The High Prevalence of Overweight and Obesity in Mexican Children

Global Analysis of Nutritional Factors and Cardiovascular Risk: Insights from Worldwide Data and a Case Study in Mexican Children

Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide, with growing concerns about the impact of omega-6 polyunsaturated fatty acids (n-6 PUFAs) on cardiovascular health. This study aims to evaluate the relationship between serum linoleic acid (LA) levels and waist-to-height ratio (WHtR), a recognized cardiovascular risk marker, in children. The research was conducted in two parts. First, a global analysis of publicly available data (2019-2021) explored the association between nutritional factors and CVD prevalence across 183 countries. Second, a cross-sectional study involving 67 children (33 with obesity and 34 with healthy weight, classified using BMI Z-scores) examined the correlation between serum LA levels and WHtR. Global analysis revealed a moderate correlation between low seafood omega-3 fatty acid intake and CVD incidence (rho = 0.341), while low polyunsaturated fatty acid consumption showed a weak correlation (rho = 0.228). In children, a significant positive correlation was observed between serum LA levels and WHtR (rho = 0.716, p < 0.001), with similar correlations found when stratified by sex (girls: rho = 0.690; boys: rho = 0.709). Serum LA levels also correlated positively with weight (rho = 0.684). These findings are consistent with the existing literature, that high serum LA levels may contribute to early cardiometabolic risk in children, emphasizing the need for dietary interventions to mitigate cardiovascular risks in early life.

Global, regional, and national burden of liver cancer in adolescents and young adults from 1990 to 2021: an analysis of the global burden of disease study 2021 and forecast to 2040

Background

The global burden of liver cancer among adolescents and young adults (AYAs) has often been underestimated, despite significant shifts in its etiology. This study analyzes the disease burden of liver cancer in AYAs from 1990 to 2021 and forecasts trends up to 2040 using data from the Global Burden of Disease Study 2021. Our goal is to provide insights that can inform resource allocation and policy planning.

Methods

Incidence, mortality, and disability-adjusted life years (DALYs) data were extracted and estimated annual percentage changes calculated to assess trends. Correlation between age-standardized rates and sociodemographic index (SDI) was analyzed using Spearman correlation, and future trends were predicted using the Bayesian age-period-cohort model.

Findings

Globally, there were 24,348 new liver cancer cases and 19,270 deaths among AYAs in 2021, with decreases in age-standardized rates for incidence, mortality, and DALYs from 1990 to 2021. East Asia bears the highest burden, with males experiencing significantly higher rates than females. The burden increases with age, peaking at 35-39 years. Higher SDI is associated with lower incidence, mortality, and DALYs. While HBV remains the leading cause, NASH is the fastest-growing contributor to liver cancer incidence and mortality. Projections indicate a continued decline in liver cancer burden among AYAs, though female cases are expected to rise.

Interpretation

Despite a gradual decline in liver cancer burden among AYAs, NASH is emerging as a significant and rising cause of incidence and mortality. Regional and gender disparities persist, highlighting the need for tailored prevention and healthcare strategies to alleviate the liver cancer AYA's burden globally.

What is a "high" prevalence of obesity? Two rapid reviews and a proposed set of thresholds for classifying prevalence levels

Categories such as "low" and "high" have been used for several decades to describe the prevalence of stunting and wasting in populations of children aged under 5 years. They provide support for public health risk assessment and policy-making, including alerting health departments and aid agencies to national trends and local needs. In the light of the need for monitoring progress to meet globally agreed targets for overweight and obesity, the classification of their prevalence will be a valuable to aid in policy development, to target resources, and to promote public health interventions. This paper reviews the current use of categories to describe obesity prevalence in policy, advocacy, and research literature. Where prevalence categories have been formally proposed, this paper compares their application on large-scale datasets. The paper then develops a set of recommended threshold values to classify prevalence levels for overweight and obesity among children under age 5 years, children aged 5-19 years, and adults.

Food Insecurity and Major Diet-Related Morbidities in Migrating Children: A Systematic Review

Children of migrant families are known to be at a higher risk of diet-related morbidities due to complex variables including food insecurity, cultural and religious beliefs, and sociodemographic factors like ethnicity, socioeconomic status, and education. Several studies have assessed the presence of specific diseases related to dietary issues in migrant children. This systematic review aims to highlight the existing body of work on nutritional deficiencies in the specific vulnerable pediatric population of immigrants. Refugees were intentionally excluded because of fundamental differences between the two groups including the reasons for migration and health status at the time of arrival. A total of 29 papers were included and assessed for quality. Most of them described a strong correlation between obesity and migration. A high prevalence of stunting, early childhood caries, iron and vitamin D deficiency was also reported, but the studies were few and heterogeneous. Food insecurity and acculturation were found important social factors (nevertheless with inconclusive results) influencing dietary habits and contributing to the development of morbidities such as obesity and other metabolic disorders, which can cause progressive unsustainability of health systems. Public health screening for diet-related diseases in migrant children may be implemented. Educational programs to improve children’s diet and promote healthy-living behaviors as a form of socioeconomic investment for the health of the new generations may also be considered.

Childhood obesity in Mexico: A critical analysis of the environmental factors, behaviours and discourses contributing to the epidemic

Mexico has the highest prevalence globally for children who are overweight. We conducted a qualitative study to understand childhood obesity in Mexico and the complex factors at play. Data were collected at three elementary schools in a low socio-economic area in Mexico City. Semi-structured interviews were conducted with 60 children, 24 parents and 28 teachers. The children interviewed were between the ages of 8 and 12 years old. Interview texts were analysed using NVivo 9 and 10 and thematic discourse analysis was used. Findings revealed how children’s choices around nutrition and physical activity were constrained by their environment and discursive constructions.

CARDIOVASCULAR RISK FACTORS IN ADOLESCENTS: ROLE OF INSULIN RESISTANCE AND OBESITY

Introduction

Childhood obesity is a public health problem characterized by early insulin resistance (IR), inflammation, and oxidative stress. The presence of an uninterrupted low-grade inflammatory state impairs metabolic and cardiovascular health. The population is particularly susceptible to develop metabolic disorders related to increased body fat.

Methods

Eighty-three adolescents were recruited and grouped according to HOMA-IR and BMI in either with or without IR and obese or normal-weight respectively. Anthropometric, biochemical, immunological and hormonal variables were determined. Transverse Analytical Study.

Results

Obesity, dyslipidemia, IL-6, and C-reactive protein were significantly higher in the IR group than in the non-IR group. Obese adolescents showed increased insulin levels, HOMA-IR, inflammatory markers, and triglycerides; while having lower HDL-C, and adiponectin when compared to normal-weight adolescents. As expected, obesity-related anthropometric markers positively correlated with IR and inflammatory markers while negatively correlated with adiponectin levels.

Conclusions

Early IR, subclinical inflammation, dyslipidemia, and hypoadiponectinemia characterize obesity in adolescents. These factors may increase the risk of future coronary heart disease (CHD) and diabetes mellitus development (DM) in early adulthood.

The contribution of at-home and away-from-home food to dietary intake among 2-13-year-old Mexican children

OBJECTIVE

Away-from-home foods have been shown to have lower nutritional quality and larger portion sizes than many foods prepared at home. We aimed to describe energy and nutrient intakes among 2-13-year-old Mexican children by eating location (at home and away from home), overall, by socio-economic status (SES) and by urbanicity.

