Nutritional status and risk factors of overweight and obesity for children aged 9-15 years in Chengdu, Southwest China

Association of Fine Particulate Matter and Its Components with Macrosomia: A Nationwide Birth Cohort Study of 336 Chinese Cities

To examine the associations between macrosomia risk and exposure to fine particulate matter (PM2.5) and its chemical components during pregnancy, we collected birth records between 2010 and 2015 in mainland China from the National Free Preconception Health Examination Project and used satellite-based models to estimate concentrations of PM2.5 mass and five main components, namely, black carbon (BC), organic carbon (OC), nitrate (NO3-), sulfate (SO42-), and ammonium (NH4+). Associations between macrosomia risk and prenatal exposure to PM2.5 were examined by logistic regression analysis, and the sensitive subgroups were explored by stratified analyses. Of the 3,248,263 singleton newborns from 336 cities, 165,119 (5.1%) had macrosomia. Each interquartile range increase in concentration of PM2.5 during the entire pregnancy was associated with increased risk of macrosomia (odds ratio (OR) = 1.18; 95% confidence interval (CI), 1.17-1.20). Among specific components, the largest effect estimates were found on NO3- (OR = 1.36; 95% CI, 1.35-1.38) followed by OC (OR = 1.23; 95% CI, 1.22-1.24), NH4+ (OR = 1.22; 95% CI, 1.21-1.23), and BC (OR = 1.21; 95% CI, 1.20-1.22). We also that found boys, women with a normal or lower prepregnancy body mass index, and women with irregular or no folic acid supplementation experienced higher risk of macrosomia associated with PM2.5 exposure.

Investigation of the Seasonal Variation in Fat Patterning of Ellisras Rural Children and Adolescents, in the Limpopo Province, South Africa

An increase in childhood obesity has become a global concern since childhood obesity often leads to adulthood obesity. This study aimed to investigate whether there is seasonal variation in fat patterning, and whether fat patterning is associated with seasons among the Ellisras population aged 5-15 years. A total of 1986 children and adolescents (1034 boys and 952 girls) aged 5-15 enrolled in this cross-sectional study. Skinfold measurements were obtained using standard procedures. Obesity prevalence was determined using frequency analysis. The correlation between obesity and two seasons was tested using multinomial regression analysis. The results showed that girls aged 11-15 years had significantly (p ≤ 0.03) larger median fat variables (triceps, biceps, and suprailiac) in spring compared to autumn. The prevalence of obesity ranged from 3-11% with boys being more obese (4-11%) than girls (3-7%) aged 5-15. Regression analysis showed a negative significant (p ≤ 0.001) correlation between autumn and obesity by the subscapular/(subscapular+triceps) (SST) ratio, both unadjusted -2.991 (95%CI -3.233:-2.803) and adjusted -2.897 (95% CI -4.331:-1.629). The findings of the study showed that there was seasonal variation in fat patterning among boys and girls in the Ellisras population and that fat patterning is associated with seasons.

Prenatal exposure to persistent organic pollutants and changes in infant growth and childhood growth trajectories

BACKGROUND

Children are born with a burden of persistent organic pollutants (POPs) which may have endocrine disrupting properties and have been postulated to contribute to the rise in childhood obesity. The current evidence is equivocal, which may partly because many studies investigate the effects at one time point during childhood. We assessed associations between prenatal exposure to POPs and growth during infancy and childhood.

METHODS

We used data from two Belgian cohorts with cord blood measurements of five organochlorines [(dichlorodiphenyldichloroethylene (p,p'-DDE), hexachlorobenzene (HCB), polychlorinated biphenyls (PCB-138, -150, -180)] (N = 1418) and two perfluoroalkyl substances [perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS)] (N = 346). We assessed infant growth, defined as body mass index (BMI) z-score change between birth and 2 years, and childhood growth, characterized as BMI trajectory from birth to 8 years. To evaluate associations between POP exposures and infant growth, we applied a multi-pollutant approach, using penalized elastic net regression with stability selection, controlling for covariates. To evaluate associations with childhood growth, we used single-pollutant linear mixed models with random effects for child individual, parametrized using a natural cubic spline formulation.

RESULTS

PCB-153 was associated with increased and p,p'-DDE with decreased infant growth, although these results were imprecise. No clear association between any of the exposures and longer-term childhood growth trajectories was observed. We did not find evidence of effect modification by child sex.

CONCLUSION

Our results suggest that prenatal exposure to PCB-153 and p,p'-DDE may affect infant growth in the first two years, with no evidence of more persistent effects.

Risk factors for obesity and overweight in Chinese children: a nationwide survey

OBJECTIVE

This study aimed to analyze a comprehensive set of potential risk factors for obesity and overweight among Chinese children with a full range of ages and with wide geographical coverage.

METHODS

In the Prevalence and Risk Factors for Obesity and Diabetes in Youth (PRODY) study (2017-2019), the authors analyzed 193,997 children aged 3 to 18 years from 11 provinces, autonomous regions, and municipalities that are geographically representative of China. All participants underwent physical examinations, and their caregivers completed questionnaires including dietary, lifestyle, familial, and perinatal information of participants. A multilevel multinomial logistic regression model was used to evaluate the potential risk factors.

