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Growth of schoolchildren: studies on somatic growth and deviant growth patterns such as weight loss and obesity and aspects of intake of breakfast and food items
Örebro University, School of Hospitality, Culinary Arts & Meal Science.ORCID iD: 0000-0002-8675-6284
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis is to explore somatic growth, and deviant growth patterns as episodes of weight loss and obesity development, including some aspects of meal patterns and food intake.

Methods: The thesis includes four studies, two cross-sectional studies (Paper I and II), and two longitudinal studies (Paper III and IV).

The first paper looks at assessment of BMI categories (underweight, overweight and obesity) prevalence and how the results relate to which growth reference that is used. Height and weight measurements of 4,518 Swedish schoolchildren aged 7–9 years were collected in 2008 using a standardised protocol from World Health Organization (WHO). Four growth references were used, from the WHO, the International Obesity Task Force (IOTF) and two Swedish growth references from Werner and Karlberg et al. (Paper I). Parts of the same data set plus a follow-up data set from 2010 was used to investigate correlations with deviances in BMI in relation to breakfast habits and selected food frequencies.

For paper three and four, a longitudinal material from two nationally representative samples was used with height and weight data of 6,572 schoolchildren, born 1973 and 1981. Episodes of BMI reduction of 10% or more were identified and correlated to final height (Paper III). The same material was used for paper four to further investigate growth patterns on group level by use of weight for height, Tri-Ponderal Mass Index (TMI), apart from BMI. On individual level, weight at age 7 years and weight at 16 years for girls and 18 years for boys, were categorized in monthly values and expressed in standard deviation (from ≤ -2 to ≥ +3 SD) (Paper IV).

Results: Depending on which growth reference we used, the prevalence of different degrees of thinness varied greatly. There were also significant gender differences depending on the growth reference we used (Paper I).

The majority of parents reported that their children (95.4%) had breakfast every day. The odds of being OW/OB was higher among those not having breakfast every day (odds ratio (OR) 1.9, drinking diet soft drinks OR 2.6, 95% and skimmed/semi-skimmed milk OR 1.8), four days a week or more (Paper II).

There was no statistically significant difference on group level in final height between individuals with and individuals without BMI reduction, independent of age and if the individuals were thin, normal weight, overweight or obese at the start of the BMI reduction episode (Paper III).

Almost the same longitudinal growth patterns were found for the two cohorts, even if weight and BMI for all almost all ages were higher in 1981 cohort. Patterns for TMI differs from those of W/H and BMI. Three main longitudinal trajectories represent the description of weight development from 7–16 years for girls and 7–18 years for boys. These patterns were mainly the same in the 1981 cohort and the 1973 cohort. (Paper IV).

Place, publisher, year, edition, pages
Örebro: Örebro University , 2018. , p. 111
Series
Örebro Studies in Culinary Arts and Meal Science, ISSN 1652-2974 ; 13
Keywords [en]
growth, body mass index, overweight, weight loss, body weight, malnutrition, breakfast intake, food habits, schoolchildren
National Category
Social Sciences Interdisciplinary
Identifiers
URN: urn:nbn:se:oru:diva-64726ISBN: 978-91-7529-231-1 (print)OAI: oai:DiVA.org:oru-64726DiVA, id: diva2:1179138
Public defence
2018-03-16, Örebro universitet, Campus Grythyttan, Gastronomiska teatern, Sörälgsvägen 2, Grythyttan, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2018-01-31 Created: 2018-01-31 Last updated: 2018-05-25Bibliographically approved
List of papers
1. Using different growth references to measure thinness and overweight among Swedish primary school children showed considerable variations
Open this publication in new window or tab >>Using different growth references to measure thinness and overweight among Swedish primary school children showed considerable variations
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2016 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, no 10, p. 1158-1165Article in journal (Refereed) Published
Abstract [en]

Aim: The study compared how four different growth references determined the prevalence of thinness and overweight, based on height and weight measurements from a nationally representative sample of Swedish children from seven to nine years of age.

Methods: The height and weight measurements of 4,518 Swedish schoolchildren aged seven to nine years were carried out in 2008 using a standardised protocol. The prevalence of different degrees of thinness and overweight were calculated using international growth references from the World Health Organization, the International Obesity Task Force and two Swedish growth references from Werner and Karlberg.

Results: Depending on which growth reference we used, the prevalence of different degrees of thinness varied from 7.5%-16.9% for the boys and 6.9%-13.7% for the girls, while for the prevalence of overweight, including obesity and severe obesity, varied from 16.5%-25.7% for the boys and 18.2-25.2% for the girls. There were also significant gender differences depending on the growth reference we used.

