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Objective: To investigate characteristics associated with body mass index (BMI) and waist circumference stability over a five-year period in women with school-age children. Methods: Women with 7-8 year-old children from western Sydney, Australia, had anthropometric measures taken in 1996/97 (n=436) and five years later (n=327). Socio-demographic characteristics examined at baseline included age, socio-economic status, smoking, and number of children. Results: Over five years, less than half of the women maintained a stable BMI (38.8%) or waist circumference (31.5%), with the majority gaining in both indicators of adiposity. BMI and socio-demographic characteristics were not predictive of BMI or waist circumference stability or decrease. Conclusions and Implications: Total and abdominal adiposity increased in these Australian women who have children. The results support the need to develop effective weight gain prevention initiatives.

Rickets is a vitamin D deficiency syndrome that results in defective bone development. The symptoms of rickets may also result from a genetic defect known as X-linked hypophosphatemic rickets. Patients with this genetic disorder have impaired reabsorption of phosphate in the proximal tubules of the kidneys, as well as deficient production of 1,25-dihydroxyvitamin D. Administering phosphate to replace that lost from the kidneys does not correct the defect, nor does vitamin D supplementation. However, the simultaneous use of both helps raise the level of phosphate in the blood and improve the bony defects. The degree to which this therapy is helpful has been uncertain. The question is not trivial, since evidence indicates that the treatment itself may cause nephrocalcinosis, an accumulation of calcium in the kidney, which can lead to kidney failure. Clearly, a treatment that risks kidney failure can be justified only if it provides very significant benefits to the patient. A study was conducted to evaluate the effects of phosphate and vitamin D therapy in 24 children, age one to 16 years. Therapy was given for 0.3 to 11.8 years. Patient height was scored by determining the relative difference between the patients and the standard growth curves; the height score was expressed as the number of standard deviations (SDs) below the average height for a particular age and sex. Furthermore, ultrasound imaging of the kidneys was performed to detect the earliest indications of nephrocalcinosis. The results show that the treated patients were an average of 1.08 SD units shorter than average, significantly different from the 2.05 SD deficiency historically established for such patients. A total of 79 percent of the patients had mild indications of nephrocalcinosis, which correlated with the dose of phosphate used in treatment, but not the duration of treatment or the dose of vitamin D. The results confirm the effectiveness of combination therapy with phosphate and vitamin D, but indicate that nephrocalcinosis is a great risk. Patients with X-linked hypophosphatemic rickets undergoing such therapy should be monitored regularly for nephrocalcinosis. Since there is little benefit to therapy after growth is completed, the treatment should not be continued any longer than necessary. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abstract Background One of the most serious, yet common co-morbidities of obesity is insulin resistance, which if untreated may progress to type 2 diabetes. This paper describes the insulin and glucose concentration distributions, the prevalence of elevated insulin, the associations between insulin and body mass index (BMI), waist circumference, waist-to-height ratio (WHtR) and fat mass index in a representative sample of Australian adolescents. Methods Cross-sectional population-based study of adolescent boys and girls (N = 496, mean age 15.3 years) attending schools in metropolitan Sydney, Australia. Fasting venous blood collected and analysed for insulin and glucose concentrations. Height, weight, waist circumference measured, BMI and waist-to-height ratio calculated. Pubertal status self-reported. Results Glucose concentrations were normally distributed and were not associated with adiposity. Insulin concentrations were distributed logarithmically, were higher among girls than boys overall and within the same ranges of BMI and waist circumference, but were lower among girls than boys within the same ranges of fat mass adjusted for height. The prevalence of elevated insulin concentration (defined as > 100 pmol/L) was 15.9% and 17.1% among boys and girls, respectively. Correlations between insulin concentration and BMI, waist circumference, WHtR and fat mass adjusted for height were 0.53, 0.49, 0.51 and 0.55, among boys, respectively, and 0.35, 0.40, 0.42 and 0.34, among girls, respectively. Conclusions Elevated insulin is highly correlated with adiposity in adolescents. BMI and WHtR are simple measures that can be used to identify young people who should be screened for insulin resistance and other co-morbidities.

Abstract Background Few young people meet television viewing guidelines. Purpose To determine the association between factors in the family and home environment and watching television, including videos and DVDs, in early adolescence. Methods Cross-sectional, self-report survey of 343 adolescents aged 12–13 years (173 girls), and their parents (338 mothers, 293 fathers). Main measures were factors in the family and home environment potentially associated with adolescents spending ≥ 2 hours per day in front of the television. Factors examined included family structure, opportunities to watch television/video/DVDs, perceptions of rules and regulations on television viewing, and television viewing practices. Results Two-thirds of adolescents watched ≥ 2 hours television per day. Factors in the family and home environment associated with adolescents watching television ≥ 2 hours per day include adolescents who have siblings (Adjusted Odds Ratio [95%CI] AOR = 3.0 [1.2, 7.8]); access to pay television (AOR = 2.0 [1.1, 3.7]); ate snacks while watching television (AOR = 3.1 [1.8, 5.4]); co-viewed television with parents (AOR = 2.3 [1.3, 4.2]); and had mothers who watched ≥ 2 hours television per day (AOR = 2.4 [1.3, 4.6]). Conclusion There are factors in the family and home environment that influence the volume of television viewed by 12–13 year olds. Television plays a central role in the family environment, potentially providing a means of recreation among families of young adolescents for little cost. Interventions which target family television viewing practices and those of parents, in particular, are more likely to be effective than interventions which directly target adolescent viewing times.