Long-term changes in body weight, BMI, and adiposity rebound among children and adolescents in the Czech Republic

Studying factors influencing facial developmental instability

BACKGROUND

Developmental instability is a component of non-genetic variation that results from random variation in developmental processes. It is considered a sensitive indicator of the physiological state of individuals. It is reflected in various ways, but in this study we focussed on its reflection in fluctuating asymmetry (FA) and morphological integration.

AIM

To assess how, if at all, variations of facial morphology mirror developmental instability across childhood with respect to sex, growth rate and socioeconomic/environmental factors.

SUBJECTS AND METHODS

A set of 210 three-dimensional facial models (of children aged between 6.3 and 14.3 years) originating from the FIDENTIS 3D Face Database was subjected to landmark-based methods of geometric morphometrics to quantify the degree of facial asymmetry and facial morphological integration. In addition, the association with age, sex, and socioeconomic factors was assessed.

RESULTS

Our results showed a nonlinear increase of FA with age up to the age of 14 years. The pattern of sex-related variants in facial FA differed in relation to age, as girls exhibited higher values of FA than boys up to the age of 9 years. We found that a signal of modularity based on functional demands and organisation of the face is of particular importance. Here, girls exhibited higher morphological covariation among modules. During more rapid adolescence-related growth, however, covariation among modules at the asymmetrical level decreased in both sexes.

CONCLUSION

We can conclude that facial morphology was shown to be strongly integrated, particularly until adolescence. This covariation can facilitate an increase of FA. In addition, the results of this study indicate there is a weak association between socioeconomic stress and facial asymmetries. In contrast, sex and growth rate are reflected in developmental instability.

Adiposity rebound and cardiometabolic health in childhood: results from the Generation XXI birth cohort

BACKGROUND

We aimed to evaluate the association of adiposity rebound (AR) timing on cardiometabolic health in childhood.

METHODS

Participants were part of the Generation XXI birth cohort, enrolled in 2005/2006 in Porto. All measurements of the child's weight and height performed by health professionals as part of routine healthcare were collected. Individual body mass index (BMI) curves were fitted for 3372 children, using mixed-effects models with smooth spline functions for age and random effects. The AR was categorized into very early (<42 months), early (42-59 months), normal (60-83 months) and late (≥84 months). At age 10 years, cardiometabolic traits were assessed and age- and sex-specific z-scores were generated. Adjusted regression coefficients and 95% confidence intervals [β (95% CI)] were computed.

RESULTS

The mean age at AR was 61.9 months (standard deviations 15.7). Compared with children with normal AR, children with very early or early AR had higher z-scores for BMI [β = 0.40 (95% CI: 0.28; 0.53); β = 0.21 (95% CI: 0.12; 0.30)], waist circumference [β = 0.33 (95% CI: 0.23; 0.43); β = 0.18 (95% CI: 0.10; 0.25)], waist-height ratio [β = 0.34 (95% CI: 0.24; 0.44); β = 0.14 (95% CI: 0.07; 0.22)], fat mass index [β = 0.24 (95% CI: 0.15; 0.33); β = 0.14 (95% CI: 0.08; 0.21)], fat-free mass index [β = 0.25 (95% CI: 0.14; 0.35); β = 0.11 (95% CI: 0.03; 0.19)], systolic blood pressure [β = 0.10 (95% CI: 0.01; 0.20); β = 0.08 (95% CI: 0.01; 0.15)], insulin [β = 0.16 (95% CI: 0.04; 0.29); β = 0.10 (95% CI: 0.01; 0.19)], HOMA-IR [β = 0.17 (95% CI: 0.04; 0.29); β = 0.10 (95% CI: 0.03; 0.19)] and C-reactive protein [β = 0.14 (95% CI: 0.02; 0.26); β = 0.10 (95% CI: 0.01; 0.19)]. Children with very early AR also had worse levels of diastolic blood pressure [β = 0.09 (95% CI: 0.02; 0.16)], triglycerides [β = 0.21 (95% CI: 0.08; 0.34)] and high-density lipoprotein cholesterol [β=-0.18 (95% CI: -0.31; -0.04)]. When analysed continuously, each additional month of age at the AR was associated with healthier cardiometabolic traits.

CONCLUSION

The earlier the AR, the worse the cardiometabolic health in late childhood, which was consistently shown across a wide range of outcomes and in the categorical and continuous approach.

Body mass index trajectories and adiposity rebound during the first 6 years in Korean children: Based on the National Health Information Database, 2008-2015

PURPOSE

We analyzed the nationwide longitudinal data to explore body mass index (BMI) growth trajectories and the time of adiposity rebound (AR).

METHODS

Personal data of 84,005 subjects born between 2008 and 2012 were obtained from infant health check-ups which were performed at 5, 11, 21, 33, 45, 57, and 69 months. BMI trajectories of each subject were made according to sex and the timing of AR, which was defined as the lowest BMI occurred. Subjects were divided according to birth weight and AR timing as follows: very low birth weight (VLBW), 0.5 kg ≤ Bwt ≤ 1.5 kg; low birth weight (LBW), 1.5 kg < Bwt ≤ 2.5 kg; non-LBW, 2.5 kg < Bwt ≤ 5.0 kg; very early AR, before 45 months; early AR, at 57 months; and moderate-to-late AR, not until 69 months.

MAIN RESULTS

Median time point of minimum BMI was 45 months, and the prevalence rates of very early, early, and moderate-to-late AR were 63.0%, 16.6%, and 20.4%, respectively. BMI at the age of 57 months showed a strong correlation with AR timing after controlling for birth weight (P < 0.001). Sugar-sweetened beverage intake at 21 months (P = 0.02) and no-exercise habit at 57 months (P < 0.001) showed correlations with early AR. When VLBW and LBW subjects were analyzed, BMI at 57 months and breastfeeding at 11 months were correlated with rapid weight gain during the first 5 months (both P < 0.001).

CONCLUSIONS

Based on this first longitudinal study, the majority of children showed AR before 57 months and the degree of obesity at the age of 57 months had a close correlation with early AR or rapid weight gain during infancy.

Differentiating effects of socio-economic factors on relative weight and nutritional status in Polish schoolchildren across intergenerational changes

OBJECTIVE

The aim of this study was an assessment of the effects of urbanisation level, family size and parental education on body mass index (BMI) and mid-upper arm circumference (MUAC) among Polish schoolchildren in cross-sectional surveys conducted between 1966 and 2012.

DESIGN

The analysis involved schoolchildren measured in four Polish Anthropological Surveys (1966, 1978, 1988 and 2012). Socio-economic factors involved: urbanisation level (city, town and village), family size (one child, two children, three children, four or more children), and father's and mother's education (lower and higher education).

SETTING

Regions in Poland - cities: Warsaw, Lodz and Wroclaw; towns: Bystrzyca Klodzka, Pinczow, Siemiatycze, Wolsztyn and their rural surroundings.

PARTICIPANTS

A total sample consisted of 63 757 children (31 774 boys and 31 983 girls) aged 7-18 years.

RESULTS

Between 1966 and 1988, both BMI and MUAC had significantly higher values in children from cities, in families with one child and with higher parental education (P < 0·05). However, MUAC revealed significant differences between particular socio-economic groups more frequently than BMI. In 2012, urbanisation level and parental education ceased to show a differentiating effect on both indicators, while family size remained a significant social factor for both measures (BMI: P < 0·05; MUAC: P < 0·01).

