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86
UDC 613.955/.96 doi.org: 10.31684/2541-8475.2019.1(13).13-19
CURRENT TRENDS IN CHANGES OF PHYSICAL DEVELOPMENT INDICATORS OF CHILDREN AND ADOLESCENTS
Altai State Medical University, Barnaul
I.P. Saldan, S.P. Filippova, O.V. Zhukova, O.I. Shved, A.P. Pashkov, N.Yu. Potseluev, K.V. Schulz, A.S. Nagornyak
The data of research literature in Russian and English in electronic search systems eLIBRARY, PubMed, international databases Scopus, Web of Science for the period of 2005-2018 are summarized and analyzed concerning the state of physical development of children and adolescents, its determinants and assessment methods in the current context. The following is presented: the age and sex standards of the physical development of children and adolescents should be regional; dependence of physical development indicators on environmental and socio-economic factors affecting the territory of residence; the need for continuous monitoring of the physical development of children and adolescents with a recheck of regional standards taking into account the ongoing processes of acceleration and deceleration.
Key words: physical development, risk factors, children and adolescents, acceleration, deceleration, nutritional status, obesity, nutrition.
Physical development (PD) assessment is an integral part of the study of the health status of the child population, as it clearly reflects the impact of environmental factors, lifestyle, and educational process on the body [1, 2, 3, 4, 5, 6, 7, 8, 9, 10]. PD includes a set of indicators: somatometric, somatoscopic, and physiometric, among which the most commonly used for the assessment are the following: body length and weight, chest circumference [11, 12, 13, 14].
In this case, the age and sex standards of PD can be only regional. Evidence in favour of this is the research which showed statistically significant differences in schoolchildren body length and weight in five regions of Russia (the cities of Moscow, St. Petersburg, Rostov-on-Don, Arkhangelsk, Omsk). Besides, data on the change of body sizes of schoolchildren in Moscow and the boost of biological development were obtained, which probably indicates the activity of acceleration [1, 6, 9, 15].
All this led to the interest in studying and generalizing the data of research literature on the state of physical development of children and adolescents, factors determining it, and methods of assessment in the current context.
The research objective is to generalize and analyze the data of research literature on the state of physical development of children and adolescents in the current context.
Materials and methods
The study was conducted on the basis of a review of research literature in Russian and English in electronic search systems eLIBRARY, PubMed, international databases Scopus, Web of Science for the period of 2005-2018. The selection of publications was based on key words that reflected the main trends in physical development of children
and adolescents. Works with low citation rate, with a small number of references were excluded from the sample group. Further, studies were selected that examined the relationship between the physical development indicators of children and adolescents and the factors influencing them, so that the nature of identified problems could then be determined (326 works). The publications were checked against the research objective, and the sample group was reduced to 151 papers. The detailed study of the materials resulted in a further reduction to 73 works, which have been included in this review.
Results and discussion
Methods for assessing physical development of children and adolescents include the method of sigmal deviations, Z-score assessment, method of assessment on regional modified scales of regression of body weight on body length, centile method, as well as combined techniques [11, 14]. To collect somatometric data, there are two methods: individualizing and generalizing. In order to obtain regional age and sex standards, comatometric data collected by generalizing method are used [11].
In view of the fact that age and sex standards of physical development can be only regional, studies often use the method of assessment on regional modified scales of regression of body weight on body length [1, 6, 10, 13, 14, 15, 16, 17, 18, 19]. So, to assess the changes in PD of schoolchildren in the city of Kiev for the period of 1996-2008, anthropometric studies were carried out, which included measurement of body weight and length, chest circumference, and assessment according to Ukrainian intergroup assessment tables (regression scales on body length) [17]. At the same time, further study on this issue was carried out in the direction of comparative assessment of
functional systems of the organism of pupils. With that, the study of physiometric indicators of PD of schoolchildren in Kiev and Moscow showed their statistically significant differences, such as, for example, the uneven rate of development of the main functional systems: muscular and respiratory [17, 18].