RESULTS

Among the actionable risk factors that were measured, higher consumption frequencies of animal offal (odds ratios [OR] for an additional time/day = 0.91, 95% CI: 0.88-0.95, same unit for OR below unless specified otherwise), dairy products (0.91, 95% CI: 0.88-0.94), freshwater products (0.94, 95% CI: 0.91-0.96), staple foods (0.94, 95% CI: 0.92-0.96), and coarse food grain (OR for every day vs. rarely = 0.92, 95% CI: 0.86-0.98) were associated with lower relative risk of obesity. However, higher restaurant-eating frequency (OR for >4 times/month vs. rarely = 1.21, 95% CI: 1.15-1.29) and longer screen-viewing duration (OR for >2 hours vs. <30 minutes = 1.16, 95% CI: 1.10-1.22) were associated with higher relative risk of obesity. Increased exercise frequency was associated with the lowest relative risk of obesity (OR for every day vs. rarely = 0.72, 95% CI: 0.68-0.77).

CONCLUSIONS

Changes in lifestyle and diet of Chinese children may help relieve their obesity burden.

Eating habits, lifestyle factors and body weight status among Moroccan school adolescents (12–19 years): The case of Beni Mellal city

BACKGROUND: Overweight and obesity among children and adolescents are serious public health issues worldwide. A better understanding of the relationships between obesity and lifestyle factors is necessary for effective prevention and management of obesity in youth. AIMS: This study aimed to assess the prevalence of overweight/obesity and associated factors among schoolchildren aged 12–19 years at Beni Mellal city, Morocco. METHODS: A school based cross sectional study was carried out. A total of 516 children were included in the study. The nutritional status was classified according to the reference curves of WHO (2007). Multivariable logistic regression analysis was used to identify factors associated with overweight/obesity. The association between dependent and independent variables were assessed using odds ratio with 95% confidence interval and p value < 0.05 was considered statistically significant. RESULTS: The prevalence of overweight was 12.40% and that of obesity was 5.20%. Overweight and obesity were statistically associated with gender (Odds Ratio (OR) = 10.15[95% CI 1.37–3.81], p = 0.001); skipping breakfast (OR = 9.19 [95% CI 1.42–5.17], p = 0.002) and eating cake, pastry and biscuit 1 to 3 times per week (OR = 4.14 [95% CI 1.02–3.25], p = 0.04) and 4 or more times a week (OR = 7.83 [95% CI 1.31–4.66], p = 0.005). CONCLUSIONS: This study revealed that prevalence of overweight/obesity among school-aged children in Beni Mellal city was high. Thus, promoting healthy dietary practices, particularly improving fruit and vegetable intake is essential to reduce the burden of overweight and obesity. Furthermore, it is important to strengthen nutrition education about avoiding junk food consumption and encouraging regular physical activity.

Associations of community, famliy and early individual factors with body mass index z-scores trajectories among Chinese children and adolescents

The prevalence of childhood overweight and obesity is increasing. This study aimed to examine trajectories of BMI z-scores among Chinese children and the potential determinants including early individual, family and community factors. Group-based trajectory modeling was employed to identify BMI z-scores trajectories of children aged 2-18 years using the five waves data (2010, 2012, 2014, 2016, and 2018) of the China Family Panel Studies (CFPS). Multivariate logistic regression was conducted to determine the association between early individual, family, community factors and BMI z-scores trajectories of children. We identified three trajectories for boys and girls, named Class 1 as "not-overweight", Class 2 as "persistent rapid descending but overweight during pre-school age", and Class 3 as "rapid rising up to school age and then become-overweight" class. Macrosomia (OR 1.772; 95% CI 1.188-2.644) and being a single child (OR 2.038; 95% CI 1.453-2.859) were more likely to belong in Class 3 among boys. Girls living in the advantaged communities (OR 1.539; 95% CI 1.052-2.252), rural-living (OR 1.558; 95% CI 1.133-2.142) and with none social integration (OR 1.496; 95% CI 1.07-2.091) were more likely to belong in Class 2. There are heterogeneous BMI z-scores trajectories of children aged 2-18, and pre-school age is a critical window that could predict the long-term growth patterns. BMI z-scores trends need to be monitored during pre-school age, focusing on those at higher risk of later overweight obesity status, and targeted interventions at the early individual, family, community levels are essential.

Integration of an interpretable machine learning algorithm to identify early life risk factors of childhood obesity among preterm infants: a prospective birth cohort

BACKGROUND

The early life risk factors of childhood obesity among preterm infants are unclear and little is known about the influence of the feeding practices. We aimed to identify early life risk factors for childhood overweight/obesity among preterm infants and to determine feeding practices that could modify the identified risk factors.

