Ethnic differences in body mass index and associated factors of adolescents from minorities in Oslo, Norway: a cross-sectional study

OBJECTIVES: To examine ethnic differences in body mass index (BMI), food habits and physical activity, and determine the factors contributing to differences in BMI. DESIGN AND METHOD: In 2000-2001, 7343 (response rate 88%) 15- and 16-year-old students, enrolled in lower secondary schools in Oslo, participated in the cross-sectional Oslo Health Study. Of these participants, 1719 were defined as ethnic minorities. RESULTS: Significant gender and ethnic differences in mean BMI were observed. Of the ethnic minority adolescents, 5.8% were underweight (<5th percentile of the US Centers for Disease Control and Prevention (CDC)/National Center for Health Statistics (NCHS) reference distribution) and 9.1% were overweight (>85th percentile of the US CDC/NCHS reference distribution). BMI was not significantly associated with either socio-economic factors or physical activity. Food habits and physical activity differed with ethnicity but not with socio-economic factors. An ordinal regression showed that girls from East Asia (odds ratio (OR) 0.4) and boys from sub-Saharan Africa (OR 0.4) had lower BMI than the Western group. Among girls, higher BMI was associated with less frequent consumption of chocolates and sweets, full-fat milk and breakfast (OR 2.4, 1.7 and 1.7, respectively). Higher BMI, for both boys and girls, was associated with current and past dieting (OR 3.7 and 4.2, respectively). CONCLUSIONS: Adolescent food habits and physical activity varied by gender and ethnicity but not with socio-economic factors. BMI was associated with ethnicity, gender and food habits, but no significant relationship was observed with socio-economic factors or physical activity. Ethnicity, in addition to gender, should be taken into consideration when studying BMI and associated factors among adolescents.     

Correlates of childhood obesity in Athens, Greece

OBJECTIVE: Childhood obesity is a growing public health problem. We have examined the association between sociodemographic profile and eating and physical activity patterns with overweight among primary-school students in Athens, Greece. DESIGN: Cross-sectional study. SETTING: Eleven primary schools in the greater Athens area, Greece. SUBJECTS: A total of 633 children aged 10-12 years (50 % boys, 50 % girls) were interviewed in person during spring 2003. Multivariate logistic regression was used to investigate the association between eating and physical activity patterns and overweight (> or =85th sex- and age-specific BMI centile). Results are presented as odds ratios and 95 % confidence intervals. RESULTS: Overweight was more common among girls than among boys (OR=1.73; 95% CI 1.11, 2.69) and substantially less common among children born outside Greece (OR=0.46; CI 0.22, 0.95). Reported physical activity (per 1.5 h per day) was unrelated to overweight (OR=0.97; CI 0.85, 1.12) but patent physical inactivity, operationalised as time spent watching television or working/playing with the computer (per 1.5 h per day) was a highly significant predictor of overweight (OR=1.20; CI 1.05, 1.36). Composition of diet was unrelated to overweight but the daily number of eating occasions, controlling for total energy intake, was significantly inversely associated with overweight (OR=0.61; CI 0.48, 0.76). CONCLUSIONS: The principal factor underlying overweight among children in Athens appears to be the extended inactivity imposed by modern childhood lifestyles. An intriguing finding is that spreading a given energy intake over several eating occasions was inversely associated with the likelihood of childhood obesity.     

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.     

Body mass index, physical activity and dietary behaviours among adolescents in the Kingdom of Tonga

OBJECTIVES: To compare the prevalence of overweight and obesity among adolescents using international and ethnic-specific cut-off points and to examine patterns of physical activity and dietary behaviours. DESIGN: Cross-sectional analytical study. SETTING: Schools on Tongatapu, Vava'u and Hapa'ai islands in the Kingdom of Tonga. SUBJECTS: A total of 443 school students aged 11-16 years underwent anthropometric measures of height and weight and provided self-reported measures of physical activity and dietary behaviours.Results Mean body mass index (BMI) was higher among girls than boys (23.7 kg m(-2) vs. 21.8 kg m(-2) and tended to increase with age. A total of 36.0% of boys and 53.8% of girls were overweight or obese using the international cut-off points, whereas 25.0% of boys and 37.6% of girls were classified in this way using Polynesian-specific cut-off points. Tinned mutton or beef was the food that most participants (56.9%) reported eating once or more per day. Over half of the young people did not eat taro, fruit or vegetables at least once per day. Regular physical activity outside of school hours was reported by 20.7% of respondents, and 58.2% watched 1 h or more of television per day. Physical activity participation was the only behaviour independently associated with a lower risk of overweight or obesity.Conclusions Using Polynesian-specific cut-off points for overweight and obesity the prevalence of these conditions was still among the highest found in adolescents. The prevalence of physical inactivity and poor dietary habits indicate that risk factors for chronic disease are well established during adolescence in Tonga.     