When studying the dynamics over time of somatometric indicators of 8-16 years old schoolchildren in the city of Gomel for the period from 1925 to 2010-2012, in 2010-2012, the examination (body length and weight, chest circumference) of 8-16 years old schoolchildren was carried out. The data obtained by other researchers in 1925 and 1973 were used to assess the dynamics of studied indicators over time. It is found that city schoolchildren at the beginning of the 21 century are characterized by higher rates of development of indicators in comparison with the peers of 1925 and 1973. Sexual dimorphism during acceleration is manifested by increased body length and weight in boys and asthenization in girls. The indicators of chest circumference of boys and girls surveyed at the beginning of the 21 century are significantly higher compared to their peers of 1925. The overall increase in body length within the studied age range is higher in the surveyed boys and girls compared to the data of 1925 and 1973, and in indicators of body weight and chest circumference - in boys and girls examined in 1973 in comparison with their peers of 1925 and 2010-2012. Schoolchildren in Gomel at the beginning of the 21 century demonstrated the presence of acceleration of development of somatometric indicators compared to the peers of 1925 and 1973 [20].
It is important to take into account the processes of acceleration occurring from one decade to the next and to review the standards of physical development in each region in due time. Recently, both domestic and foreign experts agree that the rate of acceleration is slowing everywhere. The highest peak of acceleration in Russia was observed in the mid-70s of the last century, then (in the 80s) there was a clear tendency to stabilize the process of acceleration of growth and development (stagnation), later on, gradual change of it by deceleration occurred in certain regions and major industrial cities [21].
In the city of St. Petersburg, indicators of PD of 7-17 years old schoolboys were studied, the assessment of the level and harmony of PD was conducted in accordance with the standards of the World Health Organization (WHO) ("WHO Growth Reference 2007"). The asymmetry of body length indicators with a significant representation of tall schoolchildren (1.9-10.9%) was established. The surveyed schoolchildren revealed a high level of disharmony variants of PD caused by overweight and obesity (16.4-38.2%) [22].
As for the factors influencing the PD, the analysis of the influence of the educational process organization in modern schools on the physical development of children and adolescents allowed to identify a number of intraschool environment factors, such as an increase in the study load through the intensification of the educational process, lack of motor activity, psycho-emotional tension, side effects of technical training aids use [23].
In studying the quality of life of children of groups of medical and social risk, it was established that the weight in the majority (65.5%) does not correspond to height and age, insufficient weight was in the largest share of children surveyed (58.8%) [24].
When studying the state of health of the child population in reference to the physiological full value condition of nutrition, it was revealed that insufficient calcium intake to 40% in relation to the age norm is accompanied by lower indicators of body length and weight [25, 26].
When studying the impact of actual nutrition on the health of children, the indicators of PD and nutritional status in general are assessed [2, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36]. In their research, Zh.Yu. Gorelova, M.I. Bakanov et al. [37, 38, 39, 40, 41] presented the results of the use of a specialized product in school meals for the correction of nutritional disorders in schoolchildren (weight normalization, nutritional status) during the educational process. The obtained results confirm laboratory (biochemical studies of free amino acids (AA) spectrum excretion in schoolchildren before and after taking the product) and psychophysiological studies (assessment of emotional state according to the method of HAM) [37, 38, 39, 40, 41].
In the studies, N.P. Setko, E.V. Bulycheva et al. [42] used and analyzed the data on nutritional status, functional state of musculoskeletal, respiratory, central nervous systems as the indicators to assess the effectiveness of implementation of the project for improving school nutrition in the city of Orenburg. As a result, it was found that measures to optimize school meals led to improvement of indicators of the nutritional status and functional condition of pupils [42].
PD indicators informatively reflect the conformity of the diet to the needs of the body: the body mass index (BMI) indicator is more dependent on body weight than on height, and its assessment reveals overweight or obesity. In addition, it is recommended to measure the thickness of skin folds of fat above triceps as an indicator of body fat depot, shoulder circumference [6, 26, 29, 32, 35, 43, 44, 45, 46, 47, 48]. For the correct use of BMI in childhood, WHO recommends to use a special method of assessing physical development of children and adolescents (BMI-for-age 5-19 years) [13, 14, 19, 46, 48, 49, 50, 51].
According to L.Yu. Volkova, O.N. Komarova, I.Ya. Kon' [27], it is established that for mass screening diagnostics of overweight and obesity in the conditions of organized groups, it is expedient to use anthropometric and somatometric methods.
