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Kubik MY, Fulkerson JA, Sirard JR, Garwick A, Temple J, Gurvich O, Lee J, Dudovitz B. School-based secondary prevention of overweight and obesity among 8- to 12-year old children: Design and sample characteristics of the SNAPSHOT trial. Contemp Clin Trials 2018; 75:9-18. [PMID: 30342255 PMCID: PMC6249099 DOI: 10.1016/j.cct.2018.10.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 10/05/2018] [Accepted: 10/16/2018] [Indexed: 01/17/2023]
Abstract
Rising levels of severe obesity among children, worsening disparities by race and ethnicity and reluctance of primary care clinicians' to provide obesity management to children are compelling reasons to consider alternatives to primary care management of childhood obesity. The Students Nurses and Parents Seeking Healthy Options Together (SNAPSHOT) trial will test the efficacy of an elementary school-based, school nurse-led, healthy weight management program to reduce excess weight gain among children, 8- to 12-years old with a body mass index (BMI) ≥75th percentile, by increasing healthy dietary practices and physical activity and decreasing sedentary behaviors. SNAPSHOT has enrolled and randomized 132 child/parent dyads to either the: (1) 9-month SNAPSHOT intervention that includes four home visits, 14 kid groups held during out-of-school time and five parent groups or (2) a newsletter program consisting of monthly mailings and family-focused healthy lifestyle information. Outcomes are assessed at baseline, 12-months (post intervention) and 24-months (follow-up) post randomization. The primary outcome is child age- and gender-adjusted BMI z-score. Secondary outcomes include child dietary intake assessed with 24-h dietary recall interviews and accelerometer-measured activity levels. The SNAPSHOT intervention is a model of secondary obesity prevention for children that addresses the urgent need for theory-informed, evidence-based and safe weight management programs, delivered by skilled health professionals in accessible settings. This report describes development of the SNAPSHOT trial, including recruitment and randomization procedures, assessments, intervention and implementation plans, and baseline characteristics of the study sample.
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Affiliation(s)
- Martha Y Kubik
- Temple University, College of Public Health, Department of Nursing, 3307 North Broad Street, Philadelphia, PA 19103, United States.
| | - Jayne A Fulkerson
- Temple University, College of Public Health, Department of Nursing, 3307 North Broad Street, Philadelphia, PA 19103, United States
| | - John R Sirard
- Temple University, College of Public Health, Department of Nursing, 3307 North Broad Street, Philadelphia, PA 19103, United States
| | - Ann Garwick
- Temple University, College of Public Health, Department of Nursing, 3307 North Broad Street, Philadelphia, PA 19103, United States
| | - Judy Temple
- Temple University, College of Public Health, Department of Nursing, 3307 North Broad Street, Philadelphia, PA 19103, United States
| | - Olga Gurvich
- Temple University, College of Public Health, Department of Nursing, 3307 North Broad Street, Philadelphia, PA 19103, United States
| | - Jiwoo Lee
- Temple University, College of Public Health, Department of Nursing, 3307 North Broad Street, Philadelphia, PA 19103, United States
| | - Bonnie Dudovitz
- Temple University, College of Public Health, Department of Nursing, 3307 North Broad Street, Philadelphia, PA 19103, United States
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Martinson ML, Chang YL, Han WJ, Wen J. Child Overweight and Obesity in Shanghai, China: Contextualizing Chinese Socioeconomic and Gender Differences. Int J Behav Med 2018; 25:141-149. [PMID: 29030808 DOI: 10.1007/s12529-017-9688-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE Childhood overweight and obesity is on the rise in China and in Chinese cities in particular. The aim of this study is to explore the extent of income differences in childhood overweight in Shanghai, China, and examine demographic, social, and behavioral explanations for these differences. METHODS Using the 2014 Child Well-Being Study of Shanghai, China-a survey that included extensive contextual information on children and their families in China's most populous city, prevalence rates and adjusted odds ratios of child overweight and obesity at age 7 were calculated by income tercile controlling for a wide variety of sociodemographic variables. RESULTS District aggregate income increases the odds of child overweight/obesity, but only for boys. In contrast, rural hukou status was associated with lower odds of overweight/obesity for girls. CONCLUSIONS Boys at age 7 are more likely to be overweight and obese than girls. District income further increases this likelihood for boys, while rural hukou status decreases this likelihood for girls, suggesting that preferences for boys and thinness ideals for girls may play a role in the income patterning of childhood overweight and obesity.
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Affiliation(s)
| | | | - Wen-Jui Han
- New York University Silver School of Social Work, New York, NY, USA
| | - Jun Wen
- NYU-ECNU Institute for Social Development at NYU Shanghai, East China Normal University, Shanghai, China
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103
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Sims ED, Wang KW, Fleming A, Johnston DL, Zelcer SM, Rassekh SR, Burrow S, Thabane L, Samaan MC. Tri-ponderal mass index in survivors of childhood brain tumors: A cross-sectional study. Sci Rep 2018; 8:16336. [PMID: 30397217 PMCID: PMC6218522 DOI: 10.1038/s41598-018-34602-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 10/22/2018] [Indexed: 02/07/2023] Open
Abstract
Survivors of childhood brain tumors (SCBT) face a higher risk of cardiometabolic disorders and premature mortality compared to the general population. Excess adiposity is a known risk factor for these comorbidities. However, while SCBT have higher adiposity compared to healthy controls, measuring adiposity in clinical practice involves access to specialized equipment and may impact busy clinical services. Tri-ponderal Mass Index (TMI; kg/m3) may be a superior measure of adiposity when compared to Body Mass Index (BMI; kg/m2). However, its use in determining adiposity in SCBT has not been assessed. This study aims to validate TMI as a clinical measure of adiposity in SCBT. This was a cross-sectional study including 44 SCBT (n = 20 female) and 137 (n = 64 female) non-cancer control children, 5-17 years of age. BMI and TMI were calculated from height and weight measurements. Fat mass percentage was assessed using bioelectrical impedance analysis and waist to hip and waist to height ratios were used to assess central adiposity. Regression analyses were adjusted for age, sex, puberty and treatment. TMI demonstrated strong correlations to measures of total and central adiposity and predicted adiposity in SCBT and non-cancer controls, with stronger trends in the latter group. TMI may serve as a reliable clinical measure of adiposity in both SCBT and healthy children.
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Affiliation(s)
- E Danielle Sims
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Kuan-Wen Wang
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Adam Fleming
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Donna L Johnston
- Division of Pediatric Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Shayna M Zelcer
- Pediatric Hematology Oncology, Children's Hospital, London Health Sciences Center, London, Ontario, Canada
| | - Shahrad Rod Rassekh
- Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, British Columbia's Children's Hospital, Vancouver, BC, Canada
| | - Sarah Burrow
- Division of Orthopedic Surgery, Department of Surgery, McMaster University Medical Centre, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Centre for Evaluation of Medicines, St. Joseph's Health Care, Hamilton, Ontario, Canada
- Biostatistics Unit, St Joseph's Healthcare-Hamilton, Hamilton, Ontario, Canada
| | - M Constantine Samaan
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada.
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
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104
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Wright DR, Christakis DA, Lozano P, Saelens BE. Healthy, Wealthy, and Wise? Exploring Parent Comparative Optimism About Future Child Outcomes. MDM Policy Pract 2018; 3:2381468318774776. [PMID: 30288445 PMCID: PMC6157425 DOI: 10.1177/2381468318774776] [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: 09/01/2017] [Accepted: 03/27/2018] [Indexed: 12/02/2022] Open
Abstract
Objectives. Comparative optimism is present in parental predictions of their child’s long-term, obesity-related health outcomes and some of this optimism is unrealistic. An understanding of how comparative optimism relates to parents’ predictions of health versus other child outcomes could contribute to the development of interventions and strategies pediatricians can use to improve risk assessment. Methods. In a nationally representative survey, we asked American parents of 6- to 17-year-old children (n = 410) to estimate the chances that their child and “a typical child in their community” would be affected by overweight, get married, and complete a 4-year college degree by age 30, and the child’s future salary at age 30. We collected data on family demographic and health characteristics. We modeled the difference in parent predictions for their child versus the typical child using multivariate linear regressions. Results. Compared to the typical child, parents were less likely to predict that their child would be affected by overweight (−26.6 percentage points, 95% confidence interval [CI]: −35.6, −17.7) and more likely to predict that their child would complete a 4-year degree (16.7 percentage points, 95% CI: 2.5, 31.0). Parents predicted their child would have a higher income than the typical child at age 30 ($15,266, 95% CI: $7,487, $23,046). Parents did not predict that their child would be more likely than the typical child to be married by age 30 (−2.2 percentage points, 95% CI: −8.1, 3.7). Conclusions. Some parents appear to exhibit comparative optimism around their child’s future weight status, education, and economic outcomes, but not marriage. Future experimental work should assess whether risk communication approaches that consider optimism bias influence parent risk perception and parenting behaviors.
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Affiliation(s)
- Davene R Wright
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Dimitri A Christakis
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Paula Lozano
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Brian E Saelens
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
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105
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Cobbold C. Battle of the sexes: Which is better for you, high- or low-intensity exercise? JOURNAL OF SPORT AND HEALTH SCIENCE 2018; 7:429-432. [PMID: 30450251 PMCID: PMC6230216 DOI: 10.1016/j.jshs.2018.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 04/19/2018] [Accepted: 04/27/2018] [Indexed: 06/09/2023]
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106
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DeJesus JM, Shutts K, Kinzler KD. Mere social knowledge impacts children's consumption and categorization of foods. Dev Sci 2018; 21:e12627. [PMID: 29193476 PMCID: PMC5975094 DOI: 10.1111/desc.12627] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 09/08/2017] [Indexed: 11/28/2022]
Abstract
How does social information affect the perception of taste early in life? Does mere knowledge of other people's food preferences impact children's own experience when eating? In Experiment 1, 5- and 6-year-old children consumed more of a food described as popular with other children than a food that was described as unpopular with other children, even though the two foods were identical. In Experiment 2, children ate more of a food described as popular with children than a food described as popular with adults. Experiment 3 tested whether different perceptual experiences of otherwise identical foods contributed to the mechanisms underlying children's consumption. After sampling both endpoints of a sweet-to-sour range (applesauce with 0 mL or 5mL of lemon juice added), children were asked to taste and categorize applesauce samples with varying amounts of lemon juice added. When classifying ambiguous samples that were near the midpoint of the range (2 mL and 3 mL), children were more likely to categorize popular foods as sweet as compared to unpopular foods. Together, these findings provide evidence that social information plays a powerful role in guiding children's consumption and perception of foods. Broader links to the sociality of food selection are discussed.
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Affiliation(s)
- Jasmine M. DeJesus
- Department of Psychology, Department of Pediatrics, University of Michigan
| | - Kristin Shutts
- Department of Psychology, University of Wisconsin-Madison
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107
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Smith JD, Egan KN, Montaño Z, Dawson-McClure S, Jake-Schoffman DE, Larson M, St. George SM. A developmental cascade perspective of paediatric obesity: a conceptual model and scoping review. Health Psychol Rev 2018; 12:271-293. [PMID: 29583070 PMCID: PMC6324843 DOI: 10.1080/17437199.2018.1457450] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 03/22/2018] [Indexed: 12/12/2022]
Abstract
Considering the immense challenge of preventing obesity, the time has come to reconceptualise the way we study the obesity development in childhood. The developmental cascade model offers a longitudinal framework to elucidate the way cumulative consequences and spreading effects of risk and protective factors, across and within biopsychosocial spheres and phases of development, can propel individuals towards obesity. In this article, we use a theory-driven model-building approach and a scoping review that included 310 published studies to propose a developmental cascade model of paediatric obesity. The proposed model provides a basis for testing hypothesised cascades with multiple intervening variables and complex longitudinal processes. Moreover, the model informs future research by resolving seemingly contradictory findings on pathways to obesity previously thought to be distinct (low self-esteem, consuming sugary foods, and poor sleep cause obesity) that are actually processes working together over time (low self-esteem causes consumption of sugary foods which disrupts sleep quality and contributes to obesity). The findings of such inquiries can aid in identifying the timing and specific targets of preventive interventions across and within developmental phases. The implications of such a cascade model of paediatric obesity for health psychology and developmental and prevention sciences are discussed.
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Affiliation(s)
- Justin D. Smith
- Department of Psychiatry and Behavioral Sciences, Department of Preventive Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA, (312)503-4041.
| | - Kaitlyn N. Egan
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA, (619)733-3977.
| | - Zorash Montaño
- Children’s Hospital of Los Angeles, University of Southern California, Los Angeles, California, USA, (323)804-6666.
| | - Spring Dawson-McClure
- Center for Early Childhood Health & Development, New York University Langone Medical Center, New York, New York, USA, (919)930-7240.
| | - Danielle E. Jake-Schoffman
- Division of Preventive & Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA, (508)856-6517.
| | - Madeline Larson
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA, (253)225-0119.
| | - Sara M. St. George
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA, (305)243-0726.
