Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, UK.
Wolfson Institute of Population Health, Queen Mary University of London, London EC1M 6BQ, UK.
Nutrients. 2022 Mar 25;14(7):1369. doi: 10.3390/nu14071369.
Adolescent obesity persists as a major concern, especially in Central and Eastern Europe, yet evidence gaps exist regarding the pivotal early adolescent years. Our objective was to provide a comprehensive picture using a holistic approach of measured anthropometry in early adolescence, including body composition, cardiorespiratory fitness (CRF), and reported lifestyle characteristics. We aimed to elucidate potential sex/gender differences throughout and associations to biomarkers of disease risk for obese adolescents. Methods: Trained nurses measured 19,634 early adolescents (12−14-year-olds), we collected parental reports, and, for obese adolescents, fasting blood samples in four major Polish cities using a cross-sectional developmental design. Results: 24.7% boys and 18.6% girls were overweight/obese, and 2886 had BMI ≥ 90th percentile. With increasing age, there was greater risk of obesity among boys (p for trend = 0.001) and a decreasing risk of thinness for girls (p for trend = 0.01). Contrary to debate, we found BMI (continuous) was a useful indicator of measured fat mass (FM). There were 38.6% with CRF in the range of poor/very poor and was accounted for primarily by FM in boys, rather than BMI, and systolic blood pressure in girls. Boys, in comparison to girls, engaged more in sports (t = 127.26, p < 0.0001) and consumed more fast food (t = 188.57, p < 0.0001) and sugar-sweetened beverages (167.46, p < 0.0001). Uric acid, a potential marker for prediabetes, was strongly related to BMI in the obese subsample for both boys and girls. Obese girls showed signs of undernutrition. Conclusion: these findings show that overweight/obesity is by far a larger public health problem than thinness in early adolescence and is characterized differentially by sex/gender. Moreover, poor CRF in this age, which may contribute to life course obesity and disease, highlights the need for integrated and personalized intervention strategies taking sex/gender into account.
青少年肥胖仍然是一个主要问题，尤其是在中东欧地区，但在关键的青少年早期，证据仍然存在差距。我们的目标是通过整体方法全面描述青少年早期的测量人体测量学，包括身体成分、心肺健康（CRF）和报告的生活方式特征。我们旨在阐明肥胖青少年的潜在性别差异以及与疾病风险生物标志物的关联。
受过培训的护士测量了 19634 名青少年（12-14 岁），我们收集了父母报告，对于肥胖青少年，在波兰四个主要城市使用横断面发展设计采集了空腹血样。
24.7%的男孩和 18.6%的女孩超重/肥胖，2886 名青少年的 BMI≥90 百分位。随着年龄的增长，男孩肥胖的风险增加（趋势 p 值=0.001），女孩消瘦的风险降低（趋势 p 值=0.01）。与争论相反，我们发现 BMI（连续）是衡量体脂肪量（FM）的有用指标。CRF 处于较差/非常差范围内的占 38.6%，主要是由于男孩的 FM，而不是 BMI，以及女孩的收缩压。与女孩相比，男孩更多地参与运动（t=127.26，p<0.0001），食用更多的快餐（t=188.57，p<0.0001）和含糖饮料（t=167.46，p<0.0001）。尿酸是糖尿病前期的潜在标志物，在肥胖青少年亚组中，尿酸与 BMI 密切相关，男孩和女孩均如此。肥胖女孩表现出营养不良的迹象。
这些发现表明，超重/肥胖在青少年早期远远是一个更大的公共卫生问题，并且具有不同的性别特征。此外，该年龄段的 CRF 较差，可能导致肥胖和疾病的发生，这凸显了需要采取考虑性别的综合和个性化干预策略。
