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Cepni AB, Vilson R, Helbing RR, Walsh DW, Johnston CA, Yoon CY, Hughes SO, Ledoux TA. The most optimal school recruitment strategies for school-based obesity prevention and health promotion research in the United States: A systematic review with Delphi study. Obes Rev 2024; 25:e13808. [PMID: 39032149 DOI: 10.1111/obr.13808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 06/03/2024] [Accepted: 07/08/2024] [Indexed: 07/22/2024]
Abstract
This systematic review with the Delphi study aimed to identify effective and resource-efficient (optimal) strategies for recruiting schools into health promotion interventions in the United States. A literature search was conducted in PubMed, Cochrane Library, and CINAHL (EBSCO). A total of 116 interventions reported in 160 articles were included. Most school-based interventions did not report data regarding school recruitment duration (81%), target school size (63%), and school recruitment strategies (78%). Further, no details were provided regarding the reasons for declining to participate despite being eligible. For the Delphi, responses from 23 researchers in school-based clinical trials were collected. A qualitative descriptive approach was used for coding responses and collapsed into higher-order categories based on school recruitment strategies. Delphi participants reported that (1) creating new or leveraging pre-existing partnerships, (2) intervention champion, (3) minimal school disruptions, (4) working with open mind/flexibility, and (5) transparent communication are the most optimal school recruitment strategies. Staff time and travel were the most frequently reported costs for implementing those strategies. The overall trend in school-based obesity prevention intervention studies illustrates the importance of a better understanding school recruitment. Improved reporting can allow researchers to budget their time and resources better and provide greater confidence in reaching their target school size.
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Affiliation(s)
- Aliye B Cepni
- Health and Human Performance Department, University of Houston, Houston, Texas, USA
| | - Reshma Vilson
- Health and Human Performance Department, University of Houston, Houston, Texas, USA
| | - Rachel R Helbing
- University Libraries, University of Houston, Houston, Texas, USA
| | - David W Walsh
- Health and Human Performance Department, University of Houston, Houston, Texas, USA
| | - Craig A Johnston
- Health and Human Performance Department, University of Houston, Houston, Texas, USA
| | - Cynthia Y Yoon
- Health and Human Performance Department, University of Houston, Houston, Texas, USA
| | - Sheryl O Hughes
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, USA
| | - Tracey A Ledoux
- Health and Human Performance Department, University of Houston, Houston, Texas, USA
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Bartoskova Polcrova A, Ksinan Jiskrova G, Bobak M, Pikhart H, Klánová J, Ksinan AJ. Early life social conditions and adverse experiences are associated with childhood BMI and perceived overeating. Pediatr Obes 2024:e13179. [PMID: 39379172 DOI: 10.1111/ijpo.13179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 08/22/2024] [Accepted: 09/13/2024] [Indexed: 10/10/2024]
Abstract
BACKGROUND Early life socioeconomic disadvantage and adverse experiences may lead to overeating, which is in turn associated with increased body mass index (BMI). However, recent evidence indicated that the association between childhood BMI and overeating might be bidirectional. This bidirectionality prompts the need for further investigation of early life predictors of BMI in childhood. OBJECTIVES To longitudinally assess the directionality of the association between childhood BMI and perceived overeating and to investigate their antecedent early life predictors. METHODS The sample included data from 5151 children from the ELSPAC study, collected between 18 months and 11 years of child age. The outcomes were child BMI and mother-reported overeating, assessed at the age of 3, 5, 7 and 11 years. Predictors included maternal BMI, maternal education, single parenthood, financial difficulties and adverse childhood experiences (ACEs) reported by parents and paediatricians. The random intercept cross-lagged panel model was applied. RESULTS The mean child's BMI at age 3 was 15.59 kg/m2 and increased to 17.86 kg/m2 at age 11. The percentage of parent-reported overeating increased in the following period, from about 12% at age 3 to 17% at age 11. The results showed temporal stability in perceived overeating and BMI, with a bidirectional relationship strengthening over time. The child's BMI was associated with maternal BMI. Maternal BMI was positively associated with child-perceived overeating, but a stronger effect was found for ACEs. ACEs mediated the impact of maternal education, financial difficulties and single parenthood on overeating. CONCLUSIONS We observed stable bidirectional associations between BMI and perceived overeating. The results indicated two main pathways: one linked to maternal BMI and early childhood BMI increase followed by perceived overeating and the second associated with ACEs mediating the effect of early childhood social factors on perceived overeating, leading to gradual BMI gain.
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Affiliation(s)
| | | | - Martin Bobak
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Hynek Pikhart
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Jana Klánová
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Albert J Ksinan
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
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Ruiz-Hermosa A, Sánchez-López M, Castro-Piñero J, Grao-Cruces A, Camiletti-Moirón D, Martins J, Mota J, Ceciliani A, Murphy M, Vuillemin A, Sánchez-Oliva D. The Erasmus+ EUMOVE project-a school-based promotion of healthy lifestyles to prevent obesity in European children and adolescents. Eur J Public Health 2024; 34:955-961. [PMID: 39074353 PMCID: PMC11430908 DOI: 10.1093/eurpub/ckae113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2024] Open
Abstract
The aim of this study was to describe the goals, activities, and methods of EUMOVE project in developing a set of resources targeting both primary and secondary schools that allow the entire educational community to promote healthy lifestyles (HL). The EUMOVE project is an Erasmus+ program based in the Creating Active Schools (CAS) framework. The project lasted 3 years and was developed by 14 academic and non-governmental institutions from Spain, Portugal, France, Italy, and the UK. EUMOVE was divided into three phases. In the first phase, several work packages were carried out aimed to ensure the coordination/management of the project activities. In the second phase, seven educational resources strengthened by rigorous scientific research were developed to promote HL from schools. During the last phase, all the resources were disseminated through scientific seminars, workshops with families and teachers, and the online promotion by the non-governmental institutions of each country. The EUMOVE project developed and promoted a smartphone APP, video/activity repository of physically active lessons, active break virtual platform, learning units, and parent/teachers/school-leaders' guidelines to promote physical activity, active commuting, active school playgrounds, healthy diet, and sleep habits. To our knowledge, EUMOVE is the first European project to provide a set of practical tools based on scientific evidence to help schools or future school-wide interventions implement a paradigm shift based on the CAS framework for the promotion of HL. Future research will need to investigate the implementation, effectiveness, and scalability of this proposal.
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Affiliation(s)
- Abel Ruiz-Hermosa
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- ACAFYDE Research Group, Faculty of Sports Sciences, University of Extremadura, Cáceres, Spain
| | - Mairena Sánchez-López
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Faculty of Education, Universidad de Castilla-La Mancha, Ciudad Real, Spain
| | - José Castro-Piñero
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, Spain
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cadiz, Spain
| | - Alberto Grao-Cruces
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, Spain
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cadiz, Spain
| | - Daniel Camiletti-Moirón
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, Spain
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cadiz, Spain
| | - João Martins
- Pedagogical Laboratory, Faculty of Human Kinetics, University of Lisbon, Portugal
| | - Jorge Mota
- Centro de Investigação em Actividade Física, Saúde e Lazer, Universidade do Porto, Porto, Portugal
| | - Andrea Ceciliani
- Department for Life Quality Studies, University of Bologna, Bologna, Italy
| | - Marie Murphy
- Centre for Exercise, Physical Activity, Medicine and Health, Ulster University, Jordanstown, Northern Ireland, United Kingdom
| | - Anne Vuillemin
- Laboratoire Motricité Humaine Expertise Sport Santé (LAMHESS), Université Côte d'Azur, Nice, France
| | - David Sánchez-Oliva
- ACAFYDE Research Group, Faculty of Sports Sciences, University of Extremadura, Cáceres, Spain
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, Spain
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cadiz, Spain
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Pham TTP, Van Do T, Matsushita Y, Hara M, Thi Hoa Tran M, Xuan Le H, Thi The Nguyen T, Thu Hoang U, Huyen Dao Q, Thi Kim Dinh L, Phan H, Kajio H. Reducing the incidence of overweight and obesity by a healthy lifestyle intervention program for schoolchildren in Hanoi, Vietnam: a randomized controlled trial. BMC Public Health 2024; 24:2579. [PMID: 39334085 PMCID: PMC11428474 DOI: 10.1186/s12889-024-20120-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 09/18/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND The increasing incidence and prevalence of childhood overweight (OW) and obesity (OB) are major global health challenges. This study aimed to evaluate the effectiveness of a 2-year healthy lifestyle intervention program in reducing the incidence of OW and OB among schoolchildren aged 11-12 years in Vietnam. METHODS Study design: Randomized controlled trial. PARTICIPANTS AND INTERVENTIONS In total, 733 students participated in this study. Participants were included from four schools in Hanoi based on a random cluster sampling method. Students' health outcomes were assessed at baseline and after 2 years. MAIN OUTCOMES The primary outcomes were the incidence of OW and OB, and the secondary outcomes were the prevalence and remission of OW and OB. Generalized estimating equations (GEEs) were used to determine the outcomes and risk factors. RESULTS After the intervention, the prevalence of OW decreased by 9.24% in the intervention group and 3.01% in the control group. After adjustment for age and sex, the odds of overweight were 36.7% lower in the intervention group than in the control group (OR = 0.633; 95% CI: 0.434-0.925; P = 0.018). The incidence of OW was 1.31% in the intervention group compared with 5.33% in the control group. After adjustment for age and sex, the odds of incident overweight in the intervention group were 77.4% lower than in the control group (OR = 0.226; 95% CI: 0.063-0.813; P = 0.023). The proportion of patients who achieved OW remission was 41.22% in the intervention group and 28.68% in the control group. After adjustment for age and sex, the odds of OW remission of overweight were 2.219 times greater in the intervention group than in the control group (OR = 2.219; 95% CI: 1.220-4.036; P = 0.009). For most OB-related factors, there were no significant differences between the intervention and control groups. CONCLUSION A multicomponent healthy lifestyle intervention was effective in reducing the incidence of OW; however, it had no significant effect on OB among children aged 11-12 years in Hanoi, Vietnam. TRIAL REGISTRATION Retrospectively registered number: UMIN000014992, 20/08/2023.
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Affiliation(s)
- Thuy Thi Phuong Pham
- NCGM-Bach Mai Hospital Medical Collaboration Center, 78 Giai Phong Rd, Hanoi, Vietnam.
| | - Thanh Van Do
- Center of Infectious Diseases, Bach Mai Hospital, 78 Giai Phong Rd, Hanoi, Vietnam
| | - Yumi Matsushita
- Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-Ku, Tokyo, 162-8655, Japan
| | - Mitsuhiko Hara
- Department of Health and Nutrition, Faculty of Human Ecology, Wayo Women's University, 2-3-1 Konodai, Ichikawa-shi, Chiba, 272-8533, Japan
| | - Mai Thi Hoa Tran
- NCGM-Bach Mai Hospital Medical Collaboration Center, 78 Giai Phong Rd, Hanoi, Vietnam
| | - Hung Xuan Le
- Research Methodology and Biostatistics, School of Preventive Medicine and Public Health, Hanoi Medical University, 1 Ton That Tung St, Hanoi, Vietnam
| | | | - Uyen Thu Hoang
- NCGM-Bach Mai Hospital Medical Collaboration Center, 78 Giai Phong Rd, Hanoi, Vietnam
| | - Quyen Huyen Dao
- Biochemistry Department, Bach Mai Hospital, 78 Giai Phong Rd, Hanoi, Vietnam
| | - Lien Thi Kim Dinh
- Center of Nutrition, Bach Mai Hospital, 78 Giai Phong Rd, Hanoi, Vietnam
| | - Hung Phan
- University of Medicine and Pharmacy, Vietnam National University, 144 Xuan Thuy Rd, Hanoi, Vietnam
| | - Hiroshi Kajio
- Department of Diabetes, Endocrinology and Metabolism, Central Hospital, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-Ku, Tokyo, 162-8655, Japan.
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Gansterer A, Moliterno P, Neidenbach R, Ollerieth C, Czernin S, Scharhag J, Widhalm K. Effect of a Web-Based Nutritional and Physical Activity Intervention With Email Support (the EDDY Program) on Primary School Children's BMI Z-Score During the COVID-19 Pandemic: Intervention Study. JMIR Pediatr Parent 2024; 7:e50289. [PMID: 39298741 PMCID: PMC11426922 DOI: 10.2196/50289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 01/31/2024] [Accepted: 06/11/2024] [Indexed: 09/22/2024] Open
Abstract
Background COVID-19 mitigation measures enhanced increases in children's weight and BMI due to decreased physical activity and increased energy intake. Overweight and obesity were major worldwide problems before the pandemic, and COVID-19 increased their severity even more. High BMI directly correlates with health disadvantages including cardiovascular diseases, musculoskeletal disorders, and mental health diseases. Therefore, it is vitally important to develop counteracting interventions to maintain children's health during exceptional situations like pandemics. However, worldwide data from such interventions are limited, and to our knowledge, no suitable study has been carried out during the pandemic in Austria. Objective This study was conducted to examine a 15-week web-based intervention with email support, the EDDY (Effect of Sports and Diet Trainings to Prevent Obesity and Secondary Diseases and to Influence Young Children's Lifestyle) program and the effect of nutritional education and physical activity on children's BMI z-score during the COVID-19 pandemic in Vienna, Austria. Methods The intervention consisted of 3 weekly videos-2 physical activity and 1 nutritional education video, respectively-and a biweekly email newsletter for the parents. This study was conducted in a Viennese primary school from February to June 2021 by a team of physicians, nutritionists, and sports scientists, including both professionals and students. The study population included an intervention group (who received web-based nutritional and physical activity training) and a control group (who received no intervention), comprising in total 125 children aged 8 to 11 years. Due to COVID-19 mitigation measures, the control group was a comparative group observed during the prior school year (2019-2020). Anthropometric measurements were obtained before and after the intervention in both groups. Results Due to a high dropout rate (n=57, 45.6%) because of the mitigation measures, there were 41 children in the intervention group and 27 in the control group. At baseline, the BMI z-score was 1.0 (SD 1.1) in the intervention group and 0.6 (SD 1.2) in the control group (P=.17). After the study period, the BMI z-score decreased by 0.06 (SD 0.21) in the intervention group, whereas it increased by 0.17 (SD 0.34) in the control group (P<.001). Comparing the change in BMI z-scores within BMI categories in the intervention group and control group revealed a statistically significant difference in the normal-weight children (P=.006). Further results showed that the decrease in BMI z-score was significant in the intervention group among both boys (P=.004) and girls (P=.01). Conclusions A web-based intervention with combined nutritional education and physical activity training might be an adequate tool to lessen the enhanced increase in body weight during a pandemic. Therefore, additional studies with greater sample sizes and different locations are needed. As the implementation of such intervention programs is essential, further studies need to be established rapidly.