The works on the study of peculiarities of the nutritional status of children in different environmental conditions is of interest. Studies conducted by S.K. Bermagambetova, T.K. Karimova et al. showed that the nutritional status of children has its peculiarities by indicators of physical development, hemoglobin level, serum iron, and ferritin in different ecological regions [52].
At present, the problem of obesity in children is a significant part of the literature on child and adolescent health. In this context, the prevalence of obesity among the child population is of concern to both domestic and foreign experts. According to numerous research, the number of overweight children in Europe increases rapidly and has reached high indicators [2, 27, 44, 50, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67]. In literature, there are indications that almost 60% of adults began obesity in childhood and adolescence [43, 66, 67, 68].
A number of works are devoted to the study of this problem in foreign literature. In Brazil, overweight among children is one of the major public policy issues. However, among children who lived and studied in rural areas, there is a lower prevalence of obesity, and none of the rural children were underweight. The authors note that this may be due to low social and economic conditions and more intense physical activity in their daily lives [69]. According to the national literature, obesity is common in 5.5% of children living in rural areas and in 8.5% of urban children in the Russian Federation [44, 55].
In Turkey, according to a study, the prevalence of obesity among school-aged children was 10.3% and overweight was 22.4%. Among adolescents, the number of obese boys is statistically higher than girls. Among schoolchildren who did not have breakfast, the percentage of obesity was higher than in a group that ate regularly 3 times a day. The prevalence of obesity in adolescents who watch TV for more than 3 hours a day was higher than in the rest [56]. Similar data are presented by domestic authors: the absolute majority of overweight and obese children spend more than 3 hours a day on TV and computer [66].
Doctors of various specialties as the causes of such multi-factor disease as obesity include the role of malnutrition and lifestyle [44, 60, 66, 70, 71, 72, 73]. It is noted that parents of children with overweight are not sufficiently literate in matters of a healthy lifestyle and overestimate physical activity of children, underestimating the caloric content of consumed food [44, 56, 66].
Obesity problems in childhood have led to research on clothing hygiene for obese children
and adolescents. According to studies carried out by I.A. Makhrova, I.N. Ivashchenko, the choice of proportionate clothing corresponding to the basic hygienic principles for these children is limited. The study of the design features of clothing, the analysis of the properties of materials, as well as the lifestyle of such children are relevant [53].
Conclusion
Analysis of literature sources shows, first, the dependence of indicators of physical development of children and adolescents on ecological, social, and economic factors affecting on the territory of residence; second, the need for constant monitoring of PD of the younger generation with a recheck of regional standards every decade taking into account the time trend and the ongoing divergent acceleration and deceleration processes [19].
Thus, due to the fact that in Altai Krai tables (regression scales on body length) on the research data of Professor L.N. Klimenov of 1989 are used to assess physical development of the child population aged from 1 month to 14 years, it seems reasonable to carry out appropriate studies of anthropometric indicators of children and adolescents on the territory of Altai Krai in present.
Conflict of interest. The authors declare that there is no conflict of interest.
References:
1. Baranov A.A., Kuchma V.R., Skoblina N.A. Physical development of children and adolescents at the turn of Millennium. M., 2008: 216.
2. Baskakova E.Yu. Peculiarities of physical development, actual nutrition and metabolic disorders in children depending on the character of feeding in infancy: author's abstract of the Candidate of Medical Sciences. 14.01.08. Nizhny Novgorod, 2012: 26.
3. Zul'karnaeva A.T., Povargo E.A., Zul'karnaev T.R., Ovsyannikova L.B., Agafonov A.I. Influence of certain factors on the state of health of schoolchildren. Population Health and Life Environment. 2012; 8: 29-31.
4. Gapparov M.M., Pervova Yu.V. Influence of nutrition structure and environment on the specific resistance of the organism of children and their physical development. Problems of Nutrition. 2005; 1: 33-35.
5. Kuchma V.R., Rapoport I.K. Strategy of WHO and review of international experience of prevention of diseases and promotion of health of children and adolescents in educational institutions. Public Health and Prevention of Diseases. 2008; 1: 40-45.
6. Kuchma V.R., Skoblina N.A. Evaluation comprehension of the children and adolescent physical growth in the course of the population research. Current Pediatrics. 2008; 7(1): 26-28.