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108
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Vohr BR, Heyne R, Bann CM, Das A, Higgins RD, Hintz SR. Extreme Preterm Infant Rates of Overweight and Obesity at School Age in the SUPPORT Neuroimaging and Neurodevelopmental Outcomes Cohort. J Pediatr 2018; 200:132-139.e3. [PMID: 29793869 PMCID: PMC6109599 DOI: 10.1016/j.jpeds.2018.04.073] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 02/23/2018] [Accepted: 04/25/2018] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To identify rates of overweight (body mass index [BMI] ≥85th percentile) and obesity (BMI ≥95th percentile) at 6-7 years of age and associated risk factors among extremely preterm infants born at <28 weeks of gestation. STUDY DESIGN Anthropometrics, blood pressure, and active and sedentary activity levels were prospectively assessed. Three groups were compared, those with a BMI ≥85th percentile (overweight or obese for age, height, and sex) and ≥95th percentile (obese) vs <85th percentile. Multiple regression analyses estimated the relative risks of BMI ≥85th percentile and ≥95th percentile associated with perinatal and early childhood factors. RESULTS Of 388 children, 22% had a BMI of ≥85th percentile and 10% were obese. Children with obesity and overweight compared with normal weight children had higher body fat (subscapular skinfold and triceps skinfold >85th percentile), central fat (waist circumference >90th percentile), spent more time in sedentary activity (20.5 vs 18.2 vs 16.7 hours/week), and had either systolic and/or diastolic hypertension (24% vs 26% vs 14%), respectively. Postdischarge weight gain velocities from 36 weeks postmenstrual age to 18 months, and 18 months to 6-7 years were independently associated with a BMI of ≥85th percentile, whereas weight gain velocity from 18 months to 6-7 years was associated with obesity. CONCLUSIONS One in 5 former extremely preterm infants is overweight or obese and has central obesity at early school age. Postdischarge weight gain velocities were associated with overweight and obesity. These findings suggest the obesity epidemic is spreading to the most extremely preterm infants. TRIAL REGISTRATION ClinicalTrials.gov: NCT00063063 and NCT0000.
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Affiliation(s)
- Betty R Vohr
- Department of Pediatrics, Division of Neonatal Medicine, Women & Infants Hospital and Alpert Medical School of Brown University, Providence, RI.
| | - Roy Heyne
- Department of Pediatrics, Division of Neonatal Medicine, UT Southwestern, Dallas, TX
| | - Carla M Bann
- Social Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, NC
| | - Abhik Das
- Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, MD
| | - Rosemary D Higgins
- National Institutes of Health and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD
| | - Susan R Hintz
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA
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109
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Paul IM, Savage JS, Anzman-Frasca S, Marini ME, Beiler JS, Hess LB, Loken E, Birch LL. Effect of a Responsive Parenting Educational Intervention on Childhood Weight Outcomes at 3 Years of Age: The INSIGHT Randomized Clinical Trial. JAMA 2018; 320:461-468. [PMID: 30088009 PMCID: PMC6142990 DOI: 10.1001/jama.2018.9432] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
IMPORTANCE Rapid growth and elevated weight status in early childhood increase risk for later obesity, but interventions that improve growth trajectories are lacking. OBJECTIVE To examine effects of a responsive parenting intervention designed to promote developmentally appropriate, prompt, and contingent responses to a child's needs on weight outcomes at 3 years. DESIGN, SETTING, AND PARTICIPANTS A single-center randomized clinical trial comparing a responsive parenting intervention designed to prevent childhood obesity vs a home safety intervention (control) among 279 primiparous mother-child dyads (responsive parenting group, 140; control group, 139) who enrolled and completed the first home visit from January 2012 through March 2014 with follow-up to age 3 years (completed by April 2017). INTERVENTIONS Research nurses conducted 4 home visits during infancy and annual research center visits. The responsive parenting curriculum focused on feeding, sleep, interactive play, and emotion regulation. The control curriculum focused on safety. MAIN OUTCOMES AND MEASURES The primary outcome was body mass index (BMI) z score at 3 years (z score of 0 represents the population mean; 1 and -1 represent 1 SD above and below the mean, respectively). BMI percentile at 3 years was designated previously as the primary outcome. Secondary outcomes included the prevalence of overweight (BMI ≥85th percentile and <95th percentile) and obesity (BMI ≥95th percentile) at 3 years. RESULTS Among 291 mother-child dyads randomized, 279 received the first home visit and were included in the primary analysis. 232 mother-child dyads (83.2%) completed the 3-year trial. Mean age of the mothers was 28.7 years; 86% were white and 86% were privately insured. At age 3 years, children in the responsive parenting group had a lower mean BMI z score (-0.13 in the responsive parenting group vs 0.15 in the control group; absolute difference, -0.28 [95% CI, -0.53 to -0.01]; P = .04). Mean BMI percentiles did not differ significantly (47th in the responsive parenting group vs 54th in the control group; reduction in mean BMI percentiles of 6.9 percentile points [95% CI, -14.5 to 0.6]; P = .07). Of 116 children in the responsive parenting group, 13 (11.2%) were overweight vs 23 (19.8%) of 116 children in the control group (absolute difference, -8.6% [95% CI, -17.9% to 0.0%]; odds ratio [OR], 0.51 [95% CI, 0.25 to 1.06]; P = .07); 3 children (2.6%) in the responsive parenting group were obese vs 9 children (7.8%) in the control group (absolute difference, -5.2% [95% CI, -10.8% to 0.0%]; OR, 0.32 [95% CI, 0.08 to 1.20]; P = .09). CONCLUSIONS AND RELEVANCE Among primiparous mother-child dyads, a responsive parenting intervention initiated in early infancy compared with a control intervention resulted in a modest reduction in BMI z scores at age 3 years, but no significant difference in BMI percentile. Further research is needed to determine the long-term effect of the intervention and assess its efficacy in other settings. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01167270.
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Affiliation(s)
- Ian M. Paul
- Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania
| | - Jennifer S. Savage
- Center for Childhood Obesity Research, Pennsylvania State University, University Park
- Department of Nutritional Sciences, Pennsylvania State University, University Park
| | | | - Michele E. Marini
- Center for Childhood Obesity Research, Pennsylvania State University, University Park
| | - Jessica S. Beiler
- Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania
| | | | - Eric Loken
- Department of Education Psychology, University of Connecticut, Storrs
| | - Leann L. Birch
- Department of Foods and Nutrition, University of Georgia, Athens
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Cameron JD, Doucet É, Adamo KB, Walker M, Tirelli A, Barnes JD, Hafizi K, Murray M, Goldfield GS. Effects of prenatal exposure to cigarettes on anthropometrics, energy intake, energy expenditure, and screen time in children. Physiol Behav 2018; 194:394-400. [PMID: 29913228 DOI: 10.1016/j.physbeh.2018.06.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 06/07/2018] [Accepted: 06/14/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Maternal prenatal smoking is associated with downstream childhood obesity. Although animal research suggests reduced resting energy expenditure (REE), decreased physical activity (PA), and increased energy intake as mechanisms, these relationships are unclear in humans. The objectives were to examine the association of prenatal maternal smoking with non-volitional energy expenditure (REE and the thermic effect of feeding [TEF]), child adiposity, energy intake, free-living PA (daily light PA (LPA), daily moderate-to-vigorous PA (MVPA), daily sedentary behavior (SB)), and screen time (television and computer/video game) in children. METHODS As part of a longitudinal study, 46 children (n = 27 controls and n = 19 smoking exposed) with mean age 7.6 ± 2 years were recruited. Body weight and composition (Bioelectrical Impedance), height (Stadiometer), waist circumference (cm; tape), BMI (kg/m2), REE (kcal/day; indirect calorimetry), PA (minutes; Accelerometry), screen time (hours; self-report) and ad libitum energy intake (lunch buffet; 7-day food log) were measured. Effects sizes were evaluated using Cohen's d. RESULTS Relative to controls, after controlling for age and family income, children who were exposed to cigarette smoke in utero exhibited greater waist circumference (p = 0.04, Cohen's d = 1.03), percent body fat (%BF; p = 0.02, Cohen's d = 0.97), and a trend for BMI (p = 0.05, Cohen's d = 0.86). Exposed children did not differ in REE (trend for lower: p = 0.1, Cohen's d = 0.42) or TEF but were shown to have significantly higher ad libitum energy intake (p = 0.02, Cohen's D = 0.70) from the palatable lunch buffet, but not from the out of laboratory 7-day energy intake (p = 0.8). Examining screen time behaviors, exposed children spent more time watching television during the week (p = 0.03, Cohen's D = 0.82), and overall television watching (p = 0.02, Cohen's D = 0.80); there were no group differences in any other screen time behaviors. CONCLUSIONS Children exposed to cigarette smoke in utero exhibit greater adiposity, and this exposure may have as contributing factors higher screen time, ad libitum energy intake, and a trend for reduced REE. The data suggest that lifestyle factors such as diet and screen time represent targets for obesity prevention in a high-risk population of young children exposed to prenatal cigarette smoke. Findings also highlight the need for smoking cessation programs to reduce downstream obesity in offspring.
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Affiliation(s)
- Jameason D Cameron
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.
| | | | - Kristi B Adamo
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada; University of Ottawa, Ottawa, Canada
| | - Mark Walker
- University of Ottawa, Ottawa, Canada; Ottawa Hospital Research Institute, Ottawa, Canada
| | | | - Joel D Barnes
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | | | | | - Gary S Goldfield
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada; University of Ottawa, Ottawa, Canada; Carleton University, Ottawa, Canada
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111
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Nejadsadeghi E, Sadeghi R, Shojaeizadeh D, Yekaninejad MS, Djazayeri A, Majlesi F. Influence of lifestyle factors on Body Mass Index in preschoolers in Behbahan city, southwest Iran, 2016. Electron Physician 2018; 10:6725-6732. [PMID: 29881537 PMCID: PMC5984029 DOI: 10.19082/6725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Accepted: 10/26/2017] [Indexed: 11/20/2022] Open
Abstract
Background and aim The body mass index (BMI) of Iranian preschoolers is noticeably increasing. Thus, studying the factors influencing BMI in preschool children is crucial. The purpose of this study was to identify the effects of lifestyle factors on BMI of preschool children, residing in Behbahan city, southwest Iran, in 2016. Methods A total of 120 preschool children, aged 4 to 6 years, participated in this cross-sectional study. Multi-stage random sampling was done. Using researcher-developed questionnaires whose validity and reliability was confirmed, demographic and lifestyle data were obtained, as the questionnaires were completed by the subject's mothers. Lifestyle factors included physical activity, fruit and vegetable consumption, sugar-free beverage intake, and screen time. Multiple logistic regression was conducted to analyze the influence of lifestyle-related behaviors on BMI. Data were analyzed by means of the SPSS 22 software and p<0.05 was resulted as the meaningful level of statistics. Results The average BMI values for children was 15.13±1.90 kg/m2. A total of 88.3% of children did not receive 5 cups of fruits and vegetables each day. Also, 12.5% consumed more than one serving of sweetened beverages per day. Only 2.5% engaged in 60 minutes of structured physical activity every day and 40% did not limit screen-time viewing to 2 hours per day or less. The findings indicated that the physical activity and screen time affected the BMI (p<0.05), and the duration of physical activity had inverse relationship with obesity, and screen time was directly related to obesity. Conclusion Understanding the factors affecting the BMI of preschool children can inform the development of interventions to impact children's weight-related behavior and it can be used as the basis for future healthy body weight policies. Efforts to lower the obesity rate of preschoolers should be focused on the lifestyle behaviors, especially on the physical activity and screen time.
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Affiliation(s)
- Elham Nejadsadeghi
- Ph.D. Student of Health Education and Promotion, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sadeghi
- Ph.D. of Health Education and Promotion, Associate Professor, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Davoud Shojaeizadeh
- Ph.D. of Health Education and Promotion, Professor, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mir Saeed Yekaninejad
- Ph.D. of Biostatistics, Assistant Professor, Department of Biostatistics and epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abolghassem Djazayeri
- Ph.D. of Nutrition, Professor, Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereshteh Majlesi
- Ph.D. of Maternal and Child Health, Professor, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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112
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Zamaninour N, Mirzaei K, Maghbooli Z, Keshavarz SA. Peroxisome proliferator-activated receptor gamma coactivator 1α variation: a closer look at obesity onset age and its related metabolic status and body composition. Appl Physiol Nutr Metab 2018; 43:1321-1325. [PMID: 29879371 DOI: 10.1139/apnm-2018-0190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
There is a lack of knowledge regarding the effect of polymorphisms of the peroxisome proliferator-activated receptor gamma coactivator 1α (PGC-1α) gene on the age of obesity onset. Hence, 3 polymorphisms of the PGC-1α gene (PGC-1α rs17574213, rs8192678, and rs3755863) were examined in association with obesity onset age. Also, obesity onset age-related metabolic status and body composition were evaluated. This cross-sectional study was conducted with a total of 321 obese participants. Anthropometric and biochemical information, body composition, and PGC-1α gene sequences were analyzed. The rs17574213 polymorphism was associated with obesity onset in children aged <1 years and 10-18 years. The rs8192678 polymorphism was associated with obesity onset in adulthood. Body mass index, body fat percent, and trunk fat were higher in groups whose obesity began at age <1 year or 10-18 years than in other groups. Serum levels of high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and total cholesterol were lowest in the group with obesity onset between the ages of 10 and 18 years. Visceral fat and fasting blood glucose were highest in those whose obesity began in adulthood. In conclusion, 2 polymorphisms of the PGC-1α gene were associated with obesity onset age.
