Dr S Saxena 1 Dr G Ambler 2 Prof. TJ Cole 3 Prof A. Majeed 1 1 Imperial College London, 2 UCLH...
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Transcript of Dr S Saxena 1 Dr G Ambler 2 Prof. TJ Cole 3 Prof A. Majeed 1 1 Imperial College London, 2 UCLH...
![Page 1: Dr S Saxena 1 Dr G Ambler 2 Prof. TJ Cole 3 Prof A. Majeed 1 1 Imperial College London, 2 UCLH Trust, 3 Institute of Child Health.](https://reader035.fdocuments.in/reader035/viewer/2022062404/5515f5f055034694308b46de/html5/thumbnails/1.jpg)
Dr S Saxena1 Dr G Ambler2
Prof. TJ Cole3 Prof A. Majeed1
1Imperial College London, 2UCLH Trust, 3Institute of Child Health
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England and Scotland have one of the fastest growing obesity rates in the world….more than doubled between 1980 and the early nineties...(2001 figures) show 21% of men and 23.5% of women over 16 years have a Body Mass Index of 30 or more in England.
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Background
• Obesity epidemic world wide
• US rising faster in African-Americans
• British South Asians & Afro-Caribbean adults at risk of cardiac disease
• British South Asian children have worse biochemical risk profiles for cardiac disease
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Interrelationships
Diabetes
Cardiovascular disease
Black Caribbean
S. Asian ethnicity
Obesity
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Aims
To compare the percentage of obese or overweight children within different ethnic and socio-economic groups
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Health Survey for England1999
• Annual cross sectional survey
• Focus on ethnic minority groups
• Random sampling of private households
• Interview & nurse visit for measurements
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Sampling
Ethnic boostn=3891
Ethnic groupsn=4857
General Populationn=6552
“Core”general
pop n=2061
Chinese n=342
Ethnicgroupsn=354
postcode sectors
household
screening
Systematic samplingRandom sampling
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Ethnic group categories in HSE99
‘Chinese’
‘Bangladeshi’
‘Pakistani’
‘Indian’
‘Afro-Caribbean’
‘General population’
ETHNIC GROUPS COMPARED
‘Irish’
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height 2weight /BMI =(kg) (m)(kg/m2)
Body Mass Index
Measure
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*US reference population # UK growth reference charts (1991)
Defining obesity in children
Adults overweight: BMI 25 kg/m2
obese: BMI 30 kg/m2*
• In children, BMI rapidly changes with age• In US,85th and 95th centile for OW and OB*• UK growth reference charts adopt this#
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IOTF standard 2000
Overweight Obesity
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% Response rates
Gen Pop Ethnic boost
Household 76 71
Interview 97 92-96
Nurse visit 89 86
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Results : Socio-economic status of ethnic groups
Social Ethnicity
class
G.PopAC Ind Pak Bang Chin Irish
I+II 34 22 28 18 9 37 39
IIIn 13 22 10 6 7 16 15
IIIm 31 22 30 40 35 31 29
IV+V 20 28 28 23 33 10 16
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Results : Socio-economic status of ethnic groups
Social Ethnicity
class
G.PopAC Ind Pak Bang Chin Irish
I+II 34 22 28 18 9 37 39
IIIn 13 22 10 6 7 16 15
IIIm 31 22 30 40 35 31 29
IV+V 20 28 28 23 33 10 16
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Risk of being overweight in girls by social class
0
0.4
0.8
1.2
1.6
I & II IIIn IIIm IV&V
Ad
just
ed o
dd
s ra
tios
Social class
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Risk of being overweight in boys by social class
0
0.4
0.8
1.2
1.6
I & II IIIn IIIm IV&V
Ad
just
ed o
dd
s ra
tio
Social class
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Risk overweight in boys by ethnic group
0
0.5
1
1.5
2
2.5
3
Genpopn
Afro-Carib
Indian Pakistani Bangla Chinese Irish
Ethnic group
Ad
just
ed
od
ds
rat
io
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Risk overweight in girls by ethnic group
Ethnic group
0
0.5
1
1.5
2
2.5
Genpopn
Afro-Carib
Indian Pakistani Bangla Chinese Irish
Ad
just
ed
od
ds
rat
io
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Risk of obesity in boys by ethnic group
0
0.5
1
1.5
2
2.5
3
Genpopn
Afro-Carib
Indian Pakistani Bangla Chinese Irish
Ethnic group
Ad
just
ed
od
ds
rat
io
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Risk of obesity in girls by ethnic group
00.5
11.5
22.5
33.5
4
4.55
Genpopn
Afro-Carib
Indian Pakistani Bangla Chinese Irish
Ethnic group
Ad
just
ed
od
ds
rat
io
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Strengths of study
Power: Large
Representative:Population based study
Measure: Objective (BMI)
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Ethnic group comparisons: limitations
• Different heights for same BMI
• Different fat composition for same BMI
• Ethnic group reported by parent
• Data cross sectional
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Conclusions
• Ethnicity strong determinant of obesity in children
• British Afro-Caribbean & Pakistani girls at increased risk of obesity
• Indian and Pakistani boys more likely to be overweight
• Social class differences do not contribute to obesity in children
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Possible explanations
Biologicalgenetic
susceptibility
Behaviouraldiet
exercise patterns
Factors related to ethnic group
ENERG Y REG ULATIO N
Body fat stores
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Future studies
• Longitudinal studies for cumulative risk
• Develop standards for child obesity
• Include ethnicity in assessing cardiac risk