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.     

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.     

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.     

Associations between television viewing and consumption of commonly advertised foods among New Zealand children and young adolescents

OBJECTIVES: To explore how time spent watching television (TV) is associated with the dietary behaviours of New Zealand children and young adolescents. DESIGN: Secondary data analysis of a nationally representative, cross-sectional survey. SETTING: In homes or schools of New Zealand school students. PARTICIPANTS: In total, 3275 children aged 5 to 14 years. RESULTS: The odds of being overweight or obese increased with duration of TV viewing for children and adolescents when controlling for age, sex, ethnicity, socio-economic status and physical activity. Children and adolescents who watched the most TV were significantly more likely to be higher consumers of foods most commonly advertised on TV: soft drinks and fruit drinks, some sweets and snacks, and some fast foods. Both children and adolescents watching two or more hours of TV a day were more than twice as likely to drink soft drinks five times a week or more (P = 0.03 and P = 0.04, respectively), eat hamburgers at least once a week (both P = 0.02), and eat French fries at least once a week (both P < 0.01). CONCLUSIONS: These findings suggest that longer duration of TV watching (thus, more frequent exposure to advertising) influences the frequency of consumption of soft drinks, some sweets and snacks, and some fast foods among children and young adolescents. Efforts to curtail the amount of time children spend watching TV may result in better dietary habits and weight control for children and adolescents. Future studies examining the impact of advertising on children's diets through interventions and international comparisons of legislation would provide more definitive evidence of the role of advertising in child and adolescent obesity.     

Type of kindergarten and other potential determinants of overweight in pre-school children

OBJECTIVE: The study aimed to assess the relationship of various types of kindergarten differing in length of care and food availability with the development of overweight in pre-school children. DESIGN, SETTING AND SUBJECTS: A cross-sectional study was carried out in 2002 in Stuttgart, Germany, as part of the school entrance examination. Height and weight of 2140 children (participation 70.2%) were measured and information on type of kindergarten and other potential determinants of overweight was collected by a parental questionnaire. Change in relative body mass index (BMI) position between the ages of 4 and 6 years was assessed using medical records. RESULTS: The prevalence of overweight or change in relative BMI position did not differ according to the type of kindergarten. For the prevalence of overweight in German children, adjusted odds ratios (OR) comparing institutions that open only in the morning with those opening in the morning and afternoon or for the full day were 0.86 (95% confidence interval (CI) 0.40, 1.83) and 0.63 (95% CI 0.25, 1.58), respectively. Parental BMI and duration of television watching were positively associated, and maternal educational status and duration of breast-feeding were negatively associated, with overweight and/or change in relative BMI position. The prevalence of overweight was substantially higher among non-German than among German children (adjusted OR 2.17 (95% CI 1.53, 3.07)). CONCLUSIONS: These data show no association between different types of kindergarten and the development of overweight in early childhood. Duration of television watching and breast-feeding, as well as the relatively high prevalence of overweight in ethnic minorities, deserve further attention.     

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.     

Television viewing behaviour and associations with food habits in different countries

OBJECTIVE: Several environmental factors influence adolescents' food habits and television (TV) viewing is thought to be one of these factors. The purpose of the present study was to describe sociodemographic differences in TV viewing and to examine associations of TV viewing with the consumption of sweets, soft drinks, fruit and vegetables in different countries. METHODS: Data were collected from 162,305 young people completing the 2001/02 Health Behaviour in School-Aged Children survey, a World Health Organization cross-national study on health and health behaviours among 11-, 13- and 15-year-old school pupils. Analyses of variance were used to examine sociodemographic differences in TV viewing and logistic regression analyses to examine associations between TV viewing and food habits. RESULTS: Large differences were found between countries in reported daily TV viewing time, from an average of 2.0 h in Switzerland to 3.7 h in Ukraine. The results indicate that those most likely to watch TV are boys, 13-year-olds and pupils of lower socio-economic status. Those who watched more TV were more likely to consume sweets and soft drinks on a daily basis and less likely to consume fruit and vegetables daily, although the latter associations were not so apparent among Central and Eastern European countries. CONCLUSIONS: Given the high TV viewing rates among adolescents and the association with less healthy food options, many young people are at increased risk of overweight or obesity. Interventions to modify TV viewing behaviour are needed. The findings underscore the importance of tackling socio-economic differences.     

