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Fundal Height Growth Curve for Underweight and Overweight and Obese Pregnant Women in Thai Population  [PDF]
Jirawan Deeluea,Supatra Sirichotiyakul,Sawaek Weerakiet,Rajin Arora,Jayanton Patumanond
ISRN Obstetrics and Gynecology , 2013, DOI: 10.1155/2013/657692
Abstract: Objectives. To develop fundal height growth curves for underweight and overweight and obese pregnant women based on gestational age from last menstrual period and/or ultrasound. Methods. A retrospective study was conducted at four hospitals in the northern part of Thailand between January 2009 and March 2011. Fundal height, gestational age, height, and prepregnancy weight were extracted from antenatal care and delivery records. Fundal height growth curves were presented as smoothed function of the 10th, 50th, and 90th percentiles between 20 and 40 weeks of gestation, derived from multilevel models. Results. Fundal height growth curve of the underweight was derived from 1,486 measurements (208 women) and the overweight and obese curve was derived from 1,281 measurements (169 women). The 50th percentile line of the underweight was 0.1–0.4?cm below the normal weight at weeks 23–31 and 0.5–0.8?cm at weeks 32–40. The overweight and obese line was 0.1–0.4?cm above the normal weight at weeks 22–29 and 0.6–0.8?cm at weeks 30–40. Conclusions. Fundal height growth curves of the underweight and overweight and obese pregnant women were different from the normal weight. In monitoring or screening for abnormal intrauterine growth in these women, fundal height growth curves specifically developed for such women should be applied. 1. Introduction A demographically specific fundal height (FH) growth curve derived from local pregnant women with specific ethnicity, socioeconomics, or nutritional status [1] is likely to be suitable for monitoring and screening abnormal intrauterine growth in developing countries, especially in areas where ultrasound is not available. It is simple, convenient, safe, inexpensive [2–4], and may reduce transferring rate and may avoid unnecessary ultrasound [5]. However, previous findings showed that in women of the same geographical areas, there were still other independent determinants of FH. These determinants included maternal height, maternal weight, body mass index (BMI), parity, fetal sex, and gestational age (GA) [6–8]. The determinant that most influenced the difference in the pattern of FH growth curve was body shapes of pregnant women (obese-slim or large-small BMI). Given the same GA, FH of obese women was 2?cm higher than that of slim women [7, 8]. Application of FH growth curve derived from “general” population to monitor or screen abnormal intrauterine growth in obese or slim women may result in over- or underinvestigation and/or intervention. Applying separate FH growth curves specific for women body shapes may be more
Prevalence of Obesity, Overweight and Underweight in Guidance School Students
M Golestan,S Akhavan-Karbasi,M Fallah -Tafti,M Sharafaddini
Journal of Shahid Sadoughi University of Medical Sciences , 2008,
Abstract: Introduction: Obesity is an emerging major public problem throughout the world. Obesity, over weight and under weight are the most frequent nutritional disorders in children and adolescents in developing countries. The objective of this study was to assess the prevalence of obesity, over weight and under weight in adolescent students in Yazd. Methods: In a cross sectional study, weight and height of 794 guidance school students was collected and BMI [wt (kg)/ht(m2)] determined. The National Health and Nutrition Examination Survey III growth chart which has been adopted by World Health Organization wasused and BMI>95 percentile as obesity, BMI>85 and <95 as over weight and BMI<50 as under weight were defined. Results: Prevalence of underweight13.9% (male 9.8% , female 18%), over weight 12.9% (male17.2 , female 8.8%) and obesity 6.5% (male 8.8%, female 4.3%) was significant .( P< 0.001) Conclusion: Prevalence of obesity , overweight and underweight in adolescents of Yazd is of concern and prevalence of underweight is significantly higher in girls as compared to boys .
Global and National Socioeconomic Disparities in Obesity, Overweight, and Underweight Status  [PDF]
Spencer Moore,Justin N. Hall,Sam Harper,John W. Lynch
Journal of Obesity , 2010, DOI: 10.1155/2010/514674
Abstract: Objective. To examine the association between socioeconomic factors and weight status across 53 countries. Methods. Data are cross-sectional and from the long version of the World Health Survey (WHS). There were 172,625 WHS participants who provided self-reported height and weight measures and sociodemographic information. The International Classification of adult weight status was used to classify participants by body mass index (BMI): (1) underweight (<18.5), (2) normal weight (18.5–24.9), (3) overweight (25.0–29.9), and (4) obese (>30.0). Multinomial regression was used in the analyses. Results. Globally, 6.7% was underweight, 25.7% overweight, and 8.9% obese. Underweight status was least (5.8%) and obesity (9.3%) most prevalent in the richest quintile. There was variability between countries, with a tendency for lower-income quintiles to be at increased risk for underweight and reduced risk for obesity. Conclusion. International policies may require flexibility in addressing cross-national differences in the socio-economic covariates of BMI status.
