To define the prevalence of overweight and obesity among school-aged children resident in mountain areas, rural areas and urban areas.

The sample (n = 12 832; 50.7% boys) included 9- and 11-year-old children of the Veneto Region of north-east Italy. Overweight and obesity status were determined using the International Obesity Task Force cut-off points for body mass index. The prevalence of overweight and obese subjects was calculated with a confidence interval of 95%. The Mantel–Haenszel method was used to compare the combined prevalence of overweight and obesity among children resident in mountain areas, rural areas and urban areas.

Among boys the prevalence of overweight was 21.06%, while obesity prevalence was 5.92%; among girls overweight prevalence was 21.30%, while obesity prevalence was 5.15%. The prevalence was higher among 11-year-old boys (odds ratio (OR) = 1.19; 95% confidence interval (CI): 1.06–1.33) and 9-year-old girls (OR = 1.13; 95% CI: 1.01–1.26). Children resident in rural areas presented a higher risk of overweight and obesity compared with children resident in mountain areas (Mantel–Haenszel OR = 1.27; 95% CI: 1.13–1.42; χ2 = 17.55; P < 0.0001) and in urban areas (Mantel–Haenszel OR = 1.18; 95% CI: 1.07–1.31; χ2 = 10.39; P < 0.001).

A relevant prevalence of overweight and obesity was found; the excess weight concerns one child in four. There are differences linked to different geographical areas that must be further investigated.

To examine the relationship between television (TV) viewing and body mass index (BMI) among adolescents in a region of mainland China.

Population-based cross-sectional study, conducted between September and November of 2004, on a sample of enrolled high-school students aged 12–18 years.

One hundred and sixty-eight classes randomly selected from both urban and rural areas and belonging to 15 senior and 41 junior high schools in Nanjing, China, with a regional population of 6·0 million.

In total 6848 students participated; 47·7 % from urban and 52·3 % from rural areas; 49·0 % male and 51·0 % female. The response rate among eligible participants was 89·3 %.

The proportion of overweight was 6·6 % according to the criteria of overweight recommended for Chinese adolescents. Boys than girls (8·9 % vs. 4·4 %) had higher odds of being overweight (odds ratio (OR) 2·12, 95 % confidence interval (CI) 1·74, 2·60), while the proportion of overweight was significantly lower among rural students than urban students (4·5 % vs. 8·9 %; OR 0·49, 95 % CI 0·40, 0·60). Those students who watched TV for more than 7 h/week had a 1·5 times greater odds of being overweight relative to their counterparts who watched TV for 7 h/week or less (adjusted OR 1·51, 95 % CI 1·24, 1·82). Furthermore, there was a positive linear relationship between TV viewing time and BMI, even after adjusting for age, gender, residence area, time spent in study, in sleeping and in physical activity, and monthly pocket money.

Viewing TV might increase the likelihood of being overweight for Chinese adolescents in China.

To investigate the effect of television food advertising on children’s food intake, specifically whether childhood obesity is related to a greater susceptibility to food promotion.

The study was a within-subject, counterbalanced design. The children were tested on two occasions separated by two weeks. One condition involved the children viewing food advertisements followed by a cartoon, in the other condition the children viewed non-food adverts followed by the same cartoon. Following the cartoon, their food intake and choice was assessed in a standard paradigm.

The study was conducted in Liverpool, UK.

Fifty-nine children (32 male, 27 female) aged 9–11 years were recruited from a UK school to participate in the study. Thirty-three children were normal-weight (NW), 15 overweight (OW) and 11 obese (OB).

Exposure to food adverts produced substantial and significant increases in energy intake in all children (P < 0·001). The increase in intake was largest in the obese children (P = 0·04). All children increased their consumption of high-fat and/or sweet energy-dense snacks in response to the adverts (P < 0·001). In the food advert condition, total intake and the intake of these specific snack items correlated with the children’s modified age- and gender-specific body mass index score.

These data suggest that obese and overweight children are indeed more responsive to food promotion, which specifically stimulates the intake of energy-dense snacks.