CONCLUSIONS

Since MUAC reflected socio-economic differences more frequently than BMI, it could be a more sensitive and reliable anthropometric measure revealing the effects of socio-economic factors on children's nutritional status.

Body structure, muscular strength and living conditions of primary school children in Warsaw

The aim of this study was to determine whether the living conditions of school children affects their body structure and muscular strength. Data were taken from 400 girls and 341 boys aged 7-15 years attending nine primary schools in Warsaw in 1997. A questionnaire was completed, anthropological measurements made and two muscular strength tests conducted. The questionnaire asked questions on the children's level of education, their parents' professions and monthly incomes, the number of persons in the family and the number of rooms in the family's apartment/home. Body height, body weight, chest and arm circumferences, grip strength and vertical jump height were measured and used to calculate body mass index, Marty's Index and the Sargent Vertical Jump Index. Statistical tests included Student's t-test, Principal Component Analysis (PCA) and multiple regression analysis. Body height, chest circumference, Sargent Vertical Jump Index and grip strength were significantly greater in the boys than the girls. Two factors, namely 'socioeconomic status' (F1) and 'family size' (F2), describing living conditions, were isolated after PCA. Boys from bigger families (F2) were shorter, with lower weights and BMIs, smaller chest and arm circumferences and greater grip strengths than those from smaller families, whereas girls from families of lower socioeconomic status (F1) weighed less and had greater BMIs and arm circumferences than those from higher socioeconomic status families. The results suggest that boys seem to be more 'ecosensitive' than girls.

Mid-upper arm circumference and body mass index as different screening tools of nutritional and weight status in Polish schoolchildren across socio-political changes

Intergenerational changes in many biological traits are indicators of environmental conditions. One of such anthropometric measures is the mid-upper arm circumference (MUAC) which estimates nutritional status. Likewise, Body Mass Index (BMI) is widely used as an anthropometric indicator of relative weight. The aim of this study was to reveal secular trends in MUAC and BMI, as biological indicators of changing living conditions, between 1966 and 2012 among Polish children from different socioeconomic groups. Total sample involved 64 393 schoolchildren aged 7–18 years, investigated in 4 Surveys (1966, 1978, 1988, 2012). Overall socioeconomic status (SES) was divided into two categories: lower and higher (including: urbanization, family size, parental education). Results showed that MUAC and BMI differed significantly with respect to the year of survey, sex and SES category. Both measures were higher within higher SES group compared to the lower one until 1988, while in 2012 convergence of these indicators in both SES categories was observed. Both the year of survey, sex, SES category and interactions between them had higher impact on MUAC than BMI (measured by effect size). Our findings revealed that long-term socioeconomic changes affect MUAC more noticeably than BMI. Therefore MUAC may be a more accurate screening tool.

Simulation of facial growth based on longitudinal data: Age progression and age regression between 7 and 17 years of age using 3D surface data

Modelling of the development of facial morphology during childhood and adolescence is highly useful in forensic and biomedical practice. However, most studies in this area fail to capture the essence of the face as a three-dimensional structure. The main aims of our present study were (1) to construct ageing trajectories for the female and male face between 7 and 17 years of age and (2) to propose a three-dimensional age progression (age -regression) system focused on real growth-related facial changes. Our approach was based on an assessment of a total of 522 three-dimensional (3D) facial scans of Czech children (39 boys, 48 girls) that were longitudinally studied between the ages of 7 to 12 and 12 to 17 years. Facial surface scans were obtained using a Vectra-3D scanner and evaluated using geometric morphometric methods (CPD-DCA, PCA, Hotelling’s T² tests). We observed very similar growth rates between 7 and 10 years in both sexes, followed by an increase in growth velocity in both sexes, with maxima between 11 and 12 years in girls and 11 to 13 years in boys, which are connected with the different timing of the onset of puberty. Based on these partly different ageing trajectories for girls and boys, we simulated the effects of age progression (age regression) on facial scans. In girls, the mean error was 1.81 mm at 12 years and 1.7 mm at 17 years. In boys, the prediction system was slightly less successful: 2.0 mm at 12 years and 1.94 mm at 17 years. The areas with the greatest deviations between predicted and real facial morphology were not important for facial recognition. Changes of body mass index percentiles in children throughout the observation period had no significant influence on the accuracy of the age progression models for both sexes.

Comparison of Slovak reference values for anthropometric parameters in children and adolescents with international growth standards: implications for the assessment of overweight and obesity

Aim

To compare the national reference percentile values for body height, weight, and body mass index (BMI) of children and adolescents in Slovakia with international standards and to analyze growth trends in this population.

Methods

The study was designed as a repeated cross-sectional survey. Two nationwide anthropometric surveys (NAS) performed in 2001 and 2011 assessed body weight, height, and BMI of 38 692 children aged 7 to 18 years. Age- and sex-specifıc smoothed percentiles were generated with the lambda-mu-sigma method. Slovak standards were compared with World Health Organization (WHO) 2007 z-scores and International Obesity Task Force (IOTF) standards.

Results

Medians of body height corresponded to the 75th-85th percentile of the WHO 2007 standards. The secular trend of height increase was attenuated, and the final body height did not change between NAS 2001 and NAS 2011. The cut-off BMI values for obesity, set at the 97th percentile for age <14 years, were higher across age ranges than WHO 2007 standards but lower than IOTF standards. Obesity prevalence, relatively low in 2001 (<3%), doubled during the following decade (P < 0.001), with the highest values (4.8%-7.6%) observed in children aged up to 13 years.

Conclusion

NAS 2001 data were chosen as national growth standards, as these data were not influenced by the obesity rates increase in the period between the surveys. BMI cut-offs were lower than those in most European countries. Obesity proportions in prepubertal and pubertal boys might be overestimated when WHO 2007 cut-offs are used.

The adiposity rebound in the 21st century children: meaning for what?

With the increase in the prevalence of overweight and obesity worldwide, early adiposity rebound, which is known to have a strong association with obesity, has recently been a focus of research. Early adiposity rebound is conventionally known to have a close relationship with non-communicable diseases. However, novel insights into early adiposity rebound have implied an acceleration of growth and puberty, which is directly reflected in the trends in the timing of adiposity rebound, in the 21st century compared with in the past. Furthermore, the observation that lean mass changes rather than fat mass changes show a more similar pattern to body mass index trajectories is interesting. In this article, the later outcomes and risk factors of early adiposity rebound are briefly summarized, and the current trends in the timing of adiposity rebound and novel insights into its relationship with body composition are reviewed.

