We describe diet quality by demographic factors and weight status among Barbadian children and examine associations with excess energy intake (EI). A screening tool for the identification of children at risk of excess EI was developed.

In a cross-sectional survey, the Diet Quality Index–International (DQI-I) was used to assess dietary intakes from repeat 24h recalls among 362 children aged 9–10 years. Participants were selected by probability proportional to size. A model to identify excess energy intake from easily measured components of the DQI-I was developed.

Barbados.

Primary-school children in Barbados.

Over one-third of children were overweight/obese, and mean EI for boys (8644 (se 174·5) kJ/d (2066 (se 41·7) kcal/d)) and girls (8912 (se 169·9) kJ/d (2130 (se 40·6) kcal/d)) exceeded the RDA. Children consuming a variety of food groups, more vegetables and fruits, and lower percentage energy contribution from empty-calorie foods showed reduced likelihood of excess EI. Intake of more than 2400 mg Na/d and higher macronutrient and fatty acid ratios were positively related to the consumption of excess energy. A model using five DQI-I components (overall food group variety, variety for protein source, vegetables, fruits and empty calorie intake) had high sensitivity for identification of children at risk of excess EI.

Children’s diet quality, despite low intakes of fruit and vegetables, was within acceptable ranges as assessed by the DQI-I and RDA; however, portion size was large and EI high. A practical model for identification of children at risk of excess EI has been developed.

To examine overweight and obesity (OWOB), changes in prevalence and potential risk factors in Barbadian children.

A cross-section of students were weighed and measured. The WHO BMI-for-age growth references (BAZ), the International Obesity Task Force cut-offs and the US Centers for Disease Control and Prevention growth percentiles were used to determine OWOB prevalence. Harvard weight-for-height-for-age growth standards were used to estimate differences in OWOB prevalence from 1981 to 2010. Samples of parents and students were interviewed to describe correlates of OWOB.

Barbados.

Public-school students (n 580) in class 3.

Based on WHO BAZ, the overall prevalence of OWOB was 34·8 % (95 % CI 30·9, 38·7 %). A trend of higher OWOB prevalence was seen for girls across cut-offs, with significant sex differences noted using the International Obesity Task Force cut-offs. According to Harvard growth standards, OWOB has increased dramatically, from 8·52 % to 32·5 %. Children were more likely to be OWOB when annual household income was below BBD 9000 (OR=2·69; 95 % CI 1·21, 5·99). Eating dinner with the family every night was associated with a lower prevalence of OWOB (OR=0·56; 95 % CI 0·36, 0·87).

The sharp increase of OWOB rates in Barbados warrants attention. Sex disparities in OWOB prevalence may emerge at a young age. Promoting family meals may be a feasible option for OWOB prevention. Understanding familial and sociodemographic factors influencing OWOB will be useful in planning successful intervention or prevention programmes in Barbados.

To describe (1) the prevalence of overweight and obesity and theirassociation with physical activity; (2) the effect of different cut-offpoints for body mass index (BMI) on weight status categorisation; and (3)associations of weight status with perceptions of body size, health and dietquality.

A cross-sectional study.

Secondary schools in Barbados.

A cohort of 400 schoolchildren, 11–16 years old, selected to studyphysical education practices.

Prevalence of overweight (15% boys; 17% girls) and obesity (7% boys; 12%girls) was high. Maternal obesity, as defined by the International ObesityTask Force (IOTF) BMI cut-off points, predicted weight status such thatreporting an obese mother increased the odds of being overweight by 5.25(95% confidence interval: 2.44, 11.31). Physical activity was inverselyassociated with weight status; however levels were low. Recreationalphysical activity was not associated with weight status in either category.Overweight subjects tended to misclassify themselves as normal weight andthose who misclassified perceived themselves to be of similar health statusto normal-weight subjects. The National Center for Health Statistics andIOTF BMI cut-off points produced different estimates of overweight andobesity.

Our findings suggest that inadequate physical activity and ignorance relatedto food and appropriate body size are promoting high levels of adipositywith a strong contribution from maternal obesity, which may be explained byperinatal and other intergenerational effects acting on both sexes.Prevalence studies and local proxy tools for adiposity assessment areneeded.

To determine the effects of birth weight and early childhood stunting on body mass index (BMI), body fat and fat distribution at ages 7 and 11 years, and the change from 7 to 11 years.

Prospective cohort study.

Kingston, Jamaica.

One hundred and sixteen stunted children (height-for-age below two standard deviations (<-2SD) of the National Center for Health Statistics (NCHS) references) and 190 non-stunted children (height-for-age > -1SD), identified at age 9–24 months. The stunted group was divided into a previously stunted group (height-for-age at 11 years ≥ -1SD) and a chronically stunted group (height-for-age <-1SD).

Birth weight was positively related to the children's BMI but not to measures of body fat. Birth weight was negatively associated with the subscapular/triceps skinfold (SSF/TSF) ratio at age 11 years, and to the change between 7 and 11 years. Controlling for birth weight, the chronically stunted group remained significantly smaller than the non-stunted children at both ages and increased less from 7 to 11 years in all measures except the SSF/TSF ratio, which was significantly greater at age 7 years. The previously stunted group had significantly lower BMI and percentage body fat at age 7 years than the non-stunted group. Change from 7 to 11 years was not significantly different from that of the non-stunted group except for a smaller increase in TSF. At age 11 years they had significantly lower TSF and percentage body fat1.

Children stunted in early childhood had less fat and lower BMI than non-stunted children but had a more central fat distribution that was partially explained by their lower birth weights. The association between birth weight and central fat distribution developed between 7 and 11 years.