RESUMO
BACKGROUND/OBJECTIVES: Adiposity rebound (AR) is defined as the nadir or the inflexion point of body mass index (BMI) percentiles between the age of 3 and 7 years. An early rebound is seen as a risk of obesity and, thus, AR is considered as a suitable time period for prevention. As BMI does not reflect body composition, we aimed to examine the rebounds of fat mass index (FMI) and fat-free mass index (FFMI) together with BMI. SUBJECTS/METHODS: Cross-sectional data of 19 264 children aged 3-11 years were pooled from three German studies (Kiel Obesity Prevention Study, the project 'Better diet. More exercise. KINDERLEICHT-REGIONS' and regular examinations of Jena children). Height and weight were measured. Fat mass (FM) and fat-free mass (FFM) were obtained from bioelectrical impedance analysis and analysed using a population-specific algorithm. Percentiles of BMI, FMI and FFMI were constructed by the LMS method. RESULTS: Both BMI and FMI percentiles showed a rebound, whereas FFMI percentiles steadily increased with age. On P90, FMI rebound was about 1.6-1.8 years later compared with that of BMI, that is, at ages 4.2 years (BMI) and 5.8 years (FMI) in boys and at 4.2 years (BMI) and 6.0 years (FMI) in girls. At AR, the slope of the BMI-P90 was explained by increases in FFMI rather than FMI. By contrast, at FMI rebound, the slope of BMI was strongly related to FMI. CONCLUSIONS: BMI rebound does not equal the rebound of FM. At AR, the slope in BMI is determined by the increase in FFMI. AR should be defined as FMI rebound rather than BMI rebound.
Assuntos
Adiposidade/fisiologia , Índice de Massa Corporal , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Estatura , Peso Corporal , Criança , Pré-Escolar , Estudos Transversais , Feminino , Alemanha , Humanos , Masculino , Prevalência , Aumento de Peso , População BrancaRESUMO
On behalf of the Federal Ministry of Health, a working group coordinated by the Federal Center for Health Education (BZgA) compiled quality criteria for health promotion and primary prevention measures in association with obesity in children and adolescents that are applicable both to population-wide and to target group-specific measures. The criteria are intended to support the planning of new measures and the conceptual improvement of existing measures. Additional elements are the assessment of programs for financing purposes and the rendering of accounts to funding agencies, as well as the acquisition of further knowledge. The criteria, thus, address not only project developers and providers, but also multipliers who implement measures, as well as funding agencies, who can use the criteria as a basis for assessing the measures. The structure of the quality criteria is geared to the fundamental structure of the Public Health Action Cycle. In addition, resource orientation, participation and, above all, organizational development are important aspects associated with quality that have not been given adequate consideration to date. The quality criteria are applicable to all situation-based and behavioral prevention measures, and also development processes that focus on promoting the health and normal weight development of children and adolescents.