METHODS

A total of 338,413 mother-child pairs were enrolled in the Jiaxing Birth Cohort (1999 to 2013), and 2125 eligible singleton preterm born children were included for analyses. We obtained data on health examination, anthropometric measurement, lifestyle, and dietary habits of each participant at their visits to clinics. An interpretable machine learning-based analytic framework was used to identify early life predictors for childhood overweight/obesity, and Poisson regression was used to examine the associations between feeding practices and the identified leading predictor.

RESULTS

Of the eligible 2125 preterm infants (863 [40.6%] girls), 274 (12.9%) developed overweight/obesity at age 4-7 years. We summarized early life variables into 25 features and identified two most important features as predictors for childhood overweight/obesity: trajectory of infant BMI (body mass index) Z-score change during the first year of corrected age and maternal BMI at enrollment. According to the impacts of different BMI Z-score trajectories on the outcome, we classified this feature into the favored and unfavored trajectories. Compared with early introduction of solid foods (≤ 3 months of corrected age), introducing solid foods after 6 months of corrected age was significantly associated with 11% lower risk (risk ratio, 0.89; 95% CI, 0.82 to 0.97) of being in the unfavored trajectory.

CONCLUSIONS

The trajectory of BMI Z-score change within the first year of life is the most important predictor for childhood overweight/obesity among preterm infants. Introducing solid foods after 6 months of corrected age is a recommended feeding practice for mitigating the risk of being in the unfavored trajectory.

Dyslipidemia prevalence in adolescents in public schools

OBJECTIVE

To evaluate the prevalence of dyslipidemia in adolescents enrolled in the state public education system of the city of Montes Claros, state of Minas Gerais, and compare to a Brazilian population-based study.

METHOD

This is an epidemiological, cross-sectional, and analytical study with a population of 77,833 students from 63 schools, representing four geographic areas of the city. After a sample calculation, information on 635 adolescents from 10 to 16 years of age was assessed and blood collection was conducted for the analysis of biochemical parameters of total cholesterol, triglycerides, LDL-c, and HDL-c.

RESULTS

Among the adolescents, 26.8% showed high levels of total cholesterol, 15.7% of triglycerides, and 6.5% of LDL-c, and 40.8% had low HDL-c levels.

CONCLUSION

Except for HDL-c levels, dyslipidemia prevalence and means in adolescents from Montes Claros, Minas Gerais, were above the levels found in the Brazilian population-based study used as parameter.

Comparison of selected body composition parameters in women using DXA and anthropometric method

Background

An excessive accumulation of the adipose tissue in women's organism is a frequent and important medical problem which should be monitored. The aim of this study was to explore correlations between the selected parameters of body composition assessed using DXA and anthropometric methods.

Materials and Methods

The study group consisted of 50 women aged 51-85. Both adipose mass and fat-free mass were assessed with the DXA method, and the nutritional status of the participants was evaluated with the anthropometric methods.

Results

The mean body mass index (BMI) value assessed with the DXA method amounted to 28.4 (±5.12). The Spearman's Rho correlation indicated the presence of a moderate association (0.27-0.50) between: (1) right arm lean and the circumference of the arm (P = 0.020), forearm (P = 0.011), and transverse cross-section of the arm (P = 0.020), (2) right leg fat and circumference of the thigh (P = 0.003), shin (P = 0.009), and also the musculature index of the lower extremity (P = 0.034), (3) visceral adipose tissue (VAT) mass and BMI (P = 0.050), Waist to HeightRatio (WtHR) (P = 0.031), (4) Android fat and WHtR (P = 0.044), and (5) gynoid fat and Škerlj index (P = 0.025).

Conclusion

The selected parameters assessed with DXA were significantly correlated with the selected parameters assessed with anthropometric methods. WHtR anthropometric parameter is significantly correlated with DXA parameters: VAT mass, gynoid region % fat and android region % fat.

Developmental Programming of Body Composition: Update on Evidence and Mechanisms

PURPOSE OF REVIEW

A growing body of epidemiological and experimental data indicate that nutritional or environmental stressors during early development can induce long-term adaptations that increase risk of obesity, diabetes, cardiovascular disease, and other chronic conditions-a phenomenon termed "developmental programming." A common phenotype in humans and animal models is altered body composition, with reduced muscle and bone mass, and increased fat mass. In this review, we summarize the recent literature linking prenatal factors to future body composition and explore contributing mechanisms.

RECENT FINDINGS

Many prenatal exposures, including intrauterine growth restriction, extremes of birth weight, maternal obesity, and maternal diabetes, are associated with increased fat mass, reduced muscle mass, and decreased bone density, with effects reported throughout infancy and childhood, and persisting into middle age. Mechanisms and mediators include maternal diet, breastmilk composition, metabolites, appetite regulation, genetic and epigenetic influences, stem cell commitment and function, and mitochondrial metabolism. Differences in body composition are a common phenotype following disruptions to the prenatal environment, and may contribute to developmental programming of obesity and diabetes risk.

