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Strategies to reduce sugar-sweetened beverage consumption and increase water access and intake among young children: perspectives from expert stakeholders. Public Health Nutr 2018; 21:3440-3449. [DOI: 10.1017/s1368980018002604] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectivesTo summarize stakeholder recommendations and ratings of strategies to reduce sugar-sweetened beverage (SSB) consumption and increase water access and intake among young children (0–5 years).DesignTwo online surveys: survey 1 asked respondents to recommend novel and innovative strategies to promote healthy beverage behaviour; survey 2 asked respondents to rank each of these strategies on five domains (overall importance, feasibility, effectiveness, reach, health equity). Open-ended questions were coded and analysed for thematic content.SettingUsing a snowball sampling approach, respondents were invited to complete the survey through an email invitation or an anonymous listserv link. Of the individuals who received a private email invitation, 24 % completed survey 1 and 29 % completed survey 2.SubjectsSurvey 1 (n 276) and survey 2 (n 182) included expert stakeholders who work on issues related to SSB and water consumption.ResultsSix overarching strategies emerged to change beverage consumption behaviours (survey 1): education; campaigns and contests; marketing and advertising; price changes; physical access; and improving the capacity of settings to promote healthy beverages. Labelling and sugar reduction (e.g. reformulation) were recommended as strategies to reduce SSB consumption, while water testing and remediation emerged as a strategy to promote water intake. Stakeholders most frequently recommended (survey 1) and provided higher ratings (survey 2) to strategies that used policy, systems and/or environmental changes.ConclusionsThe present study is the first to assess stakeholder opinions on strategies to promote healthy beverage consumption. This knowledge is key for understanding where stakeholders believe resources can be best utilized.
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102
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Ritchie LD, Woodward-Lopez G, Au LE, Loria CM, Collie-Akers V, Wilson DK, Frongillo EA, Strauss WJ, Sagatov RD, Landgraf AJ, Nagaraja J, Nicastro HL, Nebeling LC, Webb K. Associations of community programs and policies with children's dietary intakes: the Healthy Communities Study. Pediatr Obes 2018; 13 Suppl 1:14-26. [PMID: 29992795 PMCID: PMC6197888 DOI: 10.1111/ijpo.12440] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 05/04/2018] [Accepted: 05/30/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND The impact of community-based obesity prevention efforts on child nutrition has not been adequately studied. OBJECTIVE Examine relationships between number, type and intensity of community programs and policies (CPPs) and child nutrition. METHODS An observational study of 5138 children (grades K-8) in 130 U.S. communities was conducted in 2013-2015. CPPs were identified by 10-14 key informant interviews per community. CPPs were characterized based on: count, intensity, number of different strategies used and number of different behaviours targeted. Scores for the prior 6 years were calculated separately for CPPs that addressed primarily nutrition, primarily physical activity (PA) or total combined. Child intakes were calculated from a dietary screener and dietary behaviours were based on survey responses. Multi-level statistical models assessed associations between CPP indices and nutrition measures, adjusting for child and community-level covariates. RESULTS Implementing more types of strategies across all CPPs was related to lower intakes of total added sugar (when CPPs addressed primarily PA), sugar-sweetened beverages (for nutrition and PA CPPs) and energy-dense foods of minimal nutritional value (for total CPPs). Addressing more behaviours was related to higher intakes of fruit and vegetables (for nutrition and total CPPs) and fibre (total CPPs). Higher count and intensity (PA and total CPPs) were related to more consumption of lower fat compared with higher fat milk. A higher count (PA CPPs) was related to fewer energy-dense foods and whole grains. No other relationships were significant at P < 0.05. CONCLUSION Multiple characteristics of CPPs to prevent obesity appear important to improve children's diets.
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Affiliation(s)
- Lorrene D. Ritchie
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, California
| | - Gail Woodward-Lopez
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, California
| | - Lauren E. Au
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, California
| | | | - Vicki Collie-Akers
- Work Group for Community Development, University of Kansas, Lawrence, Kansas
| | - Dawn K. Wilson
- Department of Psychology, University of South Carolina, Columbia, South Carolina
| | - Edward A. Frongillo
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina
| | | | | | | | | | | | | | - Karen Webb
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, California
| | - on behalf of the Healthy Communities Study Team
- For complete list of members of the Healthy Communities Study Team, see Strauss WJ, Nagaraja J, Landgraf AJ, et al. The longitudinal relationship between community programs and policies to prevent childhood obesity and BMI in children: The Healthy Communities Study. Pediatr Obes 2018; ##: ##-##
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103
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Smart CE, Annan F, Higgins LA, Jelleryd E, Lopez M, Acerini CL. ISPAD Clinical Practice Consensus Guidelines 2018: Nutritional management in children and adolescents with diabetes. Pediatr Diabetes 2018; 19 Suppl 27:136-154. [PMID: 30062718 DOI: 10.1111/pedi.12738] [Citation(s) in RCA: 113] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 07/16/2018] [Indexed: 02/06/2023] Open
Affiliation(s)
- Carmel E Smart
- Department of Paediatric Endocrinology, John Hunter Children's Hospital, Newcastle, NSW, Australia.,School of Health Sciences, University of Newcastle, Newcastle, NSW, Australia
| | | | | | | | | | - Carlo L Acerini
- Department of Paediatrics, University of Cambridge, Cambridge, UK
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Eck KM, Dinesen A, Garcia E, Delaney CL, Famodu OA, Olfert MD, Byrd-Bredbenner C, Shelnutt KP. "Your Body Feels Better When You Drink Water": Parent and School-Age Children's Sugar-Sweetened Beverage Cognitions. Nutrients 2018; 10:E1232. [PMID: 30189588 PMCID: PMC6165219 DOI: 10.3390/nu10091232] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 08/30/2018] [Accepted: 09/02/2018] [Indexed: 12/21/2022] Open
Abstract
Sugar-sweetened beverages (SSBs) are a leading source of added sugar in the American diet. Further, ingestion of added sugars from SSBs exceeds recommendations. Thus, interventions that effectively reduce SSB consumption are needed. Focus group discussions with parents (n = 37) and school-aged children between the ages of 6 and 11 years (n = 41) from Florida, New Jersey, and West Virginia were led by trained moderators using Social Cognitive Theory as a guide. Trends and themes that emerged from the content analysis of the focus group data indicated that both parents and children felt that limiting SSBs was important to health and weight control. However, parents and children reported consuming an average of 1.85 ± 2.38 SD and 2.13 ± 2.52 SD SSB servings/week, respectively. Parents and children were aware that parent behaviors influenced kids, but parents reported modeling healthy SSB behaviors was difficult. Busy schedules, including more frequent parties and events as children get older, were another barrier to limiting SSBs. Parents were most successful at limiting SSBs when they were not in the house. This qualitative research provides novel insights into parents' and children's cognitions (e.g., beliefs, attitudes), barriers, and facilitators related to SSB ingestion. Consideration of these insights during nutrition intervention development has the potential to improve intervention effectiveness in reducing SSB intake.
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Affiliation(s)
- Kaitlyn M Eck
- Department of Nutritional Sciences, Rutgers University, 26 Nichol Avenue, New Brunswick, NJ 08901, USA.
| | - Aleksandr Dinesen
- Department of Nutritional Sciences, Rutgers University, 26 Nichol Avenue, New Brunswick, NJ 08901, USA.
| | - Elder Garcia
- Department of Family, Youth, and Community Sciences, University of Florida, Gainesville, FL 32611, USA.
| | - Colleen L Delaney
- Department of Nutritional Sciences, Rutgers University, 26 Nichol Avenue, New Brunswick, NJ 08901, USA.
| | - Oluremi A Famodu
- Department of Family, Youth, and Community Sciences, University of Florida, Gainesville, FL 32611, USA.
| | - Melissa D Olfert
- Division of Animal and Nutritional Sciences, West Virginia University, 1194 Evansdale Dr. G28, West Virginia University, Morgantown, WV 26506, USA.
| | - Carol Byrd-Bredbenner
- Department of Nutritional Sciences, Rutgers University, 26 Nichol Avenue, New Brunswick, NJ 08901, USA.
| | - Karla P Shelnutt
- Department of Family, Youth, and Community Sciences, University of Florida, Gainesville, FL 32611, USA.
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105
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Knight KB, Devers SA, Maloney M, Bomba AK, Walker H, Tucker K, Knight SS. Physical activity in the Families in Transformation (FIT) weight management program for children. Health Promot Perspect 2018; 8:237-242. [PMID: 30087848 PMCID: PMC6064755 DOI: 10.15171/hpp.2018.32] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 04/26/2018] [Indexed: 01/22/2023] Open
Abstract
Background: The purpose was to determine if an 8-week nutrition education and exercise program for families could influence health and fitness parameters, and retention of nutrition knowledge. Methods: Eighteen children (mean age: 10.52 ± 1.26 year; 50% boys, 50% girls; 56% white, 25% black, 19% multiracial) participated in the Families in Transformation (FIT) program. Preand post-study anthropocentric, blood pressure, fitness, and nutrition knowledge data was collected. Results: Diastolic blood pressure decreased for the total group (66.63 ± 8.81 to 63.75 ± 11.81mm Hg). Significant (P < 0.05) increases were seen for the group for push-ups (14.31 ± 7.62 to 19.63 ± 6.62) and chair squats (30.50 ± 10.21 to 34.44 ± 7.39). The reinforcing physical activity group performed significantly better on nutrition knowledge quizzes. Conclusion: Although, body mass index (BMI) z-scores did not change, there was a decrease in diastolic blood pressure, increase in fitness parameters, and increased retention of nutrition knowledge.
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Affiliation(s)
- Kathy B Knight
- Department of Nutrition and Hospitality Management, University of Mississippi, University, MS, USA
| | - Sydney A Devers
- Department of Nutrition and Hospitality Management, University of Mississippi, University, MS, USA
| | - Meagan Maloney
- Department of Nutrition and Hospitality Management, University of Mississippi, University, MS, USA
| | - Anne K Bomba
- Department of Nutrition and Hospitality Management, University of Mississippi, University, MS, USA
| | - Heather Walker
- Department of Nutrition and Hospitality Management, University of Mississippi, University, MS, USA
| | - Kathy Tucker
- Coordinator of Outreach and Innovation, Health Works! North Mississippi, North Mississippi Health Services, Tupelo, MS, USA
| | - Scott S Knight
- Director of University of Mississippi Field Station, University of Mississippi, University, MS, USA
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106
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Albert Pérez E, Mateu Olivares V, Martínez-Espinosa RM, Molina Vila MD, Reig García-Galbis M. New Insights about How to Make an Intervention in Children and Adolescents with Metabolic Syndrome: Diet, Exercise vs. Changes in Body Composition. A Systematic Review of RCT. Nutrients 2018; 10:E878. [PMID: 29986479 PMCID: PMC6073719 DOI: 10.3390/nu10070878] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 06/22/2018] [Accepted: 07/02/2018] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To record which interventions produce the greatest variations in body composition in patients ≤19 years old with metabolic syndrome (MS). METHOD search dates between 2005 and 2017 in peer reviewed journals, following the PRISMA method (Preferred Reporting Items for Systematic reviews and Meta-Analyses). The selection criteria were: diagnostic for MS or at least a criterion for diagnosis; randomized clinical trials, ≤19 years of age; intervention programs that use diet and/or exercise as a tool (interventions showing an interest in body composition). RESULTS 1781 clinical trials were identified under these criteria but only 0.51% were included. The most frequent characteristics of the selected clinical trials were that they used multidisciplinary interventions and were carried out in America. The most utilized parameters were BMI (body mass index) in kg/m² and BW (body weight) in kg. CONCLUSIONS Most of the clinical trials included had been diagnosed through at least 2 diagnostic criteria for MS. Multidisciplinary interventions obtained greater changes in body composition in patients with MS. This change was especially prevalent in the combinations of dietary interventions and physical exercise. It is proposed to follow the guidelines proposed for patients who are overweight, obese, or have diabetes type 2, and extrapolate these strategies as recommendations for future clinical trials designed for patients with MS.
