Prevalence of overweight and obesity among school children in Jena (Germany)

OBJECTIVES: To examine the prevalence and changes in the prevalence of overweight and obesity among school children in Jena (Germany) in the last twenty years and to identify factors associated with childhood overweight. DESIGN: Cross-sectional surveys in 1975, 1985, 1995 and a household questionnaire in 1995. SUBJECTS: Children from schools in Jena, aged 7-14 y, participated (1975 : 1002 boys and 1000 girls; 1985 : 781 boys and 753 girls; 1995 : 989 boys and 912 girls). MEASUREMENTS: Prevalence of overweight or obesity based on the 90th or 97th age- and sex-specific percentile of the body mass index (BMI) developed for French children. In 1995 factors examined in relation to overweight included birth weight, birth length, age-class, number of children in household, occupation of the father, education of the mother and size of flat (apartment). RESULTS: In boys the prevalence of overweight increased from 10.0 to 16.3% and in girls from 11.7 to 20.7% between 1975 and 1995. The prevalence of obesity increased from 5.3 to 8.2% in boys and from 4.7 to 9.9% in girls between 1975 and 1995. However, the peak in the increase of overweight as well as of obesity lie for both sexes between 1985 and 1995. Using logistic regression, statistically significant associations with overweight were found for occupation of the father, birth weight in both sexes and additionally, for size of flat in girls. CONCLUSIONS: Overweight and obesity are increasing health problems among Jena children. Further investigations are needed to explore the influence of factors such as feeding pattern, food habits and physical activity on overweight. Special attention should be paid to the further social development in the society and to the link between low social class and overweight. Through such investigations effective preventive strategies could be developed.     

Time trend in height,weight, and obesity prevalence in school children from Northern France, 1992-2000

OBJECTIVE: The aim of this study was to evaluate the changes in height, weight and in the prevalence of overweight and obesity between 1992 and 2000 in children living in two towns of northern France. METHODS: Two cross-sectional studies were performed in every pre-school (last section) and primary schools of the two towns in 1992 (383 girls and 421 boys enrolled) and 2000 (296 girls and 305 boys). Children were 5 to 12 year old in both studies. MEASUREMENTS: Body height and weight were measured, and BMI was calculated (weight/height(2)). Prevalence of overweight and obesity was determined according to the gender- and age- specific cut-offs of the new international reference (IOTF). We also used the 90(th) and the 97(th) percentiles of the French reference gender- and age-specific BMI curves to define two grades of overweight. RESULTS: After adjustment for age, boys were on average 1.5 cm taller in 2000 than in 1992 (p<0.001), and the same trend was observed in girls (+ 0.9 cm, p<0.075). Height-adjusted or age-adjusted weight and BMI were significantly higher in 2000 than in 1992. In girls, obesity defined by IOTF criteria increased from 1.6 to 4.4% (p<0.03) and overweight from 14.1 to 18.6% (p<0.11). In boys, the change in prevalences was significant only when the less stringent criteria (i.e. the 90(th) percentile of French references) was used (13.8% in 1992 vs 20% in 2000, p=0.03). CONCLUSION: Over an 8 years period, there was an increase in height and BMI in both boys and girls. These results show that the increase in the prevalence of obesity is accompanied by a global trend of accelerated growth.     

Trends in body mass index and overweight prevalence among children and adolescents in the region of Aragón (Spain) from 1985 to 1995

