Gendered dimensions of obesity in childhood and adolescence

Psychiatric comorbidity in childhood and adolescence headache

Primary headaches among children and adolescents have a substantial impact on quality of life, daily activities, social interaction, and school performance in combination with psychopathological symptoms. The main purpose of the present paper is to summarize clinical and epidemiological evidence for psychiatric comorbidity among children and adolescents with headaches, to describe how evidence in headache research suggest different pathways involved in the development and maintenance of these comorbid conditions, and finally suggest some elements professionals may find helpful to assess the scope of complaints, related functional impairment, and potential precipitating factors in planning of more targeted treatments.

Exploring the role of gender norms in nutrition and sexual health promotion in a piloted school-based intervention: The Philadelphia Ujima™ experience

Perceptions of masculinity and femininity influence behaviors and can be identified in young children and adolescents (Brannon, 2004). Thus, adolescents' engagement in health risk or promoting behaviors is influenced by perceptions of masculinity and femininity and the differences in expectations, norms and responsibilities for girls and boys (WHO, 2007). Girls and boys have different needs, and gender-based interventions that consider similarities as well as differences are needed. A gender-based nutrition and sexual health promotion program was developed and piloted by the Philadelphia Ujima Coalition in a high school setting. To explore the gender differences in adolescents' perceptions of the influence of gender norms on weight, nutrition, physical activity, and sexual health and the implication of these differences in future gender-integrated health promotion programming for youth, a content analysis of student and facilitator debriefing forms were implemented for the participating schools. The content analysis was used to identify central themes, concepts gained, and overall impact of the intervention sessions. Overall, gender norms influence healthy eating practices and activity through influencing perceptions of body type in adolescents. Gender norms also influence sexual activity and decision making through influencing perceptions of beauty, masculinity, femininity, pressures and popular concepts related to sexual activity. Thus, interventions that address gender may more effectively promote health and wellness in adolescents.

Comparison of Methods for the Measurement of Body Composition in Overweight and Obese Brazilian Children and Adolescents before and after a Lifestyle Modification Program

Aim: To compare the body composition of overweight children and adolescents by bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA) before and after physical activity program. Methods: One hundred and eleven patients with mean age (SD) of 12 (1.9) participated in the study. We assessed the weight, height, waist circumference (WC), and body composition by DXA and BIA. Patients underwent a program of diet and physical activity (1 h 30 min/day, 3 times a week for 3 months) and were evaluated before and after this period. Results: Mean initial zBMI were 2.3 (0.5) and waist SDS 5.9 (1.8). Significant differences were observed when we compared the measurements taken by DXA and BIA, respectively: total body fat percentage (40 and 31.5) and fat-free mass (43.1 and 50.6 kg). Regarding the trunk fat by DXA, there was a positive correlation with the WC/height ratio (r = 0.65; p < 0.01). After the intervention period, we observed a reduction in the zBMI, waist SDS, and total body fat and increase of fat-free mass by DXA. BIA only detected reduction in fat. Conclusion: BIA underestimates the percentage of fat and overestimates fat-free mass in relation to DXA. There is positive correlation between trunk fat and the ratio WC/height. In addition, DXA detected changes in body composition induced by a short period of physical training, unlike BIA. © 2014 S. Karger AG, Basel

Prevalence of overweight, obesity, and abdominal obesity among urban Saudi adolescents: gender and regional variations

The nutrition transition with associated lifestyle-related non-communicable diseases has rapidly reached many developing countries, including Saudi Arabia. Therefore, the objective of this study was to examine the prevalence of overweight, obesity, and abdominal obesity among Saudi adolescents. This school-based multicentre cross-sectional study was conducted during 2009-2010 in three major cities in Saudi Arabia: Al-Khobar, Jeddah, and Riyadh. Participants included 2,908 students of secondary schools (1,401 males and 1,507 females) aged 14 to 19 years, randomly selected using a multistage stratified cluster-sampling technique. Weight, height, and waist-circumference were measured; prevalence of overweight and obes- ity was determined using age- and sex-specific BMI cutoff reference standards of the International Obesity Task Force (IOTF). Abdominal obesity was determined using waist-to-height ratio (WHtR) cutoffs (above 0.5). The prevalence of overweight was 19.5% in males and 20.8% in females while that of obesity was 24.1% in males and 14% in females. The prevalence of abdominal obesity in males and females was 35.9% and 30.3% respectively. Higher prevalence of obesity was observed among adolescents in private schools. Across all ages, overweight and obesity ranged from 39.9% to 45.6% in males and from 30.4% to 38.7% in females. ANCOVA, controlling for age, showed significant interaction effects (city by gender). It is concluded that the proportions of overweight, obesity, and abdominal obesity, observed among Saudi adolescents were remarkably high. Such high prevalence of overweight and obesity is a major public-health concern.

Interpersonal violence and overweight in adolescents: the HUNT Study

AIMS

Overweight and obesity in children and adolescents are major public health challenges associated with psychosocial adversity and unfavourable lifestyle. Exposure to interpersonal violence, such as sexual abuse, violence and bullying, could represent precursors, accelerating or sustaining factors.

METHODS

The Young-HUNT 3 study, 2006-2008, is a population-based, cross-sectional, cohort study of Norwegian youth that includes self-report data on exposure to interpersonal violence; pubertal status and timing; socioeconomic, psychosocial, and lifestyle factors; and clinical anthropometric measures. A cohort of 10,464 adolescents aged 12-20 years from Nord-Trøndelag County were invited to participate. Body mass index served as the outcome in the simple and multiple linear regression analyses.

RESULTS

The response rate was 72.3% (7564), and 49.9% (3777) of the respondents were girls. A robust and significant relationship between interpersonal violence and increased BMI for both genders was found. Importantly, interpersonal violence remained significantly correlated with higher BMI following adjustment for pubertal development, socioeconomic and psychosocial adversity and unfavourable lifestyle factors in both genders, although most evident in girls. Adjusted regression coefficients (95% confidence intervals) for the relationship between interpersonal violence and BMI were 0.33 (0.01, 0.65) for 1 type and 0.89 (0.37, 1.41) for 2 types, compared to no exposure in girls, and 0.40 (0.09, 0.71) for 1 type and 0.35 (-0.09, 0.79) for 2 types of interpersonal violence in boys.

CONCLUSIONS

The empirical evidence of consistent associations between interpersonal violence, related psychosocial and lifestyle factors, and body fatness, indicates that these features play important roles for adolescents struggling with overweight.

Insulin resistance in obese children and adolescents

OBJECTIVE

To evaluate the presence of insulin resistance and its association with other metabolic abnormalities in obese children and adolescents.

METHODS

Retrospective study of 220 children and adolescents aged 5-14 years. Anthropometric measurements were performed (weight, height, and waist circumference) and clinical (gender, age, pubertal stage, and degree of obesity) and biochemical (glucose, insulin, total cholesterol, and fractions, triglycerides) data were analyzed. Insulin resistance was identified by the homeostasis model assessment for insulin resistance (HOMA-IR) index. The analysis of the differences between the variables of interest and the HOMA-IR quartiles was performed by ANOVA or Kruskal-Wallis tests.