7. Meshkov N.A. Methodological aspects of assessment of body adaptive response to the impact of environmental risk factors. Hygiene and Sanitation. 2012; 5: 87-91.
8. Novikova I.I. Hygienic assessment of mechanisms of health formation in children of a large industrial centre: author's abstract of the Candidate of Medical Sciences. 14.00.07http://elibrary.ru/author_items.as p?refid=181104301&fam=%D0%9D%D0%BE%D0 %B2%D0%B8%D0%BA%D0%BE%D0%B2%D0%B 0&init=%D0%98+%D0%98. Omsk, 2006: 40.
9. Kuchma V.R., Sukhareva L.M., Yampol'skaya Yu.A. et al. Main tendencies in physical development of schoolchildren in Moscow. Child and adolescent hygiene; History and contemporaneity (problems and solutions): materials of Russian national scientific research conference with international participation. M., 2009: 95.
10. Bogomolova E.S., Kuzmichev Yu.G., Badeeva T.V., Ashina M.V., Kosuga S.Yu., Kiseleva A.S. Physical development of modern schoolchildren in Nizhny Novgorod. Medical Almanac. 2012;3: 193-198.
11. Kuchma V.R. Children and Adolescent Hygiene. Guidance for practical studies. M., 2012: 560.
12. Rumyantsev G.I. Hygiene. M., 2009: 608.
13. Butte N, Garza C, De Onis M. Feasibility of international growth standards for school-aged children and adolescents. The Journal of Nutrition. 2007; 137: 153-157.
14. De Onis M, Onyango AW, Borghi E, Siyam A. Development of a WHO growth reference for school-aged children and adolescents. Bulletin of the World Health Organization. 2007; 85(9): 660-667.
15. Skoblina N.A., Kuchma V.R., Milushkina O.Yu., Bokareva N.A. Current trends of physical development of children and adolescents. Population Health and Life Environment. 2013; 8(245): 9-12.
16. Kochetkov N.V., Galstyan G.A. Regional aspects of health of children and adolescents in the Saratov Oblast. Bulletin of Medical Internet Conferences. 2013; 2: 340.
17. Platonova A.G. Changes in physical development of Kiev schoolchildren for a decade (1996-2008). Hygiene and Sanitation. 2012; 2: 69-73.
18. Platonova A.G., Skoblina N.A., Bokareva N.A., Milushkina O.Yu. Comparative assessment of functional state of health of schoolchildren in Moscow and Kiev. Hygiene and Sanitation. 2013; 3: 74-77.
19. Garza C, De Onis M. Symposium: A new 21st century international growth standards for infants and young children. Journal of Nutrition. 2007; 137: 142-143.
20. Mel'nik V.A. The secular trend of somatometric parameters of city schoolchildren from 1925 to 2010-2012. Population Health and Life Environment. 2018; 6 (303): 21-26.
21. Pivovarov Yu.P., Korolik V.V., Zinevich L.S. et al. Hygiene. Ed. Yu.P. Pivovarov. M., 2017. Vol. 2: 263-265.
22. Gritsinskaya V.L. Assessment of physical development of school-aged boys in St. Petersburg with the use of anthropometric calculator of WHO. Population Health and Life Environment. 2018; 2(299): 16-19.
23. Bokareva N.A., Milushkina O.Yu., Pivovarov Yu.P., Skoblina N.A. Impact of educational process organization on physical development of schoolchildren. Population Health and Life Environment. 2015; 11(272): 17-19.
24. Samodova I.L., Luchkevich V.S., Vitrishchak A.A. Impact of social-hygienic functioning on the quality of life of children of a group of medical and social risk. BIOMEDICAL JOURNAL Medline. ru. 2010; 11: 120-132. URL: http://www.medline.ru/ public/art/tom11/art11.html.
25. Mirskaya N.B. Risk factors negatively influencing the formation of a musculoskeletal system in children and adolescents in the current context. Hygiene and Sanitation. 2013; 1: 65-71.
26. Shcheplyagina L.A., Moiseeva T.Yu., Kovalenko T.V. et al. Osteopenia in children: diagnostics, prevention and correction. M., 2005.
