International Journal of Pediatric Obesity (Int J Pediatr Obes)

Publications in this journal

• Article: Energy expenditure and insulin sensitivity evaluation in obese children affected by hepatosteatosis.

  Fintini D, Pietrobattista A, Morino G, Cafiero G, Calzolari A, Turchetta A, Brufani C, Alisi A, Giordano U, Nobili V
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  ABSTRACT: OBJECTIVES: The aim of our study was to evaluate the physical and sedentary activities and energy expenditure (EE) in a group of children affected by non-alcoholic fatty liver disease (NAFLD), compared with normal and obese subjects, using a physical activity questionnaire (PAQ) and a SenseWear armband (SWA). METHODS: Forty NAFLD (10 females), 41 lean (NRM; 11 females) and 30 obese (OB; 10 females), age- and pubertal stage-matched, children were included. RESULTS: Sedentary activity (PAQ) was similar in NAFLD and NRM but less in OB, while SWA showed that NAFLD spent less time in physical activity and more in sedentary activities compared with NRM, but not with OB. Insulin sensitivity index result is related to active EE (cal kg(-1)  d(-1) ) in NAFLD, while homeostatic model assessment index result was negatively related to total EE in OB. CONCLUSIONS: Regular physical activity must be encouraged in all obese children affected by NAFLD or not, and SWA might be a possible valid tool for evaluating actual EE.
  International Journal of Pediatric Obesity 04/2012;
• Article: The relationship between childhood weight, dental caries and eating practices in children aged 4–8 years in Australia, 2004–2008.

  Hooley, M, Skouteris, H, Millar, L
  International Journal of Pediatric Obesity 01/2012; 7(6):461-470.
• Article: 11. Kuhle S, Kirk S, Ohinmaa A, Yasui Y, Allen A, Veugelers P (2011). Use and cost of health services among overweight and obese Canadian children. International Journal of Pediatric Obesity April 2011, Vol. 6, No. 2: 142–148.

  Kuhle S, Kirk S, Ohinmaa A, Yasui Y, Allen A, Veugelers P
  International Journal of Pediatric Obesity 04/2011; 6(2):142-148.
• Article: Use and cost of health services among overweight and obese Canadian children

  Kuhle S, Kirk S, Ohinmaa A, Yasui Y, Allen A, Veugelers P
  International Journal of Pediatric Obesity 04/2011;
• Article: The contribution of parental BMI to the metabolic health of their offspring

  Ajala O, Hosking J, Metcalf BS, Wilkin T
  International Journal of Pediatric Obesity 01/2011;
• Article: 32. Fonseca, H., Matos, M.G., Guerra, A., & Gomes-Pedro, J. (2009). Are overweight and obese adolescents different from their peers? International Journal of Pediatric Obesity, 4(3), 166-74. http://dx.doi.org/10.1080/17477160802464495

  Fonseca, Matos, M.G, Guerra, Gomes-Pedro
  International Journal of Pediatric Obesity 01/2009;
• Article: Prevalence of overweight and obesity among 11-year-old children in Cyprus, 1997-2003.

  Savvas C Savva, Michael J Tornaritis, Charalambos Chadjigeorgiou, Yiannis A Kourides, Maria Siamounki, Anthony Kafatos
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  ABSTRACT: To report 5-year changes in the prevalence of overweight and obesity in 11-year-old children in Cyprus. This was a school-based study performed in Cyprus. A total of 14,090 11-year-old children (males: 51.2%), who had been examined in the 1997-8 and 2002-3 school years, were included in the study. The International Obesity Task Force (IOTF) cut-offs were used to define overweight and obese subjects, and logistic regression models were used to estimate 5-year trends. The overall prevalence of overweight children was slightly higher in the second period but this change was not statistically significant. There was only a significant increase in overweight boys in rural areas; odds ratio (OR) (95% confidence interval [CI]) for the 5-year period was 1.33 (1.10, 1.62; p = 0.004). The overall relative increase in obesity was 17.9% and the OR (95% CI) was 1.22 (1.07, 1.38; p = 0.003). Although the prevalence of obesity was higher in males in both periods, the relative increase was substantially higher in females, 29.6% vs. 11.4%. The relative increase was also higher in rural (35.9%) compared with urban areas (8.7%); ORs (95% CI) 1.46 (1.17, 1.81) vs. 1.10 (0.94, 1.29), respectively. This is the first report documenting increasing rates of obesity among school-aged children in Cyprus. Females and children living in rural areas experienced the most striking increases. The prevalence of overweight increased only in males living in rural areas.
  International Journal of Pediatric Obesity 02/2008; 3(3):186-92.
• Article: Adiponectin in childhood.