OBJECTIVE: To analyse trends in body mass index (BMI) and overweight prevalence for children and adolescents in the region of Aragón (Spain), from 1985 to 1995. DESIGN: Nine cross-sectional examinations of schoolchildren conducted yearly from 1985 to 1995. SUBJECTS: A total of 90,997 children (45,970 males and 45,027 females) in the first school year (6-7 y of age); 106,284 scholars (52,772 males and 53,512 females) in the last school year (13-14 y of age). MEASUREMENTS: Heights and weights were measured and BMI (kg/m2) was calculated. RESULTS: We observed a trend to higher BMI values across the surveys, by sex and age. The secular trends in BMI showed the largest increases at the upper ends of the distribution, especially in males. In children in the first school year, prevalences of overweight were higher in females than in males (P<0. 001); however, in adolescents in the last school year, prevalences were higher in males than in females (P<0.001). We observed a significant trend in overweight prevalence from 1985 to 1995 in children from the first school year (P=0.0183, in males and P=0.0168, in females). In children in the last school year there was only a significant trend in males (P<0.0001). CONCLUSION: Significant changes in BMI occurred in the population studied during the period 1985-1995, but these changes differ by age and sex. The increasing skewness of BMI in the upper percentiles of the population, especially in boys, suggests that, not only is the pediatric population getting fatter, but the fatter members are becoming more obese. Our results also show a striking increase in the prevalence of overweight children in the region of Aragón (Spain) during the 1985-1995 decade.     

Long‐term changes in prevalence of overweight and obesity in Czech 7‐year‐old children: evaluation of different cut‐off criteria of childhood obesity

The objective of this paper was an evaluation of change in prevalence of overweight and obesity in Czech children, and a comparison of cut‐off points for body mass index references from the Czech Republic (CzR), International Obesity Task Force and WHO. The authors conducted a survey in 7‐year‐old children, and compared data from 1951, 1981, 1991, 2001 and 2008 (WHO cut‐offs). 2008 data were evaluated according to different cut‐offs. Results showed that since 1951 in boys, overweight prevalence increased from 13.0% in 1951 to 26.8% in 2001, in girls from 10.9% to 22.9%. Obesity increased in boys from 1.7% to 8.3%, in girls from 1.7% to 6.9%. From 2001 to 2008 obesity in boys increased; obesity in girls and overweight in both genders decreased. In 2008 cohort the following values were found: overweight and obesity: CzR criteria, percentage was lowest (14.8% boys and 11.1% girls); WHO criteria, highest prevalence (23.5% boys and 19.5% girls); obesity: lowest ratio International Obesity Task Force criteria (4.4% boys, 3.3% girls), highest ratio boys WHO criteria (10.0%), girls CzR criteria (5.0%). Overweight and obesity prevalence increased in 7‐year‐old Czech children since 1951; since 2001 prevalence is plateauing with exception of boys. Using different body mass index references resulted in marked differences in overweight and obesity prevalence.     

Epidemic increase in overweight and obesity in Chinese children from 1985 to 2005

This study tracks the temporal changes in prevalence of childhood and adolescent overweight and obesity in different regions of China from 1985 to 2005. Using a series data of the Chinese National Survey on Students Constitution and Health, we compared the temporal changes over a 20-year period of the prevalence of overweight and obesity among ten regions in China for school-aged children between 7 and 18 years of age. Large disparities in the temporal changes of obesity prevalence exist in different regions of China. North coastal residents, especially those of the upper socioeconomic status, had the earliest and largest increase in prevalence. Similar increases then followed successively in other regions of upper, moderate and low socioeconomic status, and finally in the affluent rural regions. No significant increase was found in the developing rural areas. Regions where the obesity epidemic occurred late also began to show rather rapid increases in prevalence in recent years. In 2005, the national estimates indicated that 7.73% of Chinese youth are overweight and 3.71% of them are obese, representing an estimated 21.37 million Chinese children (13.43 million boys and 7.94 million girls).     

Prevalence of overweight and obesity in the Netherlands

This paper shows the trends in the prevalence of overweight (body mass index [BMI] >or= 25 kg m-2) and obesity (BMI >or= 30 kg m-2) in the Netherlands. Overweight (obesity) prevalence in adult males increased from 37% (4%) in 1981 to 51% (10%) in 2004, and in adult females from 30% (6%) in 1981 to 42% (12%) in 2004, according to self-reported data. In boys and girls, obesity prevalence doubled or even tripled from 1980 to 1997, and again from 1997 to 2002-2004 a two- or threefold increase was seen for almost all ages. According to the most recent data, overweight (obesity) prevalence figures range, depending on age, from 9.2% to 17.3% (2.5-4.3%) in boys, and from 14.6% to 24.6% (2.3-6.5%) in girls. There is a lack of data on the national prevalence of overweight and obesity based on measured height and weight and on prevalences in different subgroups of the population. Regular national representative health examination surveys that measure height and weight are needed to assess the prevalence of overweight and obesity and its distribution over subgroups in the population, and to properly direct and evaluate prevention activities.     

