) centiles among children and adolescents relative to World Health Organization (WHO) references. METHODS A sample of 1040 school-aged children and adolescents aged 3-18 years from Multan District in Pakistan were selected for the study between January and March 2020. Multistage stratified random sampling was used for sample selection. Centile curves of height, weight, and BMI for age and gender were obtained using the lambda-mu-sigma (LMS) method, and results were compared with WHO 2007 references. RESULTS For boys and girls, the average height was 137.37 ± 8.24 and 135.62 ± 9.64 cm, average weight was 36.32 ± 6.84 and 35.21 ± 7.27 kg, and average BMI was 18.44 ± 2.67 and 18.36 ± 2.91, respectively. The height centiles of boys were higher than the WHO reference, and during the prepubertal period (age 8 years or older) the centiles were lower than the WHO reference. The height centiles of girls were higher than the WHO reference, and during the pubertal period (age 10 years or older) the centiles were lower than the WHO reference. The gender-wise BMI centiles were higher compared to the WHO reference. CONCLUSION The prevalence of thinness, overweight, and obesity in boys and girls was significantly higher than the WHO reference. The results of this study on centiles are up-to-date and will be used as a standard for comparison.
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Affiliation(s)
| | - Haris Khurram
- Department of Statistics, Bahauddin Zakariya University, Multan, Pakistan; Department of Sciences and Humanities, National University of Computer and Emerging Sciences, Chiniot-Faisalabad Campus, Chiniot, Pakistan.
| | - Zafer Iqbal
- Department of Statistics, Bahauddin Zakariya University, Multan, Pakistan
| | - Maqsooda Parveen
- Department of Statistics, Bahauddin Zakariya University, Multan, Pakistan
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12
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Qaisar R, Karim A. BMI status relative to international and national growth references among Pakistani school-age girls. BMC Pediatr 2021; 21:535. [PMID: 34852819 PMCID: PMC8638413 DOI: 10.1186/s12887-021-03017-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 11/22/2021] [Indexed: 12/17/2022] Open
Abstract
Background A sizable proportion of school-going children from developing countries has abnormal growth parameters, often not standardized with international reference values. We aimed to assess the prevalence of underweight, overweight, and obesity in the schoolgirls of Punjab according to international and local references. Methods In this population-based cross-sectional study, 10,050 school-going girls aged 8–16 years from 12 districts of northern, central, and southern Punjab were recruited. Estimates of normal weight, underweight, overweight and obesity were calculated in the girls according to three international BMI references including centers for disease control (CDC) 2000, the international obesity task force (IOTF) 2012 and world health organisation (WHO) 2007 in addition to a local reference for the population under study. We used Cohen’s kappa statistics to analyse the agreement of our data with reference values. Results There was marked overestimation of underweight (23.9%, 14.5%, 15.2% and 4.37%), slight underestimation of overweight (5.3%, 7.3%, 7.9% and 8.97%) and moderate underestimation of obesity (1.9%, 1.5%, 2.2% and 5.67%) according to CDC, IOTF, WHO and local reference, respectively. When the weight status of the study cohort was compared with the local data, we found comparable results in all four weight categories. Conclusion We recommend population-wide further studies to estimate the prevalence of weight status in school-age girls for devising appropriate references and for planning strategies for public health policy and management.
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Affiliation(s)
- Rizwan Qaisar
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, UAE
| | - Asima Karim
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, UAE. .,Department of Physiology & Cell Biology, University of Health Sciences, Lahore, Pakistan.
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13
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Physical growth of children and adolescents living at a moderate altitude: proposed percentiles based on age and sex. NUTR HOSP 2021; 38:1238-1247. [PMID: 34530621 DOI: 10.20960/nh.03722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
INTRODUCTION physical growth patterns and nutritional status of children and adolescents living at moderate altitude are not applicable for clinical assessment of growth for diverse populations around the world. OBJECTIVE a) to compare weight, height and body mass index (BMI) variables with CDC-2012 references; b) to verify if BMI and/or ponderal index (PI) are applicable to children living at moderate altitude; and c) to propose percentiles to assess physical growth by age and sex. METHODS a total of 5,377 students, ranging in age from 6.0 to 17.9 years, were evaluated. The students were from two geographic regions of moderate altitude in Peru (2,320 meters) and Colombia (2,640 meters). Weight and height were measured. BMI and PI were calculated. Weight, height and BMI were compared with CDC-2012 references. RESULTS males showed lower weight and height from age 11 to 17.9 years compared to CDC-2012. Females weighed less than the reference from 9.0 to 17.9 years. Female height was lower from 6.0 to 14.9 years; however, from 15.0 to 17.9 years, values were similar to the reference. As for BMI, there were differences in both sexes (in males, from 15.0 to 17.9 years, and in females, from 12.0 to 17.9 years). Age, weight and height explained BMI: between R2 = 17 and 83 % in males, and in females between R2 = 24 and 85 %. These same variables influenced PI in a lower percentage in both sexes: for males (R2 = 0.01 to 49 %) and for females (R2 = 0.01 to 18 %). CONCLUSIONS children and adolescents living at moderate altitude in Peru and Colombia diverge from the CDC-2012 physical growth patterns. In addition, PI is a new alternative for estimating weight in relation to BMI. The proposed curves for weight, height, and PI by age and sex could have greater implications in the control of child health programs and in clinical and epidemiological practices.
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14
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Sarna A, Porwal A, Acharya R, Ashraf S, Ramesh S, Khan N, Sinha S, Sachdev HS. Waist circumference, waist-to-height ratio and BMI percentiles in children aged 5 to 19 years in India: A population-based study. Obes Sci Pract 2021; 7:392-404. [PMID: 34401198 PMCID: PMC8346379 DOI: 10.1002/osp4.493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 01/25/2021] [Accepted: 01/29/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE Nationally representative percentiles for waist circumference (WC), waist-to-height-ratio (WHtR), and body mass index (BMI) are not available for children and adolescents in India. METHODS Using LMS method, age- and gender-specific reference growth charts were constructed for WC (n = 68,261), WHtR (n = 68,261), and BMI (n = 67,741) from children/adolescents aged 5-19 years who participated in a nationally representative survey. General obesity, indicating overall obesity, was defined as age-sex-specific BMI z-scores ≥ 95th percentile. Central obesity was defined in three ways: WC ≥ 90th percentile, WHtR ≥ 0.5, and both WC ≥ 90th percentile and WHtR ≥ 0.5. FINDINGS WC and BMI percentiles for boys and girls are lower than those previously reported from India and several other countries. The BMI percentiles are lower than the WHO 2007 reference population. The prevalence of general obesity using India specific BMI centiles was 2.9% (95% CI: 2.6-3.2). The prevalence of central obesity was 6.1% (95% CI: 5.7-6.6) using WC ≥ 90th percentile, 5.3% (95% CI: 5.0-5.7) using WHtR ≥ 0.5, and 3.6% using both criteria. Three-fourth of children with general obesity also had central obesity based on WC ≥ 90th. CONCLUSIONS Indian children are thinner than Caucasian and other Asian children, and the global WHO reference population. Using India specific reference, the prevalence of central obesity is higher than general obesity with a significant overlap between the two.
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Affiliation(s)
- Avina Sarna
- Population CouncilZone 5AGround Floor India Habitat CentreNew DelhiIndia
| | - Akash Porwal
- Population CouncilZone 5AGround Floor India Habitat CentreNew DelhiIndia
| | - Rajib Acharya
- Population CouncilZone 5AGround Floor India Habitat CentreNew DelhiIndia
| | - Sana Ashraf
- Population CouncilZone 5AGround Floor India Habitat CentreNew DelhiIndia
| | - Sowmya Ramesh
- Population CouncilZone 5AGround Floor India Habitat CentreNew DelhiIndia
| | - Nizamuddin Khan
- Population CouncilZone 5AGround Floor India Habitat CentreNew DelhiIndia
| | | | - Harshpal Singh Sachdev
- Pediatrics and Clinical EpidemiologySitaram Bhartia Institute of Science and ResearchNew DelhiIndia
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15
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Starkweather KE, Keith MH, Prall SP, Alam N, Zohora F, Emery Thompson M. Are fathers a good substitute for mothers? Paternal care and growth rates in Shodagor children. Dev Psychobiol 2021; 63:e22148. [PMID: 34087947 DOI: 10.1002/dev.22148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 12/21/2022]
Abstract
Biparental care is a hallmark of human social organization, though paternal investment varies between and within societies. The facultative nature of paternal care in humans suggests males should invest when their care improves child survival and/or quality, though testing this prediction can be challenging because of the difficulties of empirically isolating paternal effects from those of other caregivers. Additionally, the broader context in which care is provided, vis-à-vis care from mothers and others, may lead to different child outcomes. Here, we examine the effects of paternal care on child growth among Shodagor fisher-traders, where fathers provide high levels of both additive and substitutive care, relative to mothers. We modeled seasonal z-scores and velocities for height, weight, and body mass index (BMI) outcomes using linear mixed models. Our evidence indicates that, as predicted, the context of paternal care is an important predictor of child outcomes. Results show that environmental seasonality and alloparental help contribute to a nuanced understanding of the impact of Shodagor paternal care on child physiology.
