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Szczyrska J. Pediatric obesity - time to act as early as possible. Pediatr Endocrinol Diabetes Metab 2023; 29:267-273. [PMID: 38282496 PMCID: PMC10826697 DOI: 10.5114/pedm.2023.133122] [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: 05/16/2023] [Accepted: 05/25/2023] [Indexed: 01/30/2024]
Abstract
There has been a global increase in the average body mass index (BMI) in children and an alarming trend of increasing weight among the youngest children in recent decades. Childhood excess weight and obesity result in premature adult mortality and morbidity. Obesity is not only a risk factor for other diseases but is also a complex, multifactorial disease in its own right, linked to a genetic predisposition influenced by an increasingly permissive environment from intrauterine life throughout childhood and adolescence into adulthood. Knowledge of the prevalence of obesity from the earliest life stages and its trajectory is essential to raise awareness of the risks at each stage and to indicate the potential age of prevention and intervention. Taking effective anti-obesity measures in children, both preventive and therapeutic, is now a necessity, with successful interventions used to decrease body weight and thus reduce health consequences. Identified risk factors in the first 1,000 days of life and even earlier, before conception, suggest that this is a key period for the development of overweight and obesity, and it appears to be the best time for preventive action. The growing phenomenon of obesity among children requires not only prevention but also integral treatment. Lifestyle change intervention programs are considered key to the treatment of childhood obesity. Obesity trajectories, the higher effectiveness of applied interventions observed in younger age groups, and the dependence of the risk of developing complications on the duration of obesity confirm the need for early diagnosis and treatment of obesity in children from an early age. The main aim should be to prevent the onset of obesity, thus reducing the future health, social, and financial consequences.
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Affiliation(s)
- Joanna Szczyrska
- Department of Pediatrics, Gastroenterology, Allergology and Pediatric Nutrition, Medical University of Gdansk, Poland
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Vega-Salas MJ, Murray C, Nunes R, Hidalgo-Arestegui A, Curi-Quinto K, Penny ME, Cueto S, Lovegrove JA, Sánchez A, Vimaleswaran KS. School environments and obesity: a systematic review of interventions and policies among school-age students in Latin America and the Caribbean. Int J Obes (Lond) 2023; 47:5-16. [PMID: 36216909 PMCID: PMC9549440 DOI: 10.1038/s41366-022-01226-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 09/22/2022] [Accepted: 09/26/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND The rapid rise in obesity rates among school children in Latin America and the Caribbean (LAC) could have a direct impact on the region's physical and mental health, disability, and mortality. This review presents the available interventions likely to reduce, mitigate and/or prevent obesity among school children in LAC by modifying the food and built environments within and around schools. METHODS Two independent reviewers searched five databases: MEDLINE, Web of Science, Cochrane Library, Scopus and Latin American and Caribbean Health Sciences Literature for peer-reviewed literature published from 1 January 2000 to September 2021; searching and screening prospective studies published in English, Spanish and Portuguese. This was followed by data extraction and quality assessment using the Cochrane risk-of-bias tool (RoB 2) and the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I), adopting also the PRISMA 2020 guidelines. Due to the heterogeneity of the intervention's characteristics and obesity-related measurements across studies, a narrative synthesis was conducted. RESULTS A total of 1342 research papers were screened, and 9 studies were included; 4 in Mexico, and 1 each in Argentina, Brazil, Chile, Colombia, and Ecuador. Four studies reported strategies for modifying food provision; four other targeted the built environment, (modifying school premises and providing materials for physical activity); a final study included both food and built environment intervention components. Overall, two studies reported that the intervention was significantly associated with a lower increase over time in BMI/obesity in the intervention against the control group. The remaining studies were non-significant. CONCLUSIONS Data suggest that school environmental interventions, complementing nutritional and physical education can contribute to reduce incremental childhood obesity trends. However, evidence of the extent to which food and built environment components factor into obesogenic environments, within and around school grounds is inconclusive. Insufficient data hindered any urban/rural comparisons. Further school environmental intervention studies to inform policies for preventing/reducing childhood obesity in LAC are needed.
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Affiliation(s)
- María Jesús Vega-Salas
- Carrera de Nutrición y Dietética, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, 7820436, Chile.
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, RG6 6DZ, UK.
| | - Claudia Murray
- Department of Real Estate and Planning, Henley Business School, University of Reading, Reading, RG6 6UD, UK.
| | - Richard Nunes
- Department of Real Estate and Planning, Henley Business School, University of Reading, Reading, RG6 6UD, UK
| | - Alessandra Hidalgo-Arestegui
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, RG6 6DZ, UK
| | | | - Mary E Penny
- Instituto de Investigación Nutricional (IIN), Lima, 15024, Peru
| | - Santiago Cueto
- Grupo de Análisis para el Desarrollo (GRADE), Lima, 15063, Peru
- Departamento de Psicología, Pontificia Universidad Católica del Peru, Lima, 15088, Peru
| | - Julie Anne Lovegrove
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, RG6 6DZ, UK
- Institute for Food, Nutrition and Health (IFNH), University of Reading, Reading, RG6 6AH, UK
| | - Alan Sánchez
- Grupo de Análisis para el Desarrollo (GRADE), Lima, 15063, Peru
| | - Karani Santhanakrishnan Vimaleswaran
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, RG6 6DZ, UK
- Institute for Food, Nutrition and Health (IFNH), University of Reading, Reading, RG6 6AH, UK
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Moliterno P, Matjazic J, Widhalm K. Improvement of body composition in 8- to 11-year-old schoolboys: effects of a 6-months lifestyle intervention A retrospective evaluation of the “EDDY-Kids” prevention study. CHILD AND ADOLESCENT OBESITY 2022. [DOI: 10.1080/2574254x.2022.2140576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
| | - Julia Matjazic
- Austrian Academic Institute for Clinical Nutrition. Austria
| | - Kurt Widhalm
- Austrian Academic Institute for Clinical Nutrition. Austria
- Medical University of Vienna. Vienna Austria
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Enö Persson J, Leo Swenne C, von Essen L, Bohman B, Rasmussen F, Ghaderi A. Experiences of nurses and coordinators in a childhood obesity prevention trial based on motivational interviewing within Swedish child health services. Int J Qual Stud Health Well-being 2022; 17:2096123. [PMID: 35838058 PMCID: PMC9291662 DOI: 10.1080/17482631.2022.2096123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose To explore the experiences of nurses and coordinators in the PRIMROSE childhood obesity prevention trial, and to understand the factors that might help to improve the outcome of future primary prevention of obesity. Methods Using a qualitative approach, data were obtained by interviewing nine intervention nurses and three regional study coordinators. All participants were female. The interviews were transcribed and analysed using content analysis. Results Two themes emerged: The nurses experienced that it was rewarding to participate in the trial, but challenging to combine the intervention with regular work; and The study coordinators experienced that they were in a difficult position handling the conflicting needs of the research group and the nurses’ commitment to usual child health care services. The importance of support, encouragement, briefer and simpler intervention, and adaptation of the training in motivational interviewing to the setting was emphasized. Stress and lack of time were major barriers to deliver the intervention as intended. Conclusions Although the PRIMROSE intervention was developed in collaboration with representatives from the child health services, and additional research funding was provided to compensate for time spent working with the trial, nurses experienced stress and time constraints. .
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Affiliation(s)
- Johanna Enö Persson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Christine Leo Swenne
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Louise von Essen
- Healthcare Sciences and eHealth, Department of Women and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Benjamin Bohman
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Finn Rasmussen
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Ata Ghaderi
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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55
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Engels L, Mons C, Mergelsberg E, Kothe E, Hamilton K, Gardner B, ten Hoor G, Mullan B. How to improve the diet of toddlers? The feasibility of an online, habit-based intervention targeting parental feeding behaviour. Health Psychol Behav Med 2022; 10:1020-1037. [DOI: 10.1080/21642850.2022.2134869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Lisa Engels
- Department of Work & Social Psychology, Faculty of Psychology & Neurosciences, Maastricht University, Maastricht, Netherlands
| | - Carlotta Mons
- Department of Work & Social Psychology, Faculty of Psychology & Neurosciences, Maastricht University, Maastricht, Netherlands
| | - Enrique Mergelsberg
- Health Psychology and Behavioural Medicine Research Group, Faculty of Health Sciences, School of Psychology, Curtin University, Perth, Australia
| | - Emily Kothe
- Faculty of Health, School of Psychology, Deakin University, Burwood, Australia
| | - Kyra Hamilton
- Health Psychology and Behavioural Medicine Research Group, Faculty of Health Sciences, School of Psychology, Curtin University, Perth, Australia
- School of Applied Psychology, Griffith University, Nathan, Australia
| | | | - Gill ten Hoor
- Department of Work & Social Psychology, Faculty of Psychology & Neurosciences, Maastricht University, Maastricht, Netherlands
| | - Barbara Mullan
- Health Psychology and Behavioural Medicine Research Group, Faculty of Health Sciences, School of Psychology, Curtin University, Perth, Australia
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Bailey-Davis L, Moore AM, Poulsen MN, Dzewaltowski DA, Cummings S, DeCriscio LR, Hosterman JF, Huston D, Kirchner HL, Lutcher S, McCabe C, Welk GJ, Savage JS. Comparing enhancements to well-child visits in the prevention of obesity: ENCIRCLE cluster-randomized controlled trial. BMC Public Health 2022; 22:2429. [PMID: 36572870 PMCID: PMC9792161 DOI: 10.1186/s12889-022-14827-w] [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: 10/25/2022] [Accepted: 12/06/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Obesity disproportionally impacts rural, lower-income children in the United States. Primary care providers are well-positioned to engage parents in early obesity prevention, yet there is a lack of evidence regarding the most effective care delivery models. The ENCIRCLE study, a pragmatic cluster-randomized controlled trial, will respond to this gap by testing the comparative effectiveness of standard care well-child visits (WCV) versus two enhancements: adding a patient-reported outcome (PRO) measure (PRO WCV) and PRO WCV plus Food Care (telehealth coaching and a grocery store tour). METHODS A total of 2,025 parents and their preschool-aged children (20-60 months of age) will be recruited from 24 Geisinger primary care clinics, where providers are randomized to the standard WCV, PRO WCV, or PRO WCV plus Food Care intervention arms. The PRO WCV includes the standard WCV plus collection of the PRO-the Family Nutrition and Physical Activity (FNPA) risk assessment-from parents. Parents complete the PRO in the patient-portal or in the clinic (own device, tablet, or kiosk), receive real-time feedback, and select priority topics to discuss with the provider. These results are integrated into the child's electronic health record to inform personalized preventive counseling by providers. PRO WCV plus Food Care includes referrals to community health professionals who deliver evidence-based obesity prevention and food resource management interventions via telehealth following the WCV. The primary study outcome is change in child body mass index z-score (BMIz), based on the World Health Organization growth standards, 12 months post-baseline WCV. Additional outcomes include percent of children with overweight and obesity, raw BMI, BMI50, BMIz extended, parent involvement in counseling, health behaviors, food resource management, and implementation process measures. DISCUSSION Study findings will inform health care systems' choices about effective care delivery models to prevent childhood obesity among a high-risk population. Additionally, dissemination will be informed by an evaluation of mediating, moderating, and implementation factors. TRIAL REGISTRATION ClinicalTrials.gov identifier (NCT04406441); Registered May 28, 2020.
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Affiliation(s)
- Lisa Bailey-Davis
- Department of Population Health Sciences, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
- Center for Obesity & Metabolic Research, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - Amy M. Moore
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA 16802 USA
| | - Melissa N. Poulsen
- Department of Population Health Sciences, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - David A. Dzewaltowski
- College of Public Health, University of Nebraska Medical Center, 984365 Nebraska Medical Center, Omaha, NE 68198 USA
| | - Stacey Cummings
- Department of Pediatrics, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - Laina R. DeCriscio
- Health and Wellness, Steele Institute, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - Jennifer Franceschelli Hosterman
- Department of Pediatrics, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
- Departments of Internal Medicine and Pediatrics, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - Daniel Huston
- Health and Wellness, Steele Institute, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - H. Lester Kirchner
- Department of Population Health Sciences, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - Shawnee Lutcher
- Center for Obesity & Metabolic Research, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - Carolyn McCabe
- Department of Population Health Sciences, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
- Center for Obesity & Metabolic Research, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - Gregory J. Welk
- Department of Kinesiology, Iowa State University, 103E Forker, 534 Wallace Rd, Ames, IA 50011 USA
| | - Jennifer S. Savage
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA 16802 USA
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Almutairi N, Burns S, Portsmouth L. Barriers and enablers to the implementation of school-based obesity prevention strategies in Jeddah, KSA. Int J Qual Stud Health Well-being 2022; 17:2135197. [PMID: 36263729 PMCID: PMC9590444 DOI: 10.1080/17482631.2022.2135197] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction Despite schools' recognised role in mitigating childhood overweight, many schools fail to implement physical activity or nutrition strategies. The current study explored
the enablers and barriers to implementing obesity prevention strategies in
Jeddah, KSA. Methods This research is based on 14 semi-structured interviews with intermediate school principals and sports teachers to gain insight into their perception of barriers and enablers to implementing obesity prevention strategies. Themes were deductively generated from the data. Results Participants estimated the prevalence of overweight and obesity among their students to be between 3 and 15% with an increasing trend, particularly among female students. Participants identified five categories of barriers to implementation of obesity prevention intervention: curriculum; schools strategies promoting healthy weight; lack of resources; student’s lifstyle; and a lack of teachers in nutrition and sports. School regulations, staff and sufficient resources were the most frequently reported enablers. Participants also identified food services, awareness, and partnerships as barriers and enablers. Conclusion There is a need for better infrastructure and financial support for schools and professional development opportunities for teachers from the Saudi Ministry of Education. The Ministry also needs to support the development of multilevel health promotion strategies at school and home and reach out to the broader community.
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Affiliation(s)
- Naif Almutairi
- School of Population Health, Curtin University Bentley Campus, Perth, Australia,Department of Public Health, College of Health Sciences at Al-Leith, Umm Al-Qura University, Al-Leith, Kingdom of Saudi Arabia,CONTACT Naif Almutairi ; School of Population Health, Curtin University, GPO Box U1987, Perth6845, Australia
| | - Sharyn Burns
- School of Population Health, Curtin University Bentley Campus, Perth, Australia,Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Australia
| | - Linda Portsmouth
- School of Population Health, Curtin University Bentley Campus, Perth, Australia,Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Australia
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Vidmar AP, Cáceres NA, Schneider-Worthington CR, Shirazipour C, Buman MP, de la Haye K, Salvy SJ. Integration of Time-Based Recommendations with Current Pediatric Health Behavior Guidelines: Implications for Obesity Prevention and Treatment in Youth. Curr Obes Rep 2022; 11:236-253. [PMID: 36348216 PMCID: PMC9742346 DOI: 10.1007/s13679-022-00491-z] [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: 10/11/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE OF REVIEW Youth-onset obesity is associated with negative health outcomes across the lifespan including cardiovascular diseases, type 2 diabetes, obstructive sleep apnea, dyslipidemias, asthma, and several cancers. Pediatric health guidelines have traditionally focused on the quality and quantity of dietary intake, physical activity, and sleep. RECENT FINDINGS Emerging evidence suggests that the timing (time of day when behavior occurs) and composition (proportion of time spent allocated to behavior) of food intake, movement (i.e., physical activity, sedentary time), and sleep may independently predict health trajectories and disease risks. Several theoretically driven interventions and conceptual frameworks feature behavior timing and composition (e.g., 24 h movement continuum, circadian science and chronobiology, intermittent fasting regimens, structured day hypothesis). These literatures are, however, disparate, with little crosstalk across disciplines. In this review, we examine dietary, sleep, and movement guidelines and recommendations for youths ages 0-18 in the context of theoretical models and empirical findings in support of time-based approaches. The review aims to inform a unifying framework of health behaviors and guide future research on the integration of time-based recommendations into current quantity and quality-based health guidelines for children and adolescents.
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Affiliation(s)
- Alaina P Vidmar
- Department of Pediatrics, Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles and Keck School of Medicine of USC, 4650 Sunset Boulevard, Mailstop #61, Los Angeles, CA, 90027, USA.
| | - Nenette A Cáceres
- Cancer Research Center On Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, USA
| | | | - Celina Shirazipour
- Cancer Research Center On Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, USA
| | - Matthew P Buman
- College of Health Solutions, Arizona State University, Tempe, USA
| | - Kayla de la Haye
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Sarah-Jeanne Salvy
- Cancer Research Center On Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, USA
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
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Heerman WJ, Perrin EM, Yin HS, Schildcrout JS, Delamater AM, Flower KB, Sanders L, Wood C, Kay MC, Adams LE, Rothman RL. The Greenlight Plus Trial: Comparative effectiveness of a health information technology intervention vs. health communication intervention in primary care offices to prevent childhood obesity. Contemp Clin Trials 2022; 123:106987. [PMID: 36323344 DOI: 10.1016/j.cct.2022.106987] [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: 04/01/2022] [Revised: 10/17/2022] [Accepted: 10/26/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND The first 1000 days of a child's life are increasingly recognized as a critical window for establishing a healthy growth trajectory to prevent childhood obesity and its associated long-term comorbidities. The purpose of this manuscript is to detail the methods for a multi-site, comparative effectiveness trial designed to prevent childhood overweight and obesity from birth to age 2 years. METHODS This study is a multi-site, individually randomized trial testing the comparative effectiveness of two active intervention arms: 1) the Greenlight intervention; and 2) the Greenlight Plus intervention. The Greenlight intervention is administered by trained pediatric healthcare providers at each well-child visit from 0 to 18 months and consists of a low health literacy toolkit used during clinic visits to promote shared goal setting. Families randomized to Greenlight Plus receive the Greenlight intervention plus a health information technology intervention, which includes: 1) personalized, automated text-messages that facilitate caregiver self-monitoring of tailored and age-appropriate child heath behavior goals; and 2) a web-based, personalized dashboard that tracks child weight status, progress on goals, and electronic Greenlight content access. We randomized 900 parent-infant dyads, recruited from primary care clinics across six academic medical centers. The study's primary outcome is weight for length trajectory from birth through 24 months. CONCLUSIONS By delivering a personalized and tailored health information technology intervention that is asynchronous to pediatric primary care visits, we aim to achieve improvements in child growth trajectory through two years of age among a sample of geographically, socioeconomically, racially, and ethnically diverse parent-child dyads.
