The association between consumption of breakfast cereals and BMI in schoolchildren aged 12-17 years: the VYRONAS study

OBJECTIVE: To evaluate whether consumption of breakfast cereals is associated with BMI in a sample of Greek adolescents. DESIGN: A cross-sectional health and nutrition survey.Setting and subjectsDuring 200417 years were selected from twelve schools located in Vyronas region (Athens metropolitan area). Height and weight were measured and BMI was calculated. A semi-quantitative FFQ was applied and multiple logistic regression analysis was used. RESULTS: Overall, 47 % of girls were obese, whereas 192 % of girls were overweight. Only 205 % of girls reported that they consume cereals as a first choice for breakfast. Consumption of breakfast cereals was associated with lower BMI in boys (P = 0019), irrespective of age and physical activity status. More prominent results were observed for daily cereal consumption or for more than two daily servings of cereals consumed for breakfast. Consumption of pre-sweetened breakfast cereals was associated with lower BMI compared with non-pre-sweetened or no intake of cereals, in both genders (P < 0.001). Consumption of breakfast cereals was associated with 33 % (95 % CI 14 %, 48 %) lower likelihood of overweight/obesity, irrespective of age, sex and physical activity status. CONCLUSIONS: Consumption of breakfast cereals was associated with lower BMI levels and a lower likelihood of overweight/obesity in both genders; thus a solid basis for public health professionals could be built when issuing advice on weight management.     

Family average income and body mass index above the healthy weight range among urban and rural residents in regional Mainland China

OBJECTIVE: To explore the relationship between family average income (FAI; an index of socio-economic status) and body mass index (BMI; a widely used, inexpensive indicator of weight status) above the healthy weight range in a region of Mainland China. DESIGN: Population-based cross-sectional study, conducted between October 1999 and March 2000 on a sample of regular local residents aged 35 years or older who were selected by random cluster sampling. SETTING: Forty-five administrative villages selected from three urban districts and two rural counties of Nanjing municipality, Mainland China, with a regional population of 5.6 million. SUBJECTS: In total, 29,340 subjects participated; 67.7% from urban and 32.3% from rural areas; 49.8% male and 50.2% female. The response rate among eligible participants was 90.1%. RESULTS: The proportion of participants classified as overweight was 30.5%, while 7.8% were identified as obese. After adjusting for possible confounding variables (age, gender, area of residence, educational level, occupational and leisure-time physical activity, daily vegetable consumption and frequency of red meat intake), urban participants were more likely to be overweight or obese relative to their rural counterparts, more women than men were obese, and participants in the lowest FAI tertile were the least likely to be above the healthy weight range. CONCLUSIONS: The proportion of adults with BMI above the healthy weight range was positively related to having a higher socio-economic status (indexed by FAI) in a regional Chinese population.     

The association between the body mass index of first-year female university students and their weight-related perceptions and practices, psychological health, physical activity and other physical health indicators

OBJECTIVE: To investigate the association between the weight status of first-year female students (FYFS) and various weight management-related characteristics to identify possible components of a weight management programme for students. DESIGN: Cross-sectional study. SETTING: Female residences at a South African university. SUBJECTS: A total of 360 FYFS. RESULTS: Mean (+/-standard deviation (SD)) body mass index (BMI) of the FYFS was 21.8 +/- 2.6 kg m(-2), with 7.2% being underweight, 81.9% normal-weight, 10.0% overweight and 0.8% obese. Underweight, normal-weight and overweight students differed with regard to their perception of their weight (P < 0.001), weight goals (P < 0.001) and previous weight-loss practices (P < 0.001). Mean+/-SD score on the 26-item Eating Attitudes Test (EAT-26) was 8.5 +/- 9.0 with 8.4% classified as high scorers. Mean+/-SD score on the 34-item Body Shape Questionnaire (BSQ) was 87.7 +/- 32.2, with 76.1% classified as low, 11.9% as medium and 11.9% as high scorers. The self-concept questionnaire indicated that 36.7% had a high, 43.9% a medium and 19.4% a low self-concept. Higher BMI correlated with a higher BSQ score (P < 0.001), a lower self-concept (P = 0.029) and a higher EAT-26 score (P < 0.001). Smoking was prevalent amongst 13.1% of students, and 51.2% used vitamin and/or mineral supplements. Students who quitted smoking had higher (P = 0.006) BMI (22.7 +/- 2.9 kg m(-2)) than those who never smoked before (21.6 +/- 2.5 kg m(-2)). Normal-weight students were more physically active than underweight or overweight students (P = 0.038). CONCLUSIONS: The specific weight management-related needs of FYFS include information about supplement use, smoking, realistic weight goals, safe and sound weight-loss methods, weight cycling, body-shape perceptions, eating attitudes and behaviours, self-concept and physical activity. Interventions aimed at correcting these problems should target all students, regardless of their BMI.     