Assessment of body adiposity preterm children at the beginning of school age

In Poland, like in other developed countries, 6.3% of babies are born prematurely. Preterm babies suffer from numerous health issues. The aim of the study was to assess body adiposity in preterm children at the beginning of school age. The study population consisted of 61 children aged 5 to 8 years who had been born preterm. We performed standard anthropometric measurements according to internationally recognized methodology. The following parameters were used: Body Weight (BW), Body Heigh (BH), Waist Circumference (WC), Body Mass Index (BMI), Waist to Height Ratio (WtHR), Triceps Skinfold Thickness (TST), Subscapular Skinfold Thickness (SST), Umbilical Skinfold Thickness (UST), as well as total sum of the above parameters, or the Global Adiposity (GA). The anthropometric measurements were taken according to international anthropometric methodology. All anthropometric parameters for body adiposity were significantly lower in the study population than in the reference system. We found a statistically significant relationship between: the number of fetuses and: UST (p = 0.007) and z-score UST (p = 0.030); combined number of unfavorable perinatal events: and UST (p = 0.013) and z-score UST (p = 0.007), GA (p = 0.038) and z-score GA (p = 0.040). Preterm children who are about to start school have significantly lower values of anthropometric features that characterize their body adiposity. In preterm children at early school age number of fetuses diversifies UST; and combined number of unfavorable perinatal events diversifies UST and GA. It is recommended that more studies are conducted on positively oriented modification of body adiposity in these children, as well as its long term monitoring.

Prevalence and factors associated with overweight and obesity among children from primary schools in urban areas of Lomé, Togo

Objective

Overweight and obesity in childhood are serious public health issues, both in developing and developed countries. The present study aimed to ascertain overweight and obesity prevalence rates among Togolese schoolchildren in Lomé, Togo, and their correlation with physical activity, socio-economic conditions and eating habits.

Design

Cross-sectional survey conducted in December 2015. Overweight and obesity were defined using age- and sex-specific BMI cut-off points of the International Obesity Task Force. Physical activity, socio-economic conditions and eating habits were assessed with a standardized questionnaire. Specially trained medical students interviewed children and collected the data. After bivariate regression analyses, factors associated with overweight/obesity were identified by multivariate logistic regression. Statistical significance was two-sided P<0·05.

Setting

Lomé, Togo.

Subjects

Representative sample of 634 children (288 boys, 346 girls), aged 8–17 years, who were studying in primary schools.

Results

Overweight and obesity respectively affected 5·2 and 1·9 % of children surveyed. Watching television (>4 h) on weekends (OR; 95 % CI: 3·8; 1·2, 12·0, P=0·02) and medium dietary diversity score (3·0; 1·1, 8·1, P=0·03) were independently associated with overweight/obesity in a multivariate regression model. Eating breakfast in the school cafeteria (0·2; 0·1, 0·8, P=0·03) and eating fruits (0·4; 0·1, 0·9, P=0·03) significantly reduced the risk of overweight/obesity.

Conclusions

Overweight and obesity prevalence were linked with sedentary behaviour and non-optimal food diversity. Promoting physical activity and fruit consumption should be explored as interventions to reduce and prevent overweight and obesity in Lomé schoolchildren. In addition, preventive approaches in the social environment of children should be considered.

Prevalence of Thinness in Adolescent Girls in Low- and Middle-Income Countries and Associations With Wealth, Food Security, and Inequality

PURPOSE

Adequate nutrition during adolescence is important for optimal physical and cognitive development and for pregnancy either during adolescence or later life. Thinness among adolescent girls in low- and middle-income countries has been little studied.

METHODS

We used body mass index data from 40 countries from the Global School Health Survey to estimate the prevalence of moderate and severe thinness in 12- to 18-year-olds using the World Health Organization 2007 growth reference. Self-report data on going to bed hungry were used as a proxy for household food insecurity. We used multilevel models to assess whether national wealth (gross domestic product), income inequality (Gini index), national gender inequality (Gender Inequality Index), and food security (Global Food Security Index) were associated with undernutrition.

RESULTS

Prevalence rates of moderate and severe thinness across 61,603 girls from 40 countries were 6.30% (95% confidence interval [CI]: 5.71-6.95) and 1.34% (1.12-1.59), respectively, with higher rates in Asia. Combined moderate/severe thinness was more common among early (12-14 years) than later adolescents (15-18 years). Going to bed hungry sometimes was associated with increased risk of moderate/severe thinness (odds ratio [OR]: 1.102; 95% CI: 1.007-1.206). A significant inverse relationship was found between thinness and gross domestic product (OR: .94; 95% CI: .88-.99) and Global Food Security Index (OR: .96; 95% CI: .93-.99) but not Gini or Gender Inequality Index.

CONCLUSION

Thinness remains prevalent in adolescent schoolgirls in low- and middle-income countries and poses a significant threat to their health and that of the next generation. Further research is needed to assess potential interventions for this group.

