论文信息 - Overweight children and adolescents: description, epidemiology, and demographics.

2012 - Current Opinion in Psychiatry

Medical comorbidity of sleep disorders in children and adolescents

Purpose of review Sleep disorders in children and adolescents often present with various medical comorbidities. The aim of this review is to present the recent literature findings on this issue. Recent findings The major medical comorbid conditions that accompany insomnia or short sleep duration in children and adolescents are obesity and metabolic syndrome, growth hormone deficiency, allergic conditions, various disorders accompanied by chronic pain, neoplasms and blood malignancies, and genetic and congenital disorders. Hypersomnia is mainly related to malignancies. Children and adolescents with obstructive sleep apnoea syndrome or sleep-disordered breathing may suffer from obesity and metabolic syndrome, polycystic ovaries, hypothyroidism, asthma, epilepsy, various ear nose throat disorders, congenital malformations or genetic conditions. Parasomnias may be comorbid with some medical conditions, but the main challenge in their evaluation is the differential diagnosis from nocturnal epileptic seizures. Summary The co-occurrence of sleep disorders and medical conditions in childhood and adolescence is quite frequent and has an impact on general health and quality of life.

2009 - The Cochrane database of systematic reviews

Education of children and adolescents for the prevention of dog bite injuries.

BACKGROUND Dog bites can have dramatic consequences for children and adolescents. Educating young people on how to interact with dogs could contribute to reducing dog bite injuries. OBJECTIVES To determine the effectiveness of educational interventions that target children and adolescents in reducing dog bite injuries and their consequences. SEARCH STRATEGY We searched the following databases: The Cochrane Injuries Group's Specialised Register, CENTRAL (The Cochrane Library Issue 3, 2008), CAB Abstracts, Zetoc, SIGLE, MEDLINE, EMBASE, ERIC, PsycInfo, SPECTR, CINAHL, National Research Register, LILACs, African Healthline, Science Citation Index, Social Science Citation Index, CurrentClinicalTrials.Gov, Centrewatch, Controlledtrials.com, Vetgate and the WHO database. We checked the bibliographies of relevant reviews and trials and also contacted experts in the field. The searches were carried out to 18 July 2008. SELECTION CRITERIA We included randomised controlled trials and controlled before-after studies that evaluated the effectiveness of educational interventions, in populations under 20 years old, for preventing dog bites. DATA COLLECTION AND ANALYSIS Two review authors selected eligible studies based on information from the title and abstract. Two review authors decided on the inclusion of eligible trials and extracted data from the trial reports. We contacted authors of eligible studies to obtain more information. MAIN RESULTS Two studies met the inclusion criteria. No study looked at our main outcome: dog bite rates. The included studies were randomised controlled trials conducted in kindergarten and primary schools. Their methodology was of moderate quality. One study showed that the intervention group showed less 'inappropriate behaviour' when observed in the presence of a dog after a 30-minute educational intervention. Another study showed an increase in knowledge and in caution after an information programme. AUTHORS' CONCLUSIONS There is no direct evidence that educational programmes can reduce dog bite rates in children and adolescents. Educating children who are less than 10 years old in school settings could improve their knowledge, attitude and behaviour towards dogs. Educating children and adolescents in settings other than schools should also be evaluated. There is a need for high quality studies that measure dog bite rates as an outcome. To date, evidence does not suggest that educating children and adolescents is effective as a unique public health strategy to reduce dog bite injuries and their consequences.

2012 - Circulation

A Nutrient-Wide Association Study on Blood Pressure

Background—A nutrient-wide approach may be useful to comprehensively test and validate associations between nutrients (derived from foods and supplements) and blood pressure (BP) in an unbiased manner. Methods and Results—Data from 4680 participants aged 40 to 59 years in the cross-sectional International Study of Macro/Micronutrients and Blood Pressure (INTERMAP) were stratified randomly into training and testing sets. US National Health and Nutrition Examination Survey (NHANES) four cross-sectional cohorts (1999–2000, 2001–2002, 2003–2004, 2005–2006) were used for external validation. We performed multiple linear regression analyses associating each of 82 nutrients and 3 urine electrolytes with systolic and diastolic BP in the INTERMAP training set. Significant findings were validated in the INTERMAP testing set and further in the NHANES cohorts (false discovery rate <5% in training, P<0.05 for internal and external validation). Among the validated nutrients, alcohol and urinary sodium-to-potassium ratio were directly associated with systolic BP, and dietary phosphorus, magnesium, iron, thiamin, folacin, and riboflavin were inversely associated with systolic BP. In addition, dietary folacin and riboflavin were inversely associated with diastolic BP. The absolute effect sizes in the validation data (NHANES) ranged from 0.97 mm Hg lower systolic BP (phosphorus) to 0.39 mm Hg lower systolic BP (thiamin) per 1-SD difference in nutrient variable. Inclusion of nutrient intake from supplements in addition to foods gave similar results for some nutrients, though it attenuated the associations of folacin, thiamin, and riboflavin intake with BP. Conclusions—We identified significant inverse associations between B vitamins and BP, relationships hitherto poorly investigated. Our analyses represent a systematic unbiased approach to the evaluation and validation of nutrient-BP associations.