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.     

Breakfast habits affect overall nutrient profiles in adolescents

OBJECTIVE: To describe breakfast consumption patterns, on a nutrient and food item level, in Belgian adolescents. DESIGN: A 7-day estimated food record was administered in a cross-sectional survey. SETTING: Secondary schools in Ghent, Belgium. SUBJECTS: A total of 341 adolescents (13-18 years old), multistage clustered sampling. RESULTS: The energy contribution of breakfast to daily energy intake was on average 15.7% in boys and 14.9% in girls. Significantly more overweight girls and significantly more girls following vocational training were categorised as eating a low-quality breakfast. In boys, the energy contribution of polysaccharides was significantly higher in consumers of good-quality breakfasts. The intake of all selected micronutrients was significantly higher in consumers of good-quality breakfasts. In girls, the total energy intake and the proportional intake of proteins and polysaccharides were significantly higher in consumers of good-quality breakfasts, while the proportional contribution of total fat, monounsaturated and polyunsaturated fatty acids was significantly lower in these girls. The intake of all micronutrients was significantly higher in girls consuming a good-quality breakfast. In all adolescents, consumers of a good-quality breakfast had significantly higher intakes of bread, fruit, vegetables, milk and milk products, and fruit juice, while intake of soft drinks was significantly lower than in consumers of low-quality breakfasts. CONCLUSIONS: Consumers of a good-quality breakfast had a better overall dietary pattern - on a nutrient and food group level - than consumers of a low-quality breakfast. A daily breakfast, including whole-grain products, fruit and (semi-) skimmed milk products or an alternative source of calcium, is recommended.     

Food habits and physical activity patterns among Palestinian adolescents: findings from the national study of Palestinian schoolchildren (HBSC-WBG2004)

OBJECTIVE: To describe the food habits and physical (in)activity patterns and to investigate the relationship with sociodemographic factors among Palestinian adolescents. DESIGN AND SUBJECTS: The Palestinian Health Behaviour in School-aged Children (HBSC) is a cross-sectional survey of grades 6, 8, 10 and 12. Students completed a modified version of the international HBSC questionnaire. A total of 8885 students were included in this analysis; 53% were from the West Bank and 47% from the Gaza Strip. RESULTS: Adolescents in the West Bank consume more fruit, meat, chicken, sweets and soft drinks, but less vegetables than adolescents in Gaza (P<0.01). Girls reported more daily consumption of fruit, vegetables and sweets than boys (P<0.001), and less consumption of soft drinks, milk, meat and chicken (P<0.01). Boys were physically more active than girls (P<0.01), whereas girls reported doing more homework (P<0.001). Both boys and girls reported less physical activity with increasing age (P<0.001). Consumption of fruit and milk was positively associated with both parents' education, while consumption of meat, chicken and soft drinks was positively associated with mother's education only. Having breakfast on schooldays was positively associated with the father's education. Physical activity and television viewing were associated with the mother's education (P<0.01). The parents' level of education had no effect on vegetable consumption and dieting status. CONCLUSION: This study indicated that there are problems with Palestinian adolescents' eating, dieting and physical activity. Regional, gender and parental socio-economic status differences should be taken into account in developing interventions. More detailed studies are needed with more elaborate instruments about food habits and physical activity of adolescents.     

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.     