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Affiliation(s)
- K E Starkweather
- Department of Anthropology, University of Illinois Chicago, Chicago, Illinois.,Department of Anthropology, University of New Mexico, Albuquerque, New Mexico.,Department of Human Behavior, Ecology, and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - M H Keith
- Department of Anthropology, University of Washington, Seattle, Washington
| | - S P Prall
- Department of Anthropology, University of Missouri, Columbia, Missouri
| | - N Alam
- Health Systems and Population Studies Division, ICDDR,B, Dhaka, Bangladesh
| | - F Zohora
- Health Systems and Population Studies Division, ICDDR,B, Dhaka, Bangladesh
| | - M Emery Thompson
- Department of Anthropology, University of New Mexico, Albuquerque, New Mexico
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16
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Fabiano V, Barcellini L, Sartorio MUA, Pendezza E, Leone A, Meneghin F, Dilillo D, Zuccotti GV. Nutritional status of children and adolescents in three Serbian enclaves in Kosovo and Metohija. BMC Public Health 2021; 21:794. [PMID: 33894743 PMCID: PMC8070319 DOI: 10.1186/s12889-021-10848-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 04/13/2021] [Indexed: 11/16/2022] Open
Abstract
Objective To evaluate nutritional status of children and adolescents living in three Serbian enclaves in Kosovo and Metohija. Methods We conducted an observational cross-sectional, population-based study, enrolling children and adolescents who underwent a pediatric screening performed in the three Serbian enclaves of Gračanica, Gornje Kusce and Velika Hoča in Kosovo and Metohija. Children and adolescents (5–19 years) of all ethnic groups were evaluated in one of the three free outpatient medical facilities in rural villages in Kosovo. Body weight and height were measured, height-for-age z- scores (HAZ) and BMI-for-age z-scores (BAZ) indicators were analyzed. The anthropometric indicators HAZ and BAZ distributions were compared between sex and ages using Fisher’s exact test. A two-sample Z-test for proportions was used to detect differences in individual categories of height- and BMI-for-age categories across sexes and age classes. Results Three hundred twenty-eight children and adolescents (184 females, 56.1% and 144 males, 43.9%) aged between 5 and 19 years were enrolled in the study. 241/328 participants showed a normal linear growth; with significantly more girls (78.3%) than boys (67.4%) being in the normal category. Similarly, a significant difference in BAZ distribution between sexes was noted, with more females being in the normal BMI category compared to males (63.0% vs 50.0%, respectively). Underweight and severe underweight subjects showed a prevalence of 1.5 and 0.6%, respectively. Overweight and obesity prevalence was 19.5 and 9.1%, respectively, which was comparable to World Health Organization overweight and obesity prevalence data for Serbia. Conclusions Prevalence of undernutrition and severe undernutrition in children and adolescents living in three Serbian enclaves in Kosovo and Metohija is small. By contrast, a tendency to an increase in overweight and obesity, especially in the male population, was noted.
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Affiliation(s)
- Valentina Fabiano
- Department of Pediatrics, Vittore Buzzi Children's Hospital, Università di Milano, 32, Via Castelvetro, 20154, Milan, Italy
| | - Lucia Barcellini
- Department of Pediatrics, Vittore Buzzi Children's Hospital, Università di Milano, 32, Via Castelvetro, 20154, Milan, Italy.
| | - Marco Ugo Andrea Sartorio
- Department of Pediatrics, Vittore Buzzi Children's Hospital, Università di Milano, 32, Via Castelvetro, 20154, Milan, Italy
| | - Erica Pendezza
- Department of Pediatrics, Vittore Buzzi Children's Hospital, Università di Milano, 32, Via Castelvetro, 20154, Milan, Italy
| | - Alessandro Leone
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), Università di Milano, Milan, Italy
| | - Fabio Meneghin
- Neonatal Intensive Care Unit, Vittore Buzzi Children's Hospital, Università di Milano, Milan, Italy
| | - Dario Dilillo
- Department of Pediatrics, Vittore Buzzi Children's Hospital, Università di Milano, 32, Via Castelvetro, 20154, Milan, Italy
| | - Gian Vincenzo Zuccotti
- Department of Pediatrics, Vittore Buzzi Children's Hospital, Università di Milano, 32, Via Castelvetro, 20154, Milan, Italy
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17
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van Steenwyk G, Gapp K, Jawaid A, Germain P, Manuella F, Tanwar DK, Zamboni N, Gaur N, Efimova A, Thumfart KM, Miska EA, Mansuy IM. Involvement of circulating factors in the transmission of paternal experiences through the germline. EMBO J 2020; 39:e104579. [PMID: 33034389 PMCID: PMC7705452 DOI: 10.15252/embj.2020104579] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 09/04/2020] [Accepted: 09/16/2020] [Indexed: 12/12/2022] Open
Abstract
Environmental factors can change phenotypes in exposed individuals and offspring and involve the germline, likely via biological signals in the periphery that communicate with germ cells. Here, using a mouse model of paternal exposure to traumatic stress, we identify circulating factors involving peroxisome proliferator-activated receptor (PPAR) pathways in the effects of exposure to the germline. We show that exposure alters metabolic functions and pathways, particularly lipid-derived metabolites, in exposed fathers and their offspring. We collected data in a human cohort exposed to childhood trauma and observed similar metabolic alterations in circulation, suggesting conserved effects. Chronic injection of serum from trauma-exposed males into controls recapitulates metabolic phenotypes in the offspring. We identify lipid-activated nuclear receptors PPARs as potential mediators of the effects from father to offspring. Pharmacological PPAR activation in vivo reproduces metabolic dysfunctions in the offspring and grand-offspring of injected males and affects the sperm transcriptome in fathers and sons. In germ-like cells in vitro, both serum and PPAR agonist induce PPAR activation. Together, these results highlight the role of circulating factors as potential communication vectors between the periphery and the germline.
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Affiliation(s)
- Gretchen van Steenwyk
- Laboratory of NeuroepigeneticsBrain Research InstituteMedical Faculty of the University of ZurichZurichSwitzerland
- Institute for NeuroscienceDepartment of Health Sciences and TechnologyETH ZurichZurichSwitzerland
- Zurich Neuroscience CenterETH Zurich and University of ZurichZurichSwitzerland
| | - Katharina Gapp
- Institute for NeuroscienceDepartment of Health Sciences and TechnologyETH ZurichZurichSwitzerland
- Zurich Neuroscience CenterETH Zurich and University of ZurichZurichSwitzerland
- Laboratory of Molecular and Behavioral NeuroscienceETH ZurichZurichSwitzerland
- Gurdon InstituteUniversity of CambridgeCambridgeUK
- Wellcome Trust Sanger InstituteHinxtonUK
- Department of GeneticsUniversity of CambridgeCambridgeUK
| | - Ali Jawaid
- Laboratory of NeuroepigeneticsBrain Research InstituteMedical Faculty of the University of ZurichZurichSwitzerland
- Institute for NeuroscienceDepartment of Health Sciences and TechnologyETH ZurichZurichSwitzerland
- Zurich Neuroscience CenterETH Zurich and University of ZurichZurichSwitzerland
- Laboratory of Translational Research in Neuropsychiatric DisordersBRAINCITY Nencki‐EMBL Center of Excellence for Neural Plasticity and Brain DisordersWarsawPoland
| | - Pierre‐Luc Germain
- Laboratory of NeuroepigeneticsBrain Research InstituteMedical Faculty of the University of ZurichZurichSwitzerland
- Institute for NeuroscienceDepartment of Health Sciences and TechnologyETH ZurichZurichSwitzerland
- Statistical Bioinformatics GroupSwiss Institute of BioinformaticsZürichSwitzerland
| | - Francesca Manuella
- Laboratory of NeuroepigeneticsBrain Research InstituteMedical Faculty of the University of ZurichZurichSwitzerland
- Institute for NeuroscienceDepartment of Health Sciences and TechnologyETH ZurichZurichSwitzerland
- Zurich Neuroscience CenterETH Zurich and University of ZurichZurichSwitzerland
| | - Deepak K Tanwar
- Laboratory of NeuroepigeneticsBrain Research InstituteMedical Faculty of the University of ZurichZurichSwitzerland
- Institute for NeuroscienceDepartment of Health Sciences and TechnologyETH ZurichZurichSwitzerland
- Zurich Neuroscience CenterETH Zurich and University of ZurichZurichSwitzerland
- Statistical Bioinformatics GroupSwiss Institute of BioinformaticsZürichSwitzerland
| | - Nicola Zamboni
- Institute of Molecular Systems BiologyETH ZurichZurichSwitzerland
| | - Niharika Gaur
- Laboratory of NeuroepigeneticsBrain Research InstituteMedical Faculty of the University of ZurichZurichSwitzerland
- Institute for NeuroscienceDepartment of Health Sciences and TechnologyETH ZurichZurichSwitzerland
- Zurich Neuroscience CenterETH Zurich and University of ZurichZurichSwitzerland
| | - Anastasiia Efimova
- Laboratory of NeuroepigeneticsBrain Research InstituteMedical Faculty of the University of ZurichZurichSwitzerland
- Institute for NeuroscienceDepartment of Health Sciences and TechnologyETH ZurichZurichSwitzerland
- Zurich Neuroscience CenterETH Zurich and University of ZurichZurichSwitzerland
| | - Kristina M Thumfart
- Laboratory of NeuroepigeneticsBrain Research InstituteMedical Faculty of the University of ZurichZurichSwitzerland
- Institute for NeuroscienceDepartment of Health Sciences and TechnologyETH ZurichZurichSwitzerland
- Zurich Neuroscience CenterETH Zurich and University of ZurichZurichSwitzerland
| | - Eric A Miska
- Gurdon InstituteUniversity of CambridgeCambridgeUK
- Wellcome Trust Sanger InstituteHinxtonUK
- Department of GeneticsUniversity of CambridgeCambridgeUK
| | - Isabelle M Mansuy
- Laboratory of NeuroepigeneticsBrain Research InstituteMedical Faculty of the University of ZurichZurichSwitzerland
- Institute for NeuroscienceDepartment of Health Sciences and TechnologyETH ZurichZurichSwitzerland
- Zurich Neuroscience CenterETH Zurich and University of ZurichZurichSwitzerland
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18
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Najafi F, Naderpour S, Moradinazar M, Khoramdad M, Vahedian-Azimi A, Jamialahmadi T, Sahebkar A. Percentiles for anthropometric measures in 11-18 years-old students of 73 developing countries. Diabetes Metab Syndr 2020; 14:1957-1962. [PMID: 33045540 DOI: 10.1016/j.dsx.2020.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 09/29/2020] [Accepted: 10/01/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND AIMS one of the health concerns for any society is to have its own standard of growth. The aim of this study was to provide the age- and sex-specific percentile values of anthropometric measures for adolescents of developing countries. The use of global percentiles in developing countries overestimates underweight and stunting while underestimates overweight and obesity. METHODS The data were obtained from the Global School-based Student Health Survey (GSHS). This study was conducted on school students, selected by multistage random cluster sampling from 73 developing countries. A parametric method was used for constructing age-specific reference intervals (normal ranges). RESULTS In general, 210,045 11-18 years-old schoolchildren (14.38 ± 1.39) from 73 developing countries between 2003 and 2014 were included in this study, among which 103,080 (49.08%) were male and 106,965 (50.92%) were female. Calculation of body mass index (BMI) percentile showed that for all BMI percentile curves of both sexes, there was a gradual increase up to the age of around 15 years, and then remain stable (except for 95th percentile). Moreover in all weight percentile curves of boys, except 90th and above, there was a slight rise until the age of 18 years. In 10th height percentile curves and above in boys, there was a sharp increase up to the age of 17, followed by a decline. Similarly, this pattern was found for 50th height percentile and above in girls. CONCLUSION The use of global percentiles in developing countries overestimates underweight and stunting while underestimates overweight and obesity.