  Alison N Jeffery, Michael J Murphy, Brad S Metcalf, Joanne Hosking, Linda D Voss, Patrick English, Naveed Sattar, Terence J Wilkin
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  ABSTRACT: Adiponectin, a hormone produced and secreted by adipocytes, is present in circulation in high circulating concentrations, suggesting an important physiological role. An indirect regulator of glucose metabolism, adiponectin increases insulin sensitivity, improves glucose tolerance and inhibits inflammation. Plasma adiponectin relates inversely to adiposity and, importantly, reflects the sequelae of accumulation of excess adiposity. The role of adiponectin in adults has been explored in detail. Studies in children are now available and, given the increasing rates of childhood obesity, it is important to establish the role of adiponectin in mediating insulin resistance and cardiovascular disease in this age group. This paper reviews the regulation of adiponectin, its effect on body mass, glucose metabolism and cardiovascular risk in infants, children and adolescents. It demonstrates clear links between adiponectin and features of the metabolic syndrome in obese children and adolescents. However, adiponectin's role as a predictor of metabolic dysfunction in healthy, normal-weight youngsters is less clear.
  International Journal of Pediatric Obesity 02/2008; 3(3):130-40.
• Article: Neighborhood characteristics in relation to diet, physical activity and overweight of Canadian children.

  Paul Veugelers, Fortune Sithole, Sharon Zhang, Nazeem Muhajarine
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  ABSTRACT: Neighborhood infrastructure may provide an important opportunity to prevent overweight among children. In the present study we investigated whether access to shops for modestly priced fresh produce, access to parks and playgrounds, access to recreational facilities and neighborhood safety are related to children's diet, physical and sedentary activities, and body weights. Data were obtained from the Children's Lifestyle and School-performance Study, a survey including 5,471 grade five students and their parents in the province of Nova Scotia, Canada. Students completed the Harvard Food Frequency Questionnaire and had their height and weight measured. Parents completed questions on socio-economic background and how they perceived their neighborhood. We applied multilevel regression methods to relate these neighborhood characteristics with children's fruit and vegetable consumption, dietary fat intake, diet quality, frequency of engaging in sports with and without a coach, screen time, overweight and obesity. Children in neighborhoods with greater perceived access to shops had healthier diets and were less likely to be overweight or obese. Children in neighborhoods with good access to playgrounds, parks and recreational facilities were reportedly more active and were less likely to be overweight or obese, whereas children in safe neighborhoods engaged more in unsupervised sports. The study demonstrated associations between neighborhood characteristics, health behaviors and childhood overweight. This contributes to the knowledge base that is still too narrow to justify informed preventative public health policy. We advocate the evaluation of natural experiments created by new policy that affect neighborhood infrastructures as the optimal opportunity to enlarge this knowledge base.
  International Journal of Pediatric Obesity 02/2008; 3(3):152-9.
• Article: Family Weight School treatment: 1-year results in obese adolescents.

