title: The Malta Childhood National Body Mass Index Study: A Population Study.
abstract: Obesity is a chronic disease that often commences in childhood. More than a quarter of Maltese children are overweight or obese. The present study was carried out to measure height and weight (and body mass index) for all school children in Malta to precisely quantify the extent of the problem.
  
  
  
  Schooling in Malta is provided by: free state schools, subsidized Roman Catholic church-run schools, and independent private schools. All were included. Physical education teachers were trained in measurements on identical stadiometers. Bespoke spreadsheets were created using World Health Organization cut-offs for underweight, overweight, and obesity.
  
  
  
  The present study included more than 46,027 children in more than 145 schools (ages 4.7-17 years). Less than 10% were unmeasured. Approximately 40% of school-aged children in Malta are overweight or obese. The proportion of obese was greater than that of overweight. Levels of overweight and obesity were significantly different: State>Church>Independent schools. Overall, and for both sexes and for school types, there was a trend for overweight and obesity to peak in years 5 to 8, then decline slightly. Overweight and obesity was secondary>primary schools, and boys>girls. The underweight group was small with no significant difference between the school types.
  
  
  
  The present study has confirmed high levels of overweight and obesity in Maltese children. It also provides proof of concept of scalability by demonstrating the feasibility of undertaking a relatively inexpensive study of an entire childhood population. The modus operandi (utilizing physical education teachers) could relatively easily be up scaled for any country.
authors.affiliation: *Paediatric Department, Mater Dei Hospital, Tal-Qroqq †EU and International Affairs, Research and Policy Development Directorate, Floriana ‡Malta Association of Physiotherapists §Ministry for Social Dialogue, Consumer Affairs and Civil Liberties, Valletta ||Child Health Services, Primary Health Care, Floriana ¶Department of Health Information and Research, Guardamangia, Malta.
authors.forename: Victor
authors.initials: V
authors.lastname: Grech
authors.forename: Samuel
authors.initials: S
authors.lastname: Aquilina
authors.forename: Erin
authors.initials: E
authors.lastname: Camilleri
authors.forename: Karl
authors.initials: K
authors.lastname: Spiteri
authors.forename: Maria-Louisa
authors.initials: ML
authors.lastname: Busuttil
authors.forename: Victoria F
authors.initials: VF
authors.lastname: Sant'Angelo
authors.forename: Neville
authors.initials: N
authors.lastname: Calleja
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008319:Malta / Q000453:epidemiology; D063766:Pediatric Obesity / Q000175:diagnosis / Q000453:epidemiology*