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Affiliation(s)
| | | | - Rhoia Neidenbach
- Sports Medicine, Exercise Physiology and Prevention, Department of Sport and Human Movement Science, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
| | - Caroline Ollerieth
- Sports Medicine, Exercise Physiology and Prevention, Department of Sport and Human Movement Science, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
| | - Sarah Czernin
- Austrian Academic Institute for Nutrition, Vienna, Austria
| | - Juergen Scharhag
- Sports Medicine, Exercise Physiology and Prevention, Department of Sport and Human Movement Science, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
| | - Kurt Widhalm
- Austrian Academic Institute for Nutrition, Vienna, Austria
- Department of Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
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Seneviratne SN, Sachchithananthan S, Angulugaha Gamage PS, Peiris R, Wickramasinghe VP, Somasundaram N. Improved food habits and anthropometry among primary school children following a novel healthy eating programme. Pediatr Obes 2024:e13171. [PMID: 39228329 DOI: 10.1111/ijpo.13171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/15/2024] [Accepted: 08/21/2024] [Indexed: 09/05/2024]
Abstract
OBJECTIVE Assess longer-term changes in food habits and anthropometry among Grades 1-2 primary school students from four public schools in Colombo, Sri Lanka, following a 3-week programme including a classroom-based motivational storybook discussion and self-monitoring food diary (FD). METHODS This follow-up study assessed changes from baseline (pre-intervention) BMI z-scores and food habits (increased healthy food-item consumption/decreased unhealthy food-item consumption reflected by an increase in FD score) and parental perceptions (anonymous questionnaires) among 863 students (aged 6-8 years), between 9 and 12 months after completing the programme (November 2019-February 2020). RESULTS Food habits showed sustained improvement from baseline mean FD score (baseline vs. follow-up: 51 ± 23% vs. 67 ± 22%, p < 0.001), with children from all BMI subgroups (underweight [UW], normal weight [NW], overweight [OW] and obesity [OB]) showing a significant increase in FD scores (ranging from 14.1% to 17.2%, p < 0.001). BMI z-scores increased in children living with UW (-2.85 to -2.21, p < 0.00) and NW (-0.70 to -0.57, p < 0.001), but did not change in children with OW (+1.5 to +1.49, p = 0.83) and OB (+2.85 to +2.21, p = 0.19). Most parents (n = 497, 97.8%) reported satisfaction with programme outcomes. CONCLUSION This programme led to sustained improvement in food habits among young primary school children from all BMI categories, increase in BMI towards the median among children living with UW and NW, and stabilization of BMI in children with OW and OB, suggesting it as a useful tool for improving nutritional status of young children in low- and middle-income countries (LMIC) facing the double burden of under- and overnutrition.
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Affiliation(s)
- Sumudu N Seneviratne
- Department of Paediatrics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Renda A, Reilly K, Yoong S, Lum M, Lecathelinais C, Hodder R, Grady A. Assessing the implementation of healthy eating and physical activity policies and practices in Early Childhood Education and Care in New South Wales, Australia: A cross-sectional study. Health Promot J Austr 2024. [PMID: 39187294 DOI: 10.1002/hpja.917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 07/17/2024] [Accepted: 08/06/2024] [Indexed: 08/28/2024] Open
Abstract
ISSUE ADDRESSED Australian children are not meeting the recommended physical activity (PA) and healthy eating (HE) guidelines. Health behaviour practices implemented in community settings such as early education services can improve child's health outcomes and are therefore key to help meet guidelines. This study aimed to measure the implementation of HE and PA policies and practices in Early Childhood Education and Care (ECEC) services in New South Wales (NSW), Australia, and to examine their association with service characteristics. METHODS A random sample of 1122 centre-based ECEC services were invited to a cross-sectional survey measuring HE and PA policy and practice implementation. Regression analyses were conducted to assess the relationship between the service characteristics and implementation of policies/practices. RESULTS In total, 565 ECEC services completed the survey. Results show that while some practices are implemented, the implementation of practices promoting HE and PA education is low. Practices related to educator training for HE (18%) and PA (13%) were poorly implemented. The implementation of practices such as 'providing educator training around child PA', 'engaging families in activities to increase child PA' and 'encouraging supportive feeding practices' were significantly higher in services located in major cities than regional/remote services. 'Having a PA policy' and the practice of 'limiting the use of screen time' was significantly higher in long day care services than in preschools. The implementation of 'providing educator-led PA', 'providing free play opportunities' and 'having a PA policy' was significantly lower in private not-for-profit community managed services than in private for-profit services. CONCLUSIONS Implementation of various HE and PA policies and practices in regional/remote services, private not-for-profit services and preschools across NSW could be improved. SO WHAT?: Future research should be prioritised towards identifying factors influencing the implementation of these policies and practices to best tailor implementation support efforts for those who need it the most.
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Affiliation(s)
- Ana Renda
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- National Centre of Implementation Science, University of Newcastle, Newcastle, New South Wales, Australia
- Sydney Local Health District, Population Health, Sydney, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Kathryn Reilly
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- Hunter New England Local Health District, Population Health, Wallsend, New South Wales, Australia
| | - Serene Yoong
- National Centre of Implementation Science, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter New England Local Health District, Population Health, Wallsend, New South Wales, Australia
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia
| | - Melanie Lum
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- National Centre of Implementation Science, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- Hunter New England Local Health District, Population Health, Wallsend, New South Wales, Australia
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia
| | - Christophe Lecathelinais
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- Hunter New England Local Health District, Population Health, Wallsend, New South Wales, Australia
| | - Rebecca Hodder
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- National Centre of Implementation Science, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- Hunter New England Local Health District, Population Health, Wallsend, New South Wales, Australia
| | - Alice Grady
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- National Centre of Implementation Science, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- Hunter New England Local Health District, Population Health, Wallsend, New South Wales, Australia
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Kozioł-Kozakowska A, Wójcik M, Herceg-Čavrak V, Cobal S, Radovanovic D, Alvarez-Pitti J, Hartgring I, Piórecka B, Gabbianelli R, Drożdż D. Dietary Strategies in the Prevention and Treatment of Hypertension in Children and Adolescents: A Narrative Review. Nutrients 2024; 16:2786. [PMID: 39203922 PMCID: PMC11357530 DOI: 10.3390/nu16162786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2024] [Revised: 08/11/2024] [Accepted: 08/17/2024] [Indexed: 09/03/2024] Open
Abstract
This study aims to gather information on effective dietary strategies for the prevention and treatment of hypertension (HTN) in children and adolescents. It discusses specific nutritional models such as the Diet Approaches to Stop Hypertension (DASH diet), traditional Asian diets, plant-based diets, the Southern European traditional Atlantic diet, and the Mediterranean diet, highlighting the benefits of these approaches. The manuscript also addresses dehydration resulting from insufficient fluid intake among children, as well as the consumption of inappropriate beverages, like soft drinks and energy drinks, which contributes to the development of HTN. Additionally, it examines the role of oxidative stress in the pathomechanism of HTN in children, particularly in relation to the antioxidant potential of food components such as selenium, magnesium, and selected vitamins. The relationship between sodium and potassium intake from food and the development of HTN in children is also explored. Finally, this study discusses public health strategies for the prevention of HTN in children. A comprehensive search was performed across multiple databases, such as PubMed/MEDLINE, the Cochrane Library, Science Direct, and EBSCO. This search focused on locating English-language meta-analyses, systematic reviews, randomized clinical trials, and observational studies from around the globe.
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Affiliation(s)
- Agnieszka Kozioł-Kozakowska
- Department of Pediatrics, Gastroenterology and Nutrition, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University, Medical College, Wielicka 265 St., 30-663 Cracow, Poland
| | - Małgorzata Wójcik
- Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University, Medical College, Wielicka 265 St., 30-663 Cracow, Poland;
- University Children’s Hospital in Krakow, Wielicka 265 St., 30-663 Cracow, Poland;
| | - Vesna Herceg-Čavrak
- Faculty of Health Sciences, Libertas International University, 10 000 Zagreb, Croatia;
| | - Sara Cobal
- Croatian Medical Association, 10 000 Zagreb, Croatia;
| | - Dragan Radovanovic
- Department of Medical Sciences, Faculty of Sport and Physical Education, University of Nis, 18000 Nis, Serbia;
| | - Julio Alvarez-Pitti
- Pediatric Department, Consorcio Hospital General, University of Valencia, 46014 Valencia, Spain;
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Innovation in Paediatrics and Technologies-iPEDITEC—Research Group, Fundación de Investigación, Consorcio Hospital General, University of Valencia, 46014 Valencia, Spain;
| | - Isa Hartgring
- Innovation in Paediatrics and Technologies-iPEDITEC—Research Group, Fundación de Investigación, Consorcio Hospital General, University of Valencia, 46014 Valencia, Spain;
| | - Beata Piórecka
- Department of Nutrition and Drug Research, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Skawińska 8 St., 31-066 Cracow, Poland;
| | - Rosita Gabbianelli
- Unit of Molecular Biology and Nutrigenomics, School of Pharmacy, University of Camerino, 62032 Camerino, MC, Italy;
| | - Dorota Drożdż
- University Children’s Hospital in Krakow, Wielicka 265 St., 30-663 Cracow, Poland;
- Department of Pediatric Nephrology and Hypertension, Chair of Pediatrics, Institute of Pediatrics, Jagiellonian University Medical College, Wielicka 265 St., 30-663 Crakow, Poland
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Masini A, Rossi C, Dallolio L, Mascherini G. A cross-sectional analysis between physical activity levels, weight status and empathy-related behaviors in a sample of Tuscany primary school children. J Sports Med Phys Fitness 2024; 64:835-840. [PMID: 38842376 DOI: 10.23736/s0022-4707.24.15915-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
BACKGROUND The present study aimed to investigate the relationship between physical activity (PA) and the development of relational empathy skills in children, taking into account weight status. METHODS Parents/guardians of primary school children were involved in filling out a questionnaire: the Empathy Questionnaire (EmQue-I13) and children were asked to complete the Physical Activity Questionnaire for Children (PAQ-C) to investigate the self-reported PA levels. The weight status was assessed using a self-reported Body Mass Index (BMI). RESULTS Three hundred seventy parents or guardians of students who attended primary school (8.53±1.61 yrs) were recruited. The total score was 2.41±0.89 for PAQ-C and 41.17±6.32 for EmQue-I13. The three domains of EmQue-I13 were: contagion (8.16±2.67), attention to others' feelings (19.40±2.99) and prosocial actions (13.62±3.01). Linear regression models showed that a higher PAQ-C score was positively associated with empathy-related total score P<0.000. Weight status, age and gender were not associated with EmQue-I13. CONCLUSIONS Our results underline the positive association between physical activity and the development of relational empathic skills.
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Affiliation(s)
- Alice Masini
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Chiara Rossi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Laura Dallolio
- Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy
| | - Gabriele Mascherini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy -
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10
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Granados I, D'Agostino EM, Skinner AC, Neshteruk CD, Pollak KI. Neighborhood Public Transportation Access and Adolescent Body Mass Index: Results from the FLASHE Study. Child Obes 2024; 20:321-327. [PMID: 37610857 DOI: 10.1089/chi.2023.0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
Background: Prior investigators have examined the relationship between neighborhood public transportation access and physical activity among adolescents, but research is lacking on the association with obesity in this age group. This study examines the association between neighborhood public transportation access and adolescent BMI using a national sample. Methods: We used cross-sectional data from the Family Life, Activity, Sun, Health, and Eating study, a national survey (2014) that assessed physical activity and diet, among adolescents (aged 12-17 years, N = 1737) and their parents. We ran crude and adjusted linear regression models to test the association between neighborhood-level public transportation access (less prevalent and prevalent) and individual participant-level BMI z-scores. Results: The analytic sample included 336 adolescents (50% female; 69% had healthy weight; 28% had overweight or obesity). Adjusted models showed a positive relationship between high public transportation access and adolescent z-BMI (b = 0.25, confidence interval [95% CI]: -0.01 to 0.50). In stratified analyses, high public transportation access was associated with higher z-BMI for high school students (b = 0.57, 95% CI: 0.23-0.91), males (b = 0.48, 95% CI: 0.09-0.87), and adolescents in households with an income below $99,999 (0.29, 95% CI: 0.02-0.56). Conclusion: Neighborhood public transportation access is associated with adolescent BMI, but the direction of this association varies across urban adolescent demographic subgroups. Further research is needed to clarify the relationships between individual and social-environmental factors that impact public transportation access and its association with adolescent BMI.
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Affiliation(s)
- Isa Granados
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC, USA
- Duke Center for Childhood Obesity Research, Duke University School of Medicine, Durham, NC, USA
| | - Emily M D'Agostino
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Center for Childhood Obesity Research, Duke University School of Medicine, Durham, NC, USA
- Duke Clinical Research Institute, Durham, NC, USA
- Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA
- Duke Global Health Institute, Durham, NC, USA
| | - Asheley C Skinner
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Center for Childhood Obesity Research, Duke University School of Medicine, Durham, NC, USA
- Duke Clinical Research Institute, Durham, NC, USA
| | - Cody D Neshteruk
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Center for Childhood Obesity Research, Duke University School of Medicine, Durham, NC, USA
| | - Kathryn I Pollak
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC, USA
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11
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Principi N, Esposito S. Smartphone-Based Artificial Intelligence for the Detection and Diagnosis of Pediatric Diseases: A Comprehensive Review. Bioengineering (Basel) 2024; 11:628. [PMID: 38927864 PMCID: PMC11200698 DOI: 10.3390/bioengineering11060628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 06/06/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024] Open
Abstract
In recent years, the use of smartphones and other wireless technology in medical care has developed rapidly. However, in some cases, especially for pediatric medical problems, the reliability of information accessed by mobile health technology remains debatable. The main aim of this paper is to evaluate the relevance of smartphone applications in the detection and diagnosis of pediatric medical conditions for which the greatest number of applications have been developed. This is the case of smartphone applications developed for the diagnosis of acute otitis media, otitis media with effusion, hearing impairment, obesity, amblyopia, and vision screening. In some cases, the information given by these applications has significantly improved the diagnostic ability of physicians. However, distinguishing between applications that can be effective and those that may lead to mistakes can be very difficult. This highlights the importance of a careful application selection before including smartphone-based artificial intelligence in everyday clinical practice.
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Affiliation(s)
| | - Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
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12
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Wang J, Cao Y, Wei X, Winkley K, Chang YS. Empowering parents to optimize feeding practices with preschool children (EPO-Feeding): A study protocol for a feasibility randomized controlled trial. PLoS One 2024; 19:e0304707. [PMID: 38829882 PMCID: PMC11146728 DOI: 10.1371/journal.pone.0304707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 05/15/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Parental feeding practices (PFPs) play a key role in fostering preschoolers' dietary habits and in mitigating the risk of childhood obesity. Nevertheless, parents often employ inappropriate feeding practices, leading to children's potential nutrition-related issues. Thus, research is needed to inform interventions that focus on optimizing feeding practices. METHODS This protocol describes the evaluation of a novel intervention-Empowering Parents to Optimize Feeding Practices (EPO-Feeding Program). The program will be evaluated with a two-arm feasibility randomized controlled trial (RCT) in Yangzhou, China. The program includes four weekly group-based training sessions led by healthcare professionals for parents of preschool children. The intervention incorporates sessions, group discussions, motivational interviewing, and supplementary materials (e.g., key messages and educational videos) aimed at enhancing parents' knowledge, skills, and behaviours related to feeding practices. The primary outcomes include i) implementation feasibility, primarily assessed through retention rates; and ii) program acceptability through a survey and qualitative process evaluation. Secondary outcomes encompass the potential impacts on i) PFPs, ii) parental perception of child weight (PPCW), iii) parenting sense of competence, iv) children's eating behaviours, and v) child weight status. Quantitative analyses include descriptive estimates for evaluating the feasibility and linear mixed regression analysis for testing the potential effects. Qualitative valuation will use thematic framework analysis. DISCUSSION If this study shows this program to be feasible to implement and acceptable to parents, it will be used to inform a fully powered trial to determine its effectiveness. The research will also help inform policy and practices in the context of child nutrition promotion, particularly regarding implementing group-based training sessions by healthcare providers in similar settings. TRIAL REGISTRATION Clinicaltrials.gov, Protocol #NCT06181773, 20/11/2023.