The validity of parental-reported body height and weight: a comparison with objective measurements of 7-8-year-old Czech children

The values of body weight and height can be recorded in various ways. Self-reports and parentalreport methods are amongst the most typical ways to collect data. These methods have advantages, but also limits. Anthropometric measures are recommended to improve measurement precision. The aim of this study was to investigate whether the parental-reported body weight and height of 7-8-year-old Czech children corresponded with the measured body weight and height. Data concerning children’s body weight and body height were collected via parental informed consent and anthropometric measurements. The research sample consisted of 388 children from 7 to 8 years-old (boys, n = 176; girls, n = 162). Only children with parental informed consent were included. Correlations between parental-reported and measured data were analysed with the Pearson correlation coefficient to examine the strength of linear dependence between the two methods. The differences between parental-reported and measured data were tested using the Wilcoxon signed-rank test. P-values below α = 0.05 were considered statistically significant. Parents manifested a tendency to underestimate body weight and especially the body height of their children. This trend was seen in boys and girls in both age groups. Out of the 338 children with parent-reported height, parents under-reported their child’s height by 1 cm or more in 37.1% of the children, 39.6% of the parents reported a height within 0.99 cm of the measured height, and 23.3% of parents over-reported their child’s height by 1 cm or more. The same number of children had parentreported weights, parents under-reported their child’s weight by 1 kg and more in 25.2% of the children, 57.7% of the parents reported a weight within 0.99 kg of the measured weight, and 17.1% of the parents over-reported their child’s weight by 1 kg or more. The Pearson correlation coefficient between the measured and parental-reported height and weight revealed a statistically significant strong positive linear relationship in both genders (rheight = 0.912, rweight = 0.943; all p< 0.001). The differences between the measured and parental-reported height and weight were not significantly different (all p< 0.05). The high agreement and correlation between measured and parental-reported body height and weight suggest that parental-report methods can be an appropriate alternative to objective measurement and can be used as a valid tool to classify body height and weight for large population studies of Czech children in school-based research when anthropometric measures are not available.

Sleeping habits of adolescents in relation to their physical activity and exercise output: results from the ELSPAC study

BACKGROUND

Little is known about the effects of physical activity and fitness on sleep timing parameters in adolescence.

METHODS

We investigated the development of sleep timing between age 8 and 15 and its association with physical fitness at age 15 in 787 adolescents (408 males, 379 females). Physical fitness was measured using the physical work capacity (PWC) protocol. Information on sport activity was collected at ages 11 and 15. Finally, the contribution of other covariates (sex, body mass index (BMI), parental education and occupational skill level) to the association between sleep parameters and physical fitness was evaluated. The correlation of BMI and physical fitness was assessed separately.

RESULTS

Mild correlation of sleep duration at ages 8 and 15 was observed (r=0.08-0.16). Higher sport activity participation and physical fitness were found to be mildly associated with delayed bedtime and reduced sleep duration; the association with bedtime was significant after adjustment for all covariates. Sport activity at age 11 was not associated with sleep timing at age 15. Interestingly, higher BMI was linked to delayed bedtime and higher physical fitness.

CONCLUSION

Our findings do not support existing hypotheses suggesting the association of low physical activity and fitness with shorter sleep duration and high BMI in a generally non-obese adolescent population without severe sleep restriction.

Comparing BMI with skinfolds to estimate age at adiposity rebound and its associations with cardio-metabolic risk markers in adolescence

Background

Body mass index (BMI) reaches a nadir in mid-childhood, known as the adiposity rebound (AR). Earlier AR is associated with a higher risk of cardio-vascular diseases in later life. Skinfolds, which are a more direct measure of adiposity, may give better insight into the relationship between childhood adiposity and later obesity and cardio-metabolic risk.

Objective

We aimed to assess whether AR corresponds to a rebound in skinfolds, and compare associations of BMI-derived AR and skinfold-derived AR with cardio-metabolic risk markers in adolescence.

Methods

We used penalised splines with random coefficients to estimate BMI and skinfold trajectories of 604 children from the Mysore Parthenon Birth Cohort. Age at AR was identified using differentiation of the BMI and skinfold growth curves between 2 and 10 years of age. At 13.5 years, we measured blood pressure, and glucose, insulin and lipid concentrations.

Results

BMI and skinfolds had different growth patterns. Boys reached BMI-derived AR earlier than skinfold-derived AR (estimated difference: 0.41 years; 95% CI:[0.23, 0.56]), whereas the opposite was observed in girls (estimated difference: −0.71 years; 95% CI:[−0.90, −0.54]). At 13.5 years, children with earlier BMI-derived AR had higher BMI (−0.58 SD per SD increase of AR; 95%CI:[−0.65, −0.52]), fat mass (−0.44; 95%CI:[−0.50, −0.37]), insulin resistance (HOMA-IR: −0.20; 95%CI:[−0.28, −0.12]) and systolic blood pressure (−0.20; 95%CI:[−0.28, −0.11]), and lower HDL-cholesterol (0.12; 95%CI:[0.04, 0.21]). The associations were independent of BMI at time of rebound, but were fully explained by fat mass at 13.5 years. Similar associations were found for skinfold-derived AR.

Conclusion

BMI-derived adiposity rebound predicts later cardio-metabolic risk markers similarly to that derived from skinfolds, a direct measure of adiposity.

Prevalence of overweight/obesity among 7-year-old children-WHO Childhood Obesity Surveillance Initiative in Slovakia, trends and differences between selected European countries

The objectives of this study were (1) to assess the prevalence and time trends of overweight/obesity in Slovak children by applying WHO, IOTF, and the national criteria; (2) to compare the prevalence between selected European countries; and (3) to evaluate the central obesity by the waist-to-height ratio. The survey was performed within the WHO European Childhood Obesity Surveillance Initiative. The weight, height, waist, and hip were measured in 2795 children at the age of 7-7.99 years (50.1% boys; 55.5% in rural areas). The prevalence of overweight/obesity was determined using the LMS Growth. In boys, the prevalence of overweight/obesity was 17.1/14.9% according to WHO, 13.8/8.8% according to IOTF, and 9.9/8.8% according to the national criteria. Among girls, the prevalence reached 15.1/11.1%, 12.6/8.1%, and 7.5/9.5%, respectively. These rates corresponded to the average of the European countries. Central obesity was identified in 76.9% of overweight/obese, but also in 5.9% normal-weight subjects.

CONCLUSION

While overweight has increased by 3% the prevalence of obesity has doubled since 2001. The rise culminated approximately 6 years ago and has not increased since then. The body constitution differences should be considered when comparing the prevalence of overweight/obesity between populations and/or individuals. What is Known: • Knowledge of the prevalence of overweight/obesity is seminal for effective implementation of programs focusing on the reduction of incidence and prevalence of obesity in early childhood. What is New: • The most numerous and representative study on the prevalence of overweight/obesity in 7-year-old children involving 2795 (5%) of peers living in Slovakia. • The prevalence of obesity in Slovakia falls within the range of average rate of the European countries. Central obesity was identified in almost 20% subjects.

The Healthy Fitness Zone Continuum Score as a Measure of Change in Body Mass Index of School-Aged Children and Adolescents, Georgia, 2012-2014

OBJECTIVES

The FitnessGram Healthy Fitness Zone continuum (HFZc) score reflects the relative difference of a person's body mass index (BMI) from the established FitnessGram standard. As such, it may provide added utility for public health programming and research on obesity among school-aged children and adolescents. We used the standard BMI Z (BMIz) score and the alternative HFZc score to describe changes in BMI of school-aged children and adolescents in Georgia over time.

METHODS

We compiled 2012-2014 BMI data from the Georgia FitnessGram database. The sample included 162 992 boys and 141 711 girls enrolled in 239 schools from a large urban district in Georgia. We analyzed trends in BMIz and HFZc scores separately for normal-weight, overweight, and obese categories for school-aged children and adolescents using hierarchical linear models.

RESULTS

From 2012 to 2014, the BMIz score shifted favorably in up to 40.7% (2052/5047) of normal-weight, 51.0% (758/1485) of overweight, and 52.8% (5430/10 279) of obese students. We also found favorable shifts in HFZc score in up to 69.8% (105 831/151 739) of normal-weight, 78.3% (3605/4603) of overweight, and 80.8% (8305/10 279) of obese students.