Association of body mass index and dietary restraint with changes in eating behaviour throughout late childhood and early adolescence: a 5-year study

OBJECTIVES: To describe patterns of dietary behaviours specific to low quality snacking, fruit and vegetable, and fast food consumption during the transition from childhood to adolescence and to examine how these behaviours are associated with tendencies towards dietary restraint and the occurrence of overweight and obesity in mid-adolescence. DESIGN: A 5-year follow-up of self-reported eating. Hierarchical linear modelling was utilised to explore the relationship between dietary changes and body mass index (BMI) and dietary restraint while controlling for physical activity and smoking. SETTING: The sample was derived from students participating in the Quebec Heart Health Demonstration Project, and represents rural, suburban and inner city youths. SUBJECTS: A sample of 561 girls and 627 boys in the fourth, sixth, seventh and ninth grades. RESULTS: Overall the sample was characterised by a decrease in fruit and vegetable consumption and increase in low quality snacking, and a decrease in fast food consumption over the 5-year follow-up. Dietary restraint and BMI were found to be associated with dietary behaviour. Lower than average dietary restraint was associated with a lower frequency of fast food consumption and greater increase in low quality snacking over the 5-year period. Higher than average dietary restraint was associated with lesser frequency of low quality snacking at baseline. Having a BMI in the obese range was associated with more frequent fast food consumption in the fourth grade and a more rapid drop in fast food consumption across the 5-year period. CONCLUSIONS: Dietary behaviours are associated with the psychological construct dietary restraint and with weight status in this population of adolescents.     

The determinants of overweight and obesity among 10- to 15-year-old schoolchildren in the North West Province, South Africa - the THUSA BANA (Transition and Health during Urbanisation of South Africans; BANA, children) study

AIM: To investigate the determinants of overweight and obesity among 10- to 15-year-old schoolchildren in a population in the transitional phase in the North West Province of South Africa.METHODS: A cross-sectional survey was used to investigate weight status (anthropometric indicators) and determinants of overweight/obesity including dietary intake, physical activity and socio-economic status. A single, random sample (n=1257), stratified for gender, type of school and ethnic group, was used. Data were collected on demographics, family circumstances, habitual physical activity, dietary intake and anthropometry to evaluate weight status and body fat content. One-way analysis of variance, the generalised linear models procedure of SAS and the Tukey post hoc honest significant difference test were used to analyse the data.RESULTS: Few children were overweight or obese (7.8%) according to International Obesity Task Force (IOTF) standards (body mass index (BMI)-for-age). These standards were compared with other accepted standard values. Both Cole's IOTF/BMI-for-age standard and the sum of skinfold thicknesses standard classified normal-weight status similarly at a level of 92% (P<0.01) and were found to be useful in determining overweight/obesity. The prevalence rate was higher in females and white children, and was more apparent in urban areas, smaller households and children of parents with low- or high-income occupations. Boys and pre-menarcheal girls had mean body fat percentage in the normal/optimal range, whereas that of post-menarcheal girls was moderately high. Few variables showed a significant association with high body fat percentage: in boys, only the number of members in the household and physical activity levels over the weekend; in girls, only age. The overweight/obese boys mostly lived in smaller households, and the overweight/obese post-menarcheal girls were most inactive on both weekdays and weekends, and more overweight with increasing age.CONCLUSION: Smaller households, inactivity and increasing age for girls were found to be determinants that influence the development of overweight/obesity, while female gender and age post-menarche were identified as determinants of higher body fat content. For overweight/obesity prevention, the focus should be on pre-menarcheal girls, aged 10-13 years, using these determinants to identify overweight/obesity risk. Preventive programmes should aim to increase the physical activity of children to improve their current and future weight status.     

Perceptions of weight and associated factors of adolescents in Jiangsu Province, China

