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Obesity, fitness and health in Taiwanese children and adolescents

Abstract

Objective:

To examine the prevalence of childhood and adolescent obesity in Taiwan and investigate the association between excess weight and physical fitness and blood pressure.

Design:

Cross-sectional study.

Subjects:

A total of 13 935 children and adolescents aged 6–18 years (boys: 7031, girls: 6904) were involved in the 1999 survey and 24 586 (boys: 12 367, girls: 12 219) were available in the 2001 survey.

Measurements:

Weight, height, systolic and diastolic blood pressures, and health-related fitness tests (bent-leg curl-ups, sit-and-reach test and step test) were measured.

Results:

The overall prevalence of obesity (including overweight) in boys was 19.8% in 1999 and 26.8% in 2001. It was lower in girls with 15.2% in 1999 and 16.5% in 2001. The normal weight group performed better (P<0.05) than the overweight/obese group in all fitness tests except in the 2001 sit-and-reach test where there were no differences between the two groups. The risk of hypertension increased nearly two times for the overweight/obese-fit group and nearly three times for the overweight/obese-unfit group compared to the normal weight-fit group (adjusted odds ratio (AOR)=1.93, 95%CI=1.514–2.451 and AOR=2.93, 95%CI=2.493–3.454, respectively).

Conclusion:

Overall, the findings demonstrated that there is an increasing trend in overweight/obesity prevalence for Taiwanese youth even in a 2-year period. The overweight/obese youngsters tend to have poorer muscular strength and cardiovascular endurance than the normal weight group. The overweight/obese and unfit group had a greater risk of hypertension than other groups. However, this risk was significantly lower if obese/overweight children had a higher than average level of cardiovascular fitness.

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References

  • American College of Sports Medicine (2003). ACSM Fitness Book, 3rd edn. Human Kinetics: Champaign.

  • Blair SN, Kohl III HW, Paffenberger RS, Clark DG, Gibbons LW (1989). Physical fitness and all-cause mortality: a prospective study of healthy men and women. JAMA 262 (17), 2395–2401.

    Article  CAS  PubMed  Google Scholar 

  • Blair SN, Kampert JB, Kohl III HW, Barlow CE, Macera CA, Paffenbarger RS et al. (1996). Influences of cardioreapiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. JAMA 276, 205–210.

    Article  CAS  PubMed  Google Scholar 

  • Bosco JS, Gustafson WF (1983). Measurement and Evaluation in Physical Education, Fitness, and Sports. Prentice-Hall: New Jersey.

    Google Scholar 

  • Brodney S, Blair SN, Lee CD (2000). Is it possible to be overweight or obese and fit and healthy?. In: Bouchard C (ed). Physical Activity and Obesity. Human Kinetics: Champaign, 355–371.

    Google Scholar 

  • Burke V, Beilin LJ, Dunbar D, Kevan M (2004). Associations between blood pressure and overweight defined by new standards for body mass index in childhood. Prev Med 38, 558–564.

    Article  CAS  PubMed  Google Scholar 

  • Calderon KS, Yucha CB, Schaffer SD (2005). Obesity-related cardiovascular risk factors: intervention recommendations to decrease adolescent obesity. J Pediatr Nurs 20 (1), 3–14.

    Article  PubMed  Google Scholar 

  • Chen W, Wu KW, Mi LL, Liu JL (1993). Weight-for-length index in evaluation of children's body weight status: a simple and accurate method. J Formos Med Assoc (Taiwan) 92 (Suppl 3), S128–S134.

    Google Scholar 

  • Chen W, Lin CC, Peng CT, Li CI, Wu HC, Chiang J et al. (2002). Approaching healthy body mass index norms for children and adolescents from health-related physical fitness. Obes Rev 3, 225–232.

    Article  CAS  PubMed  Google Scholar 

  • Chu NF (2004). Prevalence of obesity in Taiwan. In: Department of Health (ed). Symposium on Nutrition Monitoring and Health Policy Development. Department of Health: Taiwan.