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Affiliation(s)
- Negar Zamaninour
- a Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Khadijeh Mirzaei
- b Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Zhila Maghbooli
- c Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Keshavarz
- d Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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113
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Bichteler A, Gershoff ET. Identification of Children's BMI Trajectories and Prediction from Weight Gain in Infancy. Obesity (Silver Spring) 2018; 26:1050-1056. [PMID: 29722476 PMCID: PMC8287871 DOI: 10.1002/oby.22177] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 02/13/2018] [Accepted: 02/15/2018] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The goal of this study was to identify patterns of BMI changes across childhood (ages 24 months to 13 years) and to assess whether demographic characteristics, birth weight, and percent infant weight gain from birth to 15 months predicted BMI patterns. METHODS Eleven waves of data from the Study of Early Child Care and Youth Development were used. Trained technicians assessed children's weight at birth and 10 times from 15 months to eighth grade (N = 1364). Latent growth modeling was used to estimate BMI change trajectories, and logistic regression was used to predict membership in trajectory classes. RESULTS Children in the high-rising and low-to-high BMI patterns had the highest BMI of all trajectory groups during middle childhood. Birth weight and infant weight gain were stronger predictors of trajectory membership than gender or race/ethnicity. Infant weight gain predicted high-rising membership over and above the effect of birth weight. African American children had lower birth weight, faster infant weight increase, and higher odds of being in one of the rising trajectories. Risk algorithms are provided. CONCLUSIONS Clinicians should monitor weight gain during infancy independent of birth weight. Researchers should continue investigating the lasting physiological effects of early rapid weight gain in infancy.
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Affiliation(s)
- Anne Bichteler
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Elizabeth T Gershoff
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas, USA
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Abstract
PURPOSE OF REVIEW Obesity rates in the USA have reached pandemic levels with one third of the population with obesity in 2015-2016 (39.8% of adults and 18.5% of youth). It is a major public health concern, and it is prudent to understand the factors which contribute. Racial and ethnic disparities are pronounced in both the prevalence and treatment of obesity and must be addressed in the efforts to combat obesity. RECENT FINDINGS Disparities in prevalence of obesity in racial/ethnic minorities are apparent as early as the preschool years and factors including genetics, diet, physical activity, psychological factors, stress, income, and discrimination, among others, must be taken into consideration. A multidisciplinary team optimizes lifestyle and behavioral interventions, pharmacologic therapy, and access to bariatric surgery to develop the most beneficial and equitable treatment plans. The reviewed studies outline disparities that exist and the impact that race/ethnicity have on disease prevalence and treatment response. Higher prevalence and reduced treatment response to lifestyle, behavior, pharmacotherapy, and surgery, are observed in racial and ethnic minorities. Increased research, diagnosis, and access to treatment in the pediatric and adult populations of racial and ethnic minorities are proposed to combat the burgeoning obesity epidemic and to prevent increasing disparity.
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Affiliation(s)
- Angel S Byrd
- Department of Dermatology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alexander T Toth
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Fatima Cody Stanford
- Harvard Medical School, Boston, MA, USA.
- MGH Weight Center, Gastrointestinal Unit-Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 430, Boston, MA, 02114, USA.
- Department of Pediatrics-Endocrinology, Massachusetts General Hospital, Boston, MA, USA.
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115
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Berggren S, Roswall J, Alm B, Bergman S, Dahlgren J, Almquist-Tangen G. Parents with overweight children two and five years of age did not perceive them as weighing too much. Acta Paediatr 2018; 107:1060-1064. [PMID: 29210112 DOI: 10.1111/apa.14174] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/06/2017] [Accepted: 11/30/2017] [Indexed: 11/27/2022]
Abstract
AIM This study examined whether the parents of children who were overweight at two and five years of age perceived their children as being too heavy and related the findings to sociodemographic factors. METHODS The data collection included parental questionnaires and anthropometric data from a longitudinal birth cohort of 2666 children born in the south-west region of Sweden in 2007-2008. RESULTS We found that 14.9 and 11.8% of the children were considered overweight or obese at the age of two and five, but 96.4 and 87.1% of their parents perceived their weight to be just about right at these ages. The difference was statistically significant (p < 0.001). Parents who were overweight themselves and had a low educational level were associated with a higher probability of misperception: at two years of age, the odds ratio was 2.75 (95% confidence interval 1.80-4.21), and at the age of five, it was 1.92 (1.24-2.97). CONCLUSION Most parents did not perceive that their overweight children weighed too much, but their judgement improved as the child got older. Parents who were overweight or had a low educational level were more likely to misperceive their child's weight. Health Care professionals need to be aware of this gap in perception.
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Affiliation(s)
- Sara Berggren
- Department of Paediatrics; Halland Hospital Halmstad; Halmstad Sweden
| | - Josefine Roswall
- Department of Paediatrics; Halland Hospital Halmstad; Halmstad Sweden
- Department of Paediatrics; Institute of Clinical Sciences; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Bernt Alm
- Department of Paediatrics; Institute of Clinical Sciences; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
- Child Health Care Unit; Region Halland Sweden
| | - Stefan Bergman
- Primary Health Care Unit; Department of Public Health and Community Medicine; Institute of Medicine; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
- Research and Development Centre Spenshult; Halmstad Sweden
| | - Jovanna Dahlgren
- Department of Paediatrics; Institute of Clinical Sciences; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Gerd Almquist-Tangen
- Department of Paediatrics; Institute of Clinical Sciences; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
- Child Health Care Unit; Region Halland Sweden
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116
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Nejadsadeghi E, Shojaeizadeh D, Sadeghi R, Majlesi F, Djazayeri A, Yekaninejad MS, Amanat M. Demographic determinants of obesity, and adherence to dietary and physical activity guidelines among 4 to 6-year-old children in Behbahan city, southwest Iran, 2016. Electron Physician 2018; 10:6554-6562. [PMID: 29765582 PMCID: PMC5942578 DOI: 10.19082/6554] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 08/28/2017] [Indexed: 12/15/2022] Open
Abstract
Background and aim The world is experiencing an alarming increase in prevalence of childhood obesity. The aim of this study was to determine the demographic determinants of obesity and adherence to dietary and physical activity guidelines among children aged 4 to 6 years old in Behbahan city, southwest Iran, in 2016. Methods This cross-sectional study was conducted on 120 preschool children aged 4 to 6 years old in Behbahan city, southwest Iran, in 2016. Multi-stage random sampling was done. The weight and height of the children were measured with standard methods. The demographic and behavioral factors data were collected in self report questionnaires which were completed by the children’s mothers. The Chi-square test, Independent-samples t-tests, One-way analysis of variances and logistic regression analysis were used for data analysis. SPSS software (version 22) was employed. Results This study showed that 88.3% of the children did not meet the guideline of 5 servings per day of fruit and vegetables. Only 2.5% met the guideline of 60 minutes of structured physical activity every day. Sex and mother’s occupation status were associated with adhering to screen time guideline. This study found a significant difference in the mean of screen time between sexes. Boys were more likely to meet the screen time guideline. A significant association between adhering to physical activity guidelines and mother’s occupation status was revealed. Significant statistical relationship between demographic factors and BMI categories was not illustrated. Demographic covariates were not significantly related to adherence to dietary and physical activity guidelines. Conclusion In preventive programs of obesity among 4 to 6-year-old children key lifestyle behaviors and demographic factors need to be considered.
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Affiliation(s)
- Elham Nejadsadeghi
- Ph.D. Student of Health Education and Promotion, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Davood Shojaeizadeh
- Ph.D. of Health Education and Promotion, Professor, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sadeghi
- Ph.D. of Health Education and Promotion, Associate Professor, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereshteh Majlesi
- Ph.D. of Maternal and Child Health, Professor, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abolghassem Djazayeri
- Ph.D. of Nutrition, Professor, Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mir Saeed Yekaninejad
- Ph.D. of Biostatistics, Assistant Professor, Department of Biostatistics and epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahshid Amanat
- M.Sc. Student of Psychometrics, Department of Assessment and Measurement, School of Psychology and Educational Sciences, Allameh Tabatabai University, Tehran, Iran
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117
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Palacios C, Campos M, Gibby C, Meléndez M, Lee JE, Banna J. Effect of a Multi-Site Trial using Short Message Service (SMS) on Infant Feeding Practices and Weight Gain in Low-Income Minorities. J Am Coll Nutr 2018; 37:605-613. [PMID: 29708471 DOI: 10.1080/07315724.2018.1454353] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To test the effects of weekly SMS for improving infant feeding practices and infant weight. METHODS This was a multi-site randomized clinical trial in a convenience sample of 202 caregivers of healthy term infants 0-2 months participating in the WIC program in Puerto Rico and Hawaii. Participants were randomized to receive SMS about infant's general health issues (control) or SMS for improving feeding practices (intervention) for four months. Weight, length and infant feeding practices were assessed at baseline and four months later. RESULTS A total of 170 participants completed the study (n = 86 control and n = 84 intervention). Baseline characteristics were similar between groups. At the end, exclusive breastfeeding rates were similar between groups (67.4% control and 59.1% intervention). Introduction of other foods and beverages, addition of foods to the bottle, placing infants to sleep with milk bottles, caregiver's method and response to feeding infants and distractions while feeding infants were similar between groups. Also, weight status or rate of weight gain was similar between groups. CONCLUSION There were no significant improvements in feeding practices or in weight with the intervention. The timeline of the messages in relation to the targeted behavior may have affected the effectiveness of the intervention. Earlier dissemination of messages, higher level of intensity, longer intervention, additional contacts and inclusion of other caregivers may be needed to achieve the desired effects.
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Affiliation(s)
- Cristina Palacios
- a Department of Dietetics and Nutrition , Robert Stempel College of Public Health & Social Work, Florida International University , Miami , FL , USA
| | - Maribel Campos
- b Dental and Craniofacial Genomics Center, Endowed Health Services Research Center, Medical Sciences Campus, University of Puerto Rico , San Juan , PR , USA
| | - Cheryl Gibby
- c Department of Human Nutrition , Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa , Manoa , HI , USA
| | - Marytere Meléndez
- d Center for Clinical Research and Health Promotion, Medical Sciences Campus, University of Puerto Rico , San Juan , PR , USA
| | - Jae Eun Lee
- e College of Science, Engineering and Technology, Jackson State University , Jackson , MI , USA
| | - Jinan Banna
- c Department of Human Nutrition , Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa , Manoa , HI , USA
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Russell CG, Denney-Wilson E, Laws RA, Abbott G, Zheng M, Lymer SJ, Taki S, Litterbach EKV, Ong KL, Campbell KJ. Impact of the Growing Healthy mHealth Program on Maternal Feeding Practices, Infant Food Preferences, and Satiety Responsiveness: Quasi-Experimental Study. JMIR Mhealth Uhealth 2018; 6:e77. [PMID: 29695373 PMCID: PMC5943630 DOI: 10.2196/mhealth.9303] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 12/22/2017] [Accepted: 12/22/2017] [Indexed: 01/22/2023] Open
Abstract
Background Infancy is an important life stage for obesity prevention efforts. Parents’ infant feeding practices influence the development of infants’ food preferences and eating behaviors and subsequently diet and weight. Mobile health (mHealth) may provide a feasible medium through which to deliver programs to promote healthy infant feeding as it allows low cost and easy access to tailored content. Objective The objective of this study was to describe the effects of an mHealth intervention on parental feeding practices, infant food preferences, and infant satiety responsiveness. Methods A quasi-experimental study was conducted with an mHealth intervention group (Growing Healthy) and a nonrandomized comparison group (“Baby's First Food"). The intervention group received access to a free app with age-appropriate push notifications, a website, and an online forum that provided them with evidence-based advice on infant feeding for healthy growth from birth until 9 months of age. Behavior change techniques were selected using the Behaviour Change Wheel framework. Participants in both groups completed three Web-based surveys, first when their infants were less than 3 months old (baseline, T1), then at 6 months (time 2, T2), and 9 months of age (time 3, T3). Surveys included questions on infant feeding practices and beliefs (Infant Feeding Questionnaire, IFQ), satiety responsiveness (Baby Eating Behaviour Questionnaire), and infant’s food exposure and liking. Multivariate linear regression models, estimated using maximum likelihood with bootstrapped standard errors, were fitted to compare continuous outcomes between the intervention groups, with adjustment for relevant covariates. Multivariate logistic regression adjusting for the same covariates was performed for categorical outcomes. Results A total of 645 parents (Growing Healthy: n=301, Baby's First Food: n=344) met the eligibility criteria and were included in the study, reducing to a sample size of 546 (Growing Healthy: n=234, Baby's First Food: n=312) at T2 and a sample size of 518 (Growing Healthy: n=225, Baby's First Food: n=293) at T3. There were approximately equal numbers of boy and girl infants, and infants were aged less than 3 months at baseline (Growing Healthy: mean 7.0, SD 3.7 weeks; Baby's First Food: mean 7.9, SD 3.8 weeks), with Growing Healthy infants being slightly younger than Baby's First Food infants (P=.001). All but one (IFQ subscale “concerns about infant overeating or becoming overweight” at T2) of the measured outcomes did not differ between Growing Healthy and Baby's First Food. Conclusions Although mHealth can be effective in promoting some health behaviors and offers many advantages in health promotion, the results of this study suggest that design and delivery characteristics needed to maximize the impact of mHealth interventions on infant feeding are uncertain. The sensitivity of available measurement tools and differences in baseline characteristics of participants may have also affected the results.