  Paulina Nowicka, Peter Höglund, Angelo Pietrobelli, Inge Lissau, Carl-Erik Flodmark
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  ABSTRACT: The aim was to evaluate the efficacy of a Family Weight School treatment based on family therapy in group meetings with adolescents with a high degree of obesity. Seventy-two obese adolescents aged 12-19 years old were referred to a childhood obesity center by pediatricians and school nurses and offered a Family Weight School therapy program in group meetings given by a multidisciplinary team. Intervention was compared with an untreated waiting list control group. Body mass index (BMI) and BMI z-scores were calculated before and after intervention. Ninety percent of the intervention group completed the program (34 boys, 31 girls; baseline age = 14.8 +/- 1.8 years [mean +/- standard deviation, SD], BMI = 34 +/- 4.0, BMI z-score = 3.3 +/- 0.4). In the control group 10 boys and 13 girls (baseline age = 14.3 +/- 1.6, BMI = 34.1 +/- 4.8, BMI z-score = 3.2 +/- 0.4) participated in the 1-year follow-up. Adolescents in the intervention group with initial BMI z-score < 3.5 (n = 49 out of 65, baseline mean age = 14.8, mean BMI = 33.0, mean BMI z-score = 3.1), showed a significant decrease in BMI z-scores in both genders (-0.09 +/- 0.04, p = 0.039) compared with those in the control group with initial BMI z-score < 3.5 (n = 17 out of 23, mean baseline age = 14.1, mean baseline BMI = 31.6, mean baseline BMI z-score = 3.01). No difference was found in adolescents with BMI z-scores > 3.5. Family Weight School treatment model might be suitable for adolescents with BMI z-score < 3.5 treated with a few sessions in a multidisciplinary program.
  International Journal of Pediatric Obesity 02/2008; 3(3):141-7.
• Article: Waist-to-height ratio is correlated with height in US children and adolescents aged 2-18 years.

  David J Tybor, Alice H Lichtenstein, Gerard E Dallal, Aviva Must
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  ABSTRACT: The waist-to-height ratio is an anthropometric measure of central adiposity that has emerged as a significant predictor of cardiovascular disease risk factors in children and adolescents. However, the simple waist-to-height ratio retains residual correlation with height, which could cause the measure to over- or under-adjust for the effect of height at certain ages. We investigated the dependence of waist-to-height ratio on height in the representative US National Health and Nutrition Examination Survey 1999-2004. We stratified 11 270 subjects aged 2-18 years by age and sex. There was considerable residual correlation between height and the waist-to-height ratio, ranging from -0.29 to 0.36. Thus, simply dividing waist circumference by height (WC/Ht1) might not be appropriate to "adjust for height" during periods of growth. We fitted a log-log regression of waist circumference on height to determine which exponent for height ensures that the log of the ratio is uncorrelated with the log of height, which we call the optimal exponent for WC/Ht(p). This optimal power for height in the age- and sex-specific waist-to-height ratio varies from 0.5 to 2.0, with similar patterns for males and females. The value peaks at age 8, and is close to 1 at age 18. Future research should investigate how this affects relationships between central adiposity and cardiovascular disease risk factors across these ages, and how using a power other than 1 might reduce bias and improve precision.
  International Journal of Pediatric Obesity 02/2008; 3(3):148-51.
• Article: Association between television viewing and poor diet quality in young children.

  Sonia A Miller, Elsie M Taveras, Sheryl L Rifas-Shiman, Matthew W Gillman
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  ABSTRACT: To examine the association between television/video (TV) viewing and markers of diet quality among 3-year-old children. We studied 613 boys and 590 girls, age 3 years old, who were participants in Project Viva. Each mother reported the number of hours her child watched TV on an average weekday and weekend day in the past month, from which we calculated a weighted mean. The main outcomes were intakes of selected foods and nutrients from a validated food frequency questionnaire. In linear regression models we adjusted for mother's sociodemographic information, parental body mass index (BMI), and child's age, sex, race/ethnicity, BMI z-score, sleep duration, and breast feeding duration. Mean (standard deviation, SD) age of subjects was 3.2 (0.2) years; 372 children (31%) were non-white and 151 (13%) had a household income < $40 000, and 330 mothers (28%) had completed less than a college degree. Mean (SD) TV viewing was 1.7 (1.0) hours per day. For each 1-hour increment of TV viewing per day, we found higher intakes of sugar-sweetened beverages (0.06 servings/day [95% CI 0.03, 0.10]), fast food (0.32 servings/month [95% CI 0.16, 0.49]), red and processed meat (0.06 servings/day [95% CI 0.02, 0.09]), total energy intake (48.7 kcal/day [95% CI 18.7, 78.6]), and percent energy intake from trans fat (0.05 [95% CI 0.03, 0.07]). We found lower intakes of fruit and vegetables (-0.18 servings/day [95% CI -0.32, -0.05]), calcium (-24.6 mg/day [95% CI -41.0, -8.1]), and dietary fiber (-0.44 g/day [95% CI -0.65, -0.22]). Among 3-year-olds, more TV viewing is associated with adverse dietary practices. Interventions to reduce TV viewing in this age group may lead to improved diet quality.
  International Journal of Pediatric Obesity 01/2008; 3(3):168-76.
• Article: Family physical activity and sedentary environments and weight change in children.