RESULTS

Insulin resistance was diagnosed in 33.20% of the sample. It was associated with low levels of high-density lipoprotein cholesterol (HDL-C; p=0.044), waist circumference measurement (p=0.030), and the set of clinical and metabolic (p=0.000) alterations. Insulin-resistant individuals had higher mean age (p=0.000), body mass index (BMI; p=0.000), abdominal circumference (p=0.000), median triglycerides (p=0.001), total cholesterol (p≤0.042), and low-density lipoprotein cholesterol (LDL-C; p≤0.027); and lower HDL-C levels (p=0.005). There was an increase in mean BMI (p=0.000), abdominal circumference (p=0.000), and median triglycerides (p=0.002) as the values of HOMA -IR increased, with the exception of HDL-C, which decreased (p=0.001). Those with the highest number of simultaneous alterations were between the second and third quartiles of the HOMA-IR index (p=0.000).

CONCLUSION

The results confirmed that insulin resistance is present in many obese children and adolescents, and that this condition is associated with alterations that represent an increased risk for developing metabolic disorders in adulthood.

Drivers of overweight mothers' food choice behaviors depend on child gender

BACKGROUND

National data suggest a higher prevalence of obesity among boys. One possible cause could be the food choices made by parents on behalf of their children.

OBJECTIVES

This study sought to determine whether and how mothers' food choices for their children differ by child gender and to understand the drivers of these differences.

DESIGN

Data were analyzed from a randomized controlled trial conducted using a virtual reality-based buffet restaurant. Overweight mothers filled out questionnaires and received an information module. They were then immersed in a virtual buffet restaurant to select a lunch for their 4- to 5-year-old child.

RESULTS

Of the 221 overweight mothers recruited, 55% identified their daughters as the child for whom they would be choosing the food. The caloric content of boys' meals was 43 calories higher than girls' (p = .015). This difference was due to extra calories from the less healthy food category (p = .04). Multivariate analyses identified more predictors of calorie choices for daughters' than sons' meals. Predictors of calories chosen for girls included: having both biological parents overweight (β = 0.26; p = .003), mother's weight (β = 0.17; p = .05), mother's education (β = -0.28; p = .001), her restriction of her child's food intake (β = -0.20; p = .02), and her beliefs about the importance of genetics in causing obesity (β = 0.19; p = .03). Mother's weight was the sole predictor of boys' meal calories (β = 0.20; p = .04).

CONCLUSIONS

Differences in dietary choices made for young girls and boys may contribute to lifelong gender differences in eating patterns. A better understanding of differences in feeding choices made for girls versus boys could improve the design of childhood obesity prevention interventions.

Association of sexual maturation with excess body weight and height in children and adolescents

BACKGROUND

Studies addressing the influence of early sexual maturation on the excess of body weight and height of children and adolescents are scarce. The aim of the study was to analyze the association of sexual maturation with excess body weight and height in children and adolescents.

METHODS

This was a cross-sectional study performed in Florianópolis city, Brazil, in 2007, with 2339 school children, aged 8-14 years (1107 males). Selection was based on a probabilistic, cluster-stratified sampling technique. School children were classified according to the presence of excess body weight, using sex- and age-specific body mass index (BMI) cutoff points. Z-scores were calculated from height and BMI data. Sexual maturation was self-assessed according to Tanner stages of development. Subjects were ranked based on tertiles of sexual maturation (early, normal and late) for each stage of development. Poisson and linear regression models were used.

RESULTS

Compared to the reference group (normal sexual maturation), early maturing females had higher prevalence of excess weight (adjusted prevalence ratio: 1.70; 95% CI: 1.24 to 2.33) and increased height-for-age (adjusted β: 0.37; 95% CI: 0.14 to 0.59), while late maturing females had lower prevalence of excess weight (adjusted prevalence ratio: 0.57; 95% CI: 0.37 to 0.87) and decreased height-for-age (adjusted β: -0.38; 95% CI: -0.56 to -0.20). In males, early and late sexual maturation were associated with increased (adjusted β: 0.37; 95% CI: 0.14 to 0.59) and decreased (adjusted β: -0.38; 95% CI: -0.56 to -0.20) height-for-age, respectively.

CONCLUSION

Early sexual maturation is associated with excess body weight in females and with greater height-for-age in both sexes.

Participation in community-originated interventions is associated with positive changes in weight status and health behaviors in youth

PURPOSE

To assess changes in children's health behaviors and weight status after participation in community-originated interventions.

DESIGN

Prospective cohort study following body mass index (BMI) z-score trajectory over time.

SETTING

Schools and community settings in 19 locations in North Carolina.

SUBJECTS

A total of 1144 children, with an average age of 9.5 years, participating in community-originated physical activity and nutrition interventions, such as active recess and healthy cafeteria offerings, and environment and policy changes designed to prevent and reduce the prevalence of childhood obesity. Retention from baseline to final collection was 54%. Measures . Self-reported physical activity and eating behaviors; measured height and weight were collected at baseline and after interventions (average of 20 months). Z-score was compared with expected growth without intervention.

ANALYSIS

Descriptive statistics, χ(2) tests and t-tests, and ANOVA analyses of variance to assess changes in health behaviors and weight status.

RESULTS

More than 11% of children improved their weight status, and 86% of children who began at a healthy weight remained there. The average BMI for children who were overweight at enrollment was significantly lower after intervention (1.1 kg/m(2) lower for boys and 0.88 kg/m(2) lower for girls). Overweight and obese children who made improvements in key health behaviors showed greater decreases in BMI z-score than those who did not improve those behaviors (increased fruit [-.2207 vs. -.0793] and vegetable [-.2215 vs. -.0855] intake, and drinking less soda [-.1985 vs. -.0912]). There were no significant increases in physical activity, and changes in physical activity were not related to decreases in BMI z-score in this study.

CONCLUSION

Community-originated interventions to raise awareness about food choices and to change policies and environments may improve BMI z-scores.

School and neighborhood nutrition environment and their association with students' nutrition behaviors and weight status in Seoul, South Korea

PURPOSE

We examined the association between the school and neighborhood nutrition environments and adolescent nutrition behaviors and weight status.

METHODS

We conducted a cross-sectional survey with 1,342 fourth to ninth graders in 15 schools on their food-eating behaviors. Participants were randomly selected from eight predetermined districts in Seoul, South Korea. Height and weight data from the school annual health check-ups were obtained. Dietitians from each school completed questionnaires on the school nutrition environment. Types of food outlets in a 500-meter radius of the schools were recorded. Healthy eating index was created based on 10 questions on students' eating behaviors, such as breakfast skipping, fruit consumption, and ramen noodle consumption (possible score range 0-10). Generalized estimating equation method was used for statistical modeling.

RESULTS

Higher density of supermarkets and traditional markets in the school neighborhoods was associated with a greater likelihood of child obesity after controlling for individual-level covariates (odds ratio = 1.37, 1.21-1.54). The school nutrition environment was not associated with student's healthy eating habits and weight status. Students who were younger, female, from more affluent families, who had less weekly screen time, or had stay-at-home mothers had higher scores on the healthy eating index. There was a gender difference in the associations between environmental factors and students' eating behaviors and obesity status.

CONCLUSIONS

These findings suggest that the relationship between environmental factors and individual factors and weight status may be more complicated than previously reported in other parts of the world.