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Affiliation(s)
- William J Heerman
- Vanderbilt University Medical Center, Department of Pediatrics, 2200 Children's Way, Suite 2404, Nashville, TN 37232, United States of America.
| | - Eliana M Perrin
- Johns Hopkins University, Department of Pediatrics, Schools of Medicine and Nursing, 200 N. Wolfe St, Rubenstein Building-2071, Baltimore, MD 21287, United States of America.
| | - H Shonna Yin
- New York University School of Medicine, Departments of Pediatrics and Population Health, 550 First Avenue, New York, NY 10016, United States of America.
| | - Jonathan S Schildcrout
- Vanderbilt University Medical Center, Department of Biostatistics, 1161 21st Ave S # D3300, Nashville, TN 37232, United States of America.
| | - Alan M Delamater
- University of Miami Miller School of Medicine, Department of Pediatrics, 1601 NW 12(th) Ave., Miami, FL 33136, United States of America.
| | - Kori B Flower
- University of North Carolina at Chapel Hill, Division of General Pediatrics and Adolescent Medicine, 231 MacNider Building, CB# 7225, 321 S. Columbia Street, UNC School of Medicine, Chapel Hill, NC 27599-7225, United States of America.
| | - Lee Sanders
- Stanford University School of Medicine, United States of America.
| | - Charles Wood
- Duke University School of Medicine, Department of Pediatrics, Division of General Pediatrics and Adolescent Health, 3116 N. Duke St., Durham, NC 27704, United States of America.
| | - Melissa C Kay
- Duke University School of Medicine, Department of Pediatrics, Division of General Pediatrics and Adolescent Health, 3116 N. Duke St., Durham, NC 27704, United States of America.
| | - Laura E Adams
- Vanderbilt University Medical Center, Department of Pediatrics, 2200 Children's Way, Suite 2404, Nashville, TN 37232, United States of America.
| | - Russell L Rothman
- Vanderbilt University Medical Center, Institute of Medicine and Public Health, 1161 21st Ave S # D3300, Nashville, TN 37232, United States of America.
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Hiratsuka VY, Reid M, Chang J, Jiang L, Brega AG, Fyfe-Johnson AL, Huyser KR, Johnson-Jennings M, Conway C, Steiner JF, Rockell J, Dillard DA, Moore K, Manson SM, O'Connell J. Associations Between Rurality, pre-pregnancy Health Status, and Macrosomia in American Indian/Alaska Native Populations. Matern Child Health J 2022; 26:2454-2465. [PMID: 36346567 PMCID: PMC10468113 DOI: 10.1007/s10995-022-03536-w] [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] [Accepted: 09/09/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To examine the relationships between pre-pregnancy diabetes mellitus (DM), gestational diabetes mellitus (GDM), pre-pregnancy body mass index (BMI) and county-level social determinants of health, with infant macrosomia within a sample of American Indian/Alaska Native (AI/AN) women receiving Indian Health Service (IHS) care. METHODS The sample included women-infant dyads representing 1,136 singleton births from fiscal year 2011 (10/1/2019-9/30/2011). Data stemmed from the IHS Improving Health Care Delivery Data Project. Multivariate generalized linear mixed models were fitted to assess the association of macrosomia with pre-pregnancy health status and social determinants of health. RESULTS Nearly half of the women in the sample were under age 25 years (48.6%), and most had Medicaid health insurance coverage (76.7%). Of those with a pre-pregnancy BMI measure, 66.2% were overweight or obese. Although few women had pre-pregnancy DM (4.0%), GDM was present in 12.8% of women. Most women had a normal term delivery (85.4%). Overweight, obesity, pre-pregnancy DM, and county-level rurality were all significantly associated with higher odds of infant macrosomia.
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Affiliation(s)
- Vanessa Y Hiratsuka
- Research Department, Southcentral Foundation, 4501 Diplomacy Drive, 99508, Anchorage, AK, USA.
- Center for Human Development, University of Alaska Anchorage, 3211 Providence Drive, 99508, 99504, Anchorage, AK, USA.
| | - Margaret Reid
- Department of Health Systems, Management, and Policy, Colorado School of Public Health, University of Colorado Denver, Denver, USA
| | - Jenny Chang
- Department of Medicine, School of Medicine, University of California, 301 Medical Surge II, 92697-7550, Irvine, CA, USA
| | - Luohua Jiang
- Department of Epidemiology, University of California, Irvine, 3076 AIRB, 92697-7550, Irvine, CA, USA
| | - Angela G Brega
- School of Public Health, Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, 13055 East 17th Avenue, 80045, Aurora, Colorado, CO, USA
| | - Amber L Fyfe-Johnson
- Institute for Research and Education to Advance Community Health (IREACH), Department of Medical Education and Clinical Sciences, Washington State University, 1100 Olive Way, Ste 1200, 98101, Seattle, WA, USA
| | - Kimberly R Huyser
- Department of Sociology, The University of British Columbia, Vancouver, USA
| | - Michelle Johnson-Jennings
- Canada Research Chair for Indigenous Community Engaged Research for Indigenous Community Engaged Research, LE Clinical Health Psychologist, University of Saskatchewan, University of Colorado- Associate Professor, University of Washington- Associate Professor, Washington, USA
| | - Cheryl Conway
- NE-BC; Quality Consultant, Charles George Veterans Medical Center, Asheville, NC, USA
| | - John F Steiner
- Institute for Health Research, Department of Medicine, Kaiser Permanente Colorado, University of Colorado Anschutz Medical Campus, Aurora, USA
| | - Jennifer Rockell
- Telligen, Inc. Greenwood Village, 7730 E. Belleview Ave Suite 300 Greenwood, 80111, Village, CO, USA
| | - Denise A Dillard
- Research Department, Southcentral Foundation, 4501 Diplomacy Drive, 99508, Anchorage, AK, USA
| | - Kelly Moore
- Centers for American Indian and Alaska Native Health, University of Colorado, Anschutz Medical Campus, Mail Stop F800, 13055 E. 17th Avenue, 80045, Aurora, CO, USA
| | - Spero M Manson
- Centers for American Indian and Alaska Native Health, University of Colorado, Anschutz Medical Campus, Mail Stop F800, 13055 E. 17th Avenue, 80045, Aurora, CO, USA
| | - Joan O'Connell
- Colorado School of Public Health, Centers for American Indian and Alaska Native Health, University of Colorado, Anschutz Medical Campus, Mail Stop F800, 13055 E. 17th Avenue, 80045, Aurora, CO, USA
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Arlinghaus KR, Cepni AB, Helbing RR, Goodman LP, Ledoux TA, Johnston CA. Response to school-based interventions for overweight and obesity: A systematic scoping review. Clin Obes 2022; 12:e12557. [PMID: 36128952 PMCID: PMC9669238 DOI: 10.1111/cob.12557] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 08/20/2022] [Accepted: 09/07/2022] [Indexed: 12/30/2022]
Abstract
Heterogeneity of response to paediatric obesity interventions is one of the greatest challenges to obesity care. While evaluating school-based interventions by mean changes compared to control is important, it does not provide an understanding of the individual variability in response to intervention. The objective of this study was to comprehensively review school-based interventions that reported study results in terms of response and identify definitions of response used. A scoping review was conducted using a systematic search of five scientific databases from 2009 to 2021. Inclusion criteria included randomized controlled trial design, school-based setting, weight-based outcomes (e.g., BMI, BMI z-score), weight-based outcomes analysed among youth with overweight/obesity, a study conducted in a developed country and publication in English. A total of 26 reports representing 25 unique studies were included. Overall, 19% (5/26) of articles reported response. Response was defined in three ways: maintenance/decrease in BMI z-score, decrease in BMI z-score ≥0.10, and decrease in BMI z-score ≥0.20. Few school-based interventions identified an a priori intervention goal or identified the proportion of participants who responded to the intervention. Without such evaluation participants who do not benefit are likely to be overlooked.
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Affiliation(s)
- Katherine R. Arlinghaus
- Division of Epidemiology and Community Health, School of Public HealthUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Aliye B. Cepni
- Department of Health and Human PerformanceUniversity of HoustonHoustonTexasUSA
| | | | - Lenora P. Goodman
- Division of Epidemiology and Community Health, School of Public HealthUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Tracey A. Ledoux
- Department of Health and Human PerformanceUniversity of HoustonHoustonTexasUSA
| | - Craig A. Johnston
- Department of Health and Human PerformanceUniversity of HoustonHoustonTexasUSA
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Telehealth als Therapieoption in der juvenilen Adipositasprävention. DIE DIABETOLOGIE 2022. [PMCID: PMC9713089 DOI: 10.1007/s11428-022-00977-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Übergewicht und Adipositas im Kindes- und Jugendalter gehen nicht nur mit ausgeprägten medizinischen und psychologischen Begleit- und Folgeerkrankungen einher, sondern stellen auch aus ökonomischer Sicht eine der größten Herausforderungen für das Gesundheitssystem dar. Die Beschränkungen im Rahmen der weltweiten COVID-19-Pandemie (COVID-19: „coronavirus disease 2019“) führten zu einer weiteren Aggravierung der vorbestehend hohen Prävalenz an juvenilem Übergewicht. Da pharmakologische Behandlungsmöglichkeiten im Kindes‑/Jugendalter im Allgemeinen nicht zugelassen sind und daher keine Option darstellen, spielt die Lebensstilveränderung aus therapeutischer Sicht eine gesonderte Rolle. Dabei haben multimodale Beschulungskonzepte mit Beratungen durch Mitarbeitende verschiedener Fachbereiche (beispielsweise Psychologie, Ernährung, Sport, Medizin) aktuell die besten Erfolgsaussichten. Durch den gezielten Transfer dieser Schulungsprogramme in telemedizinische Konzepte könnten deren Wirkungsgrad nachhaltig verbessert und dabei Ressourcen sowohl auf therapeutischer Seite als auch der der Betroffenen geschont werden.
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The Role of Exercise on Cardiometabolic Profile and Body Composition in Youth with Type 1 Diabetes. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121840. [PMID: 36553284 PMCID: PMC9776837 DOI: 10.3390/children9121840] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/19/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022]
Abstract
Exercise has a direct positive effect on glycemic control by promoting insulin secretion from β-pancreatic islet-cells and by increasing skeletal muscle glucose uptake. The reduction in daily insulin needs and the optimization of glycemic control improves the patient's quality of life, self-esteem, mental wellness, as well as diabetes-related mobility and mortality. The aim of this study was to investigate the effect of physical activity in children and adolescents with type-1 diabetes (T1D) on diabetic control, cardiovascular, and biochemical profiles; hs-CRP; IL6; leptin; and adiponectin levels of the population under study. This is a prospective cross-sectional study that involved 80 participants (36 boys and 44 girls) with T1D, who were aged 6-21 years and who attended the Diabetes and Metabolism Clinic of the 2nd Pediatric Department, University of Athens, "P & A Kyriakou" Children's Hospital of Athens. Twenty (25%) children were above the 75th percentile regarding total levels of physical activity, while 40 (50%) and 20 (25%) were between the 25th and 75th percentile, as well as below the 25th percentile, respectively. In the group with an intermediate level of exercise, physical activity was negatively associated with the participant's family situation (traditional, single parent, grandparent, with others, or by himself/herself) (p = 0.013), ferritin (p = 0.031), lipoprotein(a) [Lp(a)] (p = 0.016), and squared leptin levels (p = 0.040). Whereas in the groups with extreme vs. no exercise there was a negative association with the number of daily glucose measurements (p = 0.047). However, in the group with non-vigorous exercise, physical activity was positively associated with high density lipoprotein-c (HDL-c) levels (p = 0.048). The findings of this study are indicative of the beneficial role of exercise on children and adolescents with T1D, which is achieved by primarily improving their cardiometabolic profile through the amelioration of lipid profile [HDL-c, Lp(a)] and leptin levels, as well as by reducing chronic systemic inflammatory response (ferritin) and ultimately decreasing the overall diabetes morbidity.
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64
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Xiao X, Tang C, Zhai X, Li S, Ma W, Liu K, Kokoro S, Sheerah HA, Zhu H, Cao J. Early-Adulthood Weight Change and Later Physical Activity in Relation to Cardiovascular and All-Cause Mortality: NHANES 1999-2014. Nutrients 2022; 14:nu14234974. [PMID: 36501003 PMCID: PMC9736862 DOI: 10.3390/nu14234974] [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: 10/17/2022] [Revised: 11/12/2022] [Accepted: 11/18/2022] [Indexed: 11/25/2022] Open
Abstract
Limited evidence investigated the combined influence of early-adulthood weight change and later physical activity on the risk of cardiovascular (CVD) and all-cause mortality. The aim of this study is to explore the associations of early-adulthood weight change and later physical activity with CVD and all-cause mortality. This is a cohort study of 23,193 US adults aged 40 to 85 years from the National Health and Nutrition Examination Survey (NHANES) 1999 to 2014. Cox proportional hazards regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) of CVD and all-cause mortality associated with early-adulthood weight change and later physical activity. During a median follow-up of 9.2 years, there were 533 and 2734 cases of CVD and all-cause deaths. Compared with being physically inactive, the HRs of the CVD mortality of being physically active were 0.44 (0.26 to 0.73), 0.58 (0.19 to 1.82), 0.38 (0.17 to 0.86) and 0.46 (0.21 to 1.02) among individuals with stable normal, stable obese, non-obese to obese and maximum overweight early-adulthood weight change patterns. Using stable normal patterns that were physically active later as the reference, other early-adulthood weight change patterns did not show a significantly higher risk of CVD mortality when participants were physically active in later life; later physically inactive participants had a significantly increased risk of CVD mortality, with HRs of 2.17 (1.30 to 3.63), 5.32 (2.51 to 11.28), 2.59 (1.29 to 5.18) and 2.63 (1.32 to 5.26) in the stable normal, stable obese, non-obese to obese and maximum overweight groups, respectively. Similar results can be seen in the analyses for all-cause mortality. Our findings suggest that inadequate physical activity worsens the negative impact of unhealthy early-adulthood weight change patterns, which is worthy of being noted in the improvement of public health.
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Affiliation(s)
- Xinyu Xiao
- School of Public Health, Wuhan University, Wuhan 430071, China
| | - Chengyao Tang
- Biomedical Statistics, Department of Integrated Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita-shi 565-0871, Osaka, Japan
| | - Xiaobing Zhai
- Center for Artificial Intelligence Driven Drug Discovery, Faculty of Applied Sciences, Macao Polytechnic University, Macau SAR, China
| | - Shiyang Li
- School of Public Health, Wuhan University, Wuhan 430071, China
| | - Wenzhi Ma
- School of Public Health, Wuhan University, Wuhan 430071, China
| | - Keyang Liu
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita-shi 565-0871, Osaka, Japan
| | - Shirai Kokoro
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita-shi 565-0871, Osaka, Japan
| | | | - Huiping Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing 100069, China
- Correspondence: (J.C.); (H.Z.); Tel./Fax: +86-27-68759299 (J.C.)
| | - Jinhong Cao
- School of Public Health, Wuhan University, Wuhan 430071, China
- Correspondence: (J.C.); (H.Z.); Tel./Fax: +86-27-68759299 (J.C.)
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Factors Associated with Eating in the Absence of Hunger among Children and Adolescents: A Systematic Review. Nutrients 2022; 14:nu14224715. [PMID: 36432407 PMCID: PMC9699171 DOI: 10.3390/nu14224715] [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: 09/23/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 11/10/2022] Open
Abstract
Eating in the absence of hunger (EAH) has been extensively studied over the past two decades and has been associated with excess body weight and the development of obesity. However, determinants of EAH remain uncertain. This systematic review aims to identify individual, familial, and environmental factors associated with EAH among children and adolescents. We included studies with a measure of EAH in participants aged 3-17 years old and including ≥1 factor associated with EAH. Our search identified 1494 articles. Of these, we included 81 studies: 53 cross-sectional, 19 longitudinal and nine intervention studies. In childhood (≤12 years old), EAH increases with age, it is greater in boys compared to girls, and it is positively associated with adiposity. Moreover, EAH development seems to be influenced by genetics. In adolescence, the number of studies is limited; yet, studies show that EAH slightly increases or remains stable with age, is not clearly different between sexes, and findings for overweight or obesity are less consistent across studies in adolescence. For familial factors, parental restrictive feeding practices are positively associated with EAH during childhood, mostly for girls. Studies assessing environmental factors are lacking and robust longitudinal studies spanning from early childhood to adolescence are needed.
