Background Early detection of abnormal weight gain in childhood may be important for preventive purposes. It is still debated which annual changes in BMI should warrant attention. Aim To analyse 1-year increments of Body Mass Index (BMI) and standardised BMI (BMI SDS) in childhood and explore conditional change in BMI SDS as an alternative method to evaluate 1-year changes in BMI. Subjects and methods The distributions of 1-year increments of BMI (kg/m(2)) and BMI SDS are summarised by percentiles. Differences according to sex, age, height, weight, initial BMI and weight status on the BMI and BMI SDS increments were assessed with multiple linear regression. Conditional change in BMI SDS was based on the correlation between annual BMI measurements converted to SDS. Results BMI increments depended significantly on sex, height, weight and initial BMI. Changes in BMI SDS depended significantly only on the initial BMI SDS. The distribution of conditional change in BMI SDS using a two-correlation model was close to normal (mean = 0.11, SD = 1.02, n?=?1167), with 3.2% (2.3-4.4%) of the observations below -2 SD and 2.8% (2.0-4.0%) above +2 SD. Conclusion Conditional change in BMI SDS can be used to detect unexpected large changes in BMI SDS. Although this method requires the use of a computer, it may be clinically useful to detect aberrant weight development.
Previous studies have found high rates of stunted linear growth in Greenlandic children. We measured growth patterns in Greenland and compared them with international growth charts.
The study cohort comprised 279 healthy children aged 6-10 years in 2012. They participated in two pregnancy and birth cohorts in Greenland and longitudinal growth data as birth was extracted from their medical records. Growth reference ranges were estimated with the lambda-mu-sigma (LMS) method and compared with growth charts from Denmark and the World Health Organization (WHO).
The children's mean length, weight and head circumference were significantly larger than the WHO growth charts (p
Previous growth references for Norwegian children were based on measurements from the 1970s and 1980s. New reference data, collected through the Bergen Growth Study and the Medical Birth Registry of Norway, are presented as LMS values.
A cross-sectional sample of children aged 0-19 years in stratified randomized design measured in 2003-2006 as a part of the Bergen Growth Study (n = 7291) and birth data of children born in 1999-2003 from the Medical Birth Registry of Norway (n = 12 576) was used to estimate the new references by the means of the LMS method. Measurement reliability was assessed by test-rest studies.
New references were constructed for length/height, weight, body mass index (BMI) and head circumference. Length/height and weight for children aged 0-4 years were similar to previous Norwegian references, but mean height increased up to a maximum of 3.4 cm in boys and 2.5 cm in girls during the pubertal years. Mean height was similar to (or slightly higher) in comparison with other recent European references. Reliability of the measurements compared well with published estimates.
Because of the observed secular trends in growth, it is advised to use the new references, which have been endorsed by the Norwegian Department of Health.
Application of ultrasound (US) to evaluate attainment and morphology of glandular tissue provides a new rationale for evaluating onset and progression of female puberty, but currently no hormone references complement this method. Furthermore, previous studies have not explored the predictive value of endocrine profiling to determine female puberty onset.
To integrate US breast staging with hypothalamic-pituitary-gonadal hormone references and test the predictive value of an endocrine profile to determine thelarche.
Cross-sectional sample of 601 healthy Norwegian girls, ages 6 to 16 years.
Clinical and ultrasound breast evaluations were performed for all included girls. Blood samples were analyzed by immunoassay and ultrasensitive liquid chromatography-tandem mass spectrometry (LC-MS/MS) to quantify estradiol (E2) and estrone (E1) from the subpicomolar range.
References for E2, E1, luteinizing hormone, follicle-stimulating hormone, and sex hormone-binding globulin were constructed in relation to chronological age, Tanner stages, and US breast stages. An endocrine profile index score derived from principal component analysis of these analytes was a better marker of puberty onset than age or any individual hormone, with receiver-operating characteristic area under the curve 0.91 (P
The basis for this study is the fact that instrument error increases the variance of the distribution of body mass index (BMI). Combined with a defined cut-off value this may impact upon the estimated proportion of overweight and obesity. It is important to ensure high quality surveillance data in order to follow trends of estimated prevalence of overweight and obesity. The purpose of the study was to assess the impact of instrument error, due to uncalibrated scales and stadiometers, on prevalence estimates of overweight and obesity.
Anthropometric measurements from a nationally representative sample were used; the Norwegian Child Growth study (NCG) of 3474 children. Each of the 127 participating schools received a reference weight and a reference length to determine the correction value. Correction value corresponds to instrument error and is the difference between the true value and the measured, uncorrected weight and height at local scales and stadiometers. Simulations were used to determine the expected implications of instrument errors. To systematically investigate this, the coefficient of variation (CV) of instrument error was used in the simulations and was increased successively.
