Prevalence of overweight, obesity and thinness in 9-10 year old children in Mauritius

Adherence to '5-2-1-0' guidelines and multiple risky behaviours among adolescents in nine sub-Saharan African countries: evidence from Global School-based Student Health Survey 2012-2017

OBJECTIVE

Overweight and obesity constitute a new challenge in low-income and middle-countries. The obesity prevention programme, called '5-2-1-0', promotes healthy eating habits, physical activity and limited screen time among young people.This study aimed to assess adherence to the '5-2-1-0' recommendations and to study multiple risky behaviours among adolescents in nine countries in sub-Saharan Africa.

METHODS

Meta-analyses with a random effect were used to calculate overall prevalence. Non-random patterns of the co-occurrence of the four risky behaviours were explored using observed/expected prevalence ratios. Data came from the Global School-based Health Survey and 18 314 adolescents were considered.

RESULTS

Among the participants, 12.7% (95% CI 7.5% to 19.0%) had overweight and 3.2% (95% CI 1.1% to 6.1%) had obesity. In almost all countries studied, girls were more affected by overweight and obesity than boys.While only 0.2% (95% CI 0.1% to 0.4%) of the adolescents fully complied with the recommendations, 4.8% (95% CI 3.1% to 6.9%), 28.4% (95% CI 22.4% to 34.8%), 43.8% (95% CI 41.9% to 45.8%) and 17.0% (95% CI 11.8% to 23.0%), respectively, combined 1, 2, 3 and 4 risky behaviours among the four '5-2-1-0' criteria. The most observed combination was found for co-occurrence of three risky behaviours: insufficient fruit/vegetables consumption, physical activity and non-zero consumption of sugar-sweetened beverages.

CONCLUSION

In conclusion, the insufficient adherence to '5-2-1-0' recommendations and the high prevalence of the co-occurrence of risky behaviours underscore the need to strengthen health interventions and programmes to prevent obesity among adolescents in sub-Saharan Africa.

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.

Underweight, overweight, and tobacco use among adolescents aged 12-15 years: Evidence from 23 low-income and middle-income countries

INTRODUCTION

Compared with the number of studies in adults, body weight in relation to tobacco use has been understudied in the adolescent population. This study aimed to examine the association between underweight, overweight and tobacco use in low- and middle-income countries.

METHODS

Data were derived from the Global School-Based Student Health Survey (GSHS). Data from 71176 adolescents aged 12-15 years residing in 23 countries were analyzed. The Centers for Disease Control and Prevention (CDC) 2000 growth charts were used to identify underweight, normal weight, and overweight/ obesity. Weighted age- and gender-adjusted prevalence of weight categories and tobacco use was calculated. Multivariate logistic regression analysis was performed to estimate the association between weight categories and tobacco use for each country, controlling for covariates. Pooled odds ratios and confidence intervals were computed using random- or fixed-effects meta-analyses.

RESULTS

A significant association between weight categories and tobacco use was evident in only a few countries. Adolescents reporting tobacco use in French Polynesia, Suriname, and Indonesia, had 72% (95% CI: 0.15-0.56), 55% (95% CI: 0.24-0.84), and 24% (95% CI: 0.61-0.94) lower odds of being underweight, respectively. Adolescents reporting tobacco use in Uganda, Algeria, and Namibia, had 2.30 (95% CI: 1.04-5.09), 1.71 (95% CI: 1.25-2.34), and 1.45 (95% CI: 1.00-2.12) times greater odds of being overweight/obese, but those in Indonesia and Malaysia had 33% (95% CI: 0.50-0.91) and 16% (95% CI: 0.73-0.98) lower odds of being overweight/obese.

CONCLUSIONS

The association between tobacco use and BMI categories is likely to be different among adolescents versus adults. Associating tobacco use with being thin may be more myth than fact and should be emphasized in tobacco prevention programs targeting adolescents.

Prevalence, incidence, and trends of childhood overweight/obesity in Sub-Saharan Africa: a systematic scoping review

BACKGROUND

The growing burden of non-communicable diseases (NDC), particularly in low-and middle-income countries, poses a significant threat to global health. Obesity and overweight constitute major risk factors of NCDs such as heart diseases, diabetes, and kidney disease, and as a result, contribute significantly to the development of chronic morbidities, reduced quality of life, and increased risk of premature death. This study described evidence on the prevalence, incidence, and trends of childhood overweight and obesity in sub-Sahara Africa (SSA).

