Nutritional status of children under five years of age in Rondônia, Brazil Northern region and in Brazil: 2008 to 2019 / Estado nutricional das crianças menores de cinco anos em Rondônia, região Norte e Brasil: 2008 a 2019

ABSTRACT Objective To describe the nutritional profiles of children under five years of age in the state of Rondônia, comparing them with those from the Northern Region of Brazil and from Brazil. Methods This was a time series ecological study. Data were collected from the Food and Nutrition Surveillance System. The information concerned Body Mass Index by age, gender and place of residence. A time-trend analysis was performed using linear regression applying the Prais-Winsten technique and serial autocorrelation verification using the Durbin and Watson test in Stata®16.0. Results There was an annual increasing trend for the thinness, risk of overweight, overweight and obesity regardless of gender, age and location and for extreme thinness, with the exception of girls and for the age of 2 to 5 years, which revealed a stationary trend. Among boys and children of both genders under two years of age, annual growth trends were higher for non-eutrophic nutritional status when compared to the other groups. The growth rates of nutritional disorders found in the Northern region were higher than in the state of Rondônia and in Brazil. Conclusion It is necessary to review health policies aiming at the promotion and prevention of nutritional problems considering the current situation where extreme conditions such as thinness and obesity coexist, with special attention to male children under 2 years of age.

RESUMO Objetivo Descrever o perfil nutricional de crianças menores de cinco anos no estado de Rondônia comparando com dados da Região Norte e do Brasil. Métodos Estudo ecológico do tipo série temporal. Os dados foram coletados do Sistema de Vigilância Alimentar e Nutricional e utilizou-se o Índice de Massa Corporal por idade, sexo e local de moradia. Foi realizada análise de tendência temporal por meio de regressão linear aplicando a técnica de Prais-Winsten e verificação de autocorrelação serial por meio do teste de Durbin e Watson no Stata®16.0. Resultados Houve tendência anual crescente para a magreza, risco de sobrepeso, sobrepeso e obesidade independente do sexo, idade e local, e para a magreza extrema com exceção das meninas e para a idade de dois a cinco anos, que tiveram tendência estacionária. Entre os meninos e crianças menores de dois anos, as tendências de crescimento foram mais elevadas para o estado nutricional não eutrófico quando comparado aos outros grupos. As taxas de crescimento de agravos nutricionais encontradas na região Norte foram superiores ao estado de Rondônia e ao Brasil. Conclusão É necessário rever as políticas de saúde visando a promoção e prevenção de agravos nutricionais considerando a atualidade e onde coabitam extremos como a magreza e obesidade, com atenção especial às crianças com menos de dois anos e do sexo masculino.

Underweight is a major risk factor for atrial fibrillation in Asian people with type 2 diabetes mellitus.

BACKGROUND: Atrial fibrillation (AF) is prevalent in patients with type 2 diabetes mellitus (T2DM). Obesity commonly accompanies T2DM, and increases the risk of AF. However, the dose-relationship between body mass index (BMI) and AF risk has seldom been studied in patients with diabetes. METHODS: This cohort study utilized a database from National Taiwan University Hospital, a tertiary medical center in Taiwan. Between 2014 and 2019, 64,339 adult patients with T2DM were enrolled for analysis. BMI was measured and categorized as underweight (BMI < 18.5), normal (18.5 ≤ BMI < 24), overweight (24 ≤ BMI < 27), obesity class 1 (27 ≤ BMI < 30), obesity class 2 (30 ≤ BMI < 35), or obesity class 3 (BMI ≥ 35). Multivariate Cox regression and spline regression models were employed to estimate the relationship between BMI and the risk of AF in patients with T2DM. RESULTS: The incidence of AF was 1.97 per 1000 person-years (median follow-up, 70.7 months). In multivariate Cox regression, using normal BMI as the reference group, underweight (HR 1.52, 95% CI 1.25-1.87, p < 0.001) was associated with a significantly higher risk of AF, while overweight was associated with significantly reduced risk of AF (HR 0.82, 95% CI 0.73-0.89, p < 0.001). Kaplan-Meier analysis showed AF risk was highest in the underweight group, followed by obesity class 3, while the overweight group had the lowest incidence of AF (log-rank test, p < 0.001). The cubic restrictive spline model revealed a "J-shaped" or "L-shaped" relationship between BMI and AF risk. CONCLUSIONS: Underweight status confers the highest AF risk in Asian patients with T2DM.