2010 - The journals of gerontology. Series A, Biological sciences and medical sciences

Survival in older men may benefit from being slightly overweight and centrally obese--a 5-year follow-up study in 4,000 older adults using DXA.

BACKGROUND Whether overweight in old age is hazardous remains controversial. Body mass index (BMI) overestimates adiposity and fails to measure central adiposity. We used dual-energy x-ray absorptiometry (DXA) to measure adiposity and hypothesized that overall adiposity, distribution of adiposity, and muscle mass might individually affect survival. METHODS We recruited 2000 men and 2000 women aged 65 years or older. Baseline BMI, waist-hip ratio (WHR), body fat index (BFI = total body fat/height square), relative truncal fat (RTF = trunk fat/total body fat), and body muscle mass index (BMMI = total body muscle mass/height square) were measured. Mortality was ascertained by death registry after 63.3 (median) months. RESULTS Two hundred and forty-two men and 78 women died. In men, mortality hazard ratio (HR) decreased consistently by 0.85 (p < .005), 0.86 (p < .005), and 0.86 (p < .005) per every quintile increase in BMI, BFI, and BMMI, respectively. A J-shaped relationship was observed in central adiposity (RTF and WHR) quintiles; the minimum values were at the 3rd WHR quintile (0.92-0.94) and 4th RTF quintile (mean WHR, 0.94). When RTF was tested with BFI, both high and low central adiposity were unfavorable while general adiposity became marginally insignificant (p = 0.062). When BFI and BMMI were tested together, increasing adiposity rather than muscle mass favored survival (BFI quintile, HR 0.97, p .015; BMMI quintile, HR 1.00, p .997). CONCLUSIONS Older men were resistive to hazards of overweight and adiposity; and mild-grade overweight, obesity, and even central obesity might be protective. This may bear significant implication on the recommended cutoff values for BMI and WHR in the older population.

2013 - Journal of Sport and Health Science

Children and adolescents with Down syndrome, physical fitness and physical activity

Abstract Children (5–12 years) and adolescents (13–19 years) with Down syndrome (DS) possess a set of health, anatomical, physiological, cognitive, and psycho-social attributes predisposing them to limitations on their physical fitness and physical activity (PA) capacities. The paucity of studies and their conflicting findings prevent a clear understanding and/or substantiation of these limitations. The purpose of this article was to review the measurement, determinants and promotion of physical fitness and PA for youth (i.e., children and adolescents) with DS. The existing body of research indicates that youth with DS: 1) have low cardiovascular and muscular fitness/exercise capacity; 2) demonstrate a greater prevalence of overweight and obesity; 3) a large proportion do not meet the recommended amount of daily aerobic activity; and 4) their PA likely declines through childhood and into adolescence. Future research should focus on: 1) strength testing and training protocols; 2) methodologies to determine PA levels; and 3) practical interventions to increase PA.

2013 - Alcohol and Alcoholism (Oxford, Oxfordshire)

Exposure of Children and Adolescents to Alcohol Marketing on Social Media Websites

Aims: In 2011, online marketing became the largest marketing channel in the UK, overtaking television for the first time. This study aimed to describe the exposure of children and young adults to alcohol marketing on social media websites in the UK. Methods: We used commercially available data on the three most used social media websites among young people in the UK, from December 2010 to May 2011. We analysed by age (6–14 years; 15–24 years) and gender the reach (proportion of internet users who used the site in each month) and impressions (number of individual pages viewed on the site in each month) for Facebook, YouTube and Twitter. We further analysed case studies of five alcohol brands to assess the marketer-generated brand content available on Facebook, YouTube and Twitter in February and March 2012. Results: Facebook was the social media site with the highest reach, with an average monthly reach of 89% of males and 91% of females aged 15–24. YouTube had a similar average monthly reach while Twitter had a considerably lower usage in the age groups studied. All five of the alcohol brands studied maintained a Facebook page, Twitter page and YouTube channel, with varying levels of user engagement. Facebook pages could not be accessed by an under-18 user, but in most cases YouTube content and Twitter content could be accessed by those of all ages. Conclusion: The rise in online marketing of alcohol and the high use of social media websites by young people suggests that this is an area requiring further monitoring and regulation.

