362. The Evolution of Obesity

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362. The Evolution of Obesity

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Syllabus

List of tables xi
List of figures xvii
List of boxes xix
Glossary xxi
List of abbreviations xxiii
Plain English summary xxv
Scientific summary xxvii
Chapter 1 Background 1
Obesity 1
Childhood obesity 1
The association between childhood obesity and adult obesity and morbidity 1
Measuring obesity 2
Simple measures of obesity 2
More complex measures of obesity 4
Challenges when measuring obesity in children 5
Aims and objectives of the review 6
Chapter 2 Methods 9
Search strategy 9
Aim of the literature search 9
Concepts of the search strategy 9
Resources searched 11
Inclusion criteria 12
Review of prediction of adult morbidities 12
Tracking of childhood obesity into adolescence/adulthood or adolescent obesity
into adulthood 13
The diagnostic accuracy of childhood measures of obesity 13
The acceptability and ease of use of childhood measures of obesity 14
Data extraction strategy 14
Quality assessment strategy 14
Data analysis 15
Review of prediction of adult morbidities 15
Review of tracking of obesity into adulthood 17
Review of diagnostic accuracy 18
Review of the acceptability and ease of use of simple childhood measures of obesity 18
DOI: 10.3310/hta19430 HEALTH TECHNOLOGY ASSESSMENT 2015 VOL. 19 NO. 43

Chapter 3 Results 19
Flow of studies through the review 19
Review of prediction of adult morbidities 22
Summary of the existing systematic reviews of the prediction of adult morbidities 22
Quality and assessment of bias of the included primary studies for the prediction of
adult morbidities 25
Characteristics of studies included in the review of prediction of adult morbidities 28
Findings from the review of adult morbidity 32
Review of morbidities: summary of findings and conclusions 50
Review of tracking of obesity into adulthood 53
Summary of the existing systematic reviews by Singh et al. (2008) and
Brisbois et al. (2012) 53
Quality and assessment of bias of the included primary studies of tracking of obesity
into adulthood 53
Characteristics of studies included the review of tracking of obesity into adulthood 55
Findings of the review of tracking of obesity into adulthood 58
Conclusions of the tracking review 69
Review of diagnostic accuracy of childhood measures of obesity 70
Quality of the evidence for diagnostic accuracy of childhood measures of obesity 70
Diagnostic accuracy of body mass index 79
Diagnostic accuracy of skinfold thickness 85
Diagnostic accuracy of waist circumference 87
Diagnostic accuracy of waist-to-hip ratio and waist-to-height ratio 87
Diagnostic accuracy of bioelectrical impedance analysis 87
Other childhood measures 95
Direct comparisons of the diagnostic accuracy of simple childhood measures of obesity 95
Comparisons of predictive and diagnostic accuracy 110
Summary of the diagnostic accuracy data 110
Review of acceptability and ease of use of childhood measures of obesity 112
Children’s assessment of acceptability and ease of use 112
Parents’ and caregivers’ assessment of acceptability and ease of use 114
Health professionals’ assessment of acceptability and ease of use 119
Summary of acceptability and ease of use 120
Chapter 4 Discussion 121
Summary of findings 121
Prediction of adult obesity-related morbidities 121
Tracking of childhood obesity into adulthood 122
Diagnostic accuracy of simple measures for childhood obesity 122
Acceptability and ease of use of simple measures for childhood obesity 123
Strengths and limitations of the review 123
Strengths 123
Limitations 124
Chapter 5 Conclusions 125
Implications for practice 126
Further research 126

Acknowledgements 127
References 129
Appendix 1 Literature searches 145
Appendix 2 Protocol changes 213
Appendix 3 Data extraction tables 215
Appendix 4 Quality assessment tables 309
Appendix 5 Review of adult morbidities: additional results from the meta-analyses 335

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