Food insecurity, weight control practices and body mass index in adolescents

OBJECTIVE: We investigated whether experienced food insecurity was associated with weight control behaviour of adolescents. DESIGN: A national survey of 16-year-old students with the six-item food security scale, questions concerning intentions of trying to change weight, physical activity patterns, and measurement of height and weight. SETTING: Representative sample of 29 schools in Trinidad, West Indies. SUBJECTS: Data analysed for 1903 subjects including 1484 who were food-secure and 419 who were food-insecure. RESULTS: In the whole sample, food security status did not vary by body mass index (BMI) category. 'Trying to gain weight' and 'spending most free time in activities involving little physical effort' were each associated with lower BMI. 'Trying to gain weight' was more frequent in food-insecure subjects (135, 32%) than in food-secure subjects (369, 25%, P = 0.012). After adjustment for BMI, age, sex, ethnicity and socio-economic variables, the adjusted odds ratio (OR) of 'trying to gain weight' for food-insecure subjects was 1.39 (95% confidence interval (CI) 1.07-1.82, P = 0.014). Food-insecure subjects (197, 47%) were more likely than food-secure subjects (575, 39%) to report that most of their free time was spent doing things that involved little physical effort (P = 0.003). This association was not explained by adjustment for BMI, age, sex and ethnicity (OR = 1.41, 95% CI 1.13-1.76, P = 0.002) or additional socio-economic variables (OR = 1.27, 95% CI 1.02-1.57, P = 0.033). CONCLUSIONS: Adolescents who experience food insecurity are more likely to intend to gain weight but engage in less physical activity than food-secure subjects with the same BMI.     

Overweight and blood pressure: results from the examination of a selected group of adolescents in northern Italy

OBJECTIVE: The aim of the present study was to investigate blood pressure (BP) levels and their relationship with different indices of body fat in a group of adolescents, in order to evaluate the prevalence of hypertension and plan preventive and corrective strategies. DESIGN: Cross-sectional study in primary care. SETTING: All high schools in the Aosta Valley region, northern Italy. SUBJECTS: Five hundred and thirty-two adolescents of both sexes, aged 15.4 (standard deviation 0.7) years. The following parameters were measured: body weight, body height, body mass index (BMI), four skinfold thicknesses, body fat mass, waist and hip circumferences and BP. RESULTS: BMI data indicated a high prevalence of overweight subjects in both sexes, but higher in males, while the prevalence rate of obese adolescents was lower. Of the total, 11.8 % of subjects suffered from systolic hypertension, while 6.9 % suffered from diastolic hypertension. In linear correlation analysis, BMI and all adiposity indices, except waist:hip ratio, were found to be significantly associated (P ranging between 0.05 and 0.001) with both systolic BP and diastolic BP in both sexes, with r ranging between 0.152 and 0.359. Multiple regression analysis with the stepwise method showed BMI and body fat mass to have the strongest association (P < 0.001) with BP, with r ranging between 0.275 and 0.359.ConclusionUnless reversed, these conditions are worrying and predict the possible development of cardiovascular disease in adulthood. There is a pressing need to develop a comprehensive medical and nutrition plan, together with preventive and corrective strategies, in school programmes.     