DESIGN

Dietary intake was collected via one 24 h recall in the 2012 Mexican National Health and Nutrition Survey (ENSANUT). Location was reported for each food consumed. Results were adjusted for sex, day of recall, region, weight status, SES and urbanicity.

SETTING

Mexico (nationally representative).

SUBJECTS

Children aged 2-5 years (n 1905) and 6-13 years (n 2868).

RESULTS

Children consumed the majority of daily energy at home (89% of 2-5-year-olds; 82 % of 6-13-year-olds). The most common away-from-home eating location was school (22 % of 2-5-year-olds; 43 % of 6-13-year-olds), followed by the street (14 % of 2-5-year-olds; 13 % of 6-13-year-olds). The most common foods consumed away from home were wheat/rice and corn mixed dishes, sugar-sweetened beverages, pastries/candy/desserts, milk (2-5-year-olds only) and salty snacks (6-13-year-olds). Multivariate models showed that high-SES 2-5-year-olds consumed 14 % of daily energy away from home v. 8 % among low-SES 2-5-year-olds, and high-SES 6-13-year-olds consumed 21 % of daily energy away from home v. 14 % among low-SES 6-13 year-olds. There were no differences by urban residence.

CONCLUSIONS

Among Mexican children, most foods and beverages were consumed at home. However, the percentage of foods consumed or purchased away from home increased with age and with SES.

Increased Snacking and Eating Occasions Are Associated with Higher Energy Intake among Mexican Children Aged 2-13 Years

BACKGROUND

Little is known about the dietary behaviors of Mexican children with regard to frequency, amount, and quality of foods consumed at eating occasions and their impact on total daily energy intake.

OBJECTIVES

The objectives were to 1) describe foods consumed across eating occasions and 2) examine whether the number or type of total eating occasions was associated with increased total daily energy intake and differed between 2- to 5-y-old and 6- to 13-y-old Mexican children.

METHODS

A nationally representative sample of 5031 children from the 2012 ENSANUT (Encuesta Nacional de Salud y Nutrición) was used to examine the percentage of meals and snacks consumed, mean energy intake from meals and snacks, and the top food groups contributing to meals and snacks. Multivariate linear regression was used to examine the association between meals, snacks, and total eating occasions with daily energy intake for 2- to 5-y-old and 6- to 13-y-old children.

RESULTS

Eating patterns were similar across age groups (per capita mean intake of 3 meals and 1.4-1.6 snacks/d). Each additional snack was associated with greater increases in mean daily energy for older children (+191-289 kcal/d; P < 0.01) relative to younger children (+102-130 kcal/d; P < 0.01). Likewise, each additional eating occasion was associated with greater increases in mean daily energy for older children (+323 kcal/d; P < 0.01) relative to younger children (+166-261 kcal/d; P < 0.01). In both younger and older children, snacking was prevalent (75% and 68%, respectively). Top food contributors to snacks included fruit, salty snacks, candy, sweetened breads, and cookies. Among older children, whole milk as a snack was partially replaced with soda and sweetened fruit drinks.

CONCLUSION

Snacks represent an area for potential improvement in the diets of Mexican children, especially among those aged 6 to 13 y, for whom each additional snack or eating occasion was linked to even greater increases in total daily energy intake.

Obesity-Related Behaviors among Poor Adolescents and Young Adults: Is Social Position Associated with Risk Behaviors?

HighlightsDifferent measures of social position capture unique dimensions of relative rank among youth.Youth-specific measures of social position may be important in identifying the most at-risk for obesity.Lower social status youth are more likely to be at-risk for obesity-related behaviors compared to those with a higher rank. This cross-sectional study examines multiple dimensions of social position in relation to obesity-related behaviors in an adolescent and young adult population. In addition to using conventional measures of social position, including parental education and household expenditures, we explore the usefulness of three youth-specific measures of social position - community and society subjective social status and school dropout status. Data are taken from a 2004 house-to-house survey of urban households within the bottom 20th percentile of income distribution within seven states in Mexico. A total of 5,321 Mexican adolescents, aged 12-22 years, provided information on obesity-related behaviors (e.g., diet, physical activity, sedentary behavior) and indicators of subjective and objective social position. A parent in each household provided information on socioeconomic status of the parent and household. Ordinal logistic regressions are used to estimate the associations of parental, household and adolescent indicators of social position and obesity-related risk behaviors. Those adolescents with the highest odds of adopting obesity risk behaviors were the ones who perceived themselves as lower in social status in reference to their peer community and those who had dropped out of school. We found no significant associations between parental education or household expenditures and obesity-related risk behaviors. Immediate social factors in adolescents' lives may have a strong influence on their health-related behaviors. This study provides evidence for the usefulness of two particular measures, both of which are youth-specific. Adolescents and young adults who have dropped out of school and those with lower perceived relative social position within their community are more likely to be at-risk for obesity-related behaviors than those with higher relative social position. We conclude that youth-specific measures may be important in identifying the most at-risk among relatively homogeneous populations of youth.

Short-term Effects of a Physical Activity Intervention on Obesity and Cardiovascular Fitness of 12-14-year-old Boy Students

BACKGROUND

Some local governments have implemented strategies to increase physical activity as a way to control obesity in children, but in Iranian students few studies have evaluated the effects of such interventions on overweight and obese children. The aim of this study was to evaluate the effects of a short-term school-based physical activity on obesity and cardiovascular fitness in 12-14-year-old boy students.

METHODS

This study showed an intervention effect on some health-related fitness factors in students. A number of 127 boy students aged 12-14 years, in the city of Isfahan, based on preventive plan of inactivity in children at the provincial Health office selected randomly as subjects. Measurement variables include; weight, height, body mass index (BMI), waist-hip ratio (WHR), body-fat percent and aerobic power of subjects measured by valid tests.

RESULTS

This study revealed that body-fat percentage of this students changed near to 17.84% (42.25% pretest vs. 34.71% posttest), WHR 0.44%, (0.915 pretest vs. 0.911 posttest), VO2 max changed 8.54% (27.84 pretest vs. 30.22 posttest) whereas BMI was changed 2.61% (26.81 pretest vs. 26.03 posttest). Results also revealed that there were significant differences between fat percent, (P = 0.001) and VO2 max (P = 0.001), but there was no difference between BMI of subjects in pre and posttests (P = 0.452).

CONCLUSIONS

Findings of this study signify that an implementation of short-term intervention components in the school system may have a beneficial effect on body-fat percentage and cardiovascular fitness of overweight/obese children.

Correlation between Aerobic Fitness and Body Composition in Middle School Students

Background:

Since correlations have been found between body composition and physical activity in different parts of the world, inactivity and poor physical condition likely contributes main factors in childhood obesity. This study was implemented to determine the relationship between cardiovascular fitness and body-composition in a group of Iranian middle school students.

Methods:

In this descriptive study, subjects comprised of 12,946 students (10,531 girls and 2,415 boys aged 11–13 years) in the city of Isfahan. Height, weight, body-fat percent, body mass index, and cardiovascular fitness of the aforesaid students were measured by valid tests.

Results:

This study showed that fat percentage and aerobic fitness (VO₂ max) of girls were 24.73%, and 29.5 (ml/kg/min) and boys19.32% and 36.4 (ml/kg/min) respectively. Results also revealed that there was a negative significant correlation between fat percent and aerobic fitness of boys (r = −0.81), and girls (r = −0.77) respectively.