METHODS

We conducted a systematic scoping review employing the Arksey and O'Malley framework, Levac et al. recommendations, and the Joanna Briggs Institute guidelines. To obtain relevant published articles for this review, we performed a comprehensive keywords search in PubMed, Google Scholar, Web of Science, and CINAHL via EBSCOhost platform for studies published between 2009 and June 2019. Guided by the eligibility criteria, title and abstracts, as well as the full-text articles were independently screened in parallel by two investigators. All relevant data were independently extracted by two investigators using a piloted form designed in Microsoft and thematic analysis conducted.

RESULTS

Of the 81 included studies obtained from 250,148 potentially eligible articles, the majority (25) conducted in South Africa followed by 18 in Nigeria. Six studies were conducted in Ethiopia (6), Tanzania (5), Kenya (4), Cameroon (4), Ghana (3), Uganda (2), Mozambique (2), and Sudan (2). One study each was conducted in Botswana, Gambia, Lesotho, Mauritius, Seychelles, Togo, and Zimbabwe. The remaining three articles were multi-country studies. Most (81.5%) of the included studies were cross-sectional surveys and the majority (79) focused on both male and female participants. The majority (80/81) of the included studies reported on the prevalence of childhood overweight/obesity, 8 on the trends of childhood overweight/obesity, and one presented evidence on the incidence of childhood overweight and obesity in SSA.

CONCLUSION

This review demonstrates limited studies on childhood overweight/obesity in most SSA countries although the included studies suggest an increasing burden. Considering the consequences of childhood obesity, there is a need for more primary researches to inform policies decision and implementation to halt the rise of childhood obesity/overweight in SSA.

Risk factors and morbidities associated with childhood obesity in sub-Saharan Africa: a systematic scoping review

BACKGROUND

The rising burden of childhood obesity is a major public health concern, particularly in sub-Saharan Africa (SSA), where most health systems are weak and least prepared for complications that may arise. While the need for preventive action is increasingly recognized, policy implementation within the sub-region has often been inadequate, non-systematic, and ad hoc. This study described evidence on the risk factors and morbidities associated with childhood obesity in SSA.

METHODS

Guided by the Arksey and O'Malley framework incorporating the Levac et al. recommendations, and the Joanna Briggs Institute guidelines, we conducted a scoping study to address the research question. Thorough keywords systematic search was conducted for potentially eligible articles in PubMed, Google Scholar, Web of Science, and CINAHL published between 2009 and June 2019. Articles obtained were screened independently by two investigators at the abstract and full text phases using the eligibility criteria. All relevant data were extracted by two investigators in parallel and thematic analysis conducted.

RESULTS

A total of 337,229 articles were obtained from the database search of which 68 satisfied the inclusion criteria and were included for data extraction. These 68 included studies were conducted in 19 countries with the majority, 27.9% (19/68) from South Africa followed by Nigeria with 20.6% (14/68). Six of the included studies were conducted in Ethiopia, 5 studies in Kenya, 4 studies each in Tanzania and Cameroon, and 2 studies each in Ghana, Uganda, and Sudan. Of the 68 included studies, one each was conducted in Botswana, Gambia, Lesotho, Mauritius, Mozambique, Seychelles, Togo, and Zimbabwe. Most (80.9%) of the included studies were cross-sectional, and only one was an intervention trial. Of the 68 included studies, 53 reported on risk factors, 12 reported on morbidities, and 3 reported both risk factors and morbidities. We found no evidence in almost 60% (28/47) of countries included in the World Health Organisation Africa region.

CONCLUSION

This review findings suggest a paucity of literature on the risk factors of childhood obesity and morbidities in most SSA countries. Hence, there is the need to intensify research efforts, especially experimental study designs using innovative strategies to promote healthy lifestyle choices that will prevent or minimize the risks and health consequences of childhood obesity in SSA.

Overweight/obesity and associated cardiovascular risk factors in sub-Saharan African children and adolescents: a scoping review

INTRODUCTION

Recently, childhood and adolescence overweight/obesity has increased disproportionately in developing countries, with estimates predicting a parallel increase in future cardiovascular disease (CVD) burden identifiable in childhood and adolescence. Identifying cardiovascular risk factors (CVRF) associated with childhood and adolescence overweight/obesity is pivotal in tailoring preventive interventions for CVD. Whilst this has been examined extensively in high-income countries, there is scant consistent or representative data from sub-Saharan Africa (SSA).

