Content uploaded by Margaret Carroll
Author content
All content in this area was uploaded by Margaret Carroll
Content may be subject to copyright.
A preview of the PDF is not available
Prevalence of High Body Mass Index in US Children and Adolescents, 2007-2008
Abstract and Figures
The prevalence of high body mass index (BMI) among children and adolescents in the United States appeared to plateau between 1999 and 2006.
To provide the most recent estimates of high BMI among children and adolescents and high weight for recumbent length among infants and toddlers and to analyze trends in prevalence between 1999 and 2008.
The National Health and Nutrition Examination Survey 2007-2008, a representative sample of the US population with measured heights and weights on 3281 children and adolescents (2 through 19 years of age) and 719 infants and toddlers (birth to 2 years of age).
Prevalence of high weight for recumbent length (> or = 95th percentile of the Centers for Disease Control and Prevention growth charts) among infants and toddlers. Prevalence of high BMI among children and adolescents defined at 3 levels: BMI for age at or above the 97th percentile, at or above the 95th percentile, and at or above the 85th percentile of the BMI-for-age growth charts. Analyses of trends by age, sex, and race/ethnicity from 1999-2000 to 2007-2008.
In 2007-2008, 9.5% of infants and toddlers (95% confidence interval [CI], 7.3%-11.7%) were at or above the 95th percentile of the weight-for-recumbent-length growth charts. Among children and adolescents aged 2 through 19 years, 11.9% (95% CI, 9.8%-13.9%) were at or above the 97th percentile of the BMI-for-age growth charts; 16.9% (95% CI, 14.1%-19.6%) were at or above the 95th percentile; and 31.7% (95% CI, 29.2%-34.1%) were at or above the 85th percentile of BMI for age. Prevalence estimates differed by age and by race/ethnic group. Trend analyses indicate no significant trend between 1999-2000 and 2007-2008 except at the highest BMI cut point (BMI for age > or = 97th percentile) among all 6- through 19-year-old boys (odds ratio [OR], 1.52; 95% CI, 1.17-2.01) and among non-Hispanic white boys of the same age (OR, 1.87; 95% CI, 1.22-2.94).
No statistically significant linear trends in high weight for recumbent length or high BMI were found over the time periods 1999-2000, 2001-2002, 2003-2004, 2005-2006, and 2007-2008 among girls and boys except among the very heaviest 6- through 19-year-old boys.
Figures - uploaded by Margaret Carroll
Author content
All figure content in this area was uploaded by Margaret Carroll
Content may be subject to copyright.
... In the United States, in [2007][2008]9.5% of infants and toddlers were obese (3) . Increased extent of overweight has been also noticed in some other countries such as Brazil, China, Egypt, Syria, and Kuwait (4,5) . ...
... A questionnaire (answered by a family member) was designed and include: age, sex, parental education that considered as low (primary school or less) and high (secondary schooling or higher) (15) , and parental work status. In addition, type of feeding, duration of breastfeeding and formula feeding, age of weaning (< 4, 4-6, and > 6 months), number of meals per day (1,2,3), number of snacks per day (none, 1, = 2) were recorded. Other questions assessed current dietary pattern including number of meals rich in fat per week inform of saturated fats (meat, coconut, dairy products), unsaturated fats (olive, peanut) and polyunsaturated fats (sunflower, corn, soybean). ...
Background: The problem of obesity and overweight in children has been increased globally. Recently, the obesity prevalence rate reached an alarming level in both developed and developing countries.
... In 2018, more people in inner regional (71.0%) and outer regional and remote (70.3%) areas were overweight or obese, compared with major cities (65.1%). 1 A high Body Mass Index or obesity is directly associated with an increased risk of certain cancers, including colon, breast, endometrium, oesophageal, and kidney, 47 as well as being linked to the development of many chronic conditions such as diabetes and cardiovascular disease. 48 ...