    Google Scholar 

  • Chu N, Rimm EB, Wang D, Liou H, Shieh S (1998). Clustering of cardiovascular disease risk factors among obese schoolchildren: the Taipei Heart Study. Am J Clin Nutr 67, 1141–1146.

    Article  CAS  PubMed  Google Scholar 

  • Chu NF (2001). Prevalence and trends of obesity among school children in Taiwan – the Taipei Children Heart Study. Int J Obes Relat Metab Disord 25, 170–176.

    Article  CAS  PubMed  Google Scholar 

  • Chu NF (2005). Prevalence of obesity in Taiwan. Obes Rev 6, 271–274.

    Article  PubMed  Google Scholar 

  • Cole TJ, Bellizzi MC, Flegal KM, Dietz WH (2000). Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320, 1240–1243.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Deforche B, Lefevre J, De Bourdeaudhuij I, Hills AP, Duquet W, Bouckaert J (2003). Physical fitness and physical activity in obese and nonobese Flemish youth. Obes Res 11 (3), 434–441.

    Article  PubMed  Google Scholar 

  • Department of Health and Human Service (2001). Surgeon general's call to action to prevent and decrease overweight and obesity. US Department of Health and Human Service, Public Health Service, Office of the Surgeon General.

  • Dietz WH (1998). Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics 101 (3), 518–525.

    CAS  PubMed  Google Scholar 

  • Edmunds L, Waters E, Elliott EJ (2001). Evidence based paediatrics: evidence based management of childhood obesity. BMJ 323, 916–919.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Fiel A (2005). Discovering Statistics Using SPSS 2nd edn. SAGE: London.

    Google Scholar 

  • Fu WP, Lee HC, Ng CJ, Tay YK, Kau CY, Seow CJ et al. (2003). Screening for childhood obesity: international vs population-specific definitions. Which is more appropriate? Int J Obes Relat Metab Disord 27, 1121–1126.

    Article  CAS  PubMed  Google Scholar 

  • Fu C, Yeh J, Pei D, Lin HH, Lo H (2004). Prevalence of overweight adolescents and associated factors in Hualien city. Tzu Chi Med J (Taiwan) 16 (5), 301–307.

    Google Scholar 

  • Heyward VH (1991). Advanced Fitness Assessment and Exercise Prescription. Human Kinetics: Champaign.

    Google Scholar 

  • Hsieh P-L, FitzGerald M (2005). Childhood obesity in Taiwan: review of the Taiwanese literature. Nurs Health Sci 7, 134–142.

    Article  PubMed  Google Scholar 

  • Huang YC, Wu JY (2000). Weight-for-height reference among school children aged 6.5–18.5 in Taiwan. Public Health (Taiwan) 27 (3), 167–177.

    Google Scholar 

  • Huang YC, Malina RM (2002). Physical activity and health-related physical fitness in Taiwanese adolescents. Physiol Anthropol Appl Human Sci 21 (1), 11–19.

    Article  Google Scholar 

  • Huang YC, Wu JY, Yang MJ (2003). Weight-for-height reference and the prevalence of obesity for school children and adolescents in Taiwan and Fuchien Areas. J Chin Med Assoc (Taiwan) 66 (10), 599–606.

    Google Scholar 

  • Hui L, Bell AC (2003). Overweight and obesity in children from Shenzhen, People Republic of China. Health Place 9, 371–376.

    Article  PubMed  Google Scholar 

  • International Obesity Task Force (2002) Obesity in the Pacific-Too big to ignore: International Obesity Task Force Asia Pacific Office.

  • Kaneko K, Kiriike N, Ikenaga K, Miyawaki D, Yamagami S (1999). Weight and shape concerns and dieting behaviours among pre-adolescents and adolescents in Japan. Psychiatry Clin Neurosci 53 (3), 365–371.

    Article  CAS  PubMed  Google Scholar 

  • Kim DM, Ahn CW, Nam SY (2005). Prevalence of obesity in Korea. Obes Rev 6 (2), 117–121.

    Article  CAS  PubMed  Google Scholar 

  • Lee L, Pan WH, Chen CH, Lee YM (1994). The prevalence of obesity in the seven grades in Taipei city, 1991: a comparison of various body screening indices. CJPH (Taiwan) 13 (1), 11–19.