OBJECTIVE

This scoping review synthesises contemporary studies on CVRF associated with overweight and obesity in SSA children and adolescents to provide evidence on the current burden of overweight/obesity and CVD in this population.

METHODS

We searched MEDLINE and Google Scholar up to July 31, 2019 for observational and experimental studies and systematic reviews addressing childhood and adolescence overweight/obesity and CVRF in SSA without language restriction. Four investigators working in four pairs, independently selected and extracted the relevant data. The methodological quality of all included studies was assessed.

RESULTS

We included 88 studies with a total of 86,637children and adolescents from 20 SSA countries. The risk of bias was low in 62 (70.5%), moderate 18 (20.5%), and high in eight (9%) studies. Overweight/obesity in SSA children and adolescents is rising at an alarming rate. Its main associations include physical inactivity, unhealthy diets, high socio-economic status, gender and high maternal body mass index. Identified CVRF in overweight/obese SSA children and adolescents are mainly metabolic syndrome, hypertension, dyslipidaemia, diabetes and glucose intolerance. There is a dearth of guidelines or consensus on the management of either childhood overweight/obesity or CVRF in overweight/obese SSA children and adolescents.

CONCLUSION

The current findings suggest an urgent need to review current health policies in SSA countries. Health education and transforming the current obesogenic environment of the SSA child and adolescent into one which promotes physical activity and healthy dietary habits is required.

Assessing health system challenges and opportunities for better noncommunicable disease outcomes: the case of Mauritius

BACKGROUND

The objectives of the study reported in this paper were: (a) to score the coverage of core NCD population-based interventions and individual services in Mauritius; (b) to analyse and score the presence of 15 common health system challenges that impede delivery of core NCD interventions and services in Mauritius; and (c) to provide policy recommendations for Mauritius to address health system barriers to delivery of NCD interventions and services.

METHODS

The Mauritius country assessment applied the guidelines developed by the World Health Organization Regional Office for Europe for systematically scoring coverage of NCD interventions and assessing health system challenges for improving NCD outcomes. The assessment used qualitative research design approach.

RESULTS

Of the 24 core population-based interventions for addressing key NCD risk factors, 16.7% were rated extensive, 37.5% moderate and 45.8% limited. Three (20%), 8 (53%) and 4 (27%) of the 15 individual/personal CVD, diabetes and cancer services were rated extensive, moderate and limited respectively. The top five health system challenges hampering scale-up of coverage of population-based NCD interventions in Mauritius were inadequate interagency cooperation; limited application of explicit priority setting approaches; inadequate change management; sub-optimal distribution and mix human resources; insufficient population empowerment; and insufficient political commitment. The top five challenges had average scores of between 3.1 (interagency cooperation) and 2.4 (distribution and mix of human resources). The top five health system challenges constraining expansion in coverage of individual NCD services were limited integration of evidence into practice; limited use of explicit priority-setting approaches; inadequate application of information and technology solutions; insufficient population empowerment; and sub-optimal distribution and mix of human resources. The top five challenges for individual interventions had mean scores varying between 2.6 (integration of evidence into practice) and 1.7 (distribution and mix of human resources).

CONCLUSIONS

Mauritius needs to increase its domestic general government investments into the national health system and requisite multi-sectoral action to address the priority health system challenges with a view of bridging the existing gaps in coverage of NCD population-based interventions and individual services.

Socio-Ecological Model of Correlates of Double Burden of Malnutrition in Developing Countries: A Narrative Review

(1) Background: The double burden of malnutrition (DBM) is a complex problem involving the coexistence of under- and over-nutrition within the same individual, household or population. This review aimed to discuss the correlates of the double burden of malnutrition through the socio-ecological model (SEM); (2) Methods: The PubMed database was systematically searched for peer-reviewed articles related to the double burden of malnutrition. Information on correlates of the double burden of malnutrition was extracted for analysis and discussion in alignment with the levels of the socio-ecological model.; (3) Results and Discussion: The correlates of the double burden of malnutrition identified from previous literature were: Race/genetics; maternal short stature; breastfeeding status; low maternal education; family size; household food security; household dietary diversity; and rural and urban settings. In the absence of evidence linking factors in a certain level of the SEM and the double burden of malnutrition, we employed correlates of overweight status and obesity to complete this narrative. Potential intervention strategies were proposed in alignment with the targets and settings identified, based on the socio-ecological approach; (4) Conclusions: The double burden of malnutrition is a public health phenomenon associated with a variety of socio-ecological determinants. An integrated approach is needed to address the root causes of malnutrition in all its forms, and at all life stages.