CONCLUSIONS

Compared with the BMIz score, the HFZc score may be a better indicator of favorable changes in BMI over time among school-aged children and adolescents with different baseline BMI levels, making it potentially valuable for use in individualized assessments, school programs, obesity research, and public health curriculum and policy development.

Determinants of Adiposity Rebound Timing in Children

OBJECTIVE

Adiposity rebound (AR) or BMI (body mass index) rebound refers to the increase in BMI following the minimum BMI in early childhood. Early AR (before age 5) is predictive of adult obesity. To determine how 4 domains - demographics, maternal BMI, food security, and behavioral characteristics - may affect timing of AR.

STUDY DESIGN

A total of 248 children, ages 2.5-3.5 years, in Latino farmworker families in North Carolina were examined at baseline and every 3 months for 2 years. BMI was plotted serially for each child and the onset of BMI rebound was determined by visual inspection of the graphs. Given the ages of the children, all rebounds were detected before age 5 years and were deemed "early," whereas other children were classified as "nonrebounders." Classes were then compared in terms of the 4 domains with the use of bivariate analyses and linear mixed models.

RESULTS

A total of 131 children demonstrated early rebound, 59 children were nonrebounders, and a further 35 had inconclusive data. Parents of early rebounders were less likely to have documentation permitting legal residence in the US. Mothers of early rebounders were on average 3 BMI units heavier. Sex, household food security, diet quality, caloric intake, and daily activity did not differ between classes. In multivariable analysis, female sex, limited maternal education, increased maternal BMI, and increased caloric intake were significant predictors of early rebound.

CONCLUSION

High maternal BMI was the strongest predictor of early BMI rebound, but increased caloric intake also was significant. Limiting excess calories could delay premature AR and lower the risk of future obesity.

Overweight and Obesity in Children under 5 Years: Surveillance Opportunities and Challenges for the WHO European Region

Background

Many children who have overweight or obesity before puberty can develop obesity in early adulthood, which is associated with increased morbidity and mortality. The preschool years (ages 0–5) represents a point of opportunity for children to be active, develop healthy eating habits, and maintain healthy growth. Surveillance of childhood overweight and obesity in this age group can help inform future policies and interventions.

Objective

To review and report available prevalence data in WHO European Region Member States and determine how many countries can accurately report on rates of overweight and obesity in children under 5 years.

Methods

We conducted a rapid review of studies reporting on overweight and obesity prevalence in children ages 0–5 in the WHO European region member states from 1998 to 2015.

Results

Currently, 35 of the 53 member states have data providing prevalence rates for overweight and obesity for children under 5 years. There was little consistency in study methods, impacting comparability across countries. The prevalence of overweight and obesity in children under 5 years ranges from 1 to 28.6% across member states.

Conclusion

Although measuring overweight and obesity in this age group may be challenging, there is an opportunity to leverage existing surveillance resources in the WHO European Region.

School restrictions on outdoor activities and weight status in adolescent children after Japan's 2011 Fukushima Nuclear Power Plant disaster: a mid-term to long-term retrospective analysis

OBJECTIVE

Radiation fears following Japan's 2011 Fukushima nuclear disaster affected levels of physical activity in local children. We assessed the postdisaster versus predisaster weight status in school children and evaluated to what extent school restrictions on outdoor activities that were intended to reduce radiation exposure risk affected child weight.

PARTICIPANTS

We considered children aged 13-15 years from 4 of the 5 secondary schools in Soma City (n=1030, 99.1% of all children in the city), located in 35-50 km from the Fukushima nuclear plant, postdisaster (2012 and 2015) and predisaster (2010).

METHODS

Weight status, in terms of body mass index (BMI), percentage of overweight (POW) and incidence of obesity and underweight (defined as a POW ≥20% and ≤-20%, respectively) were examined and compared predisaster and postdisaster using regression models. We also constructed models to assess the impact of school restrictions on outdoor activity on weight status.

RESULTS

After adjustment for covariates, a slight decrease in mean BMI and POW was detected in females in 2012 (-0.37, 95% CI -0.68 to -0.06; and -1.97, 95% CI -3.57 to -0.36, respectively). For male children, obesity incidence increased in 2012 (OR for obesity: 1.45, 95% CI 1.02 to 2.08). Compared with predisaster weight status, no significant weight change was identified in 2015 in either males or females. School restrictions on outdoor activities were not significantly associated with weight status.

CONCLUSIONS

4 years following the disaster, weight status has recovered to the predisaster levels for males and females; however, a slight decrease in weight in females and a slight increase in risk of obesity were observed in males 1 year following the disaster. Our findings could be used to guide actions taken during the early phase of a radiological disaster to manage the postdisaster health risks in adolescent children.

Impact of the Fukushima nuclear accident on obesity of children in Japan (2008-2014)

This study used prefecture-level panel data from Japan for the period 2008-2014 to investigate the influence of the 2011 Fukushima nuclear accident on the body mass index (BMI) z-score and obesity rates of children over time. I adopted a difference-in-differences approach and found the following: (1) for the cohort aged 5-7 years in 2010, the BMI z-score and obesity rates in disaster-affected areas were higher than in other areas, although this was not observed for the other cohorts; (2) for the cohort aged 5-7 years in 2010, the influence of the accident persisted even after 3 years; and (3) the differences in the BMI z-score and obesity rate before and after the accident were greater for Fukushima Prefecture than for the other affected areas (Iwate and Miyagi prefectures). I infer that health-conscious parents, whose children had lower BMIs, may have moved from Fukushima, thereby increasing the BMI z-score of the child population living in Fukushima by around 0.05 for the cohort aged 5-7 years. The enforced reduction in physical activity increased the BMI z-score of children living in Fukushima by around 0.19 for that cohort.

Dramatic decrease in muscular fitness in the Czech schoolchildren over the Last 20 years

AIM

Obesity and physical inactivity had already reached epidemic, becoming one of the leading causes of death and disability worldwide. The objective of this study was to investigate the current level and a nearly three decades' trend of muscular fitness (MF) and the nutritional state of Czech children.

METHODS

In 2013, cross-sectional epidemiological survey was conducted in schoolchildren with examination of the anthropometric characteristics and measured MF using a UNIFIT test, which normative for MF categories was given as results of national monitoring data collected in 1987. In total 896 current schoolchildren (472 aged 8-9 years and 424 aged 12-13 years) were examined from selected children through stratified sampling from the Czech Republic.

RESULTS

Against 31% of children from 1986 there were 74% of current children classified as "poor" or "below normal" in the MF category (p<0.001). MF was inversely associated with BMI. Poor posture was diagnosed in 24% of children, more frequently in overweight (OW) and obese (OB) children in comparison to normal body weight children (p<0.001). In comparison to 10% of OW and OB children in 1991, using these cut-off points for body mass index references, the current prevalence of OW and OB doubled (19.8%).

CONCLUSIONS

Current Czech schoolchildren showed a doubled prevalence of OW and OB during the last two decades and simultaneously during nearly three decades there were more than doubled prevalence of "poor" or "under normal" MF of children, with overall dramatic decrease of MF in current schoolchildren.