The effect of the degree of disability on nutritional status and flat feet in adolescents with Down syndrome

Excessive weight and obesity are ranked among lifestyle diseases. In the case of weight gain, the effectiveness of therapy based on diet and physical activity depends considerably on patients themselves, but despite this the number of those who successfully manage to lose weight is still not satisfactory. Preventing or treating excessive weight gain in the intellectually disabled is extremely difficult since they have a higher risk for developing obesity. The below presented study assessed the effect of the degree of intellectual disability on nutritional status in adolescents with Down syndrome. It also focused on some correlations between the degree of disability and a selected constituent of the body posture, i.e. flat feet. A total of 54 males and 26 females with mild and moderate Down syndrome, aged 18.68 ± 1.73, residents of Special Needs Education Centre in Tarnów, Poland, participated in the study, in which body weight and height, BMI, fat tissue percentage and the longitudinal arch of the foot were measured. A total of 17.5% of individuals with mild and 50% of individuals with moderate ID were found overweight or obese. Weight gain more often occurred in females. It seemed that flat feet were affected to a greater extent by the participants' nutritional status than their degree of disability. The study found no unambiguous effect of the degree of disability on the nutritional status and flat feet in individuals with Down syndrome.

Impact of a nurse-directed, coordinated school health program to enhance physical activity behaviors and reduce body mass index among minority children: a parallel-group, randomized control trial

BACKGROUND

Underserved children, particularly girls and those in urban communities, do not meet the recommended physical activity guidelines (>60min of daily physical activity), and this behavior can lead to obesity. The school years are known to be a critical period in the life course for shaping attitudes and behaviors. Children look to schools for much of their access to physical activity. Thus, through the provision of appropriate physical activity programs, schools have the power to influence apt physical activity choices, especially for underserved children where disparities in obesity-related outcomes exist.

OBJECTIVES

To evaluate the impact of a nurse directed, coordinated, culturally sensitive, school-based, family-centered lifestyle program on activity behaviors and body mass index.

DESIGN, SETTINGS AND PARTICIPANTS

This was a parallel group, randomized controlled trial utilizing a community-based participatory research approach, through a partnership with a University and 5 community schools. Participants included 251 children ages 8-12 from elementary schools in urban, low-income neighborhoods in Los Angeles, USA.

METHODS

The intervention included Kids N Fitness(©), a 6-week program which met weekly to provide 45min of structured physical activity and a 45min nutrition education class for parents and children. Intervention sites also participated in school-wide wellness activities, including health and counseling services, staff professional development in health promotion, parental education newsletters, and wellness policies for the provision of healthy foods at the school. The Child and Adolescent Trial for Cardiovascular Health School Physical Activity and Nutrition Student Questionnaire measured physical activity behavior, including: daily physical activity, participation in team sports, attending physical education class, and TV viewing/computer game playing. Anthropometric measures included height, weight, body mass index, resting blood pressure, and waist circumference. Measures were collected at baseline, completion of the intervention phase (4 months), and 12 months post-intervention.

RESULTS

Significant results for students in the intervention, included for boys decreases in TV viewing; and girls increases in daily physical activity, physical education class attendance, and decreases in body mass index z-scores from baseline to the 12 month follow-up.

CONCLUSIONS

Our study shows the value of utilizing nurses to implement a culturally sensitive, coordinated, intervention to decrease disparities in activity and TV viewing among underserved girls and boys.

Age and menarcheal status do not influence metabolic response to aerobic training in overweight girls

BACKGROUND

Multidisciplinary intervention is an alternative for the treatment of children and adolescent obese. However, the influence of age and menarcheal status in the pattern of metabolic response of obese girls has not been investigated. The following study examined the effects of a 12-week multidisciplinary intervention on metabolic health in overweight girls and the contribution of age and menarcheal status on the resulting changes.

METHODS

Eighty-eight overweight girls (10 - 16 years) were considered initially for this study and randomly assigned (intervention group: n = 58; control group: n = 30). Forty-six girls completed the intervention program and 16 girls completed the follow-up for the control group. The 12-week intervention included aerobic exercises (three times per week) and nutritional intervention. Anthropometrical measures (body mass, body mass index and waist circumference), menarcheal status and metabolic profiles including glucose, insulin, triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were assessed in the beginning and after of intervention. Additionally, were calculated homeostatic model assessment-insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI).

RESULTS

After 12-week, girls decreased significantly the body mass (76.6 ± 14.7 to 75.7 ± 14.6 kg) body mass index (30.1 ± 4.0 to 29.4 ± 4.0 kg/m2) and waist circumference (98.9 ± 10.9 to 96.5 ± 11.4 cm). There were differences in HDL-C (43.1 ± 8.2 to 50.3 ± 9.4 mg/dl), TG (120.9 ± 64.3 to 93.3 ± 47.9 mg/dl) and insulin (16.9 ± 7.6 to 15.6 ± 9.8 mg/dl). Relative contribution of age was significant only for within-subject variability in waist circumference.

CONCLUSIONS

The multidisciplinary based on aerobic training intervention used in this study produced substantial benefits on metabolic health indicators in overweight girls. The changes observed were not related to inter-individual variability in age and maturity status.

Further increase of obesity prevalence in Chinese children and adolescents--cross-sectional data of two consecutive samples from the city of Shanghai from 2003 to 2008

OBJECTIVE

Putative changes in the prevalence of obesity in Chinese children and adolescents in Shanghai, one of the most urbanized areas in China, were analyzed in a cross-sectional manner in 2003-2008.

METHODS

One urban and one suburban district were randomly selected. 70,582 students in 2003 and 86,355 students in 2008 from schools from within the two districts were examined. Anthropometric parameters were measured in all. Adiposity status was estimated using body mass index according to International Obesity Task Force standards. The prevalence of obesity was analyzed.

RESULTS

The standardized prevalence of overweight significantly increased from 12.75 to 14.2% (p < 0.01), and the prevalence of obesity significantly increased from 3.35 to 3.94% (p < 0.01) during the study period. In contrast to data from developed countries, the prevalence of obesity decreased with age in both boys and girls. The prevalence of obesity and overweight in boys was significantly higher than that in girls (p < 0.01). Interestingly, the prevalence of overweight and obesity in the urban area was also significantly higher than that in suburb area (p < 0.01).

CONCLUSION

Over a 5-yr period, there was a significant increase in the prevalence of obesity in children and adolescents in Shanghai. The high percentage of overweight and obesity in the young age groups is of particular concern. Urbanization might be a causative factor for the increase in obesity prevalence in Chinese children in the Shanghai area.

Leisure time activities in adolescence in the presence of susceptibility genes for obesity: risk or resilience against overweight in adulthood? The HUNT study

BACKGROUND

Environment, health behavior, and genetic background are important in the development of obesity. Adolescents spend substantial part of daily leisure time on cultural and social activities, but knowledge about the effects of participation in such activities on weight is limited.

METHODS

A number of 1450 adolescents from the Norwegian HUNT study (1995-97) were followed-up in 2006-08 as young adults. Phenotypic data on lifestyle and anthropometric measures were assessed using questionnaires and standardized clinical examinations. Genotypic information on 12 established obesity-susceptibility loci were available for analyses. Generalized estimating equations were used to examine the associations between cultural and social activities in adolescence and adiposity measures in young adulthood. In addition, interaction effects of a genetic predisposition score by leisure time activities were tested.

