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Background/Objectives:In 2002, the prevalence of overweight and obesity, defined by body mass index (BMI), was higher in New Zealand Māori (40%) and Pacific (60%) than in European (24%) children; however, this does not take into account interethnic differences in body composition. This study compared trajectories of anthropometric indices from 2004 to 2006 among 5- and 10-year-old Māori and European children.Subjects/Methods:In 2004 and then in 2006, 1244 children (639 boys and 605 girls) aged 5 and 10 years had height, weight and fat-free mass (FFM) by bioimpedance measured to derive measures of fat mass (FM), percentage body fat (%BF), FM index (FMI, FM/height2), FFM index (FFMI, FFM/height2), and s.d. scores for BMI and %BF and BMI categories by International Obesity Task Force criteria.Results:Body composition and growth in Māori children is different from European children. Over 2 years, the BMI and %BF s.d. scores in both 5- and 10-year-old cohorts increased more in Māori children than in European children. The prevalence of overweight and obesity also increased within ethnicity and age group. The relative change of FMI and FFMI differed by age group, gender and ethnicity. In Māori girls, the magnitude of the changes between 10 and 12 years of age was most marked-the major contribution was from an increase in FMI. At 12 years, the mean %BF of Māori girls was 31.7% (95% confidence interval (CI): 30.1 and 33.3) compared with that of European girls (28.0%; 95% CI: 27.0 and 29.0).Conclusions:FM and FFM measures provide a more appropriate understanding of growth and body composition change in children than BMI, and vary with gender and ethnicity. Thus, FMI and FFMI should be tracked and compared among populations. [ABSTRACT FROM AUTHOR]

Hypophosphatasia (HPP) is a rare inborn error of metabolism that presents variably in both age of onset and severity. HPP is caused by pathogenic variants in the ALPL gene, resulting in low activity of tissue nonspecific alkaline phosphatase (TNSALP). Patients with HPP tend have a similar pattern of elevation of natural substrates that can be used to aid in diagnosis. No formal diagnostic guidelines currently exist for the diagnosis of this condition in children, adolescents, or adults. The International HPP Working Group is a comprised of a multidisciplinary team of experts from Europe and North America who have expertise in the diagnosis and management of patients with HPP. This group reviewed 93 papers through a Medline, Medline In-Process, and Embase search for the terms "HPP" and "hypophosphatasia" between 2005 and 2020 and that explicitly address either the diagnosis of HPP in children, clinical manifestations of HPP in children, or both. Two reviewers independently evaluated each full-text publication for eligibility and studies were included if they were narrative reviews or case series/reports that concerned diagnosis of pediatric HPP or included clinical aspects of patients diagnosed with HPP. This review focused on 15 initial clinical manifestations that were selected by a group of clinical experts.The highest agreement in included literature was for pathogenic or likely pathogenic ALPL variant, elevation of natural substrates, and early loss of primary teeth. The highest prevalence was similar, including these same three parameters and including decreased bone mineral density. Additional parameters had less agreement and were less prevalent. These were organized into three major and six minor criteria, with diagnosis of HPP being made when two major or one major and two minor criteria are present., (© 2023. The Author(s).)

Objective: To compare percentage body fat (%BF) for a given body mass index (BMI) among New Zealand European, Maori and Pacific Island children. To develop prediction equations based on bioimpedance measurements for the estimation of fat-free mass (FFM) appropriate to children in these three ethnic groups., Design: Cross-sectional study. Purposive sampling of schoolchildren aimed at recruiting three children of each sex and ethnicity for each year of age. Double cross-validation of FFM prediction equations developed by multiple regression., Setting: Local schools in Auckland., Subjects: Healthy European, Maori and Pacific Island children (n=172, 83 M, 89 F, mean age 9.4+/-2.8(s.d.), range 5-14 y)., Measurements: Height, weight, age, sex and ethnicity were recorded. FFM was derived from measurements of total body water by deuterium dilution and resistance and reactance were measured by bioimpedance analysis., Results: For fixed BMI, the Maori and Pacific Island girls averaged 3.7% lower %BF than European girls. For boys a similar relation was not found since BMI did not significantly influence %BF of European boys (P=0.18). Based on bioimpedance measurements a single prediction equation was developed for all children: FFM (kg)=0.622 height (cm)(2)/resistance+0.234 weight (kg)+1.166, R(2)=0.96, s.e.e.=2.44 kg. Ethnicity, age and sex were not significant predictors., Conclusions: A robust equation for estimation of FFM in New Zealand European, Maori and Pacific Island children in the 5-14 y age range that is more suitable than BMI for the determination of body fatness in field studies has been developed.

