Most cited article - PubMed ID 26380296
Secular Changes of Adiposity and Motor Development in Czech Preschool Children: Lifestyle Changes in Fifty-Five Year Retrospective Study
BACKGROUND: The long-standing widespread prevalence of obesity includes issues of its evaluation. Nutritional status may be assessed using various tools and methods; among others simple anthropometric measurements are well established. Widely used body mass index (BMI), presents an obstacle of needing to calculate a standard deviation score (SD) for correct use in the child population. As BMI overlooks body composition, it is necessary to evaluate fat and muscle mass with different methods. Established skinfolds and circumferences are used in many variations and equations to accomplish that goal; however, the parameters used in these methods also undergo secular changes. Furthermore, secular changes have been documented in fat mass distribution. The aim of the study is to assess secular changes of skinfolds thickness and body circumferences and evaluate their validity for use in clinical practice and population research. METHODS AND SAMPLE: Our database consisted of a recent (2016-2022) sample with 594 participants (298 males) and a reference sample (from 1990) with 2,910 participants (1,207 males). Both cohorts comprised Czech preschool children, aged 4.00 to 6.99 years. With standard methodology, anthropometric parameters were obtained for 13 skinfolds and eight circumferences, by trained staff. The equations of Slaughter, Durnin and Deurenberg were correspondingly calculated. Statistical evaluation was conducted in the R programming language, using Welch's test, Cohen's d and the Bland-Altman method. RESULTS: Our study found significant increases in skinfold thickness on the abdomen, chest I. and forearm, with high clinical relevance (p ≥ 0.01; d = range from 0.20 to 0.70). Contrastingly, apart from the abdominal area, a decrease of circumferences was observed. The body fat percentage estimation equations were tested for bias in the recent sample in the context of bioimpedance analysis with the Bland-Altman method. All equations are suitable for application in clinical use. DISCUSSION: Documented secular changes in fat mass distribution are only part of a contemporary accelerating trend of obesity prevalence. Our findings support the trend of a decline of circumferences and rise of skinfold thickness in corresponding areas, especially on the limbs, that is evidenced by the trend of latent obesity. The results of the study show the need to complement established diagnostic procedures in childhood obesitology with abdominal and midthigh circumferences and optionally even the maximal circumference of the forearm. These circumferences should always be measured alongside the skinfold thickness of the region. Only in this way can the overall adiposity of an individual with regard to secular changes, including the detection of latent obesity, be objectively evaluated.
- Keywords
- Body circumferences, Fat mass distribution, Obesity, Preschool children, Secular changes, Skinfold thickness,
- MeSH
- Adiposity * MeSH
- Anthropometry methods MeSH
- Body Fat Distribution * MeSH
- Child MeSH
- Body Mass Index MeSH
- Humans MeSH
- Pediatric Obesity epidemiology diagnosis MeSH
- Child, Preschool MeSH
- Body Composition physiology MeSH
- Skinfold Thickness * MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Male MeSH
- Child, Preschool MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic epidemiology MeSH
Normal-weight obesity appears to be an extended diagnosis/syndrome associated with insufficient physical fitness levels and inadequate eating habits at least from school years. However, its relation to long term health parameters in pre-school children remains unknown, even though pre-school age is crucial for the determining healthy lifelong habits. Therefore, the aim of the current study was to investigate the differences in physical fitness level and basic eating habits between normal-weight obese, normal-weight non-obese, and overweight and obese preschoolers. The research sample consisted of 188 preschoolers aged 4.0-6.9 years (Mage = 5.52 ± 0.8 year), normal-weight obese = 25; normal-weight non-obese = 143, overweight and obese = 20. Body composition was measured using bio-impedance InBody230. Six tests assessed the physical fitness level: sit-ups; standing long jump; shuttle running 4 × 5 meters; throwing with a tennis ball; multistage fitness tests; sit and reach. A four-item eating habits questionnaire for parents focusing on breakfast regularity, consumption of sweet foods and drinks, selection of food and attitude towards eating was used. A non-parametric analysis of variance and Fisher's exact test along with suitable effect sizes were used for data processing of physical fitness tests and the basic eating habits questionnaire, respectively. Normal-weight obese children performed significantly worse (from p = 0.03 to p < 0.001, ES ω2-G = low to medium) in muscular fitness, cardiorespiratory fitness and running agility compared to normal-weight non-obese counterparts and did not significantly differ in the majority of physical fitness performance tests from overweight and obese peers. In basic eating habits, normal-weight obese boys preferred significantly more sweet foods and drinks (p = 0.003 ES = 0.35, large), while normal-weight obese girls had significantly more negative attitude towards eating (p = 0.002 ES = 0.33, large) in comparison to their normal-weight non-obese peers. Normal-weight obesity seems to develop from early childhood and is associated with low physical fitness and deficits in eating habits which might inhibit the natural necessity for physically active life from pre-school age or sooner.