Overweight, obesity and underweight in rural black South African children
AL Toriola, VK Moselakgomo, BS Shaw, DT Goon
South African Journal of Clinical Nutrition , 2012,
Abstract: Background: The objective was to estimate the prevalence of overweight, obesity and underweight conditions among rural black children in South Africa. A cross-sectional study was undertaken. The setting was Mankweng and Toronto, both rural settlements in Capricorn district, Limpopo province, South Africa. Participants were 1 172 school children (541 boys and 631 girls) aged 10-16 years. Method: The prevalence of overweight, obesity and underweight was examined, using the Centers for Disease Control and Prevention (CDC) body mass index (BMI) cut-off points. Height and body weight were measured using standard techniques. Results were analysed with student t-test statistics, with probability level set at p-value ≤ 0.05. Results: The percentage of children who were at risk of overweight were higher in girls (11%) than boys (9.1%), whereas obesity occurred more among the boys (5.5%), compared with the girls (4.4%). Applying the CDC cut-off points of 5th < percentile to define underweight, 25 (4.6%) and 35 (5.2%) of boys and girls respectively were underweight. Conclusion: Similar to previous studies, this study indicates that overweight and obesity are high among South African children, even in rural settings. The study also demonstrates that underweight is prevalent among the sampled children. This supports the notion of a double burden of disease in developing countries.
Global and National Socioeconomic Disparities in Obesity, Overweight, and Underweight Status  [PDF]
Spencer Moore,Justin N. Hall,Sam Harper,John W. Lynch
Journal of Obesity , 2010, DOI: 10.1155/2010/514674
Abstract: Objective. To examine the association between socioeconomic factors and weight status across 53 countries. Methods. Data are cross-sectional and from the long version of the World Health Survey (WHS). There were 172,625 WHS participants who provided self-reported height and weight measures and sociodemographic information. The International Classification of adult weight status was used to classify participants by body mass index (BMI): (1) underweight (<18.5), (2) normal weight (18.5–24.9), (3) overweight (25.0–29.9), and (4) obese (>30.0). Multinomial regression was used in the analyses. Results. Globally, 6.7% was underweight, 25.7% overweight, and 8.9% obese. Underweight status was least (5.8%) and obesity (9.3%) most prevalent in the richest quintile. There was variability between countries, with a tendency for lower-income quintiles to be at increased risk for underweight and reduced risk for obesity. Conclusion. International policies may require flexibility in addressing cross-national differences in the socio-economic covariates of BMI status. 1. Introduction Overweight and obesity have been defined as abnormal or excessive accumulations of fat in the body that may impair health [1]. Overweight and obesity results from an energy imbalance in the amount of calories consumed and the amount of calories expended [1]. The rise of overweight and obesity globally has been attributed primarily to a twofold process: (1) a global shift toward a diet richer in caloric sweeteners, animal source foods, and fats, and (2) decreased physical activity patterns due to changes in the nature of work, modes of transportation, and urbanization [2, 3]. Overweight and obesity have been found to be major risk factors for chronic diseases, including cardiovascular disease, diabetes, musculoskeletal disorders, and some forms of cancer [1]. Although higher levels of overweight and obesity and, by extension, chronic diseases have generally characterized developed countries such as the United States, the rates of overweight and obesity are increasing much faster in the developing world [4, 5]. Undernutrition is due to food intake that is continuously insufficient or poorly absorbed and retained in the body to meet and maintain energy requirements [6]. Undernutrition is epidemic in parts of the developing world with its occurrence generally associated with high rates of infectious diseases [2] and has been estimated to contribute to the deaths of 5-6 million children under 5 each year [7]. Undernutrition affects all age groups and is especially common among the poor and
The Challenges of Underweight and Overweight in South African Children: Are We Winning or Losing the Battle? A Systematic Review  [PDF]
Makama Andries Monyeki,Adedapo Awotidebe,Gert L. Strydom,J. Hans de Ridder,Ramoteme Lesly Mamabolo,Han C. G. Kemper
International Journal of Environmental Research and Public Health , 2015, DOI: 10.3390/ijerph120201156