27. Volkova L.Yu., Komarova O.N., Kon' I.Ya. Comparative assessment of methods of detection of overweight and obesity in children. Hygiene and Sanitation. 2011; 1: 80-83.
28. Kuznetsova E.I., Setko A.G., Fateeva T.A. Peculiarities of nutritional status of city schoolchildren within the frame of the national project "School meals". Materials of the V Russian forum "Health of children: prevention of socially important diseases. Saint Petersburg-2011". SPb., 2011: 97-98.
29. Lavinsky Kh.Kh., Kulesha Z.V., Lositsky E.A. et al. Methodology of nutritional status. National Interdisciplinary Medical Journal. 2012; 1: 58-63.
30. Lukushkina E.F., Baskakova E.Yu., Durmashkina A.P. Peculiarities of physical development and actual nutrition of children in Nizhny Novgorod. Medical Almanac. 2010; 2: 105108.
31. Poryadina G.I., Kovaleva E.A., Shcherbakova M.Yu. Issues of prevention of obesity and metabolic syndrome (on the results of work "School of sensible nutrition" for obese children and adolescents). Journal "Pediatria" named after G.N. Speransky. 2012;5:37-42.
32. Kuchma V.R., Skoblina N.A., Sukhareva L.M., Bokareva N.A., Milushkina O.Yu., Rapoport I.K. et al. Assessment of physical development of children and adolescents in educational institutions. Prevention of obesity in schoolchildren. M., 2013:44.
33. Skoblina N.A. Physical development of children being in different social conditions. Russian Pediatric Journal. 2008; 3: 29-31.
34. Turchaninov D.V. Nutrition and health of rural population in Siberia in current social and economic conditions: thesis work of the Candidate of Medical Sciences: 14.00.07. Omsk, 2009: 402.
35. Shit S, Taraphdar P, Mukhopadhyay DK, Sinhababu A, Biswas AB. Assessment of nutritional status by composite index for anthropometric failure: a study among slum children in Bankura, West Bengal. Indian J Public Health. 2005; 39(4): 541547.
36. Deshmukh-Taskar PR, Nicklas TA, O'Neil CE, Keast DR, Radcliffe JD, Cho S. The relationship of breakfast skipping and type of breakfast consumption with nutrient intake and weight status in children and adolescents: the National Health and Nutrition Examination Survey 19992006. Journal of the American Dietetic Association. 2010; 110(6): 869-878.
37. Gorelova Zh.Yu., Bakanov M.I., Mazanova N.N., Solov'eva Yu.V., Letuchaya T.A., Plats-Koldobenko A.N., Fedos'kina E.A. Specialized products in school meals. Effectiveness of use. Population Health and Life Environment. 2016; 8 (281): 47-49.
38. Gorelova Zh.Yu. Analysis of domestic and foreign research on health nutrition of children and adolescents in the current context. Problems of school and university medicine and health. 2016; 3: 40-46.
39. Gorelova Zh.Yu., Bakanov M.Yu., Mazanova N.N., Letuchaya T.A. Experience of use of a specialized product in schoolchildren nutrition. Current Pediatrics. 2015; 14(51):44.
40. Gorelova Zh.Yu., Bakanov M.Yu., Mazanova N.N., Fedos'kina E.A., Letuchaya T.A., Plats A.N. Correction of schoolchildren nutrition. Additional features. Problems of Nutrition. 2015; 84(S3):100.
41. Mazanova N.N., Gorelova Zh.Yu., Vasil'eva E.M., Bakanov M.I., Letuchaya T.A. Dynamics of amino acids excretion in children and adolescents using a new milk product «Standard growth formula». Yakut Medical Journal. 2015;3 (51): 47-50.
42. Setko N.P., Bulycheva E.V., Beilina E.B., Borodina E.S. Effectiveness of implementation of measures for optimization and rationalization of nutrition of pupils of educational institutions in Orenburg. Population Health and Life Environment. 2013;8(245): 19-21.
43. Verbova A.F., Reshetova O.I. Ghrelin and hormonal metabolic indicators in boys with obesity and overweight. Problems of Endocrinology. 2009;55(2): 23-26.
44. Shcherbakova M.Yu., Poryadina G.I., Kovaleva E.A. Problem of obesity in childhood. Experimental and Clinical Gastroenterology. 2010;7:74-83.