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Affiliation(s)
- Catherine Georgina Russell
- Centre for Advanced Sensory Science, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Burwood, Australia.,Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, Sydney, Australia
| | - Elizabeth Denney-Wilson
- Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, Sydney, Australia.,Sydney Nursing School, The University of Sydney, Sydney, Australia.,Sydney Local Health District, Sydney, Australia
| | - Rachel A Laws
- Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, Sydney, Australia.,Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Gavin Abbott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Sharyn J Lymer
- Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, Sydney, Australia.,The Boden Institute of Obesity Nutrition Exercise & Eating Disorders, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Sarah Taki
- Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, Sydney, Australia.,Health Promotion Unit, Sydney Local Health District, and University of Sydney, Sydney, Australia
| | - Eloise-Kate V Litterbach
- Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, Sydney, Australia.,Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Kok-Leong Ong
- Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, Sydney, Australia.,Department of Accounting and Data Analytics, La Trobe Business School, College of Arts, Social Sciences and Commerce, La Trobe University, Melbourne, Australia
| | - Karen J Campbell
- Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, Sydney, Australia.,Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
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Miyakoshi C, Yamamoto Y, Mishina H, Shirai C, Morioka I, Fukuhara S. Childcare Environment and Japanese Children Who Are Overweight in Early Childhood. Child Obes 2018; 14:197-206. [PMID: 29473766 DOI: 10.1089/chi.2017.0199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Maternal employment may affect child care styles and contribute to the increasing prevalence of overweight children. We explored the potential risk factors for becoming overweight during early childhood, especially in the child care environment. METHODS We conducted a retrospective cohort study using data from health check-up services from 2007 to 2015 in Kobe, Japan. The main outcome was being overweight at age 3 years, which was defined by the International Obesity Task Force cutoffs. Environmental, maternal, and infantile factors were examined as possible risk factors for childhood overweight. RESULTS Of 31,463 infants, 1315 (4.2%) were classified as overweight at age 3 years. Compared with children who were cared for by their mothers during the day at 4 and 18 months, the adjusted odds ratio (aOR) for becoming overweight for those who were not cared for by their mothers was 1.52: 95% confidence interval (CI), 1.16-1.99. Long sleep duration was associated with lower risk of childhood overweight: aOR, 0.79; 95% CI, 0.66-0.96. CONCLUSION Less daytime care by mothers and shorter sleep duration were associated with increased risk of becoming overweight during childhood. Further studies are needed to determine on how the effect of those factors may be diminished with respect to childhood overweight.
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Affiliation(s)
- Chisato Miyakoshi
- 1 Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University , Kyoto, Japan .,2 Department of Pediatrics, Kobe City Medical Center General Hospital , Kobe, Japan
| | - Yosuke Yamamoto
- 1 Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University , Kyoto, Japan
| | | | | | - Ichiro Morioka
- 5 Department of Pediatrics, Kobe University Graduate School of Medicine , Kobe, Japan
| | - Shunichi Fukuhara
- 1 Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University , Kyoto, Japan .,6 Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University , Fukushima, Japan
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120
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Lumeng JC, Miller AL, Appugliese D, Rosenblum K, Kaciroti N. Picky eating, pressuring feeding, and growth in toddlers. Appetite 2018; 123:299-305. [PMID: 29331364 PMCID: PMC5817026 DOI: 10.1016/j.appet.2017.12.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 12/16/2017] [Accepted: 12/17/2017] [Indexed: 10/18/2022]
Abstract
Several common theoretical frameworks have posited causal pathways between picky eating, pressuring feeding, and growth in early childhood. The evidence to support these pathways is limited. This observational cohort study sought to examine the cross-lagged associations between mother-reported pressuring feeding, mother-reported child picky eating, and measured weight-for-length z-score (WLZ) across child ages 21, 27, and 33 months (n = 244). Cross-lagged analysis was used to evaluate longitudinal associations between these three constructs. The sample was 50.5% white, 52.3% male and 37.8% of mothers had a high school education or less. Mean WLZ was 0.52, 0.41, and 0.38 at each age, respectively. Pressuring feeding, picky eating, and WLZ each tracked strongly from 21 to 33 months. There were concurrent associations between pressuring feeding and picky eating. However, there were no prospective associations between pressuring feeding and future WLZ; WLZ and future pressuring feeding; pressuring feeding and future picky eating; picky eating and future pressuring feeding; or picky eating and future WLZ. Our results do not support causal relationships between picky eating, pressuring feeding, and growth in toddlerhood. Future work that examines alternative mechanisms shaping growth in early childhood is needed.
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Affiliation(s)
- Julie C Lumeng
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA; Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, MI, USA; Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA.
| | - Alison L Miller
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA; Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | | | - Katherine Rosenblum
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA; Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Niko Kaciroti
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA; Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
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Ferro V, Mosca A, Crea F, Mesturino MA, Olita C, Vania A, Reale A, Nobili V, Raucci U. The relationship between body mass index and children's presentations to a tertiary pediatric emergency department. Ital J Pediatr 2018; 44:38. [PMID: 29559007 PMCID: PMC5859749 DOI: 10.1186/s13052-018-0476-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 03/09/2018] [Indexed: 01/02/2023] Open
Abstract
Background The child obesity and its complications are associated with an alarming increased health care use, including the emergency department (ED). We evaluated the effects of the obesity and overweight in children admitted to ED, especially in patients with injury diagnosis. Methods A retrospective study of patients aged 6–18 years was conducted. Patients were categorized into normal weight (body mass index, BMI < 85th); overweight (BMI ≥ 85th e < 95th); obesity (BMI ≥ 95th). Multiple logistic analysis was used for estimation of risk factors associated with the BMI and to explore the association between injury diagnosis and BMI. Results The predictive factors associated with obesity and overweight were school age (p < 0.001), male gender (p < 0.001) and number of visits for year (obesity: p < 0.001 and overweight: p < 0.05). Obese children were less at injury risk than normal weight (p < 0.05). In injury subset, fractures in school age were more likely to occur in obesity (p < 0.01). Dislocated fractures (p < 0.01) and fractures at lower extremity were more likely to occur in obesity and overweight (p < 0.05). Conclusions School age children presenting to ED are more at risk of excess body weight than adolescents and are at higher fracture risk if obese and overweight. This has clear implication to support the efforts to reduce the obesity in childhood. The ED may represent a crucial setting for the early identification of these children and of co-morbidities related BMI ≥ 85th, and for a timely specialist referral of these children, especially if school age.
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Affiliation(s)
- Valentina Ferro
- Emergency Pediatric Department, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, Rome, Italy
| | - Antonella Mosca
- Hepato-Metabolic Disease Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Francesca Crea
- Emergency Pediatric Department, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, Rome, Italy
| | - Maria Alessia Mesturino
- Emergency Pediatric Department, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, Rome, Italy
| | - Carla Olita
- Emergency Pediatric Department, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, Rome, Italy
| | - Andrea Vania
- Centre for Pediatric Dietetics and Nutrition, Department of Pediatrics and Pediatric Neuropsychiatry Rome "Sapienza" University, Rome, Italy
| | - Antonino Reale
- Emergency Pediatric Department, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, Rome, Italy
| | - Valerio Nobili
- Hepato-Metabolic Disease Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Umberto Raucci
- Emergency Pediatric Department, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, Rome, Italy.
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122
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Bates CR, Buscemi J, Nicholson LM, Cory M, Jagpal A, Bohnert AM. Links between the organization of the family home environment and child obesity: a systematic review. Obes Rev 2018. [PMID: 29520946 DOI: 10.1111/obr.12662] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Due to increasingly high rates of child overweight and obesity, it is important to identify risk and protective factors that may inform more effective prevention and intervention. The degree of organization in the family home environment is a studied, but not well-specified, factor that may impact child weight. Prior research on household organization has examined an array of constructs, including family routines, limit setting, household chaos, crowding and the broad home environment. This study systematically reviews literature on organization within the family home environment and weight among children ages 2-12. Six hundred thirty-seven studies were reviewed by four coders for eligibility, and 32 studies were included in the final synthesis. Overall, 84% of studies provided evidence for relations between at least one indicator of organization within the family home environment and child weight. Studies provided compelling evidence across several constructs, suggesting that the relevance of household organization to child weight extends beyond a single indicator. Directions for future work include (i) examining the mediating role of health behaviours, (ii) examining the moderating role of socioeconomic factors, (iii) broadening this evidence base across cultures and nationalities and (iv) integrating constructs to develop a comprehensive model of organization within the home environment.
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Affiliation(s)
- C R Bates
- Department of Psychology, Loyola University Chicago, Chicago, IL, USA
| | - J Buscemi
- Department of Psychology, DePaul University, Chicago, IL, USA
| | - L M Nicholson
- Department of Psychology, Loyola University Chicago, Chicago, IL, USA
| | - M Cory
- Department of Psychology, DePaul University, Chicago, IL, USA
| | - A Jagpal
- Department of Psychology, DePaul University, Chicago, IL, USA
| | - A M Bohnert
- Department of Psychology, Loyola University Chicago, Chicago, IL, USA
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Pan L, Park S, Slayton R, Goodman AB, Blanck HM. Trends in Severe Obesity Among Children Aged 2 to 4 Years Enrolled in Special Supplemental Nutrition Program for Women, Infants, and Children From 2000 to 2014. JAMA Pediatr 2018; 172:232-238. [PMID: 29309485 PMCID: PMC5885862 DOI: 10.1001/jamapediatrics.2017.4301] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Severe obesity in childhood is associated with negative health consequences. A previous study examined trends in severe obesity among preschool-aged children in low-income families during 1998 to 2010. No recent trends have been reported. OBJECTIVE To examine trends in severe obesity by age, sex, and race/ethnicity among enrollees in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) aged 2 to 4 years during 2000 to 2014. DESIGN, SETTING, AND PARTICIPANTS Serial cross-sectional data from 22.6 million young children enrolled in WIC from 50 states, the District of Columbia, and 5 US territories from 2000 to 2014. Data analysis was conducted from February 16, 2017, to March 9, 2017. MAIN OUTCOMES AND MEASURES Prevalence of severe obesity. Severe obesity was defined as a sex-specific body mass index-for-age 120% or more of the 95th percentile on the 2000 Centers for Disease Control and Prevention growth charts. Children's weights and heights were measured. Children whose sex, weight, height, or body mass index was missing or biologically implausible were excluded. RESULTS The prevalence of severe obesity was 1.96% in 2014. During 2000 to 2004, the prevalence increased significantly overall from 1.80% to 2.11% (adjusted prevalence difference [APD], 0.26%) and among all the age, sex, and racial/ethnic groups except for Asian/Pacific Islander (APD, 0.05%-0.54% across groups with increases). The largest relative increase occurred in children aged 4 years (adjusted prevalence ratio [APR], 1.21) and non-Hispanic white (APR, 1.22) and American Indian/Alaska Native children (APR, 1.19). During 2004 to 2010, the prevalence decreased significantly overall (APD, -0.05%), among boys, children aged 2 and 3 years, and non-Hispanic black and Asian/Pacific Islander children (APD, -0.05% to -0.18%). During 2010 to 2014, the prevalence decreased significantly overall from 2.12% to 1.96% (APD, -0.14%) and among all demographic groups (APD, -0.04% to -0.30% across groups). The largest relative decrease occurred in children aged 2 years (APR, 0.88) and Hispanic (APR, 0.92), American Indian/Alaska Native (APR, 0.89), and Asian/Pacific Islander (APR, 0.87) children. CONCLUSIONS AND RELEVANCE This study provides updated prevalence and trends of severe obesity among young children enrolled in WIC and reports recent modest declines in severe obesity in all subgroups. Ongoing surveillance can assess whether declines continue into the future among low-income children.