Abstract: Underweight and overweight are adverse effects of malnutrition and both are associated with negative health consequences in children and adolescents. In South Africa, the burden of economic and social disparity coexists with malnutrition in children. The purpose of this study was to review available South Africa studies regarding the comprehensive summary of prevalence of underweight and overweight and evaluates government policies in addressing undernutrition and overnutrition in South African children and adolescents. We searched subject-specific electronic bibliographic databases of observational studies published on malnutrition, undernutrition, overnutrition, underweight and overweight in South African boys and girls from birth to 20 years of age in studies published on or after 1990. A total of sixteen cross-sectional, three longitudinal studies and one report met the criteria for inclusion in this review. Descriptive data synthesis revealed the small number of longitudinal studies highlights the dearth of research in tracking undernutrition and overnutrition in South African children. In this review, 0.7%–66% of underweight was reported among children in rural areas compared to a 3.1%–32.4% of overweight in urban areas. All studies reported a higher rate of underweight in boys than girls who were significantly more likely to have higher body fat. The data indicated that both underweight and overweight were positively related with health-related physical activity and psychological health problems such as low activity, low fitness, low self-image and self-esteem. Numerous recommendations were made in the reviewed studies, however effective strategic programs in eradicating both underweight and overweight are minimal. It is evident from the reviewed studies that the burden of underweight and overweight are still a problem in South African children. The most highly affected by underweight are rural children, while children in urban areas in transition are faced with burden of overweight. There is little evidence to suggest that government strategic programs are effective in addressing underweight and overweight in South African children. Based on these findings, sustainable school-based feeding schemes and physical education programmes are needed for optimal benefits in children and adolescents.
A study of prevalence of overweight and underweight among girls from different socioeconomic status in Ludhiana (Punjab)  [PDF]
Jaspreet Kaur,Promila Mehta
Human Biology Review , 2012,
Abstract: The present study was conducted to assess the prevalence of overweight and underweight amongst girls of age group 10 to16 years studying in private (high income group) and government(low income group) schools of Ludhiana (Punjab) during mid 2007. A total sample of 1,049 children (514 from private schools and 535 from government schools) were covered in the present study. These children were anthropometrically assessed and statistically analyzed for body measurements. Overweight and underweight were assessed with Body Mass Index (BMI) utilizing age and sex specific cut off points. According to NCHS criteria the overall prevalence of underweight, overweight and obesity was found as 7.58%, 26.84% and 9.33% in private school girls and 24.85%, 5.42% and 1.68% in government school students respectively. According to WHO criteria the percentage of underweight, overweight and obesity was found as 6.42%, 28.59% and 7.78% in private school girls and 23.17%, 5.42 %and 0.93% in government school girls. A positive correlation of parental BMI was found on BMI of children suggesting that overweight parents are likely to have overweight children. This study finds that there is a double burden of underweight and overweight in this population.
Nationwide shifts in the double burden of overweight and underweight in Vietnamese adults in 2000 and 2005: two national nutrition surveys
Do TP Ha, Edith JM Feskens, Paul Deurenberg, Le B Mai, Nguyen C Khan, Frans J Kok
BMC Public Health , 2011, DOI: 10.1186/1471-2458-11-62
Abstract: The study was based on two nationally representative surveys, the National Nutrition Survey 2000 (14,452 subjects) and the National Adult Obesity Survey 2005 (17,213 subjects). Adults aged 25-64 years were sampled to be nationally representative. Multiple multinomial logistic regression analysis was used to investigate the association of underweight and overweight with socio-economic indicators.The distribution of BMI across the population and population groups indicated a shift towards higher BMI levels in 2005 as compared to 2000. The nationwide prevalence of overweight (BMI ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2) was 6.6% and 0.4% respectively in 2005, almost twice the rates of 2000 (3.5% and 0.2%). Using the Asian BMI cut-off of 23 kg/m2 the overweight prevalence was 16.3% in 2005 and 11.7% in 2000. In contrast, the underweight prevalence (BMI < 18.5 kg/m2) of 20.9% in 2005 was lower than the rate of 25.0% in 2000. Women were more likely to be both underweight and overweight as compared to men in both 2000 and 2005. Urban residents were more likely to be overweight and less likely to be underweight as compared to rural residents in both years. The shifts from underweight to overweight were