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Villarosa AR, Maneze D, Ramjan LM, Kong A, George A. The codesign of implementation strategies for children's growth assessment guidelines in the dental setting. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:19. [PMID: 35578352 PMCID: PMC9109434 DOI: 10.1186/s40900-022-00356-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/04/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Considering the interdisciplinary role dental staff can play in addressing overweight and obesity in childhood, this study aimed to codesign guideline implementation strategies for children's growth assessment and dietary advice guidelines in the dental setting. METHODS This qualitative study utilised principles of codesign and appreciative inquiry through a series of four, two-hour focus groups with dental staff and parents. Focus groups were analysed using content analysis. RESULTS Discussion fell into two main themes, engaging patients throughout their care journey and supporting staff to engage with the guidelines. Six strategies were developed within these themes: (1) providing growth assessment information to patients and families before appointments, (2) providing refresher training to staff, (3) involving dental assistants in the growth assessment, (4) keeping dental staff updated regarding referral outcomes, (5) culturally appropriate information resources for patients and families, and (6) enabling longitudinal growth tracking in patient information systems. CONCLUSIONS This study successfully designed six implementation strategies for children's growth assessment guidelines in the dental setting. Further research is required to determine their impact on guideline adherence.
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Affiliation(s)
- Amy Ruth Villarosa
- Centre for Oral Health Outcomes and Research Translation (COHORT), Liverpool, 1871 Australia
- Western Sydney University, Penrith, 2751 Australia
- South Western Sydney Local Health District, Liverpool, 1871 Australia
- Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool BC, NSW 1871 Australia
| | - Della Maneze
- Centre for Oral Health Outcomes and Research Translation (COHORT), Liverpool, 1871 Australia
- Western Sydney University, Penrith, 2751 Australia
- South Western Sydney Local Health District, Liverpool, 1871 Australia
- Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool BC, NSW 1871 Australia
| | - Lucie Michelle Ramjan
- Centre for Oral Health Outcomes and Research Translation (COHORT), Liverpool, 1871 Australia
- Western Sydney University, Penrith, 2751 Australia
- Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool BC, NSW 1871 Australia
- Translational Health Research Institute, Western Sydney University, Penrith, 2751 Australia
| | - Ariana Kong
- Centre for Oral Health Outcomes and Research Translation (COHORT), Liverpool, 1871 Australia
- Western Sydney University, Penrith, 2751 Australia
- South Western Sydney Local Health District, Liverpool, 1871 Australia
- Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool BC, NSW 1871 Australia
| | - Ajesh George
- Centre for Oral Health Outcomes and Research Translation (COHORT), Liverpool, 1871 Australia
- Western Sydney University, Penrith, 2751 Australia
- South Western Sydney Local Health District, Liverpool, 1871 Australia
- Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool BC, NSW 1871 Australia
- Translational Health Research Institute, Western Sydney University, Penrith, 2751 Australia
- Faculty of Medicine and Health, School of Dentistry, The University of Sydney, NSW 2006 Camperdown, Australia
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Roberts KJ, Ariza AJ, Selvaraj K, Quadri M, Mangarelli C, Neault S, Davis EE, Binns HJ. Testing for rare genetic causes of obesity: findings and experiences from a pediatric weight management program. Int J Obes (Lond) 2022; 46:1493-1501. [PMID: 35562395 PMCID: PMC9105591 DOI: 10.1038/s41366-022-01139-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Genetic screening for youth with obesity in the absence of syndromic findings has not been part of obesity management. For children with early onset obesity, genetic screening is recommended for those having clinical features of genetic obesity syndromes (including hyperphagia). OBJECTIVES The overarching goal of this work is to report the findings and experiences from one pediatric weight management program that implemented targeted sequencing analysis for genes known to cause rare genetic disorders of obesity. SUBJECTS/METHODS This exploratory study evaluated youth tested over an 18-month period using a panel of 40-genes in the melanocortin 4 receptor pathway. Medical records were reviewed for demographic and visit information, including body mass index (BMI) percent of 95th percentile (%BMIp95) and two eating behaviors. RESULTS Of 117 subjects: 51.3% were male; 53.8% Hispanic; mean age 10.2 years (SD 3.8); mean %BMIp95 157% (SD 29%). Most subjects were self- or caregiver-reported to have overeating to excess or binge eating (80.3%) and sneaking food or eating in secret (59.0%). Among analyzed genes, 72 subjects (61.5%) had at least one variant reported; 50 (42.7%) had a single variant reported; 22 (18.8%) had 2-4 variants reported; most variants were rare (<0.05% minor allele frequency [MAF]), and of uncertain significance; all variants were heterozygous. Nine subjects (7.7%) had a variant reported as PSCK1 "risk" or MC4R "likely pathogenic"; 39 (33.3%) had a Bardet-Biedl Syndrome (BBS) gene variant (4 with "pathogenic" or "likely pathogenic" variants). Therefore, 9 youth (7.7%) had gene variants previously identified as increasing risk for obesity and 4 youth (3.4%) had BBS carrier status. CONCLUSIONS Panel testing identified rare variants of uncertain significance in most youth tested, and infrequently identified variants previously reported to increase the risk for obesity. Further research in larger cohorts is needed to understand how genetic variants influence the expression of non-syndromic obesity.