45. Brann LS, Skinner JD. More controlling child-feeding practices are found among parents of boys with an average body mass index compared with parents of boys with a high body mass index. Journal of the American Dietetic Association. 2005; 105(9): 1411-1416.
46. Dietz WH, Bellizzi MC. Introduction: the use of body mass index to assess obesity in children. Am. J. Clin. Nutr. 1999; 70 (1):123-125.
47. Di Landro A, Cazzaniga S, Parazzini F. et al.; GISED Acne Study Group. Family history, body mass index, selected dietary factors, menstrual history, and risk of moderate to severe acne in adolescents and young adults. J. Am. Acad. Dermatol. 2012; 67 (6):1129-1135.
48. Must A. Reference data for obesity: 85th and 95th percentiles of body mass index (wt/ht2) and triceps skinfold thickness. Am. J Clin. Nutr. 1991; 53: 839-846.
49. De Onis M, Lobstein T. Defining obesity risk status in the general childhood population: Which cut-offs should we use? International Journal of Pediatric Obesity. 2010; 5(6): 458-460.
50. Montgomery-Reagan K, Bianco JA, Huston RS. Prevalence and correlates of high body mass index in rural Appalachian children aged 6-11 years. Rural and Remote Health. 2009; 9: 1234.
51. Ogden CL, Carroll MD, Curtin LR, Lamb MM, Flegal KM. Prevalence of high body mass index in U.S. children and adolescents, 2007-2008. JAMA. 2010; 303(3): 242-249.
52. Bermagambetova S.K., Karimov T.K., Tusupkaliev B.T., Zinalieva A.N. Features of nutritional status in children in different ecological conditions. Hygiene and Sanitation. 2012;3: 57-59.
53. Makhrova I.A., Ivashchenko I.N. Problems of clothing hygiene in obese children and adolescents. Hygiene and Sanitation. 2013;2: 61-66.
54. Balykova L.A., Soldatov O.M., Samoshkina E.S., Pashutkina O.V., Balykova A.V. Metabolic syndrome in children and adolescents. Journal "Pediatria" named after G.N. Speransky. 2010; 89 (3): 127-134.
55. Dedov I.I., Mel'nichenko G.A., Butrova S.A. et al. Obesity in adolescence. Results of Russian epidemiologic research. Therapeutic Archive. 2007;79(10):28-32.
56. Dündar C, Öz H. Obesity-Related Factors in Turkish School Children. Scientific World Journal. 2012: 353485.
57. Ebbeling CB, Feldman HA, Osganian SK, Chomitz VR, Ellenbogen SJ, Ludwig DS. Effects of decreasing sugar-sweetened beverage consumption on body weight in adolescents: a randomized, controlled pilot study. Pediatrics. 2006; 117(3): 673-680.
58. Cretikos MA, Valenti L, Britt HC, Baur LA. General practice management of overweight and obesity in children and adolescents in Australia. Medical Care. 2008; 46(11): 1163-1169.
59. Wang L, Dalton 3rd WT, Schetzina KE, Fulton-Robinson H, Holt N, Ho AL, et al. Home Food Environment, Dietary Intake, and Weight among Overweight and Obese Children in Southern Appalachia. Southern medical journal. 2013; 106(10): 550-557.
60. Malik VS, Schulze MB, Hu FB. Intake of sugar-sweetened beverages and weight gain: a systematic review. Am J Clin Nutr. 2006; 84(2): 274-288.
61. Portilla MG. Body mass index reporting through the school system: Potential harm. J Am Diet Assoc. 2011; 111(3): 442-445.
62. Shrewsbury V, Wardle J. Socioeconomic status and adiposity in childhood: a systematic review of cross-sectional studies 1990-2005. Obesity (Silver Spring). 2008; 16: 275-284.
63. Triches RM. Giugliani ERJ. Obesity, eating habits and nutritional knowledge among school children. Rev Saude Publica. 2012; 56(4): 305-307.
64. Wang Y, Beydoun MA. The obesity epidemic in the United States - gender, age, socioeconomic status, racial/ethnic, and geographic characteristics: a systematic review and meta-regression analysis. Epidemiologic Reviews. 2007; 29: 6-28.