2008 - European Child & Adolescent Psychiatry

Deliberate self-harm in young people: differences in prevalence and risk factors between The Netherlands and Belgium

AbstractBackgroundThis study aimed to examine prevalence and risk factors of deliberate self-harm in Dutch and Dutch-speaking Belgian adolescents.MethodA cross sectional survey using an anonymous self report questionnaire was performed in both countries. Data on 4,431 Belgian and 4,458 Dutch 15–16 year-old school pupils were analyzed.ResultsResults showed a significant difference between the two countries indicating that lifetime and past year prevalence of deliberate self-harm were both 2.8 times higher in Belgian adolescents than in Dutch adolescents. Further analyses identified differences in the prevalence of factors associated with deliberate self-harm, with Belgian adolescents showing significant higher scores on anxiety, less problem-oriented coping and more common use of alcohol and soft drugs. Belgian adolescents were also at higher risk for the experience of several life events in the previous year and before that such as conflicts with peers, parents and partner, being bullied at school or exposure to suicidal behavior in family and friends. In addition, Belgian adolescents showed less communication with family or teachers about their problems and difficulties. ConclusionsThe results of the study suggest that the increased risk of deliberate self-harm among Belgian adolescents may be associated with an increased reporting of several important life events and with additional ineffective problem-solving such as less problem-oriented coping, more substance use and less communication about their problems. These results support the assumption that sociocultural aspects of nations can influence the risk of deliberate self-harm and are important to consider when developing prevention strategies.

2014 - Pediatrics

Cancer Incidence Rates and Trends Among Children and Adolescents in the United States, 2001–2009

OBJECTIVES: Cancer continues to be the leading disease-related cause of death among children and adolescents in the United States. More current information is needed to describe recent cancer trends and identify demographic and geographic variations. METHODS: We analyzed data from the National Program of Cancer Registries and Surveillance, Epidemiology, and End Results statewide registries representing 94.2% of the US population to identify cancers diagnosed among persons aged 0 to 19 years during 2001–2009. Age-adjusted rates and annual percentage change for trends were calculated. Data were stratified by age, gender, race, ethnicity, and geography. RESULTS: We identified 120 137 childhood and adolescent cancer cases during 2001–2009 with an age-adjusted incidence rate of 171.01 per million. The overall rate of all cancers combined remained stable over time (annual percent change [APC], 0.3%; 95% confidence interval [CI], −0.1 to 0.7). There was an increase in the overall cancer trend among African American children and adolescents (APC, 1.3%; 95% CI, 0.2 to 2.5). An increasing trend for thyroid cancer was observed among both genders (APC, 4.9%; 95% CI, 3.2 to 6.6) and specifically among adolescents and those in the Northeast, South, and West regions of the United States. Renal carcinoma incidence was increasing significantly overall (APC, 5.4%; 95% CI, 2.8 to 8.1). Extracranial and extragonadal germ cell tumors and melanoma were both significantly decreasing. CONCLUSIONS: This study reports the novel finding that renal carcinoma rates are increasing among children and adolescents. This study confirms that thyroid cancer rates are increasing and further describes rising cancer rates among African Americans.

2017 - PLoS ONE

The influence of physical activity, sedentary behavior on health-related quality of life among the general population of children and adolescents: A systematic review

Background The association between physical activity, sedentary behavior and health-related quality of life in children and adolescents has been mostly investigated in those young people with chronic disease conditions. No systematic review to date has synthesized the relationship between physical activity, sedentary behavior and health-related quality of life in the general healthy population of children and adolescents. The purpose of this study was to review systematically the existing literature that evaluated the relations between physical activity, sedentary behavior and health-related quality of life in the general population of children and adolescents. Methods We conducted a computer search for English language literature from databases of MEDLINE, EMBASE, PSYCINFO and PubMed-related articles as well as the reference lists of existing literature between 1946 and the second week of January 2017 to retrieve eligible studies. We included the studies that assessed associations between physical activity and/or sedentary behavior and health-related quality of life among the general population of children and adolescents aged between 3–18 years. The study design included cross-sectional, longitudinal and health intervention studies. We excluded the studies that examined associations between physical activity, sedentary behavior and health-related quality of life among children and adolescents with specific chronic diseases, and other studies and reports including reviews, meta-analyses, study protocols, comments, letters, case reports and guidelines. We followed up the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement in the reporting of this review. The risk of bias of the primary studies was assessed by the Newcastle-Ottawa Scale. We synthesized the difference in health-related quality of life scores between different levels of physical activity and sedentary time. Results In total, 31 studies met the inclusion criteria and were synthesized in the review. Most of the included studies used a cross-sectional design (n = 21). There were six longitudinal studies and three school-based physical activity intervention studies. One study used both cross-sectional and longitudinal designs. We found that higher levels of physical activity were associated with better health-related quality of life and increased time of sedentary behavior was linked to lower health-related quality of life among children and adolescents. A dose-response relation between physical activity, sedentary behavior and health-related quality of life was observed in several studies suggesting that the higher frequency of physical activity or the less time being sedentary, the better the health-related quality of life. Conclusions The findings in this study suggest that school health programs promoting active lifestyles among children and adolescents may contribute to the improvement of health-related quality of life. Future research is needed to extend studies on longitudinal relationships between physical activity, sedentary behavior and health-related quality of life, and on effects of physical activity interventions on health-related quality of life among children and youth.