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Affiliation(s)
| | | | - Rosa María Martínez-Espinosa
- Division of Biochemistry and Molecular Biology, Department of Agrochemistry and Biochemistry, Faculty of Sciences, University of Alicante, 03690 Alicante, Spain.
- Members of the Research Group of Applied Biochemistry (AppBiochem), Faculty of Sciences, University of Alicante, 03690 Alicante, Spain.
| | - Mariola D Molina Vila
- Members of the Research Group of Applied Biochemistry (AppBiochem), Faculty of Sciences, University of Alicante, 03690 Alicante, Spain.
- Department of Mathematics, Faculty of Sciences, University of Alicante, 03690 Alicante, Spain.
| | - Manuel Reig García-Galbis
- Members of the Research Group of Applied Biochemistry (AppBiochem), Faculty of Sciences, University of Alicante, 03690 Alicante, Spain.
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Atacama, Avda Copayapu 2862, III Region, Copiapo 1530000, Chile.
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107
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Weihrauch-Blüher S, Kromeyer-Hauschild K, Graf C, Widhalm K, Korsten-Reck U, Jödicke B, Markert J, Müller MJ, Moss A, Wabitsch M, Wiegand S. Current Guidelines for Obesity Prevention in Childhood and Adolescence. Obes Facts 2018; 11:263-276. [PMID: 29969778 PMCID: PMC6103347 DOI: 10.1159/000486512] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 12/21/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Current guidelines for prevention of obesity in childhood and adolescence are discussed. METHODS A literature search was performed in Medline via PubMed, and appropriate studies were analyzed. RESULTS Programs to prevent childhood obesity have so far remained mainly school-based and effects have been limited. Analyses by age group show that prevention programs have the best results in younger children (<12 years). Evidence-based recommendations for pre-school- and early school-aged children indicate the need for interventions that address parents and teachers alike. During adolescence, school-based interventions proved most effective when adolescents were addressed directly. To date, obesity prevention programs have mainly focused on behavior-oriented prevention. Recommendations for community- or environment-based prevention have been suggested by the German Alliance of Noncommunicable Diseases and include a minimum of 1 h of physical activity at school, promotion of healthy food choices by taxing unhealthy foods, mandatory standards for meals at kindergartens and schools as well as a ban on unhealthy food advertisement aimed at children. CONCLUSION Behavior-oriented prevention programs showed only limited long-term effects. Certain groups at risk for the development of obesity are not reached effectively by current programs. Although universally valid conclusions cannot be drawn given the heterogeneity of available studies, clearly combining behavior-based programs with community-based prevention to counteract an 'obesogenic environment' is crucial for sustainable success of future obesity prevention programs.
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Affiliation(s)
- Susann Weihrauch-Blüher
- IFB AdiposityDiseases; Leipzig University Medical Center, University of Leipzig, Leipzig, Germany
- Department of Pediatrics I / Pediatric Endocrinology and Diabetology, University Hospital of Halle/Saale, Halle/Saale, Germany
| | - Kartin Kromeyer-Hauschild
- Institute of Human Genetics, Jena University Medical Center, Friedrich-Schiller-University of Jena, Jena, Germany
| | - Christine Graf
- Institute of Movement and Neuroscience, German Sport University of Cologne, Cologne, Germany
| | - Kurt Widhalm
- Department Of Clinical Nutrition and Prevention, Children's Hospital, University Hospital of Vienna, Vienna, Austria
| | - Ulrike Korsten-Reck
- Department of Rehabilitative and Preventive Sports Medicine, University Medical Center Freiburg, Freiburg i.Br., Germany
| | - Birgit Jödicke
- Department of Pediatric Endocrinology and Diabetology and Center for Social-Pediatric Care, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Jana Markert
- IFB AdiposityDiseases; Leipzig University Medical Center, University of Leipzig, Leipzig, Germany
- Institute of Special and Inclusive Education, University of Leipzig, Leipzig, Germany
| | - Manfred James Müller
- Institute for Human Nutrition and Food Sciences, Christian-Albrechts University, Kiel, Germany
- Department of Pediatric Endocrinology and Diabetology, Hospital for Children and Adolescents, University of Ulm, Ulm, Germany
| | - Anja Moss
- Department of Pediatric Endocrinology and Diabetology, Hospital for Children and Adolescents, University of Ulm, Ulm, Germany
| | - Martin Wabitsch
- Department of Pediatric Endocrinology and Diabetology, Hospital for Children and Adolescents, University of Ulm, Ulm, Germany
| | - Susanna Wiegand
- Department of Pediatric Endocrinology and Diabetology and Center for Social-Pediatric Care, Charité Universitätsmedizin Berlin, Berlin, Germany
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108
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Henry BW, Ziegler J, Parrott JS, Handu D. Pediatric Weight Management Evidence-Based Practice Guidelines: Components and Contexts of Interventions. J Acad Nutr Diet 2018; 118:1301-1311.e23. [DOI: 10.1016/j.jand.2017.08.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Indexed: 10/18/2022]
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109
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Goldschmidt AB, Smith KE, Crosby RD, Boyd HK, Dougherty E, Engel SG, Haedt-Matt A. Ecological momentary assessment of maladaptive eating in children and adolescents with overweight or obesity. Int J Eat Disord 2018; 51:549-557. [PMID: 29626353 PMCID: PMC6002915 DOI: 10.1002/eat.22864] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 03/15/2018] [Accepted: 03/15/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Contextual factors related to maladaptive eating behavior in youth with overweight/obesity are poorly understood. This pilot study sought to elucidate immediate internal and external cues related to perceptions of overeating and loss of control (LOC) over eating in a heterogeneous sample of children and adolescents with overweight/obesity assessed in their natural environments. METHOD Community-based youth [N = 40; 55% female (n = 22)], aged 8-14 y (M age = 11.2 ± 1.9 y), with overweight/obesity (M z-BMI = 2.07 ± 0.49) reported on all eating episodes and their physiological, environmental, affective, and interpersonal antecedents and correlates via ecological momentary assessment over a 2-week period. Generalized estimating equations were used to assess the relationship between contextual variables and degree of overeating and LOC. RESULTS Eating occasions involving greater food hedonics (i.e., perceived palatability of food being consumed) were associated with greater LOC severity (within-subjects effect: B = 0.01, p = .015), although youth with lower overall levels of food hedonics reported higher LOC severity ratings on average (between-subjects effect: B = -0.04, p = .005). Youth reporting higher overall cravings reported higher average ratings of LOC severity (between-subjects effect: B = 0.20, p = .001). Finally, youth reporting greater overall influence of others on eating behavior evidenced greater average levels of overeating severity (between-subjects effect: B = 0.17, p < .001). DISCUSSION Eating-related factors appear to be most strongly associated with LOC severity, while environmental factors were most associated with overeating severity. Interventions targeting maladaptive eating in youth with overweight/obesity may benefit from helping youth incorporate palatable foods and satisfy cravings in a planned and controlled manner, and enhancing awareness of social-contextual effects on eating.
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Affiliation(s)
- Andrea B. Goldschmidt
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Weight Control and Diabetes Research Center/The Miriam Hospital, Providence, RI
| | - Kathryn E. Smith
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Ross D. Crosby
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Hope K. Boyd
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago Medicine, Chicago, IL
| | | | - Scott G. Engel
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Alissa Haedt-Matt
- Department of Psychology, Illinois Institute of Technology, Chicago, IL
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Moges T, Gebremichael B, Shiferaw S, Yirgu R. Is inadequate play area in schools associated with overweight among students in Addis Ababa, Ethiopia? A comparative cross-sectional study. Epidemiol Health 2018; 40:e2018017. [PMID: 29807411 PMCID: PMC6060341 DOI: 10.4178/epih.e2018017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 05/12/2018] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES The prevalence of childhood obesity has more than doubled since it was formally recognized as a global epidemic in 1997. With the increasingly dwindling space for private schools in Ethiopia, unresolved concerns exist among the public regarding the possible effect of limited play areas in schools on overweight/obesity. This study intended to determine and compare the levels of overweight/obesity among adolescents in private schools with and without adequate play area in Addis Ababa, Ethiopia. METHODS A school-based comparative cross-sectional study was conducted among 1,276 adolescents. Twenty private schools were grouped into 2 groups based on the size of the play area. Data were collected using a pre-tested questionnaire and anthropometric measurements and analyzed using descriptive statistical tests and logistic regression. RESULTS The magnitude of overweight/obesity was significantly higher in schools with inadequate play area (19.4%; 95% confidence interval [CI], 16.4 to 22.7) than in schools with adequate play area (14.6%; 95% CI, 11.9 to17.5). Inadequacy of the play area was also positively associated with overweight/obesity in the multiple logistic regression analysis (odds ratio [OR], 1.62; 95% CI, 1.05 to 2.51). Using private car transportation to and from school (OR, 2.27; 95% CI, 1.13 to 4.57), father's educational status (secondary school and above: OR, 2.54; 95% CI, 1.14 to 5.62), and middle wealth quintile (OR, 2.54; 95% CI, 1.50 to 4.33) were other factors significantly associated with overweight/obesity. CONCLUSIONS Inadequate play area in schools was an important contributor to overweight/obesity. Sedentary behavior was also significantly associated with overweight/obesity.
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Affiliation(s)
| | | | - Solomon Shiferaw
- Addis Ababa University College of Health Science, Addis Ababa, Ethiopia
| | - Robel Yirgu
- Addis Ababa University College of Health Science, Addis Ababa, Ethiopia
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111
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Effectiveness of a parental school-based intervention to improve young children’s eating patterns: a pilot study. Public Health Nutr 2018; 21:2485-2496. [DOI: 10.1017/s1368980018000952] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
AbstractObjectiveTo evaluate the effectiveness of a pilot study of a parental school-based intervention to promote healthy eating behaviours in young children.DesignA quasi-experimental longitudinal design with three conditions (complete intervention (CIG), minimal intervention (MIG), control (CG)), with repeated measures at baseline, immediately after the intervention, 6 months and 1 year after intervention.SettingFourteen public and state-funded kindergartens near Lisbon, Portugal.SubjectsParents (n349) of 3- to 6-year-old children assigned to the three conditions completed the baseline protocol. The ‘Red Apple’ intervention included four parental group sessions about young children’s growth, nutritional guidelines and positive parental feeding strategies, which was combined with adult–child activities at home and in the classroom, and newsletters (CIG). MIG included only a single nutritional counselling session, whereas the CG had no intervention. At the end, thirty-eight, twenty-six and fifty-four parents in the CIG, MIG and CG, respectively, had completed all evaluation components. Data regarding parental perception of children’s weight, self-efficacy, nutritional knowledge, feeding strategies, eating behaviours and BMI were collected at the four assessment moments.ResultsThe CIG showed improvements in children’s healthy food intake, compared with the MIG and CG. Parental self-efficacy regarding the regulation of children’s eating behaviours decreased in the CG but not in both intervention groups.ConclusionsConsidering the low dosage of the intervention, the results obtained were positive. Future studies should offer additional solutions to overcome barriers to parents’ participation.