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Affiliation(s)
- Jian Wang
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, United Kingdom
| | - Yang Cao
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Xiaoxue Wei
- Department of Hematology and Oncology, Shanghai Children’s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Kirsty Winkley
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, United Kingdom
| | - Yan-Shing Chang
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, United Kingdom
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13
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Bani Salameh AK, El-Hneiti M, Al Omari OS, AlBashtawy M, Karavasileiadou S, Alabbasi Y, Bubshait KS, Malak MZ. Effect of a family-based lifestyle intervention on weight reduction among Jordanian children with obesity aged 6-9 years. Food Nutr Res 2024; 68:9582. [PMID: 38863742 PMCID: PMC11165256 DOI: 10.29219/fnr.v68.9582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 10/18/2023] [Accepted: 11/29/2023] [Indexed: 06/13/2024] Open
Abstract
This study aimed to evaluate the effect of a family-based lifestyle intervention on reducing body weight among Jordanian children with obesity aged 6-9 years old. The pretest-posttest control group design was conducted among 162 children (75 in the intervention group and 87 in the control group) with obesity aged 6-9 years old at four primary schools in Jordan during the period from March 2021 to July 2021. The results found that, after the intervention, there was a statistically significant change in the F scores in the control group vs. in the intervention group (M = 37.07, SD = 2.77; M = 33.48, SD = 2.73; t (160) = 8.29, P < 0.001), where the mean BMI percentile was reduced by 2.05 in the intervention group. A significant difference was demonstrated in the median BMI percentile in the intervention and control groups post-intervention (P < 0.001). A significant difference was also noticed between the average weekly reported dietary habits and the physical activities of both the control group and the intervention group post-intervention. The findings support the effect of family-based lifestyle interventions. Healthcare providers should adopt such interventions for children living with obesity. Future study is required to evaluate the long-term effectiveness of this intervention on weight reduction.
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Affiliation(s)
| | - Mamdouh El-Hneiti
- Community Health Nursing, Faculty of Nursing, Jordan University, Amman, Jordan
| | - Omar S.H. Al Omari
- Pediatric Health Nursing, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Mohamed AlBashtawy
- Community Health Nursing, Princess Salma Faculty of Nursing, Al al-bayt University, Almafraq, Jordan
| | - Savvato Karavasileiadou
- Community, Psychiatric, Mental Health Nursing Department, College of Nursing, Princess Nourah Bint Abdul Rahman University, P.O Box 84428, Riyadh 11671, Riyadh, Saudi Arabia
| | - Yasmine Alabbasi
- Department of Maternity and Child Health Nursing, Princess Nourah Bint Abdulrahman University, P.O Box 84428, Riyadh 11671 Riyadh, Saudi Arabia
| | - Khlood Saleh Bubshait
- Fundamental of Nursing Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Malakeh Z. Malak
- Community Health Nursing, Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
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14
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Al-walah MA, Donnelly M, Alhusaini AA, Heron N. Pre-school-based behaviour change intervention to increase physical activity levels amongst young children: a feasibility cluster randomised controlled trial. Front Public Health 2024; 12:1379582. [PMID: 38756888 PMCID: PMC11096494 DOI: 10.3389/fpubh.2024.1379582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/22/2024] [Indexed: 05/18/2024] Open
Abstract
Background A significant rise in childhood obesity worldwide over the past three decades highlights the urgent need for early interventions, especially in preschools as key settings for child development. This study aimed to assess the feasibility and fidelity of a randomised controlled trial of "I'm an Active Hero" (IAAH), a theory- and evidence-based multi-component behaviour change intervention targeting physical activity and sedentary behaviour amongst preschool-aged children. Methods Two preschools in Taif city, Saudi Arabia were randomly assigned to either the intervention (n = 3 classrooms) or the usual curriculum control group (n = 3 classrooms). The intervention ran for 10 weeks from February to April 2023 and consisted of teacher-led physical activity and sedentary behaviour sessions in preschools, with an additional interactive home component. Primary outcome measures included intervention fidelity, recruitment rates, attrition rates, and compliance with trial procedures. Secondary outcomes included body mass index (BMI), objectively measured physical activity, and sedentary time via the ActiGraph GT3X accelerometer. Outcomes were measured at baseline and at 10 weeks in both study arms. Results The preschool intervention component had high fidelity (93.3%), but the home component fidelity was lower (74%). A cluster-level recruitment rate of 12% (13/112 centres) was attained, whilst the individual-level recruitment rate stood at 36% (52/143 children, mean age of 4.16 years; 23 girls). Attrition was 10%. Compliance varied with 90% for BMI, 71% for accelerometery, and 45% for questionnaires. The intervention group showed small decreases in BMI, slight increases in physical activity, and decreases in sedentary time at follow-up compared to the control group. Parents, facilitators, and assistant teachers considered the intervention to be feasible and beneficial. Conclusion The IAAH intervention was feasible to implement in Saudi Arabian preschools. Facilitators showed high fidelity in delivering it. However, preliminary data did not demonstrate effectiveness. A more comprehensive evaluation across a broader population is warranted. The intervention could be revised to optimise recruitment, compliance, and fidelity of the home-based component. Successful elements from this pilot should be retained whilst adaptations to implementation are made to strengthen key areas.Clinical trial registration: ClinicalTrials.gov, NCT05754359.
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Affiliation(s)
- Mosfer A. Al-walah
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
- Department of Physical Therapy, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Michael Donnelly
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
| | - Adel A. Alhusaini
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Neil Heron
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
- School of Medicine, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
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15
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Klitzman R, Greenberg H. Anti-obesity Medications: Ethical, Policy, and Public Health Concerns. Hastings Cent Rep 2024; 54:6-10. [PMID: 38842904 DOI: 10.1002/hast.1588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
New anti-obesity medications (AOMs) have received widespread acclaim in medical journals and the media, but they also raise critical ethical, public health, and public policy concerns that have largely been ignored. AOMs are very costly, need to be taken by a patient in perpetuity (since significant rebound weight gain otherwise occurs), and threaten to shift resources and focus away from other crucial efforts at obesity treatment and prevention. Many people may feel less motivated to exercise or reduce their caloric consumption, if they assume that obesity is now medically treatable. Policy-makers may similarly come to feel that the solution to the obesity pandemic is simply to prescribe medications and that prevention efforts are far less necessary. These drugs raise concerns about justice (since AOMs will disproportionately benefit the wealthy), medicalization, and marketing. Policy-makers, clinicians, and others need to engage in multipronged educational and policy efforts to address these challenges.
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16
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Kuhn AP, Parker EA, Lane HG, Deitch R, Wang Y, Turner L, Hager ER. Physical Activity, Confidence, and Social Norms Associated With Teachers' Classroom Physical Activity Break Implementation. Health Promot Pract 2024; 25:358-367. [PMID: 36415177 DOI: 10.1177/15248399221136857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
Despite the benefits of classroom physical activity breaks on student health and academic outcomes, more research is needed to understand what factors may be associated with classroom physical activity break implementation, to bolster buy-in from school stakeholders and increase implementation. This quantitative study examined frequency of classroom physical activity break implementation in relation to (1) objectively measured teachers' physical activity and sedentary behaviors, (2) confidence for leading classroom physical activity breaks, (3) social norms (perceptions of other teachers' classroom physical activity break implementation), and (4) teacher- and school-level demographics. In total, 153 classroom teachers in 20 elementary and middle schools completed a survey including classroom physical activity break frequency, confidence, and social norms, one item each, dichotomized (1 = "most/all the time" OR "agree/strongly agree"). Accelerometry assessed total activity and daytime sedentary behavior. Analyses included multilevel binary logistic regression. Teachers were 90% female, 68% White, and 55% in elementary schools. Odds of implementing classroom physical activity breaks were lower among middle school teachers, 14 times greater among those with greater confidence, and over 17 times greater when teachers perceived others frequently implementing classroom physical activity breaks. Teacher activity was not associated with classroom physical activity break implementation. Future interventions to increase classroom physical activity break implementation should focus on increasing teachers' confidence to lead classroom physical activity breaks and creating more buy-in from classroom teachers to enhance each school's culture of health. By enhancing teacher confidence and social norms for implementing classroom physical activity breaks, we may increase school-based physical activity opportunities.
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Affiliation(s)
| | | | | | - Rachel Deitch
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Yan Wang
- The George Washington University, Washington, DC, USA
| | | | - Erin R Hager
- University of Maryland School of Medicine, Baltimore, MD, USA
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17
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Klisch SA, Soule KE. Schools as Hubs of Health: A Comprehensive Supplemental Nutrition Assistance Program-Education Model for Promoting Wellness in Low-Income Communities. CHILDREN (BASEL, SWITZERLAND) 2024; 11:525. [PMID: 38790519 PMCID: PMC11120537 DOI: 10.3390/children11050525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/19/2024] [Accepted: 04/23/2024] [Indexed: 05/26/2024]
Abstract
Research indicates that health interventions are most effective when they address multiple social determinants of health to support positive behavior. Schools as Hubs of Health, a comprehensive model of nutrition and physical activity education, was developed to support wellness within school communities defined as low-income by the national Supplemental Nutrition Assistance Program Education (SNAP-Ed). Components of the model include the following: classroom education; garden education; youth engagement; staff training; parent and community engagement; and policies, systems, and environments. Findings over the last decade indicate positive outcomes in nutrition and physical activity behaviors, youth leadership and engagement, and systems and environmental changes that support health and wellness.
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Affiliation(s)
- Shannon A. Klisch
- University of California Cooperative Extension in San Luis Obispo & Santa Barbara Counties, University of California, Agriculture and Natural Resources, 2156 Sierra Way, Suite C, San Luis Obispo, CA 93401, USA
| | - Katherine E. Soule
- University of California Cooperative Extension in San Luis Obispo & Santa Barbara Counties, University of California, Agriculture and Natural Resources, 2156 Sierra Way, Suite C, San Luis Obispo, CA 93401, USA
- Department of Nutrition, University of California, Davis, 3135 Meyer Hall, One Shields Avenue, Davis, CA 95616, USA
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18
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Itriyeva K. Improving Health Equity and Outcomes for Children and Adolescents: The Role of School-Based Health Centers (SBHCs). Curr Probl Pediatr Adolesc Health Care 2024; 54:101582. [PMID: 38490819 DOI: 10.1016/j.cppeds.2024.101582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
School-based health centers (SBHCs) provide a critical point of access to youth in low-resource communities. By providing a combination of primary care, reproductive health, mental health, vision, dental, and nutrition services, SBHCs improve the health, wellbeing, and academic achievement of the students they serve. SBHCs operate in collaboration with schools and community primary care providers to optimize the management of chronic health conditions and other health concerns that may result in suboptimal scholastic achievement and other quality of life measures. Conveniently located in or near school buildings and providing affordable, child- and adolescent-focused care, SBHCs reduce barriers to youth accessing high quality health care. SBHCs provide essential preventive care services such as comprehensive physical examinations and immunizations to students without a primary care provider, assist in the management of chronic health conditions such as asthma, and provide reproductive and sexual health services such as the provision of contraceptives, screening and treatment for sexually transmitted infections (STIs), and management of pregnancy. Additionally, some SBHCs provide vision screenings, dental care, and nutrition counseling to students who may not otherwise access these services. SBHCs have been demonstrated to be a cost-effective model of health care delivery, reducing both health care and societal costs related to illness, disability, and lost productivity.
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Affiliation(s)
- Khalida Itriyeva
- Cohen Children's Medical Center, Division of Adolescent Medicine, Northwell, New Hyde Park, NY.
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19
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Chan CMJ, Müller-Riemenschneider F, Chia MYH, Hildon ZJL, Chong MFF. Promoting hEalthy Diet and Active Lifestyle (PEDAL): a protocol for the development and feasibility study of a multicomponent intervention among primary school children in Singapore. Pilot Feasibility Stud 2024; 10:52. [PMID: 38521958 PMCID: PMC10960416 DOI: 10.1186/s40814-024-01479-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 03/12/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Setting healthy lifestyle habits during the formative years of childhood is critical as habits can track to adulthood and help prevent obesity and chronic disease risks in later life. While multicomponent interventions have been shown to be effective in changing the lifestyle behaviours of children, there is a limited understanding of the feasibility of such interventions in primary schools in Singapore. A multiphase mixed method study was conducted to develop and examine the feasibility of a theory-based multicomponent school-based intervention-Promoting hEatlthy Eating and Active Lifestyle (PEDAL). METHODS Underpinned by Kincaid's ideation model, the PEDAL intervention was developed to increase fruit and vegetable consumption and decrease sedentary behaviours among children. This study consists of three phases. Phase 1 details the development of PEDAL, which consists of four components: (A) a series of interactive health education lessons, (B) actionable home activities to support habit formation, (C) parental/guardian engagement, and (D) optimising the school environment. In Phase 2, components A and B of PEDAL were implemented in two public, co-educational primary schools among Primary 5 students (aged 10-12 years) in Singapore. Data was collected quantitatively using questionnaires and qualitatively using focus group discussions (FGDs) with students and teachers. The feasibility dimensions of components A and B, including recruitment capability, data collection, social validity, and practicality were examined, and ideation on healthy eating and physical activity was explored. In Phase 3, the full PEDAL intervention was pilot-tested in two other public, co-education primary schools with the same target population, using a concurrent mixed method quasi-experimental study design. Feasibility dimensions and potential effectiveness of the intervention will be assessed. DISCUSSION This study will provide insights into the feasibility of PEDAL and inform its refinement. Findings from the pilot test will guide the planning of a larger-scale definitive trial. TRIAL REGISTRATION Registered with ISRCTN registry (ISRCTN16114046) on 16 October 2022.
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Affiliation(s)
- Cindy Mei Jun Chan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building (MD1), 12 Science Drive 2, #09-01Q, Singapore, 117549, Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building (MD1), 12 Science Drive 2, #09-01Q, Singapore, 117549, Singapore
- Center for Digital Health, Berlin Institute of Health (BIH), Charité-Universitatsmedizin Berlin, Berlin, Germany
| | - Michael Yong Hwa Chia
- Physical Education & Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Zoe Jane-Lara Hildon
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building (MD1), 12 Science Drive 2, #09-01Q, Singapore, 117549, Singapore
| | - Mary Foong-Fong Chong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building (MD1), 12 Science Drive 2, #09-01Q, Singapore, 117549, Singapore.
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.
