title: Obesity indices in a cohort of primary school children in Crete: a six year prospective study.
abstract: OBJECTIVE
  To report on the body mass index (BMI), waist-to-hip ratio (WHR) and sum of skinfolds in a cohort of Cretan children and identify the factors associated with these indices.
  
  
  METHODS
  The present study was a follow-up study. Children were measured prospectively at ages 6, 9 and 12.
  
  
  METHODS
  Pupils came from 40 schools randomly selected from the 541 primary schools in three different provinces of Crete. 1046 pupils were examined at age 6. At age 9, a representative sample from the original cohort (n=579) was randomly selected for re-evaluation. At the age of 12, a sample of 831 pupils was re-examined, following similar procedures.
  
  
  METHODS
  Both during baseline and each subsequent follow-up, data were obtained on pupils' anthropometry, serum lipids, dietary intake, physical fitness and physical activity as well as their dietary and their health knowledge. Data on parents' anthropometry, age, occupation, educational level, and issues relating to health habits, attitudes and knowledge were also collected.
  
  
  RESULTS
  Half of the obese children at age 6 were also obese at age 12. Cretan children had higher mean BMI than similar American cohorts. Compared to their American counterparts, Cretans had higher proportions of overweight in both genders across all ages tested. The endurance run test (ERT), an index of physical fitness, was positively associated with obesity indices. Sum of skinfolds related positively to serum LDL-C. Children from urban areas had higher skinfold sums than children from rural areas. Parental health-related hedonism related positively to children's BMI.
  
  
  CONCLUSIONS
  It appears that these findings offer some support to the reported increasing prevalence of obesity among Greek children. Higher ERT, presumably reflecting higher physical activity, is associated with lower obesity. The relationship between degree of fatness and LDL-C appears to be evidenced at an early age in life. This relationship may relate to the reported VLDL and cholesteryl ester transfer protein elevations in obesity. The parental attitude of health-related hedonism appears to be linked with children's adiposity.
authors.affiliation: Department of Social Medicine, Preventive Medicine and Nutrition, University of Crete, Iraklion, Crete, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Mamalakis
authors.forename: A
authors.initials: A
authors.lastname: Kafatos
authors.forename: Y
authors.initials: Y
authors.lastname: Manios
authors.forename: T
authors.initials: T
authors.lastname: Anagnostopoulou
authors.forename: I
authors.initials: I
authors.lastname: Apostolaki
mesh_terms: D000375:Aging; D001824:Body Constitution; D015992:Body Mass Index; D002648:Child; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D016014:Linear Models; D008297:Male; D009765:Obesity / Q000175:diagnosis* / Q000453:epidemiology; D010807:Physical Endurance; D010809:Physical Fitness; D011446:Prospective Studies; D012424:Rural Population; D012885:Skinfold Thickness; D014505:Urban Population
chemical_list: D008078:Cholesterol, LDL