Risk factors for overweight and obesity in children aged 2-6 years.

BACKGROUND: Understanding risk factors that may vary culturally can help improve preventive strategies for obesity. This is the first cross-sectional study aimed to determine the risk factors for overweight/obesity in children aged 2-6 years in a central Anatolian city in Turkey. METHODS: A total of 1582 children (1351 healthy, 231 overweight/obese) aged 2-6 years were included from the Anthropometry of Turkish Children aged 0-6 years database. Age, gender, birth weight, birth order, mother's age, mother's body mass index (BMI), weight gain of mothers during pregnancy, presence of gestational diabetes, breastfeeding duration, history of formula feeding, mother's and father's education, mother's job, monthly income, smoking at home and physical activity, sleep duration and duration of television (TV) watching of the children were evaluated as independent risk factors. Logistic regression analyses were performed to investigate risk factors for overweight/obesity. RESULTS: Having a high family income compared to bad [odds ratio (OR)=1.96; 95% confidence interval (CI): 1.237-3.106], increased the time of watching TV during the weekend (OR=1.094; 95% CI: 1.032-1.159), and similar physical activity level according to their peers compared to less (OR=2.957; 95% CI: 1.056-8.282) were found to be significantly associated with a higher risk of overweight/obesity in children aged 2-6 years old. CONCLUSIONS: The early childhood period seems to be important in the establishment of healthy behavioral patterns, especially limitation of TV watching and encouragement of physical activity. Obesogenic environment in families with high incomes need to be revealed.

Neck Circumference to Assess Obesity in Preschool Children.

OBJECTIVE: Limited information is available about the use of neck circumference (NC) to assess obesity in preschool children. This study aims to provide NC percentiles and determine the cut-off levels of NC as a measure to assess obesity in preschool children. METHODS: The data were obtained from the Anthropometry of Turkish Children aged 0-6 years (ATCA-06) study database. A total of 21 family health centers were chosen and children aged 2-6 years old from all socioeconomic levels were randomly selected from the lists of district midwives; 1766 children (874 male and 892 female; 88.3% of sample size) were included in the study. The smoothed centile curves of NC were constructed by the LMS method. Receiver operating characteristic (ROC) analysis was performed to calculate cut-off points for NC using body mass index ≥95th percentile. RESULTS: Mean NC was greater in males than females. Cut-off values for obesity were found to be statistically significant in both genders other than 3 years old boys. The NC percentiles of Turkish preschool children were slightly greater than those of other European preschool children in both genders. This difference disappeared around the adiposity rebound period. The 97th percentile values for Turkish preschool children continue to be greater in both genders. CONCLUSION: NC may be useful to define obesity in preschool children. Since ethnic and various other factors may have a role in incidence of obesity, local reference data are important in assessment of obesity.

Waist circumference percentiles among Turkish children under the age of 6 years.

Waist circumference, a proxy measure of abdominal obesity, is associated with cardio-metabolic risk factors in childhood and adolescence. Although there are numerous studies about waist circumference percentiles in children, only a few studies cover preschool children. The aim of this study was to develop age- and gender-specific waist circumference smoothed reference curves in Turkish preschool children to determine abdominal obesity prevalence and to compare them with reference curves obtained from different countries. The design of the study was cross-sectional. A total of 2,947 children (1,471 boys and 1,476 girls) aged 0-6 years were included in the study. The subjects were divided according to their gender. Waist circumference was measured by using a standardized procedure. The age- and gender-specific waist circumference reference curves were constructed and smoothed with LMS method. The reference values of waist circumference, including 3rd, 10th 25th, 50th, 75th, 90th, and 97th percentiles, and standard deviations were given for preschool children. Waist circumference values increased with age, and there were differences between genders. The prevalence of abdominal obesity was calculated as 10.1 % for boys and 10.7 % for girls. Having compared our data with two other countries' data, we found that our waist circumference data were significantly lower. This is the first cross-sectional study for age- and gender-specific references of 0- to 6-year-old Turkish children. The gender- and age-specific waist circumference percentiles can be used to determine the risk of central obesity.

