Changes in the distribution of body mass index of adults and children in the US population

Flegal, Katherine M.; Troiano, Richard P.

doi:10.1038/sj.ijo.0801232

Cited by 463 publications

(327 citation statements)

References 12 publications

(6 reference statements)

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“…In the USA, Flegal and Troiano (2000) found no changes in the lower part of the BMI distribution in younger children and a slight shift upwards in the whole population with increasing age.…”

Section: Discussionmentioning

confidence: 73%

“…In younger children and to some extent in adolescents, the principal effect is increased positive skewness at the upper part of the distribution. In addition, for adults, the entire distribution of BMI is shifted upwards (Flegal and Troiano, 2000). These observations suggest that there is a distinct subgroup that is genetically susceptible to obesity and that for adults some factors causing increases in BMI are affecting the entire population.…”

Section: Introductionmentioning

confidence: 91%

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Trends in overweight and obesity and changes in the distribution of body mass index in schoolchildren of Jena, East Germany

Kromeyer-Hauschild

Zellner

2006

Eur J Clin Nutr

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Objective: Data of Jena children (Germany) show increases in the prevalence estimates of overweight and obesity between 1975 and 2001. Our objective was to determine if these increases contribute to changes in the distribution of body mass index (BMI) in the entire population of children. The decade 1985-1995, which includes the time of German reunification, is of particular interest because of the significant socio-economic changes in East Germany, in which Jena is located. Design and subjects: The analyses were based on data from four cross-sectional growth studies in 7-to 14-year-old children performed in Jena, Germany, in 1975 (n ¼ 2013), 1985 (n ¼ 1534), 1995 (n ¼ 1906 (n ¼ 1918. Overweight and obesity were estimated by German reference data and the reference of Cole et al. Mean difference plots were used to investigate the changes in the BMI distributions within sexes between the studies. Results: Between 1985 and 1995, the prevalence of overweight and obesity increased significantly in both sexes, whereas nonsignificant changes were found between 1975 and 1985. Although there is a tendency towards increased overweight between 1995 and 2001, the differences were nonsignificant. Comparing data from 1975 and 1985, the mean difference plots showed virtually no changes in the BMI distribution. In the plots comparing the BMI distribution for 1985 data and 1995 data, the whole distribution tended to shift upwards with a greater shift in the upper BMI range. The entire population of children in Jena gained weight during this period of time. This increase may be linked to a transition towards a more Western lifestyle, that is, usually by lower energy expenditure and nutritional transitions, caused by the process of reunification of Germany in 1989. Conclusions: Weight gain appears to be a characteristic feature of the entire population studied and does not seem to be a separate problem of the obese children. This suggests that reported changes in the prevalence may be underestimating the looming public health crisis.

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Section: Discussionmentioning

confidence: 73%

Section: Introductionmentioning

confidence: 91%

Trends in overweight and obesity and changes in the distribution of body mass index in schoolchildren of Jena, East Germany

Kromeyer-Hauschild

Zellner

2006

Eur J Clin Nutr

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“…26,27 Indeed 30% of Americans are not even overweight and are resistant to weight gain. 28 One potential solution to this problem with the thrifty gene hypothesis might be that famine has been a factor driving the evolution of thrifty genes for a much shorter period of time. There is a difference of opinion among proponents of the thrifty gene idea on this issue.…”

Section: Why This Argument Is Flawedmentioning

confidence: 99%

Thrifty genes for obesity, an attractive but flawed idea, and an alternative perspective: the ‘drifty gene’ hypothesis