Undernutrition among under-five indigenous Mbororo children in the Foumban and Galim health districts of Cameroon: a cross-sectional study.

INTRODUCTION: despite increasing research interest on Indigenous peoples´ health worldwide, the nutritional status of Indigenous children in Cameroon remains unknown. This study was conducted to assess the prevalence of stunting, wasting, and underweight among under-five Indigenous Mbororo children in the Foumban and Galim health districts of the West Region. METHODS: a cross-sectional study was conducted involving 472 child-caregiver pairs from 16 Mbororo Communities in the Foumban and Galim health districts. Interviewer-administered questionnaires were used for data collection. Anthropometric measurements were collected using standard procedures. Socio-demographic data were analyzed using descriptive statistics. Anthropometric indices: height-for-age, weight-for-height, and weight-for-age - z-scores were analyzed using z-score 06 Stata version 11 and compared with World Health Organization growth reference standards. Ethical approval was obtained from the Faculty of Health Sciences Institutional Review Board of the University of Buea. RESULTS: overall prevalence of stunting, wasting and underweight were 55.08% (95% CI: 50.5-59.58), 13.77% (95% CI: 10.65-16.89), and 31.99% (95% CI: 27.76-36.21), respectively. Severe stunting, wasting and underweight were 34.53% (95% CI: 30.22-38.83), 3.18% (95% CI: 1.58-4.76), and 10.59% (95% CI: 7.80-13.37), respectively. Rates of stunting, wasting and underweight for female and male were: 56.88% and 52.71%; 12.38% and 14.72%; and 30.73% and 32.55%, respectively. Stunting, wasting and underweight rates varied with child age. CONCLUSION: the prevalence of undernutrition was high, indicating a serious public health problem and the necessity for strategies to ensure the optimal health of the target population.

The albumin-to-alkaline phosphatase ratio as an independent predictor of future non-alcoholic fatty liver disease in a 5-year longitudinal cohort study of a non-obese Chinese population.

BACKGROUND: The albumin-to-alkaline phosphatase ratio (AAPR) is a newly developed index of liver function, but its association in patients with non-alcoholic fatty liver disease (NAFLD) has not been established. The aim of this study was to investigate the association between the AAPR and NAFLD in a non-obese Chinese population. METHODS: The study included 10,749 non-obese subjects without NAFLD at baseline and divided them into quintiles according to the AAPR. A Cox multiple regression model was used to examine the association between the AAPR and its quintiles and the incidence of NAFLD. RESULTS: The average age of the study population was 43.65 ± 15.15 years old. During the 5-year follow-up, 1860 non-obese subjects had NAFLD events. In the Cox multiple regression model, after adjusting the model according to important risk factors, the AAPR and NAFLD risk were independently correlated, and with a gradual increase in the AAPR, the NAFLD risk decreased gradually (HR: 0.61, 95% CI: 0.47, 0.81; P-trend< 0.0001). Additionally, there were significant interactions between the AAPR and BMI, blood pressure and lipids (P-interaction < 0.05). Stratified analysis showed that the risk of AAPR-related NAFLD decreased in people with normal blood pressure and lipid levels, while the risk of AAPR-related NAFLD increased abnormally in people who were underweight. CONCLUSIONS: This longitudinal cohort study provides the first evidence that the AAPR is an independent predictor of future NAFLD events in non-obese people. For non-obese people with a low AAPR, especially those with BMI < 18.5 kg/m2, more attention should be given to the management of risk factors for NAFLD to prevent future NAFLD.

Anemia Prevalence and Anthropometric Status of Indigenous Women and Young Children in Rural Botswana: The San People.