Presenting the latest data on the health of rural and remote Australians, alongside RFDS aeromedical retrieval data and evidence on service gaps, the RFDS Best for the Bush report series identifies the issues that most urgently need attention from service providers, funders and policy makers, while also making recommendations for the RFDS to pursue together with governments, industry, rural and remote communities.
... The NCHS/CDC (2000) cut-off points were used to determine overweight and obesity. Based on BMI-forsex and -age, below the 85th, between the 85th and 95th, and above the 95th percentile were defined as normal weight, overweight and obese respectively [28]. Also, for the waist circumference (WC) assessment an un-stretchable tape measure was used. ...
Background
Adolescent obesity is considered as a major health concern worldwide which is closely linked to the quality of diet. The purpose of the present study was to assess the carbohydrate quality and quantity in relation to odds of overweight and obesity in adolescents.
Methods
This case-control study with a 1:1 ratio was conducted on 406 adolescents (14 to 18 years old) matched for age and gender. Participants were selected by multistage cluster random sampling method from March to October 2019 in Shiraz, Iran. Dietary intakes of the study population were assessed by a validated semi-quantitative food frequency questionnaire. Also anthropometric indices were measured using standard methods and demographic information was recorded via face to face interview. The relation between low carbohydrate diet score (LCDS) and carbohydrate quality index (CQI), and odds of obesity was evaluated by multiple Logistic regression.
Results
After adjusting the role of potential confounders, the participants in the third tertiles of LCDS (OR = 0.443, 95% CI = (0.260 to 0.755)) and CQI (OR = 0.005, 95% CI = (0.001 to 0.025)) had less odds of being overweight and obese compared to the first tertile.
Conclusion
The present study found an inverse relationship between dietary quantity and quality of carbohydrate intake and the odds of overweight and obesity in a sample of Iranian adolescents.
... This supports a study [31] that found people who had Down syndrome to be noticeably shorter than their typically developing counterparts. According to another investigation [32], more children who had Down syndrome were likely to have high BMI scores-up to 30%-than those who do not have Down syndrome (17%) and those with other intellectual deficits (12-30%). A prior study [33] found a substantial correlation between the 6MWT and several demographic factors, including height and BMI. ...
Background
Walking ability, which has been connected to better health and independence, is one of the daily activities that is negatively impacted by Down syndrome. Thus, the objective of this study was to examine the walking capacity and its association with the quality of life of children who have Down syndrome compared to those who do not have Down syndrome in Saudi Arabia.
Methods
For this cross-sectional study, we recruited 68 Arabic-speaking children aged 6 to 12 using a convenience sampling method from August to November 2021. Children were divided into two groups: those who do not have Down syndrome ( n = 38) and those who have Down syndrome ( n = 30). Children in the Riyadh region of Saudi Arabia who do not have Down syndrome were chosen randomly from two schools. Children who have Down syndrome were selected from multiple associations and centers in the same region. A 6-minute walk test was used to measure the child’s walking capacity. The Arabic version of the Pediatric Quality of Life Inventory scale was used to assess the child’s or parent’s perceptions of the child’s quality of life and its physical, emotional, social, and school functioning domains.
Results
The difference in the mean 6-minute walk test scores between children who have and who do not have Down syndrome was statistically significant, with a mean difference = 105.6, 95% confidence limit = 57.2—154.0, p < .0001. The linear regression analysis after adjusting for age, height, weight, and body mass index revealed that walking capacity was found to be significantly associated with the worst score on the Pediatric Quality of Life Inventory scale (β = −2.71, SE = 0.49, p < .0001) and its domains of physical, social, and school functioning (β = −2.29, SE = 0.54, p < .0001; β = −2.40, SE = 0.58; p = .001; β = −3.71, SE = 0.56, p = .002, respectively) in children who have Down syndrome, but they had better emotional functioning than children who do not have Down syndrome.