RESULTS

In girls, participation in cultural activities was negatively associated with waist circumference (WC) (B = -0.04, 95%CI: -0.08 to -0.00) and with waist-hip ratio (WHR) (B = -0.058, 95%CI: -0.11 to -0.01). However, participation in social activities was positively associated with WC (B = 0.040, CI: 0.00 to 0.08) in girls and with BMI (B = 0.027, CI: 0.00 to 0.05) in boys. The effect of the obesity-susceptibility genetic variants on anthropometric measures was lower in adolescents with high participation in cultural activities compared to adolescents with low participation.

CONCLUSION

This study suggests that the effects of cultural activities on body fat are different from the effects of participation in social activities. The protective influence of cultural activities in female adolescents against overweight in adulthood and their moderating effect on obesity-susceptibility genes suggest that even cultural activities may be useful in public health strategies against obesity.

Association between sedentary behaviour and socioeconomic factors, diet and lifestyle among the Balearic Islands adolescents

BACKGROUND

Many different factors influenced food habits and physical activity patterns of adolescents in a complex interactive way. The aim of this study was to assess association between sedentary behaviour and socioeconomic factors, diet and lifestyle among the Balearic Islands adolescents.

METHODS

A cross-sectional survey (n = 1961; 12-17 years old) was carried out. Physical activity was assessed using the International Physical Activity Questionnaire for adolescents (IPAQ-A). Sedentary behaviour was defined as <300 min/week of moderate and vigorous physical activity. Anthropometric measurements, body image, socio-economic and lifestyle determinants, food consumption, and adherence to the Mediterranean diet were assessed.

RESULTS

The prevalence of sedentary behaviour was 37.1% (22.0% boys, 50.8% girls). Active boys consumed frequently breakfast cereals and fresh fruit; active girls yogurt, cheese, breakfast cereals, and fresh fruit; and sedentary girls high fat foods and soft drinks. Sedentary behaviour of girls was directly associated to age, and time spent on media screen and homework, and inversely related to adherence to Mediterranean diet, and body composition. Sedentary behaviour of boys was inversely related to adherence to the Mediterranean diet, and the desire to remain the same weight.

CONCLUSIONS

The prevalence of sedentary behaviour among Balearic Islands adolescents is high, mainly among girls. Age, sex, parental educational and profession levels, body size dissatisfaction, and poor quality diet are important factors of physical activity practice among adolescents.

Children and eating. Personality and gender are associated with obesogenic food consumption and overweight in 6- to 12-year-olds

The role of children's personality traits in the consumption of potentially obesogenic foods was investigated in a sample of Norwegian children aged 6-12 years (N=327, 170 boys, 157 girls). Mothers rated their child's personality on the traits of the Five Factor Model (i.e., extraversion, benevolence, conscientiousness, neuroticism, and imagination). Mothers also completed a food frequency questionnaire assessing their child's consumption of sweet drinks, sweet foods, and fruit and vegetables, and reported their child's height and weight. Controlling for age and mothers' education, boys and girls who were less benevolent consumed more sweet drinks, and girls who were less conscientious and more neurotic consumed more sweet drinks. Boys and girls who were more benevolent and imaginative consumed more fruits and vegetables, and boys who were more extraverted, more conscientious, and less neurotic consumed more fruits and vegetables. Controlling for maternal education, boys and girls who were less extraverted, and girls who were less benevolent, less conscientious, and more neurotic were more likely to be overweight or obese. These findings suggest that children's personality traits play an important yet understudied role in their diet. Further investigation of mechanisms that relate child traits to obesogenic eating and overweight would be valuable.

Physical Activity Patterns and Quality of Life of Overweight Boys: A Preliminary Study

Objective

We compared the physical activity (PA) patterns and the quality of life (QoL) between overweight and normal-weight boys, and examined the relationship between PA and QoL of overweight boys.

Methods

Eighteen overweight boys (age range: 8–10 years, mean ± standard deviation: 9.36 ± 0.82 years) and 18 age-matched, normal-weight counterparts (age range: 8–10 years, mean ± standard deviation: 9.01 ± 0.65 years) participated in this study. All participants were in the 3rd or 4th grade. Each boy completed a QoL questionnaire and wore an accelerometer on his waist for a week to measure his PA during that period. Independent t tests were used to examine the differences in QoL and PA between the overweight and normal-weight boys. Paired t tests were used to test the differences in PA between weekdays and weekend days for each group. Finally, Pearson correlations were used to analyze the relationships between PA and QoL in overweight boys.

Results

Overweight boys reported a significantly lower QoL, and participated in significantly less PA on weekends than did normal-weight boys. A moderate and marginally significant correlation was found between PA on weekends and QoL in overweight boys.

Conclusion

Our findings suggest the importance of increasing weekend PA for overweight boys. Occupational therapists should encourage overweight boys to engage in PA that the boys are interested in on weekends, and conduct a PA program for overweight boys.

Lifestyle factors associated with overweight and obesity among Saudi adolescents

Background

A better understanding of the relationships between obesity and lifestyle factors is necessary for effective prevention and management of obesity in youth. Therefore, the objective of this study was to evaluate the associations between obesity measures and several lifestyle factors, including physical activity, sedentary behaviors and dietary habits among Saudi adolescents aged 14–19 years.

Methods

This was a school-based cross-sectional study that was conducted in three cities in Saudi Arabia (Al-Khobar, Jeddah and Riyadh). The participants were 2906 secondary school males (1400) and females (1506) aged 14–19 years, who were randomly selected using a multistage stratified cluster sampling technique. Measurements included weight, height, body mass index (BMI), waist circumference, waist/height ratio (WHtR), screen time (television viewing, video games and computer use), physical activity (determined using a validated questionnaire), and dietary habits (intake frequency per week). Logistic regression was used to examine the associations between obesity and lifestyle factors.

Results

Compared with non-obese, obese males and females were significantly less active, especially in terms of vigorous activity, had less favorable dietary habits (e.g., lower intake of breakfast, fruits and milk), but had lower intake of sugar-sweetened drinks and sweets/chocolates. Logistic regression analysis showed that overweight/obesity (based on BMI categories) or abdominal obesity (based on WHtR categories) were significantly and inversely associated with vigorous physical activity levels (aOR for high level = 0.69, 95% CI 0.41–0.92 for BMI and 0.63, 95% CI 0.45–0.89 for WHtR) and frequency of breakfast (aOR for < 3 days/week = 1.44; 95% CI 1.20–1.71 for BMI and 1.47; 95% CI 1.22–1.76 for WHtR) and vegetable (aOR for < 3 days/week = 1.29; 95% CI 1.03–1.59 for WHtR) intakes, and consumption of sugar-sweetened beverages (aOR for < 3 days/week = 1.32; 95% CI 1.08–1.62 for BMI and 1.42; 95% CI 1.16–1.75 for WHtR).

Conclusions

The present study identified several lifestyle factors associated with obesity that may represent valid targets for the prevention and management of obesity among Saudi adolescents. Primary prevention of obesity by promoting active lifestyles and healthy diets should be a national public health priority.