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Soltero EG, Lopez C, Hernandez E, O'Connor TM, Thompson D. Technology-Based Obesity Prevention Interventions Among Hispanic Adolescents in the United States: Scoping Review. JMIR Pediatr Parent 2022; 5:e39261. [PMID: 36331547 PMCID: PMC9675012 DOI: 10.2196/39261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/05/2022] [Accepted: 08/24/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Given that today's adolescents are digital front-runners, technology-based obesity prevention strategies are age-appropriate for this population. The use of remote and wireless technologies may be suitable for extending the reach and engagement of obesity prevention efforts among high-risk Hispanic youths, as this subgroup is disproportionately affected by barriers that limit participation in traditional, in-person interventions. OBJECTIVE The purpose of this scoping review was to examine the intervention and sample characteristics of technology-based obesity prevention interventions among Hispanic adolescents. We also examined feasibility criteria to assess the acceptability and appropriateness of technology-based strategies among Hispanic youths. METHODS A comprehensive search of Embase and PubMed identified 7 studies that met the inclusion criteria. Data were extracted by 2 independent reviewers. RESULTS Of the 7 included studies, half (n=4, 57%) used a randomized control trial design, with equal implementation in school (n=3, 43%) and clinic (n=4, 57%) settings. Studies commonly targeted improvements in diet (n=4, 57%) and physical activity (n=7, 100%), with only 1 (14%) study focused on sedentary behaviors. Just 2 (29%) studies reported the use of behavioral theories or models. Studies focused primarily on youths in early (n=5, 71%) or middle (n=6, 86%) adolescence, and there was limited information reported on socioeconomic status. Only 3 (43%) study conducted formative work, and few (n=3, 43%) reported on acceptability. Only 1 (14%) study reported that materials were available in Spanish and English, and only 1 (14%) study used culturally tailored content. Additionally, 3 (43%) studies used strategies that considered social determinants of health. CONCLUSIONS To increase our understanding of the feasibility and effectiveness of technology-based obesity prevention strategies among Hispanic adolescents, there is a need for more feasibility studies that are theoretically grounded and comprehensively report on feasibility-related outcomes. Future studies should also leverage technology to simultaneously address multiple health behaviors beyond diet and physical activity. The result of this review can be used to guide the development of future technology-based obesity prevention strategies among Hispanic adolescents. TRIAL REGISTRATION CliniclaTrials.gov NCT04953442; https://clinicaltrials.gov/ct2/show/NCT04953442.
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Affiliation(s)
- Erica G Soltero
- United States Department of Agriculture/Agricultural Research Services Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Callie Lopez
- United States Department of Agriculture/Agricultural Research Services Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Edith Hernandez
- United States Department of Agriculture/Agricultural Research Services Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Teresia M O'Connor
- United States Department of Agriculture/Agricultural Research Services Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Debbe Thompson
- United States Department of Agriculture/Agricultural Research Services Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
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Jabakhanji SB, Boland F, Ward M, Biesma R. Prevalence of early childhood obesity in Ireland: Differences over time, between sexes and across child growth criteria. Pediatr Obes 2022; 17:e12953. [PMID: 35758060 PMCID: PMC9787496 DOI: 10.1111/ijpo.12953] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 05/19/2022] [Accepted: 06/06/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Various child growth criteria exist for monitoring overweight and obesity prevalence in young children. OBJECTIVES To estimate early overweight and obesity prevalence in Ireland and compare the differences in prevalence across ages, growth criteria and sexes. METHODS Longitudinal body mass index data from the nationally representative Growing Up in Ireland infant cohort (n = 11 134) were categorized ('under-/normal weight', 'risk of overweight', 'overweight', 'obesity') using the sex- and age-specific International Obesity Task Force growth reference, World Health Organization growth standard and World Health Organization growth reference criteria. Differences in prevalences between criteria and sexes, and changes in each weight category and criterion across ages (9 months, 3 years, 5 years), were investigated. RESULTS Across criteria, 11%-40% of children had overweight or obesity at 9 months, 14%-46% at 3 years and 8%-32% at 5 years of age. Prevalence estimates were highest using the World Health Organization growth reference, followed by International Obesity Task Force estimates. Within each criterion, prevalence decreased significantly over time (p < 0.05). However, when combining both World Health Organization criteria, as recommended for population studies, prevalence increased, due to differences in definitions between them. Significantly more boys than girls had overweight/obesity using either World Health Organization criterion, which was reversed using the International Obesity Task Force growth reference. CONCLUSIONS To increase transparency and comparability, studies of childhood obesity need to consider differences in prevalence estimates across growth criteria. Effective prevention, intervention and policy-making are needed to control Ireland's high overweight and obesity prevalence.
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Affiliation(s)
| | - Fiona Boland
- Division of Population Health SciencesRCSI University of Medicine and Health SciencesDublinIreland
| | - Mark Ward
- School of Medicine, The Center for Medical GerontologyTrinity College DublinDublinIreland
| | - Regien Biesma
- Division of Population Health SciencesRCSI University of Medicine and Health SciencesDublinIreland,Global Health Unit, Department of Health SciencesUniversity Medical Centre Groningen, University of GroningenGroningenThe Netherlands
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Rashid AF, Wafa SW, Abd Talib R, Abu Bakar NM. An interactive Malaysian Childhood Healthy Lifestyle (i-MaCHeL) intervention programme to change weight-related behaviour in preschool child-parent dyads: Study protocol of a cluster randomised controlled trial. PLoS One 2022; 17:e0276843. [PMID: 36315523 PMCID: PMC9621421 DOI: 10.1371/journal.pone.0276843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 09/22/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction Unhealthy weight, especially childhood obesity, is emerging as a growing epidemic and a challenge in developed and developing countries. Partnership with parents to promote healthy lifestyle changes may have a lifelong impact on weight-related outcomes in children. This study aims to determine the efficacy of an Interactive Malaysian Childhood Healthy Lifestyle (i-MaCHeL) intervention programme to change weight-related behaviour in preschool child-parent dyads. Materials and methods The i-MaCHeL programme is a single-blind, theory-driven intervention, two-group cluster randomised controlled trial that evaluates the efficacy of a 3-month health promotion intervention in preschool child-parent dyads. In recognition of the value of multiple theoretical approaches, the strong theoretical basis consists of Social Cognitive Theory, Health Belief Model, and Trans-Theoretical Model principles underpinning the development of the intervention programme. In total, 460 child-parent dyads from 12 preschools in Terengganu, Malaysia, will be recruited. The children in the intervention group will expose to the i-MaCHeL classroom activities, while the parents will access the i-MaCHeL Web-based educational programme and numerous parent-child home-based online activities. The children in the control group will continue with any existing health-related activities, while the parents will receive the link to the general health newsletters. BMI z-score, dietary intake, physical activity, screen time duration, health-related quality of life, parental self-efficacy, parental role modelling, and parental policies will be assessed at baseline, 3 months’ post-baseline, and at 6 months’ follow-up (9 months’ post-baseline). General linear model repeated measure analysis will be used to determine differences between groups at the 3- and 9-month surveys with adjustment for potential covariates. Statistical analyses will follow intention-to-treat principles. Conclusion We hypothesise that the combination of the classroom and interactive Web-based activities will have a strong potential to be effective strategies to sustain child-parent engagement and participation in the weight-related behaviour change programme. Clinical trial registration ClinicalTrials.gov Identifier:NCT04711525.
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Affiliation(s)
- Ahmad Faezi Rashid
- School of Nutrition and Dietetics, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kuala Nerus, Terengganu, Malaysia
- Faculty of Hospitality, Tourism, and Wellness, Universiti Malaysia Kelantan, Kota Bharu, Kelantan, Malaysia
| | - Sharifah Wajihah Wafa
- School of Nutrition and Dietetics, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kuala Nerus, Terengganu, Malaysia
- * E-mail:
| | - Ruzita Abd Talib
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Nor Mazlina Abu Bakar
- Faculty of Business and Management, Universiti Sultan Zainal Abidin, Kuala Nerus, Terengganu, Malaysia
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69
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Ruiter ELM, Molleman GRM, Kleinjan M, Kraiss JT, ten Klooster PM, van der Velden K, Engels RCME, Fransen GAJ. The effectiveness of a web-based Dutch parenting program to prevent overweight in children 9-13 years of age: Results of a two-armed cluster randomized controlled trial. PLoS One 2022; 17:e0276168. [PMID: 36269738 PMCID: PMC9586369 DOI: 10.1371/journal.pone.0276168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 08/30/2022] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Although parental support is an important component in programs designed to prevent overweight in children, current programs pay remarkably little attention to the role of parenting. We therefore developed a web-based parenting program entitled "Making a healthy deal with your child". This e-learning program can be incorporated into existing overweight prevention programs. The aim of this study was to determine the effectiveness of this e-learning program. MATERIALS AND METHODS The effectiveness was examined in a two-armed cluster randomized controlled trial. The participants were 475 parent-child dyads of children 9-13 years of age in the Netherlands who participated in an existing schoolclass-based overweight prevention program. At the school grade level, parents were randomly assigned to either the intervention or the control condition. Measurements were taken from both parents and children at baseline, and 5 and 12 months after baseline. Primary outcomes included the child's dietary and sedentary behavior, and level of physical activity. Secondary outcomes included general parenting style, specific parenting practices, and parental self-efficacy. Linear mixed effects models and generalized linear mixed effects models were conducted in R. RESULTS Intention-to-treat analyses and completers only revealed no significant effects between the intervention and control condition on energy balance-related behaviors of the child and parenting skills after correction for multiple testing. The parents' mean satisfaction with the e-learning program (on a 10-point scale) was 7.0±1.1. CONCLUSIONS Although parents were generally satisfied with the parenting program, following this program had no significant beneficial effects regarding the children's energy balance-related behaviors or the parenting skills compared to the control condition. This program may be more beneficial if used by high-risk groups (e.g. parents of children with unhealthy energy balance-related behaviors and/or with overweight) compared to the general population, warranting further study.
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Affiliation(s)
- Emilie L. M. Ruiter
- Department of Primary and Community Care, Academic Collaborative Center AMPHI, Integrated Health Policy, ELG 117, Radboud University Medical Center, HB Nijmegen, The Netherlands
- * E-mail:
| | - Gerard R. M. Molleman
- Department of Primary and Community Care, Academic Collaborative Center AMPHI, Integrated Health Policy, ELG 117, Radboud University Medical Center, HB Nijmegen, The Netherlands
| | | | - Jannis T. Kraiss
- Department of Psychology, Health and Technology, University of Twente, AE Enschede, The Netherlands
| | - Peter M. ten Klooster
- Department of Psychology, Health and Technology, University of Twente, AE Enschede, The Netherlands
| | - Koos van der Velden
- Department of Primary and Community Care, Academic Collaborative Center AMPHI, Integrated Health Policy, ELG 117, Radboud University Medical Center, HB Nijmegen, The Netherlands
| | | | - Gerdine A. J. Fransen
- Department of Primary and Community Care, Academic Collaborative Center AMPHI, Integrated Health Policy, ELG 117, Radboud University Medical Center, HB Nijmegen, The Netherlands
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Tanous DR, Ruedl G, Kirschner W, Drenowatz C, Craddock J, Rosemann T, Wirnitzer K. School health programs of physical education and/or diet among pupils of primary and secondary school levels I and II linked to body mass index: A systematic review protocol within the project From Science 2 School. PLoS One 2022; 17:e0275012. [PMID: 36201567 PMCID: PMC9536596 DOI: 10.1371/journal.pone.0275012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/08/2022] [Indexed: 11/13/2022] Open
Abstract
The most common causes of death in Western countries today are preventable diseases mainly attributed to daily behavior. It has been well documented that genetics are influential but not the deciding factor for developing non-communicable diseases. Ideally, the public should be educated to perform methods of optimal health and wellbeing independently, meaning that individuals should be in control of their health without relying on others. As behavior is known to be consistent over time, good or poor health behavior will track from childhood into adulthood. Physical activity and diet are permanently linked to the individual's state of health, and when properly balanced, the effects on personal health summate, resulting in greater benefits from this dual-approach for public health. The objective is to highlight the different approaches (physical intervention, nutritional intervention, and dual-approach of diet and exercise) and identify effective interventions for sustainable body weight and healthy body mass index in school children. A systematic review will be conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. The review will assess school-based diet and exercise interventions on children in primary and secondary school levels I and II. Overweight and obesity develop as a result of a prolonged imbalance in the energy balance model, with both physical activity and diet being influential in the fluctuation of body weight. A dual-approach including physical activity and diet could therefore be a very promising method to promote sustainable healthy body weight in school children.
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Affiliation(s)
- Derrick R. Tanous
- Department of Sport Science, Leopold-Franzens University of Innsbruck, Innsbruck, Austria
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- * E-mail:
| | - Gerhard Ruedl
- Department of Sport Science, Leopold-Franzens University of Innsbruck, Innsbruck, Austria
| | - Werner Kirschner
- Department of Sport Science, Leopold-Franzens University of Innsbruck, Innsbruck, Austria
| | - Clemens Drenowatz
- Division of Physical Education, University of Education Upper Austria, Linz, Austria
| | - Joel Craddock
- Sydney School of Education and Social Work, The University of Sydney, Sydney, Australia
| | - Thomas Rosemann
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Katharina Wirnitzer
- Department of Sport Science, Leopold-Franzens University of Innsbruck, Innsbruck, Austria
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Health and Lifestyle Science Cluster Tirol, Subcluster Health/Medicine/Psychology, Tyrolean University Conference, Verbund West, Innsbruck, Austria
- Research Center Medical Humanities, Leopold-Franzens University of Innsbruck, Innsbruck, Austria
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71
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Triantafyllidis A, Alexiadis A, Elmas D, Gerovasilis G, Votis K, Tzovaras D. A social robot-based platform for health behavior change toward prevention of childhood obesity. UNIVERSAL ACCESS IN THE INFORMATION SOCIETY 2022; 22:1-11. [PMID: 36211232 PMCID: PMC9526206 DOI: 10.1007/s10209-022-00922-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
Childhood obesity is a major public health challenge which is linked with the occurrence of diseases such as diabetes and cancer. The COVID-19 pandemic has forced changes to the lifestyle behaviors of children, thereby making the risk of developing obesity even greater. Novel preventive tools and approaches are required to fight childhood obesity. We present a social robot-based platform which utilizes an interactive motivational strategy in communication with children, collects self-reports through the touch of tangible objects, and processes behavioral data, aiming to: (a) screen and assess the behaviors of children in the dimensions of physical activity, diet, and education, and (b) recommend individualized goals for health behavior change. The platform was integrated through a microservice architecture within a multi-component system targeting childhood obesity prevention. The platform was evaluated in an experimental study with 30 children aged 9-12 years in a real-life school setting, showing children's acceptance to use it, and an 80% success rate in achieving weekly personal health goals recommended by the social robot-based platform. The results provide preliminary evidence on the implementation feasibility and potential of the social robot-based platform toward the betterment of children's health behaviors in the context of childhood obesity prevention. Further rigorous longer-term studies are required.
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Affiliation(s)
- Andreas Triantafyllidis
- Information Technologies Institute, Centre for Research and Technology Hellas (CERTH), 57001 Thessaloníki, Greece
| | - Anastasios Alexiadis
- Information Technologies Institute, Centre for Research and Technology Hellas (CERTH), 57001 Thessaloníki, Greece
| | - Dimosthenis Elmas
- Information Technologies Institute, Centre for Research and Technology Hellas (CERTH), 57001 Thessaloníki, Greece
| | - Georgios Gerovasilis
- Information Technologies Institute, Centre for Research and Technology Hellas (CERTH), 57001 Thessaloníki, Greece
| | - Konstantinos Votis
- Information Technologies Institute, Centre for Research and Technology Hellas (CERTH), 57001 Thessaloníki, Greece
| | - Dimitrios Tzovaras
- Information Technologies Institute, Centre for Research and Technology Hellas (CERTH), 57001 Thessaloníki, Greece
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Cardon G, Chastin S, Van Stappen V, Huys N, Stefanova T, Chakarova N, Kivelä J, Alberto Moreno L, Sándor Istvánné R, Androutsos O, Manios Y, De Craemer M. The Feel4Diabetes intervention: effectiveness on 24-hour physical behaviour composition in families at risk for diabetes development. Health Promot Int 2022; 37:6775000. [DOI: 10.1093/heapro/daac092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Summary
The Feel4Diabetes project conducted a 2-year intervention aiming to encourage healthy behaviours in families in six European countries. Within this paper, the intervention effect was evaluated after the first intervention year on 24-hour physical behaviour composition in Belgian families at risk for type 2 diabetes. Parents’ and children’s levels of physical activity (PA) and sedentary behaviour (SB) were objectively measured and sleep duration was self-reported. Valid data were obtained in 82 children (mean age: 8.2 ± 0.84; 50.0% boys) and 72 parents (mean age: 40.1 ± 5.5; 27.8% fathers). Data were analysed using a compositional data approach, and mixed models were used to take clustering into account. Results showed that for children, the mean baseline composition of the 24-hour day in sleep, SB, light and moderate-to-vigorous PA for the intervention group was (11 hours 18 minutes; 6 hours 33 minutes; 5 hours 02 minutes, 1 hour 08 minutes) and for the control group (11 hours 18 minutes; 6 hours 35 minutes; 5 hours 04 minutes; 1 hour 06 minutes), respectively. For parents, the mean baseline composition was for the intervention group (8 hours 12 minutes; 9 hours 36 minutes; 5 hours 43 minutes; 27 minutes) and for the control group (8 hours 00 minute; 9 hours 00 minute; 6 hours 27 minutes; 33 minutes). No significant intervention effects were found on 24-hour physical behaviour composition of either parents or children (p = 0.19 and p = 0.21, respectively). A relatively small study population and a poor attendance rate among parents could maybe explain the lack of effectiveness. More effective strategies are needed to retain vulnerable families in interventions. Furthermore, future approaches to improve the 24-hour physical behaviour composition should maybe focus more specifically on PA, SB and sleep, and involve teachers, children and parents in the design of the intervention. Trial registration: NCT02393872 in ClinicalTrials.gov.
