Population-based centile curves for triceps, subscapular, and abdominal skinfold thicknesses in Polish children and adolescents--the OLAF study.

UNLABELLED: Skinfold thicknesses are used as valid anthropometric indicators of regional body fatness. Actual population-based values for skinfold thicknesses for Polish children are not available. The purpose of this study was to provide population-based values for triceps, subscapular, and abdominal skinfold thicknesses in healthy children and adolescents. A total number of 17,416 boys and girls aged 6.5-18.5 years, randomly selected from whole Polish population of children and adolescents, were enrolled in the study. Skinfold thicknesses (triceps, subscapular, and abdominal) were measured using Harpenden skinfold caliper. All measurements were taken after the training of participating investigators. The LMS method was used to fit percentile curves across age for each skinfold. Q tests for fit were used to assess the global goodness of fit of our final models. The study shows for the first time smoothed population-based values of body fat distribution indices for Polish children and adolescents 7-18 years of age. Reported skinfold centiles are higher compared to previously established for Warsaw children and very close to the actual US data. CONCLUSION: Our study provided for the first time population-based values for skinfold thicknesses evaluation in a way allowing to calculate reliable Z scores. The early detection of abnormal fat stores, using our population-based values and respective Z scores, may be now implemented for practice.

Regional differences in the prevalence of overweight, obesity and underweight among polish children and adolescents.

AIM: The aim of the study was to compare the prevalence of overweight, obesity, and underweight in children and adolescents from different provinces in Poland. MATERIALS AND METHODS: Data from the recent, large, population-representative sample of school-aged children and adolescents (N=17573) OLAF study: "Elaboration of the reference range of arterial blood pressure for the population of children and adolescents in Poland" - PL0080 OLAF were used in the analysis. The survey was conducted in all provinces of Poland (N=16). Data were analyzed using SAS 9.2, EpiInfo 3.5.1 and LMSgrowth software packages. The frequency of overweight, obesity, and underweight were determined. For overweight and obesity (jointly) and underweight the odds ratio (OR) was calculated for gender and voivodship of residence. The body mass index (BMI) was standardized and expressed as a z-score. The statistical significance of differences between BMI z-scores depending on voivodship of residence was assessed by the t-test. RESULTS: Significant differences were found in the occurrence of overweight and obesity among the analysed regions, and voivodships with a lower (malopolskie, swietokrzyskie, lubelskie, and podkarpackie) and higher (mazowieckie) risk of overweight and obesity were identified. In case of underweight, lódzkie and podkarpackie (<0.040) provinces were higher risk areas, while mazowieckie (<0.001) had lower risk. The prevalence of overweight (including obesity) was higher compared to the prevalence of underweight in the majority of provinces (15 out of 16). CONCLUSIONS: Analysis of regional differences in the prevalence of obesity, overweight and underweight in children and adolescents may point to the direction in which nationwide and local efforts should be made to reduce the inequalities stemming from nutritional status.

Distribution of body mass index categories among Polish children and adolescents from rural and urban areas.

AIM: To demonstrate differences in nutritional status of school-aged children and adolescents depending on school localization (urban/rural), school level (elementary/middle) and gender. MATERIALS AND METHODS: Results of current health survey 'Elaboration of the reference range of arterial blood pressure for the population of children and adolescents in Poland' - PL0080 OLAF were used in the analysis. Data were analysed by SAS. 9.2 for Windows, EpiInfo 3.5.1 and LMSgrowth. The frequency and the Odds Ratio of underweight, overweight, obesity and normal weight were calculated by school localization, school level and gender. RESULTS: Data from 13 129 pupils were used in the analysis: 5 118 from elementary schools in urban areas, 3638 from elementary schools in rural areas, 2792 from middle schools in urban areas and 1581 from middle schools in rural areas. The frequency of normal weight was lower in urban compared with rural elementary schools (67.2% vs 70.0%; OR=0.88; p=0.005). The frequency of underweight, overweight and obesity was higher in urban compared with rural elementary schools, both boys and girls. The frequency of obesity was higher in urban middle schools than rural (3.0% vs 1.6%; OR=1.88; p=0.006). In the case of boys, statistically significant difference in frequency of overweight and obesity (together) was noted in urban middle schools compared to rural middle schools (16.7% vs 11.9%; OR=1.48; p=0.003). In the case of girls, the frequency of underweight was lower in urban compared with rural middle schools (12.7% vs 15.9%; OR= 0.77; p=0.032). CONCLUSIONS: Knowing differences in the nutritional status between pupils in urban and rural areas gives the opportunity to modify nutritional education programmes depending on needs identified in the particular type of area and target groups. In urban regions, in both elementary and middle schools, boys are a risk group for excess body weight, and require more attention in preventive undertakings. In rural areas, girls in middle schools should be targeted for preventive measures dealing with underweight.