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112
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Leme ACB, Thompson D, Lenz Dunker KL, Nicklas T, Tucunduva Philippi S, Lopez T, Vézina-Im LA, Baranowski T. Obesity and eating disorders in integrative prevention programmes for adolescents: protocol for a systematic review and meta-analysis. BMJ Open 2018; 8:e020381. [PMID: 29674372 PMCID: PMC5914714 DOI: 10.1136/bmjopen-2017-020381] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Obesity and eating disorders are public health problems that have lifelong financial and personal costs and common risk factors, for example, body dissatisfaction, weight teasing and disordered eating. Obesity prevention interventions might lead to the development of an eating disorder since focusing on weight may contribute to excessive concern with diet and weight. Therefore, the proposed research will assess whether integrating obesity and eating disorder prevention procedures ('integrated approach') do better than single approach interventions in preventing obesity among adolescents, and if integrated approaches influence weight-related outcomes. METHODS AND ANALYSIS Integrated obesity and eating disorder prevention interventions will be identified. Randomised controlled trials and quasi-experimental trials reporting data on adolescents ranging from 10 to 19 years of age from both sexes will be included. Outcomes of interest include body composition, unhealthy weight control behaviours and body satisfaction measurements. MEDLINE/PubMed, PsycINFO, Web of Science and SciELO will be searched. Data will be extracted independently by two reviewers using a standardised data extraction form. Trial quality will be assessed using the Cochrane Collaboration criteria. The effects of integrated versus single approach intervention studies will be compared using systematic review procedures. If an adequate number of studies report data on integrated interventions among similar populations (k>5), a meta-analysis with random effects will be conducted. Sensitivity analyses and meta-regression will be performed only if between-study heterogeneity is high (I2 ≥75%). ETHICS AND DISSEMINATION Ethics approval will not be required as this is a systematic review of published studies. The findings will be disseminated through conference presentations and peer-reviewed journals.
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Affiliation(s)
| | - Debbe Thompson
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, USA
| | | | - Theresa Nicklas
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, USA
| | | | - Tabbetha Lopez
- Department of Health and Human Performance, College of Liberal Arts and Social Sciences, University of Houston, Houston, Texas, USA
| | - Lydi-Anne Vézina-Im
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, USA
| | - Tom Baranowski
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, USA
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113
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Myers ML, Fulkerson JA, Friend SE, Horning ML, Flattum CF. Case study: Behavior changes in the family-focused obesity prevention HOME Plus program. Public Health Nurs 2018; 35:299-306. [PMID: 29624720 DOI: 10.1111/phn.12403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The purpose of this case study is to describe two successful HOME Plus participants and highlight how an intervention with individual and group components can help families make lifestyle changes that result in improvements in child weight status. DESIGN One hundred and sixty families participated in the HOME Plus study, and were randomized to either a control or intervention group. SAMPLE Two successful HOME Plus participants were chosen because of their healthful changes in weight status and behavior and high engagement in the program. MEASUREMENTS Data were collected at baseline and postintervention, 1 year later. Data included height, weight, home food inventory, dietary recalls, and psychosocial surveys. INTERVENTION Families in the intervention group participated in cooking and nutrition education sessions, goal-setting activities, and motivational interviewing telephone calls to promote behavioral goals associated with meal planning, family meal frequency, and healthfulness of meals and snacks. RESULTS Analysis of the families' behaviors showed that Oliver (fictitious name) experienced changes in nutritional knowledge and cooking skill development while Sophia's (fictitious name) changes were associated with healthful food availability and increased family meal frequency. CONCLUSION These cases show that offering a multicomponent, family-focused program allows participants to select behavior strategies to fit their unique family needs.
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Affiliation(s)
- Michelle L Myers
- School of Nursing, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Jayne A Fulkerson
- School of Nursing, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Sarah E Friend
- School of Nursing, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Melissa L Horning
- School of Nursing, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Colleen F Flattum
- School of Nursing, University of Minnesota Twin Cities, Minneapolis, MN, USA.,Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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Bleich SN, Vercammen KA, Zatz LY, Frelier JM, Ebbeling CB, Peeters A. Interventions to prevent global childhood overweight and obesity: a systematic review. Lancet Diabetes Endocrinol 2018; 6:332-346. [PMID: 29066096 DOI: 10.1016/s2213-8587(17)30358-3] [Citation(s) in RCA: 233] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 09/20/2017] [Accepted: 09/26/2017] [Indexed: 12/31/2022]
Abstract
In view of the prevalence, health consequences, and costs of childhood obesity, there has been substantial interest in identifying effective interventions to prevent excess weight gain in young people. In this systematic review, we expand on previous reviews of obesity prevention interventions by including recent studies (until May 23, 2017) from all parts of the world. We searched MEDLINE, Embase, CINAHL Plus, Web of Science, CAB Abstracts, and PAIS Index and included randomised controlled trials, quasi-experimental studies, or natural experiments with: (1) a control group; (2) minimum follow-up of 12 months for community-based and home-based interventions or 6 months for school-based and preschool-based interventions; and (3) a primary outcome of BMI, BMI Z score, BMI percentile, body fat percentage, skinfold thickness, waist circumference, or prevalence of overweight or obesity. School-based interventions with combined diet and physical activity components and a home element (n=41) had greatest effectiveness; evidence in support of the effect of preschool-based (n=6), community-based (n=7), and home-based (n=2) interventions was limited by a paucity of studies and heterogeneity in study design. The effectiveness of school-based interventions that combined diet and physical activity components suggests that they hold promise for childhood obesity prevention worldwide. More research with rigorous evaluation and consistent reporting is needed in non-school settings and in combinations of settings.
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Affiliation(s)
- Sara N Bleich
- Department of Health Policy and Management, Harvard T H Chan School of Public Health, Boston, MA, USA.
| | - Kelsey A Vercammen
- Department of Health Policy and Management, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Laura Y Zatz
- Department of Nutrition and Department of Social and Behavioral Sciences, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Johannah M Frelier
- Department of Health Policy and Management, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Cara B Ebbeling
- New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, Boston, MA, USA
| | - Anna Peeters
- School of Health and Social Development, Deakin University, Burwood, VIC, Australia
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115
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Fetter DS, Scherr RE, Linnell JD, Dharmar M, Schaefer SE, Zidenberg-Cherr S. Effect of the Shaping Healthy Choices Program, a Multicomponent, School-Based Nutrition Intervention, on Physical Activity Intensity. J Am Coll Nutr 2018. [PMID: 29533146 DOI: 10.1080/07315724.2018.1436477] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Physical activity has been shown to have a wide range of beneficial health effects, yet few youth meet the United States physical activity recommendation of 60 minutes of moderate-to-vigorous physical activity (MVPA) everyday. The objective of this study was to determine whether physical activity patterns improved in a subsample of fourth-graders participating in the multicomponent intervention, the Shaping Healthy Choices Program (SHCP). METHODS At pre- and post-intervention assessments, youth at the control and intervention schools wore a Polar Active monitor on their nondominant wrist 24 h/d for at least 2 consecutive days. Multiple linear regression was used to evaluate change in physical activity by adjusting for covariates and other potential confounders, including ethnicity/race, household income, and sex. Statistical significance was set at p < 0.05. RESULTS Mean minutes of MVPA significantly increased at the intervention school (22.3 + 37.8; p = 0.01) and at the control school (29.1 + 49.5; p = 0.01). There were no significant differences in the change in MVPA between the schools. Youth at the intervention school significantly decreased mean minutes in sedentary activity compared to the controls (p = 0.02). CONCLUSIONS Youth who participated in the SHCP decreased time spent in sedentary activity and increased very vigorous physical activity from pre- to post-intervention, while these changes were not observed at the control school. The overall small physical activity intensity pattern shift supports that physical activity is an important area to target within a multicomponent nutrition intervention aimed at preventing childhood obesity.
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Affiliation(s)
- Deborah S Fetter
- a University of California, Davis, Nutrition , Davis , California , USA.,b University of Califonria, Davis, Center for Nutrition in Schools , Davis , California , USA
| | - Rachel Erin Scherr
- a University of California, Davis, Nutrition , Davis , California , USA.,b University of Califonria, Davis, Center for Nutrition in Schools , Davis , California , USA
| | - Jessica D Linnell
- c Oregon State Extension Service, Family and Community Health, Tillamook and Lincoln Counties , Tillamook , Oregon , USA
| | - Madan Dharmar
- d University of California, Davis , Department of Pediatrics , Sacramento , California , USA.,e University of California, Davis, Betty Irene Moore School of Nursing , Sacramento , California , USA
| | - Sara E Schaefer
- f University of California, Davis, Foods for Health Institute , Davis , California , USA
| | - Sheri Zidenberg-Cherr
- a University of California, Davis, Nutrition , Davis , California , USA.,b University of Califonria, Davis, Center for Nutrition in Schools , Davis , California , USA
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Romo-Palafox MJ, Ranjit N, Sweitzer SJ, Roberts-Gray C, Byrd-Williams CE, Briley ME, Hoelscher DM. Contribution of Beverage Selection to the Dietary Quality of the Packed Lunches Eaten by Preschool-Aged Children. J Acad Nutr Diet 2018; 118:1417-1424. [PMID: 29478941 DOI: 10.1016/j.jand.2017.11.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 11/10/2017] [Indexed: 02/01/2023]
Abstract
BACKGROUND Sweet drinks early in life could predispose to lifelong consumption, and the beverage industry does not clearly define fruit drinks as part of the sweet drink category. OBJECTIVES To ascertain the relationship between beverage selection and dietary quality of the lunches packed for preschool-aged children evaluated using the Healthy Eating Index-2010. METHODS Foods packed by parents (n=607) were observed at 30 early care and education centers on two nonconsecutive days. Three-level regression models were used to examine the dietary quality of lunches by beverage selection and the dietary quality of the lunch controlling for the nutrient composition of the beverage by removing it from the analysis. RESULTS Fruit drinks were included in 25% of parent-packed lunches, followed by 100% fruit juice (14%), milk (14%), and flavored milk (3.7%). Lunches with plain milk had the highest Healthy Eating Index-2010 scores (59.3) followed by lunches with 100% fruit juice (56.9) and flavored milk (53.2). Lunches with fruit drinks had the lowest Healthy Eating Index-2010 scores at 48.6. After excluding the nutrient content of the beverage, the significant difference between lunches containing milk and flavored milk persisted (+5.5), whereas the difference between fruit drinks and 100% fruit juice did not. CONCLUSIONS Dietary quality is associated with the type of beverage packed and these differences hold when the lunch is analyzed without the nutrient content of the beverage included.
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Wolf C, Wolf S, Weiss M, Nino G. Children's Environmental Health in the Digital Era: Understanding Early Screen Exposure as a Preventable Risk Factor for Obesity and Sleep Disorders. CHILDREN (BASEL, SWITZERLAND) 2018; 5:E31. [PMID: 29473855 PMCID: PMC5836000 DOI: 10.3390/children5020031] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 02/15/2018] [Accepted: 02/20/2018] [Indexed: 11/20/2022]
Abstract
The quantity, accessibility and focus on child-targeted programming has exponentially increased since it entered American households in the early 1900s. It may have started with the television (TV), but technology has evolved and now fits in our pockets; as of 2017, 95% of American families own a smartphone. Availability and child-tailored content has subsequently led to a decrease in the age at initial screen exposure. The negative effects that accompany the current culture of early screen exposure are extensive and need to be considered as technology continues to enter the home and inundate social interactions. Increased levels of early screen exposure have been associated with decreased cognitive abilities, decreased growth, addictive behavior, poor school performance, poor sleep patterns, and increased levels of obesity. Research on the adverse effects of early screen exposure is mounting, but further epidemiological studies are still needed to inform prevention and regulation policies.
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Affiliation(s)
- Candice Wolf
- Larner College of Medicine, University of Vermont, Burlington, VT 05405-0068, USA.
| | - Seth Wolf
- Larner College of Medicine, University of Vermont, Burlington, VT 05405-0068, USA.
| | - Miriam Weiss
- Sleep Medicine Department, Children's National Medical Center, Washington, DC 20010, USA.
| | - Gustavo Nino
- Sleep Medicine Department, Children's National Medical Center, Washington, DC 20010, USA.