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20
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Zhang PP, Wang YX, Shen FJ, Xing YF, Gu JY, Li XY, Jin H, Jin SF, Xu M, Wang HJ, Wang H, Li L. Lifestyle intervention in children with obesity and nonalcoholic fatty liver disease (NAFLD): study protocol for a randomized controlled trial in Ningbo city (the SCIENT study). Trials 2024; 25:196. [PMID: 38504343 PMCID: PMC10953067 DOI: 10.1186/s13063-024-08046-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/08/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND The increasing prevalence of childhood obesity has become an urgent public health problem, evidence showed that intervention for childhood obesity bring enormous health benefits. However, an effective individualized intervention strategy remains to be developed, and the accompanying remission of related complications, such as nonalcoholic fatty liver disease (NAFLD), needs to be assessed. This study aimed to develop an m-Health-assisted lifestyle intervention program targeting overweight/obese children and assess its effectiveness on indicators of adiposity and NAFLD. METHODS This is a cluster-randomized controlled trial that conducted in children with overweight/obesity in Ningbo city, Zhejiang Province, China. Students in Grade 3 (8-10 years old) were recruited from six primary schools, with three be randomized to intervention group and three to usual practice group. The intervention program will last for one academic year and consists of health education, dietary guidance, and physical activity reinforcement. This program is characterized by encouraging four stakeholders, including School, Clinic, famIly, and studENT (SCIENT), to participate in controlling childhood obesity, assisted by m-Health technology. Assessments will be conducted at baseline and 3 months, 9 months, 24 months, and 36 months after baseline. The primary outcome will be the differences between the two groups in students' body mass index and fatty liver index at the end of the intervention (9 months after baseline). During the implementation process, quality control methods will be adopted. DISCUSSION The program will test the effectiveness of the m-Health-assisted lifestyle intervention on children with obesity and NAFLD. The results of this study will provide evidence for establishing effective lifestyle intervention strategy aimed at childhood obesity and NAFLD and may help develop guidelines for the treatment of obesity and NAFLD in Chinese children. TRIAL REGISTRATION Clinicaltrials.gov NCT05482191. Registered on July 2022.
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Affiliation(s)
- Ping-Ping Zhang
- Ningbo Center for Healthy Lifestyle Research, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, 315000, China
| | - You-Xin Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Fang-Jing Shen
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, 315000, China
| | - Yun-Fei Xing
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Jia-Ying Gu
- Ningbo Center for Healthy Lifestyle Research, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, 315000, China
| | - Xue-Ying Li
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Han Jin
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, 315000, China
| | - Shi-Feng Jin
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Miao Xu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, 315000, China
| | - Hai-Jun Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Hui Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China.
| | - Li Li
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, 315000, China.
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du Toit LDV, Mason S, van Reenen M, Rossouw TM, Louw R. Metabolic Alterations in Mothers Living with HIV and Their HIV-Exposed, Uninfected Infants. Viruses 2024; 16:313. [PMID: 38400088 PMCID: PMC10892778 DOI: 10.3390/v16020313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/05/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
HIV-exposed, uninfected (HEU) children present with suboptimal growth and a greater susceptibility to infection in early life when compared to HIV-unexposed, uninfected (HUU) children. The reasons for these findings are poorly understood. We used a metabolomics approach to investigate the metabolic differences between pregnant women living with HIV (PWLWH) and their HEU infants compared to the uninfected and unexposed controls. Untargeted metabolomic profiling was performed using 1H-NMR spectroscopy on maternal plasma at 28 weeks' gestation and infant plasma at birth, 6/10 weeks, and 6 months. PWLWH were older but, apart from a larger 28 week mid-upper-arm circumference, anthropometrically similar to the controls. At all the time points, HEU infants had a significantly reduced growth compared to HUU infants. PWLWH had lower plasma 3-hydroxybutyric acid, acetoacetic acid, and acetic acid levels. In infants at birth, threonine and myo-inositol levels were lower in the HEU group while formic acid levels were higher. At 6/10 weeks, betaine and tyrosine levels were lower in the HEU group. Finally, at six months, 3-hydroxyisobutyric acid levels were lower while glycine levels were higher in the HEU infants. The NMR analysis has provided preliminary information indicating differences between HEU and HUU infants' plasma metabolites involved in energy utilization, growth, and protection from infection.
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Affiliation(s)
- Louise D. V. du Toit
- Department of Immunology, Faculty of Health Sciences, University of Pretoria, Pretoria 0001, South Africa;
- UP Research Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, University of Pretoria, Pretoria 0001, South Africa
- Maternal and Infant Health Care Strategies Research Unit, South African Medical Research Council, Pretoria 0001, South Africa
| | - Shayne Mason
- Human Metabolomics, Faculty of Natural and Agricultural Sciences, North-West University, Potchefstroom 2520, South Africa; (S.M.); (M.v.R.); (R.L.)
| | - Mari van Reenen
- Human Metabolomics, Faculty of Natural and Agricultural Sciences, North-West University, Potchefstroom 2520, South Africa; (S.M.); (M.v.R.); (R.L.)
| | - Theresa M. Rossouw
- Department of Immunology, Faculty of Health Sciences, University of Pretoria, Pretoria 0001, South Africa;
- UP Research Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, University of Pretoria, Pretoria 0001, South Africa
- Maternal and Infant Health Care Strategies Research Unit, South African Medical Research Council, Pretoria 0001, South Africa
| | - Roan Louw
- Human Metabolomics, Faculty of Natural and Agricultural Sciences, North-West University, Potchefstroom 2520, South Africa; (S.M.); (M.v.R.); (R.L.)
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22
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Chen C, Eichen D, Kang Sim DE, Strong D, Boutelle KN, Rhee KE. Change in Weight Status Among Children Who Do and Do Not Participate in Intensive Health Behavior and Lifestyle Treatment for Obesity. Child Obes 2024. [PMID: 38265804 DOI: 10.1089/chi.2023.0114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
Background: Primary care providers (PCPs) are expected to provide weight management counseling despite having low confidence in their ability to be effective. This analysis examined change in weight status between children who received usual care from their PCP and those who received one of two structured weight management programs in a randomized control trial. Methods: Data from parent-child dyads who were referred to the Guided Self-Help Obesity Treatment in the Doctor's Office study, but did not participate, were examined to determine change in weight status compared with those who participated in the trial. Families were divided into four groups: Group 1, structured treatment with high attendance; Group 2, structured treatment with low attendance; Group 3, PCP/usual care with some weight management counseling; and Group 4, PCP/usual care with no counseling. Anthropometric data and PCP delivery of weight management counseling were abstracted from the electronic health record. Main outcomes were changes in child BMI z-scores, BMI as a percentage relative to the 95th percentile, and BMI as a difference relative to the 95th percentile at the end of treatment and 6-month follow-up for each group. Results: Groups 1 and 2 showed significant decreases in weight status over time, with Group 1 showing the greatest decrease. Groups 3 and 4 remained relatively stable. Changes in weight status in Groups 2, 3, and 4 were significantly different from Group 1 at post-treatment. Conclusions: While structured weight management programs have a significant impact on weight status, those who received some counseling by their PCP did not show significant increases in weight status and were relatively weight stable. Efforts should be broadened to support PCPs as they provide weight management counseling in the office.
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Affiliation(s)
- Cathy Chen
- Northern California Kaiser Permanente Medical Group, Sacramento, CA, USA
| | - Dawn Eichen
- Department of Pediatrics, School of Medicine, University of California San Diego, San Diego, CA, USA
| | - D Eastern Kang Sim
- Department of Pediatrics, School of Medicine, University of California San Diego, San Diego, CA, USA
| | - David Strong
- Department of Public Health, School of Medicine, University of California San Diego, San Diego, CA, USA
| | - Kerri N Boutelle
- Department of Pediatrics, School of Medicine, University of California San Diego, San Diego, CA, USA
- Department of Public Health, School of Medicine, University of California San Diego, San Diego, CA, USA
- Department of Psychiatry, School of Medicine, University of California San Diego, San Diego, CA, USA
| | - Kyung E Rhee
- Department of Pediatrics, School of Medicine, University of California San Diego, San Diego, CA, USA
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Godoy-Cumillaf A, Fuentes-Merino P, Giakoni-Ramírez F, Duclos-Bastías D, Bruneau-Chávez J, Merellano-Navarro E. The Effects of a Physical Activity Intervention on Adiposity, Physical Fitness and Motor Competence: A School-Based, Non-Randomized Controlled Trial. CHILDREN (BASEL, SWITZERLAND) 2024; 11:137. [PMID: 38275447 PMCID: PMC10814922 DOI: 10.3390/children11010137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/18/2024] [Accepted: 01/21/2024] [Indexed: 01/27/2024]
Abstract
Evidence suggests that early physical activity interventions are a means of preventing childhood obesity and are more effective when delivered in a school setting and based on the ecological model. Therefore, the present study aims to determine the effect of a multicomponent intervention based on the ecological model on adiposity, physical fitness and motor competence in children aged 4 to 5 years. METHODS This study is a non-randomized controlled trial involving 173 children from Chile. The intervention was based on an ecological model and consisted of a physical activity program with three simultaneous parts, affecting intra- and interpersonal dimensions. The adiposity index, body mass index and waist circumference were measured. For physical fitness, muscle strength in the lower part, speed/agility and cardiorespiratory fitness were measured. Motor competence was assessed using catching, aiming and dynamic and static balance tests. RESULTS After the intervention, there was no reduction in adiposity indices; in the intervention group, body mass index increased significantly with a high effect size. The intervention group showed significant differences in physical fitness in the components of muscle strength in the lower part (p = 0.000) and speed/agility (p = 0.002). For motor competence, the intervention group showed significant improvements in most components. CONCLUSIONS The multicomponent intervention did not reduce adiposity indices; however, it caused significant improvements in the physical fitness and motor competence components, so it seems prudent to continue implementing it, given the benefits that adequate levels of motor competence and physical fitness bring to children's health, both in the short and long term.
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Affiliation(s)
- Andrés Godoy-Cumillaf
- Grupo de Investigación en Educación Física, Salud y Calidad de Vida (EFISAL), Facultad de Educación, Universidad Autónoma de Chile, Temuco 4780000, Chile; (A.G.-C.); (P.F.-M.)
| | - Paola Fuentes-Merino
- Grupo de Investigación en Educación Física, Salud y Calidad de Vida (EFISAL), Facultad de Educación, Universidad Autónoma de Chile, Temuco 4780000, Chile; (A.G.-C.); (P.F.-M.)
| | - Frano Giakoni-Ramírez
- Faculty of Education and Social Sciences, Universidad Andres Bello, Las Condes, Santiago 7550000, Chile;
| | - Daniel Duclos-Bastías
- Escuela de Educación Física, Pontificia Universidad Católica de Valparaíso, Valparaíso 2340000, Chile;
- IGOID Research Group, Physical Activity and Sport Science Department, University of Castilla-La Mancha, 45071 Toledo, Spain
| | - José Bruneau-Chávez
- Departamento de Educación Física, Deportes y Recreación, Universidad de la Frontera, Temuco 4811230, Chile;
| | - Eugenio Merellano-Navarro
- Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca 3530000, Chile
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24
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Chen Y, Zhang L, Wang M, Lu B, Shen T, Gu R, Jin X, Wang H. Insights from Multiple Stakeholders Regarding Adolescent Obesity in China: An Exploratory Qualitative Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241273183. [PMID: 39183631 PMCID: PMC11348365 DOI: 10.1177/00469580241273183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 06/03/2024] [Accepted: 06/12/2024] [Indexed: 08/27/2024]
Abstract
With a significant increase in the obesity epidemic in China, addressing adolescent obesity should be highlighted as a priority. The current qualitative study aims to explore the perspectives of key stakeholders regarding adolescent obesity, providing guidance for developing effective obesity interventions for Chinese adolescents. A total of 12 focus group discussions were convened with a range of representative stakeholders including adolescents (n = 37), parents (n = 28), and school staff (n = 21) from sample schools. Semi-structured topic guides were used for data collection. All data were transcribed verbatim and analyzed thematically. From multiple stakeholder perspectives, we finally identified 3 overarching themes (Understanding adolescent obesity, Key healthy lifestyles, and Barriers to obesity prevention practices) and 8 sub-themes. While participants had mixed perceptions of status and prevalence of adolescent obesity, all acknowledged the serious health consequences associated with it. As significant modifiable risk factors, unhealthy diet and physical activity were identified to be prevalent among Chinese teenagers and lead to excessive weight gain. However, a variety of individual, environmental and sociocultural factors hindered the implementation of healthy lifestyles, affecting adolescent obesity prevention and control. Given adolescent obesity is a complex, multifactorial and multilevel public issue, comprehensive lifestyle interventions are recommended that synergistically engage multiple stakeholders across key communities to fight the ongoing obesity epidemic.
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Affiliation(s)
- Ying Chen
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Li Zhang
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Meng Wang
- Hangzhou Centre for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Bian Lu
- Xiaoshan District Centre for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Ting Shen
- Xihu District Centre for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Renjun Gu
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xiaoyuan Jin
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Hongmei Wang
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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25
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Pavlidou E, Papadopoulou SK, Alexatou O, Voulgaridou G, Mentzelou M, Biskanaki F, Psara E, Tsourouflis G, Lefantzis N, Dimoliani S, Apostolou T, Sampani A, Chatziprodromidou IP, Angelakou EP, Giaginis C. Childhood Mediterranean Diet Adherence Is Associated with Lower Prevalence of Childhood Obesity, Specific Sociodemographic, and Lifestyle Factors: A Cross-Sectional Study in Pre-School Children. EPIDEMIOLOGIA 2023; 5:11-28. [PMID: 38247997 PMCID: PMC10801514 DOI: 10.3390/epidemiologia5010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND The Mediterranean diet (MD) has been related with a decreased probability of overweight/obesity as well as central obesity at all stages of the human life, decreasing the risk of diverse disease states and improving quality of life. Over the last few years, the prevalence of childhood overweight/obesity and especially abdominal obesity has highly increased worldwide, being associated with a higher likelihood of overweight/obesity as well as central obesity at the next stages of the life during adulthood. The purpose of the present study was to explore the relationship of MD compliance with sociodemographic, anthropometry and lifestyle features in pre-school children aged 2-5 years old. METHODS This is a cross-sectional study, which includes 5188 pre-school children from diverse regions of Greece. Relevant questionnaires were applied to evaluate the sociodemographic features of the enrolled children. Anthropometric parameters were measured by relevant techniques. Qualified questionnaires were utilized for assessing several lifestyle factors such as physical activity, quality of life, breastfeeding practices, MD adherence, as well as the prevalence of childhood asthma and diabetes mellitus type I. RESULTS Of the enrolled children, 41.7% showed low MD compliance and 36.4% of them indicated moderated compliance, while only 21.9% of them showed a high MD adherence. Overweight/obesity was noted in 24.2% of the assigned children, while abdominal obesity was noticed in 18.2% of them. Higher MD compliance was related with an elevated prevalence of sex (boys, p = 0.0005), Greek nationality (p = 0.0088), rural type of residence (p = 0.0099), childhood overweight/obesity (p < 0.0001) and abdominal obesity (p < 0.0001), lower childbirth weight (p < 0.0001), increased physical activity (p = 0.0041), improved quality of life (p = 0.0008), exclusive breastfeeding (p < 0.0001), childhood asthma (p = 0.0001) and diabetes mellitus type 1 (p = 0.0002). CONCLUSIONS A higher MD adherence is associated with specific sociodemographic, better anthropometric, and beneficial lifestyle factors in pre-school children. However, MD compliance remains low or moderate in the vast majority of children aged 2-5 years old. Thus, future public strategies and policies should be performed to inform parents of the potential beneficial effects of MD against obesity and related chronic diseases at the next stage of their children's lives.