The frequency of eating occasions reported by young New Zealand Polynesian and European women was examined. The timing and content of meals and snacks were analysed from 80 self-reported seven-day food diaries from a previous study of 80 young women (39 New Zealand Polynesian and 41 European) aged between 18 and 27 years. Nineteen Polynesian and 20 European women had a body mass index (BMI) greater than 30 kg.m-2 and were classified as obese. Breakfast was eaten more often by the European women than the Polynesian (median 4 versus 3 times.week-1, P = 0.012). Eleven (28%) of the Polynesian women skipped breakfast every day of the study week compared to only three (7%) of the Europeans (P = 0.019). Dinner was eaten more frequently by the European women (P = 0.020) who also ate significantly more meals during the week than the Polynesian (P = 0.039). Non-obese Europeans ate breakfast more frequently than their obese counterparts (P = 0.002) while no significant difference was observed between non-obese and obese Polynesians. The obese European and Polynesian groups reported similar patterns of breakfast consumption which differed significantly from the non-obese Europeans (P = 0.008). The young women in this study did not eat breakfast every day with the young Polynesian women eating fewer meals than the Europeans. There was an association between ethnic origin, body size and eating patterns in the women. These findings in comparison with previous studies in other countries indicate that the frequency of eating breakfast may be declining with time.

Background: Reduced energy expenditure and excessive energy intake have been hypothesized to cause obesity. New Zealanders of Polynesian origin have a higher prevalence of obesity than do those of European origin., Objective: We investigated relations between components of energy expenditure and body composition., Design: We measured total energy expenditure (TEE) and resting metabolic rate (RMR) in 80 young women [40 New Zealand (NZ) Polynesian and 40 NZ European] aged 18-27 y by the doubly labeled water method and indirect calorimetry, respectively. Each group was partitioned into nonobese and obese on the basis of percentage body fat., Results: TEE and body weight were highly correlated in nonobese NZ Europeans (n = 23, r = 0.76, P < 0.001), obese NZ Europeans (r = 0.58, P = 0.016), and nonobese NZ Polynesians (n = 25, r = 0.59, P = 0.002) but not in obese NZ Polynesians (r = 0.11, P = 0.70). Activity energy expenditure (AEE = TEE - RMR) was similar in obese Polynesians and Europeans (mean+/-SD: 5.5+/-2.2 and 5.2+/-1.9 MJ/d, respectively), but significantly higher in nonobese Polynesians (5.7+/-2.5 MJ/d) than in their European counterparts (3.8+/-1.9 MJ/d, P = 0.005). Similar trends were seen when AEE adjusted for body weight and TEE/RMR were compared among the subgroups. Body weight and RMR together accounted for 66% of the variation in TEE for the European group but only 17% for the Polynesian group., Conclusion: Care should be taken in applying "Caucasian norms" relating to energy expenditure to NZ Polynesian people.

Girth measurements provide a simple method for estimation of total body fat that can be used over a wide range of percentage body fat (%BF). Well-established equations for determining %BF from girth measurements were applied to 42 Caucasian and 40 Polynesian women. %BF was determined from total body water measurement using oxygen-18 dilution. The relationship between the criterion measurement of %BF and that calculated from girth measurements differed significantly between the two ethnic groups. Assessment of body fat using girth measurements should use ethnicity-specific equations.

The prediction of total body fat from simple anthropometric measurements was examined in 42 white (New Zealand European and 40 Polynesian women aged 18-27 y. Percentage body fat (%BF) was determined from measurements of total body water (TBW) by 18O dilution. Mean (+/- SD) body mass index (BMI; in kg/m2) averaged 29.2 +/- 7.9 (range: 16.5-48.0) for the New Zealand European group and 31.2 +/- 7.9 (range: 19.8-51.8) for the Polynesian group, %BF calculated from TBW was similar in the two groups (40.5 +/- 9.9% for the New Zealand European compared with 39.1 +/- 7.5% for the Polynesian group). BMI was significantly correlated with height in the Polynesian group but not in the New Zealand European group. The relation between BMI and %BF was curvilinear for both groups. At a fixed %BF, BMI was higher in the Polynesian group than in the New Zealand European group. A BMI of 30 for the New Zealand European group corresponded to a BMI of 34 for the Polynesian group at an equivalent %BF (42%). Prediction equations for %BF developed from skinfold thicknesses or girth measurements were ethnicity dependent. We conclude that the BMI criterion for obesity in whites requires revision for use in Polynesians.