The International Physical Activity Questionnaire (IPAQ): a study of concurrent and construct validity

INTRODUCTION: The International Physical Activity Questionnaire (IPAQ) was developed to measure health-related physical activity (PA) in populations. The short version of the IPAQ has been tested extensively and is now used in many international studies. The present study aimed to explore the validity characteristics of the long-version IPAQ. SUBJECTS AND METHODS: Forty-six voluntary healthy male and female subjects (age, mean +/- standard deviation: 40.7 +/- 10.3 years) participated in the study. PA indicators derived from the long, self-administered IPAQ were compared with data from an activity monitor and a PA log book for concurrent validity, and with aerobic fitness, body mass index (BMI) and percentage body fat for construct validity. RESULTS: Strong positive relationships were observed between the activity monitor data and the IPAQ data for total PA (rho = 0.55, P < 0.001) and vigorous PA (rho = 0.71, P < 0.001), but a weaker relationship for moderate PA (rho = 0.21, P = 0.051). Calculated MET-h day(-1) from the PA log book was significantly correlated with MET-h day(-1) from the IPAQ (rho = 0.67, P < 0.001). A weak correlation was observed between IPAQ data for total PA and both aerobic fitness (rho = 0.21, P = 0.051) and BMI (rho = 0.25, P = 0.009). No significant correlation was observed between percentage body fat and IPAQ variables. Bland-Altman analysis suggested that the inability of activity monitors to detect certain types of activities might introduce a source of error in criterion validation studies. CONCLUSIONS: The long, self-administered IPAQ questionnaire has acceptable validity when assessing levels and patterns of PA in healthy adults.     

Misperceptions, inactivity and maternal factors may drive obesity among Barbadian adolescents

OBJECTIVES: To describe (1) the prevalence of overweight and obesity and their association with physical activity; (2) the effect of different cut-off points for body mass index (BMI) on weight status categorisation; and (3) associations of weight status with perceptions of body size, health and diet quality. DESIGN: A cross-sectional study. SETTING: Secondary schools in Barbados. SUBJECTS: A cohort of 400 schoolchildren, 11-16 years old, selected to study physical education practices. RESULTS: Prevalence of overweight (15% boys; 17% girls) and obesity (7% boys; 12% girls) was high. Maternal obesity, as defined by the International Obesity Task Force (IOTF) BMI cut-off points, predicted weight status such that reporting an obese mother increased the odds of being overweight by 5.25 (95% confidence interval: 2.44, 11.31). Physical activity was inversely associated with weight status; however levels were low. Recreational physical activity was not associated with weight status in either category. Overweight subjects tended to misclassify themselves as normal weight and those who misclassified perceived themselves to be of similar health status to normal-weight subjects. The National Center for Health Statistics and IOTF BMI cut-off points produced different estimates of overweight and obesity. CONCLUSIONS: Our findings suggest that inadequate physical activity and ignorance related to food and appropriate body size are promoting high levels of adiposity with a strong contribution from maternal obesity, which may be explained by perinatal and other intergenerational effects acting on both sexes. Prevalence studies and local proxy tools for adiposity assessment are needed.     

The influence of age and body mass index on relative accuracy of energy intake among Japanese adults

OBJECTIVE: To examine relationships between the ratio of energy intake to basal metabolic rate (EI/BMR) and age and body mass index (BMI) among Japanese adults. DESIGN: Energy intake was assessed by 4-day semi-weighed diet records in each of four seasons (16 days in total). The EI/BMR ratio was calculated from reported energy intake and estimated basal metabolic rate as an indicator of reporting accuracy. SETTING: Residents in three areas in Japan, namely Osaka (urban), Nagano (rural inland) and Tottori (rural coastal). SUBJECTS: One hundred and eighty-three healthy Japanese men and women aged > or =30 years. RESULTS: The oldest age group (> or =60 years) had higher EI/BMR values than the youngest age group (30-39 years) in both sexes (1.74 vs. 1.37 for men; 1.65 vs. 1.43 for women). In multiple regression analyses, age correlated positively (partial correlation coefficient, beta = 0.012, P < 0.001 for men; beta = 0.011, P < 0.001 for women) and BMI correlated negatively (beta = -0.031, P < 0.001 for men; beta = -0.025, P < 0.01 for women) with EI/BMR. CONCLUSION: Age and BMI may influence the relative accuracy of energy intake among Japanese adults.     