The aim of the present study was to investigate blood pressure (BP) levels and their relationship with different indices of body fat in a group of adolescents, in order to evaluate the prevalence of hypertension and plan preventive and corrective strategies.

Cross-sectional study in primary care.

All high schools in the Aosta Valley region, northern Italy.

Five hundred and thirty-two adolescents of both sexes, aged 15·4 (standard deviation 0·7) years. The following parameters were measured: body weight, body height, body mass index (BMI), four skinfold thicknesses, body fat mass, waist and hip circumferences and BP.

BMI data indicated a high prevalence of overweight subjects in both sexes, but higher in males, while the prevalence rate of obese adolescents was lower. Of the total, 11·8 % of subjects suffered from systolic hypertension, while 6·9 % suffered from diastolic hypertension. In linear correlation analysis, BMI and all adiposity indices, except waist:hip ratio, were found to be significantly associated (P ranging between 0·05 and 0·001) with both systolic BP and diastolic BP in both sexes, with r ranging between 0·152 and 0·359. Multiple regression analysis with the stepwise method showed BMI and body fat mass to have the strongest association (P < 0·001) with BP, with r ranging between 0·275 and 0·359.

Unless reversed, these conditions are worrying and predict the possible development of cardiovascular disease in adulthood. There is a pressing need to develop a comprehensive medical and nutrition plan, together with preventive and corrective strategies, in school programmes.

We investigated associations between consumption of fruits, vegetables, sweets and soft drinks and the psychological dimensions of eating in parents and their children. The role of the parent’s characteristics for their children’s food intake was also explored.

Food intake patterns were assessed by self-reported consumption of the respective foods. Eating behaviour was measured by the Dutch Eating Behaviour Questionnaire and self-esteem by Harter self-perception scale. The participants were 1441 families (mother, father and their 12-year-old child), and additionally 354 mothers and thirty fathers.

Among parents, reported intake of fruit and vegetables were associated with restrained eating, higher self-esteem, and higher education and age. Intake of sweets was related to more external and less restrained eating, and for mothers also emotional eating. Parent’s intake of soft drink was foremost related to a younger age, and also weakly associated with psychological characteristics. The food intake of parents was more important for the children’s food intake than any other characteristics. However, children’s intake of sweets showed clear-cut positive associations with external eating.

Psychological dimensions of eating behaviour are associated with patterns of food intake, in particular for consumption of sweets, and are most prominent in the parents. The children’s food intake mirrored their parents’ intake. Being sensitive to external food cues may increase unhealthy food consumption in our society, whereas more restrained eating may indicate proneness or intention to healthier food choices among parents. Emotional eating may imply a proneness to consume sweets for comfort, in particular among mothers.

To establish the school eating habits of Mexican children, who are prone to obesity and later to high rates of adult chronic diseases.

Questionnaires for students and parents with staff questionnaires and interviews.

Randomly sampled schools in a socio-economically representative district of Mexico City.

Subjects were 1504 adolescents aged 10–19 years attending schools in Mexico City, 27 teachers and seven headmasters, sampled from both public and private schools and from the full range of socio-economic groups.

Foods brought from home were of a higher nutritional quality than those purchased at school, where purchases were dominated by crisps, soft drinks and other items with high energy density. Girls were more inclined to purchase inappropriately; those from poorer homes purchased less. Private-school students irrespective of socio-economic grade brought more food from home and purchased more expensive food at school. School policies allowed food and drink vendors to market any products within the schools, which benefited financially from these activities.

Current school food policies are conducive to amplifying the current epidemic of obesity and related adult chronic diseases, and need to change.

Being a single mother may have implications for health behaviours that can also affect the child. More information about the food intakes and body weights in single v. married/cohabiting mothers and in their children is needed. Psychological dimensions of eating behaviour and self-esteem are also of relevance to explore for single mothers and their children.

Food style patterns were assessed by self-reported consumption of fruits, vegetables, sweets and soft drinks. Eating behaviour was measured by the Dutch Eating Behaviour Questionnaire and self-esteem by the Harter self-perception scale. The participants were 1781 mothers and their 12-year-old children, of whom 278 mothers (16 %) were single.

