Three Abstracts on Overweight Children

PEDIATRICS V.107, N.1 Jan01

• Low-Grade Systemic Inflammation in Overweight Children
• Weight Status, Parent Reaction, and Self-Concept in Five-Year-Old Girls
• Peer, Parent, and Media Influences on the Development of Weight Concerns and Frequent Dieting Among Preadolescent and Adolescent Girls and Boys

Low-Grade Systemic Inflammation in Overweight Children

PEDIATRICS V.107, N.1 Jan01

Electronic Article p. e13

Received May 3, 2000; accepted Aug 16, 2000.

From the ^* Institute for Research in Extramural Medicine, Faculty of Medicine, Vrije Universiteit, Amsterdam, The Netherlands; ^± Epidemiology, Demography, and Biometry Program, National Institute on Aging, National Institutes of Health, Bethesda, Maryland; ^§ National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland; and the || Departments of Laboratory Medicine and Medicine, University of Washington, Seattle, Washington.

Objective.  Human adipose tissue expresses and releases the proinflammatory cytokine interleukin-6, potentially inducing low-grade systemic inflammation in persons with excess body fat. To limit potential confounding by inflammation-related diseases and subclinical cardiovascular disease, we tested the hypothesis that overweight is associated with low-grade systemic inflammation in children.

Design and Setting.  The third National Health and Nutrition Examination Survey, 1988-1994, a representative sample of the US population.

Participants.  A total of 3512 children 8 to 16 years of age.

Outcome Measures.  Elevated serum C-reactive protein concentration (CRP; > .22 mg/dL) and white blood cell count (10⁹ cells/L).

Results.  Elevated CRP was present in 7.1% of the boys and 6.1% of the girls. Overweight children (defined as having a body mass index or a sum of 3 skinfolds (triceps, subscapula, and supra-iliac) above the gender-specific 85th percentile) were more likely to have elevated CRP than were their normal-weight counterparts. After adjustment for potential confounders, including smoking and health status, the odds ratio (OR) was 3.74 (95% confidence interval [CI]: 1.66-8.43) for overweight boys and the OR was 3.17 (95% CI: 1.60-6.28) for overweight girls, based on the body mass index. Based on the sum of 3 skinfolds, these ORs were 5.11 (95% CI: 2.36-11.06) and 2.89 (95% CI: 1.49-5.59) for boys and girls, respectively. Overweight was also associated with statistically significant higher white blood cell counts. The results were similar when restricted to healthy, nonsmoking, nonestrogen-using children.

Conclusions.  In children 8 to 16 years of age, overweight is associated with higher CRP concentrations and higher white blood cell counts. These findings suggest a state of low-grade systemic inflammation in overweight children. inflammation, obesity, children.

Weight Status, Parent Reaction, and Self-Concept in Five-Year-Old Girls

PEDIATRICS V.107, N.1 Jan01

Received Apr 27, 2000; accepted Apr 27, 2000.

From the Department of Human Development and Family Studies, Pennsylvania State University, University Park, Pennsylvania.

Objective.  This study examined the relationship between weight status and self-concept in a sample of preschool-aged girls and whether parental concern about child overweight or restriction of access to food are associated with negative self-evaluations among girls.

Method.  Participants were 197 5-year-old girls and their parents. Girls' weight status (weight for height percentile) was calculated based on height and weight measurements. Girls' self-concept was assessed using an individually administered questionnaire. Parents' concern about their child's weight status and restriction of their child's access to food were assessed using a self-report questionnaire.

Results.  Girls with higher weight status reported lower body esteem and lower perceived cognitive ability than did girls with lower weight status. Independent of girl's weight status, higher paternal concern about child overweight was associated with lower perceived physical ability among girls; higher maternal concern about child overweight was associated with lower perceived physical and cognitive ability among girls. Finally, higher maternal restriction of girls' access to foods was associated with lower perceived physical and cognitive ability among girls with higher weight status but not among girls with lower weight status.

Conclusions.  At least as early as age 5 years, lower self-concept is noted among girls with higher weight status. In addition, parents' concern about their child's weight status and restriction of access to food are associated with negative self-evaluations among girls. Public health programs that raise parental awareness of childhood overweight without also providing constructive and blame-free alternatives for addressing child weight problems may be detrimental to children's mental health.  Key words:  preschool children, weight status, overweight, self-concept, parent reaction, parent concern, parent restriction.

Peer, Parent, and Media Influences on the Development of Weight Concerns and Frequent Dieting Among Preadolescent and Adolescent Girls and Boys

PEDIATRICS V.107, N.1 Jan01

Received Nov 4, 1999; accepted May 23, 2000.

Alison E. Field^*, Carlos A. Camargo Jr^{*, ±}, C. Barr Taylor^§, Catherine S. Berkey^{*, ||}, Susan B. Roberts^¶, and Graham A. Colditz^{*, #}

From the ^* Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; ^± Department of Emergency Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; ^§ Department of Psychiatry and Behavioral Science, Stanford Medical School, Stanford, California; ^|| Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts; ^¶ Energy Metabolism Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts; and the ^# Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts.

Objective.  To assess prospectively the influence of peers, parents, and the media on the development of weight concerns and frequent dieting.

Design.  Prospective cohort study.

Setting.  Questionnaires mailed annually to participants throughout the United States.

Participants.  One-year follow-up of 6770 girls and 5287 boys who completed questionnaires in 1996 and 1997 and were between 9 and 14 years of age in 1996.

Main Outcome Measure.  Onset of high levels of concern with weight and dieting frequently to control weight.

Results.  During 1 year of follow-up, 6% of girls and 2% of boys became highly concerned with weight and 2% of girls and 1% of boys became constant dieters. Peer influence was negligible. Independent of age and body mass index, both girls (odds ratio [OR]): 1.9; 95% confidence interval [CI]: 1.1-3.1) and boys (OR: 2.7; 95% CI: 1.1-6.4) who were making a lot of effort to look like same-sex figures in the media were more likely than their peers to become very concerned with their weight. Moreover, both girls (OR: 2.3; 95% CI: 1.1-5.0) and boys (OR: 2.6; 95% CI: 1.1-6.0) who reported that their thinness/lack of fat was important to their father were more likely than their peers to become constant dieters.

Conclusions.  Our results suggest that parents and the media influence the development of weight concerns and weight control practices among preadolescents and adolescents. However, there are gender differences in the relative importance of these influences.  Key words:  dieting, adolescents, parents, peers, media.