2003 - Chest

Impact of Body Mass Index on Outcomes Following Critical Care.

STUDY OBJECTIVES To determine the impact of body mass index (BMI) on outcomes in critically ill patients. DESIGN Retrospective analysis of a large multi-institutional ICU database. MEASUREMENTS The influence of BMI classification (underweight, < 20 kg/m(2); normal [control subjects], 20 to 25 kg/m(2); overweight, 25 to 30 kg/m(2); obese, 30 to 40 kg/m(2); severe obesity, > 40 kg/m(2)) on hospital survival, functional status at hospital discharge, and ICU/hospital length of stay (LOS) was analyzed via multivariate analysis, adjusting for age, gender, type of hospital admission, and severity score (ie, simplified acute physiologic score [SAPS] II and mortality prediction model [MPM] at time zero). Univariate analysis also was performed according to the quartile of the severity score. All comparisons were to the normal BMI group. RESULTS Of 63,646 patient datasets, 41,011 were complete for height, weight, and at least one of the two severity scores. We found increased mortality in underweight patients (odds ratio [OR] of death: SAPS group, 1.19; MPM group, 1.26) but not in overweight, obese, or severely obese patients. ICU and hospital LOS were increased in both the severely obese (OR of discharge: ICU, 0.81 and 0.84, respectively; hospital, 0.83 and 0.87, respectively) and underweight groups (OR of discharge: ICU, 0.96 and 0.94, respectively; hospital, 0.91 and 0.90, respectively). Only in the SAPS group did the obese group have increased ICU LOS (OR, 0.96) and hospital LOS (OR, 0.96). Functional status at discharge was impaired in underweight patients (OR of disability: ICU, 1.11; hospital, 1.19). Overweight patients had decreased discharge disability (OR of disability: SAPS, 0.93; MPM, 0.94), while the results in the obese group were discordant between the two severity score groups (SAPS, not significant; MPM, 0.91; p < 0.05 for all ORs). CONCLUSIONS Low BMI, but not high BMI, is associated with increased mortality and worsened hospital discharge functional status. LOS is increased in severely obese patients and, to a lesser extent, in underweight patients. Patients in the overweight and obese BMI groups may have improved mortality and discharge functional status.

1965 - Journal of Dental Research

Prevalence of Class I, Class II, and Class III Malocclusions (Angle) in an Urban Population An Epidemiological Study

The prevalence of malocclusion in the population has been the subject of debate for many years, and the conclusions reached have satisfied no one with the possible exception of the individual investigators. The chief reason for the large range in their results is probably due to the lack of general agreement on what constitutes a malocclusion. There are those who would classify all but the grossest derangement of the teeth as acceptable, while at the other extreme are those who view a few slipped contacts or rotations as malocclusion. To eliminate the confusion introduced by such value judgments, it is necessary that the material be classifiable into categories upon which all can agree. The only classification that has met this requirement is that of Angle,' who pointed out that the jaws and dental arches could be accurately assigned among three categories on the basis of the mesiodistal (anteroposterior) relation of the upper and lower first permanent molars when the teeth were occluded. Among the first recorded studies on the frequency of malocclusion was that of Angle, who examined and classified 1,000 school children of St. Louis, Missouri. These were apparently patients, because all exhibited malocclusion, which Angle grouped according to his classification shown in the accompanying table. Since the sample was not random but restricted to malocclusions, it is impossible to determine the over-all prevalence of irregularities from this study.

1995 - Obesity research

Human body composition and the epidemiology of chronic disease.