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118
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Foster C, Moore JB, Singletary CR, Skelton JA. Physical activity and family-based obesity treatment: a review of expert recommendations on physical activity in youth. Clin Obes 2018; 8:68-79. [PMID: 29224232 DOI: 10.1111/cob.12230] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 09/13/2017] [Accepted: 10/02/2017] [Indexed: 12/21/2022]
Abstract
Targeting physical inactivity in children is pertinent to aiding in the decrease of childhood obesity rates. Only 33% of adolescents are obtaining the recommended goal of at least 60 min of physical activity per day. The objectives of this review are to summarize professional recommendations for physical activity and exercise in children and adolescents, and identify family-centred strategies that can be implemented by weight management clinicians. Clinically oriented recommendations and policy statements from professional organizations were identified through literature and internet searches, summarized using rubrics of aerobic, muscle strengthening and bone strengthening exercise, then examined for details on family-based focus, inclusion of child developmental stage and age, and application to the prevention and treatment of obesity. Current recommendations give guidelines for the amount of physical activity that children should acquire and how many days a week activities should occur. However, available guidelines need an improved approach to addressing the role of the parents and caregivers in targeting physical activity and weight management in youth. Efforts must be taken in order to make sure that the types of physical activity offered are both suitable and enjoyable. Sports, games, free play and other age appropriate activities are adequate ways to increase moderate to vigorous physical activity in children. Differentiating physical activities types in accordance with developmental stage, level of enjoyment, and family characteristics is needed to establish sustainable habits. One paediatric obesity program has developed approaches to teaching families fun and engaging ways to be active together.
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Affiliation(s)
- C Foster
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Brenner FIT (Families In Training) Program, Brenner Children's Hospital, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - J B Moore
- Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - C R Singletary
- Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - J A Skelton
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Brenner FIT (Families In Training) Program, Brenner Children's Hospital, Wake Forest Baptist Health, Winston-Salem, NC, USA
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Vanderhulst E, Faik A, Vansintejan J, Van Rossem I, Devroey D. Association of Dietary Habits and Interest for Food and Science versus Weight Status in Children Aged 8 to 18 Years. J Obes 2018; 2018:4061385. [PMID: 29610682 PMCID: PMC5828495 DOI: 10.1155/2018/4061385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 07/26/2017] [Accepted: 11/29/2017] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION This study aims to describe the association between dietary habits and weight status and the interest in food and science. METHODS We examined in a cross-sectional study 525 children aged between 8 and 18 years, who attended the Brussels Food Fair or the Belgian Science Day in 2013. They were divided into three groups: special interest in science, special interest in food, and a general control group. They completed a questionnaire, and body parameters were measured. The weight status of the children was identified using the growth charts and the calculated BMI. RESULTS In total, 525 children were included: 290 children in the reference group, 194 in the food group, and 41 in the science group. The prevalence of overweight and obesity was 28% in the general control group, 14% in the food group, and 15% in the science group. Breakfast and dinner were skipped more often by children with overweight or obesity. Children from the food and science groups had more sweets and meat, had less fruit, and skipped less meals. CONCLUSION In our study, 28% of the reference group had overweight or obesity. The children with special interest in food or science differed from the control group.
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Affiliation(s)
- Els Vanderhulst
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
| | - Aicha Faik
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
| | - Johan Vansintejan
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
| | - Inès Van Rossem
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
| | - Dirk Devroey
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
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Porter KJ, Koch PA, Contento IR. Why and How Schools Make Nutrition Education Programs "Work". THE JOURNAL OF SCHOOL HEALTH 2018; 88:23-33. [PMID: 29224220 DOI: 10.1111/josh.12577] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 03/28/2017] [Accepted: 07/25/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND There are many potential health benefits to having nutrition education programs offered by expert outside sources in schools. However, little is known about why and how schools initiate, implement, and institutionalize them. Gaining this understanding may allow the impact and reach of nutrition and other health education programs in schools to be extended. METHODS A total of 22 school community members from 21 purposefully selected New York City public elementary schools were interviewed using a semistructured interview protocol about their schools' experiences initiating, implementing, and institutionalizing nutrition education programs. Interviews were audiotaped and transcribed. Chronological narratives were written detailing each school's experience and passages highlighting key aspects of each school's experience were identified. These passages (N = 266) were sorted into domains and themes which were regrouped, resorted, and adjusted until all researchers agreed the domains and themes represented the collective experiences of the schools. RESULTS The interviews elicited 4 broad domains of action: building motivation, choosing programs, developing capacity, and legitimizing nutrition education. Within each domain, themes reflecting specific actions and thoughts emerged. CONCLUSIONS The identified domains of action and their themes highlight specific, practical actions that school health advocates can use to initiate, implement, and institutionalize nutrition education programs in schools.
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Affiliation(s)
- Kathleen J Porter
- Department of Public Health Sciences, University of Virginia, School of Medicine, 16 East Main Street, Suite 103, Christiansburg, VA 24073
| | - Pamela A Koch
- Laurie M. Tisch Center for Food, Education & Policy, Teachers College Columbia University, 525 West 120th Street, Box 137, New York, NY 10025
- Teachers College Columbia University, 525 West 120th Street, Box 137, New York, NY 10025
| | - Isobel R Contento
- Department of Nutrition and Education, Teachers College Columbia University, 525 West 120th Street, Box 137, New York, NY 10025
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Salahuddin M, Pérez A, Ranjit N, Kelder SH, Barlow SE, Pont SJ, Butte NF, Hoelscher DM. Predictors of Severe Obesity in Low-Income, Predominantly Hispanic/Latino Children: The Texas Childhood Obesity Research Demonstration Study. Prev Chronic Dis 2017; 14:E141. [PMID: 29283881 PMCID: PMC5757383 DOI: 10.5888/pcd14.170129] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION The objective of this study was to identify predictors of severe obesity in a low-income, predominantly Hispanic/Latino sample of children in Texas. METHODS This cross-sectional analysis examined baseline data on 517 children from the secondary prevention component of the Texas Childhood Obesity Research Demonstration (TX CORD) study; data were collected from September 2012 through February 2014. Self-administered surveys were used to collect data from parents of children who were aged 2 to 12 years, had a body mass index (BMI) in the 85th percentile or higher, and resided in Austin, Texas, or Houston, Texas. Multivariable logistic regression models adjusted for sociodemographic covariates were used to examine associations of children's early-life and maternal factors (large-for-gestational-age, exclusive breastfeeding for ≥4 months, maternal severe obesity [BMI ≥35.0 kg/m2]) and children's behavioral factors (fruit and vegetable consumption, physical activity, screen time) with severe obesity (BMI ≥120% of 95th percentile), by age group (2-5 y, 6-8 y, and 9-12 y). RESULTS Across all ages, 184 (35.6%) children had severe obesity. Among children aged 9 to 12 years, large-for-gestational-age at birth (odds ratio [OR] = 2.31; 95% confidence interval [CI], 1.13-4.73) was significantly associated with severe obesity. Maternal severe obesity was significantly associated with severe obesity among children aged 2 to 5 years (OR = 2.67; 95% CI, 1.10-6.47) and 9 to 12 years (OR = 4.12; 95% CI, 1.84-9.23). No significant association was observed between behavioral factors and severe obesity in any age group. CONCLUSION In this low-income, predominantly Hispanic/Latino sample of children, large-for-gestational-age and maternal severe obesity were risk factors for severe obesity among children in certain age groups. Promoting healthy lifestyle practices during preconception and prenatal periods could be an important intervention strategy for addressing childhood obesity.
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Affiliation(s)
- Meliha Salahuddin
- Michael & Susan Dell Center for Healthy Living, Austin, Texas
- The University of Texas Health Science Center at Houston School of Public Health in Austin,1616 Guadalupe St, Suite 6.300, Austin, TX 78701. ;
- Population Health, Office of Health Affairs, University of Texas System, Austin, Texas
| | - Adriana Pérez
- Michael & Susan Dell Center for Healthy Living, Austin, Texas
- The University of Texas Health Science Center at Houston School of Public Health in Austin, Austin, Texas
| | - Nalini Ranjit
- Michael & Susan Dell Center for Healthy Living, Austin, Texas
- The University of Texas Health Science Center at Houston School of Public Health in Austin, Austin, Texas
| | - Steven H Kelder
- Michael & Susan Dell Center for Healthy Living, Austin, Texas
- The University of Texas Health Science Center at Houston School of Public Health in Austin, Austin, Texas
| | - Sarah E Barlow
- Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Stephen J Pont
- Texas Department of State Health Services, Office of Science and Population Health, Austin, Texas
- University of Texas at Austin Dell Medical School, Austin, Texas
| | - Nancy F Butte
- US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Houston, Texas
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Deanna M Hoelscher
- Michael & Susan Dell Center for Healthy Living, Austin, Texas
- The University of Texas Health Science Center at Houston School of Public Health in Austin, Austin, Texas
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Training early childcare providers in evidence-based nutrition strategies can help improve nutrition policies and practices of early childcare centres serving racially and ethnically diverse children from low-income families. Public Health Nutr 2017; 21:1212-1221. [PMID: 29233208 DOI: 10.1017/s1368980017003573] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE We evaluated the extent to which providing training and technical assistance to early childcare centre (ECC) directors, faculty and staff in the implementation of evidence-based nutrition strategies improved the nutrition contexts, policies and practices of ECC serving racially and ethnically diverse, low-income children in Broward County, Florida, USA. The nutrition strategies targeted snack and beverage policies and practices, consistent with Caring for Our Children National Standards. DESIGN We used the nutrition observation and document review portions of the Environment and Policy Assessment and Observation (EPAO) instrument to observe ECC as part of a one-group pre-test/post-test evaluation design. SETTING ECC located within areas of high rates of poverty, diabetes, minority representation and unhealthy food index in Broward County, Florida, USA. SUBJECTS Eighteen ECC enrolled, mean 112·9 (sd 53·4) children aged 2-5 years; 12·3 (sd 7·2) staff members; and 10·2 (sd 4·6) children per staff member at each centre. RESULTS We found significant improvements in centres' overall nutrition contexts, as measured by total EPAO nutrition scores (P=0·01). ECC made specific significant gains within written nutrition policies (P=0·03) and nutrition training and education (P=0·01). CONCLUSIONS Our findings support training ECC directors, faculty and staff in evidence-based nutrition strategies to improve the nutrition policies and practices of ECC serving racially and ethnically diverse children from low-income families. The intervention resulted in improvements in some nutrition policies and practices, but not others. There remains a need to further develop the evaluation base involving the effectiveness of policy and practice interventions within ECC serving children in high-need areas.
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123
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Eaton JC, Iannotti LL. Genome-nutrition divergence: evolving understanding of the malnutrition spectrum. Nutr Rev 2017; 75:934-950. [PMID: 29112753 DOI: 10.1093/nutrit/nux055] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Humans adapted over a period of 2.3 million years to a diet high in quality and diversity. Genome-nutrition divergence describes the misalignment between modern global diets and the genome formed through evolution. A survey of hominin diets over time shows that humans have thrived on a broad range of foods. Earlier diets were highly diverse and nutrient dense, in contrast to modern food systems in which monotonous diets of staple cereals and ultraprocessed foods play a more prominent role. Applying the lens of genome-nutrition divergence to malnutrition reveals shared risk factors for undernutrition and overnutrition at nutrient, food, and environmental levels. Mechanisms for food system shifts, such as crop-neutral agricultural policy, agroecology, and social policy, are explored as a means to realign modern diets with the nutritional patterns to which humans may be better adapted to thrive.
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Affiliation(s)
- Jacob C Eaton
- Institute for Public Health, Brown School, Washington University, St Louis, Missouri, USA
| | - Lora L Iannotti
- Institute for Public Health, Brown School, Washington University, St Louis, Missouri, USA
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124
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Alexander GL, Lindberg N, Firemark AL, Rukstalis MR, McMullen C. Motivations of Young Adults for Improving Dietary Choices: Focus Group Findings Prior to the MENU GenY Dietary Change Trial. HEALTH EDUCATION & BEHAVIOR 2017; 45:492-500. [PMID: 29068724 DOI: 10.1177/1090198117736347] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Young adulthood is often associated with poor dietary habits that may increase risk of obesity and chronic diseases. As independence grows, little is known about strategies to help balance social, work, and education commitments that may override desires to incorporate healthful food choices. OBJECTIVE In advance of a randomized trial to test an online intervention targeting young adults, we sought to identify views and experiences with healthy eating, and specifically, eating more fruits and vegetables. METHODS We conducted 13 focus groups with 68 young adults in metropolitan Detroit (Henry Ford Health System) and rural Pennsylvania (Geisinger Health System). Randomly selected adults aged 21 to 30 years, using health system automated data, were sent recruitment letters. Questions were grounded in social cognitive theory and self-determination theory. Audiotapes were transcribed, content themes identified, coded, verified for reliability, and analyzed qualitatively. RESULTS Young adults' efforts to eat healthfully included three major themes of (1) motivations to create a healthy lifestyle, teach by example, feel better, and manage weight and future health problems; (2) learning to eat well from childhood, independent living, and peers; and (3) strategies to eat better through planning, tracking, and commitment. DISCUSSION We uncovered theory-based factors that facilitate healthy dietary behavior change among young adults, including managing their behavior through self-monitoring, goal-setting, small steps, meaningful reinforcements, and social opportunities. CONCLUSIONS Targeted interventions encouraging reflection on personal values related to meaningful contemporary health benefits are likely to resonate with young adults, as will opportunities to receive and share new information.