In Botswana, there is limited data available on the health and nutritional status of the San People (also known as the Basarwa or Bushmen), an Indigenous minority group primarily living in the Ghanzi District. Our aim in this study was to assess anemia prevalence among and anthropometric indices of women and young children in Ghanzi District through a cross-sectional survey. We recruited 367 mother-child pairs (women 15-49 years and children 6-59 months) in nine randomly selected areas. A capillary blood sample was collected, and weight and height were measured. Hemoglobin (Hb) concentration was measured with use of a hemoglobinometer (HemoCue, AB), as per global recommendations. Overall, adjusted anemia prevalence was 12% in non-pregnant women (Hb < 120 g/L), 26% in pregnant women (Hb < 110 g/L), and 42% in children (Hb < 110 g/L), but it varied widely depending on whether or not the controversial factor of ethnicity was adjusted for (range of 6-26%, 22-30%, and 35-68% prevalence, respectively). Thirty-nine percent (n = 133/344) of non-pregnant women and 52% (n = 12/23) of pregnant women were underweight (BMI < 18.5 kg/m2). In children aged 6-23 months, 41% were underweight (weight-for-age z-score < -2 SD), 13% were wasted (weight-for-height z-score < -2 SD), and 65% were stunted (height-for-age z-score < -2 SD); in children aged 24-59 months, 57% were underweight, 13% were wasted, and 66% were stunted. Fifty-six percent (n = 205/367) of women self-reported smoking in any form (rolled cigarettes or snuffing). The high prevalence of smoking among women, underweight status among pregnant women, and anemia, stunting, and wasting among children is of the highest concern for public health and should be addressed in future health and nutrition programming.

Influence of Gestational Weight Gain on the Risk of Preterm Birth for Underweight Women Living in Food Deserts.

OBJECTIVE: Preterm birth (PTB) and food insecurity are two of the most significant public health crises in the United States. Effects of being underweight among populations with low food security are not well understood. We assess whether the protective effect of gestational weight gain (GWG) for women with low prepregnancy body mass index (BMI) differs by accessibility to sources of healthy food. STUDY DESIGN: Population-based retrospective cohort study using Ohio birth records analyzing all live births, 2006 to 2015. Analyses were stratified by maternal BMI (underweight, normal, overweight, and obese), Institute of Medicine (IOM) recommended GWG (under vs. met), and whether the U.S. Department of Agriculture (USDA) classified the residential census tract for each birth as a food desert. Food access data were retrieved from the USDA's 2018 Food Access Research Atlas. Covariates were selected using least absolute shrinkage and selection operator regression. Logistic regression models estimated the risk ratio (RR) of PTB for each group based on under or exceeded recommended GWG (reference = met), adjusting for coexisting risk factors. RESULTS: Analysis was performed on 1,124,299 births. PTB risk was highest for underweight women below GWG recommendations (no food desert: 21.3%, RR = 2.15, 95% confidence interval [CI]: 1.81-2.57; food desert: 21.0%, RR = 1.46, 95% CI: 0.96-2.21). Underweight women living in food deserts who exceeded GWG recommendations had lower PTB risk than those who met GWG recommendations (13.5 vs. 14.3%, RR = 0.85, 95% CI: 0.51-1.41). Factors other than GWG significantly associated with PTB included in the adjusted analysis include maternal age and race, education, marital status, interpregnancy interval, and presence of prepregnancy diabetes or hypertension. CONCLUSION: Underweight women who do not meet GWG recommendations are at high risk for PTB. Increasing pregnancy weight gain to a level that exceeds IOM recommendations was not associated with a reduction in PTB risk for underweight women who reside in food deserts compared with women who met GWG recommendations. KEY POINTS: · Women with low prepregnancy BMI are at high risk of PTB.. · Food insecurity increases the risk of PTB for underweight women.. · Excessive GWG for underweight women in food deserts does not reduce PTB risk..

Body mass index and gestational weight gain in migrant women by birth regions compared with Swedish-born women: A registry linkage study of 0.5 million pregnancies.