Weight and height percentiles for 0-84- month-old children in Kayseri--a central Anatolian city in Turkey.

OBJECTIVE: The aim of this study was to present weight and height percentiles for Turkish children aged 0-84 months residing in Kayseri, Turkey and to compare these findings with national references and international standards. METHODS: We used the data from the Anthropometry of Turkish Children aged 0-6 years (ATCA-06) study. This cross-sectional study conducted in Kayseri/Turkey between September 2009 and May 2010 included 2963 children (1491 girls, 1472 boys) aged 0-84 months. The centile curves were constructed using the LMS method. RESULTS: The 3rd, 5th, 10th, 15th, 25th, 50th, 75th, 85th, 90th, 95th, and 97th percentiles and the LMS values for boys and girls were constructed. The 50th percentiles for weight and height of the children were compared with world health organization (WHO) standards and national data. Height and weight values in Kayseri children were lower than WHO standards and Istanbul references in the first year of life. At ages 1 to 4, weight values in both genders and height in boys were slightly higher than the national and international standards. Starting at age 4 years, the weight percentiles of Kayseri children were strikingly higher compared to the national and international standards and the boys were also taller. CONCLUSIONS: This study provides cross-sectional data for weight and height percentiles of Turkish children aged 0-84 months residing in Kayseri. These data reflect the growth status of healthy Kayseri children and also indicate that these children may be more prone to obesity than the Istanbul children. Since the above-mentioned data illustrate the current growth status of this population, we believe that they will serve as a basis for monitoring future trends.

Awareness, knowledge, and use of folic acid among women: a study from Turkey.

PURPOSE: To investigate the awareness, knowledge, and behaviors relevant to folic acid intake in women aged 15-49 years. MATERIALS AND METHODS: A questionnaire designed by the researchers was administered to 1,083 women who attended to family health care centers for any reason, between 1 and 15 of December 2009. RESULTS: Half of the women (53.7%) surveyed did not hear or read about folic acid. Women older than 35 and less-educated women were more unaware of folic acid. Out of 171 pregnant women, 81.3% (139 women) were taking/took vitamin/folic acid supplementation but only 12.2% of the users started to take supplements at least 1 month before conception. Out of 912 non-pregnant women 81 (8.9%) said they are taking any vitamin or mineral supplement. Out of the women who are not pregnant, not using a modern contraceptive method and planning to have a child at the time of the survey, only 9 (10%) were taking vitamin/folic acid. The most common information sources on folic acid were the doctors. CONCLUSION: In order to improve the intake of folic acid during the recommended period, preconceptional counseling by the family doctors to inform women of childbearing age about the need to take folic acid to prevent NTDs seems to be important.

Waterpipe (narghile) smoking among medical and non-medical university students in Turkey.

OBJECTIVES: This investigation was performed in order to determine the prevalence rate of waterpipe smoking in students of Erciyes University and the effects of some socio-demographic factors. METHODS: A total of 645 students who study the first three grades of the medical faculty and the engineering faculty of Erciyes University were enrolled in the study. A questionnaire including 48 questions was applied. Chi-square test and logistic regression method were performed for the statistical analyses. RESULTS: The total prevalence rate of waterpipe smoking was found to be 32.7%. The prevalence rate of waterpipe smoking was 28.6% in the medical and 37.5% in the non-medical students. It was determined that 41.6% of the males and 20.2% of the females currently smoke waterpipe. Gender, cigarette smoking, and the presence of waterpipe smokers among family members and friends have significant effects on the prevalence of waterpipe smoking. Residence and economical status of the family and with whom the students live have no significant effect on the prevalence rate. CONCLUSIONS: Approximately one-third of the students currently smoke waterpipe. Smoking of both cigarette and waterpipe was frequently found. The measures against all tobacco products should be combined.