Conclusions
Children who have Down syndrome were less able to walk and were highly associated with the worst possible quality of life, which included the lowest levels of physical, social, and school functioning. Early interventions with techniques must be developed to improve the quality of life for these children.
p>Obesitas, atau kegemukan, merupakan salah satu masalah yang cukup merisaukan di kalangan anak dan remaja. Banyak dampak negatif yang akan terjadi apabila anak dan remaja mengalami obesitas, meliputi penyakit fisik, psikologis, maupun penurunan kualitas hidup secara keseluruhan. Berkaitan dengan hal itu, salah satu upaya yang dilakukan orang tua untuk mencegah terjadinya obesitas adalah dengan melakukan pembatasan dalam pemberian makan (restrictive feeding). Namun, kendati dimaksudkan untuk menghindari anak dan remaja dari kemungkinan obesitas, restrictive feeding secara kontraproduktif justru memberikan efek yang sebaliknya. Anak-anak yang menerima pola restrictive feeding dari orang tuanya justru memiliki peluang untuk terlibat perilaku overeating yang lebih tinggi dibandingkan anak-anak yang tidak menerima pola restrictive feeding dari orang tuanya. Penelitian ini bertujuan mengkaji lebih lanjut korelasi antara variabel parents' restrictive feeding practice dan adolescent binge eating dengan mempertimbangkan peran mediasi negative self-evaluation pada remaja. Ketiga variabel diukur menggunakan Kids' Child Feeding Questionnaire-Restriction, Self-Criticism Scale, dan Binge Eating Scale. Partisipan dalam penelitian ini berjumlah 60 remaja berusia 12-18 tahun, berjenis kelamin perempuan dan laki-laki, masih tinggal bersama orangtua, serta memiliki body mass index (BMI) dalam kategori overweight atau obesitas. Analisis data dilakukan dengan Hayes PROCESS untuk melihat peran negative self-evaluation sebagai mediator. Hasil uji mediasi menunjukkan bahwa negative self-evaluation memediasi hubungan parents’ restrictive feeding dengan adolescent binge eating (indirect effect = 1.48, p<0.05) yakni semakin tinggi level parents’ restrictive feeding maka negative self-evaluation juga meningkat, dan sebagai dampak lanjutan, tingginya negative self-evaluation berpotensi memunculkan perilaku binge eating pada remaja. Dalam hal implikasi klinis, temuan ini dapat bermanfaat bagi para praktisi untuk fokus pada pengembangan atau penargetan intervensi mengatasi gangguan makan pada remaja, juga dalam pemberian psikoedukasi lebih lanjut pada orangtua dan remaja berkaitan dengan pola pemberian makan yang baik.</p
Background
Poor weight gain has been identified as an independent risk factor for increased surgical morbidity and mortality for patients with single‐ventricle physiology undergoing staged surgical palliation. Conversely, excessive weight gain has also emerged as an independent risk factor predicting increased morbidity and mortality in a single‐center study. Given this novel single‐center concept, we investigated the impact of excessive weight on patients with single‐ventricle physiology undergoing bidirectional Glenn palliation in a multicenter study model.
Methods
Patients from the Pediatric Heart Network Single Ventricle Reconstruction Trial ( n = 387) were analyzed in a retrospective cohort study examining the independent effect of weight percentile on intensive care unit (ICU) length of stay (LOS) and ventilator days. Locally estimated scatterplot smoothing (LOESS) regression was used to plot weight‐for‐length (WFL) percentiles by ICU LOS and ventilator days. Unadjusted and adjusted ordinal regression was used to model ICU LOS and ventilator days.
Results
Scatterplots and LOESS regression curves demonstrated increasing ICU LOS and ventilator days for increasing WFL percentiles. Unadjusted ordinal regression analysis of ICU LOS demonstrated a trend of increasing ICU LOS for increasing WFL percentiles that was not statistically significant ( P = 0.11). A similar trend was demonstrated in adjusted ordinal regression that was not statistically significant ( P = 0.48). Unadjusted and adjusted ordinal regression analysis of ventilator days did not reach statistical significance ( P = 0.07).
