South Australian four-year-old Aboriginal children: residence and socioeconomic status influence weight.

OBJECTIVE: Obesity rates have increased in children in Australia in the past 15 years. However, there is little available population data describing rates of overweight and obesity in Aboriginal children. METHODS: Anthropometric data of four-year-old children (n=11,859) were collected by trained nurses at routine statewide preschool health checks during 2009. Weight status (underweight, healthy weight, overweight and obese) was determined using age and gender specific International Obesity Task Force (IOTF) cut-points. RESULTS: There were 337 Aboriginal children (3%) in the study population. Aboriginal children had significantly higher rates of overweight and obesity compared to non-Aboriginal children (28% compared to 18% respectively, χ(2) p=0.0001). A statistically significant association between BMIz score and identifying as Aboriginal remained after controlling for rural/urban residence and socioeconomic status using multiple regression analyses. CONCLUSIONS: Aboriginal children have higher rates of overweight and obesity compared to their non-Aboriginal peers by the time they are four years of age. Aboriginal children have higher BMIz scores compared to non-Aboriginal children after controlling for rural/urban residence and socioeconomic status. IMPLICATIONS: A significant investment is required to optimise the health of Aboriginal women before pregnancy and throughout pregnancy. A rethink may be necessary in the approach to dietary management and catch-up growth of Aboriginal children of low birth weight or having growth failure in early childhood.

Effect of treatment of gestational diabetes mellitus on obesity in the next generation.

OBJECTIVE: Gestational diabetes mellitus (GDM) may cause obesity in the offspring. The objective was to assess the effect of treatment for mild GDM on the BMI of 4- to 5-year-old children. RESEARCH DESIGN AND METHODS: Participants were 199 mothers who participated in a randomized controlled trial of the treatment of mild GDM during pregnancy and their children. Trained nurses measured the height and weight of the children at preschool visits in a state-wide surveillance program in the state of South Australia. The main outcome measure was age- and sex-specific BMI Z score based on standards of the International Obesity Task Force. RESULTS: At birth, prevalence of macrosomia (birth weight >or=4,000 g) was 5.3% among the 94 children whose mothers were in the intervention group, and 21.9% among the 105 children in the routine care control group. At 4- to 5-years-old, mean (SD) BMI Z score was 0.49 (1.20) in intervention children and 0.41 (1.40) among controls. The difference between treatment groups was 0.08 (95% CI -0.29 to 0.44), an estimate minimally changed by adjustment for maternal race, parity, age, and socio-economic index (0.08 [-0.29 to 0.45]). Evaluating BMI >or=85th percentile rather than continuous BMI Z score gave similarly null results. CONCLUSIONS: Although treatment of GDM substantially reduced macrosomia at birth, it did not result in a change in BMI at age 4- to 5-years-old.