Introduction: the use of body mass index to assess obesity in children.

The International Obesity Task Force (IOTF) was established in 1994 to address the increase in the worldwide prevalence of obesity. The goals of the IOTF are to 1) raise awareness in the population and among governments that obesity is a serious medical condition, 2) develop policy recommendations for a coherent and effective global approach to the management and prevention of obesity, and 3) implement appropriate strategies to manage and prevent obesity on a population basis worldwide. To assess the global prevalence of obesity in children and adolescents, the IOTF convened a workshop on childhood obesity to determine the most appropriate measurement to assess obesity in populations of and adolescents around the world.

Workshop on childhood obesity: summary of the discussion.

Childhood obesity is rapidly emerging as a global epidemic that will have profound public health consequences as overweight children become overweight adults. To address this problem, action is needed at national and international levels. However, well-documented evidence of the trends in and global prevalence of obesity in children and adolescents is required to develop sound public health policies.

How to tackle the problem early? The role of education in the prevention of obesity.

The major issues that confront the clinician in relation to childhood obesity are identifying children at risk, deciding the goal and focus of therapy, and determining how to maintain weight loss. The severity of obesity and the age at which it is present appear to be significant determinants of whether childhood obesity will persist into adulthood. At any age, severe obesity is more likely to persist, and obesity present in adolescents is much more likely to persist than obesity in young children.

Using 3 data sources and methods to shape a nutrition campaign.

The first objective of this research was to define a target population of African-American women more clearly. The second was to provide specific information about the needs and preferences of that population in order to design an effective, culturally relevant, community-based communications campaign to promote more healthful lifestyles. Data collection and analysis included the following: interviews with 10 community nutritionists and the director of the State Office of Nutrition, 6 focus groups with a total of 47 members of the target population, and direct observation and documentation of key community resources.

[Clinical guidelines as part of total quality management. Analysis of heterogenous treatment concepts of sepsis in various clinics with computer assisted generation, logical testing and complexity assessment of clinical algorithms].

Generation, local tailoring, implementation and evaluation of clinical guidelines is an integral part of quality management. Clinical guidelines are intimately related to the independency of physicians' decisions. By this the physicians should be responsible for guideline development and guarantee the use of adequate methods of total quality management and outcome assessment.

The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study.

Background: Although overweight and obesity in childhood are related to dyslipidemia, hyperinsulinemia, and hypertension, most studies have examined levels of these risk factors individually or have used internal cutpoints (eg, quintiles) to classify overweight and risk factors.

Objective: We used cutpoints derived from several national studies to examine the relation of overweight (Quetelet index, >95th percentile) to adverse risk factor levels and risk factor clustering.

Design: The sample consisted of 9167 5- to 17-year-olds examined in seven cross-sectional studies conducted by the Bogalusa Heart Study between 1973 and 1994.

Morphology of dental enamel and dentine-enamel junction in osteogenesis imperfecta.

Objectives: The aim of this study was to examine the morphology of primary and permanent human enamel, and the dentine-enamel junction, in individuals with osteogenesis imperfecta (OI) type I, III and IV in undecalcified sections using polarized light microscopy, microradiography and scanning electron microscopy (SEM), and to relate the findings to the type of OI.

Sample And Methods: Extracted or exfoliated teeth from 15 patients representing the OI types I, III and IV (12 primary teeth from seven patients, and 11 permanent teeth from eight patients). Ten primary and nine permanent teeth from normal healthy patients served as controls.

Low maternal weight gain in the second or third trimester increases the risk for intrauterine growth retardation.

Low maternal weight gain during pregnancy has been suggested as a cause of intrauterine growth retardation (IUGR). However, pregnancy weight gain and fetal growth vary greatly throughout pregnancy. We examined the relationship between maternal weight gain in individual trimesters to the risk of IUGR in 10,696 women enrolled in the National Collaborative Perinatal Project (NCPP) and the Child Health and Development Study (CHDS).

Obesity evaluation and treatment: Expert Committee recommendations. The Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services.

Objectives: The development of recommendations for physicians, nurse practitioners, and nutritionists to guide the evaluation and treatment of overweight children and adolescents.

Methods: The Maternal and Child Health Bureau, Health Resources and Services Administration, the Department of Health and Human Services convened a committee of pediatric obesity experts to develop the recommendations.

