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Monasta L.,Institute for Maternal and Child Health IRCCS Burlo Garofolo | Lobstein T.,International Association for the Study of Obesity | Cole T.J.,University College London | Vignerova J.,National Institute of Public Health | Cattaneo A.,Institute for Maternal and Child Health IRCCS Burlo Garofolo
Obesity Reviews | Year: 2011

Two international datasets are used to define overweight and obesity in pre-school children: the International Obesity Task Force (IOTF) reference and the WHO standard. This study compares the performance of the two datasets in defining overweight and obesity in 24-60 months old children. This was done by plotting the IOTF cut-offs against WHO curves and by comparing the prevalence of overweight and obesity, as defined by the IOTF reference and by the WHO standard, using 2001 data from the Czech Republic. The IOTF cut-off for overweight in 24-60 months old children goes from 1.7 to 1.1 z-scores on the WHO chart, and for obesity it shifts with age from 2.7 to 2.2 z-scores. As a consequence, at 5 years of age the prevalence of overweight in Czech girls is 3.4% using the WHO and 15.3% using the IOTF definition. These discrepancies are due to the choice of cut-offs and to the different criteria used to select the sample for the IOTF reference and the WHO standard. Research is urgently needed to identify, for the WHO standard, BMI cut-offs associated with an increased risk of overweight and obesity, and associated health outcomes later in life. © 2010 The Authors. obesity reviews © 2010 International Association for the Study of Obesity. Source


Lobstein T.,International Association for the Study of Obesity
Appetite | Year: 2013

A series of meetings on the topic of children's exposure to the marketing of food and beverages was held between researchers and government officials based in Europe and the Americas during 2010-2011. The meetings resulted in a number of outputs, including observations from policy-makers on the types of evidence they needed to strengthen policy-making. Their observations on the definitions of a child, the specification of foods using nutrient profiling schemes, the types of media carrying marketing messages, and the related policy implementation problems, are summarised in this Short Communication. The paper highlights the need for research which can directly support policy-making and which can evaluate its effectiveness. © 2012 Elsevier Ltd. Source


Cole T.J.,University College London | Lobstein T.,International Association for the Study of Obesity
Pediatric Obesity | Year: 2012

Background: The international (International Obesity Task Force; IOTF) body mass index (BMI) cut-offs are widely used to assess the prevalence of child overweight, obesity and thinness. Based on data from six countries fitted by the LMS method, they link BMI values at 18 years (16, 17, 18.5, 25 and 30 kg m-2) to child centiles, which are averaged across the countries. Unlike other BMI references, e.g. The World Health Organization (WHO) standard, these cut-offs cannot be expressed as centiles (e.g. 85th). Methods: To address this, we averaged the previously unpublished L, M and S curves for the six countries, and used them to derive new cut-offs defined in terms of the centiles at 18 years corresponding to each BMI value. These new cut-offs were compared with the originals, and with the WHO standard and reference, by measuring their prevalence rates based on US and Chinese data. Results: The new cut-offs were virtually identical to the originals, giving prevalence rates differing by <0.2% on average. The discrepancies were smaller for overweight and obesity than for thinness. The international and WHO prevalences were systematically different before/after age 5. Conclusions: Defining the international cut-offs in terms of the underlying LMS curves has several benefits. New cut-offs are easy to derive (e.g. BMI 35 for morbid obesity), and they can be expressed as BMI centiles (e.g. boys obesity = 98.9th centile), allowing them to be compared with other BMI references. For WHO, median BMI is relatively low in early life and high at older ages, probably due to its method of construction. © 2012 The Author. Source


Lobstein T.,International Association for the Study of Obesity
Proceedings of the Nutrition Society | Year: 2011

The recent rise in the prevalence of obesity in the UK population includes women of reproductive age and children. For both groups there are specific health concerns consequent on excess bodyweight, including obstetric complications, fetal growth abnormalities and a range of obesity co-morbidities seen in children that were rarely found in young people a generation earlier. This paper identifies some of the issues which challenge policy-makers: guidelines for gestational weight gain and for weight loss after pregnancy; inequalities and interventions in pregnancy; interventions to prevent child obesity; and the role of individuals, government and the commercial sector in implementing policies for promoting healthy weight. © 2011 The Author. Source


Knai C.,London School of Hygiene and Tropical Medicine | Lobstein T.,International Association for the Study of Obesity | Darmon N.,Aix - Marseille University | Rutter H.,London School of Hygiene and Tropical Medicine | McKee M.,London School of Hygiene and Tropical Medicine
International Journal of Environmental Research and Public Health | Year: 2012

There is growing evidence of social disparities in overweight among European children. This paper examines whether there is an association between socioeconomic inequality and prevalence of child overweight in European countries, and if socioeconomic disparities in child overweight are increasing. We analyse cross-country comparisons of household inequality and child overweight prevalence in Europe and review within-country variations over time of childhood overweight by social grouping, drawn from a review of the literature. Data from 22 European countries suggest that greater inequality in household income is positively associated with both self-reported and measured child overweight prevalence. Moreover, seven studies from four countries reported on the influence of socioeconomic factors on the distribution of child overweight over time. Four out of seven reported widening social disparities in childhood overweight, a fifth found statistically significant disparities only in a small sub-group, one found non-statistically significant disparities, and a lack of social gradient was reported in the last study. Where there is evidence of a widening social gradient in child overweight, it is likely that the changes in lifestyles and dietary habits involved in the increase in the prevalence of overweight have had a less favourable impact in low socio-economic status groups than in the rest of the population. More profound structural changes, based on population-wide social and environmental interventions are needed to halt the increasing social gradient in child overweight in current and future generations. © 2012 by the authors; licensee MDPI, Basel, Switzerland. Source

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