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Affiliation(s)
- Farid Najafi
- Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sara Naderpour
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Moradinazar
- Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Malihe Khoramdad
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
| | - Amir Vahedian-Azimi
- Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Tannaz Jamialahmadi
- Department of Food Science and Technology, Quchan Branch, Islamic Azad University, Quchan, Iran; Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland; Halal Research Center of IRI, FDA, Tehran, Iran
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19
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Measuring overweight and obesity in Chinese American children using US, international and ethnic-specific growth charts. Public Health Nutr 2020; 23:2663-2670. [PMID: 32611456 DOI: 10.1017/s1368980020000919] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The aim is to determine the disparity between the overweight and obesity prevalence of Chinese American school-aged children and adolescents as measured by the Centers for Disease Control and Prevention (CDC) growth reference and the prevalence as measured by international and ethnic-specific-growth references. DESIGN This retrospective, cross-sectional study measured overweight and obesity prevalence among a paediatric population using the CDC, International Obesity Task Force (IOTF), World Health Organization (WHO) and an ethnic Chinese growth curve. SETTING A community health centre in New York City, USA. PARTICIPANTS Chinese American children aged 6-17 years in 2017 (N 9160). RESULTS The overweight prevalence was 24 % (CDC), 23 % (IOTF), 30 % (WHO) and 31 % (China). The obesity prevalence was 10 % (CDC), 5 % (IOTF), 10 % (WHO) and 10 % (China). When disaggregated by age and sex, the difference was the most prominent in girls; using the China reference compared with using the CDC reference almost doubles the overweight prevalence (school-aged: 31 v. 17 %, P < 0·001, adolescent: 27 v. 14 %, P < 0·001) and the obesity prevalence (school-aged: 11 v. 5 %, P < 0·001, adolescent: 7 v. 4 %, P < 0·001). CONCLUSIONS Use of the CDC reference compared with the Chinese ethnic-specific reference results in lower overweight and obesity prevalence in Chinese American girls. Almost half of the girls who were overweight and half of the girls who were obese were not identified using the CDC reference. Using ethnic-specific references or ethnic-specific cut-points may help improve overweight identification for Chinese American children.
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Karim A, Qaisar R. Anthropometric measurements of school-going-girls of the Punjab, Pakistan. BMC Pediatr 2020; 20:223. [PMID: 32416717 PMCID: PMC7229613 DOI: 10.1186/s12887-020-02135-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 05/11/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Child's growth has been considered an important indicator to evaluate health trends in a population and to devise strategies accordingly. The purpose of the present study was to determine most commonly occurring weight abnormalities among school-going girls from Punjab and to compare with international growth references devised by World Health Organization (WHO) and Centre for Disease Control and Prevention (CDC). METHODS In this cross-sectional study a sample of 10,050 child and adolescent girls from 12 districts, 35 public/private sector schools, located in rural, semi-urban and urban areas of northern, central and southern Punjab were included. Parameters were measured according to standardised techniques and centile curves obtained by Lambda, Mu, Sigma (LMS) method. RESULTS The results showed an increase in weight, height and BMI of the Punjabi girls until 15 years. When compared with international growth references, weight and BMI in our population were significantly lowered; however, height was lower during 12-16 years of age and the differences observed were more pronounced with CDC as compared to WHO. When 3rd, 50th and 90th percentiles of weight, height and BMI in our population were compared with international standards, the values were lower in our paediatric population. CONCLUSION The Punjabi schoolgirls significantly differed from CDC and WHO references, and this difference should be taken into consideration for evaluation of growth abnormalities in our paediatric population. However, in the absence of national reference data, WHO standards have been considered more appropriate for comparison.
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Affiliation(s)
- Asima Karim
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, UAE.
- Department of Physiology & Cell Biology, University of Health Sciences, Lahore, Pakistan.
| | - Rizwan Qaisar
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, UAE
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Imran U, Khan M, Jamal R, Sahulka SQ, Goel R, Mahar R, Weidhaas J. Probabilistic risk assessment of water distribution system in Hyderabad, Pakistan reveals unacceptable health hazards and areas for rehabilitation. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2020; 191:110233. [PMID: 32004944 DOI: 10.1016/j.ecoenv.2020.110233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 01/17/2020] [Accepted: 01/18/2020] [Indexed: 06/10/2023]
Abstract
Poor water quality exacerbates multidimensional poverty in developing nations. Often centralized treatment facilities generate acceptable water quality, but the water is contaminated during distribution. Methods to assess sources of contamination in water distribution systems are lacking. A case study of two methods, human risk assessment linked to water distribution system sampling was conducted in Hyderabad, Pakistan to determine areas requiring infrastructure rehabilitation. Water samples from source water (i.e., the Indus River), treatment plant effluent and from taps in the water distribution system were analyzed by atomic adsorption spectroscopy for metals and metalloids (As, Cd, Cr, Hg, and Pb) and water quality parameters (dissolved and suspended solids, pH, conductivity, and total organic carbon). Source water exceeded acceptable drinking water levels for As, Cd, total Cr, and Pb, while the treatment plant effluent concentrations were acceptable. Concentrations of all metals and metalloids, except Hg, increased in the water distribution system post-treatment, exceeding safe drinking limits in at least one location, suggesting contamination of the water during distribution. A deterministic and a probabilistic risk assessment were conducted to evaluate two scenarios: (1) unrestricted use of piped water for all household purposes, including as drinking water and (2) restricted use of the water for purposes other than drinking in the household, including only dermal and inhalation exposure pathways. The water was deemed unsafe for unrestricted use as the sole source of drinking water by both risk assessment methods. Yet when an alternative source of drinking water was assumed and the piped water was used only for bathing and dish washing, the probabilistic risk assessment revealed acceptable health risks to the population, while the overly conservative deterministic risk assessment suggested unacceptable risks. The combined methods of water sampling, risk assessment and correlation analysis suggested areas for rehabilitation of the water distribution system in Hyderabad, Pakistan and these methods can be adopted in other developing nations to target limited funds for infrastructure rehabilitation.
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Affiliation(s)
- Uzma Imran
- US Pakistan Center for Advanced Studies in Water, Mehran University of Engineering and Technology, Jamshoro, 76062, Sindh, Pakistan.
| | - Mehran Khan
- US Pakistan Center for Advanced Studies in Water, Mehran University of Engineering and Technology, Jamshoro, 76062, Sindh, Pakistan.
| | - Rubayat Jamal
- Civil and Environmental Engineering, University of Utah, 110 Central Campus Drive Suite 2000, Salt Lake City, UT, 84112, USA.
| | - Sierra Quinn Sahulka
- Civil and Environmental Engineering, University of Utah, 110 Central Campus Drive Suite 2000, Salt Lake City, UT, 84112, USA.
| | - Ramesh Goel
- Civil and Environmental Engineering, University of Utah, 110 Central Campus Drive Suite 2000, Salt Lake City, UT, 84112, USA.
| | - Rasool Mahar
- US Pakistan Center for Advanced Studies in Water, Mehran University of Engineering and Technology, Jamshoro, 76062, Sindh, Pakistan.
| | - Jennifer Weidhaas
- Civil and Environmental Engineering, University of Utah, 110 Central Campus Drive Suite 2000, Salt Lake City, UT, 84112, USA.
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Emamian MH, Hashemi H, Fotouhi A. Obesity and underweight: Serious health problems in Iranian primary school children. Pediatr Int 2019; 61:1030-1035. [PMID: 31325396 DOI: 10.1111/ped.13978] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 05/12/2019] [Accepted: 07/11/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Childhood obesity is increasing around the world. Compared with developed countries, the rate of increase is 30% higher in developing countries, where the monitoring of obesity and overweight is essential. This study investigated the prevalence of obesity, overweight, thinness, and stunting in primary school students in Shahroud, Iran. METHODS A total of 5,620 primary students were enrolled during 2015. In rural areas all students were invited to participate, while cluster sampling was used in urban areas and 200 classrooms were selected randomly as clusters. Height, weight and body mass index Z-scores for age (HAZ, WAZ and BAZ) were calculated based on World Health Organization standard. The mean indices and prevalence of obesity, overweight, thinness, and stunting were calculated by education level, gender, and place of residence. Prevalence of obesity and overweight was estimated also by international obesity task force definition. RESULTS The mean WAZ, HAZ, and BAZ were 0.050 ± 1.25, 0.005 ± 0.98, and 0.076 ± 1.35, respectively. These indices in rural areas were significantly lower than those in urban areas (P < 0.001). Overall, 25.7% of children in urban areas (95%CI: 24.1-27.4) and 14.8% in rural areas (95%CI: 12.3-17.3) were overweight or obese, and 5.1% of rural girls (95%CI: 3.1-7.0) were stunted. CONCLUSIONS Compared with previous studies, obesity and overweight are still rising in Iranian school children, thus more serious interventions are needed. These interventions must also deal with underweight and stunting, particularly in rural areas.