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Affiliation(s)
- Eleni Pavlidou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece; (S.K.P.); (G.V.)
| | - Olga Alexatou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Gavriela Voulgaridou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece; (S.K.P.); (G.V.)
| | - Maria Mentzelou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | | | - Evmorfia Psara
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Gerasimos Tsourouflis
- Second Department of Propedeutic Surgery, Medical School, University of Athens, 11527 Athens, Greece;
| | - Nikos Lefantzis
- Department of Oral and Maxillofacial Surgery, Medical School, Attikon Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Sophia Dimoliani
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Thomas Apostolou
- Department of Physiotherapy, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece;
| | - Anastasia Sampani
- First Department of Pathology, Medical School, University of Athens, 11527 Athens, Greece;
| | | | - Exakousti-Petroula Angelakou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
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Hamulka J, Czarniecka-Skubina E, Gutkowska K, Drywień ME, Jeruszka-Bielak M. Nutrition-Related Knowledge, Diet Quality, Lifestyle, and Body Composition of 7-12-Years-Old Polish Students: Study Protocol of National Educational Project Junior-Edu-Żywienie (JEŻ). Nutrients 2023; 16:4. [PMID: 38201834 PMCID: PMC10780563 DOI: 10.3390/nu16010004] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
Increasing students' nutrition knowledge is an important goal of school education which may improve their lifestyle and consequently reduce the incidence of non-communicable chronic diseases, including obesity. This research aimed at assessing the dietary habits, nutrition-related knowledge and attitudes, and nutritional status of Polish students aged 7-12 years. Additional objectives included recognizing nutrition-related knowledge among their parents and teachers as well as the school food and nutrition environment. The final goal was to develop a nutrition education program. This study protocol presents a general and detailed approach for realizing the above-mentioned issues, including conducting quantitative and qualitative research. The study was designed as cross-sectional, covering primary school students from all over Poland, including rural, town, and metropolitan areas. Data on eating habits, lifestyle, nutrition-related knowledge, and attitudes were collected with questionnaires. Measurements of body weight, height, waist and hip circumferences, and handgrip strength were performed in accordance with the International Standards for Anthropometric Assessment (ISAK) recommendations. Body composition was assessed with bioelectrical impedance analysis. Ultimately, 2218 schools from all 16 voivodeships in Poland registered for the project. In total, quantitative data were collected among 27,295 students, 17,070 parents, and 2616 teachers. Anthropometric measurements were taken among 18,521 students. The results allow us to develop a multifaceted educational program based on knowledge and adapted to the perception of students. Our research may contribute to the identification of subpopulations of children and adolescents at risk of excessive body weight and define the predictors of obesity risk in Poland.
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Affiliation(s)
- Jadwiga Hamulka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska St., 02-787 Warsaw, Poland; (J.H.); (M.E.D.)
| | - Ewa Czarniecka-Skubina
- Department of Food Gastronomy and Food Hygiene, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska St., 02-787 Warsaw, Poland;
| | - Krystyna Gutkowska
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska St., 02-787 Warsaw, Poland;
| | - Małgorzata Ewa Drywień
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska St., 02-787 Warsaw, Poland; (J.H.); (M.E.D.)
| | - Marta Jeruszka-Bielak
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska St., 02-787 Warsaw, Poland; (J.H.); (M.E.D.)
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Schratz LM, Larkin O, Dos Santos N, Martin C. Caregiver Influences on Eating Behaviors in Children: An Opportunity for Preventing Obesity. Curr Atheroscler Rep 2023; 25:1035-1045. [PMID: 38032429 DOI: 10.1007/s11883-023-01171-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2023] [Indexed: 12/01/2023]
Abstract
PURPOSE OF REVIEW This review seeks to define caregiver practices that impact childhood eating behaviors and identify ways to utilize these relationships to prevent childhood obesity. RECENT FINDINGS Childhood obesity, which correlates with adult obesity and increased cardiovascular risk, is increasing in prevalence and severity. Caregivers play a significant role in shaping a child's eating behaviors and their predisposition to obesity. Maternal influences during pregnancy and infancy impact a child's future food preferences. Caregiver feeding styles (authoritarian, authoritative, indulgent, and uninvolved) are associated with distinct effects on children's eating behaviors and self-regulation. Authoritative feeding styles promote child autonomy while setting boundaries in the feeding environment. Early caregiver education and coaching regarding nutrition and feeding practices is beneficial to establishing healthy eating behaviors for children. Various caregivers, including parents, grandparents, siblings, teachers, and others, influence a child's eating habits at different stages of development. These caregivers can both positively and negatively impact a child's diet. Comprehensive interventions involving these various caregivers to promote healthy eating practices in children is ideal. Such interventions should be sensitive to cultural and environmental factors. Childhood obesity is a complex issue with long-term health effects. Early intervention using comprehensive approaches including all caregivers, community support, and public policies to address the social determinants of health will be beneficial. Future research should focus on valid outcome measures and equitable interventions that encompass all aspects of a child's life.
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Affiliation(s)
- Lorraine M Schratz
- Division of Pediatric Cardiology, Department of Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, 175 Cambridge Street, 5Th Floor , Boston, MA, USA.
| | - Olivia Larkin
- Division of Pediatric Cardiology, Department of Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, 175 Cambridge Street, 5Th Floor , Boston, MA, USA
| | - Nilse Dos Santos
- Division of Pediatric Cardiology, Department of Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, 175 Cambridge Street, 5Th Floor , Boston, MA, USA
| | - Christine Martin
- Division of Pediatric Cardiology, Department of Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, 175 Cambridge Street, 5Th Floor , Boston, MA, USA
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Masini A, Marini S, Ceciliani A, Barone G, Lanari M, Gori D, Bragonzoni L, Toselli S, Stagni R, Bisi MC, Sansavini A, Tessari A, Dallolio L. The effects of an active breaks intervention on physical and cognitive performance: results from the I-MOVE study. J Public Health (Oxf) 2023; 45:919-929. [PMID: 37403403 DOI: 10.1093/pubmed/fdad102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 04/12/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND The present quasi-experimental study aimed to evaluate the effects of active breaks intervention (ABs) to promote physical and cognitive improvement in primary school. METHODS The active breaks group (ABsG) performed 10 min of ABs three times per school day and the control group (CG) did normal lessons. The baseline and follow-up evaluation was conducted respectively in October 2019 and in May 2021. Cognitive performance was assessed using working memory test, physical performance was analyzed with ActiGraph accelerometers and physical fitness tests, quality of life was monitored using the Paediatric Quality of Life questionnaire (PedsQL) and classroom behavior was collected with an ad hoc questionnaire. RESULTS We enrolled 153 children (age: 7.61 ± 1.41, 54.2% males). Working memory significantly increased in the ABsG (ΔWM: 1.30 ± 1.17) than in CG (ΔWM: 0.96 ± 1.20). The 6 min Cooper test increased in the ABsG (Δ: 1.77 ± 136.03) but not in CG (Δ: -156.42 ± 187.53), P < 0.05. The weekly physical activity levels increased in both groups; however, the sedentary behavior significantly increased both in ABsG and CG. Children reported improvements in their quality of school life including feeling better in class and in school when using ABs; moreover, children improved their time on task behaviors in ABsG. CONCLUSION The present study has proven to be effective on children's physical and cognitive performance.
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Affiliation(s)
- Alice Masini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Sofia Marini
- Department of Life Quality Studies, University of Bologna, Campus of Rimini, 47921 Rimini, Italy
| | - Andrea Ceciliani
- Department of Life Quality Studies, University of Bologna, Campus of Rimini, 47921 Rimini, Italy
| | - Giuseppe Barone
- Department of Life Quality Studies, University of Bologna, Campus of Rimini, 47921 Rimini, Italy
| | - Marcello Lanari
- Pediatric Emergency Unit, S. Orsola University Hospital, Scientific Institute for Research and Healthcare (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Davide Gori
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Laura Bragonzoni
- Department of Life Quality Studies, University of Bologna, Campus of Rimini, 47921 Rimini, Italy
| | - Stefania Toselli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Rita Stagni
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi" University of Bologna, 40136 Bologna, Italy
| | - Maria Cristina Bisi
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi" University of Bologna, 40136 Bologna, Italy
| | - Alessandra Sansavini
- Department of Psychology "Renzo Canestrari", University of Bologna, 40127 Bologna, Italy
| | - Alessia Tessari
- Department of Psychology "Renzo Canestrari", University of Bologna, 40127 Bologna, Italy
| | - Laura Dallolio
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
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29
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Špečkauskienė V, Trišauskė J, Grincaitė M, Kriaučionienė V, Petrauskienė A. Changes of anthropometric indicators of lithuanian first-graders in 2008-2019 according to International Obesity Task Force (IOTF) and World Health Organization (WHO) definitions. BMC Public Health 2023; 23:2097. [PMID: 37880648 PMCID: PMC10601166 DOI: 10.1186/s12889-023-17031-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/20/2023] [Indexed: 10/27/2023] Open
Abstract
INTRODUCTION The monitoring of children's growth plays a crucial role in assessing their growth patterns and indicating their weight status. Overweight and obesity, determined by cut-offs of body mass index (BMI), are most commonly associated with unhealthy nutrition, non-communicable diseases, and other health disorders. The World Health Organization (WHO) initiated the WHO European Childhood Obesity Surveillance Initiative (COSI) to measure routinely trends in children's anthropometric changes, which allow intercountry comparisons within the European Region. Lithuania joined the COSI initiative. Our study aims to evaluate and compare underweight, normal and elevated weight (overweight and obesity) changes of Lithuanian first-graders during eleven years period. METHODS This study was composed according to the COSI study protocol, and it compares the five rounds of anthropometric measurements of Lithuanian first-graders (7-8-year-old) from 2008 to 2019. The main analysed variables were weight and height; calculated BMI, weight-for-age (W/A), height-for-age (H/A) and body mass index-for-age (BMI/A) z-scores. Changes of the indicators were evaluated according to the International Obesity Task Force (IOTF) cut-offs and WHO child growth standards, grouped by 4 estimates: underweight (thinness), normal weight, overweight and obesity. All comparisons were performed between age groups, gender and COSI round year. RESULTS The mean values for weight, height, W/A and H/A Z-scores were significantly higher for both age and gender groups when comparing later COSI round years (2016 or 2019) to earlier years (2008-2013, in some cases 2016 is included in this range). Time trends of the WHO growth standards and IOTF cut-offs indicate significant decrease among 7-year-old overweight group for boys and girls. Also, a significant decrease was indicated among boys aged 8 years in the overweight group according to the WHO definitions. The only significant increase in trend were expressed in girl's group with obesity aged 8 years according to IOTF cut-offs. CONCLUSION The prevalence of overweight and obesity of first-grade children in Lithuania indicates positive changes, that is the proportion of children with elevated body weight decreased, during eleven-year period. However, it is important to continue the monitoring of children's growth tendencies.
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Affiliation(s)
- Vita Špečkauskienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, LT47181, Lithuania.
- Department of Physics, Mathematics, and Biophysics, Faculty of Medicine, Lithuanian University of Health Sciences, Kaunas, LT, 50162, Lithuania.
| | - Justina Trišauskė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, LT47181, Lithuania
| | - Monika Grincaitė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, LT47181, Lithuania
| | - Vilma Kriaučionienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, LT47181, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, LT47181, Lithuania
| | - Aušra Petrauskienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, LT47181, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, LT47181, Lithuania
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Wu SY, Jensen JL. Association Between Motor Competence and Percentage of Body Fat in Late Childhood: Comparing Proficiency in Fundamental Motor Skills and Advanced Movement Skills. Child Obes 2023; 19:452-460. [PMID: 36219742 DOI: 10.1089/chi.2022.0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: To solve the problem of a weakening relationship between motor competence and body adiposity from late childhood to adolescence, we defined and utilized advanced movement skills (AMS) characterized by higher biomechanical, physiological, and cognitive processing demands compared with fundamental motor skills (FMS). Methods: As a cross-sectional study, the proficiency in FMS and AMS for participants (43 boys and 45 girls) aged 9-12 years was measured by the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition (BOT-2) and Test of Advanced Movement Skills (TAMS), respectively. Density plots and skewness of scoring distributions between assessments were inspected to examine test scalability. We also compared the incremental validity of BOT-2 and TAMS scores in the multiple linear regression models predicting the percentage of body fat (%BF, measured by Tanita BF-689 body scale). Results: The TAMS outcomes produced a more positively/right-skewed scoring distribution with a skewness of 0.09 compared with -0.49 for the BOT-2 scores, indicating a better test discrimination ability. The TAMS total scores were a significant predictor (B = -0.92, p = 0.03) in the model predicting %BF (R2 = 0.39, p < 0.001) and provided a greater degree of incremental validity (f2 = 0.058) compared with the BOT-2 (f2 = 0.018). Conclusions: This study provides supportive evidence that the proficiency in AMS is more appropriate, compared with FMS, at tracking the increasing motor competence and body adiposity in late childhood, which is helpful for motor skills training, physical activity promotion, and overweight/obesity prevention.
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Affiliation(s)
- Sz-Yan Wu
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Jody L Jensen
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
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Deslippe AL, González ODJ, Buckler EJ, Ball GDC, Ho J, Bucholz A, Morrison KM, Mâsse LC. Do Individual Characteristics and Social Support Increase Children's Use of an MHealth Intervention? Findings from the Evaluation of a Behavior Change MHealth App, Aim2Be. Child Obes 2023; 19:435-442. [PMID: 36576875 DOI: 10.1089/chi.2022.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Purpose: Mobile health (mHealth) apps may support improved health behavior practice among youth living in larger bodies. However, long-term use is low, limiting effectiveness. This study evaluated whether youths' motivation, satisfaction, engagement with social features, or parent co-participation supported long-term use of an app named Aim2Be. Methods: A secondary analysis of two versions of Aim2Be (preteen and teen versions) using covariate-adjusted multivariable regression was conducted. We evaluated associations between social support features (a virtual coach, a social poll, or a social wall), parent co-participation (time spent in the parent app), and app satisfaction on use (time spent in Aim2Be). Models were stratified by age and satisfaction was explored as a moderator. Results: Preteens (n = 83) engagement with the social poll (β = 0.26, p < 0.001), virtual health coach (β = 0.24, p = 0.01), app satisfaction (β = 0.31, p = 0.01), and parent co-participation (β = 0.24, p = 0.01) predicted use. In teens (n = 90), engagement with the virtual coach (β = 0.31, p < 0.001) and full utilization of social wall features (β = 0.41, p < 0.001) predicted use. Furthermore, satisfaction moderated the effects of partial utilization of the social wall among teens (β = 0.32 p = 0.02). Conclusion: Social support in mHealth apps may impact users differently depending on age. Features that include health professionals or peers may be more advantageous across ages. App developers should consider age when designing interventions. Clinical Trial Registration NCT03651284.
