Secular and seasonal trends in obesity in Chilean preschool children, 1996-2004

Seasonal variation of patulous Eustachian tube diagnoses using climatic and national health insurance data

OBJECTIVES

This study aimed to analyse if there were any associations between patulous Eustachian tube occurrence and climatic factors and seasonality.

METHODS

The correlation between the monthly average number of patients diagnosed with patulous Eustachian tube and climatic factors in Seoul, Korea, from January 2010 to December 2016, was statistically analysed using national data sets.

RESULTS

The relative risk for patulous Eustachian tube occurrence according to season was significantly higher in summer and autumn, and lower in winter than in spring (relative risk (95 per cent confidence interval): 1.334 (1.267-1.404), 1.219 (1.157-1.285) and 0.889 (0.840-0.941) for summer, autumn and winter, respectively). Temperature, atmospheric pressure and relative humidity had a moderate positive (r = 0.648), negative (r = -0.601) and positive (r = 0.492) correlation with the number of patulous Eustachian tube cases, respectively.

CONCLUSION

The number of patulous Eustachian tube cases was highest in summer and increased in proportion to changes in temperature and humidity, which could be due to physiological changes caused by climatic factors or diet trends.

Association between summer temperature and body weight in Japanese adolescents and children: An ecological analysis

OBJECTIVE

Several experimental studies reported evidence of a negative energy balance at higher temperatures. However, corresponding weight loss has not been noted in clinical practice. This study investigated the geographical association between outdoor temperature and body weight in Japanese adolescents and children.

METHODS

An ecological analysis was conducted using prefecture-level data on the mean body weight of Japanese adolescents and children over a 25-year period and Japanese mesh (regional) climatic data on the mean annual temperature, mean daily maximum temperature in August, and mean daily minimum temperature in January were also analyzed.

RESULTS

Correlation analysis uncovered a stronger association between weight and the mean daily maximum temperature in August than with other climatic variables. Moreover, multiple regression analysis indicated that height and the mean daily maximum temperature in August were statistically significant predictors of weight. This suggests that geographical differences in weight in Japanese adolescents and children can be explained by the complementary relationship between height-associated weight gain and weight loss caused by summer heat.

CONCLUSIONS

Summer temperatures may reduce the proportion of children who are overweight and contribute to geographical differences in body weight in Japanese adolescents and children. Am. J. Hum. Biol. 28:789-795, 2016. © 2016Wiley Periodicals, Inc.

Stunting, Underweight and Overweight in Children Aged 2.0-4.9 Years in Indonesia: Prevalence Trends and Associated Risk Factors

OBJECTIVE

The double burden of malnutrition affects many low and middle-income countries. This study aimed to: a) determine temporal trends in the prevalence of underweight, stunting, and at risk of overweight/ overweight or obesity in Indonesian children aged 2.0-4.9 years; and b) examine associated risk factors.

DESIGN

A repeated cross-sectional survey. This is a secondary data analysis of waves 1, 2, 3, and 4 (1993, 1997, 2000, and 2007) of the Indonesian Family Life Survey, which includes 13 out of 27 provinces in Indonesia. Height, weight and BMI were expressed as z-scores (2006 WHO Child Growth Standards). Weight-for-age-z-score <-2 was categorised as underweight, height-for-age-z-score <-2 as stunted, and BMI-z-score >+1, >+2, >+3 as at-risk, overweight and obese, respectively.

RESULTS

There are 938, 913, 939, and 1311 separate children in the 4 waves, respectively. The prevalence of stunting decreased significantly from waves 1 to 4 (from 50.8% to 36.7%), as did the prevalence of underweight (from 34.5% to 21.4%). The prevalence of 'at-risk'/overweight/obesity increased from 10.3% to 16.5% (all P<0.01). Stunting and underweight were related to lower birth weight, being breastfed for 6 months or more, having parents who were underweight or had short stature, and mothers who never attended formal education. Stunting was also higher in rural areas. Being at-risk, or overweight/obese were closely related to being in the youngest age group (2-2·9 years) or male, having parents who were overweight/obese or having fathers with university education.

CONCLUSIONS

The double burden of malnutrition occurs in Indonesian children. Development of policy to combine the management of chronic under-nutrition and over-nutrition is required.