Parental overweight/obesity, social factors, and child overweight/obesity at 7 years of age

BACKGROUND

This study used gender-based analyses to examine whether child overweight/obesity is related to parental overweight/obesity and sociodemographic factors, in a representative population-based cohort of 7-year-old children.

METHODS

Data from the Québec Longitudinal Study of Child Development 1998-2010 was used. Children (n= 1336) were randomly selected from each public health region of Québec. The study was based on face-to-face interviews and a set of questionnaires addressed to mothers and fathers.

RESULTS

Compared to children with no overweight/obese parent, the adjusted odds ratio (OR) of being overweight/obese with two overweight/obese parents was 5 for boys (95% confidence interval [CI]: 2.31-10.85) and 5.87 for girls (95%CI: 2.63-13.12). Gender differences appeared when one parent was overweight/obese. For girls, having either an overweight/obese mother (OR, 3.10; 95%CI: 1.14-8.38) or father (OR, 3.64; 95%CI: 1.68-7.91) significantly increased the odds of being overweight/obese at 7 years. For boys, however, having only an overweight/obese father (OR, 2.05; 95%CI: 1.01-4.16) was related to overweight/obesity, but having only an overweight/obese mother was not related to overweight/obesity at 7 years for boys. In girls, but not in boys, having an immigrant mother also significantly related to overweight/obesity (OR, 2.71; 95%CI: 1.28-5.75) at 7 years, after controlling for other social factors.

CONCLUSIONS

Gender differences in socialization may explain why at 7 years of age, girls' bodyweight is influenced by having even one overweight/obese parent (mother or father), while boys' bodyweight appears to be influenced only by father's overweight/obesity when only one parent is overweight/obese.

Obesity and Overweight Prevalence among a Mississippi Low-Income Preschool Population: A Five-Year Comparison

Purpose. This study determined 2010 rates of overweight/obesity in a representative sample of low-income preschoolers in Mississippi, USA and compared rates between 2005 (N = 1250) and 2010 (N = 1765). Significance. Obesity is a significant global health issue because of its well-established negative health consequences. Child obesity is a concern due to risk of early-onset obesity-related illnesses and the longevity of lifetime exposure to those illnesses. Methods. Identical measures were used in 2005 and 2010 with complex-stratified sampling designs. Results. Chi-square tests revealed that overall obesity/overweight rates between 2005 (20.6%/17.9%) and 2010 (20.8%/17.0%) had not changed significantly for the samples as a whole, nor by gender or race. Age group comparisons indicated a significant decline in obesity rates of 3 year olds (20.3% in 2005, reduced to 13.1% in 2010, P = 0.035). These findings mimic the trend toward stabilization of obesity rates noted in national low-income preschool populations.

Western and Mediterranean dietary patterns among Balearic Islands' adolescents: socio-economic and lifestyle determinants

OBJECTIVE

To assess prevailing food patterns among Balearic Islands' adolescents, and socio-economic and lifestyle determinants.

DESIGN

Cross-sectional nutritional survey carried out (2007-2008) in the Balearic Islands, a Mediterranean region. Dietary assessment was based on a 145-item semi-quantitative FFQ and two non-consecutive 24 h recalls. Anthropometric measurements and questions related to socio-economic, lifestyle, physical activity and body image were assessed.

SETTING

Data obtained from a representative sample of all inhabitants living in the Balearic Islands aged 12-17 years.

SUBJECTS

A random sample (n 1231) of the adolescent population (12-17 years old) was interviewed.

RESULTS

Factor analysis identified two major dietary food patterns: 'Western' and 'Mediterranean'. The 'Western' dietary pattern was higher among boys than girls, associated with spending ≥4 h/d on media screen time, but less prevalent among those adolescents who desired a thinner body and those girls who desired to remain the same weight. The 'Mediterranean' dietary pattern was mainly followed by girls, and also boys who spent < 2 h/d on media screen time and girls with high parental socio-economic status.

CONCLUSIONS

The present study shows the existence of two major dietary patterns among Balearic Islands' adolescents: 'Western' and 'Mediterranean', but girls are more 'Mediterranean' than boys. This evidence supports that the food pattern of Balearic Islands' adolescents is in a transitional state characterised by the loss of the traditional Mediterranean dietary pattern towards a Western dietary pattern. Low parental socio-economic status, much leisure-time on sedentary behaviours such as media screen time and body image are factors associated with the 'Western' dietary pattern.

Socio-demographic and lifestyle factors associated with overweight in a representative sample of 11-15 year olds in France: results from the WHO-Collaborative Health Behaviour in School-aged Children (HBSC) cross-sectional study

Background

The prevalence of overweight in children and adolescents is high and overweight is associated with poor health outcomes over short- and long-term. Lifestyle factors can interact to influence overweight. Comprehensive studies linking overweight concomitantly with several demographic and potentially-modifiable lifestyle factors and health-risk behaviours are limited in adolescents - an age-group characterized by changes in lifestyle behaviours and high prevalence of overweight. Thus, the objective of the current study was to examine the association of overweight with several socio-demographic and lifestyle variables simultaneously in a representative sample of adolescents.

Methods

A nationally representative sample of 11-15 year-olds (n = 7154) in France participated as part of the WHO-Collaborative Health Behaviour in School-aged Children (HBSC) study. Students reported data on their age, height, weight, socio-demographic variables, lifestyle factors including nutrition practices, physical activity at two levels of intensity (moderate and vigorous), sedentary behaviours, as well as smoking and alcohol consumption patterns using standardized HBSC protocols. Overweight (including obesity) was defined using the IOTF reference. The multivariate association of overweight with several socio-demographic and lifestyle factors was examined with logistic regression models.

Results

The adjusted odds ratios for the association with overweight were: 1.80 (95% CI: 1.37-2.36) for low family affluence; 0.73 (0.60-0.88) for eating breakfast daily; 0.69 (0.56-0.84) for moderate to vigorous physical activity (MVPA); and 0.71 (0.59-0.86) for vigorous physical activity (VPA). Significant interactions between age and gender as well as television (TV) viewing and gender were noted: for boys, overweight was not associated with age or TV viewing; in contrast, for girls overweight correlated negatively with age and positively with TV viewing. Fruit and vegetable intake, computer and video-games use, smoking and alcohol consumption were not associated with overweight.

Conclusions

In multivariate model, family affluence, breakfast consumption and moderate to vigorous as well as vigorous physical activity were negatively associated with overweight. These findings extend previous research to a setting where multiple risk and protective factors were simultaneously examined and highlight the importance of multi-faceted approaches promoting physical activity and healthy food choices such as breakfast consumption for overweight prevention in adolescents.

For whom and under what circumstances do school-based energy balance behavior interventions work? Systematic review on moderators

The aim of this review was to systematically review the results and quality of studies investigating the moderators of school-based interventions aimed at energy balance-related behaviors. We systematically searched the electronic databases of Pubmed, EMBASE, Cochrane, PsycInfo, ERIC and Sportdiscus. In total 61 articles were included. Gender, ethnicity, age, baseline values of outcomes, initial weight status and socioeconomic status were the most frequently studied potential moderators. The moderator with the most convincing evidence was gender. School-based interventions appear to work better for girls than for boys. Due to the inconsistent results, many studies reporting non-significant moderating effects, and the moderate methodological quality of most studies, no further consistent results were found. Consequently, there is lack of insight into what interventions work for whom. Future studies should apply stronger methodology to test moderating effects of important potential target group segmentations.