INTRODUCTION: Women migrating to high-income countries may have increased risks of adverse pregnancy outcomes as compared with native-born women. However, little is known whether migrant women are more likely to have unhealthy body mass index (BMI) or gestational weight gain (GWG), which is of importance considering the well-established links between unhealthy BMI and GWG with adverse pregnancy outcomes. Hence, the aim of the study was to examine the prevalence and estimate odds ratios (ORs) of underweight and obesity in the first trimester as well as inadequate and excessive GWG across birth regions in migrant (first-generation) and Swedish-born women in a population-based sample of pregnant women in Sweden. METHODS: This population-based study included 535 609 pregnancies from the Swedish Pregnancy Register between the years 2010-2018. This register has a coverage of approximately 90% and includes data on body weight, height, birth country and educational attainment. BMI in the first trimester of pregnancy was classified as underweight, normal weight, overweight and obesity whereas GWG was classified as inadequate, adequate and excessive according to the recommendations from the National Academy of Medicine, USA. BMI and GWG were examined according to 7 birth regions and the 100 individual birth countries. Adjusted ORs of underweight, obesity as well as inadequate or excessive GWG by birth regions were estimated using multinomial logistic regression. RESULTS: There were large disparities in unhealthy BMI and GWG across birth regions. For instance, women born in North Africa and Middle East and Sub-Saharan Africa had 1.40 (95% CI 1.35-1.44) and 2.13 (95% CI 2.03-2.23) higher odds of obesity compared with women born in Sweden. However, women born in Sub-Saharan Africa had also considerably higher odds of underweight (OR, 2.93 [95% CI 2.70-3.18]) and inadequate GWG (OR, 1.97 [95% CI 1.87-2.07]). The limitations of the study include the lack of a validated measure of acculturation and that the study only had data on first-generation migration. CONCLUSIONS: The large differences across the 7 regions and 100 countries highlights the importance of considering birth region and country-specific risks of unhealthy BMI and GWG in first-generation migrant women. Furthermore, inadequate GWG was common among pregnant first-generation migrant women, especially in women born in Sub-Saharan Africa, which demonstrates the need to promote adequate GWG, not only the avoidance of excessive GWG. Thus, our findings also indicate that additional support and interventions may be needed for first-generation migrant women from certain birth regions and countries in order to tackle the observed disparities in unhealthy BMI and GWG. Although further studies are needed, our results are useful for identifying groups of women at increased risk of unhealthy BMI and weight gain during pregnancy.

Body weight perceptions and obesity amongst university employed South African women.

This study aimed to rigorously assess body weight perceptions according to several body image dimensions in rural, employed African women. One hundred and thirty-two employed black African women were recruited at a rural South African university. Participants were asked to choose their 'ideal' and 'feel' perceived body size from nine standardized body image silhouettes, varying according to body size. Three body image dimensions of interest were measured, (1) 'feel' minus 'ideal' index (FID), (2) perceived minus the actual weight status (PAD) index and (3) valorization of stoutness index (participants that chose silhouettes corresponding to overweight/obesity). Using the FID dimension, older obese women had significantly higher desire for leanness, with small effects, compared with lean and younger obese women (p = .001). Those women who correctly perceived body weight (PAD = 0), were mostly obese and older (p < .0001), with moderate effects, than non-obese women. Social valorization of stoutness was observed in 58.3% of the sample, but was higher in older obese women, with small effects, compared with lean women (p = .0001). This study has shown that the majority of the study population demonstrated a social valorization of stoutness, despite a desire to be thinner and the ability to adequately perceive their own body weight in accordance with BMI.

Weight development between age 5 and 10 years and its associations with dietary patterns at age 5 in the ABCD cohort.

BACKGROUND: Social inequalities in bodyweight start early in life and track into adulthood. Dietary patterns are an important determinant of weight development in children, towards both overweight and underweight. Therefore, we aimed to examine weight development between age 5 and 10 years by ethnicity, SES and thereafter by BMI category at age 5, to explore its association with dietary patterns at age 5. METHODS: Participants were 1765 children from the Amsterdam Born Children and their Development (ABCD) cohort that had valid data on BMI at age 5 and 10 and diet at age 5. Linear mixed model analysis was used to examine weight development between age 5 and 10 years and to assess if four previously identified dietary patterns at age 5 (snacking, full-fat, meat and healthy) were associated with weight development. Analyses were adjusted for relevant confounders, stratified by ethnicity and SES and thereafter stratified per BMI category at age 5. RESULTS: Overall, weight decreased in Dutch and high SES children and increased in non-Dutch and low/middle SES children. Across the range of bodyweight categories at age 5, we observed a conversion to normal weight, which was stronger in Dutch and high SES children but less pronounced in non-Dutch and low/middle SES children. Overall, the observed associations between weight development and dietary patterns were mixed with some unexpected findings: a healthy dietary pattern was positively associated with weight development in most groups, regardless of ethnicity and SES (e.g. Dutch B 0.084, 95% CI 0.038;0.130 and high SES B 0.096, 95% CI 0.047;0.143) whereas the full-fat pattern was negatively associated with weight development (e.g. Dutch B -0.069, 95% CI -0.114;-0.024 and high SES B -0.072, 95% CI -0.119;-0.026). CONCLUSIONS: We observed differential weight development per ethnic and SES group. Our results indicate that each ethnic and SES group follows its own path of weight development. Associations between dietary patterns and weight development showed some unexpected findings; follow-up research is needed to understand the association between dietary patterns and weight development.