Conclusions:

To conclude, this study signifies that fat percentage augmentation leads to a decrease in aerobic fitness of children. Thus, fat percentage can be associated with different chronic diseases such as cardiovascular ones.

Short-term Effects of a Physical Activity Intervention on Obesity and Aerobic Fitness of Adolescent Girls

Background:

In the past two decades, physical activity has decreased during both childhood and adolescence, and particularly adolescence. It seems that schools are attractive settings in which to implement interventions designed in order to promote physical activity in children; but in Iranian students, few studies have evaluated the effects of such interventions on overweight and obese children. The aim of this study was to evaluate the effects of a short-term school-based physical activity on obesity and aerobic fitness in 12–14 years aged girls.

Methods:

This is a study with single group pretest and posttest design, in which 129 middle school girls in city of Isfahan were assessed based on preventive plan of inactivity in children at the Provincial Health Office. Variables, including weight, height, body mass index (BMI), waist-hip ratio (WHR), body fat percentage and aerobic power of subjects were measured using valid tests.

Results:

This study showed that subjects’ body fat percentage changed about 3.6% (37.74% pretest vs. 36.39% posttest), VO₂ max changed 7.43% (29.72 pretest vs. 31.93 posttest), WHR changed 1.12% (0.89 pretest vs. 0.88 posttest), whereas BMI was changed 1.65% (27.80 pretest vs. 27.34 posttest). Findings also revealed that there were significant differences between fat percent, (P = 0.001) and VO₂ max (P = 0.001) of subjects, but there was no difference between BMI of them in pre- and post-tests (P = 0.361).

Conclusions:

These results suggest that even a short-term exercise intervention may lead to positive changes in body fat percentage, WHR and aerobic fitness of overweight children. Therefore, school-based physical activity interventions can be an effective preventive strategy to control obesity and overweight in students.

Prevalence of Obesity and Overweight in 12-14-year-old Students in Isfahan-Iran

Background:

Childhood obesity is a worldwide major public health problem in both developed and developing countries. The purpose of this study was to determine the prevalence of obesity and overweight in 12-14-year-old students in the city of Isfahan.

Methods:

This study was conducted among 10,531 girls and 2415 boys aged 12–14 years in the city of Isfahan. Percentage of children in the corresponding body mass index (BMI) categories for overweight and obesity (specified by the Centers for Disease Control and Prevention criteria percentiles) were assessed, based on preventive plan of inactivity in children and youth of Isfahan province.

Results:

Findings revealed that prevalence of overweight in children varied by age from 15.3% to 26.9% in boys and 12.9% to 29.9% in girls, and prevalence of obesity varied from 14.8% to 33.7% and 15% to 29.9% in boys and girls, respectively. Percentile norms for BMI of subjects were computed based on sex categories.

Conclusions:

To conclude, results of the study revealed that subjects have approximately the same percentage of overweight/obesity compared to other children have been studied; however, in comparison to previous studies, a higher rate was witnessed in grade 8 boy students. These situations indicate that there are needs to implement some intervention programs, as well as management policies.

Child and adolescent obesity: part of a bigger picture

The prevalence of childhood overweight and obesity has risen substantially worldwide in less than one generation. In the USA, the average weight of a child has risen by more than 5 kg within three decades, to a point where a third of the country's children are overweight or obese. Some low-income and middle-income countries have reported similar or more rapid rises in child obesity, despite continuing high levels of undernutrition. Nutrition policies to tackle child obesity need to promote healthy growth and household nutrition security and protect children from inducements to be inactive or to overconsume foods of poor nutritional quality. The promotion of energy-rich and nutrient-poor products will encourage rapid weight gain in early childhood and exacerbate risk factors for chronic disease in all children, especially those showing poor linear growth. Whereas much public health effort has been expended to restrict the adverse marketing of breastmilk substitutes, similar effort now needs to be expanded and strengthened to protect older children from increasingly sophisticated marketing of sedentary activities and energy-dense, nutrient-poor foods and beverages. To meet this challenge, the governance of food supply and food markets should be improved and commercial activities subordinated to protect and promote children's health.

Examination of the relationship between body mass index (BMI) and functional independence level in children with spina bifida

OBJECTIVE

The aim of this study is to examine the relationship between body mass index (BMI) and functional independence level in children with spina bifida (SB).

METHODS

The study included 116 children between 5 and 18 years. Subjects' socio-demographic characteristics, BMI values and functional independence levels were recorded.

RESULTS

There was negative correlation between BMI and communication and social cognition in girls (p < 0.05). No correlation was found between BMI and WeeFIM in boys (p > 0.05).

CONCLUSION

The results indicated that body weight in children with SB affected functional independency and that precautions to control weight important in these children.

Body fatness in relation to physical activity and selected socioeconomic parameters of adolescents aged 15-17 years in Merida, Yucatan

BACKGROUND

Increasing rates of overweight and obesity in adolescents are major concerns in many countries, including Mexico.

OBJECTIVES

To study anthropometric and body composition characteristics (BCC) and their relations with socioeconomic status (SES), biological history and physical activity (PA) of school-going adolescent boys and girls in the city of Merida, Yucatan, Mexico.

SUBJECTS AND METHODS

In this cross-sectional study, a sample of 321 adolescents (156 boys and 165 girls) aged 15-17 years from public and private schools in Merida, was taken from a study carried out in 2008-2009.

RESULTS

Body mass index had significant correlations to BCC (fat mass and fat-free mass). The rate of stunting was higher in girls (18.20%) than in boys (7.69%). Stunted adolescents had higher body fat (%) than normally growing peers. High rates of overweight (boys 26.28%, girls 24.24%) and obesity (boys 10.26%, girls 6.06%) were recorded. SES (parents' age, education and occupation; crowding index in the family; household food expenditure), participants' biological history and PA are related with height and BCC by age and sex.

CONCLUSION

Adolescents with excess weight (overweight + obesity) reported being less physically active. SES and PA were strongly related to growth and body fatness in the studied adolescents.

Anthropometry, silhouette trajectory, and risk of breast cancer in Mexican women

BACKGROUND

Obesity has been associated with breast cancer risk in the Caucasian population but the association remains unclear in the Hispanics. Previous studies conducted among Hispanics in the U.S. have shown inconsistent results.

PURPOSE

The association between anthropometry, body shape evolution across lifetime, and the risk of breast cancer was assessed using a multi-center population-based case-control study conducted in Mexico.

METHODS

One thousand incident cases and 1074 matched control women aged 35-69 years were recruited between 2004 and 2007, and analyzed in 2011-2012. Conditional logistic regression models were used.

RESULTS

Height was related to an increased risk of breast cancer in both premenopausal (p trend=0.03) and postmenopausal women (p trend=0.002). In premenopausal women, increase in BMI; waist circumference (WC); hip circumference (HC); and waist-hip ratio (WHR) were inversely associated with breast cancer risk (p trends<0.001 for BMI and WC, 0.003 for HC, and 0.016 for WHR). In postmenopausal women, decreased risks were observed for increased WC (p trend=0.004) and HC (p trend=0.009) among women with time since menopause <10 years. Further analysis of body shape evolution throughout life showed strong and significant increase in risk of breast cancer among women with increasing silhouettes size over time compared to women with no or limited increase.