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Affiliation(s)
- Greet Cardon
- Ghent University, Department of Movement and Sports Sciences, Ghent University , Watersportlaan 2, 9000 Ghent , Belgium
| | - Sebastien Chastin
- Ghent University, Department of Movement and Sports Sciences, Ghent University , Watersportlaan 2, 9000 Ghent , Belgium
- Center for Living, School of Health and Life Science, Glasgow Caledonian University , Cowcaddens Rd, Glasgow G4 0BA , UK
| | - Vicky Van Stappen
- Ghent University, Department of Movement and Sports Sciences, Ghent University , Watersportlaan 2, 9000 Ghent , Belgium
| | - Nele Huys
- Ghent University, Department of Movement and Sports Sciences, Ghent University , Watersportlaan 2, 9000 Ghent , Belgium
| | - Tanya Stefanova
- Medical University Varna, Clinic of Paediatric Endocrinology , UMHAT “St. Marina” 1 “Hr. Smirnenski” Blvd., Varna 9010 , Bulgaria
| | - Nevena Chakarova
- Medical University of Sofia, Department of Diabetology, Clinical Centre of Endocrinology , Bulgaria bul. “Pencho Slaveykov”, 1431 Sofia Center, Sofia, Bulgarije
| | - Jemina Kivelä
- Finnish Institute for Health and Welfare , Mannerheimintie 166, 00300 Helsinki , Finland
| | - Luis Alberto Moreno
- University of Zaragoza, GENUD (Growth, Exercise, Nutrition and Development) , C/Domingo Miral s/n, 50009 Zaragoza , Spain
| | - Radó Sándor Istvánné
- University of Debrecen, Debreceni Egyetem (UoD) , Egyetem tér 1, Debrecen, 4032 Hungary
| | - Odysseas Androutsos
- Harokopio University, School of Health Science & Education, Department of Nutrition and Dietetics, Harokopio University , 70, El Venizelou Ave, 176 71 Kallithea, Athens , Greece
| | - Yannis Manios
- Harokopio University, School of Health Science & Education, Department of Nutrition and Dietetics, Harokopio University , 70, El Venizelou Ave, 176 71 Kallithea, Athens , Greece
| | - Marieke De Craemer
- Research Foundation Flanders (FWO) , Egmontstraat 5, 1000 Brussels , Belgium
- Department of Rehabilitation Sciences, Ghent University , Ghent University Hospital B3, C. Heymanslaan 10, 9000 Ghent , Belgium
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Ram B, Foley KA, van Sluijs E, Hargreaves DS, Viner RM, Saxena S. Developing a core outcome set for physical activity interventions in primary schools: a modified-Delphi study. BMJ Open 2022; 12:e061335. [PMID: 36180126 PMCID: PMC9528589 DOI: 10.1136/bmjopen-2022-061335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 08/26/2022] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES To develop a core outcome set (COS) for physical activity interventions in primary schools. DESIGN Modified-Delphi study. SETTING The UK and international. PARTICIPANTS 104 participants from four stakeholder groups (educators, public health professionals, health researchers, parents); 16 children (aged 8-9 years) from 1 London primary school. INTERVENTIONS Physical activity interventions. METHODS Four-stage process: (1) outcomes extracted from relevant studies identified from an umbrella review and a focus group; (2) list of outcomes produced and domains established; (3) stakeholders completed a two-round Delphi survey by rating (Round 1) and re-rating (Round 2) each outcome on a nine-point Likert Scale from 'not important' to 'critical': a>70% participant threshold identified the outcomes rated 'critical' to measure, and outcomes important to children were identified through a workshop; and (4) a stakeholder meeting to achieve consensus of the outcomes to include in the COS. RESULTS In total, 74 studies were extracted from 53 reviews. A list of 50 outcomes was produced and three domains were established: 'physical activity and health' (16 outcomes), 'social and emotional health' (22 outcomes) and 'educational performance' (12 outcomes). 104 participants completed survey Round 1; 65 participants completed both rounds. In total, 13 outcomes met the threshold; children identified 8 outcomes. Fourteen outcomes achieved consensus to produce the COS: five outcomes for physical activity and health (diet (varied and balanced), energy, fitness, intensity of physical activity, sleep (number of hours)); seven outcomes for social and emotional health (anxiety, depression, enjoyment, happiness, self-esteem, stress, well-being); and two outcomes for educational performance (concentration, focus). CONCLUSIONS We have developed the first COS for physical activity interventions in primary schools in consultation with those interested in the development and application of an agreed standardised set of outcomes. Future studies including these outcomes will reduce heterogeneity across studies. TRIAL REGISTRATION NUMBER Core Outcome Measures in Effectiveness Trials Initiative registration number 1322; Results.
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Affiliation(s)
- Bina Ram
- Primary Care and Public Health, Imperial College London, London, UK
| | | | - Esther van Sluijs
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, Cambridgeshire, UK
| | - Dougal S Hargreaves
- Primary Care and Public Health, Imperial College London, London, UK
- Mohn Centre for Children's Health and Wellbeing, Imperial College London, London, UK
| | - Russell M Viner
- Population, Policy and Practice Research Programme, UCL Institute of Child Health, London, UK
| | - Sonia Saxena
- Primary Care and Public Health, Imperial College London, London, UK
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Face-to-face physical activity incorporated into dietary intervention for overweight/obesity in children and adolescents: a Bayesian network meta-analysis. BMC Med 2022; 20:325. [PMID: 36056358 PMCID: PMC9438135 DOI: 10.1186/s12916-022-02462-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 07/04/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Adolescent obesity has been reported to have deleterious consequences but is considered a promising modifiable risk factor. We aimed to investigate the optimal intervention for obese and overweight children and adolescents. METHODS We searched the Medline (PubMed, 1946-December 2020), PsycINFO (Ovid, 1927-December 2020), Cochrane library (1966-December 2020), Web of Science (1900-December 2020), Embase (1974-December 2020), CINAHL (1937-December 2020), Chinese Biomedical Literature (1978-December 2020), and ClinicalTrials.gov (December 2020) databases. We included randomized controlled trials (RCTs) reporting the association between various interventions and obese/overweight children and adolescents. The quality of the included studies was judged by two independent reviewers using the Cochrane Collaboration Risk of Bias Tool. A Bayesian network meta-analysis was conducted to summarize the comparative effectiveness of interventions based on several outcomes. RESULTS We included 118 RCTs comprising 71,064 participants in our analyses. Based on the outcome of the body mass index (BMI), face-to-face physical activity (FTF PA) combined with dietary intervention (DI) (mean difference [MD] = - 0.98; 95% credible interval [CrI] - 1.19, - 0.77), FTF multi-lifestyle intervention (MLI) (MD = - 0.95; 95% CrI - 1.14, - 0.75), and mobile health (MH)-delivered MLI (MD = - 0.87; 95% CrI - 1.63, - 0.09) showed significant benefits over the named control group (NCG). For the outcome of BMI z-score, FTF PA+DI (MD = - 0.10; 95% CrI - 0.15, - 0.04) and MH-delivered PA+DI (MD = - 0.09; 95% CrI - 0.14, - 0.04) were more effective than the NCG. Sensitivity analyses revealed similar findings after exclusion of studies with < 12-month and 24-month outcome assessments for the intervention, which indicated the results were stable. CONCLUSIONS Based on limited quality evidence and limited direct evidence, our preliminary findings showed that FTF-PA+DI, FTF-MLI, and MH-delivered MLI improved the health-related parameters in obese adolescents, in comparison with NCG. Owing to the absence of strong, direct evidence of a significant difference between the various interventions for the four outcomes, we can only cautiously suggest that FTF-PA+DI is likely the most effective intervention.
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75
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White PA, Awad YA, Gauvin L, Spencer NJ, McGrath JJ, Clifford SA, Nikiema B, Yang-Huang J, Goldhaber-Fiebert JD, Markham W, Mensah FK, van Grieken A, Raat H, Jaddoe VWV, Ludvigsson J, Faresjö T. Household income and maternal education in early childhood and risk of overweight and obesity in late childhood: Findings from seven birth cohort studies in six high-income countries. Int J Obes (Lond) 2022; 46:1703-1711. [PMID: 35821522 PMCID: PMC9395266 DOI: 10.1038/s41366-022-01171-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 06/13/2022] [Accepted: 06/13/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES This study analysed the relationship between early childhood socioeconomic status (SES) measured by maternal education and household income and the subsequent development of childhood overweight and obesity. SUBJECTS/METHODS Data from seven population-representative prospective child cohorts in six high-income countries: United Kingdom, Australia, the Netherlands, Canada (one national cohort and one from the province of Quebec), USA, Sweden. Children were included at birth or within the first 2 years of life. Pooled estimates relate to a total of N = 26,565 included children. Overweight and obesity were defined using International Obesity Task Force (IOTF) cut-offs and measured in late childhood (8-11 years). Risk ratios (RRs) and pooled risk estimates were adjusted for potential confounders (maternal age, ethnicity, child sex). Slope Indexes of Inequality (SII) were estimated to quantify absolute inequality for maternal education and household income. RESULTS Prevalence ranged from 15.0% overweight and 2.4% obese in the Swedish cohort to 37.6% overweight and 15.8% obese in the US cohort. Overall, across cohorts, social gradients were observed for risk of obesity for both low maternal education (pooled RR: 2.99, 95% CI: 2.07, 4.31) and low household income (pooled RR: 2.69, 95% CI: 1.68, 4.30); between-cohort heterogeneity ranged from negligible to moderate (p: 0.300 to < 0.001). The association between RRs of obesity by income was lowest in Sweden than in other cohorts. CONCLUSIONS There was a social gradient by maternal education on the risk of childhood obesity in all included cohorts. The SES associations measured by income were more heterogeneous and differed between Sweden versus the other national cohorts; these findings may be attributable to policy differences, including preschool policies, maternity leave, a ban on advertising to children, and universal free school meals.
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Affiliation(s)
- Pär Andersson White
- Department of Health, Medicine and Care, General Practice, Linköping University, SE-58183, Linköping, Sweden.
- Crown Princess Victoria Children´s Hospital, Region Östergötland, SE-58185, Linköping, Sweden.
| | - Yara Abu Awad
- PERFORM Centre, Concordia University, H4B 1R6, Montreal, QC, Canada
| | - Lise Gauvin
- Centre de recherche du Centre Hospitalier de l'Université de Montréal, H2X 0A9, Montréal, QC, Canada
- École de santé publique, Université de Montréal, H2X 0A9, Montréal, QC, Canada
| | - Nicholas James Spencer
- Division of Health Sciences, Warwick Medical School, University of Warwick, CV4 7AL, Coventry, UK
| | | | - Susan A Clifford
- Murdoch Children's Research Institute, Melbourne, VIC, 3052, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, 3052, Australia
| | - Béatrice Nikiema
- École de santé publique, Université de Montréal, H2X 0A9, Montréal, QC, Canada
- Cree Board of Health and Social Services of James Bay, Department of Program Development and Support, G0W 1C0, Chisasibi, QC, Canada
| | - Junwen Yang-Huang
- The Generation R Study Group, Erasmus University Medical Center, 3000 CA, Rotterdam, the Netherlands
- Department of Public Health, Erasmus University Medical Center, 3000 CA, Rotterdam, the Netherlands
| | | | - Wolfgang Markham
- Division of Health Sciences, Warwick Medical School, University of Warwick, CV4 7AL, Coventry, UK
| | - Fiona K Mensah
- Murdoch Children's Research Institute, Melbourne, VIC, 3052, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, 3052, Australia
| | - Amy van Grieken
- Department of Public Health, Erasmus University Medical Center, 3000 CA, Rotterdam, the Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus University Medical Center, 3000 CA, Rotterdam, the Netherlands
| | - V W V Jaddoe
- The Generation R Study Group, Erasmus University Medical Center, 3000 CA, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus University Medical Center, 3000 CA, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus University Medical Center, 3000 CA, Rotterdam, the Netherlands
| | - Johnny Ludvigsson
- Crown Princess Victoria Children´s Hospital, Region Östergötland, SE-58185, Linköping, Sweden
- Division of Pediatrics, Dept of Biomedical and Clinical Sciences, Linköping University, SE-58185, Linköping, Sweden
| | - Tomas Faresjö
- Department of Health, Medicine and Care, General Practice, Linköping University, SE-58183, Linköping, Sweden
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Zhao C, Ma L, Gao L, Wu Y, Yan Y, Peng W, Wang Y. Effectiveness of a multifaceted intervention for the improvement of nutritional status and nutrition knowledge of children in poverty-stricken areas in Shaanxi Province, China. GLOBAL HEALTH JOURNAL 2022. [DOI: 10.1016/j.glohj.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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77
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Etzel TM, Braun JM, Kuiper JR, Calafat AM, Cecil KM, Chen A, Lanphear BP, Yolton K, Kalkwarf HJ, Buckley JP. Gestational and childhood phthalate exposures and adolescent body composition: The HOME study. ENVIRONMENTAL RESEARCH 2022; 212:113320. [PMID: 35461845 PMCID: PMC9233110 DOI: 10.1016/j.envres.2022.113320] [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: 11/08/2021] [Revised: 03/31/2022] [Accepted: 04/12/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Early life phthalate exposures may disrupt metabolism but results from human studies are inconsistent and few have examined body composition during adolescence. We investigated associations of gestational and childhood urinary phthalate biomarker concentrations with body composition at age 12 years. METHODS We used data from 206 mother-child pairs in a prospective pregnancy and birth cohort enrolled in Cincinnati, OH from 2003 to 2006. We measured nine phthalate metabolites in spot urine samples collected twice from mothers during pregnancy and up to seven times from children at 1, 2, 3, 4, 5, 8, and 12 years. At age 12 years, we assessed fat and lean mass of the whole body and android and gynoid subregions, and visceral fat area with dual x-ray absorptiometry, and calculated android to gynoid %fat ratio and age- and sex-standardized fat and lean mass index z-scores. Using a multiple informant model, we estimated covariate-adjusted associations between urinary phthalate biomarker concentrations at each time period and outcomes at age 12 years. We assessed effect measure modification by child sex using stratified models. RESULTS Generally, urinary mono-benzyl phthalate (MBzP) concentrations were modestly associated with lower fat and lean mass. Each 10-fold increase in urinary MBzP concentrations during gestation and at ages 5 and 8 years was associated with a -0.34 (95%CI: -0.72, 0.05), -0.44 (95% CI: -0.83, -0.05), and -0.35 (95% CI: -0.71, 0.00) z-score difference in lean body mass index, respectively. Urinary monoethyl phthalate, mono-(3-carboxypropyl) phthalate, and summed di(2-ethylhexyl) phthalate metabolites were associated with greater lean mass at some exposure periods. Slightly weaker but similar patterns of association were found with other body composition measures; associations did not differ by child sex. CONCLUSION While most associations were weak, exposure to certain phthalates during gestation and childhood may be associated with adolescent body composition, particularly lean mass.
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Affiliation(s)
- Taylor M Etzel
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA.
| | - Joseph M Braun
- Brown University, 121 S. Main St, Providence, RI, 02903, USA.
| | - Jordan R Kuiper
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA.
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, NE Atlanta, GA, 30341, USA.
| | - Kim M Cecil
- Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA; University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH, 45267, USA.
| | - Aimin Chen
- University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA.
| | - Bruce P Lanphear
- Simon Fraser University, 8888 University Dr, Burnaby, BC, V5A 1S6, Canada.
| | - Kimberly Yolton
- Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA; University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH, 45267, USA.
| | - Heidi J Kalkwarf
- Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA; University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH, 45267, USA.
| | - Jessie P Buckley
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA.