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Affiliation(s)
| | - Nangel Lindberg
- 2 Kaiser Permanente Northwest, Center for Health Research, Portland, OR, USA
| | - Alison L Firemark
- 2 Kaiser Permanente Northwest, Center for Health Research, Portland, OR, USA
| | | | - Carmit McMullen
- 2 Kaiser Permanente Northwest, Center for Health Research, Portland, OR, USA
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Deen JF, Adams AK, Fretts A, Jolly S, Navas-Acien A, Devereux RB, Buchwald D, Howard BV. Cardiovascular Disease in American Indian and Alaska Native Youth: Unique Risk Factors and Areas of Scholarly Need. J Am Heart Assoc 2017; 6:e007576. [PMID: 29066451 PMCID: PMC5721901 DOI: 10.1161/jaha.117.007576] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Jason F Deen
- Division of Cardiology, Seattle Children's Hospital, University of Washington, Seattle, WA
- Division of Cardiology, Department of Medicine, University of Washington Medical Center, Seattle, WA
| | - Alexandra K Adams
- Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI
- Center for American Indian and Rural Health Equity, Montana State University, Bozeman, MT
| | - Amanda Fretts
- Department of Epidemiology, Cardiovascular Health Research Unit, University of Washington, Seattle, WA
| | - Stacey Jolly
- Department of General Internal Medicine, Medicine Institute, Cleveland Clinic, Cleveland, OH
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | | | - Dedra Buchwald
- College of Medicine, Washington State University, Spokane, WA
| | - Barbara V Howard
- MedStar Health Research Institute, Hyattsville, MD
- Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC
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Yli-Piipari S, Berg A, Laing EM, Hartzell DL, Parris KO, Udwadia J, Lewis RD. A Twelve-Week Lifestyle Program to Improve Cardiometabolic, Behavioral, and Psychological Health in Hispanic Children and Adolescents. J Altern Complement Med 2017; 24:132-138. [PMID: 29017015 DOI: 10.1089/acm.2017.0130] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES To examine the effectiveness of a 12-week lifestyle program on cardiometabolic, behavioral, and psychological outcomes among overweight Hispanic children and adolescents. DESIGN A case series study with pre- and post-test analyses. Subjects/Settings/Location: A convenience sample of high-risk pediatric primary care patients (n = 22; 6 girls, 16 boys; M age = 11.73 ± 1.39 years) and their guardians in the Southeast United States. INTERVENTION Twice per week 60 min (total of 24 h) of moderate-to-vigorous intensity boxing exercise training, 12 h of nutrition education for guardians, and a 30-min pediatrician appointment. OUTCOME MEASURES Cardiometabolic (height [m], weight [kg], waist circumference [cm], body-mass index [BMI], BMI-z, BMI%, cholesterol [mg/dL], triglycerides [mg/dL], glucose [mg/dL], and low-density lipoprotein and high-density lipoprotein cholesterol [mg/dL]), behavioral (objective free time physical activity [PA] and sedentary time [min/day]), and psychological (self-determined exercise motivation) outcomes were measured/calculated, and paired-samples t-tests were conducted. RESULTS A significant reduction was observed in waist circumference t(17) = -2.57, p = 0.020, d = 0.64; BMI% t(15) = -2.53, p = 0.023, d = 0.20; fasting glucose t(15) = -6.43, p < 0.001, d = 1.67; and amotivation (-) t(17) = -2.29, p = 0.036, d = 0.64; whereas a significant increase was identified in moderate t(10) = 4.01, p = 0.002, d = 1.23 and vigorous t(10) = 3.41, p = 0.007, d = 1.07 intensity PA; intrinsic motivation t(17) = 2.71, p = 0.015, d = 0.38; and introjected regulation t(17) = 2.74, p = 0.014, d = 0.64. CONCLUSIONS A 12-week lifestyle program can be effective in improving selected health markers among overweight Hispanic children and adolescents. The positive changes in fasting glucose, BMI, and waist suggest that the participants are currently at lower risk for both type 2 diabetes and cardiovascular disease as a result of the Confidence, Ownership, Responsibility, and Exercise program.
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Affiliation(s)
- Sami Yli-Piipari
- 1 Children's Physical Activity, Fitness, and School Health Promotion, Department of Kinesiology, College of Education, University of Georgia , Athens, GA
| | - Alison Berg
- 2 Department of Foods and Nutrition, College of Family and Consumer Sciences, University of Georgia , Athens, GA
| | - Emma M Laing
- 2 Department of Foods and Nutrition, College of Family and Consumer Sciences, University of Georgia , Athens, GA
| | | | | | - Jon Udwadia
- 5 Department of Pediatrics, GRU/UGA Medical Partnership , Athens, GA
| | - Richard D Lewis
- 2 Department of Foods and Nutrition, College of Family and Consumer Sciences, University of Georgia , Athens, GA
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Al-Hamad D, Raman V. Metabolic syndrome in children and adolescents. Transl Pediatr 2017; 6:397-407. [PMID: 29184820 PMCID: PMC5682379 DOI: 10.21037/tp.2017.10.02] [Citation(s) in RCA: 133] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 09/26/2017] [Indexed: 01/19/2023] Open
Abstract
Prevalence of metabolic syndrome in children and adolescents is increasing, in parallel with the increasing trends in obesity rates. Varying definitions of this syndrome have hindered the development of a consensus for the diagnostic criteria in the pediatric population. While pathogenesis of metabolic syndrome is not completely understood, insulin resistance and subsequent inflammation are thought to be among its main mechanistic underpinnings. Overweight and obesity are cardinal features, along with abnormal glucose metabolism, dyslipidemia, and hypertension. Other disorders associated with metabolic syndrome include fatty liver, polycystic ovarian syndrome (PCOS), and pro-inflammatory states. Prevention and management of this condition can be accomplished with lifestyle modifications, behavioral interventions, pharmacological and surgical interventions as needed.
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Affiliation(s)
- Dania Al-Hamad
- Division of Pediatric Endocrinology and Diabetes, University of Utah, Salt Lake City, UT, USA
| | - Vandana Raman
- Division of Pediatric Endocrinology and Diabetes, University of Utah, Salt Lake City, UT, USA
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Childerhose JE, Alsamawi A, Mehta T, Smith JE, Woolford S, Tarini BA. Adolescent bariatric surgery: a systematic review of recommendation documents. Surg Obes Relat Dis 2017; 13:1768-1779. [DOI: 10.1016/j.soard.2017.08.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 06/25/2017] [Accepted: 08/07/2017] [Indexed: 10/19/2022]
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129
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Price C, Cohen D, Pribis P, Cerami J. Nutrition Education and Body Mass Index in Grades K-12: A Systematic Review. THE JOURNAL OF SCHOOL HEALTH 2017; 87:715-720. [PMID: 28766320 DOI: 10.1111/josh.12544] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 01/18/2017] [Accepted: 02/23/2017] [Indexed: 05/21/2023]
Abstract
BACKGROUND Overweight and obese body mass index (BMI) status affects an increasing number of children in the United States. The school setting has been identified as a focus area to implement obesity prevention programs. METHODS A database search of PubMed, Education Search Complete, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) was conducted for peer-reviewed articles published between January 2005 and December 2015 pertaining to programs offered in the school setting to grades K-12 in the United States with a nutrition education component and measured BMI percentile or BMI z-score as an outcome. RESULTS Seven studies focused on elementary (K-5) populations and 2 studies focused on grades 6-8. Among the 9 identified studies, those with long-term (greater than 1 year) implementation showed more pronounced results with positive impact on reducing overweight/obese BMI measures. CONCLUSIONS This set of studies suggests that long-term nutrition education delivered in the school setting can provide children with tools to attain a healthy weight status. Additional studies examining participants' BMI status years after the initial study, and studies examining programs in grades 9-12 are needed to determine the most effective delivery time and methods.
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Affiliation(s)
- Cayla Price
- University of New Mexico, MSC05 3040, 1 University of New Mexico, Albuquerque, NM 87131-0001
| | - Deborah Cohen
- University of New Mexico, MSC05 3040, 1 University of New Mexico, Albuquerque, NM 87131-0001
| | - Peter Pribis
- University of New Mexico, MSC05 3040, 1 University of New Mexico, Albuquerque, NM 87131-0001
| | - Jean Cerami
- University of New Mexico, MSC05 3040, 1 University of New Mexico, Albuquerque, NM 87131-0001
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130
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Elahmedi MO, Alqahtani AR. Evidence Base for Multidisciplinary Care of Pediatric/Adolescent Bariatric Surgery Patients. Curr Obes Rep 2017; 6:266-277. [PMID: 28755177 DOI: 10.1007/s13679-017-0278-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW Severe childhood obesity, defined as having a body mass index (BMI) greater than the 99th percentile for age and gender, is rising in most countries and is associated with early morbidity and mortality. Optimal management of the health of the child with obesity requires a multidisciplinary approach that identifies and treats associated derangements. RECENT FINDINGS Lifestyle interventions such as diet, exercise, and behavioral therapy for the severely obese pediatric patient are generally not effective. Few centers worldwide offer bariatric surgery for adolescents in a multidisciplinary setting, and we are the only center that offers a multidisciplinary approach that incorporates bariatric surgery for severely obese children and adolescents across all age groups. In this paper, we review up-to-date evidence in this subject including ours, and provide details on the multidisciplinary approach to pediatric obesity that accommodates bariatric surgery for children across all age groups.
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Affiliation(s)
- Mohamed O Elahmedi
- Department of Surgery, College of Medicine, King Saud University, 1 Baabda, Riyadh, 11472, Saudi Arabia
| | - Aayed R Alqahtani
- Department of Surgery, College of Medicine, King Saud University, 1 Baabda, Riyadh, 11472, Saudi Arabia.
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Bischoff SC, Boirie Y, Cederholm T, Chourdakis M, Cuerda C, Delzenne NM, Deutz NE, Fouque D, Genton L, Gil C, Koletzko B, Leon-Sanz M, Shamir R, Singer J, Singer P, Stroebele-Benschop N, Thorell A, Weimann A, Barazzoni R. Towards a multidisciplinary approach to understand and manage obesity and related diseases. Clin Nutr 2017; 36:917-938. [DOI: 10.1016/j.clnu.2016.11.007] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 11/03/2016] [Accepted: 11/03/2016] [Indexed: 12/13/2022]
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Larsen KT, Huang T, Møller NC, Andersen LB, Sørensen J. Cost-effectiveness of a day-camp weight-loss intervention programme for children: Results based on a randomised controlled trial with one-year follow-up. Scand J Public Health 2017; 45:666-674. [PMID: 28758542 DOI: 10.1177/1403494816688374] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS The aim was to analyse the cost-effectiveness of an intensive weight-loss intervention for children compared with a low-intensity intervention. METHODS One hundred and fifteen overweight children (mean age 12.0 ± 0.4) were randomised to either the camp group (CG) ( N=59) or the standard group (SG) ( N=56). Participants in the CG were offered a six-week day-camp weight-loss programme followed by a family-based supportive programme containing four meetings during the succeeding 46 weeks. Participants in the SG were offered a weekly two-hour exercise session for six weeks. Changes in body mass index (BMI) and BMI z-score 12 months after inclusion were used to compare the effects of the two interventions. Incremental cost-effectiveness ratios (ICER) were estimated from the perspective of a Danish municipality. To achieve the required number of participants, an additional intervention was initiated one year later. RESULTS In comparison with the SG, the CG changed their mean BMI by -1.2 (95% CI -1.8 to -0.5). Compared with the SG children, the CG children changed their BMI z-score by -0.20 (95% CI -0.35 to -0.05). The ICER per decreased BMI point in the CG compared with the SG was DDK 24,928. CONCLUSIONS Compared with the SG, the CG showed favourable effects after 12 months. However, the CG was more costly. The results observed in the present study may be helpful in guiding decision makers to take more informed decisions when choosing different types of intervention.