Regional Disparities in China in the Prevalence of Children Who Are Obese or Overweight

China has experienced rapid socioeconomic transitions during the last three decades, which may result in a rising prevalence of overweight and obese children in China. This article aims to fill in the existing knowledge gap by an analysis of the China Health and Nutrition Survey data to study the national prevalence of children who are overweight and obese as well as how the regional disparities and age differences in prevalence have changed between 1989 and 2009.

Dietary Patterns in Relation to General and Central Obesity among Adults in Southwest China

Dietary patterns represent a broader picture of food consumption, and are better correlated with a variety of health outcomes. However, few studies have been conducted to explore the associations between dietary patterns and obesity in Southwest China. Data from the 2010-2012 National Nutrition Survey in the province of Yunnan, Southwest China, were analyzed (n = 1604, aged 18-80 years). Dietary data were collected using the 24 h dietary recall over three consecutive days. Height, weight, and waist circumference were measured following standard methods. Exploratory factor analysis was used to identify dietary patterns. Logistic regression was used to explore the association between dietary patterns and obesity. Three distinct dietary patterns were identified, which were labeled as traditional, modern, and tuber according to their key components. With potential confounders adjusted, adults in the highest quartile of the modern pattern were at higher risk of general and central obesity (odds ratio (OR) 1.95, 95% confidence interval (CI) 1.15-3.48; OR 2.01, 95% CI 1.37-2.93). In contrast, adults in the highest quartile of the tuber pattern were at lower risk of general and central obesity (OR 0.34, 95% CI 0.15-0.61; OR 0.64, 95% CI 0.43-0.95) but at higher risk of underweight (OR 2.57, 95% CI 1.20-6.45). No significant association was found between the traditional pattern and obesity. Moreover, dietary pattern differences occurred due to the differences in socio-demographic characteristics. In conclusion, the modern dietary pattern was positively, and the tuber pattern negatively, associated with general and central obesity among adults in Southwest China.

The prevalence of obesity and influence of early life and behavioral factors on obesity in Chinese children in Guangzhou

BACKGROUND

Childhood obesity has become a public health concern in many countries. In Southern China, the prevalence of childhood obesity increased from 6.2 to 7.5 % between 2007 and 2011. This study aimed to report the current prevalence of overweight and obesity, analyzed the early life and behavioral determinants of obesity, and investigated the weight-loss practices among Chinese children in Guangzhou.

METHODS

Three thousand seven hundred sixty-six primary school students aged 7-12 years were recruited in Guangzhou, China in 2013. Questionnaires were used to assess (1) early life factors: birth weight, delivery mode, gestational age and feeding patterns; (2) behavioral factors: dietary intake, eating speed, sedentary time, physical activities and sleep duration; and (3) weight-loss practices: improving diet, increasing exercise, taking weight-loss drugs and undergoing a diet. The criteria of Working Group of Obesity in China were applied to classify overweight and obesity based on measured weight and height. Multivariable logistic regression analyses were performed to examine the determinants of overweight/obesity and adoption of weight-loss practices.

RESULTS

The prevalence of childhood overweight and obesity were 11.2 and 10.0 %, respectively. High birth weight (≥4.0 kg versus 2.5 ~ 4.0 kg, odd ratio [OR]: 2.34; 95 % confidence interval [CI]: 1.53-3.58), sugar-sweetened beverages (SSBs) intake (OR: 1.39; 95 % CI: 1.05-1.85), vegetable intake (OR: 1.12; 95 % CI: 1.01-1.24), and doing homework (OR: 1.24; 95 % CI: 1.08-1.43) were positively associated with obesity. Eating speed faster than peers was positively associated with obesity and yielded the highest OR (versus "as fast as peers", OR: 3.18; 95 % CI: 2.28-4.44). Approximately 57, 81 and 87 % of normal-weight, overweight and obese children, respectively, reported weight-loss practices. Self-perception of weight status presented as the strongest determinant for weight-loss practices.

CONCLUSIONS

The prevalence of overweight and obesity were high in Chinese children in Guangzhou, and both were higher than previous level in 2011. Further research should address the unhealthy dietary (e.g. SSBs intake, fast eating speed) and sedentary behaviors (e.g. doing homework) of these children. Moreover, an accurate perception of body weight can help promote the adoption of weight-loss practices in overweight and obese children.

The Association between Family and Parental Factors and Obesity among Children in Nanchang, China

BACKGROUND

With rapid economic development in China, traditional patterns of health behaviors are changing, concurrent with a rise in childhood obesity. While the home environment and parenting behaviors are modifiable factors that could be targeted for intervention, little is known about their relationship with children's health behaviors. Therefore, the purpose of this study was to investigate the relationship between obesity and home and parenting factors in Chinese children.

METHODS

A cross-sectional survey was conducted in Nanchang, China in 2013 with caregivers (N = 470) of a child between the ages of 2 and 10 years. Regression analyses were conducted to determine risk factors for childhood obesity.

