Physical activity, sedentary behaviors and dietary patterns as risk factors of obesity among Jordanian schoolchildren.

OBJECTIVE: To identify certain risk factors associated with childhood obesity related to lifestyle; dietary patterns, physical activity, and sedentary behavior. METHODS: A cross-sectional study was conducted among 977 schoolchildren (473 boys and 449 girls) aged 7-18 years. Children were selected randomly from three main cities in Jordan: Amman, Irbid, and Mafraq by using multistage cluster sampling method. Sedentary behaviors, physical activity and child eating behaviors were measured by using validated questionnaires. Overweight and obesity were defined by International Obesity Task Force (IOTF) criteria. RESULTS: Sedentary activities increase the risk of overweight among schoolchildren by 2-fold [RR(Relative risk) = 2.0, 95% CI(Confidence interval) (1.1-3.6), p = 0.02]. Whereas, sedentary activities for less than 3 h increased the risk of overweight by 0.8-fold [RR = 0.8, 95%CI (0.6-1.3), P = 0.388], Schoolchildren who spent<30 min/day in exercising decreased the risk of overweight by 0.5-fold [RR = 0.5, 95% CI (0.2-1.0), P = 0.06)]. Both Students who ate one meal daily and daily ate snacks from schools cafeterias had a higher tendency to be obese [(RR = 1.8, 95%CI (0.5-5.9), P = 0.368], and [RR = 1.5, 95%CI (0.9-2.5), P = 0.169] respectively. CONCLUSIONS: Physical activity, eating meals regularly and homemade food, all together play a significant role in decreasing obesity among Jordanian schoolchildren, thus a national policy that promoting active living and healthy eating among schoolchildren is warranted.

Markers of subclinical atherosclerosis in schoolchildren with obesity and metabolic syndrome.

BACKGROUND: Although increased carotid intima-media thickness (cIMT), soluble adhesion molecules and proinflammatory biomarkers are strongly implicated in the development of atherosclerotic lesions, the role of obesity and metabolic syndrome (MetS) in atherogenicity and inflammation among schoolchildren is not well investigated. AIM: To determine the levels of cIMT, endothelial dysfunction and inflammatory biomarkers in a group of schoolchildren with obesity and MetS. METHODS: Eighty-seven schoolchildren (age 10-15 years) were categorised into three groups: normal bodyweight group, obese group and severely obese with MetS group (17 boys and 12 girls in each group). Levels of cIMT were measured with high-resolution B-mode ultrasound. Serum proinflammatory cytokines interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1ß), and soluble adhesion molecules E-selectin, vascular cell adhesion molecule-1 (VCAM-1), and intercellular adhesion molecule-1(ICAM-1) were measured. RESULTS: Mean cIMT levels were significantly higher (p 0.05) among severely obese schoolchildren with MetS (0.49 ± 0.02 mm) compared with both the obese (0.43 ± 0.03 mm) and the normal bodyweight counterparts (0.36 ± 0.03 mm). Serum levels of IL-6, TNF-α, IL-1ß, E-selectin, VCAM-1 and ICAM-1 were significantly higher (p 0.05) in severely obese with MetS and obese children compared with the normal bodyweight group. However, no significant differences (p >0.05) were found between the severely obese schoolchildren with MetS and the obese without MetS. CONCLUSIONS: Severely obese schoolchildren having MetS exhibited higher cIMT levels than obese and normal bodyweight counterparts. Biomarkers of inflammation and endothelial dysfunction were higher in obese schoolchildren, but biomarkers were not increased any further by the degree of obesity nor the MetS cluster.

Markers of subclinical atherosclerosis in schoolchildren with obesity and metabolic syndrome.