Obesity and body fat distribution (FD) are established risk factors for chronic diseases. The body mass index (BMI) and the waist/hip circumference ratio (WHR) are used conventionally as indices of obesity and FD in epidemiological studies. Although some general limitations of these indices are recognized, others that affect their use in relative risks for disease are not well recognized. These include effects of sex, ethnicity, and especially age on the relationships between these indices and body composition, which can result in substantial misclassification of obesity and FD. There is considerable variability in body composition for any BMI, and some individuals with low BMIs have as much fat as those with high BMIs. This results in poor sensitivity for classifying levels of body fatness (e.g., too many "false negatives," or overweight individuals classified as not overweight), and relative risks are attenuated across all categories of BMI. A more serious problem, however, is that at different ages the same levels of BMI correspond to different amounts of fat and fat-free mass. Data from the Rosetta Study and the New Mexico Aging Process Study show that older adults have, on average, more fat than younger adults at any BMI, due to the loss of muscle mass with age. As a result, the sensitivity of BMI cutpoints with respect to body fatness decreases with age, and the use of a fixed cutpoint for all ages results in "differential misclassification bias." Taken together, these issues suggest that the increases with age in the prevalences of overweight and obesity, and in the risks for chronic diseases, may be mis-estimated using BMI. Similar issues may affect the use of WHR for estimating prevalences and associated risks of FD. New field methods for estimating body composition are available that can be applied in large, epidemiologic follow-up studies of chronic diseases. These methods will allow epidemiologists to consider, for example, whether it is increased fat, or the replacement of fat-free mass with fat, with age that is associated with risk for chronic disease.

2011 - Diabetes Care

Increasing Prevalence of Metabolic Syndrome in Korea

OBJECTIVE The number of people with metabolic syndrome is increasing worldwide, and changes in socioenvironmental factors contribute to this increase. Therefore, investigation of changes in metabolic syndrome and its components in South Korea, where rapid socioenvironmental changes have occurred in recent years, would be foundational in setting up an effective strategy for reducing this increasing trend. RESEARCH DESIGN AND METHODS We compared the prevalence and pattern of metabolic syndrome among participants in the Korean National Health and Nutrition Examination Surveys for 1998, 2001, 2005, and 2007. In each survey, stratified, multistage, probability–sampling designs and weighting adjustments were conducted to represent the entire Korean population. The revised National Cholesterol Education Program criteria were used as the definition of metabolic syndrome. All biochemical parameters were measured in a central laboratory. RESULTS A total of 6,907 (mean ± SE age 45.0 ± 0.2 years), 4,536 (45.5 ± 0.2), 5,373 (47.1 ± 0.2), and 2,890 (49.9 ± 0.3) Koreans over 20 years of age have participated in the studies in 1998, 2001, 2005, and 2007, respectively. The age-adjusted prevalence of metabolic syndrome increased significantly from 24.9% in 1998, 29.2% in 2001, and 30.4% in 2005 to 31.3% in 2007. Among the five components, the level of low HDL cholesterol increased the most, by 13.8% over the 10 years. Abdominal obesity and hypertriglyceridemia followed, with 8.7 and 4.9% increases, respectively. CONCLUSIONS Because dyslipidemia and abdominal obesity were major factors in increasing the prevalence of metabolic syndrome in Koreans for the past 10 years, lifestyle interventions should be conducted at the national level to reduce the burden and consequences of metabolic syndrome.

2004 - Journal of the American Society of Nephrology : JASN

Chronic kidney disease awareness, prevalence, and trends among U.S. adults, 1999 to 2000.

The incidence of kidney failure treatment in the United States increased 57% from 1991 to 2000. Chronic kidney disease (CKD) prevalence was 11% among U.S. adults surveyed in 1988 to 1994. The objective of this study was to estimate awareness of CKD in the U.S. population during 1999 to 2000 and to determine whether the prevalence of CKD in the United States increased compared with 1988 to 1994. Analysis was conducted of nationally representative samples of noninstitutionalized adults, aged 20 yr and older, in two National Health and Nutrition Examination Surveys conducted in 1988 to 1994 (n = 15,488) and 1999 to 2000 (n = 4101) for prevalence +/- SE. Awareness of CKD is self-reported. Kidney function (GFR), kidney damage (microalbuminuria or greater), and stages of CKD (GFR and albuminuria) were estimated from calibrated serum creatinine, spot urine albumin to creatinine ratio (ACR), age, gender, and race. GFR was estimated using the simplified Modification of Diet in Renal Disease Study equation. Self-reported awareness of weak or failing kidneys in 1999 to 2000 was strongly associated with decreased kidney function and albuminuria but was low even in the presence of both conditions. Only 24.3 +/- 6.4% of patients at GFR 15 to 59 ml/min per 1.73 m(2) and albuminuria were aware of CKD compared with 1.1 +/- 0.3% at GFR of 90 ml/min per 1.73 m(2) or greater and no microalbuminuria. At moderately decreased kidney function (GFR 30 to 59 ml/min per 1.73 m(2)), awareness was much lower among women than men (2.9 +/- 1.6 versus 17.9 +/- 5.9%; P = 0.008). The prevalence of moderately or severely decreased kidney function (GFR 15 to 59 ml/min per 1.73 m(2)) remained stable over the past decade (4.4 +/- 0.3% in 1988 to 1994 and 3.8 +/- 0.4% in 1999 to 2000; P = 0.23). At the same time, the prevalence of albuminuria (ACR >/= 30 mg/g) in single spot urine increased from 8.2 +/- 0.4% to 10.1 +/- 0.7% (P = 0.01). Overall CKD prevalence was similar in both surveys (9% using ACR > 30 mg/g for persistent microalbuminuria; 11% in 1988 to 1994 and 12% in 1999 to 2000 using gender-specific ACR cutoffs). Despite a high prevalence, CKD awareness in the U.S. population is low. In contrast to the dramatic increase in treated kidney failure, overall CKD prevalence in the U.S. population has been relatively stable.