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Affiliation(s)
- Liping Pan
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sohyun Park
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Renata Slayton
- Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, Virginia
| | - Alyson B. Goodman
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Heidi M. Blanck
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia
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A Randomized Trial of Weight Change in a National Home Visiting Program. Am J Prev Med 2018; 54:341-351. [PMID: 29455756 PMCID: PMC5826618 DOI: 10.1016/j.amepre.2017.12.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 11/14/2017] [Accepted: 12/07/2017] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Clinical trials have demonstrated significant impact in reducing weight and incidence of type 2 diabetes mellitus. However, the intensity of these trials limits their scalability to real world settings. The purpose of this study was to embed a lifestyle intervention for overweight and obese mothers within the routine practice of a parent education, home visiting organization. DESIGN Pragmatic trial that used a stratified random design. SETTING/PARTICIPANTS Overweight or obese mothers of preschool children located across St. Louis, Missouri, enrolled in Parents As Teachers, a home visiting organization reaching women and children nationwide. INTERVENTION A lifestyle intervention derived from the Diabetes Prevention Program was embedded within Parents As Teachers entitled Healthy Eating and Active Living Taught at Home (HEALTH). MAIN OUTCOME MEASURES Outcomes included the proportion of women that achieved 5% weight loss at 24 months and improvements in clinical and behavioral outcomes at 12 and 24 months. Participants were enrolled from 2012 to 2014 and data analysis began in 2016. RESULTS Women in the usual care versus intervention group were significantly less likely to achieve 5% weight loss at 24 months (11% vs 26%, p=0.01). At 12 months, there was a 2.8-kg difference in weight between groups (p=0.0006), and by 24 months a 4.7-kg difference in weight (3.2 [SD=7.6] kg vs -1.5 [SD=8.3] kg, p=0.002); group differences in waist circumference were also evident by 12 months (2.1 [SD=8.4] cm vs -0.7 [SD=9.8] cm, p=0.04) and 24 months (3.8 [SD=10.6] cm vs -2.5 [SD=9.1] cm, p=0.005), as were improvements in behavioral outcomes. There was no difference in blood pressure between groups. CONCLUSIONS HEALTH achieved modest but clinically significant weight loss outcomes, and reduced weight gain in mothers of young children. The scalability of this embedded intervention offers the potential to reach mothers in Parents As Teachers programs nationally. TRIAL REGISTRATION This study is registered at www.clinicaltrials.gov NCT01567033.
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125
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Leppänen MH, Henriksson P, Delisle Nyström C, Henriksson H, Ortega FB, Pomeroy J, Ruiz JR, Cadenas-Sanchez C, Löf M. Longitudinal Physical Activity, Body Composition, and Physical Fitness in Preschoolers. Med Sci Sports Exerc 2018; 49:2078-2085. [PMID: 28538260 DOI: 10.1249/mss.0000000000001313] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to investigate longitudinal associations of objectively measured physical activity (PA) and sedentary behavior (SB) with body composition and physical fitness at a 12-month follow-up in healthy Swedish 4-yr-old children. METHODS The data from the population-based MINISTOP trial were collected between 2014 and 2016, and this study included the 138 children who were in the control group. PA and SB were assessed using the wrist-worn ActiGraph (wGT3x-BT) accelerometer during seven 24-h periods and, subsequently, defined as SB, light-intensity PA, moderate-intensity PA, vigorous-intensity PA (VPA), and moderate-to-vigorous PA (MVPA). Body composition was measured using air-displacement plethysmography and physical fitness (cardiorespiratory fitness, lower and upper muscular strength as well as motor fitness) by the PREFIT fitness battery. Linear regression and isotemporal substitution models were applied. RESULTS Greater VPA and MVPA at the age of 4.5 yr were associated with higher fat-free mass index (FFMI) at 5.5 yr (P < 0.001 and P = 0.044, respectively). Furthermore, greater VPA and MVPA at the age of 4.5 yr were associated with higher scores for cardiorespiratory fitness, lower body muscular strength, and motor fitness at 12-month follow-up (P = 0.001 to P = 0.031). Substituting 5 min·d of SB, light-intensity PA, or moderate-intensity PA for VPA at the age of 4.5 yr were associated with higher FFMI, and with greater upper and lower muscular strength at 12-month follow-up (P < 0.001 to P = 0.046). CONCLUSION Higher VPA and MVPA at the age of 4.5 yr were significantly associated with higher FFMI and better physical fitness at 12-month follow-up. Our results indicate that promoting high-intensity PA at young ages may have long-term beneficial effects on childhood body composition and physical fitness, in particular muscular strength.
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Affiliation(s)
- Marja H Leppänen
- 1Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, FINLAND; 2Department of Clinical and Experimental Medicine, Faculty of Health Science, Linkoping University, Linkoping, SWEDEN; 3Promoting Fitness and Health through Physical Activity Research Group (PROFITH), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, SPAIN; 4Department of Biosciences and Nutrition, Karolinska Institutet, NOVUM, Huddinge, SWEDEN; and 5Marshfield Clinic Research Foundation, Marshfield, WI
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126
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Gravelle BL, Hagen TW. Metabolic characteristics of Appalachian children. Clin Nutr ESPEN 2018; 22:36-42. [PMID: 29415832 DOI: 10.1016/j.clnesp.2017.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 09/18/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of this investigation is to assess the physiological characteristics and the resting metabolic rates of a representative population of children in Buchanan County in order to identify those factors that may be contributing to the predisposition for being overweight or obese and provide nutritional and physical activity guidance for prevention. METHODS Twenty-three volunteers from grades 5, 6 and 7 from Buchannan County, VA underwent parametric and metabolic testing over three consecutive years in order to determine their height, weight, BMI, percent body fat, resting oxygen consumption (VO2), resting energy expenditure (REE), respiratory exchange ratio (RER) and daily energy expenditure (DEE) and consumption. RESULTS Over the 3 year study period, subjects' BMI increased significantly over time (p = 0.001) while there were no changes in their, REE, RER, VO2, percent fat and DEE. However, there was a moderate negative correlation between VO2 and BMI in grade 5 (r = -0.578, p = 0.002), grade 6 (r = -0.477, p = 0.015) and grade 7 (r = -0.438, p = 0.023). Gender specific differences in percent body fat were evident among subjects during the last two measurement cycles and were strongly correlated with BMI (r = 0.907, r = 0.959, p = 0.000). CONCLUSIONS The use of resting VO2, REE, and RER values as a screening tool for identifying those children or adolescents at risk for becoming overweight or obese is most likely cost and time prohibitive due to the need for several repeated measures to ensure accurate results. However increased VO2 is correlated with decreased BMI.
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Affiliation(s)
- Brent L Gravelle
- Department of Pharmaceutical Sciences, Appalachian College of Pharmacy, 1060 Dragon Road, Oakwood, VA 24631, USA.
| | - Ted W Hagen
- Department of Pharmaceutical Sciences, Appalachian College of Pharmacy, Blue Ridge Neuroscience Center, USA
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127
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Miller AL, Gearhardt AN, Fredericks EM, Katz B, Shapiro LF, Holden K, Kaciroti N, Gonzalez R, Hunter C, Lumeng JC. Targeting self-regulation to promote health behaviors in children. Behav Res Ther 2018; 101:71-81. [PMID: 29050636 PMCID: PMC5801044 DOI: 10.1016/j.brat.2017.09.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 09/15/2017] [Accepted: 09/25/2017] [Indexed: 01/10/2023]
Abstract
Poor self-regulation (i.e., inability to harness cognitive, emotional, motivational resources to achieve goals) is hypothesized to contribute to unhealthy behaviors across the lifespan. Enhancing early self-regulation may increase positive health outcomes. Obesity is a major public health concern with early-emerging precursors related to self-regulation; it is therefore a good model for understanding self-regulation and health behavior. Preadolescence is a transition when children increase autonomy in health behaviors (e.g., eating, exercise habits), many of which involve self-regulation. This paper presents the scientific rationale for examining self-regulation mechanisms that are hypothesized to relate to health behaviors, specifically obesogenic eating, that have not been examined in children. We describe novel intervention protocols designed to enhance self-regulation skills, specifically executive functioning, emotion regulation, future-oriented thinking, and approach bias. Interventions are delivered via home visits. Assays of self-regulation and obesogenic eating behaviors using behavioral tasks and self-reports are implemented and evaluated to determine feasibility and psychometrics and to test intervention effects. Participants are low-income 9-12 year-old children who have been phenotyped for self-regulation, stress, eating behavior and adiposity through early childhood. Study goals are to examine intervention effects on self-regulation and whether change in self-regulation improves obesogenic eating.
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Affiliation(s)
- Alison L Miller
- School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States; Center for Human Growth and Development, University of Michigan, 300 North Ingalls Street, Ann Arbor, MI 48109, United States.
| | - Ashley N Gearhardt
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI 48109, United States.
| | - Emily M Fredericks
- Department of Pediatrics, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States.
| | - Benjamin Katz
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI 48109, United States.
| | - Lilly Fink Shapiro
- School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States.
| | - Kelsie Holden
- School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States.
| | - Niko Kaciroti
- School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States; Center for Human Growth and Development, University of Michigan, 300 North Ingalls Street, Ann Arbor, MI 48109, United States.
| | - Richard Gonzalez
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI 48109, United States.
| | - Christine Hunter
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892, United States.
| | - Julie C Lumeng
- Center for Human Growth and Development, University of Michigan, 300 North Ingalls Street, Ann Arbor, MI 48109, United States; Department of Pediatrics, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States.
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128
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Chang LY, Mendelsohn AL, Fierman AH, Au LY, Messito MJ. Perception of Child Weight and Feeding Styles in Parents of Chinese-American Preschoolers. J Immigr Minor Health 2018; 19:302-308. [PMID: 28050678 DOI: 10.1007/s10903-016-0541-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Parent perception of weight and feeding styles are associated with obesity in other racial groups but have not been explored in-depth in Chinese-American preschoolers. Cross-sectional survey of 253 Chinese-American parents with preschoolers was performed in a community clinic. Regression analysis was used to assess relationships between parental perception of weight and feeding styles. Parent under-perception of weight was common but more likely in boys than girls (χ2 = 4.91, p = 0.03). Pressuring was also greater in boys [adjusted mean difference (95% CI) 0.24 (0.004, 0.49)]. In girls, pressuring was lower for children perceived as overweight [adjusted mean difference in CFQ scores -0.75 (-1.27, -0.23)]; in boys, pressuring was high regardless of perceived child weight. Weight perceptions and feeding styles related to childhood obesity in other groups were identified in Chinese-American families. Parent under-perception of child weight and pressure to eat were more common in boys. These factors should be addressed in Chinese-American preschooler obesity prevention programs.
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Affiliation(s)
- Lucy Y Chang
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA.
| | - Alan L Mendelsohn
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA
| | - Arthur H Fierman
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA
| | - Loretta Y Au
- Department of Pediatrics, Charles B. Wang Community Health Center, New York, NY, USA
| | - Mary Jo Messito
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA
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129
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Stark LJ, Filigno SS, Bolling C, Ratcliff MB, Kichler JC, Robson SM, Simon SL, McCullough MB, Clifford LM, Stough CO, Zion C, Ittenbach RF. Clinic and Home-Based Behavioral Intervention for Obesity in Preschoolers: A Randomized Trial. J Pediatr 2018; 192:115-121.e1. [PMID: 29150147 PMCID: PMC5732872 DOI: 10.1016/j.jpeds.2017.09.063] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 09/07/2017] [Accepted: 09/22/2017] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To test the hypotheses that an innovative skills-based behavioral family clinic and home-based intervention (LAUNCH) would reduce body mass index z score (BMIz) compared with motivational interviewing and to standard care in preschool-aged children with obesity. STUDY DESIGN Randomized controlled trial with children between the ages of 2 and 5 years above the 95th percentile for body mass index for age and sex recruited from 27 pediatrician offices across 10 recruitment cycles between March 12, 2012 and June 8, 2015. Children were randomized to LAUNCH (an 18-session clinic and home-based behavioral intervention), motivational interviewing (delivered at the same frequency as LAUNCH), or standard care (no formal intervention). Weight and height were measured by assessors blinded to participant assignment. The primary outcome, BMIz at month 6 after adjusting for baseline BMIz, was tested separately comparing LAUNCH with motivational interviewing and LAUNCH with standard care using regression-based analysis of covariance models. RESULTS A total of 151 of the 167 children randomized met intent-to-treat criteria and 92% completed the study. Children were 76% White and 57% female, with an average age of 55 months and BMI percentile of 98.57, with no demographic differences between the groups. LAUNCH participants demonstrated a significantly greater decrease in BMIz (mean = -0.32, SD = ±0.33) compared with motivational interviewing (mean = -0.05, SD = ±0.27), P < .001, ω2 = 0.74 and compared with standard care (mean = -0.13, SD = ±0.31), P < .004, ω2 = 0.75. CONCLUSIONS In preschool-age children, an intensive 6-month behavioral skills-based intervention is necessary to reduce obesity. TRIAL REGISTRATION Clinicaltrials.gov NCT01546727.