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Affiliation(s)
- Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Sanz Diez P, Yang LH, Lu MX, Wahl S, Ohlendorf A. Growth curves of myopia-related parameters to clinically monitor the refractive development in Chinese schoolchildren. Graefes Arch Clin Exp Ophthalmol 2019; 257:1045-1053. [PMID: 30903312 DOI: 10.1007/s00417-019-04290-6] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 02/26/2019] [Accepted: 03/03/2019] [Indexed: 10/27/2022] Open
Abstract
PURPOSE To produce a clinical model for the prediction of myopia development based on the creation of percentile curves of axial length in school-aged children from Wuhan in central China. METHODS Data of 12,554 children (6054 girls and 6500 boys) were collected and analyzed for the generation of the axial length growth curves. A second data set with 226 children and three yearly successive measurements was used to verify the predictive power of the axial length growth percentile curves. Percentile curves were calculated for both gender groups and four age groups (6, 9, 12, and 15 years). The second data set was used to verify the efficacy of identifying the refractive error of the children using the axial length curves, based on their spherical refractive error from the third visit. RESULTS From 6 to 15 years of age, all percentiles showed a growth trend in axial length, except for the percentiles below the first quartile, which appear to stabilize after the age of 12 (- 0.10; 95%CI, - 0.36-0.16; P = 0.23 for girls; - 0.16; 95%CI, - 0.70-0.39; P = 0.34 for boys); however, the growth continued for the remaining 75% of cases. The second data set showed that the likelihood of suffering high myopia (spherical refractive error ≤- 5.00D) during adolescent years increased when axial length values were above the first quartile, for both genders. CONCLUSIONS The data from the current study provide a tool to observe the annual growth rates of axial length and can be considered as an approach to predict the refractive development at school ages.
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Affiliation(s)
- Pablo Sanz Diez
- Carl Zeiss Vision International GmbH, Technology and Innovation, Turnstraße 27, 73430, Aalen, Germany. .,Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Straße 7, 72076, Tuebingen, Germany.
| | - Li-Hua Yang
- Wuhan Center for Adolescent Poor Vision Prevention and Control, Wuhan, 430015, China
| | - Mei-Xia Lu
- Wuhan Commission of Experts for the Prevention and Control of Adolescent Poor Vision, Wuhan, 430015, China.,Department of Epidemiology and Statistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Siegfried Wahl
- Carl Zeiss Vision International GmbH, Technology and Innovation, Turnstraße 27, 73430, Aalen, Germany.,Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Straße 7, 72076, Tuebingen, Germany
| | - Arne Ohlendorf
- Carl Zeiss Vision International GmbH, Technology and Innovation, Turnstraße 27, 73430, Aalen, Germany.,Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Straße 7, 72076, Tuebingen, Germany
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Partap U, Young EH, Allotey P, Sandhu MS, Reidpath DD. Characterisation and correlates of stunting among Malaysian children and adolescents aged 6-19 years. Glob Health Epidemiol Genom 2019; 4:e2. [PMID: 30891249 PMCID: PMC6415126 DOI: 10.1017/gheg.2019.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 01/17/2019] [Accepted: 01/22/2019] [Indexed: 12/25/2022] Open
Abstract
Background Despite emerging evidence regarding the reversibility of stunting at older ages, most stunting research continues to focus on children below 5 years of age. We aimed to assess stunting prevalence and examine the sociodemographic distribution of stunting risk among older children and adolescents in a Malaysian population. Methods We used cross-sectional data on 6759 children and adolescents aged 6-19 years living in Segamat, Malaysia. We compared prevalence estimates for stunting defined using the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) references, using Cohen's κ coefficient. Associations between sociodemographic indices and stunting risk were examined using mixed-effects Poisson regression with robust standard errors. Results The classification of children and adolescents as stunted or normal height differed considerably between the two references (CDC v. WHO; κ for agreement: 0.73), but prevalence of stunting was high regardless of reference (crude prevalence: CDC 29.2%; WHO: 19.1%). Stunting risk was approximately 19% higher among underweight v. normal weight children and adolescents (p = 0.030) and 21% lower among overweight children and adolescents (p = 0.001), and decreased strongly with improved household drinking water sources [risk ratio (RR) for water piped into house: 0.35, 95% confidence interval (95% CI) 0.30-0.41, p < 0.001). Protective effects were also observed for improved sanitation facilities (RR for flush toilet: 0.41, 95% CI 0.19-0.88, p = 0.023). Associations were not materially affected in multiple sensitivity analyses. Conclusions Our findings justify a framework for strategies addressing stunting across childhood, and highlight the need for consensus on a single definition of stunting in older children and adolescents to streamline monitoring efforts.
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Affiliation(s)
- Uttara Partap
- Department of Medicine, University of Cambridge, Cambridge, UK
- Wellcome Sanger Institute, Hinxton, UK
| | - Elizabeth H. Young
- Department of Medicine, University of Cambridge, Cambridge, UK
- Wellcome Sanger Institute, Hinxton, UK
| | - Pascale Allotey
- United Nations University International Institute of Global Health (UNU-IIGH), Kuala Lumpur, Malaysia
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia
| | - Manjinder S. Sandhu
- Department of Medicine, University of Cambridge, Cambridge, UK
- Wellcome Sanger Institute, Hinxton, UK
| | - Daniel D. Reidpath
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia
- South East Asia Community Observatory, Segamat, Malaysia
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Lohiya N, Khadilkar V, Pawar S, Khadilkar A, Chiplonkar S, Jahagirdar R. Field Testing of IAP2015 Charts. Indian J Pediatr 2018; 85:723-728. [PMID: 29368106 DOI: 10.1007/s12098-018-2621-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 01/05/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To field test the IAP2015 (Indian Academy of Pediatrics) charts in different socioeconomic classes; to compare standard deviation scores (Z-scores) of children's height, weight and body mass index (BMI) for age as computed based on IAP2007 or WHO charts against the IAP2015 references. METHODS A cross-sectional observational study was conducted in the district of Pune on apparently healthy 5-18 y old children from urban affluent, urban underprivileged and rural areas. Anthropometric measurements were performed and parameters were converted into Z-scores. RESULTS Urban affluent children were tallest and heaviest whereas urban underprivileged children were shortest. Z-score comparison showed that all children were shortest on WHO references and taller as per IAP2007 references. BMI Z-score was higher on IAP2007 charts and lower on WHO references. Highest number of children were within the reference range on IAP2015 charts among urban affluent. More children were classified stunted on WHO references and least on IAP2007 references. WHO references overestimated wasting and as per IAP2007 charts, less number were wasted. Less number of children were classified as being obese/overweight by WHO and IAP2007 references. CONCLUSIONS IAP2015 charts are better representative of healthy children of current generation and may be used to prevent inappropriate classification in present scenario.
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Affiliation(s)
- Nikhil Lohiya
- Department of Pediatric Endocrinology, Bharati Vidyapeeth Medical College and Hospital, Pune, Maharashtra, India
| | - Vaman Khadilkar
- Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, 32 Sassoon Road, Pune, 411 001, India
| | - Shubhadarshini Pawar
- Department of Pediatric Endocrinology, Bharati Vidyapeeth Medical College and Hospital, Pune, Maharashtra, India
| | - Anuradha Khadilkar
- Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, 32 Sassoon Road, Pune, 411 001, India.
| | - Shashi Chiplonkar
- Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, 32 Sassoon Road, Pune, 411 001, India
| | - Rahul Jahagirdar
- Department of Pediatric Endocrinology, Bharati Vidyapeeth Medical College and Hospital, Pune, Maharashtra, India
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Petroff D, Wolf J, Richter T, Auth MKH, Uhlig HH, Laass MW, Lauenstein P, Krahl A, Händel N, de Laffolie J, Hauer AC, Heiduk M, Flemming G, Schmidt A, Hasenclever D, Mothes T. Antibody Concentrations Decrease 14-Fold in Children With Celiac Disease on a Gluten-Free Diet but Remain High at 3 Months. Clin Gastroenterol Hepatol 2018; 16:1442-1449.e5. [PMID: 29654912 DOI: 10.1016/j.cgh.2018.04.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 03/19/2018] [Accepted: 04/02/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Celiac disease can be identified by a serologic test for IgA against tissue transglutaminase (IgA-TTG) in a large proportion of children. However, the increased concentrations of antibody rarely normalize within the months after children are placed on a gluten-free diet (GFD). Early serologic predictors of sufficient adherence to GFD are required for optimal treatment. METHODS In a prospective study, we observed the response to a GFD in 345 pediatric patients (67% girls; mean age, 8.4 y) who underwent duodenal biopsy to confirm or refute celiac disease from October 2012 through December 2015. Baseline serum samples were tested centrally for IgA-TTG and IgG against deamidated gliadin. Follow-up serologic analyses of children on a GFD were performed about 3 months later. RESULTS The geometric mean concentration of IgA-TTG decreased from 72.4-fold to 5.2-fold the upper limit of normal (ULN), or by a factor of 14.0 (95% CI, 12.0-16.4). A substantial response (defined as a larger change than the typical variation in patients not on a GFD) was observed in 80.6% of the children. Only 28.1% of patients had a substantial response in the concentration of IgG against deamidated gliadin. Concentration of IgA-TTG remained above 1-fold the ULN in 83.8% of patients, and above 10-fold the ULN in 26.6% of patients with a substantial response. CONCLUSIONS Serum concentration of IgA-TTG decreases substantially in most children with celiac disease within 3 months after they are placed on a GFD, but does not normalize in most. This information on changes in antibody concentrations can be used to assess patient response to the diet at short-term follow-up evaluations. Patients with a substantial response to a GFD often still have high antibody levels after 3 months. German Clinical Trials Registry no. DRKS00003854.