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Affiliation(s)
- Karyn J Roberts
- College of Nursing, University of Wisconsin-Milwaukee, PO Box 413, Milwaukee, WI, 53201-0413, USA. .,Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
| | - Adolfo J Ariza
- Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.,Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Kavitha Selvaraj
- Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.,Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Maheen Quadri
- Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.,Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Caren Mangarelli
- Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.,Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Sarah Neault
- Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Erica E Davis
- Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.,Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Helen J Binns
- Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.,Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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Kitani RA, Letsou K, Kokka I, Kanaka-Gantenbein C, Bacopoulou F. Difference in Hair Cortisol Concentrations between Obese and Non-Obese Children and Adolescents: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9050715. [PMID: 35626892 PMCID: PMC9139968 DOI: 10.3390/children9050715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/28/2022] [Accepted: 05/10/2022] [Indexed: 11/16/2022]
Abstract
Childhood obesity has been linked to physical and psychological comorbidities that can be carried into adulthood. A bidirectional link between body weight and the stress system appears to exist, as cortisol may affect the regulation of appetite, while adiposity can affect cortisol secretion. Among the biological tissues used to evaluate cortisol concentrations, scalp hair can provide retrospective measures. The aim of this systematic review was to investigate the difference in hair cortisol concentrations between obese and non-obese minors ≤ 19 years of age. Children and adolescents with genetic, somatic or psychiatric comorbidities were excluded. The work was conducted following the PRISMA guidelines, using prespecified search terms in the Pubmed database. The initial search yielded 56 studies, while the last step of the screening procedure concluded in 9 observational studies. Among them, the results could be characterized as inconclusive. Five of them demonstrated significantly higher hair cortisol concentrations in obese children and adolescents than normal weight subjects. On the contrary, the remaining four found no statistically significant differences in hair cortisol concentrations between obese and non-obese subjects. Different methodologies applied, and confounding factors could explain the inconsistency in the findings. Further research is needed to provide more solid results.
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Affiliation(s)
- Rosa Anna Kitani
- Postgraduate Course on the Science of Stress and Health Promotion, Medical School, National and Kapodistrian University of Athens, 4 Soranou Ephessiou St., 11527 Athens, Greece; (R.A.K.); (K.L.); (I.K.); (C.K.-G.)
| | - Konstantina Letsou
- Postgraduate Course on the Science of Stress and Health Promotion, Medical School, National and Kapodistrian University of Athens, 4 Soranou Ephessiou St., 11527 Athens, Greece; (R.A.K.); (K.L.); (I.K.); (C.K.-G.)
| | - Ioulia Kokka
- Postgraduate Course on the Science of Stress and Health Promotion, Medical School, National and Kapodistrian University of Athens, 4 Soranou Ephessiou St., 11527 Athens, Greece; (R.A.K.); (K.L.); (I.K.); (C.K.-G.)