Prevalence of obesity in Taiwan

In Taiwan, the prevalence and problem of obesity has increased significantly in recent decades and has became an important public health issue. In children (12-15 years), the prevalence of obesity (defined as body weight > 120% of mean body weight with age- and gender-specification) was 12.4%, 14.8% and 15.6% among boys and 10.1%, 11.1% and 12.9% among girls in 1980, 1986 and 1996 respectively. A survey of 1500 12-15-year-old children during 1995-1996 in Taipei city found that about 16.6% of boys and 11.1% of girls were obese, while an additional 11.6% of boys and 10.2% of girls were overweight. In adults, using the criteria defined by the Department of Health in Taiwan [overweight as (body mass index) BMI > or = 24 and obese as BMI > or = 27], the age-adjusted prevalence of obesity was 10.5% and 15.9% for men and 13.2% and 10.7% for women from 1993-1996 to 2000-2001. From these data, we found that the prevalence of obesity in Taiwan has increased steadily from 1980 to 2000 especially in children and in men.     

Secular trends in overweight and obesity among Finnish adolescents in 1977-1999

OBJECTIVE: To study the trends in overweight and obesity among Finnish adolescents in 1977-1999. DESIGN: Mailed surveys every other year. SUBJECTS: Nationally representative samples of 12, 14, 16 and 18-y-olds (n = 64,147, response rate 78.9%). METHODS: Overweight and obesity were measured by body mass index (BMI) and relative weight (RW) based on self-reported height and weight. BMI > or = the 85th percentile cut-off point for BMI in each age- and sex-specific group in the entire data set was considered as overweight, and BMI > or = 95th percentile cut-off point as obesity. RW > or = 110% and > or = 120%, calculated as the individual's weight divided by the mean weight in each age- and sex-specific height percentile group in the entire data set, were considered as overweight and obesity, respectively. The trends in overweight and obesity are described by the change in the 85th and 95th percentile cut-off points of BMI over time. The prevalence of overweight and obesity is also reported using BMI reference values recommended for international comparisons. Because of the similarity of the BMI and the RW criteria in classifying adolescents as overweight and obese, only results based on BMI are presented. RESULTS: Overweight and obesity increased linearly in all sex and age groups from 1977 to 1999. Depending on the age group, the average increase in the 85th percentile cut-off point of the BMI per 10 y was 0.6-1.1 kg/m2 in boys and 0.3-0.7 kg/m2 in girls. The 95th percentile cut-off point of the BMI for boys and girls increased by 1.1-1.6 kg/m2 and by 0.6-1.0 kg/m2 per 10 y, respectively. In boys, the increase in overweight and obesity was largest in the two youngest age groups. In girls, the increase in overweight was largest in the oldest age group, and that of obesity both in the 14 and 18-y-olds. Overweight and obesity increased more in boys than in girls in all age groups except in the 18-y-olds among whom the increase was similar in both sexes. Examination of the entire BMI distribution showed that there was little or no change over time at the lower (5th, 15th) and middle (50th) percentiles, but increasing differences at the upper end of the distribution, the increases in the 95th percentile being even more marked than those in the 85th percentile curves. According to international reference values, the age-standardized prevalence of overweight increased in boys from 7.2 to 16.7%, and in girls from 4.0 to 9.8%, between 1977 and 1999. The prevalence of obesity in boys was 1.1% in 1977 and 2.7% in 1999, and in girls 0.4 and 1.4%, respectively. CONCLUSION: Overweight and obesity increased remarkably among Finnish adolescents from 1977 to 1999. The changes concentrated at the upper end of the BMI distribution, suggesting that factors behind this development have influenced only a part of the adolescent population.     

