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People of South Asian ethnicities in the UK are at a high risk of obesity and related illnesses. This thesis tests predictions derived from the developmental origins literature regarding adiposity in British Pakistanis in middle childhood. Based on previous research, it was\ud predicted that British Pakistani children would be more adipose and have lower birth weights compared to white British children. It was also predicted that second generation British Pakistani children would be more adipose and have lower birth weights than the third\ud generation. White British children (n=211) and British Pakistani children (n=137), including second generation (n=82) and third generation (n=51), aged 7-11 years were measured for body mass index (BMI), waist circumference, triceps and subscapular skinfold thicknesses, blood pressure, and resting heart rate. Birth weight data were collected from one hospital in Middlesbrough (n=184). In addition, a pilot study was conducted on lifestyle, which explored potential differences in British Pakistani children’s lifestyle that may affect adiposity. Dietary\ud data (n=30) were gathered by multiple-pass recall interviews. Physical activity data were collected by accelerometry (n=27) and also by multiple-pass recall interviews (n=30). A questionnaire was developed for the lifestyle pilot to gain an understanding of parents’\ud (n=24) knowledge and practices of healthy lifestyles. Focus group interviews were conducted in one school with children (n=18), which explored children’s knowledge and practices of\ud healthy lifestyles. The same focus groups also explored the issue of child participation in the study to understand different motivations between ethnicities and sexes.\ud \ud Compared to white British children, British Pakistani children were significantly fatter by standard deviation scores for triceps (p=0.003) and subscapular skinfolds (p<0.000), but not by BMI (p=0.599) or waist circumference (p=0.253). British Pakistani children had significantly lower birth weights (p<0.001), and were more frequently classified as low birth weight (p=0.01) and small-for-gestational age (p<0.001). These results may support the foetal origins hypothesis, which is that early life influences can adversely affect later health, by\ud linking foetal development with adiposity in childhood. There was a higher proportion of overfat by subscapular skinfold thickness (p<0.001) in second generation British Pakistani boys compared to the third generation. The two generation groups did not differ significantly\ud in any measure of birth weight. The lifestyle pilot sub-study suggests that differences in lifestyle patterns may exist between the British Pakistani and white British families who participated, and it could provide a basis for a full study on this topic. Methods implemented in public health research should reconsider using the body mass index alone as a predictor of body fatness, especially in populations including British Pakistanis. Qualitative\ud methodologies should be used to inform study design as a way of illuminating complex and interrelated issues such as obesity and ethnicity

Topics: Childhood obesity, early orgins of disease, birth weight, diet, physical activity, study participation, migration, health in ethicity, British Pakistanis
Year: 2010
OAI identifier:
Provided by: Durham e-Theses

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  1. (2008a) Differences in body composition and cardiovascular and type 2 diabetes risk factors between migrant and E. Henderson Adiposity doi
  2. A and Unwin, N (2008b) Evolutionary perspectives on type 2 diabetes in Asia. In: Medicine and Evolution: Current Applications, Future Prospects. Elton, S and O'Higgins, P Florida: Taylor and Francis.
  3. (1981). A History of the Study of Human Growth. Cambridge University Press, p 499. E. Henderson Adiposity doi
  4. (1988). A Pakistani community in Britain. doi
  5. (2003). A qualitative assessment of nutrition knowledge levels and dietary intake of school children in Hyderabad. doi
  6. (2007). A review of the literature and a new classification of the early determinants of childhood obesity: from pregnancy to the first years of life. doi
  7. (2003). A short review of dietary assessment methods used in national and Scottish research studies [Internet] Briefing paper prepared for Working Group on Monitoring Scottish Dietary Targets Workshop.
  8. (2006). A study of central fatness using waist-to-height ratios in UK children and adolescents over two decades supports the simple message – ‘keep E. Henderson Adiposity doi
  9. (1984). A syndrome of digestive-system diseases with a genetic-basis in new world native peoples.
  10. (2002). Accelerometers identify inactive and potentially obese children (Early Bird 3). doi
  11. (2003). Accessing the community: gaining insider perspectives from the outside. doi
  12. (2008). Active People Survey. London Strauss A and
  13. (1989). Activity, Energy Expenditure and Energy Requirements of Infants and Children [Internet]
  14. (2002). Adiposity and hyperinsulinemia in Indians are present at birth. doi
  15. (2009). Agency. Available from:
  16. and Pietrobelli A (2005) Pediatric body composition methods.