CONCLUSIONS

These findings suggest that anthropometric factors may have different associations with breast cancer risk in Hispanic women than in Caucasian women. This study also shows the importance of considering the evolution of body shape throughout life.

The association of acculturation and health literacy, numeracy and health-related skills in Spanish-speaking caregivers of young children

Little is known about the relationship among acculturation, literacy, and health skills in Latino caregivers of young children. Latino caregivers of children < 30 months seeking primary care at four medical centers were administered measures of acculturation (SASH), functional health literacy (STOFHLA), numeracy (WRAT-3) and health-related skills (PHLAT Spanish). Child anthropomorphics and immunization status were ascertained by chart review. Caregivers (N = 184) with a median age of 27 years (IQR: 23-32) participated; 89.1% were mothers, and 97.1% had low acculturation. Lower SASH scores were significantly correlated (P < 0.01) with lower STOFHLA (ρ = 0.21), WRAT-3 (ρ = 0.25), and PHLAT Spanish scores (ρ = 0.34). SASH scores predicted PHLAT Spanish scores in a multivariable linear regression model that adjusted for the age of child, the age and gender of the caregiver, number of children in the family, the type of health insurance of the caregiver, and study site (adjusted β: 0.84, 95% CI 0.26-1.42, P = 0.005). This association was attenuated by the addition of literacy (adjusted β: 0.66, 95% CI 0.11-1.21, P = 0.02) or numeracy (adjusted β: 0.50, 95% CI -0.04-1.04, P = 0.07) into the model. There was no significant association between acculturation and up-to-date child immunizations or a weight status of overweight/obese. Lower acculturation was associated with worse health literacy and diminished ability to perform child health-related skills. Literacy and numeracy skills attenuated the association between acculturation and child health skills. These associations may help to explain some child health disparities in Latino communities.

New insights into the epidemiology of childhood atopic dermatitis

There is a growing desire to explain the worldwide rise in the prevalence of atopic dermatitis (AD). Trend data on the burden of AD suggest that the picture in the developing world may soon resemble that of wealthier nations, where AD affects over 20% of children. This, combined with significant variations in prevalence within countries, emphasizes the importance of environmental factors. Many hypotheses have been explored, from the modulation of immune priming by hygiene, gut microbiota diversity, and exposure to endotoxins through farm animals to the effects of pollution, climate, and diet. The discovery of the filaggrin skin barrier gene and its importance in AD development and severity has brought the focus on gene-environment interactions and the identification of environmental factors that impact on skin barrier function. This article reviews our current understanding of the epidemiology of AD, with an emphasis on the findings reported in the international literature over the last 5 years.

Prevalence and determinants of obesity among primary school children in Dar es Salaam, Tanzania

BACKGROUND

Childhood obesity has increased dramatically and has become a public health concern worldwide. Childhood obesity is likely to persist through adulthood and may lead to early onset of NCDs. However, there is paucity of data on obesity among primary school children in Tanzania. This study assessed the prevalence and determinants of obesity among primary school children in Dar es Salaam.

METHODS

A cross sectional study was conducted among school age children in randomly selected schools in Dar es Salaam. Anthropometric and blood pressure measurements were taken using standard procedures. Body Mass Index (BMI) was calculated as weight in kilograms divided by the square of height in meters (kg/m2). Child obesity was defined as BMI at or above 95th percentile for age and sex. Socio-demographic characteristics of children were determined using a structured questionnaire. Logistic regression was used to determine association between independent variables with obesity among primary school children in Dar es Salaam.

RESULTS

A total of 446 children were included in the analysis. The mean age of the participants was 11.1±2.0 years and 53.1% were girls. The mean BMI, SBP and DBP were 16.6±4.0 kg/m2, 103.9±10.3mmHg and 65.6±8.2mmHg respectively. The overall prevalence of child obesity was 5.2% and was higher among girls (6.3%) compared to boys (3.8%). Obese children had significantly higher mean values for age (p=0.042), systolic and diastolic blood pressures (all p<0.001). Most obese children were from households with fewer children (p=0.019) and residing in urban areas (p=0.002). Controlling for other variables, age above 10 years (AOR=3.3, 95% CI=1.5-7.2), female sex (AOR=2.6, 95% CI=1.4-4.9), urban residence (AOR=2.5, 95% CI=1.2-5.3) and having money to spend at school (AOR=2.6, 95% CI=1.4-4.8) were significantly associated with child obesity.

CONCLUSIONS

The prevalence of childhood obesity in this population was found to be low. However, children from urban schools and girls were proportionately more obese compared to their counterparts. Primary preventive measures for childhood obesity should start early in childhood and address socioeconomic factors of parents contributing to childhood obesity.

Specific infant feeding practices do not consistently explain variation in anthropometry at age 1 year in urban United States, Mexico, and China cohorts

Infant feeding practices generally influence infant growth, but it is unclear how introduction of specific foods affects growth across global populations. We studied 3 urban populations in the Global Exploration of Human Milk study to determine the association between infant feeding and anthropometry at 1 y of age. Three hundred sixty-five breastfeeding mother-infant pairs (120 US, 120 China, and 125 Mexico) were recruited soon after the infant's birth. Enrollment required agreement to breastfeed ≥75% for at least 3 mo. Weekly, 24-h, food frequency data were conducted on infants for 1 y and exclusive breastfeeding (EBF) duration and timing of specific complementary food introduction were calculated. Weight and length were measured at age 1 y and anthropometry Z-scores calculated using WHO standards. Cohorts in the 3 urban populations (Shanghai, China; Cincinnati, USA; and Mexico City, Mexico) differed by median EBF duration (5, 14, and 7 wk, respectively; P < 0.001), timing of introduction of meat/eggs/legumes (4.8, 9.3, and 7.0 mo, respectively; P < 0.0001), and other feeding practices. By age 1 y, infants in Shanghai were heavier and longer than Cincinnati and Mexico City infants (P < 0.001). Adjusting for nonfeeding covariates, the only feeding variable associated with anthropometry was EBF duration, which was modestly inversely associated with weight-for-age but not length-for-age or BMI Z-scores at 1 y. Although feeding variables differed by cohort, their impact on anthropometry differences was not consistent among cohorts. Overall, across these urban, international, breast-fed cohorts, differences in specific feeding practices did not explain the significant variation in anthropometry.

The shape of things to come? Obesity prevalence among foreign-born vs. US-born Mexican youth in California

Obesity among the Mexican-origin adult population in the US has been associated with longer stays in the US and with being US- vs. Mexican-born, two proxies for acculturation. This pattern is less clear for Mexican-origin children and young adults: recent evidence suggests that it may be reversed, with foreign-born Mexican youth in the US at higher risk of obesity than their US-born Mexican-American counterparts. The objective of this study is to evaluate the hypothesis that the immigrant advantage in obesity prevalence for Mexican-origin populations in the US does not hold for children and young adults. We use data from the Los Angeles Family and Neighborhood Survey (N = 1143) and the California Health Interview Survey (N = 25,487) for respondents ages 4-24 to calculate the odds of overweight/obesity by ethnicity and nativity. We find support for the hypothesis that overweight/obesity prevalence is not significantly lower for first-generation compared to second- and third-generation Mexican-origin youth. Significantly higher obesity prevalence among the first generation was observed for young adult males (ages 18-24) and adolescent females (ages 12-17). The previously-observed protective effect against obesity risk among recent adult immigrants does not hold for Mexican-origin youth.