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Affiliation(s)
- Alysha L Deslippe
- Human Nutrition, Land and Food Systems, University of British Columbia, Vancouver, British Columbia, Canada
- Healthy Starts, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Olivia De-Jongh González
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Evidence to Innovation (Behaviour Change Group), BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - E Jean Buckler
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Geoff D C Ball
- Department of Pediatrics, Faculty of Medicine and Dentistry, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Josephine Ho
- Department of Pediatrics, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Annick Bucholz
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | | | - Louise C Mâsse
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Evidence to Innovation (Behaviour Change Group), BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
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Michalak-Stoma A, Walczak K, Adamczyk M, Kowal M, Krasowska D. Selected miRNA and Psoriasis-Cardiovascular Disease (CVD)-Overweight/Obesity Network-A Pilot Study. Int J Mol Sci 2023; 24:13916. [PMID: 37762217 PMCID: PMC10530775 DOI: 10.3390/ijms241813916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/06/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Psoriasis is nowadays recognized as a multifactorial systemic disease with complex and not fully understood pathogenesis. In psoriatic patients, the increased cardiovascular disease (CVD) risk and frequent comorbidities like obesity are observed. The aim of this study was to investigate differences in miRNA (miR-22-3p, miR-133a-3p, miR-146a-5p, miR-369-3p, and Let-7b-5p) involved in CVD risk among psoriatic patients with overweight/obesity and with normal weight. The study comprised 28 male psoriatic patients and 16 male healthy controls. miRNA isolated from peripheral blood mononuclear cells was reverse-transcribed and RT-qPCR was performed. We have found decreased levels of miR-22, miR-133a, miR-146a, and miR-369 among the psoriatic patients. There was a statistically significant difference in miR-22 and miR-146a levels between psoriatic patients with overweight/obesity and with normal weight. There were positive correlations between miR-22 and miR-146a levels and psoriatic arthritis (PsA) in psoriatic patients with normal weight and between the miR-133a level and PsA in the overweight/obese patients. The decreased levels of selected miRNA are consistent with the levels observed in CVD indicating their impact on the CVD risk in psoriatic patients. miR-22 and miR-146 may be recognized as one of the contributing factors in the obesity-CVD-psoriasis network.
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Affiliation(s)
- Anna Michalak-Stoma
- Chair and Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, ul. Staszica 16, 20-081 Lublin, Poland; (K.W.); (M.A.); (M.K.); (D.K.)
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Chung CS, Sliwa SA, Merlo C, Erwin H, Xu Y. Coordinated Approach: Comprehensive Policy and Action Planning. THE JOURNAL OF SCHOOL HEALTH 2023; 93:853-863. [PMID: 37670595 DOI: 10.1111/josh.13376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/22/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Schools play a vital role in student health, and a collaborative approach may affect health factors such as physical activity (PA) and nutrition. There is a lack of recent literature synthesizing collaborative approaches in K-12 settings. We present updated evidence about interventions that used a coordinated school health approach to support K-12 student PA and nutrition in the United States. METHODS A 2-phase literature review search included a search of systematic reviews for individual qualifying studies (2010-2018), followed by a search for individual articles (2010-2020) that evaluated a coordinated approach or use of school wellness councils, committees, or teams to address PA and/or nutrition. RESULTS We identified 35 articles describing 30 studies and grouped them by intervention type. Interventions demonstrated promising findings for environmental changes and student dietary and PA behaviors. IMPLICATIONS Coordinated and multicomponent interventions demonstrated significant improvements or null results, indicating that implementation of programs and/or policies to promote healthier eating and PA practices may support and do not appear to hinder environmental or behavioral outcomes. CONCLUSIONS Schools can use a coordinated approach to implement opportunities for PA and nutrition; this may influence students' PA and dietary behaviors.
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Affiliation(s)
- Chloe S Chung
- Division of Population Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
| | - Sarah A Sliwa
- Division of Population Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion
| | - Caitlin Merlo
- Division of Population Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion
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Katramiz M, Saadé A, Al Ojaimi M, Gholmieh MN. Effect of Sleeping Disorders on the Growth Parameters of Lebanese Children. Mater Sociomed 2023; 35:201-205. [PMID: 37795160 PMCID: PMC10545929 DOI: 10.5455/msm.2023.35.201-205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 08/26/2023] [Indexed: 10/06/2023] Open
Abstract
Background Sleep is a vital physiological function for the maintenance of health and quality of life by ensuring body rest and restoring its energy levels. Remarkably, some children have sleep disordered breathing (SDB) that can disturb their normal sleep and affect the quality of their lives. Objective The aim of this study was to assess the correlation between SDB and growth impairments and wether the growth parameters vary among genders. Methods This study was conducted in two steps: 1500 questionnaires were distributed to children aged 3 to 12 years. The questionnaire covered personal information, medical history, and the Pediatric Sleep Questionnaire. The latter was used to evaluate the incidence of sleep-disordered breathing and was completed by parents of the involved children. Growth assessment was then determined for the population to find the correlation between sleep disorders and growth impairments. Results A total of 931 completed questionnaires were returned (70.7% response rate). Among the respondents, 56.3% were females whereas 43.3% were males. The mean age was 8 years. The result showed that 16.11% of children were at high risk of sleep-disordered breathing. A significant effect of SDB syndrome on growth parameters (weight-for-age parameter z-score and BMI for age z-score) was observed among males. Concerning the weight for age z-score, a significant difference was found between the means of control and SDB individuals (P = 0.0302). In male groups, the difference was significant (P=0.043), while non-significant difference was found in female groups (P = 0.69). Conclusion This study highlights a significant effect of SDB on growth parameters among males aged between 3 and 12 years.
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Affiliation(s)
| | - Antoine Saadé
- Department of Orthodontics and Dentofacial Orthopedics, Lebanese University, Beirut, Lebanon
| | - Mode Al Ojaimi
- Clinical Sciences Department, College of Medicine, University of Sharjah, UAE
| | - Mona Nahas Gholmieh
- Department of Pediatric and Community Dentistry, Lebanese University, Beirut, Leb
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Hager K, Du M, Li Z, Mozaffarian D, Chui K, Shi P, Ling B, Cash SB, Folta SC, Zhang FF. Impact of Produce Prescriptions on Diet, Food Security, and Cardiometabolic Health Outcomes: A Multisite Evaluation of 9 Produce Prescription Programs in the United States. Circ Cardiovasc Qual Outcomes 2023; 16:e009520. [PMID: 37641928 PMCID: PMC10529680 DOI: 10.1161/circoutcomes.122.009520] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 06/14/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Produce prescriptions may improve cardiometabolic health by increasing fruit and vegetable (F&V) consumption and food insecurity yet impacts on clinical outcomes and health status have not been evaluated in large, multisite evaluations. METHODS This multisite, pre- and post-evaluation used individual-level data from 22 produce prescription locations in 12 US states from 2014 to 2020. No programs were previously evaluated. The study included 3881 individuals (2064 adults aged 18+ years and 1817 children aged 2-17 years) with, or at risk for, poor cardiometabolic health recruited from clinics serving low-income neighborhoods. Programs provided financial incentives to purchase F&V at grocery stores or farmers markets (median, $63/months; duration, 4-10 months). Surveys assessed F&V intake, food security, and self-reported health; glycated hemoglobin, blood pressure, body mass index (BMI), and BMI z-score were measured at clinics. Adjusted, multilevel mixed models accounted for clustering by program. RESULTS After a median participation of 6.0 months, F&V intake increased by 0.85 (95% CI, 0.68-1.02) and 0.26 (95% CI, 0.06-0.45) cups per day among adults and children, respectively. The odds of being food insecure dropped by one-third (odds ratio, 0.63 [0.52-0.76]) and odds of improving 1 level in self-reported health status increased for adults (odds ratio, 1.62 [1.30-2.02]) and children (odds ratio, 2.37 [1.70-3.31]). Among adults with glycated hemoglobin ≥6.5%, glycated hemoglobin declined by -0.29% age points (-0.42 to -0.16); among adults with hypertension, systolic and diastolic blood pressures declined by -8.38 mm Hg (-10.13 to -6.62) and -4.94 mm Hg (-5.96 to -3.92); and among adults with overweight or obesity, BMI decreased by -0.36 kg/m2 (-0.64 to -0.09). Child BMI z-score did not change -0.01 (-0.06 to 0.04). CONCLUSIONS In this large, multisite evaluation, produce prescriptions were associated with significant improvements in F&V intake, food security, and health status for adults and children, and clinically relevant improvements in glycated hemoglobin, blood pressure, and BMI for adults with poor cardiometabolic health.
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Affiliation(s)
- Kurt Hager
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Mengxi Du
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Zhongyu Li
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
- Tufts University School of Medicine, Boston, MA
- Division of Cardiology at Tufts Medical Center, Boston, MA
| | - Kenneth Chui
- Division of Cardiology at Tufts Medical Center, Boston, MA
| | - Peilin Shi
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | | | - Sean B. Cash
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Sara C. Folta
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Fang Fang Zhang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
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Albornoz-Guerrero J, Barceló O, García-Merino S, García-Pérez-de-Sevilla G, Cigarroa I, Zapata-Lamana R. Protocol Study: Resistance Training Program, Nutritional, Sleep, and Screen Use Recommendations in Schoolchildren from Educational Centers in the Extreme South of Chile. Methods Protoc 2023; 6:74. [PMID: 37736957 PMCID: PMC10514887 DOI: 10.3390/mps6050074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 07/30/2023] [Accepted: 08/12/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Childhood obesity has tripled, reaching critical levels of malnutrition. This factor is directly associated with a poorer health-related quality of life of the child and adolescent population. This article presents the study protocol of the project "Strong schoolchildren with a healthy lifestyle" (EF-Salud), which seeks to analyze the effects of a multicomponent program based on muscle strength exercises, sleep nutritional recommendations, and the use of screens in Chilean educational centers with extremely cold weather. METHODS The study protocol of a randomized controlled trial with a pre- and post-test conducted according to the CONSORT statement is reported. The total sample (n = 144) will be schoolchildren from six different school years, four of which will perform an intervention and two control. Intervention group 1 (from two different school years) will receive a muscular strength exercise program in the classroom once a day from Monday to Friday for six months and nutritional, sleep, and use of screens recommendations once a week. Intervention group 2 (from two different school years) will receive a program of nutritional, sleep, and use of screens recommendations once per week for six months. The control group (from two different school years) will carry out their usual school day in relation to physical education classes. Before and after the intervention, the investigators will evaluate the cardiovascular risk, physical condition, and lifestyle related to sleep and use of screens. EXPECTED RESULTS The schoolchildren in intervention group 1 will obtain significant results in increased strength, decreased cardiovascular risk, improved sleep habits, and fewer hours of screen use compared to the other two groups.
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Affiliation(s)
- Javier Albornoz-Guerrero
- Departamento de Educación y Humanidades, Universidad de Magallanes, Punta Arenas 62000000, Chile;
| | - Olga Barceló
- Department of Sports Sciences, Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain;
| | - Sonia García-Merino
- Facultad de Ciencias de la Salud, Universidad Francisco de Vitoria, 28223 Madrid, Spain;
| | | | - Igor Cigarroa
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Los Ángeles 4440000, Chile;
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Reeves S, Poh BK, Chong YT, Lee JAC, Cheah WL, Hafizah YN, Nelson G, Ruzita AT, Koh D, Summerbell C, Essau CA, Gibson EL. From ToyBox Study to eToyBox: Advancing Childhood Obesity Reduction in Malaysian Kindergartens. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6614. [PMID: 37623197 PMCID: PMC10454800 DOI: 10.3390/ijerph20166614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023]
Abstract
Prevention and treatment of childhood obesity is a global concern, and in Malaysia, it is considered a national public health priority. Determinants of childhood obesity are multifactorial and include factors that directly and indirectly influence energy balance-related behaviours, including energy intake and energy expenditure. Interventions to address childhood obesity that have multiple components at different levels have been shown to be the most influential. The ToyBox-study is a childhood obesity intervention aimed at preschool-aged children and their families that had been shown to be effective in several European countries and so was chosen for adaption for the Malaysian setting. Materials were translated and adjusted for the Malaysian context and audience and implemented in kindergartens in Peninsular Malaysia and Sarawak. However, during the COVID-19 pandemic and lockdown, teaching transitioned to being online. This brought an opportunity to reach a wider audience and consider the long-term sustainability of the intervention, and thus eToybox was born. eToybox aims to bring support for healthy energy balance behaviours directly to the teachers, into kindergartens and homes, to encourage families to be active and eat healthily, and prevent or reduce obesity. Through online innovation, the Toybox Study Malaysia programme has been expanded to enhance its potential to impact the promotion of healthy lifestyles among preschoolers and their families, highlighting the importance of a holistic approach to preventing and treating childhood obesity in Malaysia.
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Affiliation(s)
- Sue Reeves
- School of Life and Health Sciences, University of Roehampton, London SW15 4JD, UK;
| | - Bee Koon Poh
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur 50300, Malaysia; (Y.T.C.); (Y.N.H.); (A.T.R.)
| | - Yi Ting Chong
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur 50300, Malaysia; (Y.T.C.); (Y.N.H.); (A.T.R.)
| | - Julia Ai Cheng Lee
- Faculty of Cognitive Sciences and Human Development, Universiti Malaysia Sarawak (UNIMAS), Kota Samarahan 94300, Sarawak, Malaysia; (J.A.C.L.); (G.N.)
| | - Whye Lian Cheah
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak (UNIMAS), Kota Samarahan 94300, Sarawak, Malaysia;
| | - Yatiman Noor Hafizah
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur 50300, Malaysia; (Y.T.C.); (Y.N.H.); (A.T.R.)
| | - Georgia Nelson
- Faculty of Cognitive Sciences and Human Development, Universiti Malaysia Sarawak (UNIMAS), Kota Samarahan 94300, Sarawak, Malaysia; (J.A.C.L.); (G.N.)
| | - Abd Talib Ruzita
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur 50300, Malaysia; (Y.T.C.); (Y.N.H.); (A.T.R.)
| | - Denise Koh
- Centre for Education and Community Wellbeing, Faculty of Education, Universiti Kebangsaan Malaysia (UKM), Bangi 43600, Selangor Dahrul Ehsan, Malaysia;
| | - Carolyn Summerbell
- Department of Sport and Exercise Sciences, Durham University, Durham DH1 3LE, UK;
| | - Cecilia A. Essau
- School of Psychology, University of Roehampton, London SW15 4JD, UK; (C.A.E.); (E.L.G.)
| | - Edward Leigh Gibson
- School of Psychology, University of Roehampton, London SW15 4JD, UK; (C.A.E.); (E.L.G.)
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Konuthula D, Tan MM, Burnet DL. Challenges and Opportunities in Diagnosis and Management of Cardiometabolic Risk in Adolescents. Curr Diab Rep 2023; 23:185-193. [PMID: 37273161 PMCID: PMC10240116 DOI: 10.1007/s11892-023-01513-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/07/2023] [Indexed: 06/06/2023]
Abstract
PURPOSE OF REVIEW This review aims to elucidate the limitations of diagnosing metabolic syndrome in adolescents as well as challenges and opportunities in the identification and reduction of cardiometabolic risk in this population. RECENT FINDINGS There are multiple criticisms of how we define and approach obesity in clinical practice and scientific research, and weight stigma further complicates the process of making and communicating weight-related diagnoses. While the goal of diagnosing and managing metabolic syndrome in adolescents would be to identify individuals at elevated future cardiometabolic risk and intervene to reduce the modifiable component of this risk, there is evidence that identifying cardiometabolic risk factor clustering may be more useful in adolescents than establishing a cutoff-based diagnosis of metabolic syndrome. It has also become clear that many heritable factors and social and structural determinants of health contribute more to weight and body mass index than do individual behavioral choices about nutrition and physical activity. Promoting cardiometabolic health equity requires that we intervene on the obesogenic environment and mitigate the compounding effects of weight stigma and systemic racism. The existing options to diagnose and manage future cardiometabolic risk in children and adolescents are flawed and limited. While striving to improve population health through policy and societal interventions, there are opportunities to intervene at all levels of the socioecological model in order to decrease future morbidity and mortality from the chronic cardiometabolic diseases associated with central adiposity in both children and adults. More research is needed to identify the most effective interventions.