  17. (1999). Anthropometric measurement error and the assessment of nutritional status. doi
  18. (1997). Anthropometry in health assessment: The importance of measurement error.
  19. (2000). Association between postnatal catch-up growth and obesity in childhood: prospective cohort study. doi
  20. (2008). Association of perinatal factors and obesity in 6- to 8-year-old Chilean children doi
  21. (2006). Associations of size at birth and dual-energy Xray absorptiometry measures of lean and fat mass at 9 to 10 y of age
  22. (2005). Attainment of precision in implementation of 24 h dietary recalls: INTERMAP UK. doi
  23. (2004). Behavioral and physiological indices related to BMI in a cohort of primary school children in Greece. doi
  24. (2008). body comp, child obesity. Text book or reference source.
  25. (2006). Body fat measurements in children as predictors for the metabolic syndrome: focus on waist circumference. doi
  26. (1993). Body mass index and percentage fat mass in healthy German schoolchildren and adolescents doi
  27. (1988). Calcium intake in the elderly: validation of a dietary questionnaire. doi
  28. (1963). Catch-up growth following illness or starvation. doi
  29. (2003). Central overweight and obesity in British youth aged 11-16 years: cross sectional surveys of waist circumference. doi
  30. (2005). Changes in food habits among Pakistani immigrant women in doi
  31. (2003). Child to adult socio-economic conditions and obesity in a national cohort. doi
  32. (1999). Childhood predictors of adult obesity: a systematic review.
  33. (2004). Children’s Fund and World Health Organization doi
  34. (2002). Clinical features, adverse effects and outcome. doi
  35. (1998). Comparison of a computerized physical activity recall with a triaxial motion sensor in middle-school youth. doi
  36. (2003). Cutoff values for normal anthropometric variables in Asian Indian adults. Diabetes Care 26:1380-1384. E. Henderson Adiposity doi
  37. (2006). Development of adiposity in adolescence: five year longitudinal study of an ethnically and socioeconomically diverse sample of young people in Britain. doi
  38. (2005). Developmental origins of the metabolic syndrome: Prediction, plasticity and programming. doi
  39. (1962). Diabetes mellitus – A ‘thrifty’ genotype rendered detrimental by ‘progress’?
  40. (2004). Differences in fat and lean mass proportions in normal and growth restricted fetuses. doi
  41. (2002). Early evidence of ethnic differences in cardiovascular risk: cross sectional comparison of British South Asian and white children. doi
  42. (2004). Early life origins of insulin resistance and type 2 diabetes in India and other Asian countries.
  43. (2005). Early life risk factors for obesity in childhood: cohort study.
  44. (2001). Early nutrition and later adiposity.
  45. (2004). Early nutrition, epigenetic changes at transposons and imprinted genes, and enhanced susceptibility to adult chronic diseases. doi
  46. (2005). Early origins of obesity: programming the appetite regulatory system. doi
  47. (2001). Energy intake by multiple pass 24−hour recall and total energy expenditure: A comparison in a representative sample of 3-4 year olds. doi
  48. (2006). Epidemic obesity and type 2 diabetes in Asia. doi
  49. et al(2006) Complement C3 and C-reactive protein are elevated in South Asians independent of a family history of stroke. doi
  50. (2009). Ethnic and gender differences in physical activity levels among 9 – 10 year -old children of white European, South Asian and African Caribbean origin: the Child Heart Health Study in England ( doi
  51. (2001). Ethnic group [Internet] 2001Census / Census Area Statistics. Available from b=276813&c=middlesbrough&d=13&e=16&g=385906&i=1001x1003x1004&m=0&r =1&s=1253790728160&enc=1&dsFamilyId=87
  52. (2004). Ethnic group differences in overweight and obese children and young people in England: cross-sectional survey.
  53. (1986). Ethnicity and the boundary process in context. doi
  54. (1922). Ethnography and participants observation. Sage Publications: Thousand Oakes.
  55. (2010). European Society of Hypertension International Protocol for the validation of blood pressure monitors: A critical review of its application and rationale for revision. Blood Pressure Monitoring doi
  56. (1982). Evolutionary medicine and health: new perspectives.
  57. (2001). Executive Summary of the Third Report of the doi
  58. (1949). Fallacy of per-weight and per-surface area standards and their relation to spurious correlations.