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Aceves-Martins M, López-Cruz L, García-Botello M, Godina-Flores NL, Gutierrez-Gómez YY, Moreno-García CF. Cultural factors related to childhood and adolescent obesity in Mexico: A systematic review of qualitative studies. Obes Rev 2022; 23:e13461. [PMID: 35587773 PMCID: PMC9541705 DOI: 10.1111/obr.13461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/29/2022] [Accepted: 04/29/2022] [Indexed: 11/29/2022]
Abstract
Culture and culturally specific beliefs or practices may influence perceptions and decisions, potentially contributing to childhood obesity. The objective of this study is to identify the cultural factors (expressed through decisions, behaviors, individual experiences, perceptions, attitudes, or views) related to childhood and adolescent obesity in Mexico. Ten databases and one search engine were searched from 1995 onwards for qualitative studies. The Sunrise Enabler Model, described within the Cultural Care Theory, guided this review. Sample, the phenomenon of interest, study design, and evaluation data were extracted, and the Critical Appraisals Skills Programme tool was used to assess the quality of the included studies. Twenty-four studies were included. Of these, 12 studies included children or adolescents, 12 included parents, eight included schoolteachers, four included school staff (other than teachers), four included food vendors, and one included policymakers. Cultural values, beliefs, lifeways (especially food and food costumes), kinship, and social factors (particularly immediate and extended family) strongly influenced childhood and adolescent obesity-related lifestyles in Mexico. Most cultural factors related to childhood obesity in Mexico identified in this review may be modifiable and amenable to practical interventions.
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Affiliation(s)
| | - Lizet López-Cruz
- Universidad Europea del Atlantico, Parque Cientifico y Tecnologico de Cantabria, Santander, Spain
| | | | - Naara L Godina-Flores
- Nutrition Department, School of Medicine and Health Sciences, Tecnológico de Monterrey, Mexico City, Mexico
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Yu B, Kelly S. Does artistic activity help kids avoid obesity? Emergent considerations in the ecology of childhood BMI. Prev Med 2022; 161:107120. [PMID: 35750262 DOI: 10.1016/j.ypmed.2022.107120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 05/07/2022] [Accepted: 06/15/2022] [Indexed: 11/29/2022]
Abstract
Although the positive relationship between arts engagement and mental health is well documented, arts participation may be an emergent factor in the ecology of childhood obesity. Prior research hypothesized several potential health benefits of arts participation including healthy diet and lifestyles, but the available evidence is mainly limited to cross-sectional covariate-adjustment models for the adult population. We employed a newly released panel of the Early Childhood Longitudinal Study kindergarten cohort (ECLS-K: 2011), which is a nationally representative sample of American children who entered kindergarten in 2010-2011 (n = 15,820). We applied both dynamic panel models with Maximum Likelihood estimation as well as difference-in-differences models to address unobserved heterogeneity. Our results showed that childhood arts activity is significantly associated with reduced weight status in elementary schooling. In particular, arts participation in elementary schooling reduced the risk of being overweight on a year-to-year basis; the effect size was between 12% and 23% of a SD of BMI for all children. Arts participation at kindergarten also had a significant relationship with cumulative changes in BMI over the course of elementary schooling, especially for female and White female children (about 22% and 32% of a SD of BMI). There are considerable arts participation gaps between families and regions, and these early artistic experiences appear to affect the risk of being overweight. This suggests the possibility of a larger social reproduction process via an ecological pathway that might be easily overlooked-the accumulation of arts experience and concurrent health inequalities in childhood.
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Affiliation(s)
- Baeksan Yu
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway; PROMENTA Research Center, Department of Psychology, University of Oslo, Norway.
| | - Sean Kelly
- Department of Educational Foundations, Organizations, and Policy, University of Pittsburgh, PA, USA
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López-Gil JF, Sánchez-Miguel PA, Tapia-Serrano MÁ, García-Hermoso A. Skipping breakfast and excess weight among young people: the moderator role of moderate-to-vigorous physical activity. Eur J Pediatr 2022; 181:3195-3204. [PMID: 35648230 PMCID: PMC9352742 DOI: 10.1007/s00431-022-04503-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 12/29/2022]
Abstract
The present study aimed to test whether the daily minutes of moderate-to-vigorous physical activity (MVPA) engaged moderate the relationship between breakfast status and excess weight (i.e., overweight and/or obesity) in a Spanish sample of young people. A cross-sectional study involving a total sample of 2890 Spanish schoolchildren (46% girls) aged 6-17 years (M = 12.3 ± 2.6) was conducted. To determine the habit of having breakfast, a dichotomous item about breakfast status (yes/no) from the Mediterranean Diet Quality Index for children and teenagers (KIDMED) was used. Physical Activity Questionnaire for Older Children and the Physical Activity Questionnaire for Adolescents were fulfilled to offer an estimation of the minutes of MVPA that individuals had in the last seven days. Body mass index (BMI) was converted into z-scores and, therefore, excess weight status (i.e., overweight and/or obesity) was established according to World Health Organization criteria for sex and age. Skipping breakfast was positively related with BMI (z-score) and excess weight. Moderation analyses suggested that daily MVPA minutes moderated the association between skipping breakfast and BMI (boys: β = - 0.175; girls: β = - 0.073) or the excess weight (boys: OR = 1.10; CI 95%, 1.02 to 1.07; girls: OR = 1.14; CI 95%, 1.04 to 1.24), meaning that physical activity of sufficient intensity seems to reduce the effect of skipping breakfast on the body weight status of young people. CONCLUSION Our results indicate that promotion of having breakfast should be accompanied by daily MVPA, as young participants who have breakfast and with higher daily MVPA seem to be more likely to have no excess weight. WHAT IS KNOWN • Some of the well-studied factors associated with childhood obesity have been skipping breakfast and insufficient physical activity. • Some studies have pointed out the association between having breakfast and both body mass index and physical activity level, in isolation. WHAT IS NEW • Daily minutes of moderate-to-vigorous physical activity moderate the association between skipping breakfast and excess weight. • Breakfast promotion as a healthy eating habit should be accompanied by increases in moderate-to-vigorous physical activity, since participants who have breakfast and with higher moderate-to-vigorous physical activity seem to be more likely to have no excess weight.
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Affiliation(s)
- José Francisco López-Gil
- Departamento de Expresión Plástica, Musical y Dinámica, Facultad de Educación, Universidad de Murcia (UM), 30100 Murcia Región of Murcia, Spain
- Health and Social Research Center, Universidad de Castilla-La Mancha (UCLM), 16071 Cuenca, Spain
| | - Pedro Antonio Sánchez-Miguel
- Departamento de Didáctica de la Expresión Musical, Plástica y Corporal, Grupo Análisis Comportamental de la Actividad Física y el Deporte (ACAFYDE), Facultad de Formación del Profesorado, Universidad de Extremadura, Av. de la Universidad, 10071 Cáceres, Spain
| | - Miguel Ángel Tapia-Serrano
- Departamento de Didáctica de la Expresión Musical, Plástica y Corporal, Grupo Análisis Comportamental de la Actividad Física y el Deporte (ACAFYDE), Facultad de Formación del Profesorado, Universidad de Extremadura, Av. de la Universidad, 10071 Cáceres, Spain
| | - Antonio García-Hermoso
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, 31008 Pamplona, Navarra, Spain
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Papamichael MM, Karaglani E, Boutsikou T, Dedousis V, Cardon G, Iotova V, Chakarova N, Usheva N, Wikström K, Imre R, RADÓ ASI, Liatis S, Makrilakis K, Moreno L, Manios Y, Manios Y, Cardon G, Lindström J, Schwarz P, Makrilakis K, Annemans L, Ko W, Manios Y, Karatzi K, Androutsos O, Moschonis G, Kanellakis S, Mavrogianni C, Tsoutsoulopoulou K, Katsarou C, Karaglani E, Qira I, Skoufas E, Maragkopoulou K, Tsiafitsa A, Sotiropoulou I, Tsolakos M, Argyri E, Nikolaou M, Vampouli EA, Filippou C, Apergi K, Filippou A, Katerina G, Dimitriadis E, Lindström J, Laatikainen T, Wikström K, Kivelä J, Valve P, Levälahti E, Virtanen E, Pennanen T, Olli S, Nelimarkka K, Cardon G, Van Stappen V, Huys N, Annemans L, Willems R, Shadid S, Schwarz P, Timpel P, Makrilakis K, Liatis S, Dafoulas G, Lambrinou CP, Giannopoulou A, Ko W, Karuranga E, Moreno L, Civeira F, Bueno G, De Miguel-Etayo P, Mª E, Gonzalez-Gil, Miguel-Berges ML, Giménez-Legarre N, Flores-Barrantes P, Ayala-Marín AM, Seral-Cortés M, Baila-Rueda L, Cenarro A, Jarauta E, Mateo-Gallego R, Iotova V, Tankova T, Usheva N, Tsochev K, Chakarova N, Galcheva S, Dimova R, Bocheva Y, Radkova Z, Marinova V, Bazdarska Y, Stefanova T, Rurik I, Ungvari T, Jancsó Z, Nánási A, Kolozsvári L, Semánova C, Bíró É, Antal E, Radó S, Martinez R, Tong M. HOW DO THE HOME FOOD ENVIRONMENT, PARENTING PRACTICES, HEALTH BELIEFS, AND SCREEN TIME AFFECT THE WEIGHT STATUS OF EUROPEAN CHILDREN?: FEEL4DIABETES-STUDY. Nutrition 2022; 103-104:111834. [DOI: 10.1016/j.nut.2022.111834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 07/28/2022] [Accepted: 08/12/2022] [Indexed: 11/26/2022]
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Understanding the perceptions of parents and preschool principals on the determinants of weight management among Iranian preschoolers: A directed qualitative content analysis. PLoS One 2022; 17:e0270244. [PMID: 35737692 PMCID: PMC9223302 DOI: 10.1371/journal.pone.0270244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 06/07/2022] [Indexed: 11/19/2022] Open
Abstract
The current study aimed to understand the perceptions and experiences of Iranian parents and principals of preschool children on weight management based on the PRECEDE-PROCEED Model (PPM), a comprehensive structure for assessing health needs for designing, implementing, and evaluating health promotion, and other public health programs. PRECEDE provides a structure for planning a targeted and focused public health program, and PROCEED provides a structure for implementing and evaluating the program. Data were gathered from 17 preschoolers’ parents and two principals using semi-structured interviews in the preschool setting in Tehran, the capital of Iran, in 2019. Data were analyzed manually through directed content analysis based on constructs in phases two and three of the PPM, simultaneously with data collection. This study identified genetic, behavioral (e.g., food preferences, physical activity, sedentary behaviors, the effect of parents’, peers’, principals’ and teachers’ behavior and also influence of grandparents’ and neighbors’ behaviors) and environmental (e.g., home, grandparents’ home and preschool) factors from the epidemiological construct. Also, predisposing (e.g., child’s attitude, parent’s and principals’ attitude, as well as parents’ knowledge and parents’ and principals’ beliefs), enabling (e.g., parental skills and skills of the principals and teachers, rules and laws in the preschools, and availability), and reinforcing (e.g., family support and influences, teachers’ encouragement and influences, and peers’ influences) factors were identified from the educational and ecological construct. Additionally, “quality of child-parent relationship” was determined as a new factor affecting preschoolers’ weight management promotion; however, it was not in the PPM. In the study, parents’ and principals’ experiences regarding preschoolers’ weight management promotion confirmed the genetic, behavioral, environmental, predisposing, enabling and reinforcing factors of the PPM. “Quality of child-parent relationship” factor may be related to the culture and family relationship type of Iranian people, which is suggested to be investigated in future studies.
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Lee RE, Szeszulski J, Lorenzo E, Arriola A, Bruening M, Estabrooks PA, Hill JL, O'Connor TM, Shaibi GQ, Soltero EG, Todd M. Sustainability via Active Garden Education: The Sustainability Action Plan Model and Process. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5511. [PMID: 35564909 PMCID: PMC9102810 DOI: 10.3390/ijerph19095511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/16/2022] [Accepted: 04/27/2022] [Indexed: 02/06/2023]
Abstract
Sustainability of intervention programming is challenging to achieve under real world conditions, since few models exist and many studies do not plan far beyond the funding period. Programming content in early care and education centers (ECECs) is often driven by guidelines. However, implementation is very sensitive to contextual factors, such as the setting and implementer (teacher) characteristics. This paper presents the model, definitions, and methodology used for the sustainability action plan capitalizing on a community-based participatory research (CBPR) approach, developed for a multi-site, multi-level garden-based childhood obesity prevention study, Sustainability via Active Garden Education (SAGE). The Ecologic Model of Obesity is applied to develop a sustainability action plan (SAP) and accompanying measures to link early care and education (ECE) environment, the community, policies, and classroom practices to an early childhood obesity prevention program. The SAGE SAP provides an example of how to iteratively evaluate and refine sustainability processes for an obesity prevention intervention utilizing CBPR approaches and will be applied to assess the sustainability of SAGE in a cluster randomized controlled trial. This SAP model can also help inform intervention delivery and scalability within ECECs.
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Affiliation(s)
- Rebecca E Lee
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 550 N. 3rd St., Phoenix, AZ 85004, USA
| | - Jacob Szeszulski
- Institute for Advancing Health through Agriculture (IHA), Texas A&M AgriLife Research, 17360 Coit Rd., Dallas, TX 75252, USA
| | - Elizabeth Lorenzo
- School of Nursing, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, USA
| | - Anel Arriola
- City of Phoenix Office of Arts and Culture, 200 W. Washington St., 10th Floor, Phoenix, AZ 85003, USA
| | - Meg Bruening
- College of Health Solutions, Arizona State University, 550 N. 3rd St., Phoenix, AZ 85004, USA
| | - Paul A Estabrooks
- College of Health, University of Utah, 260 1850 E, Salt Lake City, UT 84112, USA
| | - Jennie L Hill
- Population Health Sciences, University of Utah, 295 S Chipeta Way, Salt Lake City, UT 84108, USA
| | - Teresia M O'Connor
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St., Houston, TX 77030, USA
| | - Gabriel Q Shaibi
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 550 N. 3rd St., Phoenix, AZ 85004, USA
| | - Erica G Soltero
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St., Houston, TX 77030, USA
| | - Michael Todd
- Edson College of Nursing and Health Innovation, Arizona State University, 550 N. 3rd St., Phoenix, AZ 85004, USA
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84
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Brown V, Moodie M, Sultana M, Hunter KE, Byrne R, Zarnowiecki D, Seidler AL, Golley R, Taylor RW, Hesketh KD, Matvienko-Sikar K. A scoping review of outcomes commonly reported in obesity prevention interventions aiming to improve obesity-related health behaviors in children to age 5 years. Obes Rev 2022; 23:e13427. [PMID: 35122457 DOI: 10.1111/obr.13427] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 12/17/2021] [Accepted: 12/17/2021] [Indexed: 12/18/2022]
Abstract
This scoping review was undertaken as the first stage of development of the Core Outcome Sets for Early Prevention of Obesity in CHildhood (COS-EPOCH). The aim of this review is to identify the outcomes collected and reported in randomized controlled trials of early childhood obesity prevention interventions. A systematic scoping review was undertaken following published guidelines. Trial registries and Medline were searched, and records retrieved were screened by two reviewers. Included trials aimed to prevent childhood obesity in the first 5 years of life and were randomized. Data were extracted using a standardized form. Outcomes were assigned to outcome domains, and similar definitions within each domain were merged, based on key literature and expert consensus. Outcome and domain frequencies were estimated and presented in outcome matrices. Eighteen outcome domains were identified from 161 included studies: "anthropometry," "dietary intake," "physical activity," "sedentary behaviour," "emotional functioning/wellbeing," "feeding," "cognitive/executive functioning," "sleep," "other," "study-related," "parenting practices," "motor skill development," "environmental," "blood and lymphatic system," "perceptions and preferences," "quality of life," and "economic," "oral health." The most frequently reported outcome domain was anthropometry (92% of studies), followed by dietary intake (77%) and physical activity (60%). 221 unique outcomes were identified, indicating a high degree of heterogeneity. Body mass index was the only outcome reported in >50% of studies. The considerable heterogeneity in outcomes supports the need for the development of COS-EPOCH.
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Affiliation(s)
- Vicki Brown
- Deakin Health Economics, Institute for Health Transformation, Global Obesity Centre (GLOBE), School of Health and Social Development, Deakin University, Geelong, Australia.,Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, Australia
| | - Marj Moodie
- Deakin Health Economics, Institute for Health Transformation, Global Obesity Centre (GLOBE), School of Health and Social Development, Deakin University, Geelong, Australia.,Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, Australia
| | - Marufa Sultana
- Deakin Health Economics, Institute for Health Transformation, Global Obesity Centre (GLOBE), School of Health and Social Development, Deakin University, Geelong, Australia
| | - Kylie E Hunter
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, Australia.,NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - Rebecca Byrne
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, Australia.,School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | - Dorota Zarnowiecki
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, Australia.,Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia
| | - Anna Lene Seidler
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, Australia.,NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - Rebecca Golley
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, Australia.,Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia
| | - Rachael W Taylor
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, Australia.,Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Kylie D Hesketh
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, Australia.,Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
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85
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Aceves-Martins M, López-Cruz L, García-Botello M, Gutierrez-Gómez YY, Moreno-García CF. Interventions to Prevent Obesity in Mexican Children and Adolescents: Systematic Review. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:563-586. [PMID: 34725762 PMCID: PMC9072495 DOI: 10.1007/s11121-021-01316-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2021] [Indexed: 10/26/2022]
Abstract
The prevalence of overweight and obesity has been rising among Mexican children and adolescents in the last decades. To systematically review obesity prevention interventions delivered to Mexican children and adolescents. Thirteen databases and one search engine were searched for evidence from 1995 to 2021. Searches were done in English and Spanish to capture relevant information. Studies with experimental designs, delivered in any setting (e.g., schools or clinics) or digital domains (e.g., social media campaigns) targeting Mexican children or adolescents (≤ 18 years) and reporting weight outcomes, were included in this review. In addition, the risk of bias was appraised with the Effective Public Health Practice Project Quality Assessment Tool. Twenty-nine studies with 19,136 participants (3-17 years old) were included. The prevalence of overweight and obesity at baseline ranged from 21 to 69%. Most of the studies (89.6%) were delivered in school settings. The duration ranged from 2 days to 3 school years, and the number of sessions also varied from 2 to 200 sessions at different intensities. Overall, anthropometric changes varied across studies. Thus, the efficacy of the included studies is heterogeneous and inconclusive among studies. Current evidence is heterogeneous and inconclusive about the efficacy of interventions to prevent obesity in Mexican children and adolescents. Interventions should not be limited to educational activities and should include different components, such as multi-settings delivery, family inclusion, and longer-term implementations. Mixed-method evaluations (including robust quantitative and qualitative approaches) could provide a deeper understanding of the effectiveness and best practices.