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Affiliation(s)
- Lori J. Stark
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH
| | - Stephanie Spear Filigno
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH
| | | | | | - Jessica C. Kichler
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH
| | - Shannon M. Robson
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware
| | - Stacey L. Simon
- Department of Pediatrics, Division of Pulmonary Medicine, Children’s Hospital Colorado, Aurora, CO
| | - Mary Beth McCullough
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
| | - Lisa M. Clifford
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | | | - Cynthia Zion
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH
| | - Richard F. Ittenbach
- Department of Pediatrics, Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH
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Buscot MJ, Thomson RJ, Juonala M, Sabin MA, Burgner DP, Lehtimäki T, Hutri-Kähönen N, Viikari JSA, Jokinen E, Tossavainen P, Laitinen T, Raitakari OT, Magnussen CG. BMI Trajectories Associated With Resolution of Elevated Youth BMI and Incident Adult Obesity. Pediatrics 2018; 141:peds.2017-2003. [PMID: 29259077 DOI: 10.1542/peds.2017-2003] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Youth with high BMI who become nonobese adults have the same cardiovascular risk factor burden as those who were never obese. However, the early-life BMI trajectories for overweight or obese youth who avoid becoming obese adults have not been described. We aimed to determine and compare the young-childhood BMI trajectories of participants according to their BMI status in youth and adulthood. METHODS Bayesian hierarchical piecewise regression modeling was used to analyze the BMI trajectories of 2717 young adults who had up to 8 measures of BMI from childhood (ages 3-18 years) to adulthood (ages 34-49 years). RESULTS Compared with those with persistently high BMI, those who resolved their high youth BMI by adulthood had lower average BMI at age 6 years and slower rates of BMI change from young childhood. In addition, their BMI levels started to plateau at 16 years old for females and 21 years old for males, whereas the BMI of those whose high BMI persisted did not stabilize until 25 years old for male subjects and 27 years for female subjects. Compared with those youth who were not overweight or obese and who remained nonobese in adulthood, those who developed obesity had a higher BMI rate of change from 6 years old, and their BMI continued to increase linearly until age 30 years. CONCLUSIONS Efforts to alter BMI trajectories for adult obesity should ideally commence before age 6 years. The natural resolution of high BMI starts in adolescence for males and early adulthood for females, suggesting a critical window for secondary prevention.
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Affiliation(s)
- Marie-Jeanne Buscot
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia;
| | - Russell J Thomson
- Centre for Research in Mathematics, School of Computing, Engineering and Mathematics, Western Sydney University, Sydney, New South Wales, Australia
| | - Markus Juonala
- Research Centre of Applied and Preventive Cardiovascular Medicine and.,Departments of Medicine and.,Division of Medicine, Turku University Hospital, Turku, Finland
| | - Matthew A Sabin
- Murdoch Childrens Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - David P Burgner
- Murdoch Childrens Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.,Department of Paediatrics, Monash Medical Centre, Clayton, Victoria, Australia
| | - Terho Lehtimäki
- Fimlab Laboratories Ltd, Tampere, Finland.,Departments of Clinical Chemistry and
| | - Nina Hutri-Kähönen
- Pediatrics, Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Tampere, Finland
| | | | - Eero Jokinen
- Department of Pediatric Cardiology, Hospital for Children and Adolescents and University of Helsinki, Helsinki, Finland
| | - Paivi Tossavainen
- Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland; and
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine and.,Division of Medicine, Turku University Hospital, Turku, Finland.,Clinical Physiology and Nuclear Medicine, University of Turku, Turku, Finland
| | - Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.,Research Centre of Applied and Preventive Cardiovascular Medicine and
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Kay MC, Wasser H, Adair LS, Thompson AL, Siega‐Riz AM, Suchindran CM, Bentley ME. Consumption of obesogenic foods in non-Hispanic black mother-infant dyads. MATERNAL & CHILD NUTRITION 2018; 14:e12482. [PMID: 28627126 PMCID: PMC6651737 DOI: 10.1111/mcn.12482] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 05/12/2017] [Accepted: 05/18/2017] [Indexed: 01/29/2023]
Abstract
Obesity continues to be a problem in the United States. Of particular concern is the epidemic of early childhood obesity. A significant predictor of child diet is maternal diet, but little is known about this relationship during infancy. This study examined the association between maternal and infant consumption of key food groups from 6 to 18 months using data from the Infant Care, Feeding, and Risk of Obesity Study, a prospective cohort of 217 non-Hispanic black, low-income, first-time mothers. Using data from 24-hr dietary recalls collected during in-home visits at 6, 9, 12, and 18 months, we assessed longitudinal associations between mother and child intake of both energy-dense, nutrient-poor (obesogenic) food groups and fibre-, nutrient-rich food groups using random intercept logistic regression. Both mothers and their infants had high intake of sugar-sweetened beverages, desserts, and sweets and low intake of vegetables and whole grains. Infant consumption of key food groups was strongly associated with maternal consumption, suggesting the need for focused interventions to target maternal diet as a pathway to decreasing risk for the establishment of poor dietary patterns early in life.
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Affiliation(s)
- Melissa C. Kay
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Heather Wasser
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Linda S. Adair
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Amanda L. Thompson
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Department of AnthropologyUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Anna Maria Siega‐Riz
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Department of Public Health SciencesUniversity of VirginiaUSA
| | - Chirayath M. Suchindran
- Department of BiostatisticsUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Margaret E. Bentley
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
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Ring-Dimitriou S, Freudenthaler T, Aistleitner V, Horvath G, Stallinger J, Dimitriou M, Ardelt-Gattinger E, Weghuber D. SALTO - Study Protocol and Rationale of a Community-Oriented Obesity Prevention Program in the Kindergarten. Obes Facts 2018; 11:234-246. [PMID: 29961050 PMCID: PMC6103335 DOI: 10.1159/000481139] [Citation(s) in RCA: 4] [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] [Received: 05/09/2017] [Accepted: 08/24/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The prevalence of early childhood overweight and obesity in Austria has reached average European levels of 20% in boys and 18% in girls. The rationale and study protocol of SALTO, Salzburg Together against Obesity will be presented, which is aimed to assist adults in increasing the rate of 4- to 6-year-old children with a healthy body weight. METHODS A controlled longitudinal sequential study design consisting of 14 intervention (IK) and 8 control (CK) kindergarten was used to investigate the effect of actions tailored for teachers and parents on BMI among 4- to 6-year-old children. The study launched in November 2014 was approved by the ethics committee of the University of Salzburg. RESULTS 681 children, 181 parents (119 mothers, 62 fathers) and 30 teachers were investigated until October 2016. Preliminary analyses revealed that more boys (19%) and fathers (60% IK, 43% CK) were overweight and obese than girls (16%) and mothers (19% IK, 20% CK). CONCLUSION The challenges faced by the SALTO staff in the implementation of health-promoting actions in the kindergarten are manifold. The Community-Oriented Core Setting (COCS) intervention approach will show whether the actions will reduce the percentage of obesity and be sustainable in the long term.
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Affiliation(s)
- Susanne Ring-Dimitriou
- Department of Sports Science and Kinesiology, Paris Lodron University, Salzburg, Austria
- *Assoc. Prof. Dr. Dr. Susanne Ring-Dimitriou, Department of Sports Science and Kinesiology, Paris Lodron University, Salzburg, Austria, Schlossallee 49, 5400 Hallein, Austria,
| | - Thomas Freudenthaler
- Department of Sports Science and Kinesiology, Paris Lodron University, Salzburg, Austria
| | - Verena Aistleitner
- Salzburg Together against Obesity-SALTO, Project Management, Salzburg, Austria
| | - Gertrude Horvath
- Department of Sports Science and Kinesiology, Paris Lodron University, Salzburg, Austria
| | - Julia Stallinger
- Department of Sports Science and Kinesiology, Paris Lodron University, Salzburg, Austria
| | - Minas Dimitriou
- Department of Sports Science and Kinesiology, Paris Lodron University, Salzburg, Austria
| | | | - Daniel Weghuber
- Department of Paediatrics and Obesity Research Unit Salzburg, Paracelsus Medical University, Salzburg, Austria
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133
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Carsley S, Birken CS, Parkin PC, Pullenayegum E, Tu K. Completeness and accuracy of anthropometric measurements in electronic medical records for children attending primary care. BMJ Health Care Inform 2018; 25:963. [DOI: 10.14236/jhi.v25i1.963] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 10/20/2017] [Accepted: 11/07/2017] [Indexed: 11/18/2022] Open
Abstract
BackgroundElectronic medical records (EMRs) from primary care may be a feasible source of height and weight data. However, the use of EMRs in research has been impeded by lack of standardisation of EMRs systems, data access and concerns about the quality of the data.ObjectivesThe study objectives were to determine the data completeness and accuracy of child heights and weights collected in primary care EMRs, and to identify factors associated with these data quality attributes.MethodsA cross-sectional study examining height and weight data for children <19 years from EMRs through the Electronic Medical Record Administrative data Linked Database (EMRALD), a network of family practices across the province of Ontario. Body mass index z-scores were calculated using the World Health Organization Growth Standards and Reference.ResultsA total of 54,964 children were identified from EMRALD. Overall, 93% had at least one complete set of growth measurements to calculate a body mass index (BMI) z-score. 66.2% of all primary care visits had complete BMI z-score data. After stratifying by visit type 89.9% of well-child visits and 33.9% of sick visits had complete BMI z-score data; incomplete BMI z-score was mainly due to missing height measurements. Only 2.7% of BMI z-score data were excluded due to implausible values.ConclusionsData completeness at well-child visits and overall data accuracy were greater than 90%. EMRs may be a valid source of data to provide estimates of obesity in children who attend primary care.
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134
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Nemecek D, Sebelefsky C, Woditschka A, Voitl P. Overweight in children and its perception by parents: cross-sectional observation in a general pediatric outpatient clinic. BMC Pediatr 2017; 17:212. [PMID: 29273009 PMCID: PMC5741955 DOI: 10.1186/s12887-017-0964-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 12/08/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Childhood overweight is a growing problem in industrialized countries. Parents play a major role in the development and the treatment of overweight in their children. A key factor here is the perception of their child's weight status. As we know of other studies, parental perception of children's weight status is very poor. This study aimed to determine factors associated with childhood overweight and parental misperception of weight status. The height and weight of children, as reported by parents were compared with measured data. METHODS The study was conducted at a general pediatric outpatient clinic in Vienna, Austria. A total of 600 children (aged 0-14 years) participated in the study. Collection of data was performed by means of a questionnaire comprising items relating to parental weight and social demographics. The parents were also asked to indicate their children's weight and height, as well as the estimated weight status. Children were weighed and measured and BMI was calculated, allowing a comparison of estimated values and weight categories with the measured data. RESULTS Parental BMI, parental weight and a higher birth weight were identified as factors associated with childhood overweight. No association with the parents' educational status or citizenship could be proven. We compared parents' estimations of weight and height of their children with measured data. Here we found, that parental estimated values often differ from measured data. Using only parental estimated data to define weight status leads to misclassifications. It could be seen that parents of overweight children tend to underestimate the weight status of their children, compared to parents of children with normal weight. CONCLUSIONS Pediatricians should bear in mind that parental assessment often differs from the measured weight of their children. Hence children should be weighed and measured regularly to prevent them from becoming overweight. This is of particular importance in children with higher birth weight and children of overweight parents. TRIAL REGISTRATION Study was not registered. The study was approved by the Ethic committee of the city of Vienna. (EK 13-146-VK).
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Affiliation(s)
| | | | | | - Peter Voitl
- First Vienna Pediatric Medical Center, Vienna, Austria
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135
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Ward ZJ, Long MW, Resch SC, Giles CM, Cradock AL, Gortmaker SL. Simulation of Growth Trajectories of Childhood Obesity into Adulthood. N Engl J Med 2017; 377:2145-2153. [PMID: 29171811 PMCID: PMC9036858 DOI: 10.1056/nejmoa1703860] [Citation(s) in RCA: 440] [Impact Index Per Article: 62.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Although the current obesity epidemic has been well documented in children and adults, less is known about long-term risks of adult obesity for a given child at his or her present age and weight. We developed a simulation model to estimate the risk of adult obesity at the age of 35 years for the current population of children in the United States. METHODS We pooled height and weight data from five nationally representative longitudinal studies totaling 176,720 observations from 41,567 children and adults. We simulated growth trajectories across the life course and adjusted for secular trends. We created 1000 virtual populations of 1 million children through the age of 19 years that were representative of the 2016 population of the United States and projected their trajectories in height and weight up to the age of 35 years. Severe obesity was defined as a body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) of 35 or higher in adults and 120% or more of the 95th percentile in children. RESULTS Given the current level of childhood obesity, the models predicted that a majority of today's children (57.3%; 95% uncertainly interval [UI], 55.2 to 60.0) will be obese at the age of 35 years, and roughly half of the projected prevalence will occur during childhood. Our simulations indicated that the relative risk of adult obesity increased with age and BMI, from 1.17 (95% UI, 1.09 to 1.29) for overweight 2-year-olds to 3.10 (95% UI, 2.43 to 3.65) for 19-year-olds with severe obesity. For children with severe obesity, the chance they will no longer be obese at the age of 35 years fell from 21.0% (95% UI, 7.3 to 47.3) at the age of 2 years to 6.1% (95% UI, 2.1 to 9.9) at the age of 19 years. CONCLUSIONS On the basis of our simulation models, childhood obesity and overweight will continue to be a major health problem in the United States. Early development of obesity predicted obesity in adulthood, especially for children who were severely obese. (Funded by the JPB Foundation and others.).