  59. (2001). Fetal and early life growth and body mass index from birth to early adult hood in 1958 British cohort: longitudinal study. doi
  60. (1999). Fetal origins of adult disease – the hypothesis revisited. doi
  61. (1978). Foetus into Man: Physical Growth from Conception to Maturity. doi
  62. (1928). Foundations for research: Methods of inquiry in education and the social sciences. Lawrence Erlbaum Associates : London. E. Henderson Adiposity
  63. Freedson PS et al (2000) Using objective physical activity measures with youth: how many days of monitoring are needed? doi
  64. (1997). Generational changes in height and body mass differences between British Asians and the general population in Glasgow. doi
  65. (2001). Global and societal implications of the diabetes epidemic. doi
  66. (2004). Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care doi
  67. (2006). Health and social research in multicultural societies. doi
  68. (2003). Health consequences of obesity.
  69. (2004). High prevalence of insulin resistance in postpubertal Asian Indian children is associated with adverse truncal body fat patterning, abdominal adiposity and excess body fat. doi
  70. (1999). Hormones, health, and behavior: a socioecological and lifespan perspective. doi
  71. (1988). Human growth: selected aspects of research on well-nourished children. Annual Review of Anthropology. doi
  72. (1996). Humanities Descent. The Consequences of Ecological Instability. doi
  73. (2006). Illinois: Human Kinetics Books. Loucks
  74. (2000). Impact of birth weight on ethnic variations in subcutaneous and central adiposity in American children aged 5-11 years. A study from the Third National Health and Nutrition Examination Survey. doi
  75. (1964). Infant Mortality, childhood nutrition and ischaemic heart disease in England and Wales. doi
  76. (1988). Insulin resistance and human disease: A short history. doi
  77. (2004). Insulin resistance syndrome (metabolic syndrome) and obesity in Asian Indians: Evidence and implications. doi
  78. (2003). Is birth weight related to later glucose and insulin metabolism?—a systematic review. doi
  79. (2005). It’s good to talk: children’s views on food and nutrition. doi
  80. (2000). Kinsip andContinuity: Pakistani Families in Britain. Harwood academic publishers: Amsterdam E. Henderson Adiposity in British Pakistani and White British School Children References 209
  81. (1989). Kosrae: The sleeping lady awakens. Federated States of Micronesia: Kosrae State Tourist Division.
  82. (2005). Laboratory and field measurements of body composition. doi
  83. (2008). Lessons learned over 35 years: dietary assessment methods for school-age children. doi
  84. (2004). Life history and the early origins of health differentials. doi
  85. (2008). Low birth weight and catch-up growth associated with metabolic syndrome: a ten year systematic review.
  86. (2006). Low birth weight live births [Internet] Health and Care. Available from b=276813&c=middlesbrough&d=13&e=16&g=385906&i=1001x1003x1006&k=birth weight&m=0&r=1&s=1253790956032&enc=1&domainId=6&dsFamilyId=1154
  87. (2002). Maternal smoking during pregnancy and childhood obesity doi
  88. (2007). Metabolic syndrome in children: Current issues and South Asian perspective. doi
  89. (2002). Molecular and biological factors with emphasis on adipose tissue development.
  90. (2006). Monitoring of physical activity in young children:How much is enough?
  91. (2009). National child measurement programme: Detailed analysis of the 2007/08 national dataset [Internet] National Obesity Observatory and National Health Service. Available from:>
  92. (2003). Neonatal anthropometry: the thin-fat Indian baby. The Pune Nutritional Study. doi
  93. (2009). Obesity and overweight [Internet] Media Centre. Available from:
  94. (2007). Objective measurement of levels and patterns of physical activity. Archives of Disease doi
  95. (1988). Parent involvement in children’s health promotion: The Minnesota Home Team. doi
  96. (1994). Parental and perinatal factors associated with childhood obesity
  97. (1984). Passage to Britain: immigration in British history and politics. Harmondsworth: Penguin in association with doi
  98. (2009). Patterns of adiposity and obesity among South Asian and white European children: Child Heart Health Study in England. doi
  99. (2002). Persistence of lower birth weight in second generation South Asian babies born in the United Kingdom. doi
  100. (2001). Physical activity assessment in children and adolescents. doi
  101. (1997). Physical activity is associated with leptin in Mauritians.
  102. (2008). Physiology of Sport and Exercise. Human Kinetics.
  103. (1976). Population differences in body size, shape, and growth rate: A doi
  104. (2004). Predictors of children’s body mass index: a longitudinal study of diet and growth in children aged 2-8 y. doi
  105. (1991). Programming by early nutrition in man. CIBA Foundation Symposium: The Childhood Environment and Adult Disease. doi
  106. (2003). Programming of lean body mass: a link between birth weight, obesity, and cardiovascular disease?