Polish 2010 growth references for school-aged children and adolescents.

Growth references are useful in monitoring a child's growth, which is an essential part of child care. The aim of this paper was to provide updated growth references for Polish school-aged children and adolescents and show the prevalence of overweight and obesity among them. Growth references for height, weight, and body mass index (BMI) were constructed with the lambda, mu, sigma (LMS) method using data from a recent, large, population-representative sample of school-aged children and adolescents in Poland (n = 17,573). The prevalence of overweight and obesity according to the International Obesity Taskforce definition was determined with the use of LMSGrowth software. Updated growth references for Polish school-aged children and adolescents were compared with Polish growth references from the 1980s, the Warsaw 1996-1999 reference, German, and 2000 CDC references. A positive secular trend in height was observed in children and adolescents from 7 to 15 years of age. A significant shift of the upper tail of the BMI distribution occurred, especially in Polish boys at younger ages. The prevalence of overweight or obesity was 18.7% and 14.1% in school-aged boys and girls, respectively. The presented height, weight, and BMI references are based on a current, nationally representative sample of Polish children and adolescents without known disorders affecting growth. Changes in the body size of children and adolescents over the last three decades suggest an influence of the changing economical situation on anthropometric indices.

The height-, weight-, and BMI-for-age of Polish school-aged children and adolescents relative to international and local growth references.

BACKGROUND: The growth of children is an indicator of health and society's wellbeing. Growth references are useful in monitoring a child's growth, which is a very important part of child care. Poland's growth references are not updated regularly. Although several growth reference ranges have been developed in Poland over recent years, sampling was restricted to urban populations of major cities. The aim of this study was to assess how well Polish children match with, or diverge from, regional charts and to compare them with international growth references. METHODS: Four Polish and two international (WHO 2007 and USCDC2000) growth references were used to calculate the height, weight and BMI z-scores in a recent, large, population-representative sample of school-aged children and adolescents in Poland. The distributions of z-scores were analysed with descriptive and inferential statistical methods. RESULTS: Mean height z-scores calculated with the use of the WHO 2007 and USCDC2000 references were positive and significantly different from zero over the entire age range. The mean height z-score was closest to zero in the Poznan reference for boys (0.05) and Warszawa reference for girls (0.01). Median weight z-scores were positive under all weight references over the entire age range with only the exception of 18-year-old girls' weight z-score calculated relative to USCDC2000. Median BMI z-scores were positive in males in early childhood, decreasing with age. In the case of girls, the median BMI z-score calculated using WHO 2007 and USCDC2000 was close to zero in early childhood, decreased in adolescents and reached minimum values at age 18 years. Median BMI z-scores calculated with the use of the Lodz reference fluctuated between 0.05 and 0.2 over the studied age range. CONCLUSIONS: In this contemporary sample of Polish school-aged children, distributions of height, weight and BMI differed from those of children from the international growth references. These differences should be considered when using the references. There exist certain limitations to the analysis of height, weight, and BMI z-scores when Polish regional references are used.

[Trends in children and adolescents deaths due to suicide, event of undetermined intent and poisoning in Poland in the years 1999-2007]. / Tendencje zgonów dzieci i mlodziezy z powodu samobójstw, zdarzen o zamiarze nieokreslonym i zatruc w Polsce w latach 1999-2007.

AIM: The purpose of the study was to examine children and adolescents sex- and age-specific trends in mortality due to suicide, undetermined death and poisoning from 1999 to 2007 in Poland. METHODS: Anonymous deaths records were obtained from the Central Statistical Office and grouped according to the cause of death, age and sex. For each year and separately for 3-Year Moving Averages suicide and poisoning+undetermined death mortality rates were calculated. Time trends were analyzed by linear regression estimating annual percent change (APC) of the rates. Correlation between suicide and grouped poisoning and undetermined death was examined. RESULTS: A significant increase was observed in girls aged 10-14 years suicide mortality (APC=17,0; p<0,05). Mortality due to suicide did not change significantly from 1999 to 2007 in boys aged 10-14 and 15-19 years, and girls 15-19 years of age. In these groups negative correlation between suicides and grouped poisoning and undetermined death was observed which may indicate hidden suicide in this category of death causes. CONCLUSIONS: Monitoring suicide mortality should include observation of trends in undetermined death.