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Affiliation(s)
- Magaly Aceves-Martins
- The Rowett Institute of Nutrition and Health, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK.
| | - Lizet López-Cruz
- Universidad Europea del Atlántico, Parque Científico Y Tecnológico de Cantabria, C/Isabel Torres 21, 39011, Santander, Spain
| | - Marcela García-Botello
- Universidad de Monterrey, Zona Valle Poniente, Av. Ignacio Morones Prieto 4500, 66238, San Pedro Garza García, N.L, Mexico
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de Souza E Silva S, Leite N, Furtado-Alle L, de Souza RLR, Corazza PRP, Tradiotto MC, Milano GE, da Silva LR, Pizzi J, Lopes MDFA, Lopes WA, Tureck LV. ADRB2 gene influences responsiveness to physical exercise programs: A longitudinal study applied to overweight or obese Brazilian children and adolescents. Gene X 2022; 820:146296. [PMID: 35149152 DOI: 10.1016/j.gene.2022.146296] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 01/22/2022] [Accepted: 02/04/2022] [Indexed: 01/29/2023] Open
Abstract
We aimed to investigate whether the expression levels and polymorphisms in the ADRB2 gene have influenced the anthropometric and cardiometabolic outcomes changes in obese/overweight children submitted to physical exercise programs. This longitudinal study included 197 overweight or obese children aged 10-16 years, submitted to physical exercise programs - three sessions per week for 12 weeks. Anthropometric and cardiometabolic profile was collected before and after interventions. The ADRB2 gene expression levels were also measured in these two moments in a small intervention group (n = 17) and a control group (n = 18). Arg16Gly and Gln27Glu polymorphisms were genotyped. A positive correlation between ADRB2 expression and loss of body fat (%) (p = 0.038) was observed, which remained after sex and BMI change corrections. Carriers of the Glu27Glu genotype presented a better response to physical exercise programs regarding their triglycerides levels and triglyceride-glucose index (p = 0.001 for both). The participants' responsiveness to physical exercise programs showed variation due to the ADRB2 gene expression and the Gln27Glu polymorphism. A more significant loss of body fat was associated with higher levels of ADRB2 expression, and the Glu27Glu genotype was associated with a better cardiometabolic response. The Arg16Gly polymorphism did not show interaction with the responsiveness to physical exercise.
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Affiliation(s)
- Silvia de Souza E Silva
- Polymorphism and Linkage Laboratory, Department of Genetics, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Neiva Leite
- Department of Physical Education, Federal University of Paraná, Coração de Maria, 92 Jardim Botânico, 80215-370 Curitiba, PR, Brazil
| | - Lupe Furtado-Alle
- Polymorphism and Linkage Laboratory, Department of Genetics, Federal University of Paraná, Curitiba, Paraná, Brazil
| | | | - Patricia Ribeiro Paes Corazza
- Department of Physical Education, Federal University of Paraná, Coração de Maria, 92 Jardim Botânico, 80215-370 Curitiba, PR, Brazil
| | - Maiara Cristina Tradiotto
- Department of Physical Education, Federal University of Paraná, Coração de Maria, 92 Jardim Botânico, 80215-370 Curitiba, PR, Brazil
| | - Gerusa Eisfeld Milano
- Department of Physical Education, Federal University of Paraná, Coração de Maria, 92 Jardim Botânico, 80215-370 Curitiba, PR, Brazil
| | - Larissa Rosa da Silva
- Department of Physical Education, Federal University of Paraná, Coração de Maria, 92 Jardim Botânico, 80215-370 Curitiba, PR, Brazil
| | - Juliana Pizzi
- Department of Physical Education, Federal University of Paraná, Coração de Maria, 92 Jardim Botânico, 80215-370 Curitiba, PR, Brazil
| | - Maria de Fátima Aguiar Lopes
- Department of Physical Education, Federal University of Paraná, Coração de Maria, 92 Jardim Botânico, 80215-370 Curitiba, PR, Brazil
| | - Wendell Arthur Lopes
- Department of Physical Education, State University of Maringa, Av. Colombo 5790, 87020-900 Maringa, PR, Brazil
| | - Luciane Viater Tureck
- Polymorphism and Linkage Laboratory, Department of Genetics, Federal University of Paraná, Curitiba, Paraná, Brazil.
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87
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Ramirez A, Tovar A, Garcia G, Nieri T, Hernandez S, Sastre M, Cheney AM. Involvement of Non-Parental Caregivers in Obesity Prevention Interventions among 0-3-Year-Old Children: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084910. [PMID: 35457780 PMCID: PMC9031125 DOI: 10.3390/ijerph19084910] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/12/2022] [Accepted: 04/15/2022] [Indexed: 02/04/2023]
Abstract
INTRODUCTION We examined the scope of literature including non-parental caregiver involvement in child obesity prevention interventions. METHODS We conducted a scoping review following the Arksey and O'Malley framework, including only studies reporting the effect of an intervention on growth, weight, or early childhood obesity risk among children ages 0 to three years, published between 2000 and 2021. Interventions that did not include non-parental caregivers (adults regularly involved in childcare other than parents) were excluded. RESULTS Of the 14 studies that met the inclusion criteria, all were published between 2013 and 2020, and most interventions (n = 9) were implemented in the United States. Eight of the 14 interventions purposefully included other non-parental caregivers: five included both parents and non-parental caregivers, and the remaining three included only non-parental caregivers. Most interventions (n = 9) showed no significant impact on anthropometric outcomes. All interventions found improvements in at least one behavioral outcome (e.g., food groups intake (n = 5), parental feeding practices (n = 3), and screen time (n = 2)). This review can inform future interventions that plan to involve non-parental caregivers, which may be beneficial in shaping early health behaviors and preventing obesity early in life.
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Affiliation(s)
- Andrea Ramirez
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA;
| | - Alison Tovar
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02903, USA;
| | - Gretel Garcia
- Graduate School of Education, University of California Riverside, Riverside, CA 92521, USA;
| | - Tanya Nieri
- Department of Sociology, University of California Riverside, Riverside, CA 92521, USA; (T.N.); (M.S.)
| | - Stephanie Hernandez
- School of Public Policy, University of California Riverside, Riverside, CA 92507, USA;
| | - Myrna Sastre
- Department of Sociology, University of California Riverside, Riverside, CA 92521, USA; (T.N.); (M.S.)
| | - Ann M. Cheney
- Department of Social Medicine, Population and Public Health, School of Medicine, University of California Riverside, Riverside, CA 92521, USA
- Correspondence:
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88
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Kuhlemeier A, Jaki T, Jimenez EY, Kong AS, Gill H, Chang C, Resnicow K, Wilson DK, Van Horn ML. Individual differences in the effects of the ACTION-PAC intervention: an application of personalized medicine in the prevention and treatment of obesity. J Behav Med 2022; 45:211-226. [PMID: 35032253 PMCID: PMC11156464 DOI: 10.1007/s10865-021-00274-2] [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: 02/22/2021] [Accepted: 12/14/2021] [Indexed: 10/19/2022]
Abstract
There is an increased interest in the use of personalized medicine approaches in the prevention or treatment of obesity, however, few studies have used these approaches to identify individual differences in treatment effects. The current study demonstrates the use of the predicted individual treatment effects framework to test for individual differences in the effects of the ACTION-PAC intervention, which targeted the treatment and prevention of obesity in a high school setting. We show how methods for personalized medicine can be used to test for significant individual differences in responses to an intervention and we discuss the potential and limitations of these methods. In our example, 25% of students in the preventive intervention, were predicted to have their BMI z-score reduced by 0.39 or greater, while at other end of the spectrum, 25% were predicted to have their BMI z-score increased by 0.09 or more. In this paper, we demonstrate and discuss the process of using methods for personalized medicine with interventions targeting adiposity and discuss the lessons learned from this application. Ultimately, these methods have the potential to be useful for clinicians and clients in choosing between treatment options, however they are limited in their ability to help researchers understand the mechanisms underlying these predictions.
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Affiliation(s)
- Alena Kuhlemeier
- Department of Sociology, University of New Mexico, Albuquerque, NM, USA
| | - Thomas Jaki
- Department of Mathematics and Statistics, Lancaster University, Lancaster, UK
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - Elizabeth Y Jimenez
- Division of Adolescent Health, Department of Pediatrics, University of New Mexico, Albuquerque, NM, USA
| | - Alberta S Kong
- Division of Adolescent Health, Department of Pediatrics, University of New Mexico, Albuquerque, NM, USA
| | - Hope Gill
- Department of Individual, Family, and Community Education, University of New Mexico, Albuquerque, NM, USA
| | - Chi Chang
- Office of Medical Education Research and Development, Michigan State University, East Lansing, MI, USA
| | - Ken Resnicow
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Dawn K Wilson
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - M Lee Van Horn
- Department of Individual, Family, and Community Education, University of New Mexico, Albuquerque, NM, USA.
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89
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Weekday and Weekend Differences in Eating Habits, Physical Activity and Screen Time Behavior among a Sample of Primary School Children: The "Seven Days for My Health" Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074215. [PMID: 35409899 PMCID: PMC8998659 DOI: 10.3390/ijerph19074215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Healthy eating and active lifestyle habits are essential for a child's development, wellbeing, and health. School setting and family environment play a crucial role in shaping these habits and this could be reflected in different behavior patterns during weekdays and weekends. METHODS We investigated primary school children's lifestyle habits through a cross-sectional analysis of 428 Italian primary school children, with a mean age of 8.99 years (±1.43). Data were collected from May to June 2017 using a weekly diary to assess children's lifestyles. RESULTS Children who eat their morning snack and lunch at school three or more times during the weekdays were 5.47 times more likely (95% CI 3.02, 10.2) to consume adequate snacks and 7.79 times more likely (95% CI 4.43, 14.5) to have adequate meals than those who did not. CONCLUSION Consumption of vegetables, lunch, and snacks are significantly more adequate during the weekdays as compared to the weekends. Physical activity levels did not differ between weekdays and weekends. Moreover, children spent more time engaged in physical activities than in front of a screen during both the weekdays and the weekends. The present results are good indicators of the importance of the school canteen in defining correct eating habits. Family-based and school-based interventions could represent valuable integrative strategies for promoting a healthy lifestyle in children.
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90
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Carpena Lucas PJ, Sánchez-Cubo F, Vargas Vargas M, Mondéjar Jiménez J. Influence of Lifestyle Habits in the Development of Obesity during Adolescence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4124. [PMID: 35409807 PMCID: PMC8998286 DOI: 10.3390/ijerph19074124] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/27/2022] [Accepted: 03/29/2022] [Indexed: 12/18/2022]
Abstract
Background: The alarming increase in childhood obesity is a global public health problem since it has significant health consequences. This cross-sectional study aimed to identify the potentially modifiable risk factors for developing excess weight and determine the importance of developing certain habits to prevent childhood overweight and obesity. Methods: The sample included 416 students between the ages of 12 and 14 (12.8 ± 0.62) first-year high school students from Murcia in Spain. Data were collected on their lifestyle habits through the ENHASA questionnaire, and the somatometry of the participants was measured. Such data were studied through structural equation modeling and importance-performance map analyses. Results: The modifiable risk factors that presented the greatest potency directly regarding when developing excess weight in adolescents were ‘use of electronic devices’ and ‘not performing physical activity’ (p < 0.001). ‘Social and school environment’ and ‘diet’ showed relationships but no significant differences with overweight or obesity. Globally, the lifestyle habit of the greatest importance for not being overweight was ‘engagement in extracurricular physical activities’. On the other hand, the habits related to using new technologies in a sedentary way showed the best capacity for improvement. Therefore, it would be very efficient to focus on them to control excess weight. Conclusion: Responsible and limited use of screens and engaging in extracurricular physical activities may be the most remarkable and cost-effective strategies for obesity prevention programs.
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Affiliation(s)
| | - Francisco Sánchez-Cubo
- Department of Political Economy and Public Finance, Economic and Business Statistics and Economic Policy, Faculty of Social Sciences, University of Castilla-La Mancha, 16007 Cuenca, Spain;
| | - Manuel Vargas Vargas
- Faculty of Economic and Business Sciences, University of Castilla-La Mancha, 02006 Albacete, Spain;
| | - José Mondéjar Jiménez
- Department of Statistics, Faculty of Social Sciences in Cuenca, University of Castilla-La Mancha, 16007 Cuenca, Spain;
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91
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Edwards CH, Vie GÅ, Kinge JM. Body mass index and healthcare costs: using genetic variants from the HUNT study as instrumental variables. BMC Health Serv Res 2022; 22:396. [PMID: 35337320 PMCID: PMC8957125 DOI: 10.1186/s12913-022-07597-z] [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: 07/09/2021] [Accepted: 01/27/2022] [Indexed: 12/01/2022] Open
Abstract
Background Past studies have found associations between obesity and healthcare costs, however, these studies have suffered from bias due to omitted variables, reverse causality, and measurement error. Methods We used genetic variants related to body mass index (BMI) as instruments for BMI; thereby exploiting the natural randomization of genetic variants that occurs at conception. We used data on measured height and weight, genetic information, and sociodemographic factors from the Nord-Trøndelag Health Studies (HUNT), and individual-level registry data on healthcare costs, educational level, registration status, and biological relatives. We studied associations between BMI and general practitioner (GP)-, specialist-, and total healthcare costs in the Norwegian setting using instrumental variable (IV) regressions, and compared our findings with effect estimates from ordinary least squares (OLS) regressions. The sensitivity of our findings to underlying IV-assumptions was explored using two-sample Mendelian randomization methods, non-linear analyses, sex-, healthcare provider-, and age-specific analyses, within-family analyses, and outlier removal. We also conducted power calculations to assess the likelihood of detecting an effect given our sample 60,786 individuals. Results We found that increased BMI resulted in significantly higher GP costs; however, the IV-based effect estimate was smaller than the OLS-based estimate. We found no evidence of an association between BMI and specialist or total healthcare costs. Conclusions Elevated BMI leads to higher GP costs, and more studies are needed to understand the causal mechanisms between BMI and specialist costs. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07597-z.
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Affiliation(s)
- Christina Hansen Edwards
- Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway. .,Centre for Fertility and Health & Centre for Disease Burden, Norwegian Institute of Public Health, Oslo, Norway.
| | - Gunnhild Åberge Vie
- Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jonas Minet Kinge
- Centre for Fertility and Health & Centre for Disease Burden, Norwegian Institute of Public Health, Oslo, Norway.,Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway
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Marcos-Pasero H, Aguilar-Aguilar E, de la Iglesia R, Espinosa-Salinas I, Molina S, Colmenarejo G, Martínez JA, Ramírez de Molina A, Reglero G, Loria-Kohen V. "GENYAL" Study to Childhood Obesity Prevention: Methodology and Preliminary Results. Front Nutr 2022; 9:777384. [PMID: 35350411 PMCID: PMC8957940 DOI: 10.3389/fnut.2022.777384] [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: 09/15/2021] [Accepted: 02/04/2022] [Indexed: 11/13/2022] Open
Abstract
Objective This article describes the methodology and summarizes some preliminary results of the GENYAL study aiming to design and validate a predictive model, considering both environmental and genetic factors, that identifies children who would benefit most from actions aimed at reducing the risk of obesity and its complications. Design The study is a cluster randomized clinical trial with 5-year follow-up. The initial evaluation was carried out in 2017. The schools were randomly split into intervention (nutritional education) and control schools. Anthropometric measurements, social and health as well as dietary and physical activity data of schoolchildren and their families are annually collected. A total of 26 single nucleotide polymorphisms (SNPs) were assessed. Machine Learning models are being designed to predict obesity phenotypes after the 5-year follow-up. Settings Six schools in Madrid. Participants A total of 221 schoolchildren (6-8 years old). Results Collected results show that the prevalence of excess weight was 19.0, 25.4, and 32.2% (according to World Health Organization, International Obesity Task Force and Orbegozo Foundation criteria, respectively). Associations between the nutritional state of children with mother BMI [β = 0.21 (0.13-0.3), p (adjusted) <0.001], geographical location of the school [OR = 2.74 (1.24-6.22), p (adjusted) = 0.06], dairy servings per day [OR = 0.48 (0.29-0.75), p (adjusted) = 0.05] and 8 SNPs [rs1260326, rs780094, rs10913469, rs328, rs7647305, rs3101336, rs2568958, rs925946; p (not adjusted) <0.05] were found. Conclusions These baseline data support the evidence that environmental and genetic factors play a role in the development of childhood obesity. After 5-year follow-up, the GENYAL study pretends to validate the predictive model as a new strategy to fight against obesity. Clinical Trial Registration This study has been registered in ClinicalTrials.gov with the identifier NCT03419520, https://clinicaltrials.gov/ct2/show/NCT03419520.