65. West F, Sanders MR. The Lifestyle Behaviour Checklist: a measure of weight-related problem behaviour in obese children. International journal of pediatric obesity. 2009; 4(4):266-273.
66. Krasnoperova O.I., Smirnova E.N., Merzlova N.B., Baturin V.I. Role of heritable, perinatal and ambient factors in obesity in childhood. Children's Hospital. 2013; 3: 19-24.
67. Boylan SM, Gill TP, Hare-Bruun H, Andersen LB, Heitmann BL. Associations between adolescent and adult socioeconomic status and risk of obesity and overweight in Danish adults. Obes Res Clin Pract. 2014; 8(2): 115-200.
68. Biro FM, Wien M. Childhood obesity and adult morbidities. Am J Clin Nut. 2010; 91(5): 14991505.
69. Horne PJ, Hardman CA, Lowe CF et al. Increasing parental provision and children's consumption of lunchbox fruit and vegetables in Ireland: The Food Dudes intervention. Eur J Clin Nutr. 2009; 63(5): 613-618.
70. Mazzonetto AC, Fiates GM. Perceptions and choices of Brazilian children as consumers of food products. Appetite. 2014; 78(1): 179-184.
71. Justo GF, Callo GQ, Carletti L, Molina MCB. Nutritional extremes among school children in a rural Brazilian municipality. Rural and Remote Health. 2012; 2: 2220.
72. Slater SJ, Nicholson L, Chriqui J, Turner L, Chaloupka F. The impact of state laws and district policies on physical education and recess practices in a nationally representative sample of US public elementary schools. Archives of pediatrics & adolescent medicine. 2012; 166(4): 311-316.
73. Trudeau F, Shephard RJ. Contribution of school programmes to physical activity levels and attitudes in children and adults. Sports Med. 2005; 35(2): 89-105.
Contacts
Corresponding author: Saldan Igor Petrovich, Doctor of Medical Sciences, Rector, Head of the Department of Hygiene, Fundamentals of Ecology and Health and Safety, Altai State Medical University, Barnaul.
656038, Barnaul, Lenina Prospekt, 40. Tel.: (3852) 566800. E-mail: [email protected]
Author information
Filippova Sofia Petrovna, Candidate of Medical Sciences, Associate Professor of the Department of Hygiene, Fundamentals of Ecology and Health and Safety, Altai State Medical University, Barnaul. 656038, Barnaul, per. Nekrasova, 65. Tel.: (3852) 566835. E-mail: [email protected]
Zhukova Olga Viktorovna, Candidate of Medical Sciences, Associate Professor of the Department of Hygiene, Fundamentals of Ecology and Health and Safety, Altai State Medical University, Barnaul. 656038, Barnaul, per. Nekrasova, 65. Tel.: (3852) 566835. E-mail: [email protected]
Zhved Olga Ivanovna, Lecturer of the Department of Hygiene, Fundamentals of Ecology and Health and Safety, Altai State Medical University, Barnaul. 656038, Barnaul, per. Nekrasova, 65. Tel.: (3852) 566835. E-mail: [email protected]
Pashkov Artem Petrovich, Candidate of Medical Sciences, Associate Professor of the Department of Hygiene, Fundamentals of Ecology and Health and Safety, Altai State Medical University, Barnaul. 656038, Barnaul, per. Nekrasova, 65. Tel.: (3852) 566835. E-mail: [email protected]
Potseluev Nikolai Yurievich, Candidate of Medical Sciences, Associate Professor of the Department of Hygiene, Fundamentals of Ecology and Health and Safety, Altai State Medical University, Barnaul. 656038, Barnaul, per. Nekrasova, 65. Tel.: (3852) 566835. E-mail: [email protected]
Shults Ksenia Viktorovna, Lecturer of the
Department of Hygiene, Fundamentals of Ecology
and Health and Safety, Altai State Medical
University, Barnaul.
656038, Barnaul, per. Nekrasova, 65.
Tel.: (3852) 566835.
E-mail: [email protected]
Nagornyak Aleksei Sergeevich, Lecturer of
the Department of Hygiene, Fundamentals of
Ecology and Health and Safety, Altai State Medical
University, Barnaul.
656038, Barnaul, per. Nekrasova, 65.
Tel.: (3852) 566835.
E-mail: [email protected]