Overweight trends among Polish schoolchildren before and after the transition from communism to capitalism

This study aims to reveal the secular trends in body mass index (BMI) and the prevalence of overweight and obesity among Polish schoolchildren between the years 1966-2012, during which intense socio-political changes took place. Four surveys were conducted in several districts of Poland looking at 69,746 schoolchildren aged 7-18. Significant increase in mean BMI as well as in the prevalence of overweight and obesity was observed. During this time the highest increase in both mean BMI and excess weight was observed between 1988 and 2012, i.e. after the political transformation, resulting in the improvement of living conditions. However, with respect to girls in late adolescence, between these years, the mean BMI as well as the prevalence of overweight were leveling off, while the percentage of boys with excess body fat in the same developmental category significantly increased in 2012. In the years 1966-1978 and 1978-1988 the pattern of changes in the prevalence of overweight and obesity reflected the social and economic circumstances, i.e. temporary economic improvements, or deepening political crises and food shortage. In conclusion, the weight status of schoolchildren strongly reflects socio-political changes that took place in Poland, as well as in most of the Central European countries in the last half century.

Secular Changes of Adiposity and Motor Development in Czech Preschool Children: Lifestyle Changes in Fifty-Five Year Retrospective Study

Secular trends of adiposity and motor development in preschool children since the fifties of the last century up to the beginning of this millennium were analyzed so as to reveal possible changes due to continuously differentiating lifestyle. In preschool children (n = 3678) height, weight, skinfold thickness over triceps, subscapular, and suprailiac were measured by Harpenden caliper in 1957, 1977, 1980, 1985, 1990, and 2012. Simultaneously, motor performance was tested by evaluating the achievements in broad jump and throwing a ball, as a marker of adaptation to changing level of physical activity, free games, and exercise. Along the period of five decades the values of skinfold thickness increased significantly until 2012, mainly on the trunk. Simultaneously, the level of motor performance significantly decreased. Modifications of the way of life during the mentioned five decades characterized by sedentarism and inadequate food intake as related to energy output influenced negatively both adiposity and motor performance already in preschool children. Mostly increased deposition of fat on the trunk which is considered as a marker of possible development of metabolic syndrome was apparent already in preschool age, indicating the importance of early intervention concerning also physical activity and availability for exercise since early life.

The decline in BMI among Japanese women after World War II

The body mass index (BMI) of the Japanese is significantly lower than is found in other high-income countries. Moreover, the average BMI of Japanese women is lower than that of Japanese men, and the age-specific BMI of Japanese women has decreased over time. The average BMI of Japanese women at age 25 decreased from 21.8 in 1948 to 20.4 in 2010 whereas that of men increased from 21.4 to 22.3 over the same period. We examine the long-term BMI trend in Japan by combining several historical data sources spanning eleven decades, from 1901 to 2012, to determine not only when but also how the BMI decline among women began: whether its inception was period-specific or cohort-specific. Our nonparametric regression analysis generated five findings. First, the BMI of Japanese women peaked with the 1930s birth cohort. This means that the trend is cohort-specific. Second, the BMI of men outpaced that of women in the next cohort. Third, the BMI of Japanese children, boys and girls alike, increased steadily throughout the 20th century. Fourth, the gender difference in the BMI trend is due to a gender difference in the weight trend, not the height trend. Fifth, these BMI trends are observed in urban and rural populations alike. We conclude that the BMI decline among Japanese women began with those who were in their late teens shortly after World War II.

Time trends in BMI, body fatness, and adiposity rebound among boys from Kraków (Poland) from 1983 to 2010

OBJECTIVES

The prevalence of childhood obesity has been increasing during the last decades in many countries, but less is known about secular trends in growth curves covering the whole childhood span. The main purpose of this study was to explore changes in body weight, height, BMI, percent body fat (%BF), adiposity rebound (AR), and pubertal timing in boys from Kraków between 1983 and 2010.

METHODS

Totally, 4,986 boys (3-18 years) were measured during cross-sectional studies. Using the results of height, weight, and skinfold measurements, BMI and %BF were calculated. The LMS method was used to construct BMI and %BF percentiles. Three cut-off points were distinguished in individual age groups of the subjects-below the 15th percentile, 50th percentile, and above the 85th percentile. The mean age at pubarche was calculated by the probit method.

RESULTS

The boys from 2010 were taller and heavier than the boys from 1983. Before the time of AR, boys from 2010 had lower BMI, but after AR had higher BMI than boys from 1983. An earlier AR appeared in all BMI 2010 percentile curves as compared to 1983. The boys from 2010 also showed an acceleration of sexual maturation and earlier Tanner Stage II, equaling 11.80 years.

CONCLUSIONS

In boys from 2010, AR occurs earlier than in boys from 1983. Changes in timing of AR cannot be explained only by changes in degree of body adiposity. Early AR could be a marker of the acceleration of development.

Overweight and obesity in 4-5-year-old children in New Zealand: results from the first 4 years (2009-2012) of the B4School Check programme

AIM

We describe the prevalence of overweight and obesity in four-year-old children in New Zealand, variations with ethnicity and socio-economic status, and changes over the study duration using body mass index (BMI) measurements collected as part of the B4School Check programme.

METHODS

Demographic and BMI data were extracted for all children measured between 2009 and 2012. Overweight and obesity rates were estimated using International Obesity Task Force (IOTF) 2012 standards and the 85th (overweight) and 95th (obese) percentiles for BMI-for-age of the World Health Organization (WHO) 2006, Centers for Disease Control and Prevention 2000 and UK 1990 reference standards.

RESULTS

A total of 168,744 BMI measurements were included in the analysis with a coverage rate of 66.5%. Mean BMI was 16.30 kg/m(2) in girls and 16.44 kg/m(2) in boys. Mean BMI z-score (WHO 2006 standards) was 0.601 in girls and 0.785 in boys. Using WHO 2006 standards, 16.9% of girls and 19.6% of boys were overweight and 13.8% of girls and 18.7% of boys were obese. Using IOTF standards, 18.3% of girls and 16.2% of boys were overweight and 5.7% of girls and 4.7% of boys were found obese. Prevalence of overweight and obesity was higher in Pacific and Maori children and those living in more socio-economically deprived areas than other children. No definite time-trends were observed over the study duration.

CONCLUSIONS

The study reaffirms the high prevalence of overweight and obesity in pre-school children in New Zealand, and demonstrates the variations in prevalence when using different reference standards.

Prevalence and risk factors of abdominal obesity in Polish rural children

Secular trends of body mass index (BMI) and waist circumference indicate greater increase in abdominal obesity compared to general obesity. Determinants of obesity described by BMI are relatively well documented in various populations, unlike abdominal obesity described by waist-to-height ratio (WHtR). The aim of the study was to determine prevalence and abdominal obesity (WHtR) risk factors in a cohort of 3048 rural children aged 7-12 years from southern Poland. Biological, socio-demographic and lifestyle factors were analysed, and odds ratio and 95% confidence interval were calculated using a logistic regression analysis. The prevalence of abdominal obesity in rural boys and girls in the sample was 11% and 9% respectively. Obesity in both parents, irregular breakfasts, irregular meals during the day and regularly consumed tea were significant factors of abdominal obesity risks in rural girls. Being the only child, low number of people in a household, obesity in both parents, high energy-dense food index and no exercise significantly increased the risk of abdominal obesity in rural boys. The study demonstrated tendencies similar to other European countries in the prevalence of abdominal obesity among sexes. Lifestyle behaviours should be changed and adapted to each sex since risk factors differ between the sexes and indicate higher eco-sensitivity in boys.