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Affiliation(s)
- Zachary J. Ward
- Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Michael W. Long
- Department of Prevention and Community Health, Milken Institute School of Public Health, the George Washington University, Washington DC
| | - Stephen C. Resch
- Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Catherine M. Giles
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public, Boston, MA
| | - Angie L. Cradock
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public, Boston, MA
| | - Steven L. Gortmaker
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public, Boston, MA
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136
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Hennink-Kaminski H, Vaughn AE, Hales D, Moore RH, Luecking CT, Ward DS. Parent and child care provider partnerships: Protocol for the Healthy Me, Healthy We (HMHW) cluster randomized control trial. Contemp Clin Trials 2017; 64:49-57. [PMID: 29128650 DOI: 10.1016/j.cct.2017.11.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 11/06/2017] [Accepted: 11/07/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Formation of diet and physical activity habits begins during early childhood. However, many preschool-aged children in the United States do not achieve recommendations for a nutritious diet or active lifestyle. Two important spheres of influence, home and child care, could ensure that children receive consistent health messages. Innovative approaches that engage both parents and child care providers in a substantial way are needed. Social marketing, a promising approach for health promotion targeting children, uses principles that recognize the need to engage multiple stakeholders and to emphasize benefits and overcome barriers associated with behavior change. Yet, application of social marketing principles in interventions for preschool-age children is limited. METHODS Healthy Me, Healthy We (HMHW) is 2-arm, cluster randomized controlled trial to evaluate the effect of a 8-month social marketing campaign on the diet and physical activity behaviors of preschool children (3-4years old), their parents, and child care providers. The campaign is delivered by the child care center and includes branded classroom and at-home activities and materials. Primary outcomes are children's diet quality (assessed with Healthy Eating Index scores) and minutes of non-sedentary activity (measured via accelerometers). Secondary outcomes assess children's body mass index, nutrition and physical activity practices at the child care center and at home, and health behaviors of child care providers and parents. CONCLUSION HMHW is an innovative approach to promoting healthy eating and physical activity in preschool children. The campaign targets children during a key developmental period and leverages a partnership between providers and parents to affect behavior change.
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Affiliation(s)
| | - Amber E Vaughn
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, USA
| | - Derek Hales
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, USA; Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USA
| | - Reneé H Moore
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, USA
| | - Courtney T Luecking
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USA
| | - Dianne S Ward
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, USA; Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USA
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The Effects of College on Weight: Examining the "Freshman 15" Myth and Other Effects of College Over the Life Cycle. Demography 2017; 54:311-336. [PMID: 27928734 DOI: 10.1007/s13524-016-0530-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study examines the effects of college on weight over much of the life cycle. I compare weights for college students with their weights before and after college and with the weights of noncollege peers using data from the National Longitudinal Survey of Youth (NLSY). I also examine the longer-term effects of college measured almost three decades later. I find that college freshmen gain substantially less than the 15 pounds rumored to be typical for freshmen. Using difference models, individual-specific fixed-effects models, and instrumental variables models to control for various sources of potential bias, I find that freshman year college attendance is estimated to cause only about a one-pound increase. Supplemental results show that those from lower socioeconomic backgrounds gain more weight during the freshman college year. Longer term, having a college education consistently decreases weight. These negative effects have faded over the last 20 years, and they diminish as respondents approach middle age. These trends are more prevalent for whites and Hispanics than for blacks.
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138
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Preferred Child Body Size and Parental Underestimation of Child Weight in Mexican-American Families. Matern Child Health J 2017; 20:1842-8. [PMID: 27016351 DOI: 10.1007/s10995-016-1987-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective To determine whether parents who prefer a heavier child would underestimate their child's weight more than those who prefer a leaner child. Methods Participants were Mexican-American families (312 mothers, 173 fathers, and 312 children ages 8-10) who were interviewed and had height and weight measurements. Parents reported their preferred child body size and their perceptions of their child's weight. Parents' underestimation of their child's weight was calculated as the standardized difference between parent's perception of their child's weight and the child's body mass index (BMI) z-score. Demographic factors and parental BMI were also assessed. Results Although 50 % of children were overweight or obese, only 11 % of mothers and 10 % of fathers perceived their children as being somewhat or very overweight. Multiple regressions controlling for covariates (parental BMI and child age) showed that parents who preferred a heavier child body size underestimated their children's weight more, compared to those who preferred a leaner child (β for mothers = .13, p < .03; β for fathers = .17, p < .03). Conclusions for Practice Parents who preferred a heavier child body size underestimated their child's weight to a greater degree than parents who preferred a leaner child. Attempts by pediatricians to correct parents' misperceptions about child weight may damage rapport and ultimately fail if the misperception is actually a reflection of parents' preferences, which may not be readily amenable to change. Future research should address optimal methods of communication about child overweight which take into account parent preferences.
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139
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Vehapoglu A, Goknar N, Turel O, Torun E, Ozgurhan G. Risk factors for childhood obesity: Do the birth weight, type of delivery, and mother's overweight have an implication on current weight status? World J Pediatr 2017; 13:457-464. [PMID: 28434072 DOI: 10.1007/s12519-017-0030-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 07/29/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND The aim of this study was to identify risk factors, including the type of delivery, breastfeeding and its duration, birth weight, the timing of solid food introduction, the mother's education level at birth, and smoking status during pregnancy, that are associated with obesity in children living in Istanbul. METHODS This study involving 4990 healthy children aged 2-14 years, at an outpatient clinic in a tertiary care hospital from June 2012 to July 2014. RESULTS The overall rates of overweight and obesity in children were 13.1% and 7.8%, respectively. Results demonstrated that 44.5% of children were delivered by caesarean section. In all age groups, 7.8% of children delivered by caesarean section were obese compared with 7.9% of children born vaginally. No significant association between caesarean section delivery and obesity in childhood was found in our study [odds ratio (OR)=0.98, 95% confidence interval (CI)=0.64-2.87, P=0.454]. There was also no association between duration of breastfeeding and the introduction of solid foods before 4 months or after 6 months of age and childhood obesity (OR=0.95, 95% CI=0.69-1.3, P=0.771; OR=0.99, 95% CI=0.64-1.53, P=0.261). Regression analyses revealed that children with birth weights greater than 3801 g or those with maternal body mass index (BMI) equal to or greater than 30 had an increased risk of being obese or overweight (OR=1.78, 95% CI=1.19-2.65; OR=3.95, 95% CI=1.94-5.81). CONCLUSIONS This study demonstrated that increased birth weight and maternal BMI are significant risk factors for obesity in children living in Istanbul, Turkey. No relation between caesarean section delivery and childhood obesity was found in this study.
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Affiliation(s)
- Aysel Vehapoglu
- Department of Pediatrics, Bezmialem Vakıf University, Faculty of Medicine, Vatan Street, Fatih, Istanbul, 34093, Turkey.
| | - Nilufer Goknar
- Department of Pediatrics, Bezmialem Vakıf University, Faculty of Medicine, Vatan Street, Fatih, Istanbul, 34093, Turkey
| | - Ozden Turel
- Department of Pediatrics, Bezmialem Vakıf University, Faculty of Medicine, Vatan Street, Fatih, Istanbul, 34093, Turkey
| | - Emel Torun
- Department of Pediatrics, Bezmialem Vakıf University, Faculty of Medicine, Vatan Street, Fatih, Istanbul, 34093, Turkey
| | - Gamze Ozgurhan
- Department of Pediatrics, Suleymaniye Obstetrics and Gynecology Hospital, Istanbul, Turkey
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140
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Parental nonstandard work schedules during infancy and children’s BMI trajectories. DEMOGRAPHIC RESEARCH 2017. [DOI: 10.4054/demres.2017.37.22] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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141
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Chang-Martinez C, Ahmed NU, Natale RA, Messiah SE. State-Mandated Nutrition, Physical Activity, and Screen Time Policies in Child Care Centers. Health Promot Pract 2017; 19:411-417. [PMID: 28891723 DOI: 10.1177/1524839917729125] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The child care center (CCC) environment presents opportunities for healthy weight promotion in preschoolers. Our study examined the current state of CCC adherence to nutrition, physical activity, and screen time legislative regulations and the differences in their adherence by center socioeconomic position (SEP: low, middle, high) in Miami-Dade County. METHOD In 34 CCC, we used the Environment and Policy Assessment and Observation tool to evaluate nutrition, physical activity, and screen time practices during 1-school day. RESULTS Twenty-five of the centers (73.5%) were participants of the Child and Adult Care Food Program. Almost 80% of the centers adhered to serving low-fat/fat-free milk to children older than 2 years. Only 34.5% served vegetables and 75.9% served whole fruits during meals/snacks. Ninety-four percent of the centers had quiet and active play incorporated into their daily routines. All centers adhered to the 2-hour screen time limit for children older than 2 years. Low- and middle-SEP centers fared better in the serving of fruits, vegetables, and low-fat/fat-free milk. The centers averaged 1 hour in outdoor play regardless of SEP. High-SEP centers had no TV or screen time during day of observation. CONCLUSION CCC practices highlight opportunities for improvement in nutrition, physical activity, and screen time practices in the prevention of overweight in early childhood.
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Affiliation(s)
| | | | - Ruby A Natale
- 2 University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sarah E Messiah
- 2 University of Miami Miller School of Medicine, Miami, FL, USA
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142
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Banna J, Campos M, Gibby C, Graulau RE, Meléndez M, Reyes A, Lee JE, Palacios C. Multi-site trial using short mobile messages (SMS) to improve infant weight in low-income minorities: Development, implementation, lessons learned and future applications. Contemp Clin Trials 2017; 62:56-60. [PMID: 28827160 DOI: 10.1016/j.cct.2017.08.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 08/08/2017] [Accepted: 08/15/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Jinan Banna
- University of Hawaii at Manoa, Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, Agricultural Sciences 216, 1955 East-West Rd, Honolulu, HI 96822, United States.
| | - Maribel Campos
- University of Puerto Rico, Medical Sciences Campus, Endowed Health Services Research Center, Dental and Craniofacial Genomics Center, United States.
| | - Cheryl Gibby
- University of Hawaii at Manoa, Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, Agricultural Sciences 216, 1955 East-West Rd, Honolulu, HI 96822, United States.
| | - Rafael Enrique Graulau
- University of Puerto Rico, Graduate School of Public Health, Medical Sciences Campus, PO Box 365067, San Juan, PR 00936-5067, United States.
| | - Marytere Meléndez
- University of Puerto Rico, Center for Clinical Research and Health Promotion, Medical Sciences Campus, PO Box 365067, San Juan, PR 00936-5067, United States.
| | - Alexandra Reyes
- Nutrition Division, Puerto Rico WIC Program, Department of Health, San Juan, PR 00928-5220, United States.
| | - Jae Eun Lee
- Jackson State University, College of Science, Engineering and Technology, 1230 Raymond Rd, Jackson, MS 39204, United States.
| | - Cristina Palacios
- University of Puerto Rico, Graduate School of Public Health, Medical Sciences Campus, PO Box 365067, San Juan, PR 00936-5067, United States.
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143
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Perez LF, Miller CK, Groner JA. Adolescents with at-risk eating and lifestyle behaviors are affected by after school schedules across the clinical weight spectrum. PATIENT EDUCATION AND COUNSELING 2017; 100:1511-1518. [PMID: 28283217 DOI: 10.1016/j.pec.2017.03.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 02/14/2017] [Accepted: 03/03/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Evaluate adolescent lifestyle patterns to develop more effective health promotion programs. METHODS An interview approach was employed to gain in-depth understanding of eating and activity behaviors. Adolescents aged 13-18 years (n=43) from clinically normal and obese weight categories were enrolled. Nutrient intake and food group servings were obtained from a food frequency questionnaire. RESULTS Four participant subgroups were identified and labeled: "Idle, Engaged, Balanced and Working." "Idle" adolescents were sedentary, sometimes napped, and often snacked after dinner. "Engaged" adolescents participated in extra-curricular activities for the majority of their after school hours. "Balanced" adolescents participated in a single after-school activity followed by sedentary time; they consumed meals consistently and often snacked after dinner. "Working" adolescents were the least sedentary with limited sleep duration and inconsistent meals; they often substituted a meal with a snack. Weight status did not differentiate subgroups effectively. CONCLUSIONS Each group demonstrated at-risk behaviors for obesity. Future programs should consider after-school schedules and use activity and meal pattern assessments, not simply weight status, for program tailoring. PRACTICE IMPLICATIONS Pediatric health care providers could identify at-risk behaviors through routine assessment of diet and activity patterns in combination with weight monitoring.