OBJECTIVE: To describe perceptions of weight of adolescents and associated factors. DESIGN: Cross-sectional survey in 2002. SETTING: Eight public middle schools in two distinct socio-economic areas of Jiangsu Province, China. SUBJECTS: Eight hundred and twenty-four adolescents (aged 12-14 years) and 628 of their parents. METHODS: Self-administered questionnaires for students and their parents were used to collect the data. Height and weight of the students were measured. RESULTS: One-third of the girls perceived themselves as overweight, while only 8.9% were actually overweight or obese according to the World Health Organization definition. On the other hand, 15.0% of the girls considered themselves underweight, while 5.6% were underweight according to the definition. Among the boys, one-fifth of those defined as overweight perceived their weight as normal. Furthermore, 23.9% perceived themselves as underweight when in fact only 4.9% were classified as underweight according to the definition. About one-quarter of the students dieted in the past year. Adolescents who perceived themselves to be overweight dieted and skipped breakfast more often. They also had lower intake frequencies of animal foods, Western foods and milk/yoghurt. No disparity was observed in the intake frequency of fruits and vegetables between the groups of different weight perception. Parents' weight norms seemed to favour overweight in both genders, but especially among boys. CONCLUSIONS: Both overweight and underweight concerns were common among girls, while a higher body weight was favoured by normal-weight boys and their parents. Distorted weight perceptions in adolescents, as well as dieting, are problems that need appropriate intervention.     

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.     

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.     

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.     

Assessment of obesity and fear of fatness among inner-city Dublin schoolchildren in a one-year follow-up study

BACKGROUND: Positive secular trends in adolescent obesity and an increased prevalence of fear of fatness, particularly among girls, have been documented world-wide. There is a lack of consensus about assessment criteria for childhood obesity and no standard exists for assessing Irish children. In 1990, the Irish National Nutrition Survey used body mass index (BMI) > or =26 kg m(-2) to describe the prevalence of overweight among Irish adolescents. OBJECTIVES: (1) To examine the range in classification of Dublin schoolchildren as overweight according to four standard assessment methods; (2) to assess changes in weight status, prevalence of fear of fatness and accompanying slimming practices in a one-year follow-up; and (3) to compare the prevalence of overweight with that documented in 1990 among adolescents of similar age. DESIGN: A one-year follow-up study of 199 healthy schoolchildren (90 boys and 109 girls; mean age of 11 years at baseline) attending seven fee-paying (six single- and one mixed-sex) and eight non-fee-paying (four single- and four mixed-sex) primary schools in Dublin city centre. MEASUREMENTS: Weight, height, waist circumference and triceps skinfold were measured and used in five definitions of overweight, including published cut-off points of BMI-for-age (Centers for Disease Control and Prevention BMI-for-age charts for boys and girls; BMI reference curves for the UK 1990; International Obesity Task Force age- and sex-specific BMI cut-offs), actual relative weight and BM > or =26 kg m(-2). Assessment of body image perceptions and satisfaction (using figure line drawings) was reported in a questionnaire specifically designed for this study. RESULTS: The prevalence of overweight within the total group differed between the four standard definitions of weight status, by 9% at baseline and 8% at follow-up. Accordingly, increasing trends over the year ranged from zero to 3%. Using the criterion BMI > or =26 kg m(-2), 6% of Dublin schoolchildren were overweight, compared with 1.9% of schoolchildren in 1990. Significantly more girls than boys were affected by fear of fatness and were trying to lose weight. CONCLUSION: A standard method for assessment of weight status is urgently needed for the evaluation of obesity prevention initiatives among Irish schoolchildren. Such initiatives need to be sensitive to the pervasiveness of fear of fatness among adolescent girls.     

The role of breakfast in nutrient intake of urban schoolchildren

OBJECTIVES: To ascertain the breakfast habits of 10-15-year-old schoolchildren and to assess the quality of this meal as well as its relationship to the food consumption pattern for the full day. DESIGN: Cross-sectional survey. SUBJECTS AND SETTING: Eight hundred and two schoolchildren, boys and girls, aged 10-15 years, belonging to different urban schools located in Secunderabad, Andhra Pradesh, India. METHOD: The breakfast eating patterns of the children were studied and their impact on growth was assessed, using dietary recalls and anthropometric measurements. RESULTS: Only 42.8% of the children ate breakfast regularly. Over half of the children skipped breakfast, ranging from daily to once in two weeks. The energy and protein composition of breakfasts eaten by the children indicated that those who did not skip breakfast met one-quarter to one-third of their total daily energy and protein requirements. Mean nutrient intakes calculated from 24-hour recalls revealed that the children's diets were inadequate compared with the recommended values for energy and protein. The inadequate energy intake was reflected in a high incidence of malnutrition in both boys and girls; 40.3% of the boys and 32.1% of the girls studied were found to be underweight. Protein intake was also inadequate among boys and girls, although a higher percentage of children met their protein requirements. CONCLUSIONS: Over half of the schoolchildren studied skipped breakfast frequently, the main reason being getting up late. Children who consumed breakfast had higher daily intakes of energy and protein than children who skipped breakfast. These data confirm the importance of breakfast to overall dietary quality and adequacy in school-aged children.     