Prevalence of overweight and obesity and trends in body mass index in German pre-school children, 1982-1997

OBJECTIVE: To examine the prevalence of overweight and obesity in the entire population of 5- and 6-y-old children entering school in Germany, Bavaria, and to assess time trends over the last 15 y and the impact of ethnicity. DESIGN: Cross-sectional studies were based on the obligatory school entry health examinations: all health districts of Bavaria in 1997 (n=127 735); three health districts every 5 y from 1982 to 1997 (n=16 281). MEASUREMENTS: Body mass index (BMI; kg/m(2)) was calculated and the prevalence of overweight and obesity was defined based on national and international agreed cut-off points. Ethnicity was measured as German and non-German nationality. RESULTS: The prevalence of overweight and obese children as defined by international reference values was 9.4 and 3.1% for 5-y-old boys, 10.0 and 2.9% for 6-y-old boys, 12.2 and 3.3% for 5-y-old girls and 12.4 and 3.3% for 6-y-old girls. The whole BMI distribution in non-German children compared to German children was shifted to the right with median values in non-German children 0.3-0.5 kg/m(2) higher. In these the prevalence of overweight/obesity was 1.9/2.4 times higher for boys and 1.5/1.9 times higher for girls. The time trend between 1982 and 1997 shows an increase of the BMI distribution in the upper percentiles, whereas the lower percentiles did not change substantially. The increased prevalences of overweight/obesity for both sexes as defined by international references increased from 8.5/1.8% in 1982 to 12.3/2.8% in 1997. CONCLUSION: This large study on all children entering school in Bavaria in 1997 shows patterns of overweight and obesity which are comparable with other European data but are lower than US and Australian data. Increasing prevalences since 1982 indicate that overweight and obesity in children are of increasing public health importance in Bavaria. The upwards shift of the BMI distribution in non-German children needs further investigation.     

Assessing social differences in overweight among 15- to 16-year-old ethnic Norwegians from Oslo by register data and adolescent self-reported measures of socio-economic status

OBJECTIVE: To determine to what extent self-reported and objective data on socio-economic status (SES) are associated with overweight/obesity among 15 to 16-year-old ethnic Norwegians. DESIGN: A cross-sectional questionnaire study on health and health-related behaviors. SUBJECTS: All school children aged 15-16 years old in 2000 and 2001 in Oslo, Norway. Response rate 88% (n=7343). This article is based on the data from the 5498 ethnic Norwegians. MEASUREMENTS: Self-reported height and weight were used to measure overweight (including obesity) as defined by the International Obesity Task Force cutoffs at the nearest half-year intervals. SES was determined by register data from Statistics Norway on residential area, parental education and income and by adolescent self-reported measures on parental occupation and adolescents' educational plans. RESULTS: The prevalence of overweight/obesity was low, but higher among boys (11%) than among girls (6%). Parental education (four levels) showed the clearest inverse gradients with overweight/obesity (boys: 18, 13, 10 and 7%; girls: 11, 6, 6 and 4%). Parental education remained significantly associated with overweight/obesity when adding occupation and income to the model for the boys, whereas there were no significant associations in the final model for the girls. Overweight/obesity was associated with a lower odds ratio of planning for higher education (college/university) among boys only. CONCLUSION: For the boys, parental education was most strongly associated with overweight/obesity, and the association between overweight/obesity and educational plans appears to imply downward social mobility. The relationships between the various SES measures and overweight/obesity appeared more interrelated for the girls.     

Prevalence of excessive body weight and high blood pressure in children and adolescents in the city of Łódź