RESULTS

Obesity prevalence (21.7%) did not differ by demographic variables. Eight physical activity, nutrition, and sedentary variables had significant relationships to obesity status. Logistic regression analysis revealed three significant predictors of obesity: the number of days the family eats meals together (odds ratio = 0.84, 95% CI 0.73-0.96) and parental home computer use time (odds ratio = 0.83, 95% CI 0.72-0.96) were related to lower levels of obesity, while parental television time (odds ratio = 1.25 95% CI 1.07-1.47) was related to higher levels of obesity.

CONCLUSION

The prevalence of obesity among children is high in Nanchang. Family and environmental risk factors are significantly related to obesity.

Risk Factors for Childhood Obesity in the First 1,000 Days: A Systematic Review

CONTEXT

Mounting evidence suggests that the origins of childhood obesity and related disparities can be found as early as the "first 1,000 days"-the period from conception to age 2 years. The main goal of this study is to systematically review existing evidence for modifiable childhood obesity risk factors present from conception to age 2 years.

EVIDENCE ACQUISITION

PubMed, Embase, and Web of Science were searched for studies published between January 1, 1980, and December 12, 2014, of childhood obesity risk factors present during the first 1,000 days. Prospective, original human subject, English-language research with exposure occurrence during the first 1,000 days and with the outcome of childhood overweight or obesity (BMI ≥85th percentile for age and sex) collected between age 6 months and 18 years were analyzed between December 13, 2014, and March 15, 2015.

EVIDENCE SYNTHESIS

Of 5,952 identified citations, 282 studies met inclusion criteria. Several risk factors during the first 1,000 days were consistently associated with later childhood obesity. These included higher maternal pre-pregnancy BMI, prenatal tobacco exposure, maternal excess gestational weight gain, high infant birth weight, and accelerated infant weight gain. Fewer studies also supported gestational diabetes, child care attendance, low strength of maternal-infant relationship, low SES, curtailed infant sleep, inappropriate bottle use, introduction of solid food intake before age 4 months, and infant antibiotic exposure as risk factors for childhood obesity.

CONCLUSIONS

Modifiable risk factors in the first 1,000 days can inform future research and policy priorities and intervention efforts to prevent childhood obesity.

Psychological and physiological correlates of childhood obesity in Taiwan

Evidence of associations between psychopathology and obesity in childhood remains inconsistent, and most studies have been conducted in Western countries. This study investigated psychological and physiological correlates of obesity in a community sample of children in Taiwan. In total, 302 children (157 overweight/obese and 145 healthy-weight children) were selected from first- and fourth-grade schoolchildren in eight elementary schools in 2009. These children participated in a comprehensive health examination, including a physical examination, blood sample analysis, and questionnaire administration. We found that regarding physiological characteristics, compared with the healthy-weight children, the overweight/obese children had significantly higher values for body fat estimated using the bioelectrical impedance method (p < 0.001), systolic blood pressure (p < 0.001), and diastolic blood pressure (p = 0.001); lower values for high-density lipoprotein (p < 0.001); and worse values for glutamic-pyruvic transaminase (p < 0.001), triglycerides (p < 0.001), and fasting blood glucose (p = 0.049). In logistic models adjusted for parental and child traits and physiological characteristics, children’s overweight/obesity was significantly associated with lower self-concept (odds ratio [OR] = 0.96, 95% confidence interval [CI] = 0.93–0.99) and less disruptive behavior (OR = 0.96, 95% CI = 0.92–0.99). Less disruptive behavior and the lack of a higher prevalence of anxiety and depression in childhood obesity appear to be a unique pattern in Taiwan that warrants further investigation.

Associação entre estado nutricional da mãe e a frequência, local e companhia durante as refeições com o sobrepeso/obesidade de adolescentes da cidade de Florianópolis, Brasil

Objetivos:Objetivos: estimar a prevalência de sobrepeso/obesidade e analisar a associação entre estado nutricional da mãe, fatores sociodemográ-ficos, frequência, local e companhia nas refeições e sobrepeso/obesidade em escolares de 11 a 14 anos de Florianópolis, Santa Catarina.Métodos:estudo transversal com 962 adolescentes de escolas públicas e privadas. O sobrepeso/obesidade foi definido de acordo com a Organização Mundial da Saúde. As variáveis independentes foram: rede de ensino, sexo do escolar, escolaridade e estado nutricional da mãe, renda familiar mensal, frequência, local e companhia nas refeições. Foram realizadas análises brutas e ajustadas por meio da regressão de Poisson estimando-se razões de prevalência e intervalos de confiança de 95%.Resultados:a prevalência de sobrepeso/obesi-dade foi de 29,8% (IC95%: 25,7-33,9), sendo 11,6% de obesidade e 18,3% de sobrepeso. Entre alunos da rede pública, o sobrepeso/obesidade esteve associado ao sobrepeso/obesidade da mãe, maior número de realização de café da manhã, almoçar na escola ou em outro local e café da manhã na companhia de outras pessoas, enquanto que entre estudantes da rede privada, o evento esteve associado ao sobrepeso/obesidade da mãe.Conclusões:a elevada prevalência de sobrepeso/obesidade, tanto na rede pública quanto na privada, evidencia a necessidade de mais atenção para os fatores associados, tais como sobrepeso/obesidade da mãe, frequência, local e companhia nas refeições.