Early adiposity rebound is associated with metabolic risk in 7-year-old children

BACKGROUND

Early adiposity rebound (AR <5 years) has been consistently associated with increased obesity risk, but its relationship with metabolic markers is less clear; in addition, the biologic mechanisms involved in these associations have not been established.

OBJECTIVE

The objective of this study was to assess the association between timing of AR and metabolic status at age 7 years, evaluating the potential role of adiposity, adipose functionality and skeletal maturation in this association.

DESIGN

We estimated the age of AR from the body mass index (BMI) trajectories from 0 to 7 years in 910 children from the Growth and Obesity Chilean Cohort Study (GOCS). At 7 years, we measured waist circumference (WC) and blood glucose, insulin, triglycerides and high-density lipoprotein-cholesterol levels and constructed a metabolic risk score. We also measured percent fat mass (adiposity), plasma concentrations of leptin and adiponectin (adipose functionality) and bone age using wrist ultrasound (skeletal maturation).

RESULTS

We found that 44% of the children had an AR <5 years. Earlier AR was associated with larger WC (β: 5.10 (95% confidence interval (CI): 4.29-5.91)), higher glucose (β: 1.02 (1.00-1.03)), insulin resistance (β Homeostatic Model Assessment: 1.06 (1.03-1.09)), triglycerides (β: 10.37 (4.01-6.73)) and adverse metabolic score (β: 0.30 (0.02-0.37)). Associations decreased significantly if adiposity was added to the models (i.e. β WC: 0.85 (0.33-1.38)) and, to a lesser extent, when adipokines (i.e. β WC: 0.73 (0.14-1.32)) and skeletal maturation (i.e. β WC: 0.65 (0.10-1.20)) were added.

CONCLUSION

In GOCS children, AR at a younger age predicts higher metabolic risk at 7 years; these associations are mostly explained by increased adiposity, but adipose dysfunction and accelerated skeletal maturation also have a role.

BMI-for-age Z-score distribution shifts among Chinese children: gender disparity

OBJECTIVE

To identify gender differences among Chinese school-aged children from 1995 to 2010, and to project the future BMI-for-age Z-score distribution and prevalence of obesity.

METHODS

The data were from four cross-sectional surveys (1995, 2000, 2005, and 2010) of Chinese National Surveys on Students Constitution and Health (CNSSCH) with a national representative sample of Chinese children, involving more than 200,000 participants at each survey. BMI-for-age Z-score distributional shifts overall and in percentiles were compared by gender. Average shift was calculated for four survey periods and used for projecting future distributions and obesity prevalence.

RESULTS

BMI-for-age Z-score increased more in their upper percentile distribution, indicating that Chinese children have become heavier over the past 15 years. Gender disparity in BMI-for-age Z-score has become wider during the period. Over a 15-year period, BMI-for-age Z-score shift among girls has been stable, while boy's BMI-for-age Z-score shifts has increased linearly. By 2020, the obesity prevalence is predicted to be 10.18% and 4.99% for boys and girls, respectively.

CONCLUSIONS

The wider gender disparity suggested a larger proportion of obesity in boys than in girls. Therefore, gender-specific preventive guidelines and public health policies for childhood obesity and cardiovascular diseases are urgently needed in China.

A six decades long follow-up on body size in adolescents from Zagreb, Croatia (1951-2010)

Most studies analysing the influence of socioeconomic deterioration on body size focus on the impact of food shortages and diseases on the growth in early childhood. To evaluate how socioeconomic conditions influence the growth during the adolescence, we tracked the body size of 15-19 year-olds over the last sixty years covering the socialist period (1951-1990), the war (1991-1995) and the transition to capitalistic economy. This study of Zagreb, Croatia, adolescent population provides information on the secular trend in height, weight and Body Mass Index (BMI) and examines their relation with Real Gross Domestic Product. From 1951 to 2010 the girls' height approximately increased by 6.2cm and weight by 6.8kg, while the boys' height increased by 12.2cm and weight by 17.3kg. Prior to 1991 mean BMI in girls was higher than in boys, but from 1991 on, the interrelation between the sexes has been opposite, possibly mirroring the cultural trends that started in mid-1970s and reflecting higher sensitivity of boys to the socioeconomic changes. In conclusion, the secular trend in body size over the investigated period reflects the positive economic trends interrupted by the war. The recent increase in BMI corresponds to the country's economic recovery and indicates the "nutrition transition".

ActiTrainer-determined segmented moderate-to-vigorous physical activity patterns among normal-weight and overweight-to-obese Czech schoolchildren

This study uncovered the patterns of moderate-to-vigorous physical activity (MVPA) in normal-weight and overweight/obese children before, during, and after school lessons. ActiTrainer-based MVPA was assessed over 2 school days (with and without a physical education lesson [PEL] in a sample of three hundred thirty-eight 9- to 11-year-old children (50.3 % female; 29.6 % overweight/obese), in the Czech Republic, during spring 2012. MVPA was quantified based on the step count (number), MVPA duration, and MVPA heart-rate response (minutes). No differences in the MVPA based on the time during the school day were confirmed in normal-weight versus overweight/obese girls, whereas normal-weight boys significantly exceed their overweight/obese peers in step count and after-school and daylong MVPA. Active participation in PEL contributes to a significantly higher step count, exercise duration, and MVPA heart-rate response in normal-weight and overweight/obese boys (p < 0.001) and normal-weight (p < 0.001) and overweight/obese (p < 0.04) girls during school time. Moreover, active participation in PEL significantly (p < 0.04) increases the overall daily step count, duration, and MVPA heart-rate response in normal-weight boys and overweight/obese girls. Active exercise during PEL accounted for 16.7 % of the total number of steps, 25.1 % of overall MVPA duration, and 24.1 % of the MVPA heart-rate response in 9- to 11-year-old children. During days with a PEL, a significantly (p < 0.02) higher number of overweight/obese girls and a higher number of normal-weight boys achieved the duration of 60 min/day of MVPA compared with days without a PEL.

CONCLUSION

Adding one PEL or an equivalent amount of MVPA to the daily school routine appears to be a promising strategy to effectively increase daily MVPA, particularly among overweight/obese girls.

Trends of overweight and obesity, physical activity and sedentary behaviour in Czech schoolchildren: HBSC study

BACKGROUND

The decline of physical activity (PA) and the increased prevalence of overweight and obese children have been discussed worldwide. This study assessed the trends in the prevalence of overweight and obesity, PA and sedentary behaviour in Czech school-aged children.

METHODS

A cross-sectional questionnaire from the Czech Republic was administered in cycles in 2002, 2006 and 2010 under the Health Behaviour in School-Aged Children (HBSC) study. In the study, 14,219 children aged 11-15 years participated.

RESULTS

In comparison with 2002, there is a significant increase (P < 0.01) of obese and overweight boys in 2010. The same trend has been recorded in girls, except those in the 13-year-old group. There has been a significant decline (P < 0.05) in meeting PA recommendations in 11-year-old girls and boys and in 13-year-old girls when comparing the 2006 and 2002 data. In 2010, we found a non-significant increase or stagnation of the share of children meeting the PA recommendation compared with 2006. We found an increasing length of sedentary time for children. There were significant associations between>2 h being spent sitting by a TV or PC and consuming fruit and vegetables (negative associations) or sweets and sweetened lemonades (positive associations).