- Outpatient Specialty Clinic for Obsessive Compulsive Disorder and Behavioral Therapy, First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece
| | - Christina Kanaka-Gantenbein
- Postgraduate Course on the Science of Stress and Health Promotion, Medical School, National and Kapodistrian University of Athens, 4 Soranou Ephessiou St., 11527 Athens, Greece; (R.A.K.); (K.L.); (I.K.); (C.K.-G.)
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, Thivon & Papadiamantopoulou St., 11527 Athens, Greece
| | - Flora Bacopoulou
- Postgraduate Course on the Science of Stress and Health Promotion, Medical School, National and Kapodistrian University of Athens, 4 Soranou Ephessiou St., 11527 Athens, Greece; (R.A.K.); (K.L.); (I.K.); (C.K.-G.)
- Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Thivon & Papadiamantopoulou St., 11527 Athens, Greece
- Correspondence:
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Smith KE, Mason TB. Psychiatric comorbidity associated with weight status in 9 to 10 year old children. Pediatr Obes 2022; 17:e12883. [PMID: 35048539 PMCID: PMC9040467 DOI: 10.1111/ijpo.12883] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 08/09/2021] [Accepted: 09/01/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Paediatric overweight and obesity (OW/OB) constitute a serious public health concern. Given that psychological problems may be key contributors to the onset and maintenance of paediatric obesity, the present study examined past and current psychiatric comorbidities across the weight spectrum during middle childhood among a nationally representative sample. METHODS Participants were 11 708 9- to 10-year-old children (31.6% with OW/OB) and their caregivers who participated in the first wave of data collection in the Adolescent Brain Cognitive Development (ABCD) study. Logistic regressions were used to examine the association between weight status (i.e., underweight, healthy weight, OW, OB) and likelihood of current/past psychiatric diagnoses. RESULTS Compared to healthy weight children, those with OW/OB were more likely to have current/past major depressive disorder and binge eating disorder. Relative to healthy weight children, those with OB were more likely to have prior separation anxiety disorder, current specific phobia and oppositional defiant disorder; those with OW were more likely to have PTSD; and those with underweight were more likely to have ADHD. CONCLUSIONS Results suggest cross-sectional associations among negative emotionality, binge eating, and OW/OB, and highlight the need for ongoing prospective research to investigate directionality of associations and mechanisms of effects.
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Affiliation(s)
- Kathryn E. Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA
| | - Tyler B. Mason
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA
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105
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Palmer KK, Farquhar JM, Chinn KM, Robinson LE. Are Gross Motor Skill Interventions an Equitable Replacement for Outdoor Free Play Regarding Children's Physical Activity? Am J Health Promot 2022; 36:643-650. [PMID: 34978932 PMCID: PMC10428667 DOI: 10.1177/08901171211063261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this study was to determine if children engaged in equal amounts of physical activity during an established gross motor skill intervention (the Children's Health Activity Motor Program (CHAMP)) and outdoor free play. DESIGN Cross-sectional study; sample: Ninety-nine children (Mage = 4.21, 51% boys) were randomly divided into two movement environments: CHAMP (n = 55) or control/outdoor free play (n = 44). MEASURES Physical activity was assessed using GT3X+ Actigraph accelerometers worn on the waist across four mornings. Average physical activity across the four days during either CHAMP or outdoor free play was extracted and categorized as light, moderate, vigorous, or MVPA. Physical activity data were reduced in the Actilife software using the cutpoints from Evenson et al. ANALYSIS A 2 (treatment) x 2 (sex) mixed measures ANOVA was used to compare the amount of time children spent in light, moderate, vigorous, and MVPA. RESULTS There was a significant main effect for treatment for light PA (F(3,95) =13.60, P<.001, partial η2=.125), and post hoc t-tests support that children in the control/outdoor free play group engaged in more light PA compared with children in CHAMP (t95 = -3.75, P<.001). CONCLUSIONS Results show that children in CHAMP engaged in less light PA but equal amounts of all other physical activity behaviors than their peers in outdoor free play.