BACKGROUND: Although increased carotid intima-media thickness (cIMT), soluble adhesion molecules and proinflammatory biomarkers are strongly implicated in the development of atherosclerotic lesions, the role of obesity and metabolic syndrome (MetS) in atherogenicity and inflammation among schoolchildren is not well investigated. AIM: To determine the levels of cIMT, endothelial dysfunction and inflammatory biomarkers in a group of schoolchildren with obesity and MetS. METHODS: Eighty-seven schoolchildren (age 10-15 years) were categorised into three groups: normal bodyweight group, obese group and severely obese with MetS group (17 boys and 12 girls in each group). Levels of cIMT were measured with high-resolution B-mode ultrasound. Serum proinflammatory cytokines interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1ß), and soluble adhesion molecules E-selectin, vascular cell adhesion molecule-1 (VCAM-1), and intercellular adhesion molecule-1(ICAM-1) were measured. RESULTS: Mean cIMT levels were significantly higher (p 0.05) among severely obese schoolchildren with MetS (0.49 ± 0.02 mm) compared with both the obese (0.43 ± 0.03 mm) and the normal bodyweight counterparts (0.36 ± 0.03 mm). Serum levels of IL-6, TNF-α, IL-1ß, E-selectin, VCAM-1 and ICAM-1 were significantly higher (p 0.05) in severely obese with MetS and obese children compared with the normal bodyweight group. However, no significant differences (p >0.05) were found between the severely obese schoolchildren with MetS and the obese without MetS. CONCLUSIONS: Severely obese schoolchildren having MetS exhibited higher cIMT levels than obese and normal bodyweight counterparts. Biomarkers of inflammation and endothelial dysfunction were higher in obese schoolchildren, but biomarkers were not increased any further by the degree of obesity nor the MetS cluster.

Effectiveness of intermittent iron treatment of two- to six-year-old Jordanian children with iron-deficiency anemia.

BACKGROUND: Iron deficiency is a common nutritional problem in young children among vulnerable populations in Jordan. Several studies have shown the effectiveness of intermittent iron supplementation in improving iron status. Such a study has not been carried out in 2- to-6-year-old Jordanian children diagnosed with iron deficiency anemia in a clinical setting. OBJECTIVE: To study the effectiveness of intermittent versus daily iron treatment in a clinical setting in 2- to 6-year-old Jordanian children with iron-deficiency anemia. METHODS: About 4400 children aged 2 to 6 years who visited Prince Hashim Military Hospital in Zarqa, Jordan, from August 2000 to June 2001 were screened for age, general health, and birthweight. About 10% of these children were screened for anemia, using complete blood count (defined as a hemoglobin level < or = 10.5 g/dL, and a mean corpuscular volume < or =75 ft). Anemic children underwent further screening for iron deficiency, defined as serum ferritin level < or =12 microg/L. Children with iron-deficiency anemia, as indicated by hemoglobin < or = 10.5 g/dL, mean corpuscular volume < or =75 fL, and serum ferritin < or =12 microg/L, or as indicated by mean corpuscular volume < or =75 fL and hemoglobin < or = 10.5 g/dL, were enrolled in the study after informed oral consent by their parents. Study children (n=134) were assigned randomly to one of three groups. Subjects in group 1 (n=45), group 2 (n=45), and group 3 (n=44) received iron treatment daily, weekly, and twice weekly, respectively. Out of 134 children recruited for the study, only 63 (39 boys and 24 girls) completed the 3-month treatment period. All of the children received medicinal iron drops at a dosage of 5 mg elemental iron as ferrous sulfate per kilogram of body weight. The parents also received nutritional counseling. RESULTS: At the end of treatment, hemoglobin, serum ferritin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration increased significantly in all groups with no significant differences between groups. The increases in hemoglobin in groups 1, 2, and 3 were 2.47 +/- 0.17, 2.12 +/- 0.18, and 2.18 +/- 0.18 g/dL, respectively. Measurements of final serum ferritin concentration were available for only 12, 12, and 10 children in groups 1, 2, and 3, respectively. In all children who completed the study, except for one in group 1, hemoglobin, mean corpuscular volume, and serum ferritin reached normal values in response to iron treatment. CONCLUSIONS: Weekly and twice-weekly iron therapy with 5 mg elemental iron as ferrous sulfate per kilogram of body weight accompanied by nutritional counseling was as effective as daily iron therapy in correcting iron-deficiency anemia in 2- to 6-year-old children under the clinical conditions of this study.