title: Overweight among children and adolescents in a Native Canadian community: prevalence and associated factors.
abstract: BACKGROUND
  The prevalence of pediatric obesity in North America is increasing. Native American children are at especially high risk.
  
  
  OBJECTIVE
  The objective was to evaluate the prevalence of pediatric overweight and associated behavioral factors in a Native Canadian community with high rates of adult obesity and type 2 diabetes mellitus.
  
  
  METHODS
  Height and weight were measured in 445 children and adolescents aged 2-19 y. Fitness level, television viewing, body image concepts, and dietary intake were assessed in 242 subjects aged 10-19 y. Overweight was defined as a body mass index > or =85th percentile value for age- and sex-specific reference data from the third National Health and Nutrition Examination Survey (NHANES III). Multiple logistic regression was used to examine factors associated with overweight, with adjustment for age and sex.
  
  
  RESULTS
  The overall prevalence of overweight in subjects aged 2-19 y was significantly higher than NHANES III reference data [boys: 27. 7% (95% CI: 21.8, 34.5); girls: 33.7% (95% CI: 27.9, 40.1)]. In the subset aged 10-19 y, > or =5 h television viewing/d was associated with a significantly higher risk of overweight than was < or =2 h/d [odds ratio (OR) = 2.52; 95% CI: 1.06, 5.98]. Subjects in the third and fourth quartiles of fitness had a substantially lower risk of overweight than did those in the first quartile [third quartile compared with first quartile: OR = 0.24 (95% CI: 0.09, 0.66); fourth quartile compared with first quartile: OR = 0.13 (95% CI: 0.03, 0. 48)]. Fiber consumption on the previous day was associated with a decreased risk of overweight (OR = 0.69; 95% CI: 0.47, 0.99 for each 0.77 g/MJ increase in fiber intake).
  
  
  CONCLUSIONS
  Pediatric overweight is a harbinger of future diabetes risk and indicates a need for programs targeting primary prevention of obesity in children and adolescents.
authors.affiliation: Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Canada.
authors.forename: A J
authors.initials: AJ
authors.lastname: Hanley
authors.forename: S B
authors.initials: SB
authors.lastname: Harris
authors.forename: J
authors.initials: J
authors.lastname: Gittelsohn
authors.forename: T M
authors.initials: TM
authors.lastname: Wolever
authors.forename: B
authors.initials: B
authors.lastname: Saksvig
authors.forename: B
authors.initials: B
authors.lastname: Zinman
mesh_terms: D000293:Adolescent; D000328:Adult; D001828:Body Image; D015992:Body Mass Index; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004032:Diet; D015444:Exercise; D005260:Female; D006801:Humans; D007198:Indians, North American; D008297:Male; D009765:Obesity / Q000208:ethnology* / Q000209:etiology; D010809:Physical Fitness; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013690:Television