CONCLUSIONS

An increasing percentage of obese or overweight children, increased sedentary time and a decline or stagnation of the proportion of children meeting recommendations for PA were found among Czech schoolchildren. Future research should evaluate PA recommendations with respect to gender, age and effective intervention approach to reduce the obesity incidence in childhood.

Age-related changes in body composition in a sample of Czech women aged 18-89 years: a cross-sectional study

Background

The Czech Republic lacks body composition data for women. Therefore, the purpose of the study was to analyze body composition [body fat mass (BFM), fat-free mass (FFM), body fat percentage (%BFM) and visceral adipose tissue (VAT)] and to evaluate the changes that occur with aging in women aged 18–89 years. We also analyzed anthropometric characteristics of study participants and developed age-specific percentile curves for body composition parameters.

Methods

A cross-sectional, non‐randomized study was conducted with a sample of 1,970 apparently healthy Czech women. Body composition was measured using a direct segmental multi-frequency bioelectrical impedance analysis (BSM-BIA).

Results

The mean BFM was 19.7 ± 8.9 kg, and BFM reached its peak in women over 70, at 27.6 ± 8.8 kg. There was a strong correlation between BFM and age (r = 0.61; r² = 0.37). Fifty percent of the women in the study had a BFM between 13.0 and 25.0 kg. The %BFM (r = 0.69; r² = 0.47) and VAT (r = 0.88; r² = 0.77) were also significantly associated with age. The reference range for %BFM was 22.0–35.6 % (25th–75th percentile). The mean FFM was 45.8 ± 5.5 kg, and FFM decreased with age (r = −0.27; r² = 0.07).

Conclusions

The results presented in this study showed a statistically significant increase in BFM,  %BFM and VFA as age increased, and the values reached their peak in women over 70. Even when FFM decreased slightly with age, body weight increased because of the increase in BFM.

The incidence of metabolic syndrome in obese Czech children: the importance of early detection of insulin resistance using homeostatic indexes HOMA-IR and QUICKI

Common alimentary obesity frequently occurs on a polygenic basis as a typical lifestyle disorder in the developed countries. It is associated with characteristic complex metabolic changes, which are the cornerstones for future metabolic syndrome development. The aims of our study were 1) to determine the incidence of metabolic syndrome (based on the diagnostic criteria defined by the International Diabetes Federation for children and adolescents) in Czech obese children, 2) to evaluate the incidence of insulin resistance according to HOMA-IR and QUICKI homeostatic indexes in obese children with and without metabolic syndrome, and 3) to consider the diagnostic value of these indexes for the early detection of metabolic syndrome in obese children. We therefore performed anthropometric and laboratory examinations to determine the incidence of metabolic syndrome and insulin resistance in the group of 274 children with obesity (128 boys and 146 girls) aged 9-17 years. Metabolic syndrome was found in 102 subjects (37 %). On the other hand, the presence of insulin resistance according to QUICKI <0.357 was identified in 86 % and according to HOMA-IR >3.16 in 53 % of obese subjects. This HOMA-IR limit was exceeded by 70 % children in the MS(+) group, but only by 43 % children in the MS(-) group (p<0.0001). However, a relatively high incidence of insulin resistance in obese children without metabolic syndrome raises a question whether the existing diagnostic criteria do not falsely exclude some cases of metabolic syndrome. On the basis of our results we suggest to pay a preventive attention also to obese children with insulin resistance even if they do not fulfill the actual diagnostic criteria for metabolic syndrome.

Frequency of under- and overweight among children and adolescents during the economic transition in Poland

The aim of this study is to examine the prevalence of underweight, overweight and obesity, using International Obesity Task Force (IOTF) criteria, in four cohorts of children and adolescents living in Poland in different economic eras: communist economy (1977/1978), crisis of the 1980s (1987/1988), political and economic transformation (1992/1994) and the free market economy (2002/2004). Analysis was conducted on a database including 10,934 records for children of the age 7-18 years. In Poland, in the last 26 years of economic and political transformations, the epidemic of obesity was not noticed but the growing incidence of children and adolescents with body mass deficit was observed (p<0.0001) (20.2% of girls in 2002/2004 vs. 11.0% in 1977/1978 and 12.1% of boys in 2002/2004 vs. 7.2% in 1977/1978). Lower parental education and a higher number of children in a family resulted in a higher prevalence of underweight (odds ratio [OR] fluctuated from 1.26 to 1.63). The social effects of the political transformation in Poland significantly affected families with low socio-economic status (SES), and especially more eco-sensitive boys. This result is opposite to the trends observed in Western countries and makes an important contribution to the current knowledge of the course of further changes in weight-to-height ratio at a global scale.

The declining prevalence of overweight among Russian children: income, diet, and physical activity behavior changes

The aim of this study is to examine the relationships among income, diet, physical activity behaviors and overweight among Russian children during a period of economic upheaval. Subjects include 2151 schoolchildren aged 7-13 derived from cross-sectional waves of the Russia Longitudinal Monitoring Surveys in 1995 and in 2002. Diet was assessed by 24-h recall and physical activity (h/week) and household income by parental questionnaire. Hours spent in vigorous activities were low (1.0-1.5 h/week), and time spent in sedentary behaviors increased from 31 to 37 h/week between 1995 and 2002. In 1995 there was a direct relationship of income to energy and fat intake, and time spent in vigorous activity, and an inverse relationship of income to h/week spent in moderate activities (such as walking to school). The effect of having low income parents was less in 2002 than in 1995. Overweight prevalence did not differ significantly by income in either year, but there was a significant decline in overweight among high income children. Only hours spent in moderate physical activity was moderately protective against overweight. Income disparities do not explain trends in overweight among Russian children.

Prevalence of overweight and obesity in children aged 6-13 years-alarming increase in obesity in Cracow, Poland

This study in children aged 6-13 years (n = 1,499) was performed between October 2008 and March 2009. Height and weight measurements were taken to calculate BMI. The prevalence of overweight and obesity was determined by means of IOTF cut-offs with respect to age. Alarming is the fact that the percentage of obese children in Cracow increased dramatically from 1.04% in boys and 0.20% in girls in 1971 to 7% in boys and 3.6% in girls in 2009. In this report, a higher percentage of overweight boys was observed in rural boys (28.14%) than in urban ones (27.31%). Obesity was identified in an almost twice as high percentage of urban boys (7.78%) as in rural ones (3.52%). A higher percentage of overweight girls was registered in rural areas (16.49%) than in urban ones (16.09%). Obesity was prevailing in rural girls (4.12%) relative to their urban counterparts (3.44%). The highest number of overweight urban boys was diagnosed in the group of 12-year-olds (n = 48) and rural boys in the group of 10-year-olds (n = 39), as well as in urban girls aged 11 (n = 17) and rural girls aged 9 (n = 9). The highest number of obesity was observed in rural boys aged 12 (n = 3) and in urban boys aged 9 and 10 (n = 9 in both groups). In the group of girls, obesity prevailed in urban 9-year-olds (n = 5) and in rural 7-year-olds (n = 5).

CONCLUSIONS

Overweight and obesity affect boys almost twice as frequently as girls. Obesity is twice as frequent in urban boys as in their rural peers.

From an inactive and obese to a fit child: how long is the way? Czech experiences

To achieve a higher level of overall fitness and to prevent obesity with accompanying comorbidities requires life-long effort starting early in life during the prenatal period. A sufficiently intense, regular, and ongoing physical activity regime and adequate exercise are indispensable, along with monitored diet. Once acquired, a desirable level of body composition and functional capacity can be lost relatively quickly due to regime interruption. Adhering to the optimal regime of diet and activity that not long ago used to be the norm is especially difficult under present life conditions, and new and innovative procedures have to be defined and introduced.