  Anna Timperio, Jo Salmon, Kylie Ball, Louise A Baur, Amanda Telford, Michelle Jackson, Louisa Salmon, David Crawford
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  ABSTRACT: To examine associations between family physical activity and sedentary environment and changes in body mass index (BMI) z-scores among 10-12-year-old children over three years. Design. Longitudinal (three-year follow-up). Subjects. In total, 152 boys and 192 girls aged 10-12 years at baseline. Measured height and weight at baseline and follow-up (weight status, BMI z-scores); aspects of the family physical activity and sedentary environment (parental and sibling modelling, reinforcement, social support, family-related barriers, rules/restrictions, home physical environment) measured with a questionnaire completed by parents at baseline. At baseline, 29.6% of boys and 21.9% of girls were overweight or obese, and mean (standard deviation, SD) BMI z-scores were 0.44 (0.99) and 0.28 (0.89), respectively. There was a significant change in BMI z-score among girls (mean change = 0.19, SD = 0.55, p < 0.001), but not boys. Among boys, the number of items at home able to be used for sedentary behaviour (B = 0.11, p = 0.037) was associated with relatively greater increases in BMI z-score. Among girls, sibling engagement in physical activity at least three times/wk (B = -0.17, p = 0.010) and the number of physical activity equipment items at home (B = -0.05, p = 0.018) were associated with relatively greater decreases in BMI z-score. Sibling physical activity and environmental stimuli for sedentary behaviours and physical activity within the home may be important targets for prevention of weight gain during the transition from childhood to adolescence.
  International Journal of Pediatric Obesity 01/2008; 3(3):160-7.
• Article: Energy expenditure of obese, overweight, and normal weight females during lifestyle physical activities.

  Jennifer L Aull, David A Rowe, Robert C Hickner, Brenda M Malinauskas, Matthew T Mahar
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  ABSTRACT: To quantify energy expenditure of various lifestyle physical activities of obese, overweight, and normal-weight girls. In total, fifty-five girls participated in six activities: a treadmill walk at 4.0 km x hr(-1), run, football throw, walk in open area, cycle, and riding a scooter. Intensities for all activities except the treadmill walk were self-selected. Energy expenditure was measured using the COSMED K4b(2) portable metabolic system. Analyses of variance were used to compare the three groups (obese n = 11, overweight n = 16, and normal weight n = 28) on relative VO2 (ml x kg(-1) x min(-1) and ml x FFM(-1) x min(-1)), and absolute energy expenditure (kJ x min(-1)). Magnitudes of the mean differences were examined using Cohen's delta (ES). Relative VO2 (ml x FFM(-1) x min(-1)) was not significantly different (p > 0.05) among the groups for any activity. Obese girls expended more energy (p < 0.05) than normal-weight girls on all weight bearing activities. These differences were large (ES > or = 0.91). The differences in kJ x min(-1) between the obese and normal weight groups for the bicycle and scooter activities were moderate to large (ES > or = 0.56), although not statistically significant. The overweight group expended more energy than the normal weight group and less energy than the obese group on all activities (ES = 0.17 to 1.82), although these differences were generally not statistically significant. The oxygen costs of various activities are similar among obese, overweight, and normal-weight girls when expressed relative to fat-free mass. When engaging in self-selected levels of activity, obese girls have a higher absolute energy expenditure than normal-weight girls.
  International Journal of Pediatric Obesity 01/2008; 3(3):177-85.
• Article: Child overweight and obesity in the USA: prevalence rates according to IOTF definitions.

  Tim Lobstein, Rachel Jackson-Leach
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  ABSTRACT: To establish the prevalence of child overweight and obesity in the USA using IOTF-recommended definitions. Original data from the NHANES surveys for 1999-2000 and 2003-2004 were analysed using the IOTF cut-offs and prevalence levels calculated using sample weightings provided. In 1999-2000, overweight (including obesity) was affecting 29% of school-age children. By 2003-2004 this figure had risen above 35%. Obesity alone was affecting 10% of school children in the 1999-2000, and over 13% in 2003-2004. The United States is experiencing levels of child overweight and obesity that are among the highest recorded in any country in the world.
  International Journal of Pediatric Obesity 02/2007; 2(1):62-4.
• Article: Associations between family circumstance and weight status of Australian children.