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Affiliation(s)
- Kristian Traberg Larsen
- 1 Centre of Research in Childhood Health (RICH), Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
| | - Tao Huang
- 2 Department of Physical Education, Shanghai Jiao Tong University, China
| | - Niels Christian Møller
- 1 Centre of Research in Childhood Health (RICH), Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
| | - Lars Bo Andersen
- 3 Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Jan Sørensen
- 4 Center for Health Economic Research (COHERE), Department of Public Health, University of Southern Denmark, Denmark
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133
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Wright R, Casamassimo PS. Assessing attitudes and actions of pediatric dentists toward childhood obesity and sugar-sweetened beverages. J Public Health Dent 2017; 77 Suppl 1:S79-S87. [PMID: 28712110 DOI: 10.1111/jphd.12240] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 06/23/2017] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Childhood obesity is a major US health concern, and oral health professionals have opportunities to participate in an interprofessional effort to intervene owing to their access to young patients and their abilities in addressing obesity-related dietary habits like consumption of sugar-sweetened beverages (SSBs). This study determined attitudes, behaviors, future intentions, and perceived barriers of pediatric dentists regarding efforts to prevent childhood obesity and reduce children's consumption of SSBs. METHODS The American Academy of Pediatric Dentistry conducted an online electronic survey with a convenience sample of approximately 7,450 pediatric dentists and pediatric dental residents during spring 2016. RESULTS Over 17 percent of pediatric dentists offer childhood obesity interventions. Of those not providing interventions, 67 percent were interested in offering obesity-prevention services. Nearly 94 percent of pediatric dentists offer information or other interventions on consumption of SSBs. Statistically significant barriers to providing healthy weight interventions were fear of offending parents, appearing judgmental, or creating parent dissatisfaction and a lack of parental acceptance of guidance about weight management from a dentist. Significant barriers to SSB interventions were sufficient time and health professional education. CONCLUSIONS More pediatric dentists stated they offer childhood obesity interventions than in previous surveys reporting 6 percent, but respondents suggested that a child's weight is seen as a medical rather than dental issue. Most pediatric dentists provide interventions related to consumption of SSBs, perceiving the issue as integral to their care of children.
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Affiliation(s)
- Robin Wright
- Pediatric Oral Health Research and Policy Center, American Academy of Pediatric Dentistry, Chicago, Illinois, United States
| | - Paul S Casamassimo
- Pediatric Oral Health Research and Policy Center, American Academy of Pediatric Dentistry, Chicago, Illinois, United States
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134
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Wilson M, Ramsay S, Young KJ. Engaging Overweight Adolescents in a Health and Fitness Program Using Wearable Activity Trackers. J Pediatr Health Care 2017; 31:e25-e34. [PMID: 28501356 DOI: 10.1016/j.pedhc.2017.03.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 03/03/2017] [Accepted: 03/12/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Our objectives were to (a) examine feasibility and receptivity of overweight adolescents joining a community-based group fitness program and (b) test preliminary efficacy of a 12-week pilot intervention designed to promote health, fitness, and self-efficacy for the identified teens. METHODS The 12-week fitness program for overweight adolescents was developed and included planned physical activities, nutrition classes, and goal-setting sessions. A one-group pre-/posttest study design evaluated 20 participants from grades 10 through 12 who enrolled in the program pilot study. Participants were given a wearable activity tracker that captured data using an Internet-based platform. Outcome measures included body mass index, screen time, fitness, and cardiovascular measures. RESULTS A community fitness program for overweight adolescents was successfully implemented. High school students were receptive to the intervention and reported high program satisfaction. Positive effects included measurements of strength, systolic blood pressure, weight, and screen time behaviors. DISCUSSION This study provides evidence to support the feasibility, acceptance, and preliminary effects of the pilot program with overweight adolescents.
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135
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Zahnd WE, Smith T, Ryherd SJ, Cleer M, Rogers V, Steward DE. Implementing a Nutrition and Physical Activity Curriculum in Head Start Through an Academic-Community Partnership. THE JOURNAL OF SCHOOL HEALTH 2017; 87:465-473. [PMID: 28463443 DOI: 10.1111/josh.12515] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 08/25/2016] [Accepted: 01/05/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Schools may be an effective avenue for interventions that prevent childhood obesity. I am Moving I am Learning/Choosy Kids© (IMIL/CK) is a curriculum recommended by Head Start (HS) for education in nutrition, physical activity, and healthy lifestyle habits. METHODS We formed an academic-community partnership (ACP), the Springfield Collaborative for Active Child Health, to promote prevention of childhood obesity, in part, to implement the IMIL/CK curriculum in local HS sites. The ACP included a medical school, HS program, public school district, and state health department. RESULTS Community-based participatory research principles helped identify and organize important implementation activities: community engagement, curriculum support, professional teacher training, and evaluation. IMIL/CK was piloted in 1 school then implemented in all local HS sites. All sites were engaged in IMIL/CK professional teacher training, classroom curriculum delivery, and child physical activity assessments. Local HS policy changed to include IMIL/CK in lesson plans and additional avenues of collaboration were initiated. Furthermore, improvements in physical activity and/or maintenance or improvement of healthy weight prevalence was seen in 4 of the 5 years evaluated. CONCLUSIONS An ACP is an effective vehicle to implement and evaluate childhood obesity prevention programming in HS sites.
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Affiliation(s)
- Whitney E Zahnd
- Center for Clinical Research, Southern Illinois University School of Medicine, PO Box 19664, Springfield, IL 62794-9664
| | - Tracey Smith
- Family & Community Medicine Medical Student Education and Community Outreach; Co-Director, Population Health & Prevention Curriculum; Assistant Professor of Family and Community Medicine, Springfield, IL 62794-9671
| | - Susan J Ryherd
- Center for Clinical Research, Southern Illinois University School of Medicine, Springfield, IL 62794-9664
| | - Melissa Cleer
- Office of Community Health and Service, Southern Illinois University School of Medicine, Springfield, IL 62794-9604
| | - Valerie Rogers
- Springfield Public Schools District 186, 900 West Edwards, Springfield, IL 62704
| | - David E Steward
- Community Health and Service, Office of Community Health and Service, Southern Illinois University School of Medicine, Springfield, IL 62794-9604
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136
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Ulijaszek SJ, Pentecost M, Marcus C, Karpe F, Frühbeck G, Nowicka P. Inequality and childhood overweight and obesity: a commentary. Pediatr Obes 2017; 12:195-202. [PMID: 26990034 DOI: 10.1111/ijpo.12128] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 02/17/2016] [Indexed: 02/02/2023]
Abstract
Statements on childhood overweight and obesity (COO) have focused on different avenues for prevention and treatment, critical stages of the life cycle, including pregnancy and lactation, individual, family, school and community-based interventions, multidisciplinary family programmes and multicomponent interventions. This commentary is concerned with the less-addressed relationship between COO and inequality. It describes current global patterns of inequality and COO and the ways in which those inequalities are linked to COO at micro-level, meso-level and macro-level. It then describes current programmatic approaches for COO inequality, preventive and medical, and considers important pitfalls in the framing of the problem of COO and inequality. It ends with describing how childhood and adolescent overweight and obesity prevention and treatment programmes might be formulated within broader socio-political frameworks to influence outcomes.
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Affiliation(s)
- S J Ulijaszek
- School of Anthropology, University of Oxford, Oxford, UK
| | - M Pentecost
- School of Anthropology, University of Oxford, Oxford, UK
| | - C Marcus
- Karolinska Institutet, Stockholm, Sweden
| | - F Karpe
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - G Frühbeck
- Department of Endocrinology and Nutrition, Clinica Universidad de Navarra, CIBEROBN, IdiSNA, Pamplona, Spain
| | - P Nowicka
- Karolinska Institutet, Stockholm, Sweden.,Department of Food, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
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137
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Bacopoulou F, Landis G, Rentoumis A, Tsitsika A, Efthymiou V. Mediterranean diet decreases adolescent waist circumference. Eur J Clin Invest 2017; 47:447-455. [PMID: 28407234 DOI: 10.1111/eci.12760] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Accepted: 04/10/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND To explore the effects of a multicomponent-multilevel school-based educational intervention on the nutritional habits and abdominal obesity indices of a representative adolescent sample. MATERIALS AND METHODS A representative sample of 1610 adolescents aged 12-17 years in 23 public high schools of three municipalities in the Attica region in Greece participated in a programme funded by the European Union (August 2013-August 2014). Participants underwent dietary assessment with the use of the Mediterranean Diet Quality Index in children and adolescents (KIDMED), blood pressure (BP) assessment and screening for general and abdominal obesity by measuring body mass index, waist circumference (WC) and waist-to-height ratio (WHtR), at baseline and following a 6-month school-based intervention. The intervention involved nutritional education, physical activity and body image awareness using a multilevel approach to the adolescent participants, their parents, school teachers and health staff. RESULTS Analysis included 1032 adolescents (mean age ± SD 14·1 ± 1·6 years). Following intervention, mean KIDMED score ± SD increased significantly from 5·6 ± 2·4 to 5·8 ± 2·4 (P = 0·004). Higher percentage of boys (P = 0·028) and younger adolescents (P < 0·001) had optimal KIDMED scores ≥ 8. Significant decreases were observed in overweight and obesity (P = 0·033), mean systolic (P = 0·049) and diastolic (P < 0·001) BP, WC (P < 0·001) and WHtR (P < 0·001). WC decreased as the KIDMED score increased (P = 0·020). Living with both parents (P = 0·036), higher maternal (P = 0·039) and paternal (P = 0·004) education and having a younger father (P = 0·034) were associated with better adherence to Mediterranean diet, post-intervention. CONCLUSIONS Increased adherence to MD was associated with decreased WC, indicating a potential of multicomponent-multilevel school-based interventions to combat adolescent abdominal obesity.
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Affiliation(s)
- Flora Bacopoulou
- Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, 'Aghia Sophia' Children's Hospital, Athens, Greece
| | - Georgios Landis
- Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, 'Aghia Sophia' Children's Hospital, Athens, Greece
| | - Anastasios Rentoumis
- Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, 'Aghia Sophia' Children's Hospital, Athens, Greece
| | - Artemis Tsitsika
- Adolescent Health Unit, Second Department of Pediatrics, School of Medicine National and Kapodistrian University of Athens, 'P. and A. Kyriakou' Children's Hospital, Athens, Greece
| | - Vasiliki Efthymiou
- Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, 'Aghia Sophia' Children's Hospital, Athens, Greece
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Scherr RE, Linnell JD, Dharmar M, Beccarelli LM, Bergman JJ, Briggs M, Brian KM, Feenstra G, Hillhouse JC, Keen CL, Ontai LL, Schaefer SE, Smith MH, Spezzano T, Steinberg FM, Sutter C, Young HM, Zidenberg-Cherr S. A Multicomponent, School-Based Intervention, the Shaping Healthy Choices Program, Improves Nutrition-Related Outcomes. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2017; 49:368-379.e1. [PMID: 28189500 DOI: 10.1016/j.jneb.2016.12.007] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 12/13/2016] [Accepted: 12/17/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of the Shaping Healthy Choices Program (SHCP). DESIGN A clustered, randomized, controlled intervention lasting 1 school year. SETTING Schools in northern and central California. PARTICIPANTS Fourth-graders (aged 9-10 years) at 2 control schools (n = 179) and 2 intervention schools (n = 230). INTERVENTION Garden-enhanced education, family, and community partnerships; increased regionally procured produce in the lunchroom; and school-site wellness committees. MAIN OUTCOME MEASURES Changes in body mass index (BMI) percentiles/Z-scores; nutrition knowledge, science process skills, and vegetable identification and preferences; and reported fruit and vegetable intake. ANALYSIS Student t test, chi-square, ANOVA of change, and multilevel regression mixed model to evaluate change in outcomes with school as a random effect to account for cluster design effects. Statistical significance was set at P < .05. RESULTS There was a greater improvement in BMI percentile (-6.08; P < 0.01), BMI Z-score (-0.28; P < .001), and waist-to-height ratio (-0.02; P < .001) in the intervention compared with the control schools. CONCLUSIONS AND IMPLICATIONS The SHCP resulted in improvements in nutrition knowledge, vegetable identification, and a significant decrease in BMI percentiles. This supports the concept that the SHCP can be used to improve the health of upper elementary school students.
