Exercise has been found to be effective for prevention of weight gain and maintenance of a stable weight in adults. The objective of this study was to evaluate the effect of a school-based aerobic exercise program on the obesity indexes of preschool children. Subjects were 292 second-year elementary school pupils from 2 kindergartens in Hat Yai municipality, Songkhla province, southern Thailand. A specially designed exercise program, including a 15-min walk before beginning the morning class and a 20-min aerobic dance session after the afternoon nap, 3 times a week, was conducted for 29.6 wk. Weight, height, and triceps skinfold thickness were measured 4 times. At the end of the study, the prevalence of obesity, using 95th percentile National Center for Health Statistics triceps-skinfold-thickness cutoffs, of both the exercise and control groups decreased. That of the exercise group decreased from 12.2% at baseline to 8.8% (Wilcoxon signed-rank test, P = 0.058), whereas that of the control group decreased from 11.7% to 9.7% (Wilcoxon signed-rank test, P = 0.179). A sex difference in the response of body mass index (BMI) to exercise was observed. Girls in the exercise group had a lower likelihood of having an increasing BMI slope than the control girls did (odds ratio: 0.32; 95% CI: 0.18, 0.56). In conclusion, our study suggests that a 29.6-wk school-based exercise program can prevent BMI gain in girls and may induce a remission of obesity in preschool-age children.
OBJECTIVE: To study the association between current or previous weight status and school performance among children and young adolescents of Hat Yai municipality, southern Thailand. DESIGN: Cross-sectional and longitudinal study SETTING: Primary and secondary schools of Hat Yai municipality, southern Thailand. SUBJECTS: 1207 grades 3 ± 6 and 587 grades 7 ± 9 students. MEASUREMENTS: Body mass index (BMI, kgam 2 ) calculated from weight and height measurement of subjects in 1992 and 1994; parental education level and occupation, and monthly income, by questionnaire performed in 1992; gradepoint-average (GPA) and grades of mathematics and Thai language from the school records of ®nal examinations in 1994. RESULTS: Overweight subjects (BMI value b 85th percentile of the NHANES-I data for age and gender) in grades 7 ± 9 had a mean GPA 0.20 point (95% con®dence internal (CI) 0.04, 0.37) lower than that of the normal weight children after controlling for gender, age, school and grade. They were twice more likely to have low grades (lower than 2 on the scales of 0 ± 4) of mathematics and Thai language than normal weight children. There were no associations between GPA or individual subject grades and previous BMI status in 1992. Children in grades 7 ± 9 who became overweight over the two years, had a mean GPA of 0.48 point lower than those who did not become overweight (95% CI 0.12, 0.84). In grades 3 ± 6 subjects, however, becoming overweight had no effect on GPA and individual subject scores. CONCLUSIONS: Our study showed that being overweight and becoming overweight during adolescence (grades 7 ± 9) was associated with poor school performance, whereas such an association did not exist in children (grades 3 ± 6).
The prevalence of obesity in Thailand has been doubled in the past two decades. Data from three consecutive National Health examination surveys (NHES) have shown a secular trend, as the prevalence of obesity with body mass index > or =25 kg m(-2) in adults increased from 13.0% in men and 23.2% in women in 1991 to 18.6% and 29.5% in 1997 and 22.4% and 34.3% in 2004 respectively. Obesity prevalence in children, using weight for height criteria, increased from 5.8% in 1997 to 7.9% in 2001 for the 2-5-year-olds and from 5.8% to 6.7% for the 6-12-year-olds. The data also show disproportionate increases of obesity in the rural area, which indicates the problem no longer restricts to the higher socioeconomic group.
Many studies have reported comparable hemoglobin response in subjects given intermittent and daily iron supplements. However, the effect of intermittent iron supplementation on impaired cognitive function, one of the serious consequences of iron deficiency among children, has not been studied. We investigated the effects of 1 d/wk (weekly) and 5 d/wk (daily) iron supplementation on changes in results of intelligence quotient (IQ), Thai language, and mathematics tests among Thai primary schoolchildren. A double-blind, randomized, placebo-controlled trial was conducted. Primary schoolchildren (n = 397) were randomly assigned to receive iron supplements daily or weekly or placebo. Ferrous sulfate (300 mg) or placebo tablets were given under direct observation by the researcher for 16 wk. Changes in IQ, and Thai language and mathematics scores were then compared. The increases in hemoglobin concentration were comparable in the weekly and daily iron supplementation groups but serum ferritin increased more in the children supplemented daily. Children receiving daily iron supplements, however, had a significantly lower increase in IQ (3 +/- 12 points) than those receiving the supplement weekly (6 +/- 12 points) or placebo (6 +/- 12 points), whereas the last-mentioned two groups did not differ. Z-scores of Thai language and mathematics test results did not differ among the groups. We conclude that weekly iron supplementation is the regimen of choice in this study community.
The association between iron deficiency anaemia and cognitive function impairment has been widely reported in young children, but whether the impairment is a result of iron deficiency per se or a combination of iron deficiency and anaemia, and how these conditions interact, is still questionable. Four hundred and twenty-seven school children from two schools in socioeconomically deprived communities were selected in southern Thailand. Iron status was determined by haemoglobin and serum ferritin concentrations. Cognitive function in this study was measured by IQ test and school performance, including Thai language and mathematics scores, using z-scores based on distributions within the same grade and school. Data on demography and socioeconomic status were collected by questionnaire answered by the parents. Linear regression models were used to investigate the effect of anaemia and iron deficiency, reflected by haemoglobin and serum ferritin concentration, on cognitive function and school performance. We found that cognitive function increased with increased haemoglobin concentration in children with iron deficiency, but did not change with haemoglobin concentration in children with normal serum ferritin level. Children with iron deficiency anaemia had consistently the poorest cognitive function (IQ, 74.6 points; Thai language score, 0.3 SD below average; and mathematics score, 0.5 SD below average). Children with non-anaemic iron deficiency but with high haemoglobin levels had significantly high cognitive function (IQ, 86.5 points; Thai language score, 0.8 SD above average; and mathematics score, 1.1 SD above average). This study found a dose-response relationship between haemoglobin and cognitive function in children with iron deficiency, whereas no similar evidence was found in iron sufficient children.
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