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Affiliation(s)
- David Petroff
- Clinical Trial Centre, University of Leipzig, Germany.
| | - Johannes Wolf
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Medical Faculty of the University, University Hospital, Leipzig, Germany
| | - Thomas Richter
- Children's Hospital of the Clinical Centre "Sankt Georg" Leipzig, Germany
| | - Marcus K H Auth
- Alder Hey Children's National Health Service Foundation Trust, Liverpool, United Kingdom
| | - Holm H Uhlig
- Translational Gastroenterology Unit, Nuffield Department of Medicine, John Radcliffe Hospital, Oxford, United Kingdom; Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Martin W Laass
- University Children's Hospital, Technical University Dresden, Germany
| | - Peter Lauenstein
- German Clinic for Diagnostics, Helios Children's Hospital, Wiesbaden, Germany
| | - Andreas Krahl
- Children's Hospital "Prinzessin Margaret," Darmstadt, Germany
| | | | - Jan de Laffolie
- Children's Hospital, Justus Liebig University Giessen, Germany
| | | | | | | | | | - Dirk Hasenclever
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Germany
| | - Thomas Mothes
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Medical Faculty of the University, University Hospital, Leipzig, Germany
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Asim M, Nawaz Y. Child Malnutrition in Pakistan: Evidence from Literature. CHILDREN (BASEL, SWITZERLAND) 2018; 5:E60. [PMID: 29734703 PMCID: PMC5977042 DOI: 10.3390/children5050060] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 04/16/2018] [Accepted: 04/23/2018] [Indexed: 12/30/2022]
Abstract
Pakistan has one of the highest prevalences of child malnutrition as compared to other developing countries. This narrative review was accomplished to examine the published empirical literature on children’s nutritional status in Pakistan. The objectives of this review were to know about the methodological approaches used in previous studies, to assess the overall situation of childhood malnutrition, and to identify the areas that have not yet been studied. This study was carried out to collect and synthesize the relevant data from previously published papers through different scholarly database search engines. The most relevant and current published papers between 2000⁻2016 were included in this study. The research papers that contain the data related to child malnutrition in Pakistan were assessed. A total of 28 articles was reviewed and almost similar methodologies were used in all of them. Most of the researchers conducted the cross sectional quantitative and descriptive studies, through structured interviews for identifying the causes of child malnutrition. Only one study used the mix method technique for acquiring data from the respondents. For the assessment of malnutrition among children, out of 28 papers, 20 used the World Health Organization (WHO) weight for age, age for height, and height for weight Z-score method. Early marriages, large family size, high fertility rates with a lack of birth spacing, low income, the lack of breast feeding, and exclusive breastfeeding were found to be the themes that repeatedly emerged in the reviewed literature. There is a dire need of qualitative and mixed method researches to understand and have an insight into the underlying factors of child malnutrition in Pakistan.
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Affiliation(s)
- Muhammad Asim
- Population Research Center, University of Texas, Austin, TX 78712, USA.
- Department of Sociology, University of Sargodha, Sargodha, Punjab 40100, Pakistan.
| | - Yasir Nawaz
- Department of Sociology, University of Sargodha, Sargodha, Punjab 40100, Pakistan.
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Iftikhar S, Khan N, Siddiqui JS, Baig-Ansari N. Development of Growth Charts of Pakistani Children Aged 4-15 Years Using Quantile Regression: A Cross-sectional Study. Cureus 2018; 10:e2138. [PMID: 29632748 PMCID: PMC5880592 DOI: 10.7759/cureus.2138] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Growth charts are essential tools used by pediatricians as well as public health researchers in assessing and monitoring the well-being of pediatric populations. Development of these growth charts, especially for children above five years of age, is challenging and requires current anthropometric data and advanced statistical analysis. These growth charts are generally presented as a series of smooth centile curves. A number of modeling approaches are available for generating growth charts and applying these on national datasets is important for generating country-specific reference growth charts. Objective To demonstrate that quantile regression (QR) as a viable statistical approach to construct growth reference charts and to assess the applicability of the World Health Organization (WHO) 2007 growth standards to a large Pakistani population of school-going children. Methodology This is a secondary data analysis using anthropometric data of 9,515 students from a Pakistani survey conducted between 2007 and 2014 in four cities of Pakistan. Growth reference charts were created using QR as well as the LMS (Box-Cox transformation (L), the median (M), and the generalized coefficient of variation (S)) method and then compared with WHO 2007 growth standards. Results Centile values estimated by the LMS method and QR procedure had few differences. The centile values attained from QR procedure of BMI-for-age, weight-for-age, and height-for-age of Pakistani children were lower than the standard WHO 2007 centile. Conclusion QR should be considered as an alternative method to develop growth charts for its simplicity and lack of necessity to transform data. WHO 2007 standards are not suitable for Pakistani children.
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Affiliation(s)
| | - Nazeer Khan
- Department of Research, Jinnah Sindh Medical University
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Partap U, Young EH, Allotey P, Sandhu MS, Reidpath DD. The Use of Different International References to Assess Child Anthropometric Status in a Malaysian Population. J Pediatr 2017; 190:63-68.e1. [PMID: 29144273 PMCID: PMC5667719 DOI: 10.1016/j.jpeds.2017.07.049] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 06/14/2017] [Accepted: 07/26/2017] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To assess the prevalence of child underweight, overweight, and obesity in a Malaysian population according to 3 international references because classification of anthropometric status may differ according to the reference used to express body mass index (BMI). STUDY DESIGN We assessed data from 6414 children aged 6-18 years, collected by the South East Asia Community Observatory. Child underweight, overweight, and obesity were expressed according to 3 internationally used BMI references: World Health Organization 2007, International Obesity Task Force 2012, and Centers for Disease Control and Prevention 2000. We assessed agreement in classification of anthropometric status among the references using Cohen's kappa statistic and estimated underweight, overweight, and obesity prevalence according to each reference using mixed effects Poisson regression. RESULTS There was poor to moderate agreement between references when classifying underweight, but generally good agreement when classifying overweight and obesity. Underweight, overweight, and obesity prevalence estimates generated using the 3 references were notably inconsistent. Overweight and obesity prevalence estimates were higher using the World Health Organization reference vs the other 2, and underweight prevalence was up to 8.5% higher and obesity prevalence was about 4% lower when using the International Obesity Task Force reference. CONCLUSIONS The choice of reference to express BMI may influence conclusions about child anthropometric status and malnutrition prevalence. This has implications regarding strategies for clinical management and public health interventions.
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Affiliation(s)
- Uttara Partap
- Department of Medicine, University of Cambridge, Cambridge, UK; Wellcome Trust Sanger Institute, Hinxton, United Kingdom
| | - Elizabeth H Young
- Department of Medicine, University of Cambridge, Cambridge, UK; Wellcome Trust Sanger Institute, Hinxton, United Kingdom
| | - Pascale Allotey
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia; South East Asia Community Observatory, Segamat, Malaysia
| | - Manjinder S Sandhu
- Department of Medicine, University of Cambridge, Cambridge, UK; Wellcome Trust Sanger Institute, Hinxton, United Kingdom.
| | - Daniel D Reidpath
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia; South East Asia Community Observatory, Segamat, Malaysia
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Filho VCB, Lopes ADS, Fagundes RR, de Campos W. [Anthropometric indices among schoolchildren from a municipality in Southern Brazil: a descriptive analysis using the LMS method]. REVISTA PAULISTA DE PEDIATRIA 2016; 32:333-41. [PMID: 25510997 PMCID: PMC4311787 DOI: 10.1016/j.rpped.2014.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Accepted: 04/18/2014] [Indexed: 12/02/2022]
Abstract
OBJECTIVE: To describe the percentile values for body mass index (BMI), waist circumference
(WC) and waist-to-height (WHtR) of children from Colombo, Brazil, and compare them
with data of children from other countries. METHODS: This was a cross-sectional study with a random sample of 2,035 children aged 6-11
years. Age- and sex-specific smoothed percentiles curves for BMI, WC and WHtR were
created using the LMS method. Values of 10th, 50th and
90th percentiles from Brazilian children were compared with data
from other countries. RESULTS: There was a trend of increasing BMI and WC with age in both sexes. WHtR remained
constant with advancing age in boys and girls. Comparison of the growth pattern
among countries showed clear differences. Southern Brazil boys and girls had
elevated 90th percentile values for BMI, which was similar to German
children and higher than the North American and World Health Organization
percentile values. However, children from this study had intermediate values for
WC and WHtR in comparison to children from other countries. CONCLUSIONS: Elevated BMI values were observed among southern Brazilian children, but WC and
WHtR percentile values were lower in southern Brazilian children than in children
from other countries. Interventions at different levels should be made to avoid a
probable increase of nutritional disorders (especially general obesity) in the
next years.
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Blackwell AD, Urlacher SS, Beheim B, von Rueden C, Jaeggi A, Stieglitz J, Trumble BC, Gurven M, Kaplan H. Growth references for Tsimane forager-horticulturalists of the Bolivian Amazon. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2016; 162:441-461. [PMID: 28218400 DOI: 10.1002/ajpa.23128] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 10/12/2016] [Accepted: 10/20/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Growth standards and references currently used to assess population and individual health are derived primarily from urban populations, including few individuals from indigenous or subsistence groups. Given environmental and genetic differences, growth may vary in these populations. Thus, there is a need to assess whether international standards are appropriate for all populations, and to produce population specific references if growth differs. Here we present and assess growth references for the Tsimane, an indigenous population of Bolivian forager-horticulturalists. METHODS Mixed cross-sectional/longitudinal anthropometrics (9,614 individuals; 30,118 observations; ages 0-29 years) were used to generate centile curves and Lambda-Mu-Sigma (LMS) tables for height-for-age, weight-for-age, body mass index (BMI)-for-age, and weight-for-height (WFH) using Generalized Additive Models for Location Shape and Scale (GAMLSS). Velocity curves were generated using SuperImposition by Translation and Rotation (SITAR). Tsimane ≤5 years were compared to World Health Organization (WHO) standards while those >5 years were compared to WHO school age references. All ages were compared to published references for Shuar forager-horticulturalists of the Ecuadorian Amazon. RESULTS Tsimane growth differs from WHO values in height and weight, but is similar for BMI and WFH. Tsimane growth is characterized by slow height velocity in childhood and early adolescent peak height velocity at 11.3 and 13.2 years for girls and boys. Tsimane growth patterns are similar to Shuar, suggesting shared features of growth among indigenous South Americans. CONCLUSIONS International references for BMI-for-age and WFH are likely appropriate for Tsimane, but differences in height-for-age and weight-for-age suggest Tsimane specific references may be useful for these measures.