Asthma in Mexican school-age children is not associated with passive smoking or obesity

Background

Asthma has increased in various regions of the world. The factors associated with the growth in prevalence are still to be determined.

Objective

To evaluate the degree of association of the prevalence of asthma with passive smoking and obesity in school-children in western Mexico.

Methods

A population-based cross-section analytic study. A stratified random sample of 740 primary school pupils of between 6 and 12 years of age was chosen. Asthma, passive smoking and a background of allergic diseases were identified by means of a standardized questionnaire filled out by the parents of the participants. Obesity was identified by means of the body mass index. Proportional sections of population were estimated and the degree of association between asthma (dependent variable) and the independent variables was evaluated by means of multivariate logistic regression.

Results

The following factors of prevalence were found: asthma 8.1%; obesity 19.9%; background of smoking in the father 6.7% and in the mother 13.3%. There was no significant association to be found with asthma in either passive smoking where one of the parents smoked (p = 0.39) or in obesity (p = 0.09). On the other hand, the background of allergic diseases in the mother showed statistically significant association with asthma in the boys (odds ratio = 3.5, 95% confidence interval 1.4 to 8.59), but not in the girls.

Conclusion

With the exception of the maternal background of allergy, neither obesity nor passive smoking are factors associated with asthma in Mexican children.

Higher risk for obesity among Mexican-American and Mexican immigrant children and adolescents than among peers in Mexico

We conducted a cross-sectional study among 1,717 children and adolescents of Mexican origin ages 5-19 years living in Mexico and Texas to explore the influence of country of birth and country of longest residence on their overweight and obesity status. Descriptive statistics were used to compare demographic and anthropometric characteristics of participants born and raised in Mexico (Mexicans), born in Mexico and raised in the United States (Mexican immigrants), and born and raised in the United States (Mexican-Americans). Univariate and multivariate nominal logistic regression was used to determine the demographic predictors of obesity adjusted by country of birth, country of residence, age, and gender. Almost half (48.8%) of the Mexican-Americans and 43.2% of the Mexican immigrants had body mass index at the 85th percentile or above, compared to only 29.3% of the Mexicans (P < .001). Thus, Mexican-Americans and Mexican immigrants were more likely to be obese than their Mexican peers [Mexican-Americans: odds ratio (OR) = 2.5 (95% confidence interval [CI] 1.8-3.4); Mexican immigrants: OR = 2.2 (95% CI 1.6-3.0)]. In addition, males were more likely than females to be obese [OR = 1.6 (95% CI 1.2-2.1)], and adolescents 15-19 years of age were less likely than their younger counterparts [OR = 0.5 (95% CI 0.4-0.7)] to be obese. The high prevalence of obesity among children of Mexican origin in the United States is of great concern and underscores the urgent need to develop and implement obesity preventive interventions targeting younger children of Mexican origin, especially newly arrived immigrant children. In addition, future obesity research should take into consideration the country of origin of the study population to develop more culturally specific obesity interventions.

Nutritional quality of foods and beverages on child-care centre menus in Mexico

OBJECTIVE

The purpose of the present study was to assess the nutritional quality of foods and beverages listed on menus serving children in government-sponsored child-care centres throughout Mexico.

DESIGN

For this cross-sectional menu assessment, we compared (i) food groups and portion sizes of foods and beverages on the menus with MyPlate recommendations and (ii) macronutrients, sugar and fibre with Daily Reference Intake standards.

SETTING

Menus reflected foods and beverages served to children attending one of 142 government-sponsored child-care centres throughout Mexico.

SUBJECTS

There were fifty-four distinct menus for children aged 4–6 months, 7–9 months, 10–12 months, 13–23 months, 24–47 months and 48–72 months.

RESULTS

Menus included a variety of foods meeting minimum MyPlate recommendations for each food category except whole grains for children aged 48–72 months. Menus listed excessive amounts of high-energy beverages, including full-fat milk, fruit juice and sugar-sweetened beverages for children of all ages. The mean daily energy content of menu items yielded an average of 2?76 MJ for infants, 4.77 MJ for children aged 13–23 months, 5.36 MJ for children aged 24–47 months and 5.87 MJ for children aged 48–72 months. Foods and beverages on menus provided sufficient grams of carbohydrate and fat, but excessive protein.

CONCLUSIONS

Menus provided a variety of foods but excessive energy. Whole grains were limited, and high-energy beverages were prevalent. Both may be appropriate targets for nutrition intervention. Future studies should move beyond menus and assess what children actually consume in child care.

Obesity genetics: a monopoly game of genes

Obesity is a complex disease that affects all ethnic populations worldwide. The etiology of this disease is based on the interaction of genetic factors, environment and lifestyles indicators. Genetic contribution to the epidemic has gained attention from 2 sources: monogenic syndromes that display severe obesity, and the polygenic model of common obesity. Single mutations can render a syndrome with severe obesity resulting from alteration in central o peripheral appetite control mechanisms. The interaction of several polymorphisms and epigenetic modifications constitute the basic plot for common obesity, molecular ingredients that should not confuse the investigator-they make this riddle even harder to decipher.

Growth status among low-income Mexican and Mexican-American elementary school children

OBJECTIVES

Childhood obesity remains a problem among Latino children in the United States. Acculturation to an American diet and sedentary lifestyle may be causative factors. The research purpose was to assess child growth status, including sitting height, in relation to acculturation among Mexican and Mexican-American children.

METHODS

Anthropometric measures of weight, height, and sitting height were taken in a cross-sectional survey of Mexican and Mexican-American elementary school children (N = 484) in Phoenix, Arizona. Height-for-age (HAZ), weight-for-age (WAZ), and body mass index (BMI) Z-scores were calculated based on the Centers for Disease Control 2000 growth reference. Sitting height Z-scores (SHZ) were determined from the NHANES III reference values. Questions about language usage were asked of the children as a proxy for acculturation. Differences in growth measures and acculturation between those born in the United States or Mexico were evaluated by chi-square or t-tests.

RESULTS

The mean HAZ value (-0.23) was close to the reference median. There were no significant differences in HAZ or SHZ by birth country or gender. WAZ values for boys were significantly higher than for girls. More girls (64%) than boys (54%) had normal BMIs. More Mexican-born boys (28%) were obese than Mexican-born girls (17%; P = 0.026) in comparison to the US-born boys (31%) and girls (24%; P = n.s.). Acculturation scale score and male gender predicted a small percentage of the variation in BMIZ.

CONCLUSIONS

Environmental and cultural factors that promote obesity among low-income Mexican and Mexican-American children are similar regardless of birth country but boys may be at greater risk of obesity than girls.

Canaries in a coalmine: Immigration and overweight among Mexican-origin children in the US and Mexico

The prevalence of overweight is higher for Hispanic children of immigrants than children of natives. This does not fit the pattern of the epidemiological paradox, the widely supported finding that immigrants tend to be healthier than their U.S.-born peers, and it suggests that exposure to the U.S. increases immigrant children's risk of overweight. This study's primary contribution is to better assess how exposure to the U.S. environment affects childhood overweight among a homogamous ethnic group, Mexican-Americans. We do so by using an innovative binational study design to compare the weight of Mexican-American children of immigrants, Mexican-American children of natives, and Mexican children in Mexico with different propensities of having immigrant parents. Cross-sectional data are derived from a pooled sample of 9982 6-19 year old children living in either Mexico or the United States in the early 2000s. Mexican-resident children with a very high propensity to have immigrant parents have significantly lower percentile BMIs and lower odds of overweight than Mexican children with lower propensities of emigration and U.S.-resident Mexican-American children. This suggests that selection into immigration streams does not account for the high prevalence of overweight among children of Mexican immigrants. Rather, U.S. exposure significantly raises children of Mexican immigrants' risk of being overweight. Moreover, second generation children have the highest percentile BMIs and greatest odds of overweight of all comparison groups, including children of natives. This suggests that they experience risks above and beyond the effects of exposure to American society.