Diet and overweight and obesity in populations of African origin: Cameroon, Jamaica and the UK

OBJECTIVES: To determine the relationship of diet to overweight and obesity among populations of African origin. DESIGN AND SETTING: Cross-sectional data were obtained from adults aged 25-74 years in rural Cameroon (n = 686), urban Cameroon (n = 975), Jamaica (n = 924) and Afro-Caribbeans in the UK (n = 257). Dietary data were collected using food-frequency questionnaires specifically designed for each site. Body mass index (BMI) was used as a measure of overweight. RESULTS: The expected gradient in the distribution of overweight across sites was seen in females (rural Cameroon, 9.5%; urban Cameroon, 47.1%; Jamaica, 63.8%; UK, 71.6%); however, among males overweight was less prevalent in Jamaica (22.0%) than urban Cameroon (36.3%). In developing countries increased risks of overweight (BMI > or = 25 kg m(-2) were influenced by higher energy (urban Cameroonian men) and protein (Jamaican women) intakes. No dietary variables were associated with obesity (BMI > or = 30 kg m(-2) in Cameroon or Jamaica. In the UK, energy intakes were inversely related with overweight whereas increased risks of being overweight were associated with higher protein (men) and fat (women) intakes. Similarly, whereas higher protein and fat intakes in UK men and women were associated with obesity, carbohydrate intakes were associated with decreased risks of obesity in men. CONCLUSIONS: Diet and overweight were associated in the UK but few dietary variables were related to overweight in Jamaica and the Cameroon. These findings suggest that associations between diet and overweight/obesity are not generalisable among populations.     

Relationship between BMI and blood pressure in girls and boys

AimTo investigate the relationship between BMI and blood pressure as this is of crucial interest in evaluating both public health and the clinical impact of the so-called obesity epidemic. METHODS: Data were gathered from 1899 children aged between 6 and 14 years, analysing and evaluating a possible relationship between BMI and systolic and diastolic blood pressure values for both girls and boys. Each child was classified on the basis of age- and sex-specific BMI percentile as normal weight (<85th percentile), overweight (95th percentile). RESULTS: In comparisons among ageBMI percentile groups, systolic and diastolic blood pressure values were higher in obese and overweight groups than in normal weight groups for both sexes. Although BMI among girls was higher than among boys in all three percentile groups, there were no significant differences between sexes with respect to blood pressure values.ConclusionThe present findings emphasize the importance of the prevention of obesity in order to prevent future related problems such as hypertension in children and adolescents.     

Habitual physical activity and body composition of black township adolescents residing in the North West Province, South Africa

OBJECTIVE: It is known that stunting and obesity affect a large proportion of children in the world, and these can be affected by the physical activity levels of the children. In the present study, we evaluated the association between physical activity, physical development and body composition in black adolescent children. DESIGN: Cross-sectional study. SETTING: Black township schools in the North West Province, South Africa. METHODS: Three-hundred and thirteen grade 8 children were included in the Physical Activity in Youth study. Anthropometric measurements, body composition measures and maturity level as assessed by Tanner stages were determined in these children. In addition, Previous Day Physical Activity Recall questionnaires were administered on the children to record the various activities they undertake daily. RESULTS: The demographic characteristics of the children showed a high level of homogeneity. A high prevalence of stunting (16.3%) was observed in the children, which was higher in boys than in girls (21.6 vs. 12.3%). Also prevalent was overweight/obesity (8.6%), but this was higher in girls than in boys (13.4 vs. 1.6%). The children also showed a reduction in levels of physical activity with advancement in maturity; furthermore, boys showed a more central form of fat deposition whilst girls showed more gynoid deposition. CONCLUSIONS: The study revealed that physical activity plays a role in determining body composition, and further indicated that physical activity is associated with favourable body composition measures. Children who were more active were likely to have less fat deposits.