    Google Scholar 

  • Lee YM (1995). Prevalence of obesity among high school students in Hualien city: a comparison between weight-length index and body mass index. Chin J Fam Med (Taiwan) 5 (3), 128–135.

    Google Scholar 

  • Lee CM, Lee MC (1997). Obesity in adolescents. Healthy World (Taiwan) 138, 97–109.

    Google Scholar 

  • Lee CD, Blair SN, Jackson AS (1999). Cardiorespiratory fitness, body composition, and all-cause and cardiovascular disease mortality in men. Am J Clin Nutr 69, 373–380.

    Article  CAS  PubMed  Google Scholar 

  • Lin CC, Lai MM, Liu CS, Li TC (1998). The prevalence of obesity in the school-aged children in Taichung city: a comparison of various body anthropometric indices. Chin J Fam Med (Taiwan) 8, 134–143.

    Google Scholar 

  • Livingstone B (2000). Epidemiology of childhood obesity in Europe. Eur J Pediatr 159 (Suppl: 1), S14–34.

    Article  PubMed  Google Scholar 

  • Lobstein T, Frelut ML (2003). Prevalence of overweight among children in Europe. Obes Rev 4, 195–200.

    Article  CAS  PubMed  Google Scholar 

  • Lobstein T, Baur L, Uauy R (2004). Obesity in children and young people: a crisis in public health. Obes Rev 5 (Suppl: 1), 4–85.

    Article  PubMed  Google Scholar 

  • Loke KY (2002). Consequences of childhood and adolescents obesity. Asia Pacific J Clin Nutr 11 (3), S702–S704.

    Article  Google Scholar 

  • Materson BJ (2003). What defines an adolescent as having hypertension? J Hypertens 21, 13–14.

    Article  CAS  PubMed  Google Scholar 

  • Matsushita Y, Yoshiike N, Kaneda F, Yoshita K, Takimoto H (2004). Trends in childhood obesity in Japan over the last 25 year from the national nutrition survey. Obes Res 12 (2), 205–214.

    Article  PubMed  Google Scholar 

  • Must A, Strauss RS (1999). Risks and consequences of childhood and adolescent obesity. Int J Obes 23 (Suppl: 2), S2–S11.

    Article  Google Scholar 

  • National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004). The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 114 (Suppl), 555–576.

  • North American Association for The Study of Obesity (2003). Childhood obesity. [cited 2005 17 April]; Available from:www.naaso.org/information/childhood_overweight.asp.

  • Ozdirenc M, Ozcan A, Akin F, Gelecek N (2005). Physical fitness in rural children compared with urban children in Turkey. Pediatr Int 47 (1), 26–31.

    Article  PubMed  Google Scholar 

  • Pall D, Katona E, Fulesdi B, Zrinyi M, Zatik J, Bereczki D et al. (2003). Blood pressure distribution in a Hungarian adolescent population: comparison with normal values in the USA. J Hypertens 21, 41–47.

    Article  CAS  PubMed  Google Scholar 

  • Pongprapai S, Mo-suwan L, Leelasamran W (1994). Physical fitness of obese school children in Hat Yai, southern Thailand. Southeast Asian J Trop Med Public Health 25 (2), 354–360.

    CAS  PubMed  Google Scholar 

  • Reich A, Müller G, Gelbrich G, Deutscher K, Gödicke R, Kiess W (2003). Obesity and blood pressure: results from the examination of 2365 schoolchildren in Germany. Int J Obes 27 (12), 1459–1464.

    Article  CAS  Google Scholar 

  • Ricciardelli LA, McCabe MP (2001). Children's body image concerns and eating disturbance: a review of the literature. Clin Psychol Rev 21 (3), 325–344.

    Article  CAS  PubMed  Google Scholar 

  • Sallis JF, Prochaska JJ, Taylor WC (2000). A review of correlates of physical activity of children and adolescents. Med Sci Sports Exerc 32 (5), 963–975.