The effects of socio-economic status on BMI, waist:hip ratio and waist circumference in a group of Iranian women

OBJECTIVE: To assess the effects of socio-economic status (SES) on BMI, waist:hip ratio (WHR) and waist circumference (WC) in a group of Iranian women. METHODS: A cross-sectional study was conducted on 888 women in Sistan and Baluchestan Province. SES was measured using level of education. In addition, parity, marital status and physical activity were assessed. Standardized measurements were taken, BMI and WHR were calculated. RESULTS: Low education level was a strong determinant of overweight and obesity among Iranian women. After controlling for age, women with higher education level had significantly lower BMI, WC and parity. Multiple linear regression analysis found a significant negative association of BMI and WC with education level and a significant positive association of BMI and WC with parity. Significant factors associated with obesity by a logistic regression model were education level (OR for university graduates v. illiterate or low literacy levels: 1.00 v. 3.70; P = 0.01), living with spouse (OR for married v. single subjects: 1.00 v. 0.15; P = 0.05), parity (OR for more than five v. less than two pregnancies: 1.00 v. 0.34; P = 0.03) and WC (OR for < 0.88 cm v. > or = 0.88 cm: 1.00 v. 11.20; P = 0.001). CONCLUSION: The present study revealed that educational level, multiple pregnancies, marital status and lack of exercise are some possible explanations for the obesity among Sistan and Baluchestan women.     

Obesity and related risk factors among low socio-economic status minority students in Chicago

OBJECTIVES: To assess overweight and related risk factors among urban low socio-economic status (SES) African-American adolescents in an attempt to study the underlying causes of ethnicity and gender disparities in overweight. METHODS: Cross-sectional data collected on anthropometric measures, diet, physical activity and family characteristics from 498 students in grades 5-7 in four Chicago public schools were analysed to study the risk factors for overweight using stepwise regression analysis. RESULTS: Only 37.2% of the students lived with two parents. Nearly 90% had a television (TV) in their bedroom, and had cable TV and a video game system at home. Overall. 21.8% (17.7% boys versus 25.1% girls) were overweight (body mass index (BMI) >/= 95th percentile); and 39.8% had a BMI >/= 85th percentile. Compared with national recommendations, they had inadequate physical activity and less than desirable eating patterns. Only 66.1% reported having at least 20 min vigorous exercise or 30 min of light exercise in >/= 5 days over the past 7 days; 62.1% spent >3 h days- 1 watching TV/playing video games/computer, while 33.1% spent >/= 5 h days- 1. Their vegetable and fruit consumption was low, and they consumed too many fried foods and soft drinks: 55.1% consumed fried food twice or more daily and 19.5% four times or more daily; 70.3% consumed soft drinks twice or more daily and 22.0% four times or more daily on average. Gender, physical activity and pocket money were significant predictors of overweight (P < 0.05). CONCLUSIONS: Several factors in the students' behaviours, school and family environments may increase overweight risk among this population. There is a great need for health promotion programmes with a focus on healthy weight and lifestyle, and targeting urban low-SES minority communities.     

Overweight and obesity among Iranian female adolescents in Rasht: more overweight in the lower social group

OBJECTIVE: This study aimed to investigate the frequency of overweight and obesity among Iranian adolescent girls aged 14-17 years and its possible association with maternal education in Rasht city in 2005. DESIGN: A cross-sectional survey on 1054 schoolgirls. SETTING: High schools in Rasht city, Iran. METHODS: A multistage sampling method was used and 1054 randomly selected schoolgirls were studied. Data on age and mother's years of schooling were collected by questionnaire and body weight and height were measured. Overweight and obesity were defined using age- and sex-specific body mass index (BMI) cut-off points proposed by the International Obesity Task Force (IOTF), and compared with 85th and 95th BMI percentile curves of the IOTF reference population, respectively. Data analyses included two groups based on mother's years of schooling: less educated ( < 12 years) and more educated ( > or = 12 years). RESULTS: The overall prevalence of overweight and obesity in this population was 21.9 and 5.3%, respectively. Results of logistic regression analysis showed that the risk of overweight was higher for lower age group (odds ratio = 2.0, 95% confidence interval 0.18-3.09). Overweight was more common in girls with less educated mothers than in girls with more educated mothers (26.0 vs. 19.8%, P = 0.03). CONCLUSION: These data indicate that overweight is highly prevalent among adolescent girls, especially in lower social groups in Rasht, and the rate is exceeding those reported in other parts of the country. Preventive strategies need to be adopted to combat the epidemic of overweight and obesity in this population.     