2017 - JAMA Otolaryngology–Head & Neck Surgery

Declining Prevalence of Hearing Loss in US Adults Aged 20 to 69 Years

Importance As the US population ages, effective health care planning requires understanding the changes in prevalence of hearing loss. Objective To determine if age- and sex-specific prevalence of adult hearing loss has changed during the past decade. Design, Setting, and Participants We analyzed audiometric data from adults aged 20 to 69 years from the 2011-2012 cycle of the US National Health and Nutrition Examination Survey, a cross-sectional, nationally representative interview and examination survey of the civilian, noninstitutionalized population, and compared them with data from the 1999-2004 cycles. Logistic regression was used to examine unadjusted, age- and sex-adjusted, and multivariable-adjusted associations with demographic, noise exposure, and cardiovascular risk factors. Data analysis was performed from April 28 to June 3, 2016. Interventions Audiometry and questionnaires. Main Outcomes and Measures Speech-frequency hearing impairment (HI) defined by pure-tone average of thresholds at 4 frequencies (0.5, 1, 2, and 4 kHz) greater than 25 decibels hearing level (HL), and high-frequency HI defined by pure-tone average of thresholds at 3 frequencies (3, 4, and 6 kHz) greater than 25 decibels HL. Results Based on 3831 participants with complete threshold measurements (1953 men and 1878 women; mean [SD] age, 43.6 [14.4] years), the 2011-2012 nationally weighted adult prevalence of unilateral and bilateral speech-frequency HI was 14.1% (27.7 million) compared with 15.9% (28.0 million) for the 1999-2004 cycles; after adjustment for age and sex, the difference was significant (odds ratio [OR], 0.70; 95% CI, 0.56-0.86). Men had nearly twice the prevalence of speech-frequency HI (18.6% [17.8 million]) as women (9.6% [9.7 million]). For individuals aged 60 to 69 years, speech-frequency HI prevalence was 39.3% (95% CI, 30.7%-48.7%). In adjusted multivariable analyses for bilateral speech-frequency HI, age was the major risk factor (60-69 years: OR, 39.5; 95% CI, 10.5-149.4); however, male sex (OR, 1.8; 95% CI, 1.1-3.0), non-Hispanic white (OR, 2.3; 95% CI, 1.3-3.9) and non-Hispanic Asian race/ethnicity (OR, 2.1; 95% CI, 1.1-4.2), lower educational level (less than high school: OR, 4.2; 95% CI, 2.1-8.5), and heavy use of firearms (≥1000 rounds fired: OR, 1.8; 95% CI, 1.1-3.0) were also significant risk factors. Additional associations for high-frequency HI were Mexican-American (OR, 2.0; 95% CI, 1.3-3.1) and other Hispanic race/ethnicity (OR, 2.4; 95% CI, 1.4-4.0) and the combination of loud and very loud noise exposure occupationally and outside of work (OR, 2.4; 95% CI, 1.4-4.2). Conclusions and Relevance Adult hearing loss is common and associated with age, other demographic factors (sex, race/ethnicity, and educational level), and noise exposure. Age- and sex-specific prevalence of HI continues to decline. Despite the benefit of delayed onset of HI, hearing health care needs will increase as the US population grows and ages.

2009 - Archives of internal medicine

Demographic differences and trends of vitamin D insufficiency in the US population, 1988-2004.