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Affiliation(s)
- Aaron D Blackwell
- Department of Anthropology, University of California Santa Barbara, California.,Tsimane Health and Life History Project, San Borja, Bolivia
| | - Samuel S Urlacher
- Department of Anthropology, Hunter College, City University of New York, New York
| | - Bret Beheim
- Tsimane Health and Life History Project, San Borja, Bolivia.,Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany.,Department of Anthropology, University of New Mexico, Albuquerque, New Mexico
| | - Christopher von Rueden
- Tsimane Health and Life History Project, San Borja, Bolivia.,Jepson School of Leadership Studies, University of Richmond, Richmond, Virginia
| | - Adrian Jaeggi
- Tsimane Health and Life History Project, San Borja, Bolivia.,Department of Anthropology, Emory University, Atlanta, Georgia
| | - Jonathan Stieglitz
- Tsimane Health and Life History Project, San Borja, Bolivia.,Department of Anthropology, University of New Mexico, Albuquerque, New Mexico.,Institute for Advanced Study in Toulouse, Toulouse, France
| | - Benjamin C Trumble
- Department of Anthropology, University of California Santa Barbara, California.,Tsimane Health and Life History Project, San Borja, Bolivia.,Center for Evolution and Medicine, Arizona State University, Tempe, Arizona.,School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona
| | - Michael Gurven
- Department of Anthropology, University of California Santa Barbara, California.,Tsimane Health and Life History Project, San Borja, Bolivia
| | - Hillard Kaplan
- Tsimane Health and Life History Project, San Borja, Bolivia.,Department of Anthropology, University of New Mexico, Albuquerque, New Mexico
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Wang YJ, Zhou HJ, Liu PJ, Liu GL, Zheng Y, Wei B, Hao CX, Zhang Y, Kang HQ, Lu XL, Yuan Y. Risks of undernutrition and malnutrition in hospitalized pediatric patients with spinal cord injury. Spinal Cord 2016; 55:247-254. [PMID: 27502842 DOI: 10.1038/sc.2016.113] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 05/11/2016] [Accepted: 05/28/2016] [Indexed: 01/02/2023]
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Scherdel P, Dunkel L, van Dommelen P, Goulet O, Salaün JF, Brauner R, Heude B, Chalumeau M. Growth monitoring as an early detection tool: a systematic review. Lancet Diabetes Endocrinol 2016; 4:447-56. [PMID: 26777129 DOI: 10.1016/s2213-8587(15)00392-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 10/08/2015] [Accepted: 10/09/2015] [Indexed: 11/20/2022]
Abstract
Growth monitoring of apparently healthy children aims at early detection of serious underlying disorders. However, existing growth-monitoring practices are mainly based on suboptimal methods, which can result in delayed diagnosis of severe diseases and inappropriate referrals. We did a systematic review to address two key and interconnected questions underlying growth monitoring: which conditions should be targeted, and how should abnormal growth be defined? We systematically searched for studies reporting algorithms for growth monitoring in children and studies comparing the performance of new WHO growth charts with that of other growth charts. Among 1556 identified citations, 69 met the inclusion criteria. Six target conditions have mainly been studied: Turner syndrome, coeliac disease, cystic fibrosis, growth hormone deficiency, renal tubular acidosis, and small for gestational age with no catch-up after 2 or 3 years. Seven algorithms to define abnormal growth have been proposed in the past 20 years, but their level of validation is low, and their overall sensitivities and specificities vary substantially; however, the Grote and Saari clinical decision rules seem the most promising. Two studies reported that WHO growth charts had poorer performance compared with other existing growth charts for early detection of target conditions. Available data suggest a large gap between the widespread implementation of growth monitoring and its level of evidence or the clinical implications of early detection of serious disorders in children. Further investigations are needed to standardise the practice of growth monitoring, with a consensus on a few priority target conditions and with internationally validated clinical decision rules to define abnormal growth, including the selection of appropriate growth charts.
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Affiliation(s)
- Pauline Scherdel
- Early Determinants of the Child's Health and Development Team (ORCHAD), INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Université Paris Descartes, Paris, France; Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Université Paris Descartes, Paris, France; Paris-Sud University, Paris, France.
| | - Leo Dunkel
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Paula van Dommelen
- Department of Life Style, The Netherlands Organisation (TNO), Leiden, Netherlands
| | - Olivier Goulet
- Department of Pediatric Gastroenterology-Hepatology and Nutrition, Necker Children's Hospital, AP-HP, Université Paris Descartes, Paris, France
| | | | - Raja Brauner
- Unité d'Endocrinologie Pédiatrique, Fondation Ophtalmologique Adolphe de Rothschild, Université Paris Descartes, Paris, France
| | - Barbara Heude
- Early Determinants of the Child's Health and Development Team (ORCHAD), INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Université Paris Descartes, Paris, France
| | - Martin Chalumeau
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Université Paris Descartes, Paris, France; Department of General Pediatrics, Necker Children's Hospital, AP-HP, Université Paris Descartes, Paris, France
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Prenkert M, Ehnfors M. Growth data of underprivileged children living in rural areas of Chin State, Burma/Myanmar, compared to the WHO reference growth standards: an observational study. BMJ Open 2016; 6:e009119. [PMID: 26787249 PMCID: PMC4735213 DOI: 10.1136/bmjopen-2015-009119] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To explore growth data (height-for-age, weight-for-age and BMI-for-age) of children living in poor socioeconomic conditions in rural areas of Chin State, Burma/Myanmar; and to compare these data with the growth and development z-score (GDZ) values for school-aged children and adolescents, provided by the WHO. SETTING A support and educational programme, run by the Swedish association Chin Development and Research Society (CDRS), was carried out among underprivileged school-aged children, unable to attend school without economic and practical support, living in villages and remote areas in Chin State. PARTICIPANTS Community leaders who were well familiar with the citizens in the community identified children in need of this support. Other community members could also suggest or apply for this. The sample includes all participating children in the CDRS programme at the time of the data collection in six townships. The children were placed in host families, close to a suitable school. Two samples with a total of 639 children from 144 villages and remote areas were obtained:1. Children in the CDRS Chin Programme (CCP) (2007-2010) comprised 558 children: 50% girls and boys.2. Children in the Chin Society (CCS) (2010) comprised 81 children: 44% girls and 56% boys. PRIMARY OUTCOME MEASURES Growth data. RESULTS All growth data from both groups deviated significantly from the WHO standard references (p ≤ 0.001). The prevalence of stunting (height-for-age ≤-2SD) was 52% among girls and 68% among boys. High levels of wasting (weight-for-age ≤-2SD) were found among girls 29% and boys 36% aged 5-10 years. In addition, severe thinness (BMI-for-age ≤-2SD) was found among girls 31% and boys 44%, all results to be compared to the expected 2.27%. CONCLUSIONS Many more than expected-according to the WHO reference values-in CCP and CCS suffered from stunting, wasting and thinness.
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Affiliation(s)
- Malin Prenkert
- Faculty of Medicine and Health, Centre for Health Care Sciences, Örebro University, Örebro, Sweden
- Faculty of Medicine and Health, School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Margareta Ehnfors
- Faculty of Medicine and Health, School of Health and Medical Sciences, Örebro University, Örebro, Sweden
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INCIDENCE OF, AND RISK FACTORS FOR, MALNUTRITION AMONG CHILDREN AGED 5-7 YEARS IN SOUTH INDIA. J Biosoc Sci 2015; 48:289-305. [PMID: 26440753 DOI: 10.1017/s0021932015000309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Protein-energy malnutrition is a major health problem contributing to the burden of disease in developing countries. The aim of this study was to assess the incidence of, and risk factors for, malnutrition among school-going children in south India. A total of 2496 children aged 5-7 years from rural and urban areas of south India were recruited in 1982 and followed up for malnutrition over a period of 9 years. Their body heights and weights were measured every six months and socio-demographic factors such as mother's education and father's education and relevant household characteristics and hygiene practices collected. Body mass index and height-for-age z-scores were used to determine children's levels of underweight and stunting, respectively, classified as normal, mild/moderate or severe. Risk factor analysis was done for pre-pubertal ages only using Generalized Estimating Equations with cumulative odds assumption. There was a significant difference between male and female children in the incidence of severe underweight and stunting (6.4% and 4.2% respectively). Children in households with no separate kitchen had 1.3 (1.0-1.6) times higher odds of being severely underweight (p=0.044) compared with those with a kitchen. Children without a toilet facility had significantly higher odds of severe underweight compared with those who did. Children with illiterate parents had higher odds of severe stunting than those with literate parents. In conclusion, the prevalence of malnutrition among these south Indian children has not changed over the years, and the incidence of severe malnutrition was highest in children when they were at pubertal age. The risk factors for stunting were mostly poverty-related, and those for underweight were mostly hygiene-related. Adolescent children in south India should be screened periodically at school for malnutrition and provided with nutritional intervention if necessary.
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Kessaram T, McKenzie J, Girin N, Merilles OEA, Pullar J, Roth A, White P, Hoy D. Overweight, obesity, physical activity and sugar-sweetened beverage consumption in adolescents of Pacific islands: results from the Global School-Based Student Health Survey and the Youth Risk Behavior Surveillance System. BMC OBESITY 2015; 2:34. [PMID: 26401344 PMCID: PMC4572651 DOI: 10.1186/s40608-015-0062-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 08/18/2015] [Indexed: 12/26/2022]
Abstract
BACKGROUND Overweight, obesity and their consequences are challenges to sustainable social and economic development in Pacific island countries and territories (PICTs). Complementing previous analyses for adults, the purpose of this paper is to synthesise available data on overweight, obesity and their risk factors in adolescents in the region. The resulting Pacific perspective for the younger generation will inform both the national and regional public health response to the crisis of noncommunicable diseases. METHODS We examined the prevalence of overweight, obesity, physical activity and carbonated sugar-sweetened beverage (SSB) consumption, by using published results of two cross-sectional surveys: the Global School-Based Student Health Survey (GSHS) and the Youth Risk Behavior Surveillance System (YRBSS). GSHS was conducted in ten PICTs between 2010 and 2013 and provided results for 13-15 year olds. YRBSS surveys, conducted repeatedly in five PICTs between 1999 and 2013, provided results for grade 9-12 students (approximately 14-18 years) and enabled examination of trends. RESULTS Obesity prevalence ranged from 0 % in female students in Vanuatu to 40 % in males in Niue (GSHS). Among grade 9-12 students (YRBSS), obesity was highest in American Samoa (40 % of males; 37 % of females). Approximately 60 % of students in the Cook Islands, Niue and Tonga (GSHS) and American Samoa (YRBSS), were overweight. In both surveys, less than half of students reported engaging in sixty minutes of physical activity on at least 5 days of the past week. Daily consumption of carbonated SSBs in the past month was reported by over 42 % of students in six PICTs (GSHS), and in the past week by more than 18 % of students in three PICTs (YRBSS). In PICTs conducting YRBSS, obesity prevalence remained high or increased within the period 1999-2013. CONCLUSION There is a need for urgent action on overweight, obesity and their risk factors in Pacific youth. The multiple social, economic and physical determinants of this public health crisis must be addressed. This requires all sectors within government and society in PICTs to implement and evaluate policies that will protect and promote the health of their populations across the life course.