BACKGROUND: Overweight and elevated blood pressure in children and adolescents are two independent risk factors of basic importance for early prevention of cardiovascular and metabolic diseases. AIM: To evaluate the prevalence of overweight and elevated blood pressure in children and adolescents aged 7-18 years from the city of ?ód?. METHODS: A total of 25,309 children and adolescents (12,669 girls and 12,640 boys) aged 7-19 years from 111 schools in the city of ?ód? were examined. Basic anthropometric measurements (body mass and height) as well as three independent blood pressure measurements using the auscultatory method were performed. The prevalence of overweight and obesity were evaluated based on BMI analysis and using international criteria (IOTF). The prevalence of prehypertension state and hypertension was evaluated using the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. RESULTS: The mean prevalence of overweight (without obesity) was 15.1% (13.2% for girls and 17% for boys) and obesity was found in 3.7% of children (2.9% of girls and 4.4% of boys). Prevalence of the prehypertensive state and hypertension was 11.1% and 4.9%, respectively. In the younger groups of children aged 7-13 years the prevalence of overweight as well as elevated blood pressure was significantly (p <0.001) higher than in groups aged 14-19 years. CONCLUSIONS: The results indicate that the prevalence of overweight as well as elevated blood pressure is significantly higher in younger groups of children. The observed relations may result from specific social determinants and improper nutritional habits. The results show that intensive preventive activities should also be directed towards younger groups of children.     

The prevalence of overweight and obesity among Danish school children

In 14 Danish municipalities physicians have gathered weight and height data from 7541 9th grade students (86.7% of all students in 9th grade participating). Overall 25.2% of the population were overweight (body mass index > 90th percentile). Boys were more frequently overweight than girls (29.3% vs. 21.1%) (P < 0.05). 14.1% of the boys and 8.2% of the girls were obese (body mass index > 97th percentile). Categorizing the participating municipalities by socioeconomic status students in municipalities with low status had a significantly higher prevalence of overweight than students in municipalities with high status. Overweight and obesity among Danish school children is a major concern and there are significant social differences in the prevalence of overweight.     

Parental overweight, socioeconomic status and high birth weight are the major determinants of overweight and obesity in 5-7 y-old children: baseline data of the Kiel Obesity Prevention Study (KOPS)

OBJECTIVES: To identify the major risk factors of overweight and obesity in prepubertal children. DESIGN: Cross-sectional study. SETTING: In all, 32 primary schools in Kiel (248 000 inhabitants), northwest Germany. SUBJECTS: A total of 2631 5-7-y-old German children and their parents. MAIN OUTCOME MEASURES: Weight status, socio-economic status (SES), parental overweight, dietary intake, activity, inactivity and further determinants (birth weight, breast feeding, nutritional status of siblings) of the children. RESULTS: The prevalence of overweight (>/=90th BMI percentile of reference) was 9.2% in boys and 11.2% in girls, respectively. Considered univariately, family-, environment- and development-related determinants showed some relations to overweight and obesity. In multivariate analyses parental overweight, a low SES as well as a high birth weight were the strongest independent risk factors of overweight and obesity in children. Additionally, there were sex-specific risk factors: parental smoking and single households were risk factors in boys, whereas a low activity was associated with obesity in girls. Birth weight was associated with obesity, but not with overweight. The prevalence of obesity reached 29.2% in boys and 33.4% in girls with all the three main risk factors. CONCLUSIONS: Overweight families of low SES have the highest risk of overweight and obese children. Future prevention programmes must also take into account sex-specific risk factors.     

Prevalencia e incidencia de sobrepeso y obesidad en 2,5 millones de niños y adolescentes en España

Introduction and objectivesChildhood obesity trends are plateauing in Spain, but limited information is available about how they differ by region. This study assessed childhood and adolescent the prevalence and incidence of overweight and obesity from 2005 to 2017 across 8 Spanish regions.MethodsThis longitudinal study used height and weight measurements from 2.5 million children aged 2 to 17 years to calculate overweight and obesity, according to the World Health Organization (WHO) guidelines. Data were obtained from The Base de datos para la Investigación Farmacoepidemiológica en Atención Primaria, and the Information System for Research in Primary Care. Prevalence and incidence rates and trends from 2005 to 2017 were calculated and stratified by age, sex, and region.ResultsThe overall obesity prevalence increased in boys and girls from age 2 (0.8%; 95%CI, 0.8-0.9 in both sexes) until peaking at age 7 in girls (17.3%; 95%CI, 17.1-17.5) and age 9 in boys (24.1%; 95%CI 23.9-24.3). The highest and lowest obesity prevalences were observed in Murcia and Navarre. Overall obesity prevalence trends decreased from 2005 to 2017 in all age-sex groups and in most regions. Highest obesity incidence rates were found in children aged 6 to 7 years, (4.5 [4.5-4.5] and 3.5 [3.5-3.5] new obesity cases per 100 person-years in boys and girls, respectively). Boys had higher prevalence and incidence rates than girls across all regions. Overweight/obesity prevalence and incidence rates and their trends were consistently higher than the obesity results, although a similar pattern was observed across sex and age.ConclusionsOverweight and obesity prevalence slightly decreased in Spain from 2005 to 2017, but regional, sex, and age differences persisted. Because incidence peaked around the age of 6 years, it may be important to begin health promotion programs at an early age.     