Prevalence of overweight and obesity among school-aged children in urban, rural and mountain areas of the Veneto Region, Italy

OBJECTIVE: To define the prevalence of overweight and obesity among school-aged children resident in mountain areas, rural areas and urban areas.Design, setting and subjectsThe sample (n = 12 832; 50.7% boys) included 9- and 11-year-old children of the Veneto Region of north-east Italy. Overweight and obesity status were determined using the International Obesity Task Force cut-off points for body mass index. The prevalence of overweight and obese subjects was calculated with a confidence interval of 95%. The Mantel-Haenszel method was used to compare the combined prevalence of overweight and obesity among children resident in mountain areas, rural areas and urban areas. RESULTS: Among boys the prevalence of overweight was 21.06%, while obesity prevalence was 5.92%; among girls overweight prevalence was 21.30%, while obesity prevalence was 5.15%. The prevalence was higher among 11-year-old boys (odds ratio (OR) = 1.19; 95% confidence interval (CI): 1.06-1.33) and 9-year-old girls (OR = 1.13; 95% CI: 1.01-1.26). Children resident in rural areas presented a higher risk of overweight and obesity compared with children resident in mountain areas (Mantel-Haenszel OR = 1.27; 95% CI: 1.13-1.42; chi2 = 17.55; P < 0.0001) and in urban areas (Mantel-Haenszel OR = 1.18; 95% CI: 1.07-1.31; chi2 = 10.39; P < 0.001). CONCLUSIONS: A relevant prevalence of overweight and obesity was found; the excess weight concerns one child in four. There are differences linked to different geographical areas that must be further investigated.     

Is overweight and obesity in 9-10-year-old children in Liverpool related to deprivation and/or electoral ward when based on school attended?

OBJECTIVES: To determine whether weight problems in children (overweight, obesity and overweight or obesity) were related to deprivation indices when attributed only according to electoral ward of the school attended. To determine whether children with weight problems were more likely to be found in some wards rather than others, and to compare the distribution for boys and girls. DESIGN: Retrospective, cross-sectional, observational study. SETTING: One hundred and six primary schools from all parts of Liverpool city. SUBJECTS: Five cohorts of 9-10-year-old children between 1998 and 2003. Main outcome measures: Body mass index (BMI) for each child to estimate proportions overweight, obese and overweight or obese according to international criteria. RESULTS: Between January 1998 and March 2003, the heights and weights of 7902 boys and 7514 girls were measured and BMI calculated. The prevalence of boys and girls categorised as overweight or obese was very high (1620, 20.6% and 1909, 25.7%, respectively). Prevalence was not related to deprivation and varied between wards only for the girls; some wards had very different prevalence rates for boys and girls (Picton: 59 boys, 23.4%; 106 girls, 36.6%). The most deprived ward did not have a remarkable prevalence of overweight or obesity (Speke: 32 boys, 15.3%; 40 girls, 19.8%). CONCLUSIONS: Obesity is a major problem and requires urgent action but targeting intervention on the basis of administrative areas may be very wasteful. Different factors seem to lead to obesity in boys and girls, and attention should be paid to the role of the physical environment.     

Trends in overweight by socio-economic status in Vietnam: 1992 to 2002

OBJECTIVE: To explore socio-economic factors associated with rising rates of overweight among Vietnamese adults. DESIGN: The study was based on three national surveys of socio-economic factors and health conducted over a 10-year period. The studies were: the Vietnamese Living Standard Survey 1992-1993 (11 982 participants); the Vietnamese Living Standard Survey 1997-1998 (15 975 participants); and the Vietnamese National Health Survey 2001-2002 (94 656 participants). SUBJECTS: Male and female adults >18 years old were stratified by gender, age group, area of residence, occupation, education and relative food expenditures. Overweight was defined using body mass index (BMI) > or = 25 kg m(-2). RESULTS: Overweight rates in Vietnam more than doubled between 1992 and 2002 (from 2.0 to 5.7%). Significant increases were observed for men and women, in urban and rural areas, and for all age groups. In univariate analyses, both age and higher socio-economic status were associated with higher rates of overweight. Using the most recent survey, urban populations were more likely to be overweight than rural ones (odds ratio (OR) = 1.79), white-collar workers were more likely to be overweight than manual labourers (OR = 1.95) and persons in the top level of food expenditures were more likely to be overweight than persons in the bottom level (OR = 4.96) after adjustment for other factors. Education was inversely associated with overweight after adjusting for covariates. CONCLUSION: Economic growth and improved standard of living are associated with higher rates of overweight in nations in early stages of economic development. In Vietnam, higher rates of overweight were observed among the higher income and occupation groups.     