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Affiliation(s)
- Helena Marcos-Pasero
- Nutrition and Clinical Trials Unit, GENYAL Platform, IMDEA-Food Institute, CEI UAM + CSIC, Madrid, Spain
- Faculty of Health Sciences, Valencian International University (VIU), Valencia, Spain
| | - Elena Aguilar-Aguilar
- Nutrition and Clinical Trials Unit, GENYAL Platform, IMDEA-Food Institute, CEI UAM + CSIC, Madrid, Spain
| | - Rocío de la Iglesia
- Departamento de Ciencias Farmaceúticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Madrid, Spain
| | - Isabel Espinosa-Salinas
- Nutritional Genomics and Health Unit, GENYAL Platform, IMDEA-Food Institute, CEI UAM + CSIC, Madrid, Spain
| | - Susana Molina
- GenyalLab, GENYAL Platform, IMDEA-Food Institute, CEI UAM + CSIC, Madrid, Spain
| | - Gonzalo Colmenarejo
- Biostatistics and Bioinformatics Unit, IMDEA-Food Institute, CEI UAM + CSIC, Madrid, Spain
| | - J. Alfredo Martínez
- Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute, CEI UAM + CSIC, Madrid, Spain
- IdisNA, Navarra Institute for Health Research, Pamplona, Spain
- Center of Biomedical Research in Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
| | - Ana Ramírez de Molina
- Molecular Oncology and Nutritional Genomics of Cancer, IMDEA-Food Institute, CEI UAM + CSIC, Madrid, Spain
| | - Guillermo Reglero
- Production and Development of Foods for Health, IMDEA-Food Institute, CEI UAM + CSIC, Madrid, Spain
- Department of Production and Characterization of Novel Foods, Institute of Food Science Research (CIAL), CEI UAM+CSIC, Madrid, Spain
| | - Viviana Loria-Kohen
- Nutrition and Clinical Trials Unit, GENYAL Platform, IMDEA-Food Institute, CEI UAM + CSIC, Madrid, Spain
- Departamento de Nutrición y Ciencia de los Alimentos, Facultad de Farmacia, Universidad Complutense de Madrid, Grupo de Investigación VALORNUT-UCM, Madrid, Spain
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Kraus EM, Scott KA, Zucker R, Heisey-Grove D, King RJ, Carton TW, Daley MF, Deakyne Davies SJ, Block JP, Haemer M, Goodman AB, Garrett N, Davidson AJ. A Governance Framework to Integrate Longitudinal Clinical and Community Data in a Distributed Data Network: The Childhood Obesity Data Initiative. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:E421-E429. [PMID: 34446639 PMCID: PMC8781231 DOI: 10.1097/phh.0000000000001408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
CONTEXT Integrating longitudinal data from community-based organizations (eg, physical activity programs) with electronic health record information can improve capacity for childhood obesity research. OBJECTIVE A governance framework that protects individual privacy, accommodates organizational data stewardship requirements, and complies with laws and regulations was developed and implemented to support the harmonization of data from disparate clinical and community information systems. PARTICIPANTS AND SETTING Through the Childhood Obesity Data Initiative (CODI), 5 Colorado-based organizations collaborated to expand an existing distributed health data network (DHDN) to include community-generated data and assemble longitudinal patient records for research. DESIGN A governance work group expanded an existing DHDN governance infrastructure with CODI-specific data use and exchange policies and procedures that were codified in a governance plan and a delegated-authority, multiparty, reciprocal agreement. RESULTS A CODI governance work group met from January 2019 to March 2020 to conceive an approach, develop documentation, and coordinate activities. Governance requirements were synthesized from the CODI use case, and a customized governance approach was constructed to address governance gaps in record linkage, a procedure to request data, and harmonizing community and clinical data. A Master Sharing and Use Agreement (MSUA) and Memorandum of Understanding were drafted and executed to support creation of linked longitudinal records of clinical- and community-derived childhood obesity data. Furthermore, a multiparty infrastructure protocol was approved by the local institutional review board (IRB) to expedite future CODI research by simplifying IRB research applications. CONCLUSION CODI implemented a clinical-community governance strategy that built trust between organizations and allowed efficient data exchange within a DHDN. A thorough discovery process allowed CODI stakeholders to assess governance capacity and reveal regulatory and organizational obstacles so that the governance infrastructure could effectively leverage existing knowledge and address challenges. The MSUA and complementary governance documents can inform similar efforts.
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Affiliation(s)
- Emily M. Kraus
- Obesity Prevention and Control Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion (Drs King, Kraus, and Goodman), and Center for Surveillance Epidemiology and Laboratory Services (Ms Garrett), Centers for Disease Control and Prevention, Atlanta, Georgia; Public Health Informatics Institute, Decatur, Georgia (Dr Kraus); Denver Public Health, Denver, Colorado (Drs Davidson and Scott); Departments of Epidemiology (Dr Scott) and Biostatistics and Informatics (Dr Davidson), Colorado School of Public Health, Aurora, Colorado; Adult & Child Consortium for Health Outcomes Research & Delivery Science (Ms Zucker), and Department of Pediatrics, Section of Nutrition (Dr Haemer), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Health Technical Center, The MITRE Corporation, McLean, Virginia (Dr Heisey-Grove); Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado (Dr Daley); Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Block); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); United States Public Health Service, Washington, District of Columbia (Dr Goodman); Research Informatics & Advanced Analytics, Analytics Resource Center, and Children's Hospital Colorado, Aurora, Colorado (Ms Deakyne Davies)
| | - Kenneth A. Scott
- Obesity Prevention and Control Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion (Drs King, Kraus, and Goodman), and Center for Surveillance Epidemiology and Laboratory Services (Ms Garrett), Centers for Disease Control and Prevention, Atlanta, Georgia; Public Health Informatics Institute, Decatur, Georgia (Dr Kraus); Denver Public Health, Denver, Colorado (Drs Davidson and Scott); Departments of Epidemiology (Dr Scott) and Biostatistics and Informatics (Dr Davidson), Colorado School of Public Health, Aurora, Colorado; Adult & Child Consortium for Health Outcomes Research & Delivery Science (Ms Zucker), and Department of Pediatrics, Section of Nutrition (Dr Haemer), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Health Technical Center, The MITRE Corporation, McLean, Virginia (Dr Heisey-Grove); Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado (Dr Daley); Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Block); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); United States Public Health Service, Washington, District of Columbia (Dr Goodman); Research Informatics & Advanced Analytics, Analytics Resource Center, and Children's Hospital Colorado, Aurora, Colorado (Ms Deakyne Davies)
| | - Rachel Zucker
- Obesity Prevention and Control Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion (Drs King, Kraus, and Goodman), and Center for Surveillance Epidemiology and Laboratory Services (Ms Garrett), Centers for Disease Control and Prevention, Atlanta, Georgia; Public Health Informatics Institute, Decatur, Georgia (Dr Kraus); Denver Public Health, Denver, Colorado (Drs Davidson and Scott); Departments of Epidemiology (Dr Scott) and Biostatistics and Informatics (Dr Davidson), Colorado School of Public Health, Aurora, Colorado; Adult & Child Consortium for Health Outcomes Research & Delivery Science (Ms Zucker), and Department of Pediatrics, Section of Nutrition (Dr Haemer), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Health Technical Center, The MITRE Corporation, McLean, Virginia (Dr Heisey-Grove); Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado (Dr Daley); Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Block); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); United States Public Health Service, Washington, District of Columbia (Dr Goodman); Research Informatics & Advanced Analytics, Analytics Resource Center, and Children's Hospital Colorado, Aurora, Colorado (Ms Deakyne Davies)
| | - Dawn Heisey-Grove
- Obesity Prevention and Control Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion (Drs King, Kraus, and Goodman), and Center for Surveillance Epidemiology and Laboratory Services (Ms Garrett), Centers for Disease Control and Prevention, Atlanta, Georgia; Public Health Informatics Institute, Decatur, Georgia (Dr Kraus); Denver Public Health, Denver, Colorado (Drs Davidson and Scott); Departments of Epidemiology (Dr Scott) and Biostatistics and Informatics (Dr Davidson), Colorado School of Public Health, Aurora, Colorado; Adult & Child Consortium for Health Outcomes Research & Delivery Science (Ms Zucker), and Department of Pediatrics, Section of Nutrition (Dr Haemer), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Health Technical Center, The MITRE Corporation, McLean, Virginia (Dr Heisey-Grove); Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado (Dr Daley); Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Block); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); United States Public Health Service, Washington, District of Columbia (Dr Goodman); Research Informatics & Advanced Analytics, Analytics Resource Center, and Children's Hospital Colorado, Aurora, Colorado (Ms Deakyne Davies)
| | - Raymond J. King
- Obesity Prevention and Control Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion (Drs King, Kraus, and Goodman), and Center for Surveillance Epidemiology and Laboratory Services (Ms Garrett), Centers for Disease Control and Prevention, Atlanta, Georgia; Public Health Informatics Institute, Decatur, Georgia (Dr Kraus); Denver Public Health, Denver, Colorado (Drs Davidson and Scott); Departments of Epidemiology (Dr Scott) and Biostatistics and Informatics (Dr Davidson), Colorado School of Public Health, Aurora, Colorado; Adult & Child Consortium for Health Outcomes Research & Delivery Science (Ms Zucker), and Department of Pediatrics, Section of Nutrition (Dr Haemer), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Health Technical Center, The MITRE Corporation, McLean, Virginia (Dr Heisey-Grove); Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado (Dr Daley); Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Block); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); United States Public Health Service, Washington, District of Columbia (Dr Goodman); Research Informatics & Advanced Analytics, Analytics Resource Center, and Children's Hospital Colorado, Aurora, Colorado (Ms Deakyne Davies)
| | - Thomas W. Carton
- Obesity Prevention and Control Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion (Drs King, Kraus, and Goodman), and Center for Surveillance Epidemiology and Laboratory Services (Ms Garrett), Centers for Disease Control and Prevention, Atlanta, Georgia; Public Health Informatics Institute, Decatur, Georgia (Dr Kraus); Denver Public Health, Denver, Colorado (Drs Davidson and Scott); Departments of Epidemiology (Dr Scott) and Biostatistics and Informatics (Dr Davidson), Colorado School of Public Health, Aurora, Colorado; Adult & Child Consortium for Health Outcomes Research & Delivery Science (Ms Zucker), and Department of Pediatrics, Section of Nutrition (Dr Haemer), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Health Technical Center, The MITRE Corporation, McLean, Virginia (Dr Heisey-Grove); Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado (Dr Daley); Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Block); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); United States Public Health Service, Washington, District of Columbia (Dr Goodman); Research Informatics & Advanced Analytics, Analytics Resource Center, and Children's Hospital Colorado, Aurora, Colorado (Ms Deakyne Davies)
| | - Matthew F. Daley
- Obesity Prevention and Control Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion (Drs King, Kraus, and Goodman), and Center for Surveillance Epidemiology and Laboratory Services (Ms Garrett), Centers for Disease Control and Prevention, Atlanta, Georgia; Public Health Informatics Institute, Decatur, Georgia (Dr Kraus); Denver Public Health, Denver, Colorado (Drs Davidson and Scott); Departments of Epidemiology (Dr Scott) and Biostatistics and Informatics (Dr Davidson), Colorado School of Public Health, Aurora, Colorado; Adult & Child Consortium for Health Outcomes Research & Delivery Science (Ms Zucker), and Department of Pediatrics, Section of Nutrition (Dr Haemer), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Health Technical Center, The MITRE Corporation, McLean, Virginia (Dr Heisey-Grove); Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado (Dr Daley); Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Block); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); United States Public Health Service, Washington, District of Columbia (Dr Goodman); Research Informatics & Advanced Analytics, Analytics Resource Center, and Children's Hospital Colorado, Aurora, Colorado (Ms Deakyne Davies)
| | - Sara J. Deakyne Davies
- Obesity Prevention and Control Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion (Drs King, Kraus, and Goodman), and Center for Surveillance Epidemiology and Laboratory Services (Ms Garrett), Centers for Disease Control and Prevention, Atlanta, Georgia; Public Health Informatics Institute, Decatur, Georgia (Dr Kraus); Denver Public Health, Denver, Colorado (Drs Davidson and Scott); Departments of Epidemiology (Dr Scott) and Biostatistics and Informatics (Dr Davidson), Colorado School of Public Health, Aurora, Colorado; Adult & Child Consortium for Health Outcomes Research & Delivery Science (Ms Zucker), and Department of Pediatrics, Section of Nutrition (Dr Haemer), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Health Technical Center, The MITRE Corporation, McLean, Virginia (Dr Heisey-Grove); Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado (Dr Daley); Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Block); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); United States Public Health Service, Washington, District of Columbia (Dr Goodman); Research Informatics & Advanced Analytics, Analytics Resource Center, and Children's Hospital Colorado, Aurora, Colorado (Ms Deakyne Davies)
| | - Jason P. Block
- Obesity Prevention and Control Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion (Drs King, Kraus, and Goodman), and Center for Surveillance Epidemiology and Laboratory Services (Ms Garrett), Centers for Disease Control and Prevention, Atlanta, Georgia; Public Health Informatics Institute, Decatur, Georgia (Dr Kraus); Denver Public Health, Denver, Colorado (Drs Davidson and Scott); Departments of Epidemiology (Dr Scott) and Biostatistics and Informatics (Dr Davidson), Colorado School of Public Health, Aurora, Colorado; Adult & Child Consortium for Health Outcomes Research & Delivery Science (Ms Zucker), and Department of Pediatrics, Section of Nutrition (Dr Haemer), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Health Technical Center, The MITRE Corporation, McLean, Virginia (Dr Heisey-Grove); Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado (Dr Daley); Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Block); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); United States Public Health Service, Washington, District of Columbia (Dr Goodman); Research Informatics & Advanced Analytics, Analytics Resource Center, and Children's Hospital Colorado, Aurora, Colorado (Ms Deakyne Davies)
| | - Matthew Haemer
- Obesity Prevention and Control Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion (Drs King, Kraus, and Goodman), and Center for Surveillance Epidemiology and Laboratory Services (Ms Garrett), Centers for Disease Control and Prevention, Atlanta, Georgia; Public Health Informatics Institute, Decatur, Georgia (Dr Kraus); Denver Public Health, Denver, Colorado (Drs Davidson and Scott); Departments of Epidemiology (Dr Scott) and Biostatistics and Informatics (Dr Davidson), Colorado School of Public Health, Aurora, Colorado; Adult & Child Consortium for Health Outcomes Research & Delivery Science (Ms Zucker), and Department of Pediatrics, Section of Nutrition (Dr Haemer), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Health Technical Center, The MITRE Corporation, McLean, Virginia (Dr Heisey-Grove); Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado (Dr Daley); Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Block); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); United States Public Health Service, Washington, District of Columbia (Dr Goodman); Research Informatics & Advanced Analytics, Analytics Resource Center, and Children's Hospital Colorado, Aurora, Colorado (Ms Deakyne Davies)
| | - Alyson B. Goodman
- Obesity Prevention and Control Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion (Drs King, Kraus, and Goodman), and Center for Surveillance Epidemiology and Laboratory Services (Ms Garrett), Centers for Disease Control and Prevention, Atlanta, Georgia; Public Health Informatics Institute, Decatur, Georgia (Dr Kraus); Denver Public Health, Denver, Colorado (Drs Davidson and Scott); Departments of Epidemiology (Dr Scott) and Biostatistics and Informatics (Dr Davidson), Colorado School of Public Health, Aurora, Colorado; Adult & Child Consortium for Health Outcomes Research & Delivery Science (Ms Zucker), and Department of Pediatrics, Section of Nutrition (Dr Haemer), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Health Technical Center, The MITRE Corporation, McLean, Virginia (Dr Heisey-Grove); Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado (Dr Daley); Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Block); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); United States Public Health Service, Washington, District of Columbia (Dr Goodman); Research Informatics & Advanced Analytics, Analytics Resource Center, and Children's Hospital Colorado, Aurora, Colorado (Ms Deakyne Davies)
| | - Nedra Garrett
- Obesity Prevention and Control Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion (Drs King, Kraus, and Goodman), and Center for Surveillance Epidemiology and Laboratory Services (Ms Garrett), Centers for Disease Control and Prevention, Atlanta, Georgia; Public Health Informatics Institute, Decatur, Georgia (Dr Kraus); Denver Public Health, Denver, Colorado (Drs Davidson and Scott); Departments of Epidemiology (Dr Scott) and Biostatistics and Informatics (Dr Davidson), Colorado School of Public Health, Aurora, Colorado; Adult & Child Consortium for Health Outcomes Research & Delivery Science (Ms Zucker), and Department of Pediatrics, Section of Nutrition (Dr Haemer), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Health Technical Center, The MITRE Corporation, McLean, Virginia (Dr Heisey-Grove); Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado (Dr Daley); Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Block); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); United States Public Health Service, Washington, District of Columbia (Dr Goodman); Research Informatics & Advanced Analytics, Analytics Resource Center, and Children's Hospital Colorado, Aurora, Colorado (Ms Deakyne Davies)
| | - Arthur J. Davidson
- Obesity Prevention and Control Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion (Drs King, Kraus, and Goodman), and Center for Surveillance Epidemiology and Laboratory Services (Ms Garrett), Centers for Disease Control and Prevention, Atlanta, Georgia; Public Health Informatics Institute, Decatur, Georgia (Dr Kraus); Denver Public Health, Denver, Colorado (Drs Davidson and Scott); Departments of Epidemiology (Dr Scott) and Biostatistics and Informatics (Dr Davidson), Colorado School of Public Health, Aurora, Colorado; Adult & Child Consortium for Health Outcomes Research & Delivery Science (Ms Zucker), and Department of Pediatrics, Section of Nutrition (Dr Haemer), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Health Technical Center, The MITRE Corporation, McLean, Virginia (Dr Heisey-Grove); Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado (Dr Daley); Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Block); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); United States Public Health Service, Washington, District of Columbia (Dr Goodman); Research Informatics & Advanced Analytics, Analytics Resource Center, and Children's Hospital Colorado, Aurora, Colorado (Ms Deakyne Davies)
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Apperley LJ, Blackburn J, Erlandson-Parry K, Gait L, Laing P, Senniappan S. Childhood obesity: A review of current and future management options. Clin Endocrinol (Oxf) 2022; 96:288-301. [PMID: 34750858 DOI: 10.1111/cen.14625] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 02/02/2023]
Abstract
Obesity is becoming increasingly prevalent in paediatric populations worldwide. In addition to increasing prevalence, the severity of obesity is also continuing to rise. Taken together, these findings demonstrate a worrying trend and highlight one of the most significant challenges to public health. Childhood obesity affects multiple organs in the body and is associated with both significant morbidity and ultimately premature mortality. The prevalence of complications associated with obesity, including dyslipidaemia, hypertension, fatty liver disease and psychosocial complications are becoming increasingly prevalent within the paediatric populations. Treatment guidelines currently focus on intervention with lifestyle and behavioural modifications, with pharmacotherapy and surgery reserved for patients who are refractory to such treatment. Research into adult obesity has established pharmacological novel therapies, which have been approved and established in clinical practice; however, the research and implementation of such therapies in paediatric populations have been lagging behind. Despite the relative lack of widespread research in comparison to the adult population, newer therapies are being trialled, which should allow a greater availability of treatment options for childhood obesity in the future. This review summarizes the current evidence for the management of obesity in terms of medical and surgical options. Both future therapeutic agents and those which cause weight loss but have an alternative indication are also included and discussed as part of the review. The review summarizes the most recent research for each intervention and demonstrates the potential efficacy and limitations of each treatment option.