Body Dissatisfaction, Restrictive, and Bulimic Behaviours Among Young Women: A Polish-Japanese Comparison.

The growing number of women, who are characterized by restrictive and bulimic behaviours towards their own body is observed especially in countries influenced by Westernalization. However, there is a lack of cross-cultural studies in this area. The main aim of the present study was to examine the psychological and socio-cultural risk factors for eating disorders in Polish and Japanese women. A cross-sectional research study was conducted among 18- to 29-year old Polish (n = 89) and Japanese (n = 97) women. The variables were measured using the Sociocultural Attitudes Towards Appearance Scale SATAQ-3, and the Eating Disorders Inventory EDI-3. The descriptive and comparative statistics, Spearman's rho, and the stepwise regression analysis were used. The global internalization of socio-cultural standards of body image proved to be a significant predictor of Body Dissatisfaction among Polish and Japanese women. The main analysis showed a significant relation between the Drive for Thinness and Interoceptive Deficits in the group of Japanese women, as well as a correlation between Drive for Thinness and Asceticism in the group of Polish women. The obtained results could improve the prevention aimed the dysfunctional eating behaviours. However, the cultural nuances need to be considered in understanding the risk factors for eating disorders.

The prevalence of underweight and overweight/obesity and its correlates among adults in Laos: a cross-sectional national population-based survey, 2013.

PURPOSE: The study aimed to assess the prevalence of underweight and overweight or obesity and their sociodemographic, lifestyle, and health factors in a national adult population in Lao People's Democratic Republic (PDR) (Laos). METHODS: A national cross-sectional study based on a stratified cluster random sampling was conducted in 2013. The total sample included 2531 individuals 18-64 years, (females = 59.3%; mean age 38.7 years, SD = 12.8) from Laos. Questionnaire interview, blood pressure and anthropometric measurements, and biochemistry tests were conducted. Multinomial logistic regression was utilized to determine the association between sociodemographic, lifestyle and health status factors, and underweight and overweight or obesity relative to normal weight. RESULTS: Using Asian criteria for body mass index (BMI) classification, 9.7% of the population was underweight (BMI < 18.5, kg/m2), 47.5% had normal weight (BMI 18.5-22.9 kg/m2), 17.5% overweight (23.0-24.9 kg/m2), 19.6% class I obesity (BMI 25.0-29.9 kg/m2), and 5.6% class II obesity (BMI ≥ 30.0 kg/m2) (or 42.8% overweight, class I or class II obesity). In adjusted multinomial logistic regression, female sex (adjusted relative risk ratio-ARRR 0.67, confidence interval-CI 0.45, 0.99), current tobacco use (ARRR 1.57, CI 1.02, 2.41), and having no hypertension (ARRR 0.50, CI 0.26, 0.97) were associated with underweight, and middle and older age (ARRR 1.79, CI 1.41, 2.25), being Lao-Tai (ARRR 1.37, CI 1.06, 1.76), urban residence (ARRR 1.62, CI 1.20, 2.17), having meals outside home (ARRR 1.36, CI 1.04, 1.77), no current tobacco use (ARRR 0.57, CI 0.34, 0.59), low physical activity (ARRR 1.39, CI 1.01, 1.92), having hypertension (ARRR 2.52, CI 1.94, 3.26), and dyslipidaemia (ARRR 1.56, CI 1.21, 2.00) were associated with overweight or obesity. CONCLUSION: A dual burden of both adult underweight and overweight or obesity was found in Laos. Sociodemographic, lifestyle, and health status risk factors were identified for underweight and overweight or obesity, which can help in guiding public health programmes to address both these conditions. LEVEL OF EVIDENCE: Level V, descriptive cross-sectional survey.

Household air pollution and caste-ethnic differences in undernutrition among children in Nepal.