Risk factors for overweight among Brazilian adolescents of low-income families: a case-control study

OBJECTIVE: To study risk factors for overweight among Brazilian adolescents of low-income families. DESIGN: Case-control study of obese and non-obese adolescents. SETTING: Anthropometric survey including 1420 students (aged 14-19 years) attending a public high school in S?o Paulo, Brazil. METHODS: Selection of 83 overweight (body mass index (BMI) >85th percentile) and 89 non-overweight (BMI >5th percentile and <85th percentile) subjects, frequency-matched by age, gender, pubertal development and socio-economic status. Among the nutritional, familial and behavioural data available, five covariates (parents' obesity, adolescents' past obesity, to have a best friend, dietary restriction and habit of napping) were included in the fitted hierarchical conditional logistic regression models. MEASUREMENTS: Parents or guardians and adolescents were weighed, measured and answered a pre-tested questionnaire applied by trained nutritionists and paediatricians. RESULTS: The prevalence of overweight was 15.2%. As previous risks, obese parents and obesity during infancy presented odds ratios (OR) and 95% confidence intervals (CI) of 2.23 (1.15-4.35) and 3.60 (1.47-8.80), respectively. As concurrent factors, the habit of napping, to have a best friend and reported dietary restriction presented OR (95% CI) of 3.43 (1.32-8.92), 5.15 (1.76-15.07) and 7.26 (2.95-17.88), respectively. Dietary patterns, frequency of obesogenic foods and other physical activity indicators presented no statistical significance. CONCLUSION: In case-control studies, OR may overestimate the true risks. Parents' obesity and previous childhood obesity were identified as risk factors; therefore these factors should be the target for preventive programmes and policies in order to prevent the burden of obesity in the near future.     

The impact of a national mass media campaign in The Netherlands on the prevention of weight gain

OBJECTIVE: A 5-year nationwide mass media campaign aimed at prevention of overweight was organised from 2002 onwards. The present study evaluates the first campaign, which was aimed primarily at increasing awareness of weight gain. DESIGN AND SUBJECTS: Data were collected by telephone interview in four independent cross-sectional surveys among non-obese Dutch adults aged 25-35 years (total n = 1,949) for statistical analyses. Awareness of personal body-weight status, overweight-related risk perceptions, attitudes towards weight-gain prevention, motivation to prevent weight gain and self-reported body mass index (BMI) were measured in each survey. Campaign exposure was assessed in the post-intervention surveys. To identify intervention effects over time multiple linear and logistic regression analyses were used, adjusted for secular time effects and age. RESULTS: After the campaign about 65% of the respondents knew about the campaign. The campaign was associated with more positive attitudes towards the prevention of weight gain (beta = 0.16; P < 0.01) and higher self-reported BMI (beta = 0.14; P < 0.01). CONCLUSIONS: The results suggest that the first campaign reached a large proportion of the population and initiated some positive change in attitudes, but did not achieve significant improvements in other determinants of weight-gain prevention among non-obese young adults.     