BACKGROUND Vitamin D insufficiency is associated with suboptimal health. The prevalence of vitamin D insufficiency may be rising, but population-based trends are uncertain. We sought to evaluate US population trends in vitamin D insufficiency. METHODS We compared serum 25-hydroxyvitamin D (25[OH]D) levels from the Third National Health and Nutrition Examination Survey (NHANES III), collected during 1988 through 1994, with NHANES data collected from 2001 through 2004 (NHANES 2001-2004). Complete data were available for 18 883 participants in NHANES III and 13 369 participants in NHANES 2001-2004. RESULTS The mean serum 25(OH)D level was 30 (95% confidence interval [CI], 29-30) ng/mL during NHANES III and decreased to 24 (23-25) ng/mL during NHANES 2001-2004. Accordingly, the prevalence of 25(OH)D levels of less than 10 ng/mL increased from 2% (95% CI, 2%-2%) to 6% (5%-8%), and 25(OH)D levels of 30 ng/mL or more decreased from 45% (43%-47%) to 23% (20%-26%). The prevalence of 25(OH)D levels of less than 10 ng/mL in non-Hispanic blacks rose from 9% during NHANES III to 29% during NHANES 2001-2004, with a corresponding decrease in the prevalence of levels of 30 ng/mL or more from 12% to 3%. Differences by age strata (mean serum 25[OH]D levels ranging from 28-32 ng/mL) and sex (28 ng/mL for women and 32 ng/mL for men) during NHANES III equalized during NHANES 2001-2004 (24 vs 24 ng/mL for age and 24 vs 24 ng/mL for sex). CONCLUSIONS National data demonstrate a marked decrease in serum 25(OH)D levels from the 1988-1994 to the 2001-2004 NHANES data collections. Racial/ethnic differences have persisted and may have important implications for known health disparities. Current recommendations for vitamin D supplementation are inadequate to address the growing epidemic of vitamin D insufficiency.

2005 - Advance data

Anthropometric reference data for children and adults: U.S. population, 1999-2002.

This report presents national anthropometric reference data based on health examination survey results from the National Health and Nutrition Examination Survey (NHANES), 1999-2002, for all ages of the U.S. population. Weighted population means, standard errors of the means, and selected percentiles are presented for the total U.S. population by sex, race or ethnic group, and age in years or age group. Findings for some population groups are reported in a way that is comparable with results reported from National Health Examination Surveys (NHES) and NHANES conducted between 1960 and 1994. These data add to the knowledge about trends in child growth and development and are used to monitor prevalent conditions in the U.S. population such as overweight and obesity.

2015 - The International Journal of Behavioral Nutrition and Physical Activity

Improving wear time compliance with a 24-hour waist-worn accelerometer protocol in the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE)

BackgroundWe compared 24-hour waist-worn accelerometer wear time characteristics of 9–11 year old children in the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) to similarly aged U.S. children providing waking-hours waist-worn accelerometer data in the 2003–2006 National Health and Nutrition Examination Survey (NHANES).MethodsValid cases were defined as having ≥4 days with ≥10 hours of waking wear time in a 24-hour period, including one weekend day. Previously published algorithms for extracting total sleep episode time from 24-hour accelerometer data and for identifying wear time (in both the 24-hour and waking-hours protocols) were applied. The number of valid days obtained and a ratio (percent) of valid cases to the number of participants originally wearing an accelerometer were computed for both ISCOLE and NHANES. Given the two surveys’ discrepant sampling designs, wear time (minutes/day, hours/day) from U.S. ISCOLE was compared to NHANES using a meta-analytic approach. Wear time for the 11 additional countries participating in ISCOLE were graphically compared with NHANES.Results491 U.S. ISCOLE children (9.92±0.03 years of age [M±SE]) and 586 NHANES children (10.43 ± 0.04 years of age) were deemed valid cases. The ratio of valid cases to the number of participants originally wearing an accelerometer was 76.7% in U.S. ISCOLE and 62.6% in NHANES. Wear time averaged 1357.0 ± 4.2 minutes per 24-hour day in ISCOLE. Waking wear time was 884.4 ± 2.2 minutes/day for U.S. ISCOLE children and 822.6 ± 4.3 minutes/day in NHANES children (difference = 61.8 minutes/day, p < 0.001). Wear time characteristics were consistently higher in all ISCOLE study sites compared to the NHANES protocol.ConclusionsA 24-hour waist-worn accelerometry protocol implemented in U.S. children produced 22.6 out of 24 hours of possible wear time, and 61.8 more minutes/day of waking wear time than a similarly implemented and processed waking wear time waist-worn accelerometry protocol. Consistent results were obtained internationally. The 24-hour protocol may produce an important increase in wear time compliance that also provides an opportunity to study the total sleep episode time separate and distinct from physical activity and sedentary time detected during waking-hours.Trial registrationClinicalTrials.gov NCT01722500.