    Article  CAS  PubMed  Google Scholar 

  • Serdula MK, Ivery D, Coates RJ, Freedman DS, Williamson DF, Byers T (1993). Do obese children become obese adults? a review of the literature. Prev Med 22 (2), 167–177.

    Article  CAS  PubMed  Google Scholar 

  • Slack T, Hsu Y, Tsai C, Hong F (2002). The road to modernisation: sport in Taiwan. Int J Hist Sport 19, 343–365.

    Article  Google Scholar 

  • Stone EJ, McKenzie TH, Welk GJ, Booth ML (1998). Effects of physical activity intervention in youth. Am J Prev Med 15 (4), 298–315.

    Article  CAS  PubMed  Google Scholar 

  • Tabachnick BG, Fidell LS (2001). Using Multivariate Statistics. Allyn & Bacon: London.

    Google Scholar 

  • Taiwan Department of Health (2004) Hypertension in Taiwan.

  • Taiwan National Council on Physical Fitness and Sports (1999). National Physical Fitness Survey. National Council on Physical Fitness and Sports: Taiwan.

  • Taiwan National Council on Physical Fitness and Sports (2001). National Physical Fitness Survey. National Council on Physical Fitness and Sports: Taiwan.

  • Taiwan National Institute for the Health Research (2001). Physical activity and children and adolescent obesity. Taiwan National Institute for the Health Research: Taipei.

  • UK Department of Health (2003). Health Survey for England 2002. The Stationery Office: London.

  • Vanhala M, Vanhala P, Kumpusalo E, Halonen P, Takala J (1998). Relation between obesity from childhood to adulthood and the metabolic syndrome: population based study. BMJ 317, 319.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Wabitsch M (2000a). Overweight and obesity in European children: definition and diagnostic procedures, risk factors and consequences for later health outcome. Eur J Pediatr 159 (Suppl 1), S8–S13.

    Article  PubMed  Google Scholar 

  • Wabitsch M (2000b). Overweight and obesity in European children and adolescents: causes and consequences, treatment and prevention. An introduction. Eur J Pediatr 159 (Suppl 1), S5–S7.

    Article  PubMed  Google Scholar 

  • Wang Y (2001). Cross-national comparison of childhood obesity: the epidemic and the relationship between obesity and socio-economic status. Int J Epidemiol 30, 1129–1136.

    Article  CAS  PubMed  Google Scholar 

  • Wang Y, Wang JQ (2002). A comparison of international references for assessment of child and adolescent overweight and obesity in different populations. Eur J Clin Nutr 56, 973–982.

    Article  CAS  PubMed  Google Scholar 

  • Wang Y, Monteiro C, Popkin BM (2002). Trends of obesity and underweight in older children and adolescents in the United States, Brazil, China and Russia. Am J Clin Nutr 75, 471–474.

    Article  Google Scholar 

  • World Health Organization (2000). Obesity: preventing and managing the global epidemic- Report of a WHO Consultation. World Health Organization (WHO Technical Report Series, No. 894).

  • World Health Organization (2003). 2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension. J Hypertens 21, 1983–1992.

  • Yu YY (1999). Discussion on obesity. School Health (Taiwan) 35, 85–99.

    Google Scholar 

  • Yu C, Liaw Y, Barnd SM (2004). Cultural and social factors affecting women's physical activity participation in Taiwan. Sport, Education and Society 9 (3), 379–393.

    Article  Google Scholar 

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Acknowledgements

We would like to thank the National Council on Physical Fitness and Sports in Taiwan and also thank the Research and Development Center of Physical Education Test, National College of Physical Education and Sports in Taiwan.

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Correspondence to K R Fox.

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Guarantor: KR Fox.

Contributors: LJC helped to analyse the data, wrote the first draft of the paper, and final version of the paper. KF, AH, and JMW contributed to advising on the analysis, writing the paper, and final version of the paper.

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Chen, L., Fox, K., Haase, A. et al. Obesity, fitness and health in Taiwanese children and adolescents. Eur J Clin Nutr 60, 1367–1375 (2006). https://doi.org/10.1038/sj.ejcn.1602466

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  • DOI: https://doi.org/10.1038/sj.ejcn.1602466

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