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Affiliation(s)
- Kara K. Palmer
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Leah E. Robinson
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
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106
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Tugault-Lafleur CN, De-Jongh González O, Macdonald J, Bradbury J, Warshawski T, Ball GDC, Morrison K, Ho J, Hamilton J, Buchholz A, Mâsse L. Efficacy of the Aim2Be intervention in changing lifestyle behaviours among adolescents with overweight and obesity: A Randomized Controlled Trial (Preprint). J Med Internet Res 2022; 25:e38545. [PMID: 37097726 PMCID: PMC10170359 DOI: 10.2196/38545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 09/13/2022] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Aim2Be is a gamified lifestyle app designed to promote lifestyle behavior changes among Canadian adolescents and their families. OBJECTIVE The primary aim was to test the efficacy of the Aim2Be app with support from a live coach to reduce weight outcomes (BMI Z score [zBMI]) and improve lifestyle behaviors among adolescents with overweight and obesity and their parents versus a waitlist control group over 3 months. The secondary aim was to compare health trajectories among waitlist control participants over 6 months (before and after receiving access to the app), assess whether support from a live coach enhanced intervention impact, and evaluate whether the app use influenced changes among intervention participants. METHODS A 2-arm parallel randomized controlled trial was conducted from November 2018 to June 2020. Adolescents aged 10 to 17 years with overweight or obesity and their parents were randomized into an intervention group (Aim2Be with a live coach for 6 months) or a waitlist control group (Aim2Be with no live coach; accessed after 3 months). Adolescents' assessments at baseline and at 3 and 6 months included measured height and weight, 24-hour dietary recalls, and daily step counts measured with a Fitbit. Data on self-reported physical activity, screen time, fruit and vegetable intake, and sugary beverage intake of adolescents and parents were also collected. RESULTS A total of 214 parent-child participants were randomized. In our primary analyses, there were no significant differences in zBMI or any of the health behaviors between the intervention and control groups at 3 months. In our secondary analyses, among waitlist control participants, zBMI (P=.02), discretionary calories (P=.03), and physical activity outside of school (P=.001) declined, whereas daily screen time increased (P<.001) after receiving access to the app compared with before receiving app access. Adolescents randomized to Aim2Be with live coaching reported more time being active outside of school compared with adolescents who used Aim2Be with no coaching over 3 months (P=.001). App use did not modify any changes in outcomes among adolescents in the intervention group. CONCLUSIONS The Aim2Be intervention did not improve zBMI and lifestyle behaviors in adolescents with overweight and obesity compared with the waitlist control group over 3 months. Future studies should explore the potential mediators of changes in zBMI and lifestyle behaviors as well as predictors of engagement. TRIAL REGISTRATION ClinicalTrials.gov NCT03651284; https://clinicaltrials.gov/ct2/show/study/NCT03651284. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s13063-020-4080-2.
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Affiliation(s)
- Claire N Tugault-Lafleur
- School of Nutrition Sciences, Faculty of Health Sciences, The University of Ottawa, Ottawa, ON, Canada
| | - Olivia De-Jongh González
- School of Population and Public Health, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
| | | | | | | | - Geoff D C Ball
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Katherine Morrison
- Department of Pediatrics, Center for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, ON, Canada
| | - Josephine Ho
- Cumming School of Medicine, Department of Pediatrics, University of Calgary, Calgary, AB, Canada
| | - Jill Hamilton
- Department of Paediatrics, Hospital for Sick Children, Toronto, ON, Canada
| | - Annick Buchholz
- Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
| | - Louise Mâsse
- School of Population and Public Health, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
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Davidson TL, Ramirez E, Kwarteng EA, Djan KG, Faulkner LM, Parker MN, Yang SB, Zenno A, Kelly NR, Shank LM, Tanofsky-Kraff M, Snelling A, Belson SI, Hyde A, Chen KY, Yanovski JA. Retrieval-induced forgetting in children and adolescents with and without obesity. Int J Obes (Lond) 2022; 46:851-858. [PMID: 35042933 PMCID: PMC8967761 DOI: 10.1038/s41366-021-01036-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 11/02/2021] [Accepted: 11/23/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES Previous research indicates that youth with obesity exhibit deficits in executive functioning (EF), which often take the form of impaired response inhibition. One aspect of EF not previously studied in obesity is the adaptive process known as retrieval-induced forgetting (RIF), the suppression/inhibition of intrusive or non-target items by the retrieval of specific items from memory. The present study investigated if child or adolescent obesity disrupts the ability to inhibit retrieval of intrusive memories. SUBJECTS/METHODS We compared the manifestation of RIF in children (ages 8-12) and adolescents (ages 13-18) as a function of their weight status and sex. We also evaluated the effects of these variables on simple recall of items from episodic memory under conditions where competition from intrusive items was reduced. RESULTS Children with obesity did not demonstrate significant RIF, whereas RIF was exhibited by preteens without obesity and by teenage