  107. (2008). Public Health Observatory doi
  108. (2002). Qualitative Researching. doi
  109. (1968). rate of intra-uterine growth. doi
  110. (2001). Relation between consumption of sugarsweetened drinks and childhood obesity: a prospective, observational analysis. doi
  111. (1984). Research progress in validation of clinical methods of assessing body composition. doi
  112. (1990). Risk by place of death from cardiovascular disease and chronic bronchitis determined by place of birth in England and Wales doi
  113. (1993). Role of insulin resistance in human disease (syndrome X): An expanded definition. doi
  114. (1998). Role of the prenatal environment in the development of obesity. doi
  115. (1991). Self-report measure of children's physical health. doi
  116. (2006). Size at birth, postnatal growth and risk of obesity doi
  117. (1989). Skinfold equations for estimation of body fatness in children and youth. doi
  118. (2007). Sleep deprivation and energy metabolism: to sleep, perchance to eat? Current Opinion in Endocrinology, doi
  119. (1989). Socio-economic status and obesity: a review of the literature. doi
  120. (2002). Technical reliability of the CSA activity monitor: The early bird study. doi
  121. (2003). Techniques to identify themes. doi
  122. (1999). The ‘thrifty’ genotype in doi
  123. (1998). The assessment of physical activity in individuals and populations: why try to be more precise about how physical activity is assessed.
  124. (1976). The Biology of Human Fetal Growth. London:
  125. (1993). The British Hypertension Society protocol for the evaluation of blood pressure measuring devices. doi
  126. (2006). The crucial role of dietary n-6 polyunsaturated fatty acids in excessive adipose tissue development: relationship to childhood obesity Nestle Nutrition Workshop Series Pediatric Program, doi
  127. (2001). The development of waist circumference percentiles in British children aged 5.0 – 16.9. doi
  128. (2000). The effect of type of physical activity measure on the relationship between body fatness and habitual physical activity in children: a meta-analysis. doi
  129. (1999). The Focus interview and focus groups: continuities and discontinuities. In: Bryman A and Burgess RG eds. Qualitative Researching. Thousand Oakes: Sage,
  130. (1999). The impact of immigration: a documentary history of the effects and experiences of immigrants in Britain since
  131. (2003). The influence of birth weight and intrauterine environment on adiposity and fat distribution later in life.
  132. (2002). The lifecycle effects of nutrition and body size on adult adiposity, diabetes and cardiovascular disease. doi
  133. (2007). The obesity epidemic in the United States—gender, age socioeconomic, racial/ethnic and geographical characteristics: a systematic review and meta-regression analysis. doi
  134. (1991). The Relation of Physical Activity to Cardiovascular Disease Risk Factors in Mauritians.
  135. (2003). The structuring of ethnic inequalities in health: economic position, racial discrimination and racism. doi
  136. (2004). Total energy expenditure and physical activity in young Scottish children: mixed longitudinal study. doi
  137. (2004). Trends in the association between obesity and socioeconomic status in US adults: 1971-2000. Obesity Research 12:1622-1632. E. Henderson Adiposity doi
  138. (2005). Trends in waist circumferences in young British children: a comparative study. doi
  139. (1999). Twins and maternal smoking: ordeals for the fetal origins hypothesis doi
  140. (2000). Utilizing Insider-Outsider Research Teams in Qualitative Research. doi
  141. (2000). Validation of A&D UA-767 device for the self-measurement of blood pressure. doi
  142. (1997). Validation of an instrument for measurement of physical activity in youth. doi
  143. (2005). Validation of energy intake by 24−hour multiple pass recall: comparison with total energy expenditure in children aged 5−7 years. doi
  144. (2005). Waist circumference criteria for the diagnosis of abdominal adiposity are not applicable uniformly to all populations and ethnic groups. doi
  145. (2003). Why do kids eat healthful food? Perceived benefits of and barriers to healthful eating and physical activity among children and adolescents. doi
  146. (2002). Working group on blood pressure monitoring of the European Society of Hypertension International Protocol for validation of blood pressure measuring devices in adults. doi
  147. (2000). World Health Organization doi
  148. (2006). You don’t do fieldwork, fieldwork does you’: between subjectivation and objectivation in anthropological fieldwork. In: Hobbs and Wright eds. A Handbook of Fieldwork. doi

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