Parental perception of preschool child body weight

Obesity in preschoolers has risen dramatically in the last decade. Although studies have demonstrated that parents of preschoolers have incorrect perceptions of their child's body weight, little is known about the factors that may be associated with these perceptions. The purpose of this study was to examine the relationships between parental perceptions of preschool child body weight and parental psychosocial factors. Quantitative analyses included descriptive statistics, correlations, and regression analyses. More than one third of the children in the sample were at risk for being overweight or were already overweight. However, less than 6% of parents felt that their child had an elevated body weight. Results from univariate logistic regression analyses demonstrated that the parent's health literacy level was a significant predictor of the accuracy of their perceptions regarding their child's body weight (p < .05). Parental concern regarding child weight and perceived level of efficacy did not significantly predict the accuracy of their perceptions. Results from this study indicate that assessing parental perceptions of preschool child body weight can help providers accurately understand how parents view their children and lead to tailored educational interventions. In addition, the results support previous research suggesting that parental health literacy is a key to providing high-quality family-centered care.

Migrant networks and pathways to child obesity in Mexico

The purpose of this paper is twofold: 1) to assess the link between migrant networks and becoming overweight or obese and 2) to explore the pathways by which migrant networks may contribute to the increasing overweight and obese population of children in Mexico. Using two waves of the Mexican Family Life Survey (MxFLS), we find that children and adolescents (ages 3 to 15) living in households with migrant networks are at an increased risk of becoming overweight or obese over the period of observation, relative to their peers with no migrant networks. Sedentary behavior and household-level measures of economic wellbeing explain some of the association between networks and changes in weight status, but the role of extended networks remains significant. Community-level characteristics related to migration do not account for any of the observed relationship between household-level networks and becoming overweight or obese.

Socioeconomic differences in obesity among Mexican adolescents

OBJECTIVE

We investigate socioeconomic disparities in adolescent obesity in Mexico. Three questions are addressed. First, what is the social patterning of obesity among Mexican adolescents? Second, what are the separate and joint associations of maternal and paternal education with adolescent obesity net of household wealth? Third, are there differences in socioeconomic status (SES) gradients among Mexican boys and girls, rural residents and non-rural residents?

METHODS

Using data from the Mexican National Health Survey 2000 we examined the slope and direction of the association between SES and adolescent obesity. We also estimated models for sub-populations to examine differences in the social gradients in obesity by sex and non-rural residence.

RESULTS

We find that household economic status (asset ownership and housing quality) is positively associated with adolescent obesity. High paternal education is related to lower obesity risk, whereas the association between maternal education and obesity is positive, but not always significant.

CONCLUSION

The household wealth components of SES appear to predispose Mexican adolescents to higher obesity risk. The effects of parental education are more complex. These findings have important policy implications in Mexico and the United States.

Higher metabolic syndrome in obese asthmatic compared to obese nonasthmatic adolescent males

The relationship between asthma and obesity has been documented in children and adolescents; however, few studies on metabolic syndrome and asthma have been performed.

OBJECTIVE

To determine the prevalence of metabolic syndrome in adolescents among the following groups: obese with asthma (OA), obese without asthma (ONA), nonobese with asthma (NOA), and nonobese without asthma (NONA).

PATIENTS AND METHODS

The authors measured anthropometric (height, weight, waist circumference, body mass index, and waist-hip ratio), clinical (Tanner stage, blood pressure, fat and muscle reserve, and exercise), and biochemical parameters (basal and load glucose, cholesterol, triglycerides, high-density lipoproteins, uric acid, and insulin) in 500 Mexican adolescents.

RESULTS

A total of 111 OA, 198 ONA, 63 NOA, and 71 NONA adolescents completed the study. There were no differences in age, height, Tanner stage, high-density lipoproteins, or basal glucose among groups. Cholesterol, triglycerides, uric acid, basal insulin, and homeostasis model assessment (HOMA)-IR were significantly higher among the obese than nonobese groups but were similar between the OA and ONA groups. The prevalence of impaired fasting glucose was significantly higher among ONA versus OA males. The prevalence of metabolic syndrome (define as > or =3 abnormal cardiometabolic risk factors by de Ferranti, Cook, and International Diabetes Federation [IDF] criteria) was higher among OA teens than in the ONA group; however, this association was significant only among males. Adolescents from the ONA group were able to perform significantly more vigorous exercise than the other groups.

CONCLUSION

Adolescent males who were obese and also had mild persistent asthma had a significantly higher prevalence of metabolic syndrome than obese males without asthma. However, overall, asthma seems to confer a protective effect against the prediabetes condition in males.

Subclinical metabolic abnormalities associated with obesity in prepubertal Mexican schoolchildren

Childhood obesity has increased to epidemic levels and is considered a public health problem due to its association with a number of metabolic abnormalities, which are being detected at earlier stages of life. The objective was to evaluate the association between the presence of subclinical metabolic abnormalities (SMA) and obesity in a sample of pre-pubertal Mexican schoolchildren. Children of both sexes and 6 to 13 years old were questioned for signs of puberty, underwent anthropometric measurement and had their Body Mass Index (BMI) calculated. Two groups were formed: those with obesity (case group) and those with normal weight paired by age and chosen randomly (control group). Fasting insulin, glucose and cholesterol were measured. 92 children were included, 46 in each group, mean age 9.9 and 9.5 years old, respectively (p = 0.97). A higher frequency of hyperinsulinism was found in the case group: Fasting insulin > 15 mU/ml, 75% vs. 21% (case group vs. control group, respectively); fasting glucose to insulin ratio < 6, 72% vs. 24%; HOMA IR > 2.7, 83% vs. 14%; and decrease in QUICKI (< 0.3), 80% vs. 19% (p = 0.000). Hypercholesterolemia was 25% vs. 15% (p = 0.22), impaired fasting glucose 28% vs. 8% (p = 0.01), and family history of diabetes mellitus (DM) 35% vs. 9% (OR = 5.6; 95% CI = 1.5-22.2; p = 0.002). In this sample of Mexican schoolchildren, obesity was associated to a higher frequency of SMA, such as hyperinsulinism and impaired fasting glucose, and to a family history of DM.

Prevalence of overweight and obesity in Saudi children and adolescents

BACKGROUND AND OBJECTIVE

There is limited information on overweight and obesity in Saudi children and adolescents. The objective of this study was to establish the national prevalence of overweight and obesity in Saudi children and adolescents.

METHODS

The 2005 Saudi reference data set was used to calculate the body mass index (BMI) for children aged 5 to 18 years. Using the 2007 WHO reference, the prevalence of overweight, obesity and severe obesity were defined as the proportion of children with a BMI standard deviation score more than +1, +2 and +3, respectively. The 2000 CDC reference was also used for comparison.