  Kylie Hesketh, David Crawford, Jo Salmon, Michelle Jackson, Karen Campbell
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  ABSTRACT: To examine associations between weight status and multiple indicators of family circumstance in Australian elementary school children. Data were combined from the 2001 Children's Leisure Activities Study (CLAS Study) and 2002/3 Health, Eating and Play Study (HEAP Study), involving 2520 children in Grades Prep (mean age 6 years) and 5-6 (mean age 11 years) in Melbourne, Australia. Children's body mass index (BMI) was calculated from measured height and weight. Weight status (non-overweight or overweight) was determined according to International Obesity Taskforce cut-off points and BMI was transformed to z-scores based on the 2000 US growth chart data. Parents reported family circumstance (number of parents in the home, marital status, presence of siblings, parental education, parental employment status, parental work hours [HEAP Study only]) and parental BMI. Regression analyses were conducted for the sample overall and separately for young girls, young boys, older girls and older boys. Children in single-parent homes, those without siblings, and those with less educated mothers and fathers tended to have higher z-BMIs (p=0.002, p=0.003, p<0.001 and p<0.001, respectively) and were more likely to be overweight (p=0.003, p<0.001, p<0.001 and p=0.02, respectively). Associations were stronger for older children. Parental employment and work hours were not consistently associated with child weight status. The multivariable models did not demonstrate a cumulative explanatory effect (R(2)=0.02), except when maternal BMI was included (R(2)=0.07). Individual measures of family circumstance were differentially associated with child weight status and appeared to be largely independent of other measures of family circumstance. Childhood overweight interventions may need to be tailored based on the age, gender, maternal BMI and family circumstances of the target group.
  International Journal of Pediatric Obesity 02/2007; 2(2):86-96.
• Article: Restrained eating in overweight children: does eating style run in families?

  Simone Munsch, Kathrin Hasenboehler, Tanja Michael, Andrea H Meyer, Binia Roth, Esther Biedert, Juergen Margraf
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  ABSTRACT: Overweight children show abnormalities in eating style, such as restrained eating and tendency toward overeating (comprising both emotional and external eating). Family surroundings play a major role in developing eating behaviors in children. We tested whether restrained eating and tendency toward overeating predicted the amount of food intake in 41 overweight children (23 girls and 18 boys) and their parents (40 mothers and 11 fathers) after receiving a preload. We further investigated with questionnaires whether there were associations between the parents' and their children's eating behavior and whether mothers' food intake predicted the amount of food consumed by children in an experimental trial. We found that neither children with restrained eating nor their mothers ate more after a preload, but children with a high tendency toward overeating ate somewhat more after receiving a preload. Further analyses showed that children's food intake in the preload paradigm was predicted by mothers' food intake. Our findings point to a familial transmission of eating styles: children eat as their primary caregivers do, even when the caregivers are not present in the laboratory.
  International Journal of Pediatric Obesity 02/2007; 2(2):97-103.
• Article: Comparison of a short food frequency questionnaire with the Youth/Adolescent Questionnaire in the Growing Up Today Study.