participants with- and without obesity (Weight Status × Age Group interaction p = 0.028). This pattern of results did not differ as a function of sex for either age group. No differences in episodic memory were found. Additional analyses using Age as continuous covariate (and not as a nominal group) comparing participants who exhibited RIF with those who did not, found that the no RIF group consumed fast-food meals more frequently (p = 0.024) and had higher percentages of total body adiposity and android fat compared to the RIF group (p's < 0.05). CONCLUSIONS The findings expand what is known about the effects of childhood obesity on cognitive functioning, identify impaired RIF with specific behavioral and dietary factors and increased adiposity, and suggest the possibility that impairments in the ability to inhibit intrusive memories of food and eating may contribute to poor early-life weight control.
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Affiliation(s)
- Terry L Davidson
- Department of Neuroscience, American University, 4400 Massachusetts Avenue, NW, Washington, DC, 20016, USA.
- Center for Neuroscience and Behavior, American University, 4400 Massachusetts Avenue, NW, Washington, DC, 20016, USA.
| | - Eliana Ramirez
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Esther A Kwarteng
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Kweku G Djan
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Loie M Faulkner
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Megan N Parker
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Shanna B Yang
- Nutrition Department, Clinical Research Center, NIH, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Anna Zenno
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Nichole R Kelly
- Department of Counseling Psychology and Human Services, Prevention Science Institute, University of Oregon, Eugene, OR, 97403-5207, USA
| | - Lisa M Shank
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR), USU, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
- Metis Foundation, 300 Convent St #1330, San Antonio, TX, 78205, USA
| | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR), USU, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Anastasia Snelling
- Center for Neuroscience and Behavior, American University, 4400 Massachusetts Avenue, NW, Washington, DC, 20016, USA
- Department of Health Studies, American University, 4400 Massachusetts Avenue, NW, Washington, DC, 20016, USA
| | - Sarah Irvine Belson
- Center for Neuroscience and Behavior, American University, 4400 Massachusetts Avenue, NW, Washington, DC, 20016, USA
- School of Education, American University, 4400 Massachusetts Avenue, NW, Washington, DC, 20016, USA
| | - Alexia Hyde
- Department of Neuroscience, American University, 4400 Massachusetts Avenue, NW, Washington, DC, 20016, USA
| | - Kong Y Chen
- Energy Metabolism Section, Diabetes, Endocrinology, and Obesity Branch, National Institute of Digestive Diseases, Diabetes, and Kidney Disorders, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Jack A Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
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108
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López-Gil JF. The Eating Healthy and Daily Life Activities (EHDLA) Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:370. [PMID: 35327742 PMCID: PMC8947596 DOI: 10.3390/children9030370] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/18/2021] [Accepted: 03/03/2022] [Indexed: 12/21/2022]
Abstract
BACKGROUND Childhood obesity is one of the greatest public health concerns facing advanced societies, Spain being one of the countries with the highest incidence. In this sense, the Region of Murcia has been pointed out as the Spanish autonomous community with the highest prevalence of excess weight among young people. More specifically, the Valle de Ricote has shown an even greater proportion of excess weight among young people. Several sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors are related to excess weight. Based on the lack of information, this research project will try to provide relevant information to design intervention programs, as well as to implement effective public policies to try and reverse this alarming situation. Therefore, this research project aims (1) to obtain cross-sectional and longitudinal data on the excess weight and their potential sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors associated among adolescents from the Valle de Ricote (Region of Murcia, Spain) (aged 12-17 years), and (2) to examine the association between excess weight and their potential sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors associated among this population. METHODS A cross-sectional study and follow-up study will be performed. This research project will involve adolescents using a simple random sampling technique. A total of three secondary schools from the Valle de Ricote (Region of Murcia, Spain) will be included in this project. The minimum sample size will be 1138, establishing a 95% confidence interval, a 40% prevalence of excess weight, a 3% margin of error, and a non-response rate of 10%. Primary outcome measures will be: (1) anthropometric measurements, (2) sociodemographic factors, (3) environmental factors, (4) lifestyle factors, (5) health-related factors, (6) cognitive factors, and (7) psychological factors. CONCLUSION This research project will aim to determine the prevalence of excess weight and interrelate their potential sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors associated. The obtained results will help to manage and propose possible multidisciplinary interventions and strategies in order to prevent and reduce the excess weight in adolescents from the Valle de Ricote. Furthermore, orientations will be given to transfer the obtained results to the public sector to evaluate or change the adopted policies.