This study investigated whether the association between household air pollution (HAP) and nutritional status (stunting, underweight, or wasting) among children differ by caste/ethnicity. Child anthropometry data for 9,914 children aged 0-59 months were analyzed linearly as Z scores and as dichotomous categories. Exposure to HAP was significantly associated with a decrease in child height-for-age and child weight-for-age, as well as with stunting and underweight. Children in low caste (Dalits) had higher prevalence of stunting (odds ratio [OR] = 1.21; 95% confidence intervals [CI] = 1.01, 1.44), underweight (OR = 1.47; 95% CI = 1.24, 1.75), and wasting (OR = 1.53; 95% CI = 1.21, 1.92) than those children in upper caste group. This association was modestly attenuated with adjustment for HAP. Exposure to HAP partly explained the caste-ethnic difference in undernutrition among children in Nepal.

Prevalence and determinants of type 2 diabetes among lean African migrants and non-migrants: the RODAM study.

BACKGROUND: Exposure to adverse conditions earlier in life-course can predispose to type 2 diabetes in adulthood, irrespective of body mass index (BMI). However, the burden of type 2 diabetes in lean Africans is not well understood despite higher exposure to adverse early life conditions. Mirroring ongoing epidemiological transition, we assessed the burden and determinants of type 2 diabetes in a homogenous group of lean Ghanaians residing in rural and urban Ghana, and as migrants in Europe. METHODS: Baseline data from 2179 RODAM study participants with BMI<25kg/m2 (25-70 years) were analyzed. Prevalence and determinants of type 2 diabetes were estimated using logistic regression analysis. Adjustments were made for socio-demographic and lifestyle factors, use of anti-diabetic medication and optimal blood glucose control. RESULTS: Prevalence of type 2 diabetes in rural, urban and migrant lean participants were 3.5%, 8.9% and 7.5% respectively, representing 55.4%, 35.6%, 13.2% of all participants with type 2 diabetes. Compared with lean rural participants, the odds of type 2 diabetes were higher in lean urban participants (adjusted OR = 8.81, 95% CI = 6.56-11.06), followed by migrants (5.27, 95% CI = 3.51-6.91). Irrespective of site, determinants of type 2 diabetes in lean participants include; presence of hypertension, physical inactivity, hypercholesterolemia and age (>45 years). CONCLUSIONS: Our study shows a high prevalence of type 2 diabetes among lean African populations in different geographical settings. Future studies are needed in-order to examine how contextual differences are related to the pathophysiology of type 2 diabetes in lean individuals.

Ancient origins of low lean mass among South Asians and implications for modern type 2 diabetes susceptibility.

Living South Asians have low lean tissue mass relative to height, which contributes to their elevated type 2 diabetes susceptibility, particularly when accompanied by obesity. While ongoing lifestyle transitions account for rising obesity, the origins of low lean mass remain unclear. We analysed proxies for lean mass and stature among South Asian skeletons spanning the last 11,000 years (n = 197) to investigate the origins of South Asian low lean mass. Compared with a worldwide sample (n = 2,003), South Asian skeletons indicate low lean mass. Stature-adjusted lean mass increased significantly over time in South Asia, but to a very minor extent (0.04 z-score units per 1,000 years, adjusted R2 = 0.01). In contrast stature decreased sharply when agriculture was adopted. Our results indicate that low lean mass has characterised South Asians since at least the early Holocene and may represent long-term climatic adaptation or neutral variation. This phenotype is therefore unlikely to change extensively in the short term, so other strategies to address increasing non-communicable disease rates must be pursued.

Thin idealization and causal attributions mediate the association between culture and obesity stereotypes: An examination of Chinese and American adolescents.