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Affiliation(s)
- Rachel E Scherr
- Department of Nutrition, University of California, Davis, Davis, CA; Center for Nutrition in Schools, University of California, Davis, Davis, CA
| | | | - Madan Dharmar
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA
| | - Lori M Beccarelli
- Department of Nutrition, University of California, Davis, Davis, CA; Center for Nutrition in Schools, University of California, Davis, Davis, CA
| | | | - Marilyn Briggs
- Department of Nutrition, University of California, Davis, Davis, CA; Center for Nutrition in Schools, University of California, Davis, Davis, CA
| | - Kelley M Brian
- University of California Cooperative Extension, Placer and Nevada Counties, University of California Agriculture and Natural Resources, Auburn, CA; University of California Agriculture and Natural Resources, Davis, CA
| | - Gail Feenstra
- University of California Agriculture and Natural Resources, Davis, CA; Agricultural Sustainability Institute, University of California Sustainable Agriculture Research and Education Program, University of California, Davis, Davis, CA
| | - J Carol Hillhouse
- University of California Agriculture and Natural Resources, Davis, CA; Agricultural Sustainability Institute, University of California Sustainable Agriculture Research and Education Program, University of California, Davis, Davis, CA
| | - Carl L Keen
- Department of Nutrition, University of California, Davis, Davis, CA; University of California Agriculture and Natural Resources, Davis, CA; Department of Internal Medicine, University of California, Davis, Davis, CA
| | - Lenna L Ontai
- University of California Agriculture and Natural Resources, Davis, CA; Department of Human Ecology, University of California, Davis, Davis, CA
| | - Sara E Schaefer
- Foods for Health Institute, University of California, Davis, Davis, CA
| | - Martin H Smith
- University of California Agriculture and Natural Resources, Davis, CA; Department of Human Ecology, University of California, Davis, Davis, CA; Department of Population Health and Reproduction, University of California, Davis, Davis, CA
| | - Theresa Spezzano
- University of California Agriculture and Natural Resources, Davis, CA; University of California Cooperative Extension, Merced and Stanislaus Counties, University of California Agriculture and Natural Resources, Modesto, CA
| | - Francene M Steinberg
- Department of Nutrition, University of California, Davis, Davis, CA; University of California Agriculture and Natural Resources, Davis, CA
| | - Carolyn Sutter
- Department of Human Ecology, University of California, Davis, Davis, CA
| | - Heather M Young
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA
| | - Sheri Zidenberg-Cherr
- Department of Nutrition, University of California, Davis, Davis, CA; Center for Nutrition in Schools, University of California, Davis, Davis, CA; University of California Agriculture and Natural Resources, Davis, CA.
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Markides BR, Crixell SH, Thompson C, Biediger-Friedman L. Staff Workshop Improves Child Care Center Menus in South Central Texas: A Best Food for Families, Infants, and Toddlers (Best Food FITS) Intervention. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2017; 49:435-440.e1. [PMID: 28495041 DOI: 10.1016/j.jneb.2017.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 01/30/2017] [Accepted: 02/05/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To assess the efficacy of an educational workshop for child care center staff to improve menus. METHODS Staff from 18 centers attended a nutrition educational workshop that included an activity that compared center menus to MyPlate standards. Four weeks of menus collected before and after the workshop were imported into SuperTracker; the Food Details report produced menu data clustered by day and center. Changes in pre-post menus were assessed using Healthy Eating Index scores and the SAS software macro, MIXCORR. RESULTS After the workshop, there was a lower probability that fruit juice (P = .03) and starchy vegetables (P = .004) and a higher probability that non-starchy vegetables (P < .001) and whole grains (P = .004) were on menus; amounts of refined grains (P = .004), savory snacks (P < .001), and cheese (P = .004) were significantly lower. Total Healthy Eating Index scores improved after the workshop (P = .009). CONCLUSIONS AND IMPLICATIONS Comparing 4 weeks of menus revealed menu changes. Workshop interventions show promise for improving children's health.
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Affiliation(s)
- Brittany Reese Markides
- Nutrition and Foods, School of Family and Consumer Sciences, Texas State University, San Marcos, TX
| | - Sylvia Hurd Crixell
- Nutrition and Foods, School of Family and Consumer Sciences, Texas State University, San Marcos, TX.
| | - Courtney Thompson
- Nutrition and Foods, School of Family and Consumer Sciences, Texas State University, San Marcos, TX
| | - Lesli Biediger-Friedman
- Nutrition and Foods, School of Family and Consumer Sciences, Texas State University, San Marcos, TX
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140
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Bennett EA, Kolko RP, Chia L, Elliott JP, Kalarchian MA. Treatment of Obesity Among Youth With Intellectual and Developmental Disabilities: An Emerging Role for Telenursing. West J Nurs Res 2017; 39:1008-1027. [PMID: 28349744 DOI: 10.1177/0193945917697664] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Childhood obesity is a serious health issue, associated with medical comorbidity and psychosocial impairment that can persist into adulthood. In the United States, youth with intellectual and developmental disabilities are more likely to be obese than youth without disabilities. A large body of evidence supports the efficacy of family-based treatment of childhood obesity, including diet, physical activity, and behavior modification, but few interventions have been developed and evaluated specifically for this population. We highlight studies on treatment of obesity among youth with intellectual and developmental disabilities, including both residential/educational settings as well as outpatient/hospital settings. All interventions were delivered in-person, and further development of promising approaches and delivery via telenursing may increase access by youth and families. Nursing scientists can assume an important role in overcoming barriers to care for this vulnerable and underserved population.
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141
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Murray M, Dordevic AL, Bonham MP. Systematic Review and Meta-Analysis: The Impact of Multicomponent Weight Management Interventions on Self-Esteem in Overweight and Obese Adolescents. J Pediatr Psychol 2017; 42:379-394. [DOI: 10.1093/jpepsy/jsw101] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 11/30/2016] [Indexed: 11/13/2022] Open
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Styne DM, Arslanian SA, Connor EL, Farooqi IS, Murad MH, Silverstein JH, Yanovski JA. Pediatric Obesity-Assessment, Treatment, and Prevention: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2017; 102:709-757. [PMID: 28359099 PMCID: PMC6283429 DOI: 10.1210/jc.2016-2573] [Citation(s) in RCA: 636] [Impact Index Per Article: 90.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 11/10/2016] [Indexed: 02/06/2023]
Abstract
COSPONSORING ASSOCIATIONS The European Society of Endocrinology and the Pediatric Endocrine Society. This guideline was funded by the Endocrine Society. OBJECTIVE To formulate clinical practice guidelines for the assessment, treatment, and prevention of pediatric obesity. PARTICIPANTS The participants include an Endocrine Society-appointed Task Force of 6 experts, a methodologist, and a medical writer. EVIDENCE This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation approach to describe the strength of recommendations and the quality of evidence. The Task Force commissioned 2 systematic reviews and used the best available evidence from other published systematic reviews and individual studies. CONSENSUS PROCESS One group meeting, several conference calls, and e-mail communications enabled consensus. Endocrine Society committees and members and co-sponsoring organizations reviewed and commented on preliminary drafts of this guideline. CONCLUSION Pediatric obesity remains an ongoing serious international health concern affecting ∼17% of US children and adolescents, threatening their adult health and longevity. Pediatric obesity has its basis in genetic susceptibilities influenced by a permissive environment starting in utero and extending through childhood and adolescence. Endocrine etiologies for obesity are rare and usually are accompanied by attenuated growth patterns. Pediatric comorbidities are common and long-term health complications often result; screening for comorbidities of obesity should be applied in a hierarchal, logical manner for early identification before more serious complications result. Genetic screening for rare syndromes is indicated only in the presence of specific historical or physical features. The psychological toll of pediatric obesity on the individual and family necessitates screening for mental health issues and counseling as indicated. The prevention of pediatric obesity by promoting healthful diet, activity, and environment should be a primary goal, as achieving effective, long-lasting results with lifestyle modification once obesity occurs is difficult. Although some behavioral and pharmacotherapy studies report modest success, additional research into accessible and effective methods for preventing and treating pediatric obesity is needed. The use of weight loss medications during childhood and adolescence should be restricted to clinical trials. Increasing evidence demonstrates the effectiveness of bariatric surgery in the most seriously affected mature teenagers who have failed lifestyle modification, but the use of surgery requires experienced teams with resources for long-term follow-up. Adolescents undergoing lifestyle therapy, medication regimens, or bariatric surgery for obesity will need cohesive planning to help them effectively transition to adult care, with continued necessary monitoring, support, and intervention. Transition programs for obesity are an uncharted area requiring further research for efficacy. Despite a significant increase in research on pediatric obesity since the initial publication of these guidelines 8 years ago, further study is needed of the genetic and biological factors that increase the risk of weight gain and influence the response to therapeutic interventions. Also needed are more studies to better understand the genetic and biological factors that cause an obese individual to manifest one comorbidity vs another or to be free of comorbidities. Furthermore, continued investigation into the most effective methods of preventing and treating obesity and into methods for changing environmental and economic factors that will lead to worldwide cultural changes in diet and activity should be priorities. Particular attention to determining ways to effect systemic changes in food environments and total daily mobility, as well as methods for sustaining healthy body mass index changes, is of importance.
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Affiliation(s)
- Dennis M Styne
- University of California Davis, Sacramento, California 95817
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143
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Davis RE, Cole SM, McKenney-Shubert SJ, Jones SJ, Peterson KE. An Exploration of How Mexican American WIC Mothers Obtain Information About Behaviors Associated With Childhood Obesity Risk. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2017; 49:187-195.e1. [PMID: 27876321 PMCID: PMC5346458 DOI: 10.1016/j.jneb.2016.10.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 09/24/2016] [Accepted: 10/02/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To explore how a sample of Mexican American mothers with preschool-aged children recruited from a Midwestern Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinic obtained information about 4 behaviors associated with childhood obesity risk: eating, physical activity, screen time, and sleep. DESIGN One-on-one structured interviews in which participants were asked how they communicated with family, learned to take care of their first infant, and obtained information about the 4 targeted behaviors for their preschool-aged child. SETTING An urban WIC clinic in the Midwest. PARTICIPANTS Forty Mexican-descent mothers enrolled in WIC with children aged 3-4 years. PHENOMENON OF INTEREST Exposure to information about the 4 targeted behaviors among Mexican-descent mothers participating in WIC. ANALYSIS Quantitative and qualitative data were used to characterize and compare across participants. RESULTS Participants primarily obtained information from their child's maternal grandmother during their first child's infancy and from health professionals for their preschool-aged child. Participants typically obtained information through interpersonal communication, television, and magazines. Participants were most interested in healthy eating information and least interested in screen time information. Some participants did not seek information. CONCLUSIONS AND IMPLICATIONS Participants engaged in different patterns of information seeking across their child's development and the 4 behaviors, which suggests that future research should be behaviorally specific. Findings from this study suggest several hypotheses to test in future research.
