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      Is there a rapid increase in prevalence of obesity in Polish children? An 18-year prospective observational study in Gdansk, Poland

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          Abstract

          Introduction

          The prevalence of overweight and obesity is not regularly screened among Polish children. Very few longitudinal data exist on the prevalence and increase of overweight and obesity in this population. The aim of the study was to analyze the prevalence of overweight and obesity among selected age categories of children from Gdansk, on the basis of 1992–2012 data.

          Material and methods

          The anthropometric data (body weight and height, body mass index) of 70,329 children aged between 6 and 13 years were analyzed. Data were collected during annually performed child health measurements in schools by medical staff of Gdansk Center for Health Promotion during 1992–2012.

          Results

          No constant trend to increase or decrease in the prevalence of overweight or obesity was documented in any of the studied age groups ( p > 0.05). An age-related increase in the prevalence of overweight and obesity was observed throughout all consecutive age categories in boys and in prepubertal girls ( p < 0.05). Overweight and obesity were significantly more frequent in girls than in boys from all age categories ( p < 0.05), except 12- and 13-year-old children ( p = 0.173; p = 0.973), in whom no gender-specific differences were documented.

          Conclusions

          Our study did not confirm the previously reported growing tendency in the prevalence of overweight and obesity among children. However, our findings point to an age-related increase in the prevalence of excess body weight in the pediatric population.

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          Most cited references20

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          Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013.

          In 2010, overweight and obesity were estimated to cause 3·4 million deaths, 3·9% of years of life lost, and 3·8% of disability-adjusted life-years (DALYs) worldwide. The rise in obesity has led to widespread calls for regular monitoring of changes in overweight and obesity prevalence in all populations. Comparable, up-to-date information about levels and trends is essential to quantify population health effects and to prompt decision makers to prioritise action. We estimate the global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013. We systematically identified surveys, reports, and published studies (n=1769) that included data for height and weight, both through physical measurements and self-reports. We used mixed effects linear regression to correct for bias in self-reports. We obtained data for prevalence of obesity and overweight by age, sex, country, and year (n=19,244) with a spatiotemporal Gaussian process regression model to estimate prevalence with 95% uncertainty intervals (UIs). Worldwide, the proportion of adults with a body-mass index (BMI) of 25 kg/m(2) or greater increased between 1980 and 2013 from 28·8% (95% UI 28·4-29·3) to 36·9% (36·3-37·4) in men, and from 29·8% (29·3-30·2) to 38·0% (37·5-38·5) in women. Prevalence has increased substantially in children and adolescents in developed countries; 23·8% (22·9-24·7) of boys and 22·6% (21·7-23·6) of girls were overweight or obese in 2013. The prevalence of overweight and obesity has also increased in children and adolescents in developing countries, from 8·1% (7·7-8·6) to 12·9% (12·3-13·5) in 2013 for boys and from 8·4% (8·1-8·8) to 13·4% (13·0-13·9) in girls. In adults, estimated prevalence of obesity exceeded 50% in men in Tonga and in women in Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa. Since 2006, the increase in adult obesity in developed countries has slowed down. Because of the established health risks and substantial increases in prevalence, obesity has become a major global health challenge. Not only is obesity increasing, but no national success stories have been reported in the past 33 years. Urgent global action and leadership is needed to help countries to more effectively intervene. Bill & Melinda Gates Foundation. Copyright © 2014 Elsevier Ltd. All rights reserved.
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            References for growth and pubertal development from birth to 21 years in Flanders, Belgium.

            Due to the secular trend in length and height, growth references need to be updated regularly. Reference charts that were until recently used in Belgium are based on samples collected more than 30 years ago, and references for body mass index (BMI) and pubertal development have not been established before. To establish contemporary cross-sectional reference charts for height, weight, BMI, head circumference, and pubertal development from birth to 21 years of age, based on a representative sample of children from Flanders, Belgium. 15 989 healthy subjects of Belgian origin, 0-25 years of age, were measured in 2002-2004. Growth curves were fitted with the LMS method, and percentiles for the pubertal development were estimated with generalized additive models on status quo data from 8690 subjects aged 6-22 years of age. A positive secular trend in height and weight is observed in children above 5 years of age. Adult median height has increased by 1.2 cm/decade in boys and 0.8 cm/decade in girls; median weight by 0.9 kg/decade in boys, and 1.0 kg/decade in girls, and the weight distribution became more skewed. The BMI curve is comparable to that of other populations, except for higher percentiles. This reflects the increasing prevalence of overweight and obesity. Median age at menarche (13.0 years) has not advanced any more over the past 50 years. Median ages at menarche and B2 in girls and G2 or T4 in boys are comparable to other West European estimates, but approximately 10% enter G2/T4 before 9 years of age. The ongoing secular trend in height and weight makes growth charts previously used in Belgium obsolete. New representative charts for growth and pubertal development are introduced. For weight monitoring, it is advised that the now-available BMI growth charts are used.
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              Reference data for obesity: 85th and 95th percentiles of body mass index (wt/ht2) and triceps skinfold thickness.

              Body mass index (BMI) and triceps skinfold thickness (TSF) are commonly used measures of adiposity in clinical and epidemiologic studies. The 85th and 95th percentiles of BMI and TSF are often used operationally to define obesity and superobesity, respectively. Race-specific and population-based 85th and 95th percentiles of BMI and TSF for people aged 6-74 y were generated from anthropometric data gathered in the National Health and Nutrition Examination Survey 1 (NHANES I). The complex sample design of the survey is reflected in the reference values presented. Racial differences in these extremes of the distribution do not emerge until adulthood. Researchers may choose population-based, race-specific, or age-specific criteria for obesity on the basis of assumptions underlying their specific research questions.
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                Author and article information

                Journal
                Arch Med Sci
                Arch Med Sci
                AMS
                Archives of Medical Science : AMS
                Termedia Publishing House
                1734-1922
                1896-9151
                19 December 2017
                January 2018
                : 14
                : 1
                : 22-29
                Affiliations
                [1 ]Department of Public Health and Social Medicine, Medical University of Gdansk, Gdansk, Poland
                [2 ]Gdansk Center for Health Promotion, Gdansk, Poland
                [3 ]Department of Pediatrics, Pediatric Gastroenterology, Hepatology and Nutrition, Medical University of Gdansk, Gdansk, Poland
                Author notes
                Corresponding author: Michał Brzeziński MD, PhD, Department of Public Health and Social Medicine, Medical University of Gdansk, al. Zwyciestwa 42 a, 80-210 Gdansk, Poland. Phone: +48 58 349 15 40, Fax: +48 58 349 15 48. E-mail: brzezinski@ 123456gumed.edu.pl
                Article
                31296
                10.5114/aoms.2018.72239
                5778428
                29379529
                7e35af7f-1d86-434f-abd5-275e4ec59f49
                Copyright: © 2017 Termedia & Banach

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.

                History
                : 07 March 2017
                : 02 May 2017
                Categories
                Clinical Research

                Medicine
                excess body weight,percentile charts,secular trends
                Medicine
                excess body weight, percentile charts, secular trends

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