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Affiliation(s)
| | - Marcia M Tan
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Deborah L Burnet
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Department of Pediatrics, University of Chicago, Chicago, IL, USA
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Schumacher LM, Ard J, Sarwer DB. Promise and unrealized potential: 10 years of the American Medical Association classifying obesity as a disease. Front Public Health 2023; 11:1205880. [PMID: 37521999 PMCID: PMC10375286 DOI: 10.3389/fpubh.2023.1205880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/30/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction In June 2013, the American Medical Association (AMA), one of the most influential healthcare organizations in the United States, voted to recognize obesity as a disease. Many who supported this change believed that recognition by AMA of obesity as a disease would serve as a tipping point that would increase access to care, accelerate training and research on the prevention and treatment of obesity, and reduce weight stigma. On the 10-year anniversary of this vote, this perspective piece outlines key advances made, as well as unrealized potential, in improving the obesity public health landscape since the AMA's classification of obesity as a disease. Methods We draw on the empirical literature, as well as our experiences as clinical psychologists, a physician, and public health researchers specializing in obesity, to provide an overview of major advances and continued challenges in improving access to obesity treatment, accelerating prevention and training, and reducing weight stigma. We also outline important next steps to advance these goals. Results While several notable advancements have occurred, significant work remains to create equitable access to evidence-based treatments, bring research and training on obesity on par with its prevalence, and reduce the pervasiveness and harm of weight stigma. Conclusion The past decade has witnessed some advances with respect to access to care and attention, yet there is unrealized potential that awaits attention. Truly conceptualizing and treating obesity as a chronic disease requires a major paradigm shift.
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Affiliation(s)
- Leah M. Schumacher
- Department of Kinesiology, College of Public Health, Temple University, Philadelphia, PA, United States
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, United States
| | - Jamy Ard
- Department of General Surgery, Atrium Health Wake Forest Baptist, Weight Management Center, Winston-Salem, NC, United States
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - David B. Sarwer
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, United States
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, United States
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Kim KN, Shin MK. Association of Infant Feeding Characteristics With Dietary Patterns and Obesity in Korean Childhood. J Prev Med Public Health 2023; 56:338-347. [PMID: 37551072 PMCID: PMC10415650 DOI: 10.3961/jpmph.22.504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 06/02/2023] [Indexed: 08/09/2023] Open
Abstract
OBJECTIVES Young children's feeding characteristics can play an important role in eating habits and health during later childhood. This study was conducted to examine the associations of feeding characteristics with dietary patterns and obesity in children. METHODS This study utilized data from the Korea National Health and Nutrition Examination Survey conducted between 2013 and 2017. In total, 802 toddlers were included, with information on their demographic characteristics, feeding practices and duration, and 24-hour recall obtained from their parents. Feeding characteristics were categorized into feeding type, duration of total breastfeeding, duration of total formula feeding, duration of exclusive breastfeeding, and age when starting formula feeding. Dietary patterns were identified based on factor loadings for the food groups for 3 major factors, with "vegetables & traditional," "fish & carbohydrates," and "sweet & fat" patterns. Overweight/obesity was defined as ≥85th percentile in body mass index based on the 2017 Korean National Growth charts for children and adolescents. Multiple regression analysis was conducted to examine associations between feeding characteristics and dietary patterns. The association between dietary patterns and obesity was analyzed using multivariable logistic regression analysis. RESULTS The early introduction of formula feeding was inversely associated with the "vegetables & traditional" pattern (β=-0.18; 95% confidence interval [CI], -0.34 to -0.02). A higher "vegetables & traditional" intake was associated with a lower risk of obesity (odds ratio, 0.48; 95% CI, 0.24 to 0.95). CONCLUSIONS Feeding characteristics are associated with dietary patterns in later childhood, and dietary patterns were shown to have a potential protective association against obesity.
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Affiliation(s)
- Kyoung-Nam Kim
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul,
Korea
| | - Moon-Kyung Shin
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul,
Korea
- Institute for Health and Society, Hanyang University, Seoul,
Korea
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Marcotrigiano V, Stingi GD, Nugnes PT, Mancano S, Lagreca VM, Tarricone T, Salerno G, Pasquale P, Marchet P, Sava GA, Citiulo A, Tissi M, Oliva S, Cinquetti S, Napoli C. Collective Catering Activities and Official Controls: Dietary Promotion, Sustainability and Future Perspectives. Healthcare (Basel) 2023; 11:healthcare11091347. [PMID: 37174889 PMCID: PMC10178468 DOI: 10.3390/healthcare11091347] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/26/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023] Open
Abstract
Ensuring safe meals with suitable hygienic-sanitary and nutritional features is an essential requirement to guarantee health in different settings. This study aims to evaluate the compliance of collective catering menus adopted in both school canteens and healthcare facilities in a regional area where specific guidelines have been issued, assessing many matters from food weight to single courses and from the use of wholegrain pasta and bread to the rotation of seasonal fruit and vegetables. Overall, 85 menus, edited by freelance professionals and endorsed by the Food Hygiene and Nutrition Service staff of the Local Health Authority, were assessed from 2018 to 2022, highlighting critical issues potentially attributable at a local level to the lack of complete knowledge of the existence of guidelines and official reference documents among nutrition professionals. Since the preliminary outcomes show non-compliance in both sectors investigated, it is essential to continue to strengthen the role of prevention departments entrusted with services dedicated to food and nutritional safety and promote joint official controls performed by healthcare workers and other professionals with different backgrounds in order to ensure safe food for the target population that use collective catering services. In school canteens and healthcare facilities, providing and administering food is an opportunity to promote health through a balanced diet and safe food and offers opportunities for the development of community well-being and the local economy in a sustainable manner, understood in economic, environmental and social terms.
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Affiliation(s)
- Vincenzo Marcotrigiano
- Prevention Department, Local Health Authority BT, Barletta-Andria-Trani, 76125 Trani, Italy
| | | | - Prudenza Tiziana Nugnes
- Food Hygiene and Nutrition Service, Prevention Department, Local Health Authority BT, Barletta-Andria-Trani, 76125 Trani, Italy
| | - Sabrina Mancano
- Food Hygiene and Nutrition Service, Prevention Department, Local Health Authority BT, Barletta-Andria-Trani, 76125 Trani, Italy
| | - Vita Maria Lagreca
- Food Hygiene and Nutrition Service, Prevention Department, Local Health Authority BT, Barletta-Andria-Trani, 76125 Trani, Italy
| | - Teresa Tarricone
- Food Hygiene and Nutrition Service, Prevention Department, Local Health Authority BT, Barletta-Andria-Trani, 76125 Trani, Italy
| | - Gerardo Salerno
- Department of Neurosciences, Mental Health and Sensory Organs "NESMOS", Sapienza University of Rome, 00189 Rome, Italy
| | - Pietro Pasquale
- Apulia Region, Health and Wellness Promotion Section, Food Hygiene and Preventive Nutrition Organizational Structure, 70126 Bari, Italy
| | - Paola Marchet
- Prevention Department, Local Health Authority "AULSS 1 Dolomiti", 32100 Belluno, Italy
| | - Giovanni Andrea Sava
- Food Hygiene and Nutrition Service, Prevention Department, Local Health Authority "AULSS 1 Dolomiti", 32100 Belluno, Italy
| | - Alessandro Citiulo
- Food Hygiene and Nutrition Service, Prevention Department, Local Health Authority "AULSS 1 Dolomiti", 32100 Belluno, Italy
| | - Monica Tissi
- Food Hygiene and Nutrition Service, Prevention Department, Local Health Authority "AULSS 1 Dolomiti", 32100 Belluno, Italy
| | - Stefania Oliva
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Sandro Cinquetti
- Prevention Department, Local Health Authority "AULSS 1 Dolomiti", 32100 Belluno, Italy
| | - Christian Napoli
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, 00189 Rome, Italy
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Datar A, Nicosia N, Samek A. Heterogeneity in place effects on health: The case of time preferences and adolescent obesity. ECONOMICS AND HUMAN BIOLOGY 2023; 49:101218. [PMID: 36623470 PMCID: PMC10164697 DOI: 10.1016/j.ehb.2022.101218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 09/06/2022] [Accepted: 12/20/2022] [Indexed: 05/08/2023]
Abstract
We leverage a natural experiment in combination with data on adolescents' time preferences to assess whether there is heterogeneity in place effects on adolescent obesity. We exploit the plausibly exogenous assignment of military servicemembers, and consequently their children, to different installations to identify place effects. Adolescents' time preferences are measured by a validated survey scale. Using the obesity rate in the assigned installation county as a summary measure of its obesity-related environments, we show that exposure to counties with higher obesity rates increases the likelihood of obesity among less patient adolescents but not among their more patient counterparts.
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Affiliation(s)
- Ashlesha Datar
- Center for Economic and Social Research, University of Southern California, 635 Downey Way, Los Angeles, CA 90089, USA.
| | - Nancy Nicosia
- RAND Corporation, 20 Park Plaza # 920, Boston, MA 02116, USA.
| | - Anya Samek
- Rady School of Management, University of California, San Diego, Wells Fargo Hall, 9500 Gilman Drive #0553, La Jolla, CA 92093, USA.
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Varì R, Silenzi A, d’Amore A, Catena A, Masella R, Scazzocchio B. MaestraNatura Reveals Its Effectiveness in Acquiring Nutritional Knowledge and Skills: Bridging the Gap between Girls and Boys from Primary School. Nutrients 2023; 15:nu15061357. [PMID: 36986085 PMCID: PMC10055962 DOI: 10.3390/nu15061357] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/09/2023] [Accepted: 03/09/2023] [Indexed: 03/15/2023] Open
Abstract
MaestraNatura (MN) is a nutrition education program developed to both enhance awareness about the importance of healthy eating behaviour and skills on food and nutrition in primary school students. The level of knowledge about food and nutritional issues was assessed by a questionnaire administered to 256 students (9–10 years old) attending the last class of primary school and was compared with that of a control group of 98 students frequenting the same schools that received traditional nutrition education based on curricular science lessons and one frontal lesson conducted by an expert nutritionist. The results indicated that students in the MN program showed a higher percentage of correct responses to the questionnaire when compared with the control group (76 ± 15.4 vs. 59 ± 17.7; p < 0.001). Furthermore, the students attending the MN program were requested to organise a weekly menu before (T0) and when finished (T1) the MN program. The results evidenced an overall significant improvement in the score obtained at T1 with respect to those at T0 (p < 0.001), indicating a strong improvement in the ability to translate the theoretical concepts of nutrition guidelines in practice. In addition, the analysis revealed a gender gap between boys and girls, with boys showing a worse score at T0 that was ameliorated after the completion of the program (p < 0.001). Overall, MN program is effective in improving nutrition knowledge amongst 9–10-year-old students. Furthermore, students showed an increased ability to organise a weekly dietary plan after completing the MN program, a result which also bridged gender gaps. Thus, preventive nutrition education strategies specifically addressed to boys and girls, and involving both the school and family, are needed to make children aware of the importance of a healthy lifestyle and to correct inadequate eating habits.
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Affiliation(s)
- Rosaria Varì
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Annalisa Silenzi
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Antonio d’Amore
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Alice Catena
- Postgraduate School of Hygiene and Preventive Medicine, University of Brescia, 25123 Brescia, Italy
| | - Roberta Masella
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
- Correspondence:
| | - Beatrice Scazzocchio
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
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Jurić P, Jurak G, Morrison SA, Starc G, Sorić M. Effectiveness of a population-scaled, school-based physical activity intervention for the prevention of childhood obesity. Obesity (Silver Spring) 2023; 31:811-822. [PMID: 36811242 DOI: 10.1002/oby.23695] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 11/25/2022] [Accepted: 11/27/2022] [Indexed: 02/24/2023]
Abstract
OBJECTIVE The aim of this study was to examine the effectiveness of a real-world, population-scaled, school-based physical activity (PA) intervention that provided two to three additional physical education lessons per week to children aged 6 to 14 years in Slovenia. METHODS More than 34,000 participants from over 200 schools were compared with a similar number of nonparticipants from the same schools. Generalized estimating equations were used to estimate the effects of differing levels of exposure to the intervention (i.e., from 1-5 years) on BMI in children with normal weight, overweight, or obesity at baseline. RESULTS BMI was lower in the intervention group, irrespective of participation duration or baseline weight status. The difference in BMI increased with the program duration, with maximal effects being seen after 3 to 4 years of participation, and was consistently larger for children with obesity (peaking at 1.4 kg/m2 [95% CI: 1.0-1.9] for girls with obesity and peaking at 0.9 kg/m2 [95% CI: 0.6-1.3] for boys with obesity). The program started to become effective at reversing obesity after 3 years, whereas the lowest numbers needed to treat (NNTs) were observed after 5 years (NNTs = 17 for girls and 12 for boys). CONCLUSIONS The population-scaled, school-based PA intervention was effective in preventing and treating obesity. The effects were the greatest in children initially presenting with obesity, such that the program was able to benefit children needing support the most.
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Affiliation(s)
- Petra Jurić
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
| | - Gregor Jurak
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | | | - Gregor Starc
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Maroje Sorić
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
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Ling FCM, Simmons J, Horton M. Development and Validation of Physical Activity-Specific Rumination Scale for Children Through UK Children's Voice. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2023; 94:283-293. [PMID: 35344472 DOI: 10.1080/02701367.2021.1971150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/10/2021] [Indexed: 06/14/2023]
Abstract
Many physical activity (PA) interventions implemented to tackle the child obesity epidemic have shown limited effectiveness, possibly due to a lack of consideration of potential stress that accompanies behavior adaptation and the automatic perseverative cognition that exacerbates the stress (namely rumination). Purpose: The main aim of this paper is to develop and validate the PA-specific Rumination Scale for Children (PARSC) that assesses children's tendencies to engage in repeated negative thoughts about PA (Study 2). Items in the scale were derived from qualitative information about factors that inherently demotivates PA participation (intrinsic barriers) through the lived experience of UK children (Study 1). Methods: For Study 1, pedometry PA data were collected from 143 children (aged 6-10 years). Twenty-one focus groups were formed based on participants' year group, sex and PA level. For PARSC validation (Study 2), 382 children completed the questionnaire twice. Self-report PA, device-based PA, and avoidant coping were also assessed. Results: Study 1-Four overarching themes identified as intrinsic barriers were lack of competence, fear of negative experiences, external constraints and lacking a sense of purpose. Altogether, 10 higher order and lower order themes were used to construct PARSC items. Study 2-From Rasch analysis, PARSC possessed sound internal validity, internal consistency, and test-retest reliability. Self-report PA and avoidant coping were predictive of PA-specific rumination, but not device-based PA. Conclusion: PARSC is a useful tool to identify children ruminative about PA for whom interventions can be designed, with the intrinsic barriers considered, to promote PA behavior adaptation.