Few studies have examined age or cultural differences in the stereotypes adolescents have of persons with obesity. The present research explored the hypotheses that American adolescents have more negative obesity stereotypes than Chinese adolescents and that the effects of culture are mediated by weight attributions and thin idealization. Participants (N = 335; 181 female; M age = 14.83 years, SD = 1.57 years) completed measures of thin idealization and causal attributions and made generalizations from and attributions of stereotypical personality characteristics to obese figures. Not only did stereotypes differ between countries, but generalizations of negative characteristics from obese figures increased with age. In addition, American adolescents more firmly endorsed the 'thin ideal' and were more likely to attribute obesity to internal causes that Chinese adolescents. As anticipated, between-country differences in stereotyping were mediated by thin idealization and causal attributions. Findings are discussed in terms of the 'doctrine of the mean', social identity theory, and dual-process theories. Statement of Contribution The development of obesity stereotypes has been the subject of a number of recent studies. Although scarce, research on adolescents' obesity stereotypes indicates that the strength of these stereotypes increases with age and that these increases are mediated by thin idealization and causal attributions. The current research adds to this growing literature that differences between Chinese adolescents' and American adolescents' obesity stereotypes - in terms of the assignment of stereotypical traits to people with obesity and the generalization of negative traits from an individual person with obesity to people with obesity as a group - are mediated by thin idealization and attributions about obesity's causes. The research also indicates that (1) age differences in obesity stereotyping vary as a function of the method used to measure stereotypes, (2) Chinese adolescents are less likely than American adolescents to attribute obesity to characterological flaws, and (3) American adolescents idealize thinness more than Chinese adolescents.

Contrasting patterns of overweight and thinness among preschool children of different ethnic groups in Norway, and relations with maternal and early life factors.

BACKGROUND: Childhood obesity is a worldwide health challenge and risk factor for adult life obesity, which predisposes to development of type 2 diabetes and cardiovascular diseases. However, also thinness in early life has been related to these diseases, especially if followed by fat gain. In European countries, susceptibility to cardio-metabolic diseases varies considerably between ethnic groups. We investigated ethnic differences in overweight and thinness in a multi-ethnic, population-based cohort of preschool children in Norway, and associations with maternal and early postnatal factors. METHODS: Participants were children aged 4-5 years (n = 570) drawn from the population-based STORK Groruddalen cohort of healthy women and offspring followed from early pregnancy. Ethnic groups were: European (n = 298), South Asian (n = 154), and Middle East/North African (n = 118). Children's growth data were provided from routine visits at local Child Health Clinics. Weight status was defined by the International Obesity Task Force. Using multinomial logistic regression analysis, we explored ethnic differences in overweight and thinness, and associations with maternal-, pre, - and postnatal factors. RESULTS: Children of Middle East/North African origin had higher prevalence of overweight (22.0%) compared to European (12.8%) children, and in adjusted logistic regression analysis almost the double risk (OR 1.98; 95%CI: 1.08-3.63). Prevalence was lower in children of South Asian origin (5.2%). Children with South Asian background had higher prevalence of thinness (26.0%) compared to ethnic Europeans (10.4%), and the double risk (OR 2.20; 95%CI: 1.25-3.87) in adjusted models. Applying newly suggested BMI adjustments in South Asian children, taking into account their relatively increased adiposity, markedly increased the prevalence of overweight, and decreased the prevalence of thinness in this subgroup. Birthweight and maternal prepregnant overweight were strongly, positively associated with overweight, and inversely associated with thinness. Lower maternal age was associated with overweight only. CONCLUSIONS: In a multi-ethnic cohort we found strikingly different patterns of overweight and thinness among children of different ethnic groups at age 4-5 years, and a strong association between maternal BMI and their children's weight status. More knowledge is needed on what characterizes and what promotes healthy growth patterns in multi-ethnic populations.

Are eating behaviors related with by body mass index, gender and age?

The present study was carried out with parents of 520 healthy children between the ages of 2-12 and their parents who were referred to the diet polyclinic of a hospital in Ankara. The data were collected through personal interviews. The interviews included identifying the characteristics of the child and his/her parents, anthropometric measurements, questions investigating eating status, and the Children's Eating Behavior Questionnaire. According to the body mass index-Z scores, there were differences between subgroups of food responsiveness, emotional overeating, enjoyment of food, food fussiness, and slowness in eating. The gender-based desire to drink score was, on average, higher in boys. No gender-based differences were found in other subgroups, whereas the scores in the food fussiness and slowness in eating and emotional undereating were higher in the preschool group when analyzed by age. In conclusion, eating behaviors of overweight and obese children differ from those of normal and underweight children.

Tracking of thinness and overweight in children of Dutch, Turkish, Moroccan and South Asian descent from 3 through 15 years of age: a historical cohort study.