Influences of social support, perceived barriers, and negative meanings of physical activity on physical activity in middle school students

BACKGROUND

A profound decline in physical activity occurs in puberty. This phenomenon is not well understood. Therefore, the purpose of this study is to examine associations between family/friend social support for physical activity, negative meanings of physical activity (NMPA), and internal /external barriers to physical activity with moderate to vigorous physical activity (MVPA), and sedentary and light behavior (SLB) in youth.

METHODS

A total of 350 participants from 7 Los Angeles County middle schools participated in the study (62% Latina, 79% females). Hypothesized pathways were examined using structural equation modeling. Psychosocial variables and participation in MVPA and SLB were assessed by self-reported questionnaires.

RESULTS

NMPA were related to lower levels of family/friend social support and greater internal/external barriers. Family social support was the only significant indicator of MVPA (β=0.79). Low family social support was related to higher SLB (β=-0.25).

CONCLUSIONS

Family social support seems crucial to promote MVPA and reduce SLB in adolescents and might be influenced by child's feelings about physical activity. Future research should consider the interrelationship between psychosocial correlates of physical activity.

Obesity and motor coordination ability in Taiwanese children with and without developmental coordination disorder

The purpose of this study was to investigate the associations between obesity and motor coordination ability in Taiwanese children with and without developmental coordination disorder (DCD). 2029 children (1078 boys, 951 girls) aged nine to ten years were chosen randomly from 14 elementary schools across Taiwan. We used bioelectrical impedance analysis to measure percentage of body fat (PBF) and the Movement Assessment Battery for Children test (MABC test) to evaluate the motor coordination ability. Using cut-off points based on PBF from past studies, boys and girls were divided into obese, overweight and normal-weight groups, respectively. In boys, total impairment scores and scores on balance subtest in the MABC were significantly higher in the obese and overweight groups when compared against the normal-weight group. Girls in the obese and the overweight groups had higher balance impairment scores than those of the normal-weight group. Among boys, the prevalence of obesity was highest in the DCD group, when compared to the borderline DCD and TD boys. A higher percentage of DCD girls were overweight and obese than TD girls. Obesity may be associated with poor motor coordination ability among boys and girls, and particularly in relation to balance ability. Children with DCD may have a higher risk to be overweight or obese in Taiwan.

CAREGIVERS' ATTITUDES AND PRACTICES: INFLUENCE ON CHILDHOOD BODY WEIGHT

Childhood excess weight is probably associated with, or reflected in, parental attitudes. The objective of this study was to study the relationships between childhood excess weight and parental attitudes. The study subjects were 53 boys and 56 girls, aged 6–10, regularly attending schools in Porto Alegre, south Brazil, and one of their parents or caregivers. Attitudes of the parents or caregivers were assessed by the Child Feeding Questionnaire (CFD). Weight and height of the children were measured, parents self-reported their weight and height and body mass indexes were calculated for both. The WHO criteria for overweight and obesity were used for the adults. The CDC criteria for overweight and risk for overweight were used for the corresponding children. Boys presented excess weight more often than girls. The parents of children with excess weight showed higher scores for perceived child weight, concern about child weight, restriction and monitoring. In logistic regression, excess weight in children was associated with perceived child weight, restriction and male sex; pressure to eat was negatively associated with excess BMI. In Porto Alegre, south Brazil, excess body weight in children aged 6–10 is associated with parental perceived child weight and concern about it, monitoring and restriction; being a boy increases the odds of being overweight.

Early life factors and being overweight at 4 years of age among children in Malmö, Sweden

Background

Rising rates of obesity and overweight is an increasing public health problem all over the world. Recent research has shown the importance of early life factors in the development of child overweight. However, to the best of our knowledge there are no studies investigating the potential synergistic effect of early life factors and presence of parental overweight on the development of child overweight.

Methods

The study was population-based and cross-sectional. The study population consisted of children who visited the Child Health Care (CHC) centers in Malmö for their 4-year health check during 2003-2008 and whose parents answered a self-administered questionnaire (n = 9009 children).

Results

The results showed that having overweight/obese parents was strongly associated with the child being overweight or obese. Furthermore, there was an association between unfavorable early life factors (i.e., mother smoking during pregnancy, presence of secondhand tobacco smoke early in life, high birth weight) and the development of child overweight/obesity at four years of age, while breastfeeding seemed to have a protective role. For example, maternal smoking during pregnancy was associated with an odds ratio (OR) of 1.47 (95% CI: 1.22, 1.76) for overweight and 2.31 (95% CI: 1.68, 3.17) for obesity. The results further showed synergistic effects between parental overweight and exposure to unfavourable early life factors in the development of child overweight.

Conclusions

The present study shows the importance of early life factors in the development of child overweight and obesity, and thus puts focus on the importance of early targeted interventions.

High-fat diet-induced obesity in animal models

Epidemiological studies have shown a positive relationship between dietary fat intake and obesity. Since rats and mice show a similar relationship, they are considered an appropriate model for studying dietary obesity. The present paper describes the history of using high-fat diets to induce obesity in animals, aims to clarify the consequences of changing the amount and type of dietary fats on weight gain, body composition and adipose tissue cellularity, and explores the contribution of genetics and sex, as well as the biochemical basis and the roles of hormones such as leptin, insulin and ghrelin in animal models of dietary obesity. The major factors that contribute to dietary obesity - hyperphagia, energy density and post-ingestive effects of the dietary fat - are discussed. Other factors that affect dietary obesity including feeding rhythmicity, social factors and stress are highlighted. Finally, we comment on the reversibility of high-fat diet-induced obesity.

Associations between diet and (in)activity behaviours with overweight and obesity among 10–18-year-old Czech Republic adolescents

Objectives

To assess the prevalence of normal weight, overweight and obesity among 10–18-year-old Czech Republic adolescents and to assess the association between energy balance-related behaviours and overweight/obesity.

Design

Cross-sectional data from ‘The 6th Nation-wide Anthropological Survey of Children and Adolescents 2001 Czech Republic’ have been used.

Setting

Height and weight were objectively measured. Data on adolescents’ behaviours were assessed with self-reported questionnaires. Background variables were assessed by means of a parental questionnaire. Multi-level logistic regression analyses were conducted to assess behavioural risk factors of being overweight/obese.

Subjects

Data on 31 228 adolescents aged 10–18 years were included in the present study.

Results

The highest prevalence of being overweight or obese was found among boys and younger adolescents. Boys were more physically active, watched more television (TV) and used the computer more often than did girls. Being on a diet and skipping meals were positively associated with being overweight/obese, independent of gender. In boys (10–14 years old), inverse associations with being overweight/obese were found when being more physically active. Monitoring weight showed inverse relations with being overweight/obese in 15–18-year-old girls. Watching TV more than 7 h a week was positively associated with being overweight/obese in 15–18-year-old girls, and was found to be negatively associated in boys of the same age group.

Conclusions

These behaviours should be targeted when preventing overweight and obesity among Czech Republic adolescents. Studies using better measures of energy balance-related behaviours are needed.

Challenge! Health promotion/obesity prevention mentorship model among urban, black adolescents

OBJECTIVES

The objective of this study was to evaluate a 12-session home/community-based health promotion/obesity prevention program (Challenge!) on changes in BMI status, body composition, physical activity, and diet.