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Affiliation(s)
- Leanna F Perez
- The Ohio State University Department of Human Sciences, Human Nutrition Columbus, OH, 43210, USA.
| | - Carla K Miller
- The Ohio State University Department of Human Sciences, Human Nutrition Columbus, OH, 43210, USA.
| | - Judith A Groner
- Nationwide Children's Hospital, Section of Ambulatory Pediatrics Columbus, OH, 43205, USA.
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Grummon AH, Vaughn A, Jones DJ, Ward DS. Cumulative Risk Exposure and Waist Circumference in Preschool-Aged Children: the Mediating Role of Television and Moderating Role of Sex. Ann Behav Med 2017; 51:489-499. [PMID: 28097514 PMCID: PMC5513794 DOI: 10.1007/s12160-016-9872-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Children exposed to multiple stressors are more likely to be overweight, but little is known about the mechanisms explaining this association. PURPOSE This cross-sectional study examined whether children exposed to multiple stressors had higher waist circumference, and whether this association was mediated through children's television time. METHODS Participants were 319 parent-child dyads. Children were 2-5 years old and had at least one overweight parent (BMI ≥ 25 kg/m2). Data were collected at baseline of a larger childhood obesity prevention study and included information on psychosocial stressors (e.g., parenting stress), demographic stressors (e.g., low income), children's television time, and children's waist circumference. Two cumulative risk scores were created by summing stressors in each domain (demographic and psychosocial). Mediation and moderated mediation analyses were conducted. RESULTS Indirect effects of both cumulative risk scores on waist circumference through television time were not significant; however, moderated mediation analyses found significant moderation by gender. The indirect effects of both risk scores on waist circumference through television time were significant and positive for girls, but near-zero for boys. CONCLUSIONS Reducing television time should be explored as a strategy for buffering against the negative health effects of exposure to multiple stressors among girls. Longitudinal and intervention research is needed to confirm these results and to identify mediating factors between cumulative risk and body weight among boys.
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Affiliation(s)
- Anna H Grummon
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Amber Vaughn
- Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
| | - Deborah J Jones
- Department of Psychology, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
| | - Dianne S Ward
- Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA.
- Department of Nutrition, Gillings School of Global Public Health, and Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, 135 Dauer Drive, 2200 McGavran-Greenberg Hall, CB no. 7461, Chapel Hill, NC, 27599-7461, USA.
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145
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Crosnoe R, Dunifon R. A developmental perspective on the link between parents' employment and children's obesity. AMERICAN PSYCHOLOGIST 2017; 72:474-486. [PMID: 28726455 PMCID: PMC6371798 DOI: 10.1037/amp0000044] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Despite public concerns about the negative implications of the increased labor force participation of mothers for child development, decades of research have revealed few risks and some benefits. One potential risk-a consistently observed association between maternal employment and childhood obesity-offers a window into how some dimensions of family health may be undermined by work in an economic and policy context that is not family friendly. The purpose of this article is to identify ways that a developmental perspective can enrich the literature on how children's weight may be related to the work experiences of both mothers and fathers across diverse populations, a literature that heretofore has been dominated by economic and demographic perspectives, focused almost solely on women, and largely ignored racial/ethnic variation. After reviewing the extant literature, we put forward a conceptual model that uses ecological and developmental insights to identify the mechanisms by which parents' employment might matter to children's weight and discuss this model in the context of the contemporary landscape of family policy. (PsycINFO Database Record
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Affiliation(s)
- Robert Crosnoe
- Population Research Center, University of Texas at Austin
| | - Rachel Dunifon
- Department of Policy Analysis and Management, Cornell University
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146
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Şahin MK, Güven V. Okul Öncesi Sağlık Taramalarının Değerlendirilmesi: Artvin İli Örneği. ANKARA MEDICAL JOURNAL 2017. [DOI: 10.17098/amj.286159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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147
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Roach E, Viechnicki GB, Retzloff LB, Davis-Kean P, Lumeng JC, Miller AL. Family food talk, child eating behavior, and maternal feeding practices. Appetite 2017; 117:40-50. [PMID: 28587941 DOI: 10.1016/j.appet.2017.06.001] [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: 10/03/2016] [Revised: 03/28/2017] [Accepted: 06/02/2017] [Indexed: 01/04/2023]
Abstract
Families discuss food and eating in many ways that may shape child eating habits. Researchers studying how families talk about food have examined this process during meals. Little work has examined parent-child food-related interactions outside of mealtime. We assessed family food talk at home outside of mealtime and tested whether food talk was associated with obesogenic child eating behaviors, maternal feeding practices, or child weight. Preschool and school-aged mother-child dyads (n = 61) participated in naturalistic voice recording using a LENA (Language ENvironment Analysis) recorder. A coding scheme was developed to reliably characterize different types of food talk from LENA transcripts. Mothers completed the Children's Eating Behavior Questionnaire (CEBQ) and Child Feeding Questionnaire (CFQ) to assess child eating behaviors and maternal feeding practices. Child weight and height were measured and body mass index z-score (BMIz) calculated. Bivariate associations among food talk types, as a proportion of total speech, were examined and multivariate regression models used to test associations between food talk and child eating behaviors, maternal feeding practices, and child BMIz. Proportion of child Overall Food Talk and Food Explanations were positively associated with CEBQ Food Responsiveness and Enjoyment of Food (p's < 0.05). Child food Desire/Need and child Prep/Planning talk were positively associated with CEBQ Enjoyment of Food (p < 0.05). Child Food Enjoyment talk and mother Overt Restriction talk were positively associated with CEBQ Emotional Over-Eating (p < 0.05). Mother Monitoring talk was positively associated with CFQ Restriction (p < 0.05). Mother Prep/Planning talk was negatively associated with child BMIz. Food talk outside of mealtimes related to child obesogenic eating behaviors and feeding practices in expected ways; examining food talk outside of meals is a novel way to consider feeding practices and child eating behavior.
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Affiliation(s)
- Elizabeth Roach
- Center for Human Growth and Development, University of Michigan, USA; Department of Nutritional Sciences, University of Michigan School of Public Health, USA
| | | | - Lauren B Retzloff
- Center for Human Growth and Development, University of Michigan, USA
| | - Pamela Davis-Kean
- Center for Human Growth and Development, University of Michigan, USA; Institute for Social Research, University of Michigan, USA; Department of Psychology, University of Michigan, USA
| | - Julie C Lumeng
- Center for Human Growth and Development, University of Michigan, USA; Department of Nutritional Sciences, University of Michigan School of Public Health, USA; Department of Pediatrics, University of Michigan Medical School, USA
| | - Alison L Miller
- Center for Human Growth and Development, University of Michigan, USA; Department of Health Behavior and Health Education, University of Michigan School of Public Health, USA.
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148
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Amer M, Arfaj GA, Alodhayani AA. Children's Physical Activity Awareness among Mothers in a Saudi Arabian Health Center. J Clin Diagn Res 2017; 11:OC51-OC56. [PMID: 28511437 DOI: 10.7860/jcdr/2017/25768.9602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 12/16/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Physical inactivity is a major contributor to the increasing levels of obesity and other serious medical conditions among children and adolescents worldwide. A major factor in this increase is lack of awareness of mothers' regarding the Physical Activity (PA) of their children. AIM The current study aimed to identify the degree of knowledge and awareness of Saudi mothers' regarding their children's physical activities, which will be useful for improving physical education, health programs, and eventually children's health care. MATERIALS AND METHODS A total of 342 mothers attending a vaccination clinic, well-baby, or women's health clinic participated in the study, in which questionnaire was used to assess the awareness regarding PA. RESULTS The majority of mothers agreed that they have a crucial role in motivating their children to engage in PA, but was not aware of current recommendations. CONCLUSION Awareness of Saudi mothers' regarding their children's PA was exceedingly low. Creating awareness of children's PA is essential.
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Affiliation(s)
- Maysah Amer
- Family Medicine Physician, Department of Family Medicne, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Ghada Al Arfaj
- Family Medicine Physician, Department of Family Medicne, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Abdulaziz A Alodhayani
- Assistant Professor, Department of Family Medicne and Community, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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149
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Miller AL, Kaciroti N, Sturza J, Retzloff L, Rosenblum K, Vazquez DM, Lumeng JC. Associations between stress biology indicators and overweight across toddlerhood. Psychoneuroendocrinology 2017; 79:98-106. [PMID: 28273588 PMCID: PMC5367941 DOI: 10.1016/j.psyneuen.2017.02.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 02/11/2017] [Accepted: 02/12/2017] [Indexed: 12/21/2022]
Abstract
Biological stress responses are proposed as a pathway through which stress exposure can "get under the skin" and lead to health problems, specifically obesity. Yet, it is not clear when such associations may emerge or whether they are bidirectional. Cortisol and salivary alpha amylase (sAA) were considered indicators of the biological stress response. We tested the longitudinal association between cortisol and sAA and weight in 215 low-income children at ages 21, 27, and 33 months (52% male; 46% non-Hispanic white). sAA and cortisol intercept and slope (representing morning level and rate of change across the day) were calculated for each age point using random effect models. Children were weighed and length measured and categorized as overweight versus normal weight (overweight defined as weight-for-length z-score ≥85th percentile for age and sex). Cross-lagged models stratified by sex and controlling for birthweight z-score tested the concurrent and cross-lagged associations between each of 4 indices of stress biology individually (cortisol and sAA intercept and slope) and overweight. Overweight status was correlated across time. Cortisol and sAA were correlated across occasions of measurement, though somewhat less strongly in boys. There were no concurrent associations between stress indicators and overweight. sAA at 27 months predicted greater risk of overweight at 33 months in girls, such that both lower sAA intercept and more rapidly increasing sAA at 27 months predicted greater risk of overweight at 33 months (β=-0.64, p<0.05 and β=1.09, p<0.05, respectively). For boys only, overweight at 21 months predicted lower sAA intercept at 27 months (β=-0.35, p<0.05). Findings suggest that longitudinal associations of stress biology and weight status may be present only on a limited basis very early in the lifespan.
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Affiliation(s)
- Alison L Miller
- Center for Human Growth and Development, University of Michigan, United States; Department of Health Behavior and Health Education, University of Michigan School of Public Health,United States.
| | - Niko Kaciroti
- Center for Human Growth and Development, University of Michigan, United States; Department of Biostatistics, University of Michigan School of Public Health, United States
| | - Julie Sturza
- Center for Human Growth and Development, University of Michigan, United States
| | - Lauren Retzloff
- Center for Human Growth and Development, University of Michigan, United States
| | - Katherine Rosenblum
- Center for Human Growth and Development, University of Michigan, United States; Department of Psychiatry, University of Michigan Medical School, United States
| | - Delia M Vazquez
- Center for Human Growth and Development, University of Michigan, United States; Department of Biostatistics, University of Michigan School of Public Health, United States; Department of Pediatrics, University of Michigan Medical School, United States
| | - Julie C Lumeng
- Center for Human Growth and Development, University of Michigan, United States; Department of Pediatrics, University of Michigan Medical School, United States; Department of Nutritional Sciences, University of Michigan School of Public Health, United States
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150
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Northrup AA, Smaldone A. Maternal Attitudes, Normative Beliefs, and Subjective Norms of Mothers of 2- and 3-Year-Old Children. J Pediatr Health Care 2017; 31:262-274. [PMID: 27745978 DOI: 10.1016/j.pedhc.2016.08.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 08/26/2016] [Accepted: 08/30/2016] [Indexed: 11/28/2022]
Abstract
INTRODUCTION This exploratory study examined maternal attitudes, normative beliefs, subjective norms, and meal selection behaviors of mothers of 2- and 3-year-old children. METHODS Guided by the Theory of Reasoned Action, we had mothers complete three surveys, two interviews, and a feeding simulation exercise. Data were analyzed using descriptive and bivariate statistics and multivariate linear regression. RESULTS A total of 31 mothers (50% Latino, 34% Black, 46.9% ≤ high school education, 31.3% poor health literacy) of 32 children (37.5% overweight/obese) participated in this study. Maternal normative beliefs (knowledge of U.S. Department of Agriculture recommendations) did not reflect actual U.S. Department of Agriculture recommendations. Collectively, regression models explained 13% (dairy) to 51% (vegetables) of the variance in behavioral intent, with normative belief an independent predictor in all models except grain and dairy. DISCUSSION Meal selection behaviors, on average, were predicted by poor knowledge of U.S. Department of Agriculture recommendations. Dietary guidance appropriate to health literacy level should be incorporated into well-child visits.
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