BACKGROUND: Overweight is shown to track (= to maintain a relative position in a distribution) from childhood to adulthood, but is mostly studied in preobesogenic cohorts and in single ethnic groups. Little is known about tracking of thinness by ethnicity. OBJECTIVES: to determine (differences in) tracking of BMI (class) from 3 through 15 years and the prediction of BMI class at 13-15 years of age in contemporary Dutch, Turkish, Moroccan and South Asian children living in the Netherlands. METHODS: Historical cohort of 7625 children, born 1994-1997, with 24,376 measurements of BMI. BMI z-score and BMI class was analysed using universal criteria. South Asian children were also assessed using ethnic specific BMI criteria. Diagnostic odds ratios (OR) and test properties were calculated to estimate the ability of BMI class at 3-4 years to predict BMI class at 13-15 years. RESULTS: Tracking of thinness between 3 and 15 years was stronger than that of overweight, as indicated by a generally higher diagnostic OR. BMI trajectories between 3 and 15 years of age of thin, normal weight and overweight adolescents were, although significantly different, quite similarly shaped in children of Dutch, Turkish and Moroccan descent. The South Asian BMI trajectory deviated considerably from the other ethnic groups, but the differences disappeared when South Asian specific BMI criteria were applied. A substantial proportion of overweight developed between 5-10 years, after which less children shifted to other BMI classes. A total of 55-78% of children with overweight at 3-4 years retained their overweight at 13-15 years, and 10-20% of 3-4 year olds with thinness remained thin. CONCLUSIONS: In all ethnic groups, overweight and especially thinness highly tracked into adolescence. South Asian children differed from the other ethnic groups when universal BMI criteria were applied, but with South Asian specific BMI criteria tracking patterns became more concordant.

Inflammatory signatures distinguish metabolic health in African American women with obesity.

Obesity-driven Type 2 diabetes (T2D) is a systemic inflammatory condition associated with cardiovascular disease. However, plasma cytokines and tissue inflammation that discriminate T2D risk in African American women with obese phenotypes are not well understood. We analyzed 64 circulating cytokines and chemokines in plasma of 120 African American women enrolled in the Black Women's Health Study. We used regression analysis to identify cytokines and chemokines associated with obesity, co-morbid T2D and hypertension, and compared results to obese women without these co-morbidities, as well as to lean women without the co-morbidities. We then used hierarchical clustering to generate inflammation signatures by combining the effects of identified cytokines and chemokines and summarized the signatures using an inflammation score. The analyses revealed six distinct signatures of sixteen cytokines/chemokines (P = 0.05) that differed significantly by prevalence of T2D (P = 0.004), obesity (P = 0.0231) and overall inflammation score (P < E-12). Signatures were validated in two independent cohorts of African American women with obesity: thirty nine subjects with no metabolic complications or with T2D and hypertension; and thirteen breast reduction surgical patients. The signatures in the validation cohorts closely resembled the distributions in the discovery cohort. We find that blood-based cytokine profiles usefully associate inflammation with T2D risks in vulnerable subjects, and should be combined with metabolism and obesity counselling for personalized risk assessment.

Prevalence of excess body weight and underweight among 26 Chinese ethnic minority children and adolescents in 2014: a cross-sectional observational study.

BACKGROUND: Little is known regarding the nutritional burden in Chinese ethnic minority children. This study aimed to investigate the epidemiological characteristics of excess body weight and underweight for 26 ethnic groups. METHODS: Data on 80,821 participants aged 7-18 years across 26 minorities, with completed records from a large national cross-sectional survey, were obtained from Chinese National Survey on Students' Constitution and Health (CNSSCH) in 2014. Excess body weight, underweight and their components were classified according to Chinese national BMI references. RESULTS: The overall prevalence of excess body weight and underweight among ethnic groups were 12.0% and 14.5%, in which 4.4% and 4.1% of the participants were classified as obese and severe wasting, respectively. Compared with girls, boys showed a higher prevalence of underweight, severe wasting and obesity, but a lower prevalence of excess body weight (P < 0.05). Among 26 ethnic groups, Koreans had the highest prevalence of excess body weight (30.4%), while Bouyeis showed the highest prevalence of underweight (25.7%). The ethnic minority groups with high prevalence of excess body weight and underweight were more likely to show high burden of obesity and severe wasting, respectively. However, it is not the case for some groups, such as Miaos and Shuis. CONCLUSIONS: A worrying dual burden of excess body weight and underweight was recognized in Chinese ethnic minority children. Since various characteristics were found among different minorities, the ethnic-specific effort is warranted to improve their nutritional status.