Availability of data assessing the prevalence and trends of overweight and obesity among European adolescents

OBJECTIVE

To review recent data on objectively measured overweight/obesity in national representative samples of European adolescents (aged 10-18 years), as well as availability of studies assessing trends in overweight/obesity in this target group. Attention was paid to the ability of the data to describe the obesity epidemic, especially in sociodemographic subgroups.

DESIGN/SETTING/SUBJECTS

Data on prevalence and trends in overweight/obesity among adolescents in the twenty-seven European Community member states, Iceland, Norway and Switzerland, available as scientific publications as well as reports or unpublished data by the end of 2009, were retrieved. Reports on the most recent objectively measured data from national representative samples were selected and described with regard to the years of data collection, sample sizes, response rates, age ranges included, trends by age, type of measures of overweight/obesity, sociodemographic variables and the sources of information.

RESULTS

Objectively measured data on national representative samples were identified for only half of the countries, and the trend studies were mainly conducted applying subnational samples. Most studies used the criteria from the International Obesity Task Force (IOTF) to define overweight/obesity, but the age ranges studied and the years of data collection varied, and information on sample sizes and response rates were often not presented. Data on trends of overweight/obesity over time are increasing, and the most recent studies indicate that the prevalence rate of overweight/obesity has stabilized. Few studies reported data by sociodemographic subgroups other than gender and age.

CONCLUSIONS

Objectively measured data on national representative samples of adolescents appear scattered, and there is a large heterogeneity with respect to the quality and comparability of available data. Increasing use of the IOTF criteria for overweight/obesity contributes to improved comparability across studies. Data by sociodemographic subgroups, and in particular by socio-economic status, are scarce.

Changes in central fatness and abdominal obesity in children and adolescents from Cracow, Poland 1983-2000

BACKGROUND

In the light of the world increase of overall and abdominal obesity, little is known about the trends in abdominal obesity and its prevalence in Poland, a country which at the end of 20th underwent a socio-economic transformation that conduced to obesogenic environments.

AIM

The study traced the trends and prevalence of abdominal obesity in two successive cohorts of children and adolescents from Cracow, Poland between 1983 and 2000.

SUBJECTS AND METHODS

The data examined in this study were from two series of cross-sectional studies; the first in 1983 included 3252 boys and 3288 girls, and the second in 2000 included 2409 boys and 2093 girls aged 4-20. Waist circumference (WC) and waist-to-height ratio (WHtR) were applied to assess the type of fat distribution.

RESULTS

Means of WC and WHtR were higher in juvenile but lower in childhood and late adolescence periods in boys and girls from the 2000 cohort as compared to the 1983 one. The prevalence of abdominal obesity in Cracow children examined in 1983 was 3.9% for boys and 2.4% for girls, and in 2000 was 6.4% and 3.1%, respectively (in boys: chi(2) = 16.03, p = 0.0001; in girls: chi(2) = 1.90, p = 0.1684).

CONCLUSIONS

The 1983-2000 trend towards increasing prevalence of abdominal obesity in children and adolescents from Cracow is not as intensive as in other European countries, e.g. Britain, but it requires further monitoring.

Overweight and obesity in infants and pre-school children in the European Union: a review of existing data

The objective of this study was to synthesize available information on prevalence and time trends of overweight and obesity in pre-school children in the European Union. Retrieval and analysis or re-analysis of existing data were carried out. Data sources include WHO databases, Medline and Google, contact with authors of published and unpublished documents. Data were analysed using the International Obesity Task Force reference and cut-offs, and the WHO standard. Data were available from 18/27 countries. Comparisons were problematic because of different definitions and methods of data collection and analysis. The reported prevalence of overweight plus obesity at 4 years ranges from 11.8% in Romania (2004) to 32.3% in Spain (1998-2000). Countries in the Mediterranean region and the British islands report higher rates than those in middle, northern and eastern Europe. Rates are generally higher in girls than in boys. With the possible exception of England, there was no obvious trend towards increasing prevalence in the past 20-30 years in the five countries with data. The use of the WHO standard with cut-offs at 1, 2 and 3 standard deviations yields lower rates and removes gender differences. Data on overweight and obesity in pre-school children are scarce; their interpretation is difficult. Standard methods of surveillance, and research and policies on prevention and treatment, are urgently needed.

BMI distribution/social stratification in Swiss conscripts from 1875 to present

BACKGROUND/OBJECTIVES

We aimed to extend the actual overweight discussion with new unbiased Swiss conscript data from 2005 to 2006, and to present for the first time Swiss data on body mass index (BMI) before 1950 and for the late-nineteenth century.

SUBJECTS/METHODS

For this study, 19-year-old Swiss male conscripts (draft army; Cantons Bern, Zurich, Basel-Stadt and Basel-Land) from the census of 1875-1879, 1933-1939 and 2005-2006 (N=28 033; 2005-2006 census) were included. BMI distribution (World Health Organization (WHO) classification) and social stratification (International Labour Organization classification) were main outcome measures.

RESULTS

Mean BMI of 19-year-old men in Switzerland increased in the 50 years between the 1870s and the 1930s by 0.80 kg/m(2) and between the 1930s and 2005 by 1.45 kg/m(2). The modern BMI sample is much more right skewed and s.d. is higher. Obesity prevalence (according to modern WHO classification) has increased by a factor of 105 from 1870s until present. Over 23% of our representative sample of Swiss men in 2005-2006 had a BMI of over 25 kg/m(2). In 2005-2006, contrary to the nineteenth century, unskilled workers had articulately higher BMI values at the 75th, 90th and 95th percentile than students; 12% of unskilled workers were obese against 2% of students.

CONCLUSIONS

It thus seems that BMI relations between the upper and the lower end of the socio-economic strata changed inversely from the late-nineteenth century to 2005-2006. We further propose that the phenomenon of massive right-skewing BMI distribution between the 1930s and 2005-2006 affected the lower socio-economic strata to a far greater extent than the higher socio-economic group.

Body image perceptions in Western and post-communist countries: a cross-cultural pilot study of children and parents

The development of an unrealistic ideal body image and body size dissatisfaction among children is common in Western countries, including the USA and many European nations. However, little is known about children's body image perceptions in post-communist countries. This pilot study evaluated body image perceptions in a sample of Czech school-aged children and their parents and compared them with the perceptions of American children and parents. Ninety-seven Czech and 45 American 4th-6th graders and their parents from eight urban schools participated in this study. A previously developed silhouette body image instrument was utilized in a parent questionnaire and during child interviews to measure perceived and ideal body image perceptions of children and parents. Descriptive statistics, independent t-tests and paired t-tests were used to compare differences between children's and parents' perceived and ideal body image perceptions. Associations between body image perceptions and other variables were explored using bivariate correlations. American children had a thinner ideal body image compared with Czech children (P < 0.05). However, a larger proportion of Czech boys desired to be thinner compared with American boys (34.2% vs. 20%). Parent's ideal body image for their children did not differ by nationality (P = 0.858). While the pressure on children to look thinner was apparent among both American and Czech children, Czech children considered a larger body size as more ideal. A future study should evaluate body image perceptions and factors influencing these perceptions in a representative sample of Czech children and parents.