- Keywords
- eating habits, normal-weight obesity, physical fitness, preschool age children,
- MeSH
- Exercise MeSH
- Child MeSH
- Humans MeSH
- Pediatric Obesity epidemiology etiology MeSH
- Public Health Surveillance MeSH
- Child, Preschool MeSH
- Cross-Sectional Studies MeSH
- Surveys and Questionnaires MeSH
- Schools MeSH
- Feeding Behavior * MeSH
- Body Weight * MeSH
- Physical Fitness * MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Male MeSH
- Child, Preschool MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
Changes in lifestyle can be significantly reflected in growth and development. Adaptations to reduced levels of physical activity, together with non-corresponding nutritional intakes, can result in body build and body composition changes at an early age. The present cross-sectional study aimed to evaluate the secular trend of modifications of body composition and body mass index (BMI) in Czech preschoolers over the last two to three decades. Boys and girls (386 boys and 372 girls) aged 4 to 6 years in 2014-2019 were measured. Outcome data were compared with the reference sample of preschoolers from 1990: 911 boys and 896 girls. Body height, BMI, and percentage of body fat, muscle, and bone mass were evaluated. Height and BMI have not changed. Body fat increased in both genders (p < 0.01), and contrarily, a significant reduction of muscle and skeletal mass was revealed (p < 0.001). Significant changes in body composition and unchanged BMI indicate the development of latent obesity during the last few decades. Due to latent obesity in a recent cohort, the differences in the prevalence of overweight and obesity markers according to BMI and fat percentage were tested. The prevalence of overweight and obesity was higher by 7.2% in boys, and by 6.5% in girls, as compared to children evaluated according to only their BMI results. Secular changes in preschoolers' physical builds over the last 25 years are not reflected in body height and BMI, but in body composition. Insufficient development of active, lean body mass proportionally compensated by increased fat mass was also indicated.
- Keywords
- body composition, body mass index (BMI), latent obesity, preschool children, secular trend,
- Publication type
- Journal Article MeSH
Modelling of the development of facial morphology during childhood and adolescence is highly useful in forensic and biomedical practice. However, most studies in this area fail to capture the essence of the face as a three-dimensional structure. The main aims of our present study were (1) to construct ageing trajectories for the female and male face between 7 and 17 years of age and (2) to propose a three-dimensional age progression (age -regression) system focused on real growth-related facial changes. Our approach was based on an assessment of a total of 522 three-dimensional (3D) facial scans of Czech children (39 boys, 48 girls) that were longitudinally studied between the ages of 7 to 12 and 12 to 17 years. Facial surface scans were obtained using a Vectra-3D scanner and evaluated using geometric morphometric methods (CPD-DCA, PCA, Hotelling's T2 tests). We observed very similar growth rates between 7 and 10 years in both sexes, followed by an increase in growth velocity in both sexes, with maxima between 11 and 12 years in girls and 11 to 13 years in boys, which are connected with the different timing of the onset of puberty. Based on these partly different ageing trajectories for girls and boys, we simulated the effects of age progression (age regression) on facial scans. In girls, the mean error was 1.81 mm at 12 years and 1.7 mm at 17 years. In boys, the prediction system was slightly less successful: 2.0 mm at 12 years and 1.94 mm at 17 years. The areas with the greatest deviations between predicted and real facial morphology were not important for facial recognition. Changes of body mass index percentiles in children throughout the observation period had no significant influence on the accuracy of the age progression models for both sexes.
- MeSH
- Models, Biological * MeSH
- Child MeSH
- Humans MeSH
- Longitudinal Studies MeSH
- Maxillofacial Development physiology MeSH
- Adolescent MeSH
- Face * MeSH
- Sex Characteristics * MeSH
- Child Development physiology MeSH
- Adolescent Development physiology MeSH
- Imaging, Three-Dimensional * MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Clinical Trial MeSH
- Research Support, Non-U.S. Gov't MeSH
Background: Normal weight obesity in children has been associated with excessive body fat, lower bone density and decreased total lean mass. However, no studies have been done into whether normal weight obese children differ in skeletal robustness or lean mass development on the extremities from normal weight non-obese, overweight, and obese peers although these are important indicators of healthy development of children. Methods: Body height, body weight, BMI, four skinfolds, and two limb circumferences were assessed. We calculated total body fat using Slaughter's equations, the Frame index for skeletal robustness and muscle area for the upper arm and calf using Rolland-Cachera equations. Using national references of BMI and measured skinfolds, three subgroups of participants (9-12 years) consisting of 210 middle-school-aged children (M-age = 11.01 ± 1.05)-110 girls and 100 boys-were selected: (A) overweight obese (OWOB) (n = 72); (B) normal weight obese (NWO) (n = 69); and, (C) normal weight non-obese (NWNO) (n = 69). All values, were converted to Z-scores to take account of participant's sex and age. Results: NWO children had significantly poorer skeletal robustness on lower extremities and poorer muscle area on the upper arm and calf compared to NWNO counterparts with significantly higher evidence in boys-skeletal robustness NWO boys: Z-score = -0.85; NWO girls: Z-score = -0.43; lean mass on the calf: NWO boys Z-score = -1.34; NWO girls: Z-score = -0.85. The highest skeletal robustness-but not muscle area on the calf-was detected in OWOB children. Conclusions: Further research should focus on whether this poor skeletal and lean mass development: (1) is a consequence of insufficient physical activity regimes; (2) affects physical fitness of NWO children and could contribute to a higher prevalence of health problems in them. We have highlighted the importance of the development of a simple identification of NWO children to be used by pediatricians.