Prevalence of overweight and obesity among African primary school learners: a systematic review and meta-analysis

INTRODUCTION

The increasing trend in the global prevalence of childhood overweight and obesity presents a major public health challenge. This study reports the results of a systematic review and meta-analysis to estimate the prevalence of overweight and obesity among primary school learners residing in Africa according to the different body mass index criteria and population level characteristics.

METHODS

A search of multiple databases was conducted to identify relevant research articles published between January 1980 and February 2017. Random effects models were used to pool prevalence data within and across population level characteristics after variance stabilization through arcsine transformation (PROSPERO registration number CRD42016035248).

RESULTS

Data from 45 studies across 15 African countries, and comprising 92,379 and 89,468 participants for overweight and obesity estimates were included. Estimated overweight and obesity prevalence differed significantly across criteria: 10.5% [95% confidence interval, CI: 7.1-14.3] and 6.1% [3.4-9.7] by World Health Organization; 9.5% [6.5-13.0] and 4.0% [2.5-5.9] by International Obesity Task Force; and 11.5% [9.6-13.4] and 6.9% [5.0-9.0] by Centre for Diseases Control, respectively (p = 0.0027 for overweight; p < 0.0001 for obesity). Estimates were mostly higher in urban, and private schools, but generally similar by gender, major geographic regions, publication year and sample size. Substantial heterogeneity in the estimates across and within criteria were not always explained by major study characteristics.

CONCLUSION

Overweight and obesity are prevalent among African primary school learners, particularly those attending urban, and private schools. The results from this meta-analysis could be helpful in making informed decisions on childhood obesity prevention efforts in African countries.

Double burden of malnutrition among children under 5 in poor areas of China

OBJECTIVE

The aim of this study was to investigate the nutritional status and its risk factors among children under 5 years, with special focus on the coexistence of under and over nutrition in population level.

METHODS

We enrolled 6,570 children under 5 years among 26 counties in poor areas of China. Prevalences of malnutrition (stunting, underweight, wasting, overweight) were calculated. Overweight was evaluated using two indicators-weight for height Z score (WHZ) and body mass index for age Z score (BAZ), and results were compared.

RESULTS

The total prevalence of malnutrition was 19.2%. The prevalence of stunting and overweight were as high as 8.4% and 8.8%, respectively. The BAZ-estimated prevalence of overweight was 9.9%, which was higher than the WHZ-estimated prevalence (p<0.001). Children older than 12 months age, within a minority group, with a caregiver of illiteracy/primary education level were significantly associated with stunting in multilevel regression models (p<0.05). Children younger than 24 months age and boys were significantly associated with overweight (p<0.05).

CONCLUSIONS

Stunting and overweight were coexisted in surveyed areas. In conclusion, BAZ tended to overestimate the overweight prevalence compared with WHZ. While with the raising problem of childhood overweight, stunting should still be on the agenda for the poor areas in China. To improve children's nutritional status in poor areas of China, caregivers with children at high risk of malnutrition should be guided for healthy feeding practices.

Dietary intake and lifestyle behaviors of children in Mauritius

The purpose of the study was to explore the dietary intake, fruit, vegetable and energy intake and lifestyle behaviors among Mauritian children. A validated questionnaire was used, assessing dietary intake, mean energy intake, mean body mass index (BMI), lifestyle behaviors as well as nutritional knowledge (NK) among males and females. 336 children aged 6–12 years (165 males and 171 females) from 8 public primary schools were recruited. Statistical analyses revealed that children consumed less nutritious foods such as fruits, vegetables and whole grains and more of refined and calorie-laden foods, with no significant differences across genders. Mean energy intake of children was 1522 ± 282.4 kcal per day while mean BMI was 17.5 ± 4.03 kg/m². Majority of children had a low-to-moderate physical activity level (PAL), with males being more active than females on average (P = 0.021). 88.7% of children watched TV for more than an hour daily, with 84.8% of them reporting to be eating during the process. Females were more likely to be breakfast skippers (P = 0.003). Maximum frequency of snacking was twice daily (72.7%) while consumption of fast food was once or twice weekly (44.0%). Results indicate the need for intervention with aim of improving the dietary and life quality of children in Mauritius.

