Our study demonstrates that the abnormal nutritional status in children and adolescents represents a considerably larger public health problem, not only for the increase of overweight and obesity prevalence, but also the thinness condition in selected age groups.
Previous studies have shown the prevalence in all countries, the trends over the years, and the impact of both immediate and long-term effects on health and well-being, increasing the risk of cardiovascular and metabolic diseases in adulthood [8
]. Much has been written about its genetic, nutritional and obstetric risk factors [23
]. Profound insights into the biological regulation of appetite, food intake, and weight gain have been gained by identifying and characterizing the rare genetic mutations in individuals and families with extreme obesity, especially [30
]. Attention has been given to maternal weight gain in pregnancy, concluding that increased adiposity at birth may predispose to increased risk of obesity and highlight the importance of the impact that women avoid gaining excessive weight in pregnancy [29
]. Preventive and treatment strategies have been proposed, recognizing that the childhood malnutrition is not an issue for the education sector alone, but it needs to be tackled at a multisectorial level, identifying the particularly important role of local governments, nongovernment organizations, and the media [31
In relation to the assessment of nutritional status in Italian children recent studies founded that the excess weight concerns one child out of four, in association to significant differences in the prevalence of overweight and obesity in relation to geographical distribution (Northern, Central and Southern Italy) [32
]. Recently, an important survey performed by Italian Ministry of Health has achieved that 23.6% of all Italian children are overweight, while 12.6% obese at 8 years old [33
]. However, in the most studies an accurate distribution of all scholastic population by age is not given. Although our study population is lower than previously described (595 versus 2610 cases), the strength of this study is the distribution of all students from 6 to 19 years old by age in order to identify all specific age groups requiring an appropriate health program.
In consideration of the age distribution of our study population, identifyed as another strength of our investigation, we can detected the prevalence of thinness, commonly neglected for the greater impact of obesity and overweight on well-being. Surprisingly, in developing countries the undernutrition is growing, in females particularly. Obviously, we evaluated our results considering the different growth rate in both genders. Adjustments for growth time are important, as recommended by WHO [18
], because female overweight is strongly associated with early growth, while the same time is related to low BMI in male gender [34
]. Trend of early maturation is recognized recently [17
], and evidence is reported in terms of prevalence of thinness in male group and overweight in female group, respectively [34
In conclusion, nutritional status should be considered in specific age groups and, if confirmed in future and larger studies, the high degrees of malnutrition condition (obesity and thinness) are relieved in target age groups. If our initial findings will be confirmed on a larger population, therapeutic approach to specific age groups can be planned in order to achieve long-lasting benefits.