Country-level and individual correlates of overweight and obesity among primary school children: a cross-sectional study in seven European countries

BACKGROUND

The present study aims to estimate childhood overweight and obesity prevalence and their association with individual and population-level correlates in Eastern and Western European countries.

METHODS

Data were obtained from the School Children Mental Health in Europe, a cross-sectional survey conducted in 2010 in Italy, Germany, the Netherlands, Romania, Bulgaria, Lithuania and Turkey. The sample consists of 5,206 school children aged 6 to 11 years old. Information on socio-demographics, children's height and weight, life-style and parental attitude were reported by the mothers. Country-level indicators were obtained through several data banks. Overweight and obesity in children were calculated according to the international age and gender-specific child Body Mass Index cut-off points. Multivariable logistic regression models included socio-demographic, lifestyle, mothers' attitude, and country-level indicators to examine the correlates of overweight.

RESULTS

Overall prevalence was 15.6% (95% CI = 19.3-21.7%) for overweight and 4.9% (95% CI = 4.3-5.6%) for obesity. In overweight (including obesity), Romanian children had the highest prevalence (31.4%, 95% CI = 28.1-34.6%) and Italian the lowest (10.4%, 95% CI = 8.1-12.6%). Models in the pooled sample showed that being younger (aOR = 0.93, 95% = CI 0.87-0.97), male (aOR = 1.24, 95% CI = 1.07-1.43), an only child (aOR = 1.40, 95% CI = 1.07-1.84), spending more hours per week watching TV (aOR = 1.01, 95% CI =1.002-1.03), and living in an Eastern Country were associated with greater risk of childhood overweight (including obesity). The same predictors were significantly associated with childhood overweight in the model conducted in the Eastern region, but not in the West. Higher Gross Domestic Product and Real Domestic Product, greater number of motor and passenger vehicles, higher percentage of energy available from fat, and more public sector expenditure on health were also associated with lower risk for childhood overweight after adjusting for covariables in the pooled sample and in the east of Europe, but not in the West.

CONCLUSIONS

Prevalence rates of overweight and obesity in school children is still high, especially in Eastern regions, with some socio-demographic factors and life-styles associated with being overweight. It is also in the Eastern region itself where better macro-economic indicators are related with lower rates of childhood overweight. This represents a public health concern that deserves special attention in those countries undertaking economic and political transitions.

Low birthweight or rapid catch-up growth: which is more associated with cardiovascular disease and its risk factors in later life? A systematic review and cryptanalysis

BACKGROUND

The effects of birthweight (the Barker hypothesis) and growth trajectory in early life on the incidence of cardiovascular disease (CVD) and its risk factors in later life have been investigated in a number of studies.

OBJECTIVE

To undertake a systematic review and cryptanalysis of the association of low birthweight (LBW) and the postnatal growth trajectory with CVD and its risk factors.

METHODS

English-language publications in PubMed, ISI Web of Science and Scopus were searched. Initially, two independent reviewers identified relevant papers in several steps and the quality of papers was then determined by a validated quality-appraisal checklist.

RESULTS

By applying maximum sensitivity, 7259 paper were identified, 382 of which were duplicates and 1273 were considered to be relevant to the topic. Then, after title and abstract review, 628 irrelevant papers were excluded; 26 papers were added after reference-checking. Then, 250 other papers were deleted after full text review. Finally, 39 relevant papers remained and were entered into the systematic review. Overall, 79·6% of all CVD risk factors reported in primary studies of the rapid catch-up growth hypothesis were statistically significant, whereas the corresponding figure was 58·5% for the effects of LBW (Barker hypothesis).

CONCLUSIONS

This systematic review highlights the importance of low birthweight in increasing the risk of CVD and its risk factors in later life. The results support rapid postnatal catch-up growth of LBW neonates as a more important factor than LBW alone in CVD and its risk factors.

Caries experience and its association with weight status among 8-year-old children in Qingdao, China

Objectives:

Childhood obesity/underweight status and caries are both important public health problems. This study aims to investigate the caries status and its association with body weight in 8-year-old children in Qingdao, China.

Materials and Methods:

We initiated a cross-sectional investigation on 744 children aged 8 years during the Oral Health Survey in 2012. Dental caries assessments were carried out and weight status was recorded accordingly. The resulting caries status including caries prevalence, dmft (deciduous dentition), and (dmft + DMFT) (mixed dentition), as well as BMI indices were analyzed for comparison and correlation.

Results:

The prevalence of dental caries among the 744 children aged 8 years participating in this survey was 86.3%. The caries status represented by dmft (deciduous dentition) and (dmft + DMFT) (mixed dentition) values was 4.31 and 4.85, respectively, and the restoration rate was extremely low, which was no more than 3.0%. Significant difference was found in dmft/(dmft + DMFT) values between different BMI groups, and underweight individuals were found to have the highest dmft/(dmft + DMFT) value. An inverse relationship between body BMI and dmft/(dmft + DMFT) index was identified based on Pearson's correlation.