Conclusion: Using four different growth references, two international and two Swedish, produced wide variations in the prevalence of thinness and overweight, together with significant gender differences. In the absence of a global definition, we need both national and international growth references.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2016
Keywords
Body mass index cut-off levels, childhood, crowth surveillance, obesity, underweight
National Category
Nutrition and Dietetics Pediatrics
Research subject
Culinary Arts and Meal Science; Nutrition; Pediatrics
Identifiers
urn:nbn:se:oru:diva-50027 (URN)10.1111/apa.13400 (DOI)000383619400022 ()26991338 (PubMedID)2-s2.0-84987846807 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2006-1624, 2006-1506Swedish Research Council, 7509, 2006-7777
Note

Funding Agencies:

Örebro University, Sweden

Oslo and Akershus University College, Norway

The Swedish University Hospital (ALF)

Karolinska Institut

Region Västra Götaland

Available from: 2016-04-28 Created: 2016-04-28 Last updated: 2018-02-21Bibliographically approved
2. Reported habitual intake of breakfast and selected foods in relation to overweight status among seven-to nine-year-old Swedish children
Open this publication in new window or tab >>Reported habitual intake of breakfast and selected foods in relation to overweight status among seven-to nine-year-old Swedish children
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2017 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, no 8, p. 886-894Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of this study was to examine the reported frequency of breakfast intake and selected food and beverages in the investigated group of Swedish children in comparison with recommended intakes. Furthermore, the study analyses these food habits and some demographic and lifestyle factors in relation to overweight and obesity.

Methods: This cross-sectional study builds on data collected in 2008 and 2010. Measured anthropometric data and parent questionnaire data were collected. A total of 2620 Swedish children (52.1% boys) aged seven to nine years were included.

Results: The majority of parents reported that their children (95.4%) had breakfast every day. The majority of children had fresh fruit (84.7%) and vegetables (83.9%) most days a week. Only 1.6% of the children were reported to have fast food and 6.0% to have sugar containing soft drinks, four days a week or more. The prevalence of overweight including obesity (OW/OB) was 17.8% for boys, 18.6% for girls. The odds of being OW/OB was higher among those not having breakfast every day (odds ratio (OR) 1.9, 95% confidence interval (CI) 1.20-2.96), drinking diet soft drink (OR 2.6, 95% CI 1.52-4.42) and skimmed/semi-skimmed milk (OR 1.8, 95% CI 1.37-2.36) four days a week or more. Parents being overweight and having low education levels were also related to a higher risk of their children being overweight.

Conclusions: The parental reports of children's food habits pointed at favourable eating patterns for most investigated children. Breakfast skipping, diet soft drinks and low-fat milk consumption were more frequent among OW/OB children. Longitudinal studies are needed to determine the causal relationships.

Place, publisher, year, edition, pages
Sage Publications, 2017
Keywords
Child growth, breakfast, food habits, WHO Childhood Obesity Surveillance Initiative
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:oru:diva-63801 (URN)10.1177/1403494817724951 (DOI)000418185200021 ()29160159 (PubMedID)2-s2.0-85038350923 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and WelfareThe Karolinska Institutet's Research Foundation
Available from: 2018-01-03 Created: 2018-01-03 Last updated: 2018-03-20Bibliographically approved
3. Do substantial BMI reduction episodes among Swedish schoolchildren have any impact on their final height?
Open this publication in new window or tab >>Do substantial BMI reduction episodes among Swedish schoolchildren have any impact on their final height?
2018 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, no 7, p. 1223-1229Article in journal (Refereed) Published
Abstract [en]

AIM: This study investigated whether substantial body mass index (BMI) reductions in Swedish schoolchildren aged 7-19 years, caused by disease, healthy or unhealthy behaviour, had any impact on their final height.

METHODS: We used height and weight data on 6,572 subjects from two nationally representative longitudinal samples of Swedish children born in 1973 and 1981. These provided information on their final height and any BMI reduction episodes.

RESULTS: Of the 6,572 subjects (50.9% boys), among individuals with information on final height, 1,118 had a BMI reduction of 5% and less than 10%, and 346 had at least one substantial BMI reduction of 10% of more. On a group level, there was no statistically significant difference in the final height of individuals with BMI reductions of 10% or more and those without. The findings were independent of age and the subject's BMI at the start of the reduction episode. However, there were a number of cases where a substantial BMI reduction probably had an impact on the subject's final height.

CONCLUSION: Our study found no evidence that a substantial BMI reduction had any impact on final height on a group level, but further analyses of specific case studies are necessary to determine whether substantial BMI reduction might have an impact on final height.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
Body Mass Index reduction, final height, longitudinal study, schoolchildren, weight loss
National Category
Pediatrics
Identifiers
urn:nbn:se:oru:diva-64913 (URN)10.1111/apa.14258 (DOI)000435258200018 ()29405369 (PubMedID)2-s2.0-85042559671 (Scopus ID)
Available from: 2018-02-08 Created: 2018-02-08 Last updated: 2018-07-24Bibliographically approved
4. The longitudinal development of body weight among individuals from age 7 to 18 years in Sweden
Open this publication in new window or tab >>The longitudinal development of body weight among individuals from age 7 to 18 years in Sweden
(English)Manuscript (preprint) (Other academic)
National Category
Social Sciences Interdisciplinary
Research subject
Culinary Arts and Meal Science
Identifiers
urn:nbn:se:oru:diva-65118 (URN)
Available from: 2018-02-21 Created: 2018-02-21 Last updated: 2018-02-21Bibliographically approved

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Nilsen, Bente B.

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