Childhood obesity - The shape of things to come

Optimal Weight for Life Program in the Division of Endocrinology, Children's Hospital Boston, USA.
New England Journal of Medicine (Impact Factor: 54.42). 01/2008; 357(23):2325-7. DOI: 10.1056/NEJMp0706538
Source: PubMed
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    ABSTRACT: This paper introduces quantifiable growth-and-obesity profiles of children in family-centered care. This work presents a model based on the mathematical-statistical technique of 'box interpolation', which generates patient-and parent-friendly profiles based on one set of height and weight measurements of parents and children. Mid-parental (Target) heights and optimal weights were compared with measured heights and weights to determine if the children were obese (wasted) and tall (stunted), associating a numerical index with each condition, in the form of percentage. This model, also, estimated adult-heights and weights of children and indicated whether parents were obese (wasted). Data were collected by authors, following standard protocols developed by our team, as part of the NGDS (National Growth and Developmental Standards) Pilot Project. This project was approved by Institutional Review Board. Informed consents were obtained from parents of participating families. Each child was weighed and measured, in the presence of father and mother, barefoot, wearing short underpants, stripped to waist. Data from 70 participants of different localities of Karachi (17 families, consisting of 17 fathers, 17 mothers, 16 boys, 20 girls) were analyzed. Boys showed a greater risk of obesity (46.15%) as compared to girls (17.65%), when both parents were obese (15 families). Excessive obesity (wasting), failure-to-grow, short children developing normally, and failure-to-thrive, children neither growing nor developing normally, may be the cause of an underlying physical or psychological problem needing a head-to-toe evaluation. The method reported in this paper may be helpful in identifying such cases in children 3 -10-year old, if regular height and weight screenings are conducted.
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    ABSTRACT: Background: Reference percentile curves are usually used as a screening tool to determine growth disorders. Anthropometric indices are population-dependent and may differ according to ethnicity, dietary pattern and lifestyle habits. This study aims to compare the curves of anthropometric measures obtained in two national studies conducted among Iranian children and adolescents in 2003-2004 and 2009-2010. Materials and Methods: Anthropometric measures obtained in two nationwide surveys conducted in 10-18-year-old Iranian students were compared. Lambda-mu-sigma (LMS) Chart Maker Pro program was used to develop age- and gender-specific percentiles and to smooth and fit the model. Results: In 2003-2004, the mean and standard deviation (SD) of body mass index (BMI) and waist circumference (WC) were 18.98 ± 3.81 kg/m2 and 67.50 ± 11.05 cm in boys; and 19.44 ± 3.78 kg/m2 and 66.55 ± 9.89 cm in girls, respectively. In 2009-2010, the corresponding figures were 19.16 ± 4.07 kg/m2, 69.42 ± 11.43 cm, 19.63 ± 4.11 kg/m2, and 67.29 ± 9.69 cm, respectively. Height curves did not show considerable changes in two studies. Comparison of two series of studies showed that the weight, BMI, WC, and waist-to-height ratio were lower in adolescent girls than boys especially in higher percentiles. Moreover, in both genders, weight, BMI, and WC percentiles decreased. Conclusion: The growth charts of Iranian children and adolescents aged 10-18 years have changed over 5 years. The reference growth curves change over time in the pediatric age group, repeated surveys should be conducted to update the age- and gender-specific reference curves in different populations.
    Journal of research in medical sciences 11/2014; 19(8):709-14. · 0.61 Impact Factor
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    ABSTRACT: Childhood obesity remains a public health concern, and tracking local progress may require local surveillance systems. Electronic health record data may provide a cost-effective solution. To demonstrate the feasibility of estimating childhood obesity rates using de-identified electronic health records for the purpose of public health surveillance and health promotion. Data were extracted from the Public Health Information Exchange (PHINEX) database. PHINEX contains de-identified electronic health records from patients primarily in south central Wisconsin. Data on children and adolescents (aged 2-19 years, 2011-2012, n=93,130) were transformed in a two-step procedure that adjusted for missing data and weighted for a national population distribution. Weighted and adjusted obesity rates were compared to the 2011-2012 National Health and Nutrition Examination Survey (NHANES). Data were analyzed in 2014. The weighted and adjusted obesity rate was 16.1% (95% CI=15.8, 16.4). Non-Hispanic white children and adolescents (11.8%, 95% CI=11.5, 12.1) had lower obesity rates compared to non-Hispanic black (22.0%, 95% CI=20.7, 23.2) and Hispanic (23.8%, 95% CI=22.4, 25.1) patients. Overall, electronic health record-derived point estimates were comparable to NHANES, revealing disparities from preschool onward. Electronic health records that are weighted and adjusted to account for intrinsic bias may create an opportunity for comparing regional disparities with precision. In PHINEX patients, childhood obesity disparities were measurable from a young age, highlighting the need for early intervention for at-risk children. The electronic health record is a cost-effective, promising tool for local obesity prevention efforts. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
    American Journal of Preventive Medicine 02/2015; 48(2):234-40. DOI:10.1016/j.amepre.2014.10.020 · 4.28 Impact Factor


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