Simulations showed that the estimated prevalence of overweight and obesity increased systematically with the size of instrument error when the mean instrument error was zero. The estimated prevalence was 16.4% with no instrument error and was, on average, overestimated by 0.5 percentage points based on observed variance of instrument error from the NCG-study. Further, the estimated prevalence was 16.7% with 1% CV of instrument error, and increased to 17.8%, 19.5% and 21.6% with 2%, 3% and 4% CV of instrument error, respectively.
Failure to calibrate measuring instruments is likely to lead to overestimation of the prevalence of overweight and obesity in population-based surveys.
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Identifying important ages for the development of overweight is essential for optimizing preventive efforts. The purpose of the study was to explore early growth characteristics in children who become overweight or obese at the age of 8 years to identify important ages for the onset of overweight and obesity.
Data from the Norwegian Child Growth Study in 2010 (N?=?3172) were linked with repeated measurements from health records beginning at birth. Weight and height were used to derive the body mass index (BMI) in kg/m2. The BMI standard deviation score (SDS) for each participant was estimated at specific target ages, using a piecewise linear mixed effect model.
At 8 years of age, 20.4% of the children were overweight or obese. Already at birth, overweight children had a significantly higher mean BMI SDS than normal weight 8-year-olds (p?
To answer the questions: how does body mass index (BMI) correlate to five overweight related anthropometric variables during different ages in childhood, and which anthropometric variables contribute most to variation in BMI during childhood?
Data on BMI, height (H), sitting height (SH), waist circumference (WC), waist to height ratio (WHtR), waist to sitting height ratio (WSHtR), subscapular skinfold (SSF), and triceps skinfold (TSF), from 4,576 Norwegian children 4.00-15.99 years of age, were transformed to standard deviation scores (SDS) and studied using correlation and multiple regression analyses.
The correlations between BMI SDS and the standardized anthropometric variables were in general strong and positive. For all variables, the correlations were weakest in the youngest age group and highest between 7 and 12 years. WC SDS and WHtR SDS were most strongly correlated with BMI SDS through all ages and in both sexes. A model with seven anthropometric variables adjusted for age and sex explained 81.4% of the variation in BMI SDS. When adjusted for all other variables, WC SDS contributed most to the variation in BMI SDS (b = 0.467, CI [0.372, 0.562]). Age group, but not sex, contributed significantly to variation in BMI SDS.
The interrelationships between BMI SDS and five standardized overweight related anthropometric variables were dependent on age, being weakest in the youngest age group. Independent of sex and age, WC SDS was in this study superior to other anthropometric variables in contributing to variation in BMI SDS during childhood.
AIM: The aim of this study was to estimate the prevalence of childhood overweight and obesity and to identify socio-demographic risk factors in Norwegian children. METHODS: The body mass index of 6386 children aged 2-19 years was compared with the International Obesity Task Force (IOTF) cut-off values to estimate the prevalence of overweight including obesity (OWOB) and obesity (OB). The effect of socio-demographic factors on this prevalence was analysed using multiple ordinal logistic regression analysis in a subsample of 3793 children. RESULTS: The overall prevalence of OWOB was 13.8% (13.2% in boys and 14.5% in girls, p = 0.146), but the prevalence was higher in primary school children aged 6-11 years (17%, p
Discriminating adipose and glandular tissue is challenging when clinically assessing breast development. Ultrasound facilitates staging of pubertal breast maturation (US B), but has not been systematically compared to Tanner breast (Tanner B) staging, and no normative data have been reported.
To present normative references for US B along with references for Tanner B, pubic hair (PH), and menarche.
A cross-sectional sample of 703 healthy girls aged 6 to 16 years were examined.
Breast development was determined with US B and Tanner B staging. Tanner PH and menarcheal status were recorded. The age distributions of entry in US B, Tanner B, and PH stages and menarche were estimated with generalized linear and generalized additive models with a probit link. Method agreement was tested with weighted Cohen's kappa.
The median (±2SD) ages for thelarche, US B2 and Tanner B2, were 10.2 (7.7, 12.8) and 10.4 (8.0, 12.7) years. The median (±2SD) ages at Tanner PH2 and menarche were 10.9 (8.5, 13.3) and 12.7 (11.0, 16.2) years. Cohen's kappa of agreement (95% confidence interval) between US B and Tanner B was 0.87 (0.85-0.88). When the methods disagreed, US B was usually more advanced.
Thelarche occurred at a slightly younger age when assessed with ultrasound compared to clinical Tanner staging, although the 2 methods had a very good agreement when determining pubertal breast maturation. A significant decrease of 2.8 months in age at menarche was observed during the past decade in Norwegian girls.