Prevalence and determinants of stunting and overweight in 3-year-old black South African children residing in the Central Region of Limpopo Province, South Africa

OBJECTIVES: To determine the prevalence of stunting, wasting and overweight and their determinants in 3-year-old children in the Central Region of Limpopo Province, South Africa. DESIGN: Prospective cohort study. SETTING: Rural villages in the Central Region of the Limpopo Province, South Africa. SUBJECTS: One hundred and sixty-two children who were followed from birth were included in the study. Anthropometric measurements and sociodemographic characteristics of the children were recorded. RESULTS: Height-for-age Z-scores were low, with a high prevalence of stunting (48%). The children also exhibited a high prevalence of overweight (22%) and obesity (24%). Thirty-one (19%) children were both stunted and overweight. Gaining more weight within the first year of life increased the risk of being overweight at 3 years by 2.39 times (95% confidence interval (CI) 1.96-4.18) while having a greater length at 1 year was protective against stunting (odds ratio (OR) 0.41; 95% CI 0.17-0.97). Having a mother as a student increased the risk for stunting at 3 years by 18.21 times (95% CI 9.46-34.74) while having a working mother increased the risk for overweight by 17.87 times (95% CI 8.24-38.78). All these factors also appeared as risks or as being protective in children who were both overweight and stunted, as did living in a household having nine or more persons (OR 5.72; 95% CI 2.7-12.10). CONCLUSION: The results of this study highlight the importance of evaluating anthropometric status in terms of both stunting and overweight. Furthermore, it is important to realise the importance of normal length and weight being attained at 1 year of age, since these in turn predict nutritional status at 3 years of age.     

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.     

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.     

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.     

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.     

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.     

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.     

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.     

Predictors of poor anthropometric status among children under 2 years of age in rural Uganda

OBJECTIVE: To assess predictors of poor anthropometric status among infants and young children.DESIGN: Cross-sectional survey.SETTING: The rural subsistence agricultural district of Hoima, western Uganda.SUBJECTS: Seven hundred and twenty children aged 0-23 months with their mothers/carers.METHODS: Participants were recruited in September 2002, using a two-stage cluster sampling methodology. A structured questionnaire was administered to mothers in their home settings. Information on health, household socio-economic status, child feeding practices and anthropometric measurement was gathered. Conditional logistic regression analysis was applied taking into account the hierarchical relationships between potential determinants of poor anthropometric status.RESULTS: The mean Z-score for weight-for-height was -0.2 (95% confidence interval (CI) -0.1, -0.7), for height-for-age was -1.1 (95% CI -1.2, -0.9) and for weight-for-age was -0.7 (95% CI -0.8, -0.6). Wasting was independently associated only with a history of fever in the 2 weeks prior to the survey (odds ratio (OR)=4.4, 95% CI 1.5, 13), while underweight was associated with a history of fever (OR=2.4, 95% CI 1.3, 4.4) and cough (OR=3.0, 95% CI 1.3, 6.8). Stunting was positively associated with a wider range of factors, including: history of a fever episode (OR=1.7, 95% CI 1.0, 2.9), lack of a latrine in the household (OR=2.7, 95% CI 1.5, 4.9), failure to de-worm children 12 months or older (OR=1.7, 95% CI 1.1, 2.8), and being born to a non-formally educated mother compared with mothers educated above primary school (OR=2.1, 95% CI 1.1, 4.0).CONCLUSIONS: In analyses guided by the hierarchical interrelationships of potential determinants of malnutrition, wasting and underweight turned out to be independently predicted by morbidity (proximal) factors. Stunting, however, was predicted by socio-economic (distal), environmental and health-care (intermediate) factors in addition to morbidity. Strategies aimed at improving the growth of infants and young children in rural communities should address morbidity due to common childhood illness coupled with environmental and socio-economically oriented measures.     