2008

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Almost 50 years ago Neel proposed a hypothesis to explain the prevalence of obesity and diabetes in modern societyFthe 'thrifty gene' hypothesis. The fundamental basis of the hypothesis was that, in our early evolutionary history, genes, that promoted efficient fat deposition would have been advantageous because they allowed their holders to survive at periods of famine. In modern society, such genes are disadvantageous because they promote fat deposition in preparation for a famine that never comes, and the result is widespread obesity and diabetes. In recent years I, and others, have questioned some of the fundamental assumptions of this hypothesisFparticularly focusing on whether differential survival of lean against obese in famines provides sufficient selective pressure for the spread of so-called 'thrifty genes'. These arguments have been criticized because famines not only affect survival but also fecundity, and obese people would be expected to sustain fecundity longer in the face of food shortages. In this paper, I show that the reduced fecundity argument is flawed because famines are almost universally followed by periods of enhanced fecundity, which offsets the decline observed during the famine itself. The net effect of famines on fecundity is consequently insufficient to rescue the thrifty gene idea. Elsewhere, I have suggested an alternative scenario that subsections of the population have a genetic predisposition to obesity due to an absence of selection, combined with genetic drift. The scenario presented earlier was based on evidence from prehistory concerning the release of our ancestors from heavy predation pressure around 2 million years ago. I suggest here that this is one of a number of potential scenarios based on random genetic drift that may explain the specific aetiology of the obesity epidemic. Together, these alternatives, based on central notion that genetic drift rather than positive selection was a dominant factor, may be called the 'drifty gene' hypothesis.

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“…Childhood overweight is increasingly common worldwide [1][2][3] as are the consequences that include increased risk of later cardiovascular disease and diabetes. 4,5 The metabolic syndrome (MS) describes the clustering of central obesity, dyslipidaemia (raised triglycerides and/or low-or highdensity lipoprotein), hyperinsulinaemia, impaired glucose tolerance and elevated blood pressure (BP), and is a clear indicator of adult morbidity.…”

Section: Introductionmentioning

confidence: 99%

Comparison of metabolic syndrome prevalence using six different definitions in overweight pre-pubertal children enrolled in a weight management study

et al. 2006

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Objectives: To assess the implications of variation in Metabolic Syndrome (MS) definition (biochemical and anthropometric indicators) on MS prevalence estimates in a population of overweight and mildly obese children. Design: Cross-sectional study. Subjects: Ninety-nine (64 girls) overweight or mildly obese, but otherwise healthy, pre-pubertal 6-9-year olds recruited for a randomized controlled trial of weight management. Measures: Height, weight and waist circumference were measured with BMI and waist z-scores calculated. Fasting cholesterol and fractions, glucose and insulin were measured, together with systolic and diastolic blood pressure (BP). Anthropometric and metabolic indicators were classified as normal or elevated using adult-or child-specific cut points with clustering of MS indicators also assessed using two adult and three child-specific definitions. Results: A total of 0-4% of subjects were classified with MS when adult definitions were applied. This increased to between 39 and 60% using child-specific definitions, varying according to whether hyperinsulinaemia was central to the MS classification. Systolic BP, triglycerides, total cholesterol, high-density lipoprotein cholesterol and waist z-score increased across insulin quartiles (Po0.05). The use of body mass index and waist circumference in the MS definition classified the same subjects. Conclusions: The classification of MS in children depends strongly on the definition chosen, with MS prevalence estimates higher if insulin is part of the definition and child-specific cut points for metabolic indicators are used. Hyperinsulinaemia and MS are common consequences of childhood obesity but they are not commonly part of the assessment or management plan for weight management in children. There is a need for the establishment of normal insulin ranges and consistent definition of MS in childhood and adolescence.

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Changes in the distribution of body mass index of adults and children in the US population

Cited by 463 publications

References 12 publications

Trends in overweight and obesity and changes in the distribution of body mass index in schoolchildren of Jena, East Germany

Trends in overweight and obesity and changes in the distribution of body mass index in schoolchildren of Jena, East Germany

Thrifty genes for obesity, an attractive but flawed idea, and an alternative perspective: the ‘drifty gene’ hypothesis

Comparison of metabolic syndrome prevalence using six different definitions in overweight pre-pubertal children enrolled in a weight management study

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