Single mothers had lower intake of fruits and vegetables and lower self-worth compared to the married and cohabiting mothers, controlling for age, education and BMI. Although single mothers did not have a higher BMI, their daughters were heavier than girls from complete families. Daughters to single mothers furthermore had a higher intake of soft drinks, higher levels of restrained eating and lower self-worth. No such difference was found for the boys.

A lower sense of self-worth and lower intake of fruit and vegetables in single mothers could be seen in the context of the social disadvantages and less social support. Girls may be more inclined to be affected by family status than the boys, seen in a more unfortunate psychological pattern and a higher body weight. Boy’s health behaviours may be more unaffected by living in single families.

Childhood obesity is a growing public health problem. We have examined the association between sociodemographic profile and eating and physical activity patterns with overweight among primary-school students in Athens, Greece.

Cross-sectional study.

Eleven primary schools in the greater Athens area, Greece.

A total of 633 children aged 10–12 years (50 % boys, 50 % girls) were interviewed in person during spring 2003. Multivariate logistic regression was used to investigate the association between eating and physical activity patterns and overweight (≥85th sex- and age-specific BMI centile). Results are presented as odds ratios and 95 % confidence intervals.

Overweight was more common among girls than among boys (OR=1·73; 95% CI 1·11, 2·69) and substantially less common among children born outside Greece (OR=0·46; CI 0·22, 0·95). Reported physical activity (per 1·5 h per day) was unrelated to overweight (OR=0·97; CI 0·85, 1·12) but patent physical inactivity, operationalised as time spent watching television or working/playing with the computer (per 1·5 h per day) was a highly significant predictor of overweight (OR=1·20; CI 1·05, 1·36). Composition of diet was unrelated to overweight but the daily number of eating occasions, controlling for total energy intake, was significantly inversely associated with overweight (OR=0·61; CI 0·48, 0·76).

The principal factor underlying overweight among children in Athens appears to be the extended inactivity imposed by modern childhood lifestyles. An intriguing finding is that spreading a given energy intake over several eating occasions was inversely associated with the likelihood of childhood obesity.

To investigate the beliefs of South African metropolitan adults regarding the importance of influencing cardiovascular health by eating certain food types, and to compare these beliefs between different race, living standards, age and gender groups.

Randomised cross-sectional study. Trained fieldworkers administered questionnaires by conducting face-to-face interviews with consumers.

Two thousand South Africans (16 years and older) were randomly selected from metropolitan areas in South Africa. The data were weighted to be representative of the total South African metropolitan population (N = 10 695 000) based on gender, age and race distribution.

The majority (94 %) of the population indicated that it is important to influence cardiovascular risk-related health issues by eating certain food types, especially the higher LSM (Living Standard Measure) groups within the different race groups. Weight loss was considered the least important (61 % indicated that it is important) compared with cholesterol lowering (80 %), blood pressure (89 %), diabetes (86 %) and healthy blood vessels (89 %). In the higher LSM groups (7–10) higher proportions of respondents agreed than in the lower LSM groups (2 and 3). No differences were seen in responses between different gender, race and age groups.

This study shows that the metropolitan South African adult population considers the influence on cardiovascular health by eating certain food types to be important. However, modifying weight loss by eating certain food types was considered less important.

A substantial fall in high-density lipoprotein cholesterol (HDL-C) during puberty in boys, but not girls, has been reported in Western populations. The fall in boys is believed to be due to hormonal changes – androgens have been shown to be associated with lower HDL-C, whereas oestrogens are associated with higher HDL-C. The fall in HDL-C during puberty was not observed, however, in a study of Moslem boys in Israel, nor in a group of Japanese boys. A diet high in phyto-oestrogens may account for the lack of a fall in HDL-C in these populations.

To examine the effect of dietary supplementation with phyto-oestrogens on the HDL-C concentration of adolescent boys from a Western population. We hypothesised that dietary supplementation of 50 mg of the isoflavones daidzein and genistein would produce a 12% higher HDL-C concentration than in controls at the end of a 6-week intervention period.

A randomised controlled trial.

Hellyer College in Burnie (Tasmania, Australia).