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Affiliation(s)
- Tara Kessaram
- Public Health Division, Secretariat of the Pacific Community, BP D5 98848 Noumea, New Caledonia
| | - Jeanie McKenzie
- Public Health Division, Secretariat of the Pacific Community, BP D5 98848 Noumea, New Caledonia
| | - Natalie Girin
- Public Health Division, Secretariat of the Pacific Community, BP D5 98848 Noumea, New Caledonia
| | | | - Jessica Pullar
- Public Health Division, Secretariat of the Pacific Community, BP D5 98848 Noumea, New Caledonia
| | - Adam Roth
- Public Health Division, Secretariat of the Pacific Community, BP D5 98848 Noumea, New Caledonia
| | - Paul White
- Public Health Division, Secretariat of the Pacific Community, BP D5 98848 Noumea, New Caledonia
| | - Damian Hoy
- Public Health Division, Secretariat of the Pacific Community, BP D5 98848 Noumea, New Caledonia
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Bahreynian M, Motlagh ME, Qorbani M, Heshmat R, Ardalan G, Kelishadi R. Prevalence of Growth Disorders in a Nationally Representative Sample of Iranian Adolescents According to Socioeconomic Status: The CASPIAN-III Study. Pediatr Neonatol 2015; 56:242-7. [PMID: 25603727 DOI: 10.1016/j.pedneo.2014.12.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Revised: 09/18/2014] [Accepted: 12/15/2014] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This study aims to assess the prevalence of growth disorders among a nationally representative sample of Iranian adolescents according to the socioeconomic status (SES) of their living area. METHODS This nationwide cross-sectional survey was conducted among a representative sample of 5624 adolescents aged 10-18 years. They were selected by multistage cluster sampling from 27 provinces of Iran. Subnational classification of the country was based on geography and social class of each region. Analysis of variance and Chi-square tests were used to compare the prevalence of growth disorders according to sex and SES of the living regions. RESULTS The mean and standard deviation for body mass index was 19.42 (4.09) kg/m(2), with a significant trend from the Southeast region with lowest SES to the Central part with highest SES (p(trend) < 0.001). The prevalence of obesity, combined overweight and obesity, as well as abdominal adiposity increased with a significant trend from low to high SES (all p(trend) < 0.001, except for girls' height, p(trend) = 0.003). The opposite direction was documented for the prevalence of underweight and short stature, with the highest frequencies in the Southeast (lowest SES) and the lowest in Central part (highest SES). CONCLUSION Excess weight was more prevalent in high SES regions, whereas underweight and short stature were more prevalent in low SES regions. These findings underscore the necessity of implementing evidence-based health promotion programs and preventive strategies according to SES.
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Affiliation(s)
- Maryam Bahreynian
- Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Mostafa Qorbani
- Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran; Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Gelayol Ardalan
- Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Kelishadi
- Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
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Urlacher SS, Blackwell AD, Liebert MA, Madimenos FC, Cepon-Robins TJ, Gildner TE, Snodgrass JJ, Sugiyama LS. Physical growth of the shuar: Height, Weight, and BMI references for an indigenous amazonian population. Am J Hum Biol 2015; 28:16-30. [PMID: 26126793 DOI: 10.1002/ajhb.22747] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 05/04/2015] [Accepted: 05/15/2015] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES Information concerning physical growth among small-scale populations remains limited, yet such data are critical to local health efforts and to foster basic understandings of human life history and variation in childhood development. Using a large dataset and robust modeling methods, this study aims to describe growth from birth to adulthood among the indigenous Shuar of Amazonian Ecuador. METHODS Mixed-longitudinal measures of height, weight, and body mass index (BMI) were collected from Shuar participants (n = 2,463; age: 0-29 years). Centile growth curves and tables were created for each anthropometric variable of interest using Generalized Additive Models for Location, Scale, and Shape (GAMLSS). Pseudo-velocity and Lambda-Mu-Sigma curves were generated to further investigate Shuar patterns of growth and to facilitate comparison with United States Center for Disease Control and Prevention and multinational World Health Organization growth references. RESULTS The Shuar are small throughout life and exhibit complex patterns of growth that differ substantially from those of international references. Similar to other Amazonians, Shuar growth in weight compares more favorably to references than growth in height, resulting in BMI curves that approximate international medians. Several additional characteristics of Shuar development are noteworthy, including large observed variation in body size early in life, significant infant growth faltering, extended male growth into adulthood, and a markedly early female pubertal growth spurt in height. Phenotypic plasticity and genetic selection in response to local environmental factors may explain many of these patterns. CONCLUSIONS Providing a detailed reference of growth for the Shuar and other Amazonian populations, this study possesses direct clinical application and affords valuable insight into childhood health and the ecology of human growth.
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Affiliation(s)
- Samuel S Urlacher
- Department of Human Evolutionary Biology, Harvard University, Cambridge, Massachusetts, 02138
| | - Aaron D Blackwell
- Department of Anthropology, University of California, Santa Barbara, California, 93106.,Broom Center for Demography, University of California, Santa Barbara, California, 93106.,Center for Evolutionary Psychology, , University of California, Santa Barbara, California, 93106
| | - Melissa A Liebert
- Department of Anthropology, University of Oregon, Eugene, Oregon, 97403.,Institute of Cognitive and Decision Sciences, University of Oregon, Eugene, Oregon, 97403
| | | | - Tara J Cepon-Robins
- Department of Anthropology, University of Oregon, Eugene, Oregon, 97403.,Institute of Cognitive and Decision Sciences, University of Oregon, Eugene, Oregon, 97403
| | - Theresa E Gildner
- Department of Anthropology, University of Oregon, Eugene, Oregon, 97403.,Institute of Cognitive and Decision Sciences, University of Oregon, Eugene, Oregon, 97403
| | - J Josh Snodgrass
- Department of Anthropology, University of Oregon, Eugene, Oregon, 97403.,Institute of Cognitive and Decision Sciences, University of Oregon, Eugene, Oregon, 97403
| | - Lawrence S Sugiyama
- Broom Center for Demography, University of California, Santa Barbara, California, 93106.,Department of Anthropology, University of Oregon, Eugene, Oregon, 97403.,Institute of Cognitive and Decision Sciences, University of Oregon, Eugene, Oregon, 97403
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Eckhardt CL, Eng H, Dills JL, Wisner KL. The prevalence of rapid weight gain in infancy differs by the growth reference and age interval used for evaluation. Ann Hum Biol 2015; 43:85-90. [PMID: 26065692 DOI: 10.3109/03014460.2014.1002533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Infant rapid weight gain (RWG) may predict subsequent obesity, but there are inconsistencies in the growth references and age intervals used for assessment. METHODS This study evaluated whether the prevalence of RWG (an increase of >0.67 in weight-for-age z-score) differed by growth reference (2006 WHO standards vs 2000 CDC references) and age interval of assessment (0-3, 0-6, 6-12 and 0-12 months). Pooled data from singleton term infants from two observational studies on maternal mood disorders during pregnancy were used (n = 161). Differences in RWG prevalence by growth reference and age interval were tested using Cochran's Q and McNemar's tests. RESULTS The CDC reference produced a higher RWG prevalence (14% of infants additionally categorized as RWG, p < 0.0001) within the 0-3 month age interval compared to the WHO standards; this pattern was reversed for the 6-12 and 0-12 month intervals. RWG prevalence did not differ across age interval within the WHO standards, but did differ with the CDC references (range: 22% for 0-3 months to 4.2% for 6-12 months, p < 0.0001). CONCLUSIONS Caution is advised when comparing studies with different criteria for RWG. Future studies should use the 2006 WHO standards and a consistent age interval of evaluation.
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Affiliation(s)
- Cara L Eckhardt
- a School of Community Health, Portland State University , Portland , OR 97201 , USA
| | - Heather Eng
- b Department of Epidemiology , Graduate School of Public Health, University of Pittsburgh , Pittsburgh , PA 15261 , USA , and
| | - John L Dills
- b Department of Epidemiology , Graduate School of Public Health, University of Pittsburgh , Pittsburgh , PA 15261 , USA , and
| | - Katherine L Wisner
- c Departments of Psychiatry and Behavioral Sciences, and Obstetrics and Gynecology , Asher Center for the Study and Treatment of Depressive Disorder, Northwestern University , Chicago , IL 60611 , USA
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Association of serum hs-CRP and lipids with obesity in school children in a 12-month follow-up study in Japan. Environ Health Prev Med 2014; 20:116-22. [PMID: 25511645 DOI: 10.1007/s12199-014-0433-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 11/27/2014] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To investigate the association of serum lipids and high-sensitivity C-reactive protein (hs-CRP) with obesity in school children and to explore whether hs-CRP levels could be used to predict the presence or absence of obesity 12 months later. METHODS The subjects were school children (6-11 years old) in Japan. Blood sampling and physical measurements were performed in school (2001); low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, and hs-CRP levels were measured. Data from children who could be followed 12 months later were analyzed. Subjects weighing 20% or more over his/her standard weight were regarded as obese, and the association of obesity with serum parameters was analyzed. RESULTS Data from 612 subjects were analyzed (follow-up rate, 75.4%). The mean of each serum parameter was significantly higher (inverse for HDL-C; lower) in obese than that in non-obese children. Logistic regression analysis for obesity at baseline showed that the odds ratio (OR) of hs-CRP was the highest [OR, 2.15; 95% confidence interval (CI), 1.65-2.78 for an interquartile rage (IQR) increase]; the association with triglycerides and LDL-C/HDL-C was significant. At the 12-month follow-up, the OR of high hs-CRP remained the highest of all serum parameters (2.09; 95% CI, 1.63-2.69 for an IQR increase). CONCLUSIONS High levels of triglycerides, LDL-C/HDL-C, and hs-CRP increased the risk of obesity in school children. Hs-CRP is considered to be a better predictor of obesity 12 months later than is LDL-C/HDL-C.