Childhood and adolescent overweight and obesity in Latin America: a systematic review

The number of children and adolescents who are overweight or obese worldwide is alarming. We did a systematic review to estimate the prevalence of overweight and obesity in children aged 0-19 years in Latin America. We searched specialised databases and seven books for relevant studies that were done in Spanish-speaking and Portuguese-speaking Latin American and Caribbean countries and published in peer-reviewed journals between January 2008, and April 2013. Indicators used were BMI (kg/m(2)) in all age groups and weight-for-height in children younger than 5 years. We identified 692 publications and included 42. Estimated prevalence of overweight in children younger than 5 years in Latin America was 7·1% with the weight-for-height WHO 2006 classification method. National combined prevalences of overweight and obesity with the WHO 2007 classification method ranged from 18·9% to 36·9% in school-age children (5-11 years) and from 16·6% to 35·8% in adolescents (12-19 years). We estimated that 3·8 million children younger than 5 years, 22·2-25·9 million school-age children, and 16·5-21·1 million adolescents were overweight or obese. Overall, between 42·5 and 51·8 million children aged 0-19 years were affected-ie, about 20-25% of the population. Although undernutrition and obesity coexist in the region, policies in most countries favour prevention of undernutrition, and only a few countries have implemented national policies to prevent obesity. In view of the number of children who are overweight or obese, the associated detrimental effects on health, and the cost to health-care systems, implementation of programmes to monitor and prevent unhealthy weight gain in children and adolescents are urgently needed throughout Latin America.

WHO European Childhood Obesity Surveillance Initiative 2008: weight, height and body mass index in 6-9-year-old children

What is already known about this subject Overweight and obesity prevalence estimates among children based on International Obesity Task Force definitions are substantially lower than estimates based on World Health Organization definitions. Presence of a north-south gradient with the highest level of overweight found in southern European countries. Intercountry comparisons of overweight and obesity in primary-school children in Europe based on measured data lack a similar data collection protocol. What this study adds Unique dataset on overweight and obesity based on measured weights and heights in 6-9-year-old children from 12 European countries using a harmonized surveillance methodology. Because of the use of a consistent data collection protocol, it is possible to perform valid multiple comparisons between countries. It demonstrates wide variations in overweight and obesity prevalence estimates among primary-school children between European countries and regions.

BACKGROUND

Nutritional surveillance in school-age children, using measured weight and height, is not common in the European Region of the World Health Organization (WHO). The WHO Regional Office for Europe has therefore initiated the WHO European Childhood Obesity Surveillance Initiative.

OBJECTIVE

To present the anthropometric results of data collected in 2007/2008 and to investigate whether there exist differences across countries and between the sexes.

METHODS

Weight and height were measured in 6-9-year-old children in 12 countries. Prevalence of overweight, obesity, stunting, thinness and underweight as well as mean Z-scores of anthropometric indices of height, weight and body mass index were calculated.

RESULTS

A total of 168 832 children were included in the analyses and a school participation rate of more than 95% was obtained in 8 out of 12 countries. Stunting, underweight and thinness were rarely prevalent. However, 19.3-49.0% of boys and 18.4-42.5% of girls were overweight (including obesity and based on the 2007 WHO growth reference).The prevalence of obesity ranged from 6.0 to 26.6% among boys and from 4.6 to 17.3% among girls. Multi-country comparisons suggest the presence of a north-south gradient with the highest level of overweight found in southern European countries.

CONCLUSIONS

Overweight among 6-9-year-old children is a serious public health concern and its variation across the European Region highly depends on the country. Comparable monitoring of child growth is possible across Europe and should be emphasized in national policies and implemented as part of action plans.