Adolescent boys (aged 16–18 years) were recruited through a letter sent to parents. A total of 132 eligible participants enrolled and five subjects withdrew from the trial.

No significant increase in HDL-C was observed in the treatment group (–0.02 mmol l–1, standard error (SE)=0.03, P = 0.53) or the placebo group (0.05 mmol l–1, SE = 0.03, P = 0.11).

Factors other than isolated dietary isoflavones may be responsible for the lack of fall in HDL-C during puberty in Japanese and Moslem boys.

This paper examines trends in the neighbourhood food store environment (defined by the number and geographic density of food stores of each type in a neighbourhood), and in food consumption behaviour and overweight risk of 5779 men and women.

The study used data gathered by the Stanford Heart Disease Prevention Program in four cross-sectional surveys conducted from 1981 to 1990.

Four mid-sized cities in agricultural regions of California.

In total, 3154 women and 2625 men, aged 25–74 years.

From 1981 to 1990, there were large increases in the number and density of neighbourhood stores selling sweets, pizza stores, small grocery stores and fast-food restaurants. During this period, the percentage of women and men who adopted healthy food behaviours increased but so did the percentage who adopted less healthy food behaviours. The percentage who were obese increased by 28% in women and 24% in men.

Findings point to increases in neighbourhood food stores that generally offer mostly unhealthy foods, and also to the importance of examining other food pattern changes that may have a substantial impact on obesity, such as large increases in portion sizes during the 1980s.

To evaluate the effect of two types of iron pots on haemoglobin (Hb) and serum ferritin (SF) concentrations in young children (6–24 months), adolescent girls (11–15 years) and women of reproductive age (15–44 years), whose households were provided with iron pots for cooking food over a period of 6 months, compared with controls.

We randomly assigned 161 households including 339 individuals from the three subgroups to cast iron pots, blue steel pots or oral iron supplements (control). In the control group, children received micronutrient Sprinkles™, and adolescent girls and women received iron tablets daily for 6 months. We measured Hb, SF and C-reactive protein concentrations at baseline and 6 months, and compared groups using regression models.

Anaemia prevalence (Hb < 110 g l−1 in infants, Hb < 120 g l−1 in girls or women) was 47% (cast iron group), 50% (blue steel group) and 50% (control) at baseline. At 6 months, there were no significant differences in Hb concentrations among groups; however, differences in SF concentrations were significant (P < 0.0001) – the control group had higher SF concentrations compared with the groups using iron pots. Also, differences in the prevalence of iron-deficiency anaemia (IDA; anaemia plus SF < 15 μg l−1) were almost significant between cast iron and control groups (P = 0.08), and blue steel and control groups (P = 0.05).

There is no evidence that iron cooking pots are effective against IDA. Further research is warranted to determine whether the iron leached from the pots is bioavailable.

The aim of the present study was to determine the impact of food advertising in primary and secondary schools on the food purchasing habits of children.

All forty-four primary and secondary schools in Rzeszow, Poland were included in the investigation; 15 000 children attend primary and secondary schools in the region. Schools were visited by members of the research team, who filled in a questionnaire regarding the type of food products displayed or advertised in the school shop window and recorded the presence of direct corporate advertising in the proximity of the school shop. Shop owners were asked to fill in a form describing food purchases by students within the week preceding the visit. The school principal (or one of teachers) completed a form describing the school’s policy regarding food advertising and the sponsorship of school activities by food companies.

Recommended foods like milk, yoghurts and fruit were offered by only 40·9 % of shops. There was a correlation between foods offered in the shop and foods purchased by students. In schools, 40·9 % (95 % CI 25·8, 56·0 %) of shop windows displayed or advertised ‘healthy’ foods while 9·1 % (95 % CI 0·0, 17·9 %) of shops displayed advertisements of food companies. The difference between display of ‘healthy’ food in shop windows and display of food on company advertisements was significant (likelihood ratio χ2 test, P < 0·04). Type of school (primary v. secondary) was not significant factor in advertising or purchasing pattern.

Educational programmes should be introduced in schools with the aim of improving the understanding of nutritional principles among pupils, teachers and parents.