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 AND DETERMINANTS OF STUNTING AMONG PRIMARY SCHOOL CHILDREN IN RURAL AND URBAN COMMUNITIES IN OBAFEMI OWODE LOCAL GOVERNMENT AREA, SOUTHWESTERN NIGERIA

BACKGROUND

Studies on stunting in children have largely focused on the underfive, establishing it as a strong predictor of mortality in these children. Few studies have documented the prevalence or determinants of stunting among school children in southwestern Nigeria. The aim of the study was to determine the prevalence and predictors of stunting among selected primary school children in rural and urban communities of Obafemi Owode Local Government Area, Ogun State.

METHOD

A cross-sectional study of rural and urban primary school children was conducted. An interviewer-administered questionnaire was used to collect information on respondents' and parents' socio-demographic characteristics. Stunting was defined as height-for-age less than two standard deviations from the median height-for-age of the standard World Health Organization reference population. Using EPI-INFO version 6.03, children were classified as stunted if z-scores of height-for-age were less than 2 standard deviations below the National Centre for Health statistics (NCHS)/WHO median. Height and weight were taken using a stadiometer and weighing scale respectively. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) Version 16.0 while predictors were determined using logistic regression at 95% level of significance.

RESULTS

A total of 1,160 primary school children were studied with 52.2% from rural schools. Males constituted 57.1% and 51.8% in the rural and urban school respectively. Prevalence of stunting among rural school children was 46.2%, and was significantly higher (p≤0.001) than among urban children at 33.8%. Younger children <10 years (OR: 0.088; 95CI: 0.052 - 0.150) and children between 11-12 years (OR: 0.534; 95CI: 0.322 - 0.886) were at a significantly lower risk of stunting both in rural schools compared to children >13 years.

CONCLUSION

The prevalence of stunting was high especially among pupils from schools in the rural communities. This underscores the need for urgent feasible and effective nutrition programs for primary school children especially those in rural schools within the study area.

Changes of Overweight and Obesity Prevalence Among School Children in North West of Iran After 3 Years Follow-up (2009-2011): A Longitudinal Study

Background:

Obesity and overweight among children is a major public health problem in developed and developing countries and has important health and economic implications. This longitudinal study aimed to assessing the prevalence trend of overweight and obesity in West Azerbaijan in North West of Iran.

Methods:

This study was a longitudinal follow-up study and was conducted in school children at 2009–2011 year. The subjects were all school children (12 years of age) that were recruited from rural and urban schools in West Azerbaijan. Overall, 22,820 girls and 28,763 boys were enrolled in 2009 and were followed for 3 years. A body mass index (BMI) 85^th–95^th percentile was classified as overweight and a BMI >95^th percentile was classified as obese. All statistical analyses were performed using the Excel Software. Descriptive statistics were used to characterize the sample in different time periods. The prevalence was calculated as the ratio of number of present cases to a given population number in a given subgroup at a given time.

Results:

In urban schools, the prevalence of overweight among girls and boys was 118.26 and 103.9 per 1000 persons in 2009 year, respectively, and this trend was increased in both girls (152.90 per 1000 persons) and boys (125.72 per 1000 persons) in 2011. The obesity trend was increased among both girls and boys (22.26 and 26.52 among girls and boys in 2009 to 24.66 and 28.65 per 1000 persons in 2011), respectively. In rural schools, the prevalence of overweight among girls was increased from 84.5 in 2009 to 108.89 per 1000 persons in 2011, but this trend was decreased among boys (from 95.49 in 2009 to 43.9 per 1000 persons in 2011), and the prevalence of obesity among boys was increased at the end of follow-up, but this trend was decreased among girls.

Conclusions:

Overweight and obesity in children has increased. Further studies are necessary to evaluate the relationship between obesity and overweight and risk factors such as dietary pattern and physical inactivity.

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

Objective

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

Design

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

Setting

Seven districts of Shanghai, China.

Subjects

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

Results

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

Conclusions

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

Trend of Overweight and Obesity, Based on Population Study among School Children in North West of Iran: Implications for When to Intervene

INTRODUCTION

Childhood overweight and obesity is a major public health problem in both developed and developing countries. Overweight and obesity in children may have severe consequences later in a dolescence and adulthood. The aim of current study was to determine the prevalence trend of overweight and obesity in school-aged children from 2009 to 2011.