What young Dutch adults say they do to keep from gaining weight: self-reported prevalence of overeating, compensatory behaviours and specific weight control behaviours

OBJECTIVE: The aim of this study was to explore the prevalence of and differences in self-reported occasions of overeating (such as at celebrations and other parties), compensatory behaviours and specific weight gain prevention strategies among young Dutch adults according to sociodemographics and overweight status. DESIGN AND SUBJECTS: Cross-sectional data were analysed from Dutch adults aged 20-40 years, recruited from an Internet research panel (n = 857, response rate = 76.6%). Using electronic questionnaires, self-report data were collected on sociodemographics, body mass index (BMI), occasions of overeating, compensatory behaviours, and diet and physical activity used as weight gain prevention strategies. Associations were tested using multiple linear and logistic regression analyses. RESULTS: Of the participants, 48.6% reported occasions of overeating at least once a week during the 4-week period, 44.6% reported compensating for these occasions and 72.9% reported engaging in dietary and physical activities specifically for weight gain prevention purposes. Only 32.1% of the respondents reported using the recommended combination of diet and physical activity as a weight gain prevention strategy. In addition, results showed that overweight people (BMI > or = 25 kg m-2) and women were more likely to report overeating than people with healthy body weights (odds ratio (OR) = 1.79; 95% confidence interval (CI) 1.32-2.42) and men (OR = 1.50; 95% CI 1.14-1.97). Overweight people, women and people who regularly reported overeating were also significantly more likely to report compensatory behaviours by eating less and to report specific weight gain prevention strategies using diet and physical activity. CONCLUSION: The present study suggests that people experience frequent occasions of overeating and try to compensate for such occasions in different ways. However, the combination of dietary changes and physical activity recommended by experts was seldom reported.     

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.     

Prevalence of obesity, food choices and socio-economic status: a cross-sectional study in the north-west of Iran

AIM: To document the epidemiological features and influencing factors of obesity in the north-west of Iran, to provide baseline information for setting up a regional population-based centre to control and prevent obesity-related disorders in the area. METHODS: In this cross-sectional study, a total of 300 subjects were selected/studied in Tabriz, one of the major cities in Iran. Data on basic characteristics, anthropometric measurements, dietary assessment and physical activity were collected. Obesity was defined as body mass index > or =30 kg m(-2) for both women and men. RESULTS: Total prevalence of obesity in the area was 22.4% (95% confidence interval (CI): 18.0-27.6). The prevalence of obesity was 24% (95% CI: 18.5-31.4) for women and 18% (95% CI: 12.5-25.6) for men. For both women and men obesity prevalence showed a positive association with age (P<0.001), while there was a negative correlation of obesity with education and income (P<0.001). Fruit consumption decreased the risk of obesity in both women and men (odds ratio (OR)=0.60, 95% CI: 0.49-0.71 vs. OR=0.62, 95% CI: 0.51-0.74, respectively). The same significant pattern was observed for the consumption of green vegetables (OR=0.71, 95% CI: 0.57-0.63 vs. OR=0.86, 95% CI: 0.77-0.98 for women and men, respectively), legumes (OR=0.70, 95% CI: 0.59-0.84 vs. OR=0.78, 95% CI: 0.66-0.91 for women and men, respectively) and dairy products (OR=0.73, 95% CI: 0.61-0.91 vs. OR=0.77, 95% CI: 0.63-0.93 for women and men, respectively). CONCLUSIONS: Our study showed that educational attainment, higher income and consumption of certain food groups (i.e. vegetables, fruits, legumes and dairy products) may decrease the risk of obesity. Our findings also indicate the crucial necessity of establishing a population-based centre for obesity in the area. The essential information is now achieved to propose to local health authorities to act accordingly. However, more population-based investigations on dietary choices are needed to develop effective preventive strategies to control overweight and obesity disorders in different regions.