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Barbosa Filho VC, Lopes ADS, Fagundes RR, Campos WD. Anthropometric indices among schoolchildren from a municipality in Southern Brazil: a descriptive analysis using the LMS method. REVISTA PAULISTA DE PEDIATRIA 2014. [DOI: 10.1590/s0103-05822014000400009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE: To describe the percentile values for body mass index (BMI), waist circumference (WC) and waist-to-height (WHtR) of children from Colombo, Brazil, and compare them with data of children from other countries.METHODS: This was a cross-sectional study with a random sample of 2,035 children aged 6-11 years. Age- and sex-specific smoothed percentiles curves for BMI, WC and WHtR were created using the LMS method. Values of 10th, 50th and 90th percentiles from Brazilian children were compared with data from other countries.RESULTS: There was a trend of increasing BMI and WC with age in both sexes. WHtR remained constant with advancing age in boys and girls. Comparison of the growth pattern among countries showed clear differences. Southern Brazil boys and girls had elevated 90th percentile values for BMI, which was similar to German children and higher than the North American and World Health Organization percentile values. However, children from this study had intermediate values for WC and WHtR in comparison to children from other countries.CONCLUSIONS: Elevated BMI values were observed among southern Brazilian children, but WC and WHtR percentile values were lower in southern Brazilian children than in children from other countries. Interventions at different levels should be made to avoid a probable increase of nutritional disorders (especially general obesity) in the next years.
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Abstract
Overweight and obesity in childhood is an increasing problem for the less affluent countries of the world. The prevalence of overweight/obesity varies, not only between countries but across countries, depending on the environments in which children live. Changes in physical activity and diet are having adverse effects on children's nutrition. Greater affluence and urbanisation with more technology such as television in homes are associated with overweight. Affluence also brings the ability to purchase commercial, prepared 'fast-food' items, leading too often to disadvantageous effects on children's diets. The solutions to this rising tide of overweight/obesity seem to lie with broad-based programmes initiated at central government level or at more local community level but which are designed to reach across and throughout societies to enable families and communities to modify the unhealthy lifestyle which too often accompanies increasing affluence and development.
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Orden AB, Apezteguía MC. Weight and height centiles of Argentinian children and adolescents: a comparison with WHO and national growth references. Ann Hum Biol 2014; 43:9-17. [PMID: 25350773 DOI: 10.3109/03014460.2014.970576] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Studies in several countries comparing the performance of WHO references and their own national growth standards reported differences that could affect screening and growth monitoring. AIM To estimate weight and height centiles on a sample of Argentinian children and adolescents and compare selected centiles with WHO and national growth references. SUBJECTS AND METHODS A cross-sectional school survey was conducted on 6239 boys and girls aged 5-18. Data were collected between 2005-2009 in Santa Rosa, Argentina. Smoothed weight and height centiles were estimated by the LMS method and compared with WHO 2007 and Argentinian (ARG) growth references. RESULTS Weight centiles were higher than those of WHO and ARG. Height centiles were above the ARG and below the WHO ones. The greatest differences with ARG were seen before puberty and then declined up to age 18. In contrast, differences with WHO increased from puberty onwards. CONCLUSION Compared with the ARG reference, linear growth of these schoolchildren shows a secular acceleration without substantial improvements in the adult height. In relation to WHO, the results suggest that around the adolescent growth spurt differences in linear growth between populations became larger, limiting the clinical usefulness of international growth references in adolescents.
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Affiliation(s)
- Alicia B Orden
- a Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) and.,b Instituto de Desarrollo e Investigaciones Pediátricas 'Prof. Dr. Fernando E. Viteri' (IDIP - MS/CIC, PBA), Hospital de Niños Sor M. Ludovica , Argentina
| | - María C Apezteguía
- b Instituto de Desarrollo e Investigaciones Pediátricas 'Prof. Dr. Fernando E. Viteri' (IDIP - MS/CIC, PBA), Hospital de Niños Sor M. Ludovica , Argentina
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Reference curves of anthropometric indices in two national studies conducted among Iranian children in 2003-2004 and 2009-2010: The Caspian study. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2014; 19:709-14. [PMID: 25422654 PMCID: PMC4235089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Revised: 02/26/2014] [Accepted: 08/20/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Reference percentile curves are usually used as a screening tool to determine growth disorders. Anthropometric indices are population-dependent and may differ according to ethnicity, dietary pattern and lifestyle habits. This study aims to compare the curves of anthropometric measures obtained in two national studies conducted among Iranian children and adolescents in 2003-2004 and 2009-2010. MATERIALS AND METHODS Anthropometric measures obtained in two nationwide surveys conducted in 10-18-year-old Iranian students were compared. Lambda-mu-sigma (LMS) Chart Maker Pro program was used to develop age- and gender-specific percentiles and to smooth and fit the model. RESULTS In 2003-2004, the mean and standard deviation (SD) of body mass index (BMI) and waist circumference (WC) were 18.98 ± 3.81 kg/m(2) and 67.50 ± 11.05 cm in boys; and 19.44 ± 3.78 kg/m(2) and 66.55 ± 9.89 cm in girls, respectively. In 2009-2010, the corresponding figures were 19.16 ± 4.07 kg/m(2), 69.42 ± 11.43 cm, 19.63 ± 4.11 kg/m(2), and 67.29 ± 9.69 cm, respectively. Height curves did not show considerable changes in two studies. Comparison of two series of studies showed that the weight, BMI, WC, and waist-to-height ratio were lower in adolescent girls than boys especially in higher percentiles. Moreover, in both genders, weight, BMI, and WC percentiles decreased. CONCLUSION The growth charts of Iranian children and adolescents aged 10-18 years have changed over 5 years. The reference growth curves change over time in the pediatric age group, repeated surveys should be conducted to update the age- and gender-specific reference curves in different populations.
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Rezaeian S, Ahmadzadeh J, Esmailnasab N, Veisani Y, Shayan M, Moradi N. Assessment of Health and Nutritional Status in Children Based on School Screening Programs. HEALTH SCOPE 2014. [DOI: 10.17795/jhealthscope-14462] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Chirwa ED, Griffiths PL, Maleta K, Norris SA, Cameron N. Multi-level modelling of longitudinal child growth data from the Birth-to-Twenty Cohort: a comparison of growth models. Ann Hum Biol 2013; 41:168-79. [PMID: 24111514 PMCID: PMC4219852 DOI: 10.3109/03014460.2013.839742] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Different structural and non-structural models have been used to describe human growth patterns. However, few studies have compared the fitness of these models in an African transitioning population. Aim: To find model(s) that best describe the growth pattern from birth to early childhood using mixed effect modelling. Subjects and methods: The study compared the fitness of four structural (Berkey-Reed, Count, Jenss-Bayley and the adapted Jenss-Bayley) and two non-structural (2nd and 3rd order Polynomial) models. The models were fitted to physical growth data from an urban African setting from birth to 10 years using a multi-level modelling technique. The goodness-of-fit of the models was examined using median and maximum absolute residuals, Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC). Results: There were variations in how the different models fitted to the data at different measurement occasions. The Jenss-Bayley and the polynomial models did not fit well to growth measurements in the early years, with very high or very low percentage of positive residuals. The Berkey-Reed model fitted consistently well over the study period. Conclusion: The Berkey-Reed model, previously used and fitted well to infancy growth data, has been shown to also fit well beyond infancy into childhood.
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Affiliation(s)
- Esnat D Chirwa
- Wits/MRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa
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Kakar N, Ahmad J, Kubisch C, Borck G. Exon skipping and severe childhood-onset obesity caused by a leptin receptor mutation. Am J Med Genet A 2013; 161A:2672-4. [PMID: 23949901 DOI: 10.1002/ajmg.a.36125] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 06/10/2013] [Indexed: 11/09/2022]
Affiliation(s)
- Naseebullah Kakar
- Institute of Human Genetics, University of Ulm, Ulm, Germany; Department of Biotechnology and Informatics, BUITEMS, Quetta, Pakistan
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Braitstein P, Ayaya S, Nyandiko WM, Kamanda A, Koech J, Gisore P, Atwoli L, Vreeman RC, Duefield C, Ayuku DO. Nutritional status of orphaned and separated children and adolescents living in community and institutional environments in uasin gishu county, kenya. PLoS One 2013; 8:e70054. [PMID: 23922900 PMCID: PMC3724723 DOI: 10.1371/journal.pone.0070054] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 06/14/2013] [Indexed: 11/18/2022] Open
Abstract
Objective To describe the nutritional status of orphaned and separated children and adolescents (OSCA) living in households in the community (HH), on the street, and those in institutional environments in western Kenya. Methods The study enrolled OSCA from 300 randomly selected households (HH), 19 Charitable Children’s Institutions (CCIs), and 100 street-involved children. Measures of malnutrition were standardized with Z-scores using World Health Organization criteria; Z-scores ≤-2 standard deviations (sd) were moderate-severe malnutrition. Data were analyzed using multivariable logistic regression adjusting for child age, sex, HIV status, whether the child had been hospitalized in the previous year, time living with current guardian, and intra-household clustering for adequacy of diet and moderate-severe malnutrition. Results Included are data from 2862 participants (1337 in CCI’s, 1425 in HH’s, and 100 street youth). The population was 46% female with median age at enrolment of 11.1 years. Only 4.4% of households and institutions reported household food security; 93% of children in HH reported an adequate diet vs. 95% in CCI’s and 99% among street youth. After adjustment, OSCA in HH were less likely to have an adequate diet compared to those in CCI’s (AOR 0.4, 95% CI 0.2–1.0). After adjustment, there were no differences between the categories of children on weight-for-age, weight-for-height, or BMI-for-age. Children living in HH (AOR 2.6, 95% CI: 2.0–3.4) and street youth (AOR: 5.9, 95% CI: 3.6–9.5) were more likely than children in CCI’s to be low height-for-age. Conclusion OSCA in HH are less likely to have an adequate diet compared to children in CCI’s. They and street children are more likely to be moderately-severely low height-for-age compared to children in CCI’s, suggesting chronic malnutrition among them.
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Affiliation(s)
- Paula Braitstein
- Indiana University School of Medicine, Department of Medicine, Indianapolis, Indiana, USA.
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Gleiss A, Lassi M, Blümel P, Borkenstein M, Kapelari K, Mayer M, Schemper M, Häusler G. Austrian height and body proportion references for children aged 4 to under 19 years. Ann Hum Biol 2013; 40:324-32. [DOI: 10.3109/03014460.2013.776110] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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