Childhood obesity and socioeconomic status: a novel role for height growth limitation

OBJECTIVE: To assess prevalence and socioeconomic context of overweight and obesity in a cohort of Scottish children. DESIGN:Cross-sectional study. SETTING: Primary schools in Dundee, Angus, and Fife, Eastern Scotland, UK. PARTICIPANTS: A total of 1240 boys and 1214 girls aged between 4-10 y. MAIN OUTCOME MEASURE: Weight, height and body mass index (weight/height2). RESULTS: Overall overweight or obesity prevalence was 24.6%, while prevalence of obesity alone was 6.1%. Individuals from schools with a high level of low-income families were 65% more likely to be overweight as judged by BMI. However, these children weighed the same as more affluent children of the same age, but were 1.26 cm shorter. CONCLUSION: These data confirm the continued increase in childhood obesity in the UK and reveal a role for height-growth limitation in the absence of overall growth restriction, among children from low-income groups. This observation raises important questions regarding socioeconomic environmental factors in promoting the currently increasing levels of obesity.     

Overweight and obesity in Brazilian adolescents

OBJECTIVE: This study aimed to describe the prevalence of overweight and obesity (OW+O) among Brazilian adolescents and to identify risks for subpopulations defined according to the five country macro-regions and situation (urban-rural) of the domiciles, income, years of school attendance, age and sex. DESIGN: A nationwide home-based survey representative of the Brazilian civilian noninstitutionalized population, performed in 1989. METHODS: The sampling plans followed a stratified, multistage, probability cluster design in The National Research of Health and Nutrition sample, which collected anthropometric data of 14,455 domiciles. In all, 13,715 adolescents ranging from 10 to 19 y of age were studied. The OW+O was defined from a body mass index (BMI) equal or superior to the 85th percentile of the reference population of the NCHS. The prevalences in the different studied groups were compared using the adjusted odds ratio in logistic regression models. RESULTS: The prevalence of OW+O was of 7.7%, reaching 10.6% within the female group and 4.8% within the male group. A direct relation could be established between the socioeconomic level and OW+O. Adolescents of the most industrialized region of the country presented a risk of OW+O 1.86 (95% CI 1.51-2.30) times higher than that found in the least developed region. Male youngsters who lived in urban areas were more liable (OR=1.71, 95% CI 1.30-2.25) to overweight than their counterparts of rural areas. The occurrence of menarche increased two and a half times (OR=2.58, 95% CI 2.11-3.15) the risk of OW+O within the female group of adolescents. CONCLUSIONS: The results demonstrate a low prevalence of OW+O among Brazilian adolescents when compared with adolescents of more industrialized regions. The OW+O is twice as high within the female group, which represents a much greater difference than the one encountered in industrialized countries, probably owing to the muscular work carried out preponderantly by male adolescents of lower socioeconomic levels. Higher prevalences in subpopulations of higher socioeconomic level and of more industrialized regions show the great need for differentiated actions to control overweight and obesity in the country.     