Conclusion
Excessive weight gain has a clinically relevant but not statistically significant association with increased ICU LOS and ventilator days for those patients in the >90th WFL percentile for age.
This retrospective study aimed to assess the value of 24-hour ambulatory blood pressure monitoring (ABPM) in distinguishing primary from secondary hypertension in pediatric patients. Our study was conducted on 293 patients referred to a pediatric nephrology clinic over 11 years. Various ABPM parameters were analyzed, including daytime and nighttime systolic and diastolic blood pressures, heart rate, and blood pressure load. Among the participants, 74% were normotensive (white-coat hypertension), 21.5% had primary hypertension, and 4.4% had secondary hypertension. There were no significant differences in the analyzed variables between primary and secondary hypertension groups. Our findings suggest that ABPM might not reliably differentiate between the two in this cohort. As white-coat hypertension becomes more prevalent, ABPM remains a valuable tool in preventing unnecessary workups in children without sustained hypertension. However, our study did not identify specific endpoints for distinguishing primary from secondary hypertension.
Over 34% of adults aged 20 years and older are obese, but there has been no significant change in the prevalence since 2003-2004. The increasing trend in obesity over the last 25 years is a result of a shift in the entire BMI distribution and an increase in the prevalence of those who are extremely obese. In addition, disparities continue to exist. Non-Hispanic black and Mexican-American women continue to experience a higher prevalence of obesity than their non-Hispanic white counterparts. Although approximately two-thirds of obese individuals have been told by a health care provider that they are "overweight," obesity is extremely difficult to treat and the prevalence of obesity is not declining. Nonetheless, even without reaching ideal weight, research has shown that a moderate amount of weight loss can be beneficial in terms of reducing risk factors, such as high blood pressure. Maintenance of weight loss, however, remains difficult.
Objectives
The development of recommendations for physicians, nurse practitioners, and nutritionists to guide the evaluation and treatment of overweight children and adolescents.
Methods
The Maternal and Child Health Bureau, Health Resources and Services Administration, the Department of Health and Human Services convened a committee of pediatric obesity experts to develop the recommendations.
Results
The Committee recommended that children with a body mass index (BMI) greater than or equal to the 85th percentile with complications of obesity or with a BMI greater than or equal to the 95th percentile, with or without complications, undergo evaluation and possible treatment. Clinicians should be aware of signs of the rare exogenous causes of obesity, including genetic syndromes, endocrinologic diseases, and psychologic disorders. They should screen for complications of obesity, including hypertension, dyslipidemias, orthopedic disorders, sleep disorders, gall bladder disease, and insulin resistance. Conditions that indicate consultation with a pediatric obesity specialist include pseudotumor cerebri, obesity-related sleep disorders, orthopedic problems, massive obesity, and obesity in children younger than 2 years of age. Recommendations for treatment evaluation included an assessment of patient and family readiness to engage in a weight-management program and a focused assessment of diet and physical activity habits. The primary goal of obesity therapy should be healthy eating and activity. The use of weight maintenance versus weight loss to achieve weight goals depends on each patient's age, baseline BMI percentile, and presence of medical complications. The Committee recommended treatment that begins early, involves the family, and institutes permanent changes in a stepwise manner. Parenting skills are the foundation for successful intervention that puts in place gradual, targeted increases in activity and targeted reductions in high-fat, high-calorie foods. Ongoing support for families after the initial weight-management program will help families maintain their new behaviors.
Conclusions
These recommendations provide practical guidance to pediatric clinicians who evaluate and treat overweight children.