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Sanmarchi F, Masini A, Poli C, Kawalec A, Esposito F, Scrimaglia S, Scheier LM, Dallolio L, Sacchetti R. Cross-Sectional Analysis of Family Factors Associated with Lifestyle Habits in a Sample of Italian Primary School Children: The I-MOVE Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4240. [PMID: 36901251 PMCID: PMC10002146 DOI: 10.3390/ijerph20054240] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
The acquisition of healthy dietary and exercise habits during childhood is essential for maintaining these behaviors during adulthood. In early childhood, parents have a profound influence on a child's lifestyle pursuits, serving as both role models and decision-makers. The present study examines family factors as potential contributors to healthy lifestyle habits and their child's overall diet quality among a sample of primary school children. A secondary aim is to evaluate several aspects of diet quality using the Mediterranean adaptation of the Diet Quality Index-International (DQI-I). This cross-sectional study involved 106 children enrolled in a primary school located in Imola, Italy. Data were collected from October to December 2019 using an interactive tool used to assess parent characteristics, children's lifestyle, food frequency (ZOOM-8 questionnaire), and actigraph accelerometers to capture children's physical activity and sedentary behavior. Adherence to the Mediterranean Diet (expressed by KIDMED Index) was positively associated with fathers' educational level, parental sport participation, and the parent's overall nutritional knowledge. Higher mothers' educational level was inversely associated with children's leisure screen time. Parents' nutritional knowledge was positively related to children's average daily minutes of organized sport activities. The better score for DQI-I was for consumption adequacy, followed by variety and moderation. The lowest score was for overall balance. The present study reinforces the importance of family factors in young children's lifestyle choices, particularly their dietary, leisure time, and exercise habits.
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Affiliation(s)
- Francesco Sanmarchi
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Alice Masini
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Carolina Poli
- Department of Medical and Surgical Science, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Anna Kawalec
- Department and Clinic of Paediatric Nephrology, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Francesco Esposito
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Susan Scrimaglia
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Lawrence M. Scheier
- LARS Research Institute, Inc., Sun City, AZ 85351, USA
- Prevention Strategies, Greensboro, NC 27410, USA
| | - Laura Dallolio
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Rossella Sacchetti
- Department of Education Studies “Giovanni Maria Bertin”, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
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Echeverri B, Kozak AT, Gildner DJ, Pickett SM. Night eating syndrome subtypes: differences in binge eating and food addiction symptoms. Eat Weight Disord 2023; 28:3. [PMID: 36752994 PMCID: PMC9908657 DOI: 10.1007/s40519-023-01534-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/05/2023] [Indexed: 02/09/2023] Open
Abstract
PURPOSE The purpose of the current study was to examine differences in binge eating and food addiction symptoms between Night Eating Syndrome (NES) latent subtypes: evening hyperphagia with nocturnal ingestions (EHNI), evening hyperphagia-only (EHO), and nocturnal ingestions-only (NIO). It was hypothesized that the EHNI group would report more binge eating behaviors and more food addiction symptoms than both the EHO and NIO groups. Further, it was hypothesized that the EHO and NIO groups would differ with the EHO group reporting more binge eating behaviors and the NIO group reporting more food addiction symptoms. METHODS Participants completed measures online relating to night eating, binge eating, and food addiction. Average age of the final sample was 34.3 (SD = 10.5) and 62.0% were men. Responses to the Night Eating Questionnaire (NEQ; Allison et al., 2008) were used to create an EHNI group (n = 65), an EHO group (n = 32), and a NIO group (n = 69). ANOVAs were conducted to examine between-group differences on disordered eating symptoms. RESULTS Participants in the EHNI group reported more severe binge eating and food addiction symptoms than those in the EHO and NIO groups. However, there were no significant differences in binge eating or food addiction between the EHO and NIO groups. CONCLUSION Individuals who meet both NES core criteria (evening hyperphagia and nocturnal ingestions) are likely at a higher risk for experiencing other, more severe disordered eating pathologies. Implications concerning assessment and future research on NES typology are discussed. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Affiliation(s)
- Brenda Echeverri
- Center for Translational Behavioral Science, Florida State University College of Medicine, Tallahassee, FL 32310 USA
- Department of Psychology, Oakland University, Rochester, MI 48309 USA
| | - Andrea T. Kozak
- Department of Psychology, Oakland University, Rochester, MI 48309 USA
| | - Daniel J. Gildner
- Center for Translational Behavioral Science, Florida State University College of Medicine, Tallahassee, FL 32310 USA
- Department of Psychology, Oakland University, Rochester, MI 48309 USA
| | - Scott M. Pickett
- Center for Translational Behavioral Science, Florida State University College of Medicine, Tallahassee, FL 32310 USA
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Pfister F, Pozas C. The influence of Chile's food labeling and advertising law and other factors on dietary and physical activity behavior of elementary students in a peripheral region: a qualitative study. BMC Nutr 2023; 9:11. [PMID: 36631817 PMCID: PMC9832755 DOI: 10.1186/s40795-023-00671-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 01/05/2023] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND In 2016, Chile implemented the Food Labeling and Advertising Law to fight childhood obesity through front-of-package food labelling, marketing restrictions and school activities and programs. Nevertheless, little is known on its influence on key stakeholders in vulnerable peripheral regions of the country. This study aimed at identifying important influencing factors including the Food Labeling and Advertising Law on dietary habits and physical activity patterns of second graders in Chile, as perceived by school representatives and the children themselves. METHODS Semi-structured interviews with four school directors and 17 groups of three second graders, informal interviews with 9 key teachers and 4 food services staff complemented with documented observations were carried out in four primary schools of the Chilean city of Punta Arenas, in the Magallanes Punta Arenas region. The different sources allowed for triangulation of results. RESULTS FLAL seems to have a negligible influence on young children's diet and physical activity in the study region. Barriers are children's deeply rooted dietary habits, excessive screen-time, the parents' lacking problem awareness, limited time for parenting practices and bad role modeling. Environmental barriers are overloaded schools due to insufficient coordination between governmental entities, lacking funds for sound teacher training and unsafe neighborhoods limiting children's play. CONCLUSIONS Policy interventions aimed at reducing childhood obesity need to include and empower schools, families and local communities as active partners and consider their framework conditions for greater influence on dietary habits and physical activity.
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Affiliation(s)
- Franziska Pfister
- grid.424060.40000 0001 0688 6779School of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008 Bern, Switzerland
| | - Claudia Pozas
- grid.424060.40000 0001 0688 6779School of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008 Bern, Switzerland
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Gago C, Aftosmes-Tobio A, Beckerman-Hsu JP, Oddleifson C, Garcia EA, Lansburg K, Figueroa R, Yu X, Kitos N, Torrico M, Leonard J, Jurkowski JK, Mattei J, Kenney EL, Haneuse S, Davison KK. Evaluation of a cluster-randomized controlled trial: Communities for Healthy Living, family-centered obesity prevention program for Head Start parents and children. Int J Behav Nutr Phys Act 2023; 20:4. [PMID: 36631869 PMCID: PMC9832428 DOI: 10.1186/s12966-022-01400-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 12/08/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND This study reports the outcomes of Communities for Healthy Living (CHL), a cluster randomized obesity prevention trial implemented in partnership with Head Start, a federally-funded preschool program for low-income families. METHODS Using a stepped wedge design, Head Start programs (n = 16; Boston, MA, USA) were randomly assigned to one of three intervention start times. CHL involved a media campaign and enhanced nutrition support. Parents were invited to join Parents Connect for Healthy Living (PConnect), a 10-week wellness program. At the beginning and end of each school year (2017-2019), data were collected on the primary outcome of child Body Mass Index z-score (BMIz) and modified BMIz, and secondary outcomes of child weight-related behaviors (diet, physical activity, sleep, media use) and parents' weight-related parenting practices and empowerment. Data from 2 years, rather than three, were utilized to evaluate CHL due to the COVID-19 pandemic. We used mixed effects linear regression to compare relative differences during intervention vs. control periods (n = 1274 vs. 2476 children) in (1) mean change in child BMIz and modified BMIz, (2) the odds of meeting child health behavior recommendations, (3) mean change in parenting practices, and (4) mean change in parent empowerment. We also compared outcomes among parents who chose post-randomization to participate in PConnect vs. not (n = 55 vs. 443). RESULTS During intervention periods (vs. control), children experienced greater increases in BMIz and modified BMIz (b = 0.06, 95% CI = 0.02,0.10; b = 0.07, 95% CI = 0.03, 0.12), yet were more likely to meet recommendations related to three of eight measured behaviors: sugar-sweetened beverage consumption (i.e., rarely consume; Odds Ratio (OR) = 1.5, 95% CI = 1.2,2.3), water consumption (i.e., multiple times per day; OR = 1.6, 95% CI = 1.2,2.3), and screen time (i.e., ≤1 hour/day; OR = 1.4, 95% CI = 1.0,1.8). No statistically significant differences for intervention (vs. control) periods were observed in parent empowerment or parenting practices. However, parents who enrolled in PConnect (vs. not) demonstrated greater increases in empowerment (b = 0.17, 95% CI = 0.04,0.31). CONCLUSIONS Interventions that emphasize parent engagement may increase parental empowerment. Intervention exposure was associated with statistically, but not clinically, significant increases in BMIz and increased odds of meeting recommendations for three child behaviors; premature trial suspension may explain mixed results. TRIAL REGISTRATION ClinicalTrials.gov, NCT03334669 , Registered October 2017.
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Affiliation(s)
- Cristina Gago
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Alyssa Aftosmes-Tobio
- School of Social Work, Boston College, 140 Commonwealth Ave, 115 McGuinn Hall, Chestnut Hill, MA, 02467, USA
| | - Jacob P Beckerman-Hsu
- School of Social Work, Boston College, 140 Commonwealth Ave, 115 McGuinn Hall, Chestnut Hill, MA, 02467, USA
| | - Carly Oddleifson
- School of Social Work, Boston College, 140 Commonwealth Ave, 115 McGuinn Hall, Chestnut Hill, MA, 02467, USA
| | - Evelin A Garcia
- Department of Global Health & Population, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Kindra Lansburg
- Action for Boston Community Development (ABCD), Boston, MA, 02111, USA
| | - Roger Figueroa
- Division of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY, 14853, USA
| | - Xinting Yu
- School of Social Work, Boston College, 140 Commonwealth Ave, 115 McGuinn Hall, Chestnut Hill, MA, 02467, USA
| | - Nicole Kitos
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Merieka Torrico
- Action for Boston Community Development (ABCD), Boston, MA, 02111, USA
| | - Jessie Leonard
- Community Action Agency of Somerville (CAAS), Somerville, MA, 02143, USA
| | - Janine K Jurkowski
- Department of Health Policy, Management, and Behavior, State University of New York, Albany, NY, 12222, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Erica L Kenney
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Kirsten K Davison
- School of Social Work, Boston College, 140 Commonwealth Ave, 115 McGuinn Hall, Chestnut Hill, MA, 02467, USA.
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Rae S, Maguire J, Aglipay M, Barwick M, Danavan K, Haines J, Jenkins J, Klaassen M, Moretti ME, Ong F, Persaud N, Porepa M, Straus S, Tavares E, Willan A, Birken C. Randomized controlled trial evaluating a virtual parenting intervention for young children at risk of obesity: study protocol for Parenting Addressing Early Years Intervention with Coaching Visits in Toronto (PARENT) trial. Trials 2023; 24:8. [PMID: 36600302 PMCID: PMC9811050 DOI: 10.1186/s13063-022-06947-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 11/22/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The prevalence of overweight (15%) and obesity (6%) in children under 5 years of age in Canada are high, and young children with overweight and obesity are at increased risk of the development of chronic disease(s) in adulthood. Prior research has demonstrated very few published trials on effective obesity prevention interventions in young children at risk of obesity, within primary healthcare settings. The aim of this study is to determine if 18-48-month-old children at risk for obesity, who are randomized to receive the Parents Together program (i.e., intervention group), have reduced body mass index z-score (zBMI), compared to those not receiving the intervention, at a 12-month follow-up. Secondary clinical outcomes between the intervention and control groups will be compared at 12 months. METHODS A pragmatic, parallel group, 1:1, superiority, randomized control trial (RCT) through the TARGetKids! Practice Based Research Network will be conducted. Young children (ages 18-48 months) who are at increased risk for childhood obesity will be invited to participate. Parents who are enrolled in the intervention group will participate in eight weekly group sessions and 4-5 coaching visits, facilitated by a trained public health nurse. Children and parents who are enrolled in the control group will receive the usual health care. The primary outcome will be compared between intervention arms using an analysis of covariance (ANCOVA). Feasibility and acceptability will be assessed by parent focus groups and interviews, and fidelity to the intervention will be measured using nurse-completed checklists. A cost-effectiveness analysis (CEA) will be conducted. DISCUSSION This study will aim to reflect the social, cultural, and geographic diversity of children in primary care in Toronto, Ontario, represented by an innovative collaboration among applied child health researchers, community health researchers, and primary care providers (i.e., pediatricians and family physicians in three different models of primary care). Clinical and implementation outcomes will be used to inform future research to test this intervention in a larger number, and diverse practices across diverse geographic settings in Ontario. TRIAL REGISTRATION ClinicalTrials.gov NCT03219697. Registered on June 27, 2017.
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Affiliation(s)
- Sarah Rae
- grid.17063.330000 0001 2157 2938Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON Canada ,grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, The Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON Canada
| | - Jonathon Maguire
- grid.415502.7Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, ON Canada ,grid.34429.380000 0004 1936 8198Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON Canada
| | - Mary Aglipay
- grid.415502.7Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, ON Canada
| | - Melanie Barwick
- grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, The Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON Canada
| | - Karoon Danavan
- grid.17063.330000 0001 2157 2938Department of Pediatrics, Department of Medicine, University of Toronto, Toronto, ON Canada
| | - Jess Haines
- grid.34429.380000 0004 1936 8198Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON Canada
| | - Jennifer Jenkins
- grid.17063.330000 0001 2157 2938Applied Psychology and Human Development, University of Toronto, Toronto, ON Canada
| | - Marie Klaassen
- grid.417191.b0000 0001 0420 3866Toronto Public Health, Toronto, ON Canada
| | - Myla E. Moretti
- grid.17063.330000 0001 2157 2938Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON Canada ,grid.42327.300000 0004 0473 9646Clinical Trials Unit, Ontario Child Health Support Unit, The Hospital for Sick Children, Toronto, ON Canada
| | - Frank Ong
- grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, The Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON Canada
| | - Nav Persaud
- grid.415502.7Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, ON Canada ,grid.415502.7Department of Family and Community Medicine, Centre for Urban Health Solutions and Department of Family and Community Medicine, University of Toronto, St. Michael’s Hospital, Toronto, ON Canada
| | - Michelle Porepa
- grid.17063.330000 0001 2157 2938Department of Pediatrics, Department of Medicine, University of Toronto, Toronto, ON Canada
| | - Sharon Straus
- grid.415502.7Department of Pediatrics, St Michael’s Hospital, Pediatric Research, Toronto, ON Canada
| | - Erika Tavares
- grid.42327.300000 0004 0473 9646Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada
| | - Andrew Willan
- grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, The Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada
| | - Catherine Birken
- grid.17063.330000 0001 2157 2938Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON Canada ,grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, The Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Pediatrics, Department of Medicine, University of Toronto, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON Canada
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