RESULTS

There were 19 317 healthy children and adolescents from 5 to 18 years of age, 50.8% of whom were boys. The overall prevalence of overweight, obesity and severe obesity in all age groups was 23.1%, 9.3% and 2%, respectively. A significantly lower prevalence of overweight (23.8 vs 20.4; P<.001) and obesity (9.5 vs 5.7; P<.001) was found when the CDC reference was used.

CONCLUSIONS

This report establishes baseline national prevalence rates for overweight, obesity and severe obesity in Saudi children and adolescents, indicating intermediate levels between developing and industrialized countries. Measures should be implemented to prevent further increases in the numbers of overweight school-age children and adolescents and the associated health hazards.

Dental caries, tooth eruption timing and obesity: a longitudinal study in a group of Mexican schoolchildren

OBJECTIVES

To identify the possible association between dental caries and body mass index (BMI) and to explore the effect of BMI on tooth eruption in a cohort of elementary schoolchildren.

MATERIAL AND METHODS

A 4-year longitudinal study was completed. A total of 110 children from a public elementary school, located in a middle-income area of Mexico City, entered the study; of these, 88 completed the 4-year follow-up period. Dental caries assessments were carried out using the WHO criteria for decayed, missing and filled primary and permanent teeth indices (dmft and DMFT, respectively) and surface indices (dmfs and DMFS, respectively). BMI was used to classify the children's obesity status, according to the Centers for Disease Control 2000 reference charts.

RESULTS

At 7 years of age, 29.6% of the children were in the overweight or at risk of being overweight categories and, by 11 years of age, this proportion had risen to 45.5%. The mean dmft for children aged 7 years was 2.70 and, for children aged 11 years, the DMFT was 0.54. Children in the higher BMI categories had more erupted teeth than the other children (p < 0.001). A lower dmfs index was detected in the overweight children, compared with children with a lower BMI (p < 0.001).

CONCLUSIONS

The overweight children had more erupted teeth and a lower caries index. The complex relationships between body composition and oral health should be considered in pediatric patients.

Understanding infant feeding beliefs, practices and preferred nutrition education and health provider approaches: an exploratory study with Somali mothers in the USA

The objective of this study was to explore Somali mothers' beliefs and practices around infant feeding and education, towards developing a culturally informed infant nutrition curriculum for health providers. Four focus groups were conducted to explore: (1) beliefs about infant feeding, hunger and ideal weight; (2) feeding practices; (3) nutrition education approaches; and (4) provider/mother interactions. Thirty-seven Somali mother participants identified the following themes within these topics: (1) strategies for assessing hunger, satiety and when to feed; shared beliefs that plump babies are healthy, leading to worry about infant weight; (2) context of breast milk adequacy, difficulties breastfeeding and environmental and cultural barriers to breastfeeding, leading to nearly universal early supplementation with formula; (3) preferred education approaches include provider visits with interpreters, Somali language educational materials and advice from older, experienced family members; and (4) desired health provider skills include: listening, explaining, empathy, addressing specific concerns, repeating important information, offering preventive advice and sufficient visit time. This study presents knowledge about Somali beliefs and practices that can directly guide discussions with these families. Given that these infants appear on a trajectory towards obesity, influencing infant feeding practices in the Somali community is a good upstream approach to preventing obesity. These findings will underpin a new infant nutrition curriculum for health providers.

Effect of recreational physical activity on insulin levels in Mexican/Hispanic children

The effect of increased recreational physical activity in children on insulin levels has not yet been studied. We carried out a randomized controlled trial in 76 children 6-9 years old, 32 of them increased their physical activity and 30 maintained the same level. In the intervention group, after a week of baseline, recreational activity three times/week was programmed for 12 weeks. We compared insulin, homeostatic model assessment (HOMA) index, glucose, HDL-C, LDL-C, triglycerides, and body mass index in both groups. Thereafter, we compared groups of normal weight, overweight, and with obesity in the experimental group. The group of recreational activity increased their median daily steps (15,329 to 19,910) and decreased insulin (p < 0.001) and HOMA index (4.36 vs. 2.39, p < 0.001). The diminution of insulin levels was more significant in the overweight group (p < 0.007). In conclusion, in our group, children who increased physical activity during 12 weeks decrease insulin levels and insulin resistance without change in other metabolic and anthropometric variables.

BMI centile curves for Japanese children aged 5–17 years in 2000–2005

Objectives

To examine changes in the age-specific prevalence of overweight and obesity in Japanese children between 2000 and 2005 and compare Japanese centile curves with international ones.

Design

A large, Japanese, representative cross-sectional growth study.

Setting

Japan.

Subjects

Japanese children aged 5–17 years, including 669 986 subjects in 2000, 670 143 in 2001, 668 760 in 2002, 670 785 in 2003, 669 120 in 2004 and 668 234 in 2005.

Main outcome measure

BMI (weight/height2).

Results

The prevalence of overweight and obesity in children aged 5–17 years decreased from 2000 to 2005 in both males and females, according to the definitions of the Centers for Disease Control and Prevention and the International Obesity Taskforce. For each year, the centile curves were drawn so that at age 17 years they passed through respectively 24·46 kg/m2 and 24·70 kg/m2 for males, and 29·41 kg/m2 and 29·69 kg/m2 for females, which are the BMI values at age 17 years from the international reference curves.

Conclusions

The study results indicate that centile curves can change according to the time of observation, thus suggesting that international reference curves therefore need to be regularly revised while including more data from a larger range of countries.

Fast-food and sweetened beverage consumption: association with overweight and high waist circumference in adolescents

Objective

Overweight and obesity have increased to epidemic proportions among adolescents and are associated with chronic non-communicable diseases and excess mortality in adulthood. The association of overweight/obesity with poor dietary habits has not been studied in adolescents in middle-income developing countries. The present study aimed to estimate the prevalence of overweight, obesity and high waist circumference (WC) in 15–19-year-old Jamaican adolescents and to investigate the association with fast-food and sweetened beverage consumption.

Design

The study enrolled 1317 (598 male, 719 female) adolescents aged 15–19 years using multistage, nationally representative sampling. Age-specific prevalence calculation used internal Z-score lines connecting with the WHO adult cut-off points. Logistic regression was used to examine the association of overweight or high WC with fast-food and sweetened beverage consumption, adjusting for potential confounders.

Results

The overall prevalence of overweight, obesity and high WC was approximately 15 %, 6 % and 10 %, respectively. Prevalence estimated using internal Z-scores was similar to that using the International Obesity Taskforce cut-off points. Obesity (8·0 % in females, 3·3 % in males) and high WC (16·2 % in females, 1·7 % in males) were significantly more prevalent in females when using internal Z-score cut-offs. High WC was associated with the absence of fruit consumption (P = 0·043) and overweight with high sweetened beverage consumption (P = 0·018).

Conclusion

Overweight occurs frequently among Jamaican 15–19-year-olds and is associated with increased consumption of sweetened beverages. High WC is more prevalent among females and is related to low consumption of fruits and vegetables. Measures to reduce the consumption of sweetened beverages and increase fruit intake may reduce the prevalence of excess body fat among adolescents.

Fetal macrosomia and adolescence obesity: results from a longitudinal cohort study

OBJECTIVE

To assess the association between fetal macrosomia and adolescent obesity.

DESIGN

Longitudinal cohort study of the association between macrosomia and adolescent obesity.