Published reports based on different definitions indicate that in Canada, Mexico and the United States childhood overweight
and obesity have increased dramatically since 1980, with the US leading the way. The prevalence of overweight, using the International
Obesity Task Force (IOTF) definitions (Cole et al. 2000) in 7–13 year old girls doubled in Canada between 1981 and 1996 and
tripled in boys (Tremblay et al. 2002). In 2004 in Canada, 26% of children and adolescents aged 2–17 were overweight or obese
and 8% were obese (Shields 2006). Among children under 5 years of age in Mexico, overweight prevalence (z-score of weight-for-height
above +2 of World Health Organization/National Center for Health Statistics/Centers for Disease Control and Prevention (WHO/NCHS/CDC)
references (Dibley et al. 1987)) increased from 4.2 to 5.3% between 1988 and 1999 (Rivera et al. 2002). In the US, between
1980 and 2006 the prevalence of high body mass index (BMI ≥95th percentile of the sex specific 2000 CDC growth charts) increased
from 6 to 16% among children and teens 2 through 19 years of age (Ogden et al. 2002, 2003, 2007, 2008).
An expert committee was convened to determine specific criteria for overweight to be integrated into routine preventive screening of adolescents. Body mass index (BMI) should be used routinely to screen for overweight adolescents. Youth with BMIs > or = 95th percentile for age and sex, or > 30 (in kg/m2) should be considered overweight and referred for indepth medical follow-up to determine underlying diagnoses. Adolescents with BMIs > or = 85th percentile but < 95th percentile or < or = 30, should be considered at risk of overweight, and should be referred to a second-level screen. The second-level screen includes family history, blood pressure, total cholesterol, large prior increment in BMI, and concern about weight. If youths are positive for any of the items on the second-level screen they should be referred for further medical assessment.
Obese children may be at increased risk of becoming obese adults. To examine the relationship between obesity in childhood and obesity in adulthood, we reviewed the epidemiologic literature published between 1970 and July 1992. Comparison between studies was complicated by differences in study design, definitions of obesity, and analytic methods used. Although the correlations between anthropometric measures of obesity in childhood and those in adulthood varied considerably among studies, the associations were consistently positive.
About a third (26 to 41%) of obese preschool children were obese as adults, and about half (42 to 63%) of obese school-age children were obese as adults. For all studies and across all ages, the risk of adult obesity was at least twice as high for obese children as for nonobese children. The risk of adult obesity was greater for children who were at higher levels of obesity and for children who were obese at older ages.
The wide range of estimates in this literature are, in part, due to differences in study designs, definitions of obesity, ages at which participants were measured, intervals between measurements, and population and cultural differences.
The development of recommendations for physicians, nurse practitioners, and nutritionists to guide the evaluation and treatment of overweight children and adolescents.
The Maternal and Child Health Bureau, Health Resources and Services Administration, the Department of Health and Human Services convened a committee of pediatric obesity experts to develop the recommendations.
The Committee recommended that children with a body mass index (BMI) greater than or equal to the 85th percentile with complications of obesity or with a BMI greater than or equal to the 95th percentile, with or without complications, undergo evaluation and possible treatment. Clinicians should be aware of signs of the rare exogenous causes of obesity, including genetic syndromes, endocrinologic diseases, and psychologic disorders. They should screen for complications of obesity, including hypertension, dyslipidemias, orthopedic disorders, sleep disorders, gall bladder disease, and insulin resistance. Conditions that indicate consultation with a pediatric obesity specialist include pseudotumor cerebri, obesity-related sleep disorders, orthopedic problems, massive obesity, and obesity in children younger than 2 years of age. Recommendations for treatment evaluation included an assessment of patient and family readiness to engage in a weight-management program and a focused assessment of diet and physical activity habits. The primary goal of obesity therapy should be healthy eating and activity. The use of weight maintenance versus weight loss to achieve weight goals depends on each patient's age, baseline BMI percentile, and presence of medical complications. The Committee recommended treatment that begins early, involves the family, and institutes permanent changes in a stepwise manner. Parenting skills are the foundation for successful intervention that puts in place gradual, targeted increases in activity and targeted reductions in high-fat, high-calorie foods. Ongoing support for families after the initial weight-management program will help families maintain their new behaviors.
These recommendations provide practical guidance to pediatric clinicians who evaluate and treat overweight children.