  Helaine R H Rockett, Catherine S Berkey, Graham A Colditz
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  ABSTRACT: Our purpose was to design and evaluate a shorter version of our 126-item food frequency questionnaire (long FFQ) for use with adolescents. A shorter FFQ is needed that can reliably rank research subjects according to their intakes of energy, macronutrients and selected micronutrients. Dietary data were collected annually, for 3 years, using the full-list FFQ from 16 882 participants of the Growing Up Today Study (GUTS). From this full-list FFQ data, the top ten food contributors for energy and each macronutrient, and the top five food contributors for eight other selected micronutrients were compiled to create a 26-item (short-list) FFQ. Arithmetic means and Pearson correlations were computed to assess relationships between nutrient intakes estimated from the short- and full-list FFQs. We further compared both FFQs with three 24-hour recalls (approximately every 4 months over a 1-year period). Linear regression models were fitted, using energy and nutrients estimated from the short-list FFQ and separately from the full-list FFQ, to see how results may differ. As expected, mean nutrient values from the short-list FFQ were substantially below those from the full-list FFQ. Pearson correlations >0.85 between the short- and full-list FFQs were found for most nutrients. However, correlations between nutrients from the short-list FFQ and the three 24-hour recalls were lower (mean correlation =0.40) than the full-list FFQ. Linear regression models suggested that the short-list FFQ performed nearly as well as the full-list FFQ, for studying associations between energy and several nutrients (trans fatty acids, saturated fat, and glycemic load) and the non-dietary factor, TV viewing. Model betas for energy and nutrients from the short-list FFQ were slightly smaller than betas obtained from the full-list FFQ, but all were statistically significant. The short-list FFQ can assess nutrient values of a population for analytic research purposes, such as studying associations between certain dietary intakes and non-dietary factors.
  International Journal of Pediatric Obesity 02/2007; 2(1):31-9.
• Article: Validity of thoracic gas volume equations in children of varying body mass index classifications.

  Duncan Radley, David A Fields, Paul J Gately
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  ABSTRACT: The aim of the study was to evaluate air-displacement plethysmography (ADP) thoracic gas volume (TGV) prediction equations in children representing a wide range of body mass index (BMI). 254 children (5 to 17 years) were recruited from two centres (England and the United States). Subjects were stratified into three BMI categories according to the International Obesity TaskForce (IOTF) criteria: lean (48 male, 42 female), overweight (15 male, 29 female), and obese (52 male, 68 female). As part of the normal ADP procedure, TGV was measured (TGV(Meas)), predicted using child specific equations developed by Fields (TGV(Fields)) and adult derived equations by Crapo (TGV(Crapo)) with percentage body fat (PF) estimates subsequently calculated (PF(Meas), PF(Fields), PF(Crapo)). Compared with the mean TGV(Meas), the TGV(Fields) estimates were within+/-0.2 L in all groups, except obese males (+0.5 L), while the mean TGV(Crapo) estimates were greater than+/-0.3 L in all groups except lean males (+0.1 L). When converted to PF, the mean PF(Fields) estimates were within+/-1% of the measured value in all groups, except obese males (+1.1%), while the mean PF(Crapo) estimates were greater than+/-1% in all groups, except lean males (+0.5%). Using either prediction equation, Bland-Altman analysis revealed that the greatest PF+/-95% limits of agreement were in the lean and overweight groups and lowest in the obese groups. The Fields child-specific TGV prediction equations provide accurate mean PF estimates and appear better than using the Crapo equations if a measured TGV cannot be achieved in children of a wide range of BMI. However, individual predictions may result in large PF errors especially in lean children.
  International Journal of Pediatric Obesity 02/2007; 2(3):180-7.
• Article: Calibration of an accelerometer during free-living activities in children.

  Calum Mattocks, Sam Leary, Andy Ness, Kevin Deere, Joanne Saunders, Kate Tilling, Joanne Kirkby, Steven N Blair, Chris Riddoch
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  ABSTRACT: The aims of this study were to develop an equation to predict energy expenditure and to derive cut-points for moderate and vigorous physical activity intensity from the Actigraph accelerometer output in children aged 12 years. The children performed a series of activities (lying, sitting, slow walking, fast walking, hopscotch and jogging) while wearing an Actigraph and a portable metabolic unit. The sample was divided into a developmental and a validation group. Random intercepts models were used to develop a prediction equation in the developmental group. The equation was assessed in the validation group by calculating limits of agreement (actual minus predicted energy expenditure). Thresholds for moderate and vigorous activity were derived by refitting the energy expenditure model with VO2 as the outcome. The developmental group comprised 163 children, while the validation group comprised 83 children. The equation, adjusted for age and gender, adequately predicted energy expenditure from accelerometer counts. Physical activity intensity cut-points were derived from resting VO2. The lower threshold for moderate intensity (four METs), adjusted for age and gender, was 3581 counts per minute. The lower threshold for vigorous activity (six METs) was 6130 counts per minute. The prediction equation and the derived cut-points will help to better interpret the output of the Actigraph in children aged 12 years. The cut-point for moderate to vigorous physical activity is higher than that reported previously.
  International Journal of Pediatric Obesity 02/2007; 2(4):218-26.