Prevalence of Overweight and Obesity in Chinese Preschoolers in Singapore

Introduction: This study examines the prevalence of overweight and obesity in 6- to 72-month-old Chinese preschoolers in Singapore using 3 references. Materials and Methods: This was a population-based cross-sectional study of 3009 Chinese preschoolers aged 6 to 72 months from southwestern and western parts of Singapore. Overweight and obesity were defi ned by using the Center for Disease Control (CDC) (85th and 95th percentile, respectively), the International Obesity Task Force (IOTF) and the local National Health Group Polyclinics (NHGP), Singapore (90th and 97th percentile, respectively) references. Results: The prevalence of overweight and obesity in 24 to 72 months old Chinese children were 8.1% and 7.1% (the CDC reference), 7.6% and 3.9% (the IOTF reference) and 7.5% and 5.3% (the local reference [NHGP]) respectively. For preschoolers aged 6 to 72 months, the prevalence of overweight and obesity was 7.0% and 5.3%, respectively, using the local reference. An increasing trend in the prevalence of obesity with increasing age was seen in both genders, using the CDC and IOTF references (P ≤0.001 and 0.001, respectively). The boys were more likely to be obese than the girls using the CDC reference (OR = 1.42, 95% CI, 1.02 to 1.97, P = 0.03). Conclusion: Our study showed a lower prevalence of overweight and obesity among Chinese preschoolers in Singapore when compared to other countries like the United States, Italy, Chile using the CDC and/or IOTF references. The CDC reference overestimated whereas the IOTF reference underestimated the prevalence of overweight and obesity for our population when compared to using the local NHGP reference. Key words: CDC, Cross-sectional, IOTF, Population-based

Variations in data collection can influence outcome measures of BMI measuring programmes

BACKGROUND

The World Health Organization (WHO) promotes the surveillance of obesity prevalence through standardized and harmonized surveillance systems. However, variations in data collection between countries, or between coordinating regions in countries can affect outcome measures.

METHODS

Multilevel analysis of 2007/08 National Child Measurement Programme (NCMP) data estimating the relationship between BMI z-score and data collection variations within coordinating regions whilst adjusting for individual-level and school-level variables. The 2007/08 NCMP collected height and weight measurements for 478,381 Reception year pupils (4-5-year-olds) and 496,297 year 6 pupils (10-11-year-olds) from 17,279 primary schools in 152 data collection coordinating regions in England.

RESULTS

Data collection variables accounted for 29.7% of the regional variation in BMI z-score for Reception year pupils but only 5.3% for the older Year 6 pupils. Digit preference in the rounding of weight measurements had the greatest impact of all the data collection variables, explaining 26.4% of the regional variation in BMI z-score for Reception year pupils and 4.0% for Year 6 pupils.

CONCLUSIONS

Although variations in data collection may have a small effect on individual measurements their impact can be magnified when scaled up to regional or national figures. All measurement programmes must regularly identify and minimize variations in data collection to improve accuracy of outcome measures. These factors include those identified within this study: participation and opt out rates, the time in the year the measurements are taken and the recording of measurements to the correct decimal place.

Maternal anthropometry and feeding behavior toward preschool children: association with childhood body mass index in an observational study of Chilean families

BACKGROUND

A better understanding of the link between eating behavior and maternal feeding practices with childhood and maternal weight status is of great interest.

OBJECTIVE

To assess the association between childhood anthropometric measures with mothers' Body Mass Index (BMI) and their feeding practices toward preschool children in Chile.

METHODS

1029 children (504 boys, 4.3 +/- 0.3 years) and their mothers were selected from public nurseries located in low income neighborhoods in Santiago. Mothers' BMI, children's BMI and waist-to-height ratios were registered. Maternal feeding practices towards their children's nutritional habits were measured using an adapted version of the Child Feeding Questionnaire (CFQ).

RESULTS

We found a direct correlation (p < 0.001) between children's BMI z-score and their mothers' BMI, both in boys (Spearman rho = 0.26) and girls (rho = 0.30). A direct association was also found between children's BMI z-score with scores of the subscale "concern for child's weight" (Spearman rho = 0.26 in boys and rho = 0.37 in girls; p < 0.001) and "food restriction" (rho = 0.19 in boys and rho = 0.27 in girls; p < 0.001). A reverse significant association was found between children's BMI z-score with scores of "pressure to eat" (rho = -0.30 in boys and rho = -0.36 in girls; p < 0.001). Analyses of the combined categories of childhood obesity and/or maternal obesity showed an important influence of children's weight status on CFQ scores.

CONCLUSION

Mothers' BMI and children's BMI z-scores are highly correlated. We found significant associations between mothers' behaviour subscales and children's BMI z-score. It is not possible to establish a causal link between mother's CFQ scores and children's nutritional status, given the cross-sectional nature of this study and the bidirectional influences that exist between mothers and their children.