Adiposity in British secondary school children: a population based study

Abstract

Summary:
Adiposity is defined as the property of containing fat. Excessive adiposity is a cause of both morbidity and mortality in adults. Important consequences include increased risks of type 2 diabetes, coronary heart disease and stroke, (particularly through the increased risks of high blood pressure, dyslipidaemia and insulin resistance associated with adiposity), osteoarthritis, gall bladder disease and some cancers (particularly endometrial, breast, and colon). There is concern, both in the UK and in other settings, that levels of adiposity have risen during the past 20-30 years or so, both in adults and in children and adolescents, in whom relative increases in risk have been particularly large.
Key adiposity indicators include markers of general adiposity, of which body mass index weight (kg)/height2 (m2) is the most commonly used and markers of central adiposity, of which waist circumference is the most commonly used; central adiposity is particularly related to increased risks of cardiovascular disease and type 2 diabetes. High levels of body mass index, and, increasingly waist circumference, have been used to define overweight and obesity, although the definition of cut-offs for abnormality is difficult, especially in children and adolescents.
In British adults, there are marked geographic, social and ethnic variations in the occurrence of adiposity. Higher levels of adiposity have been reported in Northern England and Wales when compared to Southern England, in lower social class groups compared to higher ones and among South Asians compared to White Europeans. However, there is limited information on the extent of geographic, social and ethnic variation in adiposity in children. Although raised adiposity in an individual fundamentally reflects an imbalance between energy intake and expenditure, many potential determinants of adiposity have been identified. These include not only recent and previous dietary factors and physical activity, but also early life exposures and parental influences.
In a population-based study of British 13-16 year-olds, this Thesis sets out to address four overall aims;- (i) to examine patterns of adiposity, including the interrelationships of different adiposity markers; (ii) to explore geographic, social and ethnic differences in adiposity and relate them to patterns observed in adults; (iii) to examine the association of three individual factors – current physical activity pattern, infant feeding and parental BMI – with adiposity; (iv) to examine the associations between adiposity markers, blood pressure and insulin resistance, particularly to determine which adiposity measures are most strongly related to these factors in adolescence.

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ORCID for C. Fall: orcid.org/0000-0003-4402-5552

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