METHODS

A total of 235 black adolescents (aged 11-16 years; 38% overweight/obese) were recruited from low-income urban communities. Baseline measures included weight, height, body composition, physical activity (PA), and diet. PA was measured by 7-day play-equivalent physical activity (> or =1800 activity counts per minute). Participants were randomly assigned to health promotion/obesity prevention that is anchored in social cognitive theory and motivational interviewing and was delivered by college-aged black mentors or to control. Postintervention (11 months) and delayed follow-up (24 months) evaluations were conducted. Longitudinal analyses used multilevel models with random intercepts and generalized estimating equations, controlling for baseline age/gender. Stratified analyses examined baseline BMI category.

RESULTS

Retention was 76% over 2 years; overweight/obese status declined 5% among intervention adolescents and increased 11% among control adolescents. Among overweight/obese youth, the intervention reduced total percentage of body fat and fat mass and increased fat-free mass at delayed follow-up and increased play-equivalent physical activity at postintervention but not at delayed follow-up. Intervention adolescents declined significantly more in snack/dessert consumption than control adolescents at both follow-up evaluations.

CONCLUSIONS

At postintervention, there were intervention effects on diet and PA but not BMI category or body composition. At delayed follow-up, dietary changes were sustained and the intervention prevented an increase in BMI category. Body composition was improved for overweight/obese youth. Changes in body composition follow changes in diet and PA and may not be detected immediately after intervention.

Should public health interventions aimed at reducing childhood overweight and obesity be gender-focused?

BACKGROUND

Overweight in childhood is a major public health concern that calls for immediate preventative action. An increasing number of reports suggest that gender specific approaches to prevention may be more effective. However, there is a paucity of information to guide gender-sensitive health promotion and population health interventions for the prevention of overweight in childhood. In the present study, we sought to determine gender-differentials in overweight and underlying behaviors, nutrition and physical activity, among pre-adolescents in Alberta, Canada, to inform the discussion on gender-focused interventions for chronic disease prevention.

METHODS

In 2008, we surveyed 3421 grade five students and their parents of 148 randomly selected schools. Students completed the Harvard food frequency questionnaire, questions on physical activities, and had their height and weight measured. Parents completed questions on socio-economic background and child's lifestyle. We applied multilevel regression methods to assess gender differentials in overweight, nutrition and physical activity.

RESULTS

Overall, the prevalence of overweight was slightly higher among boys (29.1%) than girls (27.9%) with more pronounced differences in towns and urban geographies. Boys reported to be much more physically active relative to girls (OR = 2.12, 95% CI: 1.73-2.60). Diets of boys, relative to those of girls, reportedly constituted more fat and were less likely to meet the recommendation of 6 daily servings of vegetables and fruits (OR = 0.81, 95% CI: 0.71-0.93).

CONCLUSION

Our findings confirm the existence of gender differences in physical activity and nutrition, and support gender-focused health promotion whereby priority is given to physical activity among girls and to healthy eating among boys.

Physical activity and dietary intake of children aged 9-11 years and the influence of peers on these behaviours: a 1-year follow-up

BACKGROUND

This study investigated physical activity and dietary intake of children aged 9-11 years, and the influence of peers on these behaviours over a 2-year period.

METHODS

A total of 106 (64 girls; 42 boys) children were investigated annually, over 2 years. Measures included physical activity (sealed pedometer), self-report measures of dietary intake and physical activity, and a peer influence questionnaire. Anthropometric measures of height and weight were also obtained.

RESULTS

The findings reveal insufficient energy intakes, physical activity levels and fruit and vegetable consumption but high intakes of saturated fat and sodium, over time, in both boys and girls. Both male calcium and female iron intakes were also of concern. Throughout the survey, peers were found to influence physical activity behaviour but not dietary intake.

CONCLUSIONS

The fact that youth consistently failed to meet established nutrition and physical activity recommendations highlights the importance of promoting physical activity and healthy eating to children younger than 9 years of age. The finding that peers significantly influence physical activity behaviour over time should be considered when designing new physical activity interventions aimed at young people.

Household income during childhood and young adult weight status: evidence from a nutrition transition setting

This article explores whether household income at different stages of childhood is associated with weight status in early adulthood in a nutrition transition setting (a developing country with both underweight and overweight populations). I use multinomial logistic regression to analyze prospective, longitudinal data from Cebu, Philippines. Results suggest that increasing prenatal income is associated with lower risk of being underweight at age 21, while increasing income during childhood is associated with an increased risk of being overweight at age 21. When gender differences are considered, prenatal income has an important protective effect against the risk of being overweight for girls. For boys, prenatal income has little effect on overweight status, but early childhood income increases their risk of becoming overweight. For both boys and girls, income in mid-childhood (ages 9-12) is associated with a particularly high risk of becoming overweight by age 21, net of earlier income. These results suggest that, in this nutrition transition setting, childhood income operates through complex developmental and behavioral mechanisms to affect early adult overweight status; and that increasing household income after birth may do little to prevent underweight status in early adulthood.

Do working mothers raise couch potato kids? Maternal employment and children's lifestyle behaviours and weight in early childhood

Alarm about the increasing prevalence of childhood obesity has focussed attention on individual lifestyle behaviours that may contribute to unhealthy weight. More distal predictors such as maternal employment may also be implicated since working mothers have less time to supervise children's daily activities. The research reported here used two waves of data from the Longitudinal Study of Australian Children to investigate whether mothers' hours in paid work shape young children's television viewing, snacking and physical activity, and through those lifestyle behaviours, children's weight at ages 4-5 years and 6-7 years. At both ages, children's lifestyle behaviours were interrelated and associated with weight status. Cross-sectional analysis confirmed small, direct associations between longer hours of maternal employment and child weight at age 4-5 years, but not with child's weight measured two years later. In both the cross-sectional and prospective analyses, the children of mothers who worked part-time watched less television and were less likely to be overweight than children of mothers who were not employed or who worked full-time. While associations were small, they remained significant after adjustment for maternal weight, household income and other factors. The combination of direct and indirect relationships between mothers' work hours and the weight status of their young children provides additional support to calls for family-friendly work policies as an important means for promoting healthy family lifestyles and early childhood wellbeing.

Overweight in school-aged children and its relationship with demographic and lifestyle factors: results from the WHO-Collaborative Health Behaviour in School-aged Children (HBSC) study

OBJECTIVES

To examine overweight prevalence and its association with demographic and lifestyle factors in 11-15 year olds in the HBSC 2005-2006 survey.

METHODS

Self-reports of height, weight, eating patterns, physical activity and sedentary behaviours were obtained from nationally representative samples in 41 countries (n=204,534).

RESULTS

Overweight prevalence was highest in USA (28.8 %) and lowest in Latvia (7.6 %). In most countries, overweight was more prevalent in boys than girls. Overweight was consistently negatively associated with breakfast consumption and moderate to vigorous physical activity; OR range: 0.48-0.79 and 0.50-0.78, respectively.

CONCLUSION

Overweight prevalence in youth remained high across the countries examined. The primary factors linked to overweight were breakfast consumption and physical activity. These data should contribute to formulating preventive programs and policies.