Trends in child and adolescent obesity prevalence in economically advanced countries according to socioeconomic position: a systematic review

Recent obesity trends in children and adolescents suggest a plateau. However, it is unclear whether such trends have been experienced across socioeconomic groups. We analysed whether recent trends in child and adolescent overweight and obesity differ by socioeconomic position (SEP) across economically advanced countries. Eligible studies reported overweight and obesity prevalence in children and/or adolescents (2–18 years), for at least two time points since 1990, stratified by SEP. Socioeconomic differences in trends in child and adolescent overweight and obesity over time were analysed. Differences in trends between SEP groups were observed across a majority of studies. Over half the studies indicated increasing prevalence among low SEP children and adolescents compared to a third of studies among children and adolescents with a high SEP. Around half the studies indicated widening socioeconomic inequalities in overweight and obesity. Since 2000 a majority of studies demonstrated no change or a decrease in prevalence among both high and low SEP groups. However around 40% of studies indicated widening of socioeconomic inequalities post‐2000. While our study provides grounds for optimism, socioeconomic inequalities in overweight and obesity continue to widen. These findings highlight the need for greater consideration of different population groups when implementing obesity interventions. © 2015 World Obesity     

Trends in overweight and obesity in middle-aged subjects from southwestern France, 1985-1997

The trends in overweight and obesity between 1985 and 1997 were assessed in southwestern France using data from three independent, cross-sectional representative samples of the population aged 35-64 y: 678 men and 645 women in 1985-1987, 586 men in 1989-1991, and 614 men and 569 women in 1995-1997. Men had higher rates of overweight, whereas prevalence rates for obesity were similar between genders. In men, prevalence rates for overweight and obesity were respectively 50 and 10% in 1985-1987, 49 and 13% in 1989-1991, and 50 and 13% in 1995-1997; in women, prevalence rates were respectively 26 and 11% in 1985-1987 and 25 and 11% in 1995-1997; only the prevalence of obesity increased significantly in men. In both genders, prevalence rates of overweight and obesity increased with age group. We conclude that overweight and obesity have remained relatively stable in southwestern France, but the reasons for such a stability remain to be assessed.     

Assessment of obesity in a community sample of prepubertal children

The aims of this study were to quantify the effect of obesity definition on estimates of prevalence, and to determine the sensitivity and specificity of three commonly used definitions of overweight/obesity in children: body mass index (BMI) s.d. score > 2.00; BMI s.d. score > 1.04; weight > 120% ideal. A representative community sample of children in Edinburgh, Scotland (n=240, 124 boys and 116 girls; mean age 8.5 s.d. 0.4y) was recruited. Obesity was defined by a criterion method based on % body fat: > 25% fat in boys; > 32% fat in girls. Sensitivity of BMI s.d. score > 2.00 was relatively poor in both sexes (60% in girls; 36% in boys) but had high specificity (98%). Sensitivity of the other two clinical definitions was higher, and was better in girls than boys, but with lower specificity. Choice of definition had a profound effect on prevalence estimates. In conclusion, sensitivity of the definitions of obesity currently recommended for children, when tested in this sample, was heavily dependent on the definition used and differed between boys and girls. This should be considered when choosing a definition of obesity in clinical practice and epidemiology.     

上海市6～18岁少儿肥胖患病率调查

目的　研究上海市 6～ 18岁年龄组的儿童青少年肥胖和超重患病率情况。　方法　采用整群系统抽样的方法随机抽取上海市区、郊区各一个区 ,普查区内所有中小学学生共 6 5 0 0 6名 (郊区 4 0 310名 ,市区 2 4 6 96名 )的身高、体重。以体质指数 (BMI)评价调查对象的肥胖患病率 ,并比较标化患病率的差异。　结果　 (1)调查对象肥胖粗患病率为 3 5 8% ,超重标化患病率为 3 30 % ;超重粗患病率达 13 2 5 % ,标化患病率为 12 95 %。 (2 )总体上肥胖和超重的标化患病率市区显著高于郊区 (肥胖 :P <0 0 0 1,超重 :P <0 0 0 1) ;女性的发病率显著低于男性 (肥胖 :P <0 0 0 1,超重 :P <0 0 0 1)。 (3)肥胖和超重患病率随年龄增加显著减低 (P <0 0 0 1)。　结论　本组的肥胖患病率稍高于我国 1996年全国性调查的 0～ 7岁组儿童肥胖患病率 ,远低于美国上世纪 90年代末期的水平 ;各年龄组肥胖患病率随年龄增加而逐渐减低 ,与西方发达国家青少年肥胖患病率随年龄增加而增高的趋势有显著的不同。