Results: The Committee recommended that children with a body mass index (BMI) greater than or equal to the 85th percentile with complications of obesity or with a BMI greater than or equal to the 95th percentile, with or without complications, undergo evaluation and possible treatment.

Growth and development of term children born with low birth weight: effects of genetic and environmental factors.

Objective: To evaluate the role of intrauterine growth retardation (IUGR) on childhood growth and development, controlling for environmental and genetic factors.

Methods: Women and infants enrolled in the National Collaborative Perinatal Project were analyzed. Weight, length, and IQ were assessed at birth and at 7 years in the entire National Collaborative Perinatal Project population in term infants born with and without IUGR ("population cohort").

Role of the prenatal environment in the development of obesity.

Establishing that prenatal life is a critical or sensitive period for the development of obesity may focus basic research and clinical prevention efforts on this period. This review summarizes evidence that the intrauterine environment influences the risk of later obesity and considers the mechanisms by which this may occur. The association between birth weight and adult weight suggests that there are enduring effects of the intrauterine environment on later obesity risk.

Aspects of teeth from archaelogic sites in Sweden and Denmark.

The purpose of this study was to examine ground sections of primary second molars and permanent first molars from the same jaws. Teeth from 11 individuals were collected from archaeologic sites in Sweden and Denmark. Longitudinal buccolingual sections were examined in a polarization light microscope and in a Philips scanning electron microscope (SEM).

Childhood weight affects adult morbidity and mortality.

Few studies have examined the long-term effects of childhood obesity on adult disease. Nonetheless, obesity present in childhood or adolescence seems to increase the likelihood of adult morbidity and mortality. In men who were obese during adolescence, all-cause mortality and mortality from cardiovascular disease and colon cancer were increased.

Early adiposity rebound and the risk of adult obesity.

Objective: At 5 to 6 years of age, body fatness normally declines to a minimum, a point called adiposity rebound (AR), before increasing again into adulthood. We determined whether a younger age at AR was associated with an increased risk of adult obesity and whether this risk was independent of fatness at AR and parent obesity.

Design: A retrospective cohort study using lifelong height and weight measurements recorded in outpatient medical records.

Physical activity, genetic, and nutritional considerations in childhood weight management.

Almost one-quarter of U.S. children are now obese, a dramatic increase of over 20% in the past decade.

Body fatness and bioelectrical impedance in non-obese pre-menarcheal girls: comparison to anthropometry and evaluation of predictive equations.

Objectives: To determine in non-obese pre-menarcheal girls if bioelectrical impedance (BIA) is a better predictor of body fatness than triceps skinfold (TSF) or body mass index (BMI) and to cross-validate published equations for determination of fat-free mass (FFM) from BIA in pre-menarcheal girls.

Design: Cross-sectional analysis of data from 132 non-obese pre-menarcheal girls. The relationship of percent body fat (%BF), derived from isotopic dilution of H2 18O to TSF, BMI, and %BF by BIA, calculated from measures of height, weight and resistance was examined by correlation analysis.

Predicting obesity in young adulthood from childhood and parental obesity.

Background: Childhood obesity increases the risk of obesity in adulthood, but how parental obesity affects the chances of a child's becoming an obese adult is unknown. We investigated the risk of obesity in young adulthood associated with both obesity in childhood and obesity in one or both parents.

Methods: Height and weight measurements were abstracted from the records of 854 subjects born at a health maintenance organization in Washington State between 1965 and 1971.

Periods of risk in childhood for the development of adult obesity--what do we need to learn?

The prenatal period, the period of adiposity rebound and adolescence appear to represent critical periods for the development of obesity that persists into adulthood. Nonetheless, relatively little is known about the extent to which incident obesity at each of these intervals contributes to the prevalence of adult obesity. Similarly, little is known about the mechanisms that operate at each of these critical periods to entrain adult obesity.

Pulp calcifications in traumatized primary incisors. A morphological and inductive analysis study.

The purpose of this study was to investigate histopathological changes in primary teeth following trauma, and to look for possible correlations between the morphology of pulpal calcification and clinical findings. The material consisted of 123 primary teeth from 98 Danish children aged 9-108 months (mean age 33.5 +/- 19.