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Affiliation(s)
- Rachel E Davis
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC.
| | - Suzanne M Cole
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI
| | | | - Sonya J Jones
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Karen E Peterson
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI; Center for Human Growth and Development, University of Michigan, Ann Arbor, MI
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Grugni G, Licenziati MR, Valerio G, Crinò A, Maffeis C, Tanas R, Morino GS. The rehabilitation of children and adolescents with severe or medically complicated obesity: an ISPED expert opinion document. Eat Weight Disord 2017; 22:3-12. [PMID: 27585923 DOI: 10.1007/s40519-016-0305-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Accepted: 07/14/2016] [Indexed: 11/28/2022] Open
Abstract
Severe/medically complicated obesity in childhood, and particularly in adolescence, is a real disability that requires an intensive and continuous approach which should follow the procedures and schedule of rehabilitation medicine. Given the lack of a specific document focusing on children and adolescents, the Childhood Obesity Study Group set out to explore the available evidence for the treatment of severe or medically complicated obesity and to set standards tailored to the specific context of the Italian Health Service. Through a series of meetings and electronic communications, the writing committee (selected from members of the Study Group) selected the key issues, explored the literature and produced a draft document which was submitted to the other experts until the final synthesis was approved by the group. In brief, the following issues were involved: (1) definition and epidemiology; (2) identification of common goals designed to regain functional competence and limit the progression of metabolic and psychological complications; (3) a multi-professional team approach; (4) the care setting. This paper is an expert opinion document on the rehabilitation of severe and medically complicated obesity in children and adolescents produced by experts belonging to the Childhood Obesity Study Group of the Italian Society for Pediatric Endocrinology and Diabetology (ISPED).
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Affiliation(s)
- Graziano Grugni
- Division of Auxology, Italian Auxological Institute, Verbania, Italy
| | | | - Giuliana Valerio
- Department of Movement Sciences and Wellness, Parthenope University, Naples, Italy
| | - Antonino Crinò
- Autoimmune Endocrine Diseases Unit Bambino Gesù Hospital, Research Hospital Palidoro, Rome, Italy
| | - Claudio Maffeis
- Pediatric Diabetes and Metabolic Disorders Unit, Department of Life and Reproduction Sciences, University of Verona, Verona, Italy
| | - Rita Tanas
- Pediatric Unit, Azienda Ospedaliera Universitaria, Ferrara, Italy
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145
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Winkler MR, Moore ED, Bennett GG, Armstrong SC, Brandon DH. Parent-adolescent influences on everyday dietary practices: Perceptions of adolescent females with obesity and their mothers. MATERNAL AND CHILD NUTRITION 2017; 13. [PMID: 28097807 DOI: 10.1111/mcn.12416] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 11/08/2016] [Accepted: 11/15/2016] [Indexed: 11/29/2022]
Abstract
Parents demonstrate an important influence on adolescent obesity and dietary behavior; yet, family-based obesity interventions continue to exhibit limited success among adolescents. To further inform family-based approaches for adolescent obesity treatment, we examined the perceptions of adolescent females with obesity and their mothers of the influences experienced within the parent-adolescent relationship that affect everyday dietary practices. We conducted six focus group interviews (three adolescent female and three mother) among 15 adolescent (12-17 years old) females with obesity and 12 of their mothers. Content analysis techniques were used to analyze the transcribed interviews. Adolescent females with obesity discussed a diverse set of parental influences (controlling, supporting and cultivating, overlooking and tempting, acquiescing, providing, attending, and not providing and avoiding) on their daily dietary practices. Among mother focus groups, mothers discussed specific intentional and unintentional types of influences from children that affected the food and drink they consumed, prepared, and acquired. Findings provide a fuller view of the varied social influences on everyday dietary practices within the parent-adolescent relationship. They indicate the importance of examining both parent-to-child and child-to-parent influences and begin to illuminate the value of attending to the social circumstances surrounding dietary behaviors to strengthen family-based obesity treatment approaches.
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Affiliation(s)
- Megan R Winkler
- School of Nursing, Duke University, Durham, North Carolina, USA
| | | | - Gary G Bennett
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA.,Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | | | - Debra H Brandon
- School of Nursing, Duke University, Durham, North Carolina, USA.,School of Medicine, Duke University, Durham, North Carolina, USA
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146
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Larson N, Miller JM, Eisenberg ME, Watts AW, Story M, Neumark-Sztainer D. Multicontextual correlates of energy-dense, nutrient-poor snack food consumption by adolescents. Appetite 2017; 112:23-34. [PMID: 28082196 DOI: 10.1016/j.appet.2017.01.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 12/07/2016] [Accepted: 01/08/2017] [Indexed: 11/24/2022]
Abstract
Frequent consumption of energy-dense, nutrient-poor snack foods is an eating behavior of public health concern. This study was designed to inform strategies for reducing adolescent intake of energy-dense snack foods by identifying individual and environmental influences. Surveys were completed in 2009-2010 by 2540 adolescents (54% females, mean age = 14.5 ± 2.0, 80% nonwhite) in Minneapolis-St. Paul, Minnesota schools. Daily servings of energy-dense snack food was assessed using a food frequency questionnaire that asked about consumption of 21 common snack food items, such as potato chips, cookies, and candy. Data representing characteristics of adolescents' environments were collected from parents/caregivers, friends, school personnel, Geographic Information System sources, and a content analysis of favorite television shows. Linear regression was used to examine relationships between each individual or environmental characteristic and snack food consumption in separate models and also to examine relationships in a model including all of the characteristics simultaneously. The factors found to be significantly associated with higher energy-dense snack food intake represented individual attitudes/behaviors (e.g., snacking while watching television) and characteristics of home/family (e.g., home unhealthy food availability), peer (friends' energy-dense snack food consumption), and school (e.g., student snack consumption norms) environments. In total, 25.5% of the variance in adolescents' energy-dense snack food consumption was explained when factors from within each context were examined together. The results suggest that the design of interventions targeting improvement in the dietary quality of adolescents' snack food choices should address relevant individual factors (e.g., eating while watching television) along with characteristics of their home/family (e.g., limiting the availability of unhealthy foods), peer (e.g., guiding the efforts of a peer leader in making healthy choices), and school environments (e.g., establishing student norms for selecting nutrient-dense snack foods).
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Affiliation(s)
- Nicole Larson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, United States.
| | - Jonathan M Miller
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, United States.
| | - Marla E Eisenberg
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN 55414, United States.
| | - Allison W Watts
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, United States.
| | - Mary Story
- Global Health and Community and Family Medicine, Duke Global Health Institute, Duke University, 112 Trent Hall, 310 Trent Drive, Box 90519, Durham, NC 27708, United States.
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, United States.
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Savoie-Roskos MR, Wengreen H, Durward C. Increasing Fruit and Vegetable Intake among Children and Youth through Gardening-Based Interventions: A Systematic Review. J Acad Nutr Diet 2016; 117:240-250. [PMID: 27964852 DOI: 10.1016/j.jand.2016.10.014] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 10/12/2016] [Indexed: 11/28/2022]
Abstract
Although there are numerous health benefits associated with eating fruit and vegetables (F/V), few children are consuming recommended amounts. Gardening interventions have been implemented in various settings in an effort to increase children's F/V consumption by expanding knowledge, exposure, and preferences for a variety of F/V. The purpose of this review was to identify the effectiveness of gardening interventions that have been implemented to increase F/V consumption among children. A systematic review was conducted using four electronic databases: Web of Science, PubMed, Scopus, and the Cumulative Index to Nursing and Allied Health Literature. English language studies conducted in developed countries between January 2005 and October 2015 were included in this review. Included studies measured F/V consumption among children aged 2 to 15 years before and after implementation of a gardening intervention in a school, community, or afterschool setting. All study designs were included in this review. A total of 891 articles were identified through database searching and cross-referencing. After removing duplicates, 650 articles remained and were screened using inclusion and exclusion criteria. Twenty-seven full-text articles were analyzed and 14 articles were included in this review. Of the 14 articles reviewed, 10 articles found statistically significant increases in fruit or vegetable consumption among participants after implementation of a gardening intervention. However, many studies were limited by the use of convenience samples, small sample sizes, and self-reported measurements of F/V consumption. Although the evidence is mixed and fraught with limitations, most studies suggest a small but positive influence of gardening interventions on children's F/V intake. Future studies that include control groups, randomized designs, and assessments of F/V consumption over at least 1 year are needed to advance the literature on this topic.
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Knight KB, W. Cole J, M. Dodd L, B. Oakley C. Eating Good and Moving Like We Should: A Consideration for Registered Dietitians in Schools. INTERNATIONAL JOURNAL OF SCHOOL HEALTH 2016. [DOI: 10.17795/intjsh-43043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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149
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The knowledge of Polish primary care physicians about bariatric surgery. Wideochir Inne Tech Maloinwazyjne 2016; 11:164-170. [PMID: 27829939 PMCID: PMC5095277 DOI: 10.5114/wiitm.2016.62446] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 08/24/2016] [Indexed: 11/17/2022] Open
Abstract
Introduction The general practitioner (GP) can play a key role in this multi-disciplinary team, coordinating care provided by dietitians and surgeons, maximizing the potential benefits of surgery. Therefore, it seems important to verify changes in GPs’ knowledge about surgical treatment of obesity. Aim To reassess knowledge of obesity surgical treatment among Polish primary care physicians and their willingness to improve it in the future. Material and methods To assess the knowledge of Polish primary care physicians about surgical treatment of obesity, a prospective study, which included an anonymous online questionnaire, was conducted in the years 2015–2016. Results Two hundred and six physicians answered the invitation. One hundred and sixty-six (81.8%) respondents were familiar with the indications for bariatric operation. The great majority of respondents, 198 (96.6%), were aware that bariatric surgery is efficient in the treatment of the metabolic syndrome. The study revealed a disproportion between the number of patients who would be potential candidates for bariatric treatment, who are currently under care of participating physicians, and the number of patients who are referred to a bariatric surgeon. Conclusions Our study demonstrates that nowadays bariatric surgery is a recognized method of treatment, but physicians remain reluctant to refer their patients for surgical treatment of obesity. It was found that there is a large disproportion between the number of patients who are referred to a bariatric surgeon and the number of patients who require this treatment. It may be a result of lack of knowledge in the field of bariatric surgery.
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150
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Abstract
OBJECTIVE Although research studies increasingly use children as primary reporters in dietary assessments, it is unclear how well children's self-reported intake correlates with independently validated reports of their intake; this meta-analysis assesses that correlation. DESIGN Moderators of the correlation between self-reported and independently validated intake were predicted a priori: type of dietary intake assessment (24 h recall, food diary and food frequency questionnaires), validation measures, parental assistance and age. Online databases were searched for articles published from 1990 to 2014 that compared children's self-reports of dietary intake to validated observations of food intake in children age 4-16. MAIN OUTCOME MEASURES Summary effect size Pearson r between children's self-reported dietary intake and independently validated dietary intake were calculated. RESULTS In k = 32 samples from 23 studies, a statistically significant correlation (r = .48, Z = 7.26, p < .001) was found between children's self-reported dietary intake and independently validated reports of dietary intake. Validation method (Q = 17.49, df = 2, p < .001) and parental assistance (Z = 2.03, p = .042) were significant moderators of this correlation. Self-report methodology (Q = 3.95, df = 2, p = .139) and age (Q = .02, p = .879) were not significant moderators of the distribution of effect sizes. CONCLUSION Together, these results provide baseline information about children's recall in dietary intake assessments conducted with children as primary reporters.
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Affiliation(s)
- Brittany Merson
- a Department of Psychology , Claremont Graduate University , Claremont , CA , USA
| | - Kathy Pezdek
- a Department of Psychology , Claremont Graduate University , Claremont , CA , USA
| | - Karen Saywitz
- b Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine , UCLA , Los Angeles , CA , USA
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