SUBJECTS

Between 1 October 2005 and 1 February 2007, a follow-up study of live-born infants born in 1993-1995 in Wuxi, a suburban area of Shanghai, was conducted. Subjects with birth weight > 4000 g were selected as the exposed. For each exposed subject, one subject with a birth weight of 2500-4000 g, matched by year of birth, sex of infant, and type of institute at birth, was chosen as non-exposed. Clinical data were collected by structured interview and physical examination. Obesity was defined as body mass index (weight (kg)/height (m(2))) higher than the sex-age-specific criteria by the working group on obesity in China. Distribution of baseline characteristics and adolescent obesity rate between the exposed and non-exposed groups was compared.

RESULTS

A total of 1435 pairs of exposed and non-exposed subjects were included in the final analysis. No major difference in baseline characteristics (other than birth weight) was found between the exposed and non-exposed groups. Obesity rate was significantly higher in the exposed group (2.9%) than in the non-exposed group (1.6%). Adolescent obesity rates were 1.4, 1.9, 2.6, and 5.6%, respectively, in study subjects with a birth weight of 2500-3499, 3500-3999, 4000-4499, and > or =4500 g. The association between birth weight and adolescent obesity remained essentially the same when mother's demographic and anthropometric factors, breast feeding, and adolescent life-style factors were adjusted.

CONCLUSION

Compared with infants of normal birth weight, infants with birth weight >4000 g, especially those >4500 g, are at increased risk of adolescent obesity.

School food in Mexican children

Objective

To establish the school eating habits of Mexican children, who are prone to obesity and later to high rates of adult chronic diseases.

Design

Questionnaires for students and parents with staff questionnaires and interviews.

Setting

Randomly sampled schools in a socio-economically representative district of Mexico City.

Subjects

Subjects were 1504 adolescents aged 10–19 years attending schools in Mexico City, 27 teachers and seven headmasters, sampled from both public and private schools and from the full range of socio-economic groups.

Results

Foods brought from home were of a higher nutritional quality than those purchased at school, where purchases were dominated by crisps, soft drinks and other items with high energy density. Girls were more inclined to purchase inappropriately; those from poorer homes purchased less. Private-school students irrespective of socio-economic grade brought more food from home and purchased more expensive food at school. School policies allowed food and drink vendors to market any products within the schools, which benefited financially from these activities.

Conclusions

Current school food policies are conducive to amplifying the current epidemic of obesity and related adult chronic diseases, and need to change.

Pediatric obesity: the unique issues in Latino-American male youth

Pediatric obesity in the United States has been steadily rising over the past few decades, and it is a clear risk factor for adult obesity and obesity-related morbidity and mortality. A review of the literature from three major national databases reveals that the prevalence rates of obesity within Latino male children and adolescents is, in general, higher than other major gender-ethnic groups. Additionally, obese Latino male youth seem to be especially prone to a variety of obesity-related morbidities. Given the rising percentage of Latinos among our nation's youth, there is an urgency to develop and implement clinical and community research strategies to prevent and treat obesity within this high-risk gender-ethnic group. This article reviews the prevalence of pediatric obesity within the three largest databases in the U.S. with Latino representation. The paper then discusses unique issues in the etiology and ramifications of obesity within young Latino-American boys, reviews the few intervention studies that focus on Latino youth, and discusses potential strategies for further research.

Sex differences in under and over nutrition among school-going Black teenagers in South Africa: an uneven nutrition trajectory

OBJECTIVES

To investigate the nutritional status of Black South African teenagers by sex and compare it with nutritional profiles of teenagers from other countries.

METHODS

The first South African Youth Risk Behaviour Survey (2002) was adapted to include anthropometric data and this paper reports on the prevalence of under and over nutrition among 5322 Black teenagers, aged 13.0-17.9 years, grades 8-11. Prevalence of over nutrition in this study was compared with other countries using a World Bank country economic classification.

RESULTS

Significant sex differences were observed for under and over nutrition. Boys (18.4%) had a higher prevalence of underweight than girls (2.6%) (P < 0.005), who were more at risk of overweight than boys (20.9%vs. 4.2%) (P < 0.005). Boys (21.9%) were more stunted than girls (9.4%) (P < 0.05), but stunted girls were at greater risk of overweight than boys across all levels of stunting. The prevalence of overweight among boys (4.2%) was lower than in other countries while for girls (20.9%) was similar to several upper middle and high income countries.

CONCLUSION

Gender sensitive strategies are required to address both under and over nutrition among South African teenagers to reduce stunting and future chronic disease epidemics in adulthood. This paper suggests that Black South African teenagers are experiencing an uneven nutritional transition across sex, from under nutrition to over nutrition.

Overweight and obesity in a rural Amerindian population in Oaxaca, Southern Mexico, 1968-2000

The purpose of this study was to evaluate secular change in the prevalence of overweight and obesity in a rural Zapotec Indian community in southern Mexico between 1968 and 2000. Cross-sectional surveys of children 6-13 years, adolescents 13-17 years, and adults 19 years of age and older resident in a rural community in Oaxaca were conducted in 1968/1971, 1978, and 2000. Individuals present in the 1968, 1978, and 2000 surveys provided a small longitudinal component. Height and weight were measured; the BMI was calculated. International criteria for overweight and obesity were used. Overweight and obesity were virtually absent in school children 6-13 years in 1968 and 1978 and in adolescents in 1978. Small proportions of children (boys, 5%; girls, 8%) and adolescents (boys, 3%; girls, 15%) were overweight in 2000; two children (1%) and no adolescents were obese. Among adults, 7% of males and 19% of females were overweight and <1% of males and 4% of females were obese in 1971/1978, but 46% of males and 47% of females were overweight; and 5% of males and 14% of females were obese in 2000. The trends for children, adolescents, and adults were confirmed in the longitudinal subsamples. In conclusion, overweight and obesity are not presently a major problem in children and adolescents in this rural Zapotec community. Overweight, in particular, and to a lesser extent obesity have increased in prevalence among adults since the late 1970s. The results suggest adulthood as a critical period for onset of overweight and obesity in this sample.

Maternal BMI and country of birth as indicators of childhood obesity in children of Mexican origin

OBJECTIVE

The goal of this study was to evaluate the relationship between maternal and childhood BMI at baseline in a group of 5- to 18-year-old children and their mothers, all of whom were of Mexican origin, low socioeconomic status, and enrolled in a cohort study in Houston, TX.

RESEARCH METHODS AND PROCEDURES

Using data from 438 mother-child dyads residing in the same household, we completed logistic regression analyses to determine maternal factors associated with the child being overweight or at-risk-for-overweight, after adjusting for the child's gender, age, and level of physical activity and other maternal confounders.

RESULTS

Almost one-half of the boys and girls (47% and 44%, respectively) were either overweight or at-risk-for-overweight. Obese mothers were twice as likely to have an overweight and/or at-risk-for-overweight child compared with normal-weight mothers. Women born in the U.S. were twice as likely to have an overweight and/or at-risk-for-overweight child compared with women born in Mexico. In addition, women with less than a high school education were twice as likely to have an overweight child compared with their more educated peers.

DISCUSSION

The high prevalence of overweight or at-risk-for-overweight among Mexican-origin children of low socioeconomic status suggests a continued need to develop and implement culturally sensitive preventive interventions for this minority population. Our data also suggest a need to tailor such interventions particularly for children of obese mothers and those born in the U.S.