METHODS

The present study was a population-based study and conducted in three consecutive years, from 2009 to 2011. The study population included all of primary, secondary and high school children in rural and urban regions of West Azerbaijan province in West-North of Iran. Body mass index (BMI), the ratio of weight to height squared [weight (kg)]/ [height (m)]2, was calculated to the nearest decimal place. Overweight and obesity were classified using CDC recommendations for age and sex: a BMI 85th- 95th percentile was classified as overweight and a BMI >95th percentile was classified as obese. All statistical analyses were performed using the Excel Software. Descriptive statistics were used to characterize the sample in different time periods. The prevalence was calculated as the ratio of number present cases to a given population number in a given subgroup at a given time.

RESULTS

Overall, 165740, 145146 and 146203 school children were assessed at 2009, 2010 and 2011, respectively. Prevalence of overweight in primary school children among girls were 52.83, 86.93 and 116.36 and for boys were 57.07, 53.4 and 93.55 per 1000 person in 2009, 2010 and 2011 years, respectively. The prevalence of obesity in secondary school children for girls were 22.26, 27.75 and 28.43 and 26.52, 25.72 and 35.85 for boys per 1000 person in 2009, 2010 and 2011, respectively, The highest prevalence of overweight was 77.58, 142.4 and 126.46 per 1000 person among primary, secondary and high school children, respectively, in 2011. The lowest prevalence of obesity was 12.52, 24.1 and 21.61 per 1000 person among primary, secondary and high school children, respectively, in 2009.

CONCLUSIONS

However, the rapid increase in both obesity and overweight should have a special attention. Research on prevalence trend of overweight and obesity in children is poorly reported in Iran. So that, future studies need to follow-up on the associations between overweight and obesity with health outcomes when children develop and reach adolescence and adulthood.

Low body weight/thinness, overweight and obesity of children and adolescents from a Brazilian region of low economic status

OBJECTIVE

To assess the prevalence of low body weight/thinness, overweight and obesity in a representative sample of children and adolescents from a Brazilian region with low economic development.

METHODS

A total of 982 girls and 986 boys, aged seven to 17 years old and assisted by Segundo Tempo Program, from Montes Claros, Minas Gerais, Brazil, were included in the study. Low body weight/thinness, overweight and obesity were defined based on body mass cut-off indexes recommended by the International Obesity Task Force. The prevalence of the nutritional status according to sex and age was compared by chi-square test.

RESULTS

In girls, the frequency of low body weight/thinness, overweight and obesity was 4.1, 18.4 and 3.8%, respectively; in boys, these percentages were 6.3, 13.2 and 2.9%, respectively. The low body weight/thinness for girls raised from 2.7% (7-10 years old) to 5.5% (15-17 years old); the body weight excess (overweight and obesity) decreased from 30.1 to 16.2% for the same age groups. In boys, the corresponding trends were from 3.2 to 9.4% for low body weight/thinness, and from 23.4 to 9.2%, for body weight excess.

CONCLUSIONS

The data indicate that, even in a region with low economic status, the body weight excess was the main problem associated with nutritional health. The high overweight and obesity prevalence rates indicate the need of public policies for promoting healthy feeding behaviors and physical activity.

BMI and cardiovascular function in children and adolescents of Mauritius Island

Among countries which have undergone a rapid socio-economic and nutrition transition over the past few decades, the Indian Ocean island of Mauritius is among those with the greatest surge in the prevalence of type 2 diabetes and CVD. The aim of the present study was to characterise the BMI and cardiovascular functions of children and adolescents of this at-risk population. Data were collected through measurements of anthropometry, resting heart rate and blood pressure in a nationally representative sample (n 2489) of children (5–10 years) and adolescents (11–18 years), and analysed according to sex and ethnic identity: South Asian Hindus and Muslims (both of Indian ancestry), Creole (of varying degrees of African ancestry) and Chinese (of mainland China ancestry). Based on standards of the WHO or International Obesity Task Force, one in six of these young individuals exhibit a high BMI-for-age. Analysis by ethnicity revealed that Creole males and females show higher BMI-for-age but also lower heart rate (P < 0·001) even after adjustment for BMI. Additionally, Chinese males and females show higher systolic blood pressure (P < 0·01), independently of BMI. None of these ethnic differences could be related to household income, diet type (vegetarian v. non-vegetarian) or to fruit consumption. This study in children and adolescents of this multi-ethnic at-risk population for CVD reveal ethnic differences in BMI-for-age as well as consistent BMI-independent ethnic differences in heart rate and systolic blood pressure. These findings underscore the need to establish the BMI–fat % relationship across the various ethnic groups and for more detailed investigations about their differences in lifestyle and dietary habits that might explain their differential cardiovascular functions prior to adulthood.