Lifestyle risk factors for overweight in Japanese male college students

Objective

To identify lifestyle and sociodemographic risk factors of overweight among male college students.

Design

A retrospective cohort study.

Setting

Annual health checkup in a single university in Japan.

Participants

Male students who underwent two successive health checkups from their third school year between 2000 and 2007 and whose BMI at baseline of this study was 22·0 kg/m2 or more (n 4634).

Results

During the 1-year follow-up, 598 students (12·9 %) reached the study endpoint, i.e. more than a 5 % increase in BMI. Independent risk factors for substantial BMI increase included infrequent exercise (OR = 1·33; 95 % CI 1·11, 1·60), no or infrequent alcohol drinking (OR = 1·30; 95 % CI 1·08, 1·57), frequently skipping breakfast (OR = 1·34; 95 % CI 1·12, 1·61), preference for fatty food (OR 1·36; 95 % CI 1·04, 1·78) and living alone (OR = 1·23; 95 % CI 0·99, 1·52). Students were readily stratified according to risk for substantial BMI gain by counting the number of their risk factors. OR (95 % CI) for the risk between the no risk factor group and students with two, three, four and five risk factors were 1·61 (0·96, 2·70), 2·24 (1·34, 3·75), 2·42 (1·39, 4·23) and 6·22 (2·58, 15·0), respectively.

Conclusion

These data suggest that avoidance of certain risk factors in college life is associated with a decrease in incidence of overweight among male students.

Association between peer relationship problems and childhood overweight/obesity

AIMS

To assess the association between peer relationship problems and childhood overweight and obesity.

METHODS

Data on 4718 preschool children were obtained at the obligatory school entry health examination in Bavaria. Parentally reported peer relationship problems ('normal', 'borderline' or 'abnormal') were assessed from the Strengths and Difficulties Questionnaire. Overweight and obesity were defined according to age- and gender-specific BMI cut-off points. Multivariate logistic regression analysis was performed to control potential confounders.

RESULTS

The prevalence of overweight and obesity was higher among children with 'borderline' or 'abnormal' peer relationship problems compared to 'normal' children. The association of 'abnormal' peer relationship problems was still significant in the final logistic regression model for girls [odds ratio (OR) for overweight 2.0; 95% confidence interval (CI): 1.4-3.0; OR for obesity 2.6; 95% CI: 1.3-5.0]. Among boys the adjusted odds ratio were lower and no longer significant.

CONCLUSION

The significantly increased prevalence of overweight and obesity among preschool children with peer relationship problems could not be explained by confounding. It seems evident that there is a relevant co-morbidity of peer relationship problems and obesity in pre-school children pointing to the need of interventions focusing on both physical as well as psychosocial health.

Prevalence of overweight and obesity among 7-9-year-old children in Aveiro, Portugal: comparison between IOTF and CDC references

OBJECTIVE

To estimate the prevalence of overweight and obesity in schoolchildren from Aveiro, Portugal, according to two criteria: the International Obesity Task Force (IOTF) and the US Centers for Disease Control and Prevention (CDC) cut-offs.

DESIGN

Weight, height and waist circumference were measured. Using the BMI, gender- and age-specific prevalences of overweight and obesity were determined according to the IOTF cut-offs extrapolated from an adult BMI of 25 and 30 kg/m2 and the CDC cut-off values of 85th and 95th BMI percentile.

SETTING

Aveiro, Portugal.

SUBJECTS

A random representative sample of 905 children (457 boys; 448 girls) aged 7-9 years.

RESULTS

The prevalence of excess weight (overweight and obesity) was lowest according to IOTF cut-offs compared to CDC (28.1 % v. 31.2 %), especially obesity (8.1 % v. 14.0 %). However, the CDC and IOTF criteria have a strong agreement (Cohen's k = 0.755; P < 0.001). There were significant differences in excess weight between boys and girls according to the CDC (26.9 % v. 35.7 %; P = 0.003). Obese children are younger and the majority present abdominal obesity.

CONCLUSIONS

The present study shows a high prevalence of excess weight in Aveiro children, similar to other Portuguese regions and among the highest in Europe, especially in the female gender. The IOTF cut-off values give a lower prevalence of excess weight, namely obesity.

Effects of peer influence on dietary intake and physical activity in schoolchildren

Objective

To investigate the dietary intake and physical activity of boys and girls aged 9–13 years, and the influence of peers on these behaviours.

Design

Cross-sectional study.

Setting

Nine primary and secondary schools in south-west London.

Subjects

A total of 315 children wore sealed pedometers, provided self-report measures of dietary intake and answered a questionnaire relating to peer influence. Anthropometric measures of height and weight were also obtained.

Results

Obese children had the lowest reported energy intakes and the lowest step counts per day. Boys took significantly more steps per day than girls, however girls were closer to achieving their recommended cut-offs for physical activity. Girls had lower energy intakes per day and lower BMI Z-scores than boys, however both genders, across all age groups, had higher than recommended intakes of saturated fat. There were significant associations between peer influence and physical activity levels but not between peer influence and dietary intake.

Conclusions

Low energy intake and physical activity levels but high saturated fat intakes among boys and girls across all age groups highlight the importance of promoting both physical activity and healthy food choices. The finding that peers have a significant effect on physical activity levels but not on dietary intake offers an important approach for the design of health promotion interventions and obesity prevention programmes. Such designs may be particularly beneficial for obese youth, since the low physical activity levels found could be a major contributing factor to the maintenance of the condition.

Prevalence and risk factors for obesity in Balearic Islands adolescents

The aim of this work was to assess the prevalence and risk factors of obesity in the Balearic Islands' adolescents. A cross-sectional nutritional survey was carried out in the Balearic Islands (2007-2008). A random sample (n 1231) of the adolescent population (12-17 year old) was interviewed. Anthropometric measurements, two non-consecutive 24 h recalls and a general questionnaire incorporating questions related to sociodemographic and lifestyle variables including the physical activity questionnaire were used. The prevalence of overweight was 19.9 % (boys) and 15.5 % (girls), and obesity 12.7 % (boys) and 8.5 % (girls). The main risk factors associated with a higher prevalence of obesity were low parental education level (boys OR: 3.47; 95 % CI: 1.58, 7.62; girls OR: 3.29; 95 % CI: 1.38, 7.89), to skip meals (boys OR: 4.99; 95 % CI: 2.1, 11.54; girls OR: 2.20; 95 % CI: 0.99, 4.89), age (12-13-year-old boys; OR: 2.75; 95 % CI: 1.14, 6.64), attention to mass media (television (TV)+radio; boys OR: 1.50; 95 % CI: 0.81, 2.84; girls OR: 2.06; 95 % CI: 0.91, 4.68), short sleep (boys OR: 3.42; 95 % CI: 0.88, 13.26), low parental socioeconomic status (girls OR: 3.24, 95% CI: 1.04, 10.05 ) and smoking (girls OR: 2.51; 95 % CI: 0.88, 7.13). A programme of action including school healthy education and promotion programmes targeted at parents and adolescents are needed. These programmes may be mainly focused to increase educational level, to make the adolescents to be aware of to skip meals and to smoke are not appropriate methods to reduce the risk of obesity, but the usefulness is to do not eat while watching TV, to sleep 8-10 h/d and to be physically active.