Obesity and associated lifestyle behaviours in Iran: findings from the First National Non-communicable Disease Risk Factor Surveillance Survey

OBJECTIVE: To assess the national prevalence of overweight and obesity, as well as some associated lifestyle behaviours, for the first time in Iran. DESIGN AND SETTINGS: This population-based study was performed in early 2005 as part of the World Health Organization (WHO) STEPwise approach to non-communicable diseases' risk factor surveillance. Dietary and physical activity habits were assessed by WHO questionnaires. SUBJECTS: The study population comprised 89,532 subjects aged over 15 years living in the 28 provinces of Iran. RESULTS: Overall, 50.4% (n = 45,113) of the participants were male and 64.6% (n = 57 866) were from the urban areas. The national estimates of overweight, obesity and morbid obesity were 28.6%, 10.8% and 3.4%, respectively. Body mass index (BMI) > or = 25 kg m-2 in men, women, urban residents and rural residents were found in 37%, 48%, 46.7% and 35.5%, respectively. Abdominal obesity was present in 43.4% of women, 9.7% of men, 28.5% of the urban residents and 23% of the rural residents. Overweight as well as generalised and abdominal obesity were more prevalent in the 45-64-year age group. Although there was no significant difference in frequency of consumption of the food groups in subjects with different BMI categories, various kinds of physical activities showed a steady decline with increasing BMI. CONCLUSIONS: The findings of the present study provide alarming evidence for health professionals and policy makers about the very high prevalence of generalised and abdominal obesity in Iran. The unhealthy lifestyle habits, notably sedentary lifestyles in our community, are the major contributing factors for this emerging public health problem.     

Prevalence of overweight and obesity among young people in Great Britain

OBJECTIVE: To determine the prevalence of overweight and obesity in British young people (4-18 years) in 1997. DESIGN: Cross-sectional analysis of the National Diet and Nutrition Survey of young people. SETTING: Great Britain. SUBJECTS: Nationally representative sample of 1836 young people (age 4-18 years). RESULTS: The prevalence of obesity based on body mass index (weight/height(2)) and the International Obesity Task Force cut-offs was 4.0%, with a further 15.4% identified as overweight. Asians were almost four times as likely to be obese as white subjects (13.6 vs. 3.5%, P<0.001). Among white subjects there was no significant difference in the prevalence of obesity between girls and boys, or with age. The risk of obesity was significantly higher in subjects from social classes IV and V than from social classes I-III (6.5 vs. 2.7%, P=0.003). Subjects living in Scotland and Wales were significantly more likely to be obese than those in England (7.6 and 6.5 vs. 2.9%, respectively, P<0.01). Multiple logistic regression showed that, among white subjects, those in social classes IV and V living in Wales and Scotland were three times more likely to be obese than the other children in the survey (odds ratio 3.3, 95% confidence interval 1.1-9.8). CONCLUSION: These data provide information on the national prevalence of overweight and obesity in Great Britain and baseline data from which to monitor future trends. This analysis provides important demographic information on those most at risk of obesity, which may be used to inform public health strategies to prevent obesity in young people.     

Dietary intake among under-, normal- and overweight 9- and 15-year-old Estonian and Swedish schoolchildren

OBJECTIVES: To determine the differences in macronutrient and food group contribution to total food and energy intakes between Estonian and Swedish under-, normal- and overweight schoolchildren, and to estimate the association between diet and body mass index (BMI). DESIGN: Cross-sectional comparison between Estonian and Swedish children and adolescents of different BMI groups. SETTING: Twenty-five schools from one region in Estonia and 42 in two regions of central Sweden. SUBJECTS: In total 2308 participants (1176 from Estonia and 1132 from Sweden), including 1141 children with a mean age of 9.6 +/- 0.5 years and 1167 adolescents with a mean age of 15.5 +/- 0.6 years. RESULTS: Overweight was more prevalent among younger girls in Sweden (17.0 vs. 8.9%) and underweight among girls of both age groups in Estonia (7.9 vs. 3.5% in younger and 10.5 vs. 5.1% in older age group of girls). Compared with that of normal- and underweight peers, the diet of overweight Estonian children contained more energy as fat (36.8 vs. 31.7%) but less as carbohydrates, and they consumed more milk and meat products. Absolute BMI of Estonian participants was associated positively with energy consumption from eggs and negatively with energy consumption from sweets and sugar. Swedish overweight adolescents tended to consume more energy from protein and milk products. Risk of being overweight was positively associated with total energy intake and energy from fish or meat products. In both countries the association of overweight and biological factors (pubertal maturation, parental BMI) was stronger than with diet. CONCLUSION: The finding that differences in dietary intake between under-, normal- and overweight schoolchildren are country-specific suggests that local dietary habits should be considered in intervention projects addressing overweight.