- Keywords
- adipose tissue, body mass index, children, lean mass, normal weight obesity, skeletal robustness,
- Publication type
- Journal Article MeSH
BMI, skinfold thickness, and circumferential measures were assessed in groups of normal healthy Czech boys (n = 1764) and girls (n = 1762) 3-6 years of age in the late 1950s and 1960s (sample C), in the 1990s (sample B), and in 2014-2016 (sample A). During these decades BMI has not changed significantly, and in selected groups (boys 3, 5, and 6, girls 3 and 6 years) it was most recently found to be significantly lower (P ≤ 0.05). Subscapular, suprailiac, triceps, midthigh, and above patella skinfold thicknesses significantly increased in sample A as compared to sample C (P ≤ 0.001). Comparison of the same skinfolds measured in the nineties (sample B) and more recently (sample A) showed similar increase of subcutaneous fat (P ≤ 0.001). The increase of adiposity characterized by skinfolds occurring in spite of not markedly changed BMI indicates significant changes of body composition-latent (also hidden) obesity. The increase of adiposity was relatively greatest on the trunk (P ≤ 0.001)-which is considered a marker of the greatest health risk. The decrease of femoral circumference (P ≤ 0.05) along with simultaneous increase of thigh skinfold (P ≤ 0.01) revealed the decrease of muscle mass in the lower extremity, obviously due to the reduction of weight-transferring physical activity.
- MeSH
- Adiposity physiology MeSH
- Anthropometry MeSH
- Child MeSH
- Body Mass Index MeSH
- Humans MeSH
- Obesity epidemiology physiopathology MeSH
- Child, Preschool MeSH
- Body Composition physiology MeSH
- Body Weight MeSH
- Adipose Tissue physiopathology MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Male MeSH
- Child, Preschool MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic epidemiology MeSH
BACKGROUND: To explore the time trends (2005-2015) of pedometer-determined weekday and weekend physical activity (PA) and obesity prevalence in 4-7-year-old Czech preschool children and changes in proportion of kindergarten vs. leisure-time PA. METHODS: The study compared data of two cross-sectional cohorts of preschool children (2005: 92 boys and 84 girls; 2015: 105 boys and 87 girls) in the Czech Republic, using the same measurements and procedures in both cases. PA was monitored by the Yamax Digiwalker SW-200 pedometer for at least eight continuous hours a day over seven consecutive days. Body weight and height were measured using calibrated Tanita scales and anthropometry. The analysis of variance was conducted to examine the gender and cohort effect on step counts. The t-test was used to examine the difference in step counts in kindergarten (or leisure-time) between non-obese and obese children, and the chi-square test compared the prevalence of obesity between 2005 and 2015. RESULTS: The steps/day (mean ± standard deviation) of preschoolers was significantly higher (p < 0.05) in 2015 (11,739 ± 4,229 steps/day) than in 2005 (10,922 ± 3,181 steps/day); and (p < 0.001) in boys (11,939 ± 3,855 steps/day) than in girls (10,668 ± 3,587 steps/day). In 2015, girls, but not boys, had a significantly (p < 0.01) greater step count on weekdays than in 2005, but not at weekends. A decline of leisure-time step counts on weekdays between 2005 and 2015 in girls (6,8652005 vs. 6,0592015, p < 0.01) and boys (7,8612005 vs. 6,4362015, p < 0.001) is compensated for by the increase of step counts in kindergarten (girls: 3,0582005 vs. 5,3302015, and boys: 4,0032005 vs. 5,9992015, p < 0.001). The prevalence of obesity was not significantly different either in 2005 or 2015 among preschool girls (7.14 % 2005 vs. 9.20 % 2015) or boys (6.52 % 2005 vs. 9.52 % 2015). CONCLUSION: The steps/day of preschoolers was higher in 2015 than in 2005; this higher level of PA was the result of increased PA in kindergartens over the last ten years, particularly among girls. Thus, the current PA program in kindergartens effectively compensates for the decline in PA in leisure-time of weekdays of non-obese and obese preschoolers compared to 2005 and 2015. Prevalence of obesity among Czech preschool children remains relatively stable between 2005 and 2015.
- Keywords
- Kindergarten, Leisure-time, Obesity, Step count, Trend, Weekdays, Weekend, Yamax pedometer,
- MeSH
- Actigraphy methods MeSH
- Analysis of Variance MeSH
- Anthropometry MeSH
- Time MeSH
- Exercise * MeSH
- Child MeSH
- Calibration MeSH
- Humans MeSH
- Pediatric Obesity epidemiology MeSH
- Child, Preschool MeSH
- Prevalence MeSH
- Cross-Sectional Studies MeSH
- Chi-Square Distribution MeSH
- Sex Factors MeSH
- Leisure Activities * MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Male MeSH
- Child, Preschool MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Comparative Study MeSH
- Geographicals
- Czech Republic epidemiology MeSH