clearer among the higher food expenditure levels.The double nutrition burden was clearly present in Vietnam. The distribution of BMI across the population groups generally indicated a shift towards higher BMI levels in 2005 as compared to 2000. The prevalence of overweight was increased while the declined level of undernutrition was still high in 2005. The shifts of underweight to overweight were most obvious among population groups with higher food expenditure levels.In developing countries the prevalence of overweight is increasing, while underweight prevalence is still high. This situation is known as the double burden of malnutrition [1]. Although the underweight prevalence is decreasing it is still high, between 20% and 50%, in countries such as India, Bangladesh, China,
Double burden: a cross-sectional survey assessing factors associated with underweight and overweight status in danang, vietnam
Kiet A Ly, Thanh GN Ton, Quang V Ngo, Tung T Vo, Annette L Fitzpatrick
BMC Public Health , 2013, DOI: 10.1186/1471-2458-13-35
Abstract: In 2010, 1713 residents age >=35 years from 900 households in 6 of 56 urban, rural and mixed urban--rural communes in Danang were selected to participate using multistagecluster sampling methodology; 1621 qualified adults enrolled. Participants completed a health survey based on WHO STEPwise Approach to Chronic Disease Risk Factor Surveillance and additional questions on chest pain and stroke symptoms. Anthropometric and other measurements were conducted. Relative risk regression was used to identify independent risk factors for underweight or overweight/obesity according to WHO standard cut-offs and suggested Asian-specific cut-offs (<18.5 kg/m2 or 23--27.49 kg/m2; and >=27.5 kg/m2).We observed 12.4% prevalence of underweight and 16.0% for overweight/obesity using WHO standard. The prevalence of overweight/obesity doubled (33.7%) when Asian-specific cut-offs were applied. For both definitions, rural communes had the highest prevalence of underweight while urban communes had the highest prevalence of overweight/obesity. Being underweight was associated with less urbanization. Factors independently associated with being underweight included older age, rural living, current smoking, and lower systolic pressure. Factors independently associated with Asian-specific BMI definition for being overweight/obese included older age, urbanization, higher systolic pressure, and diabetes. Age was not an independent factor with WHO standard cut-offs; however, myocardial infarction and diabetes showed strong associations.The double burden of underweight and overweight/obesity observed in Danang is consistent with patterns found for large cities in Vietnam that are undergoing rapid economic growth and urbanization of lifestyle. Factors independently associated with underweight and overweight/obesity status by WHO standard and Asian-specific definitions include urbanization and modifiable lifestyle factors. Further studies are needed to define ethnic specific BMI cut-offs for Vietnam
The Use of Stunkard’s Figure Rating Scale to Identify Underweight and Overweight in Chinese Adolescents  [PDF]
Wing-Sze Lo, Sai-Yin Ho, Kwok-Kei Mak, Tai-Hing Lam
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0050017
Abstract: Background To compare the performance of Stunkard’s current body size (CBS) with self-reported body mass index (BMI), waist circumference (WC) and waist to stature ratio (WSR) in predicting weight status in Chinese adolescents, and to determine the CBS cutoffs for overweight/obesity and underweight. Methodology This cross-sectional study was conducted in a sample of 5,418 secondary school students (45.2% boys; mean age 14.7 years). Height and weight were measured by trained teachers or researchers. Subjects were classified as underweight, normal weight, or overweight/obese according to the International Obesity Task Force cutoffs. Subjects were asked to select the figure that best resembled their CBS on the Stunkard’s figure rating scale. Self-reported height, weight, WC and WSR were also obtained. The performance of CBS, self-reported BMI, WC and WSR as a weight status indicator was analysed by sex-specific receiver operating characteristic curves. The optimal CBS cutoffs for underweight and overweight/obesity were determined based on the Youden Index. Principal Findings Apart from self-reported BMI, CBS had the greatest area under curve (AUC) for underweight in boys (0.82) and girls (0.81). For overweight/obesity, CBS also had a greater AUC (0.85) than self-reported WC and WSR in boys, and an AUC (0.81) comparable to self-reported WC and WSR in girls. In general, CBS values of 3 and 5 appeared to be the optimal cutoffs for underweight and overweight/obesity, respectively, in different sex-age subgroups. Conclusions/Significance CBS is a potentially useful indicator to assess weight status of adolescents when measured and self-reported BMI are not available.
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