2008 - European Journal of Clinical Nutrition

Age, period and birth cohort effects on prevalence of overweight and obesity in Australian adults from 1990 to 2000

Objective:To assess the individual contributions of age, period and birth cohort to prevalence of overweight and obesity in the Australian population during 1990 to 2000.Design:Age-period-cohort Poisson regression modelling of data from National Health Surveys conducted in Australia in 1990, 1995 and 2000.Subjects:Adults aged 20 years and over. Weightings were applied to account for differences in sampling and participation rates so that the sample is representative of the entire Australian adult population.Methods:Twelve age groups, based on 5-year intervals from 20 to 24 years to greater than 75 years, three survey periods and 14 cohorts, also based on 5-year intervals from pre-1915 up to 1976–1980, were used in the analysis. The data were age-standardized to the 2000 population and body mass index (BMI) was calculated. Log-linear models, for the prevalence rates of overall overweight (BMI ⩾25) and of obesity (BMI ⩾30) were fitted to the data.Results:Age (P<0.001), period (P<0.001) and cohort (P=0.002) all showed significant independent effects on prevalence of overall overweight in the Australian population such that prevalence rises with increasing age, recency of period and cohorts born since 1960. Age (P<0.001) and period (P<0.001) demonstrated strong effects on prevalence of obesity but birth cohort (P=0.07) was not significant. The effects were similar for men and women except that the overall effect of birth cohort on overall overweight was significant in women (P<0.05) but not men (P=0.09).Conclusion:The prevalence of overweight and obesity in Australian adults continued to rise during the 1990s. The obesogenic environment seems to have worsened and more recently born cohorts may be at increased risk of overweight.

2010 - Journal of the American Dietetic Association

The relationship of breakfast skipping and type of breakfast consumption with nutrient intake and weight status in children and adolescents: the National Health and Nutrition Examination Survey 1999-2006.

BACKGROUND National data comparing nutrient intakes and anthropometric measures in children/adolescents in the United States who skip breakfast or consume different types of breakfasts are limited. OBJECTIVE To examine the relationship between breakfast skipping and type of breakfast consumed with nutrient intake, nutrient adequacy, and adiposity status. SUBJECTS Children aged 9 to 13 years (n=4,320) and adolescents aged 14 to 18 years (n=5,339). DESIGN Cross-sectional data from the National Health and Nutrition Examination Survey 1999-2006. METHODS Breakfast consumption was self-reported. A 24-hour dietary recall was used to assess nutrient intakes. Mean adequacy ratio (MAR) for micronutrients and anthropometric indexes were evaluated. Covariate-adjusted sample-weighted means were compared using analysis of variance and Bonferroni's correction for multiple comparisons among breakfast skippers (breakfast skippers), ready-to-eat (RTE) cereal consumers, and other breakfast (other breakfast) consumers. RESULTS Twenty percent of children and 31.5% of adolescents were breakfast skippers; 35.9% of children and 25.4% of adolescents consumed RTE cereal. In children/adolescents, RTE cereal consumers had lower intakes of total fat and cholesterol and higher intakes of total carbohydrate, dietary fiber, and several micronutrients (P<0.05 for all) than breakfast skippers and other breakfast consumers. RTE cereal consumers had the highest MAR for micronutrients, and MAR was the lowest for breakfast skippers (P<0.05). In children/adolescents, breakfast skippers had higher body mass index-for-age z scores (P<0.05) and a higher waist circumference (P<0.05) than RTE cereal and other breakfast consumers. Prevalence of obesity (body mass index > or = 95th percentile) was higher in breakfast skippers than RTE cereal consumers (P<0.05) in children/adolescents and was higher in other breakfast consumers than RTE cereal consumers only in adolescents (P<0.05). CONCLUSIONS RTE cereal consumers had more favorable nutrient intake profiles and adiposity indexes than breakfast skippers or other breakfast consumers in US children/adolescents.

Overweight children and adolescents: description, epidemiology, and demographics.

A Comparison of Physical Activity Patterns and Physical Self-Perception in Obese and non-Obese Children

b) Corresponding Author

Activity-aware computing: modeling of human activity and behavior

Treating Child Obesity and Associated Medical Conditions

Oscillometric Blood Pressure Standards for Children

Pubertal alterations in growth and body composition. V. Energy expenditure, adiposity, and fat distribution.

The Obesity Epidemic in the United States

Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report.

Association between overweight or obesity and household income and parental body mass index in Australian youth: analysis of the Australian National Nutrition Survey, 1995.

Tracking of Physical Activity, Physical Inactivity, and Health-Related Physical Fitness in Rural Youth

Determinants of Healthy Eating in Children and Youth

One Hundred Years of Growth: The Evolution of Height, Mass, and Body Composition in Australian Children, 1899-1999

Measurement Issues in the Assessment of Physical Activity in Children

Go Girls!: Results from a Nutrition and Physical Activity Program for Low-Income, Overweight African American Adolescent Females

Students’ Tendency to Walk to School: Case Study of Tehran

[Prevalence of overweight in adolescents: a population-based study in a southern Brazilian city].

Childhood overweight: a contextual model and recommendations for future research

A genome-wide study reveals copy number variants exclusive to childhood obesity cases.

Development of eating behaviors among children and adolescents.

The importance of physical activity in the prevention of overweight and obesity in childhood: a review and an opinion