Conclusions:

A severe state of caries disease was revealed in 8-year-old children in the Chinese city of Qingdao, for whom urgent dental intervention and treatment were needed. Furthermore, underweight individuals were found with the most severe caries experience, indicating caries may affect the development and growth of the afflicted children. Thus, more emphasis should be placed on improving their dental health, with caries prevention being given the priority.

Prevalence of dyslipidemia according to the nutritional status in a representative sample of São Paulo

BACKGROUND

Overweight is one of the major public health problems in Brazil; it is associated with dyslipidemia, which is an important risk factor for cardiovascular diseases.

OBJECTIVE

To evaluate the lipid profile of residents of the municipality of São Paulo, state of São Paulo, according to the nutritional status.

METHODS

Data from the population-based cross-sectional study ISA-Capital 2008 on a sample of residents of São Paulo were used. Participants were categorized into groups according to body mass index and age range. The levels of total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, and non-HDL cholesterol were measured. The association between lipid profile, nutricional status, and waist circumference was investigated. The data were processed using the survey mode of the Stata 11.0 software.

RESULTS

The prevalence of any type of dyslipidemia in the population was 59.74%, with low HDL-cholesterol dyslipidemia being the most common type. Not overweight individuals had higher mean levels of HDL-cholesterol and lower levels of LDL-cholesterol, total cholesterol, triglycerides, and non-HDL cholesterol when compared with the overweight group. The rate of inadequacy of these variables was higher in the overweight individuals, regardless of the age group, to the exception of LDL-cholesterol in the adults and elderly. A higher prevalence of isolated hypertriglyceridemia was observed in individuals with higher waist circumference among the adults and the total population.

CONCLUSION

The results indicate an association between dyslipidemia and overweight in the population of the city of São Paulo. The most prevalent dyslipidemia in this population was low HDL-cholesterol.

Prenatal programming of obesity in a swine model of leptin resistance: modulatory effects of controlled postnatal nutrition and exercise

The main role of early nutritional programming in the current rise of obesity and associated diseases is well known. However, translational studies are mostly based in postnatal food excess and, thus, there is a paucity of information on the phenotype of individuals with prenatal deficiencies but adequate postnatal conditions. Thus, we assessed the effects of prenatal programming (comparing descendants from females fed with a diet fulfilling 100 or only 50% of their nutritional requirements for pregnancy) on gene expression, patterns of growth and fattening, metabolic status and puberty attainment of a swine model of obesity/leptin resistance with controlled postnatal nutrition and opportunity of exercise. Maternal restriction was related to changes in the relationships among gene expression of positive (insulin-like growth factors 1 and 2) and negative (myostatin) regulators of muscle growth, with negative correlations in gilts from restricted pregnancies and positive relationships in the control group. In spite of these differences, the patterns of growth and fattening and the metabolic features during juvenile growth were similar in control gilts and gilts from restricted pregnancies. Concomitantly, there was a lack of differences in the timing of puberty attainment. However, after reaching puberty and adulthood, females from restricted pregnancies were heavier and more corpulent than control gilts, though such increases in weight and size were not accompanied by increases in adiposity. In conclusion, in spite of changes in gene expression induced by developmental programming, the propensity for higher weight and adiposity of individuals exposed to prenatal malnutrition may be modulated by controlled food intake and opportunity of physical exercise during infant and juvenile development.

Epidemiology of general obesity, abdominal obesity and related risk factors in urban adults from 33 communities of Northeast China: the CHPSNE study

BACKGROUND

Obesity increases the risk of many diseases. However, there has been little literature about the epidemiology of obesity classified by body mass index (BMI) or waist (abdominal obesity) among urban Chinese adults. This study is to fill the gap by assessing the prevalence of obesity and associated risk factors among urban Chinese adults.

METHODS

A representative sample of 25,196 urban adults aged 18 to 74 years in Northeast China was selected and measurements of height, weight and waist circumference (WC) were taken from 2009-2010. Definitions of overweight and obesity by the World Health Organization (WHO) were used.

RESULTS

The overall prevalence rates of general obesity and overweight classified by BMI were 15.0% (15.7% for men and 14.3% for women, p<0.01) and 19.2% (20.8% for men and 17.7% for women, p<0.01), respectively, and the overall prevalence rate of abdominal obesity was 37.6% (31.1% for men and women 43.9% for women, p<0.01). Multivariable logistic regression showed that the elderly and those who had a history of parental obesity, alcohol drinking, or former cigarette smoking were at high risk of obesity classified by BMI or WC, whereas those with a higher level of education, higher family income, or a healthy and balanced diet were at low risk of obesity. Analysis stratified by gender showed that men with a higher level education level, a white-collar job, a cadre job, or higher family income were the high risk group, and women with a higher level of education or higher family income were the low risk group.

CONCLUSIONS

Obesity and overweight have become epidemic in urban populations in China; associations of risk factors with obesity differ between men and women.