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Affiliation(s)
- Louise J Apperley
- Department of Paediatric Endocrinology, Alder Hey Children's Hospital, Liverpool, UK
| | - James Blackburn
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University of London, London, UK
| | | | - Lucy Gait
- Department of Paediatric Clinical Psychology, Alder Hey Children's Hospital, Liverpool, UK
| | - Peter Laing
- Department of Paediatric Endocrinology, Alder Hey Children's Hospital, Liverpool, UK
| | - Senthil Senniappan
- Department of Paediatric Endocrinology, Alder Hey Children's Hospital, Liverpool, UK
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95
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Kouvari M, Karipidou M, Tsiampalis T, Mamalaki E, Poulimeneas D, Bathrellou E, Panagiotakos D, Yannakoulia M. Digital Health Interventions for Weight Management in Children and Adolescents: Systematic Review and Meta-analysis. J Med Internet Res 2022; 24:e30675. [PMID: 35156934 PMCID: PMC8887634 DOI: 10.2196/30675] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 09/10/2021] [Accepted: 09/22/2021] [Indexed: 12/15/2022] Open
Abstract
Background Recent meta-analyses suggest the use of technology-based interventions as a treatment option for obesity in adulthood. Similar meta-analytic approaches for children are scarce. Objective The aim of this meta-analysis is to examine the effect of technology-based interventions on overweight and obesity treatment in children and adolescents. Methods A systematic literature search was performed using MEDLINE (PubMed), Scopus, and Cochrane Library for randomized clinical trials to identify interventional studies published between January 2000 and February 2021. Results In total, 9 manuscripts from 8 clinical trials of 582 children or adolescents were considered eligible. BMI, BMI z-score, and other BMI-related baseline metrics during and after intervention were considered as primary outcomes. In 7 of 8 studies, a technology-based intervention was applied in addition to conventional care. Of the 8 studies, 6 studies were conducted in the United States, 1 in Australia, and 1 in northwestern Europe. In total, 5 studies included adolescents, whereas the rest addressed children aged 9 to 12 years. Intervention duration ranged from 3 to 24 months. Significant differences between groups in BMI metric changes were reported by 5 of the 8 studies. Pooled analysis revealed an overall significant decrease in BMI metrics in the intervention group (standardized mean difference –0.61, 95% CI –1.10 to –0.13; P=.01). Subgroup analysis revealed that significance was lost in case of no parental involvement (standardized mean difference –0.36, 95% CI –0.83 to 0.11; P=.14). The small number of clinical trials found, the varying study quality, and the study heterogeneity are some limitations of this review. Conclusions The studies reported herein describe functional and acceptable technology-based approaches, in addition to conventional treatments, to enhance weight loss in young populations.
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Affiliation(s)
- Matina Kouvari
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.,Faculty of Health, University of Canberra, Canberra, Australia
| | - Melina Karipidou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Thomas Tsiampalis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Eirini Mamalaki
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Dimitrios Poulimeneas
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Eirini Bathrellou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.,Faculty of Health, University of Canberra, Canberra, Australia
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
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Barragan M, Luna V, Hammons AJ, Olvera N, Greder K, Drumond Andrade FC, Fiese B, Wiley A, Teran-Garcia M, Team TACR. Reducing Obesogenic Eating Behaviors in Hispanic Children through a Family-Based, Culturally-Tailored RCT: Abriendo Caminos. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19041917. [PMID: 35206123 PMCID: PMC8872523 DOI: 10.3390/ijerph19041917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 02/04/2023]
Abstract
Family-based interventions that incorporate culturally-tailored multi-component curricula and are grounded on evidence-based information and theoretical frameworks can help reduce the prevalence of obesity among Hispanic children. Abriendo Caminos: Clearing the Path to Hispanic Health is a multi-site culturally-tailored randomized control trial that aims to reduce obesity rates in Hispanic families by delivering education on nutrition, family wellness, and physical activity. This study evaluated the effect of the Abriendo Caminos six-week intervention on dietary behaviors of Hispanic children (6–18 years). Mothers (n = 365) reported their child’s eating behavior intake using the U.S. Department of Education’s Early Childhood Longitudinal Study protocol (ECLS). Pre/post dietary changes were evaluated using separate generalized estimating equation models adjusted for site, child sex, and child age group. Findings indicate a reduction in the frequency of sugar-sweetened beverages (OR 0.55, 95% CI 0.35, 0.87, p = 0.01), French fries (OR 0.56, 95% CI 0.36, 0.86, p = 0.009), and fast food (OR 0.55, 95% CI 0.36, 0.84, p = 0.006) consumption among children in the intervention arm. Additionally, children in the intervention arm increased their frequency of vegetable consumption (OR 1.84, 95% CI 1.08, 3.12, p = 0.03). The Abriendo Caminos intervention effectively improved four of eight eating behaviors in a short-term intervention.
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Affiliation(s)
- Maribel Barragan
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA; (M.B.); (V.L.)
| | - Viridiana Luna
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA; (M.B.); (V.L.)
| | - Amber J. Hammons
- Department of Child and Family Science, California State University, Fresno, CA 93740, USA;
| | - Norma Olvera
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX 77204, USA;
| | - Kimberly Greder
- Department of Human Development and Family Studies, Iowa State University, Ames, IA 50011, USA;
| | | | - Barbara Fiese
- Department of Human Development and Family Studies, Family Resiliency Center, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA;
| | - Angela Wiley
- Department of Human Development and Family Science, Auburn University, Auburn, AL 36849, USA;
| | - Margarita Teran-Garcia
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA; (M.B.); (V.L.)
- Integrated Health Disparities Programs, University of Illinois Extension, Champaign, IL 61820, USA
- Carle Illinois College of Medicine, Family Resiliency Center, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Correspondence:
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The essential conditions needed to implement the Indigenous Youth Mentorship Program: a focused ethnography. BMC Public Health 2022; 22:213. [PMID: 35105323 PMCID: PMC8808991 DOI: 10.1186/s12889-021-12412-1] [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: 06/18/2021] [Accepted: 12/08/2021] [Indexed: 11/15/2022] Open
Abstract
Background The Indigenous Youth Mentorship Program (IYMP) is a 20-week communal, relationship-based afterschool healthy living program for Indigenous youth in Canada. IYMP embraces the Anishnaabe/Nehiyawak concepts of Mino-Bimaadiziwin/miyo-pimâtisiwin (“living in a good way”) via its core components of physical activities/games, healthy snacks, and relationship-building. A strength of IYMP is that it values autonomy, adaptability, and the school community context. However, this presents challenges when evaluating its implementation, given that traditional implementation science methods tend to oversimplify the process. In response, essential conditions for the implementation of school-based healthy living programs across diverse contexts have been developed. The purpose of this research was to understand the applicability of these essential conditions within the context of IYMP. Methods 15 participants (n = 10 Young Adult Health Leaders; n = 5 coordinators) with experience implementing IYMP in the provinces of Alberta, Saskatchewan, Manitoba, and Quebec were purposefully sampled. Focused ethnography was the guiding method and one-on-one semi-structured interviews were used as the data generation strategy. The purpose of the interviews was to understand what conditions are needed to implement IYMP. The interview guide was based on previously established essential conditions developed by the research team. Interviews were audio-recorded and transcribed, and content analysis was used to identify patterns in the data. Results The overarching theme that emerged from the interviews was the applicability of the essential conditions when implementing IYMP. Participants felt the eight core conditions (students as change agents, school/community-specific autonomy, demonstrated administrative leadership, higher-level support, dedicated champion(s) to engage school community, community support, quality and use of evidence, and professional development) and four contextual conditions (time, funding and project support, readiness and understanding, and prior community connectivity) were necessary, but made suggestions to modify two conditions (youth led and learning opportunities) to better reflect their experiences implementing IYMP. In addition, a new core condition, rooted in relationship, emerged as necessary for implementation. Conclusions This research adds to the literature by identifying and describing what is needed in practice to implement a communal, relationship-based afterschool healthy living program. The essential conditions may support other researchers and communities interested in implementing and rippling similar programs. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12412-1.
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Ma L, Wen X, Xue H, Zhao L, Ding Y, Xu F, Ruan G, Li Y, Chang S, Wang Y. National childhood obesity-related intervention systems and intervention programs in China in 1949 to 2020: A narrative review. Obesity (Silver Spring) 2022; 30:320-337. [PMID: 35088555 DOI: 10.1002/oby.23316] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 08/15/2021] [Accepted: 08/16/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVE This review examines main government and nongovernmental institutions for childhood obesity prevention and control in China, as well as major national interventions for childhood obesity. METHODS PubMed, China National Knowledge Infrastructure (CNKI), Wanfang, official websites of national governments and professional institutions/associations, Baidu.com, and Google.com were systematically searched in March 2020 to April 2020. A total of 20 international and national experts on childhood obesity were surveyed. RESULTS "Government-led multisector cooperation" obesity-related intervention systems have been formed. National-level interventions were mainly implemented by the Chinese State Council and its administrative departments, along with national professional institutions/associations. Provincial, municipal, and county governments and their subordinate departments coordinated local works. Actions taken by these sectors to fight childhood obesity included developing and implementing regulations and laws, health standards and practice guidelines, surveillance for obesity and related determinants, governmental budget and research funds, and interventions. A total of 14 major national childhood obesity-related interventions were found: comprehensive interventions (e.g., "Healthy Lifestyle for All campaign," 2007), diet and nutrition (e.g., "Chinese Rural Compulsory Education Student Nutrition Improvement Program," since 2011), and physical activity (e.g., "Happy 10 Minutes Program," 2006). CONCLUSIONS Although obesity-related intervention systems and national interventions were implemented, more efforts and stronger government leadership and commitment are needed.
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Affiliation(s)
- Lu Ma
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Xiaozhong Wen
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, USA
| | - Hong Xue
- Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, USA
| | - Li Zhao
- West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Yixin Ding
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Fei Xu
- Nanjing City Center for Disease Control and Prevention, Nanjing, China
| | - Guorui Ruan
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Yixuan Li
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Suying Chang
- Child Health Development Section, UNICEF Office for China, Beijing, China
| | - Youfa Wang
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
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Calancie L, Nappi D, Appel J, Hennessy E, Korn AR, Mitchell J, Patrick A, Werner K, Economos CD. Implementing and Evaluating a Stakeholder-Driven Community Diffusion-Informed Early Childhood Intervention to Prevent Obesity, Cuyahoga County, Ohio, 2018-2020. Prev Chronic Dis 2022; 19:E03. [PMID: 35050848 PMCID: PMC8794263 DOI: 10.5888/pcd19.210181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
PURPOSE AND OBJECTIVES The purpose of this article is to demonstrate and evaluate aspects of a Stakeholder-Driven Community Diffusion (SDCD)-informed intervention with a group of stakeholders drawn from a large coalition seeking a novel approach for promoting policy, systems, and environmental-level change. The objectives were to implement an SDCD intervention, assess changes in participants' perspectives, and evaluate where the group's actions fit within the context of a systems map that the group created during the intervention. INTERVENTION APPROACH An SDCD-informed intervention convened 12 multisector stakeholders from the Early Ages Healthy Stages coalition in Cuyahoga County, Ohio. They participated in group model building activities to promote systems thinking related to childhood obesity prevention, reviewed evidence about topics of interest to the group, and were provided with technical assistance and seed funding to guide the selection and implementation of actions prioritized by the group. EVALUATION METHODS Data were collected via meeting notes and group model building outputs to demonstrate implementation and action prioritization; online surveys and qualitative interviews to measure perspective change among stakeholders; and a follow-up survey to the broader coalition assessing actions coalition members were taking. RESULTS An SDCD-informed intervention guided the development of a systems map and the selection of 4 actions: 1) develop a better understanding of the local early childcare environment; 2) assess the effectiveness and impact of Ohio Healthy Programs (OHP); 3) advocate for OHP and improved early childhood education quality; and 4) hold OHP designees accountable to high-quality programming. Data collected from surveys and interviews showed increased awareness of programs, resources, and collaboration opportunities among stakeholders. Follow-up survey results showed ongoing coalition action throughout the systems map. IMPLICATIONS FOR PUBLIC HEALTH Using an SDCD-informed intervention among a coalition of community stakeholders provided a unique approach for implementing, assessing, and analyzing collaborative efforts to prevent childhood obesity in Cuyahoga County. Our approach can be applied to help researchers and stakeholders improve efforts to address childhood obesity in their communities.
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Affiliation(s)
- Larissa Calancie
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Deanna Nappi
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Julia Appel
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Erin Hennessy
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Ariella R Korn
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | | | | | - Kelsey Werner
- Boston College School of Social Work, Chestnut Hill, Massachusetts
| | - Christina D Economos
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA 02111.
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Palacios C, Simon P, Steward A, Garner T, Hameed H, Shetgiri R. Impact of an Elementary School-Based Wellness Initiative on Child Obesity Prevalence: LiveWell Kids. Health Promot Pract 2022; 24:560-565. [PMID: 35043717 DOI: 10.1177/15248399211065717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Despite major public health investments over the past several decades, little progress has been made in reducing the prevalence of obesity among school-aged children in the United States. In 2007, the Redondo Beach Unified School District (RBUSD) and the Beach Cities Health District launched a wellness initiative, LiveWell Kids, that included multi-level interventions to improve nutrition and increase physical activity. The initiative also included annual measurements of height and weight among all kindergartners and first, third, and fifth graders in the eight elementary schools in the RBUSD. To assess trends in obesity prevalence, we analyzed height and weight data collected during the 2008 to 2009 to 2018 to 2019 school years. To more fully assess the impact of the initiative, we conducted a least-squares regression difference-in-differences analysis of data from the California Physical Fitness Testing Program on measured height and weight among fifth graders from the RBUSD, three neighboring school districts, and Los Angeles County overall. Among elementary school students in the RBUSD, obesity prevalence decreased from 13.9% in 2008 to 2009 to 6.4% in 2018 to 2019. Significant declines in prevalence were observed in all eight elementary schools, and across all grade levels and demographic groups. Among fifth graders, a similar decline in obesity prevalence was not observed in the other school districts or the county overall. The findings suggest that interventions that adhere to the socio-ecologic model and engage students, parents, and school personnel at all levels while also addressing school and community environments may reduce obesity prevalence among elementary school-aged children.
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Affiliation(s)
| | - Paul Simon
- Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Ali Steward
- Beach Cities Health District, Redondo Beach, CA, USA
| | - Tessa Garner
- Beach Cities Health District, Redondo Beach, CA, USA
| | - Heena Hameed
- Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Rashmi Shetgiri
- Los Angeles County Department of Public Health, Los Angeles, CA, USA
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