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Affiliation(s)
- José Francisco López-Gil
- Departamento de Expresión Plástica, Musical y Dinámica, Facultad de Educación, Universidad de Murcia (UM), 30100 Murcia, Spain;
- Health and Social Research Center, Universidad de Castilla-La Mancha (UCLM), 16071 Cuenca, Spain
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Alremawi S, Arabiyat AA. The Effectiveness of a Behavioral Program in Reducing the Aggressive Behavior of Children with Mild Mental Disabilities at the Mu’tah Center for Special Education. Health Psychol Res 2022; 10:32317. [DOI: 10.52965/001c.32317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Sameer Alremawi
- Department of Psychology and special education, Al-Balqa Applied University
| | - Ahmed A. Arabiyat
- Department of Psychology and special education, Al-Balqa Applied University
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Francis LA, Rollins BY, Keller KL, Nix RL, Savage JS. Profiles of Behavioral Self-Regulation and Appetitive Traits in Preschool Children: Associations With BMI and Food Parenting Practices. Front Nutr 2022; 9:796580. [PMID: 35308281 PMCID: PMC8931462 DOI: 10.3389/fnut.2022.796580] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
Appetitive traits that contribute to appetite self-regulation have been shown to relate to non-food-related regulation in general domains of child development. Latent profile analysis (LPA) was used to identify typologies of preschool children's behavioral self-regulation (BSR) and appetitive traits related to appetite self-regulation (ASR), and we examined their relation with children's BMIz and food parenting practices. Participants included 720 children and their parents (90% mothers), drawn from the baseline assessment of a childhood obesity preventive intervention. BSR measures included teacher reports of children's inhibitory control, impulsivity and attentional focusing, as well as an observed measure of inhibitory control. ASR was assessed using parents' reports of children's appetitive traits related to food avoidance (e.g., satiety responsiveness, slowness in eating) and food approach (e.g., enjoyment of food, food responsiveness). Children's body mass index z-score (BMIz) was calculated from measured height and weight. Parents' BMI and food parenting practices were also measured. Four profiles were identified that characterized children with dysregulated behavior, higher food approach and lower food avoidance (16%), dysregulated behavior but lower food approach and higher food avoidance (33%), regulated behavior but highest food approach and lowest food avoidance (16%), and highly-regulated behavior, lowest food approach and highest food avoidance (35%). Children's BMIz was highest in the profile consisting of children with dysregulated behavior, higher food approach and lower food avoidance. BMI was similar in the profile with children with regulated behavior but highest food approach and lowest food avoidance; children in this profile also had parents who reported the highest levels of controlling food parenting practices, and the lowest levels of parental modeling of healthy eating. Compared to all other profiles, children in the profile characterized by highly-regulated behavior, lowest food approach and highest food avoidance had the lowest BMIz and had parents who reported food parenting practices characterized by the highest levels of child control in feeding and the lowest levels of pressure to eat. These findings provide evidence of differing patterns of relations between self-regulation across behavioral and eating domains, and children's obesity risk may vary based on these different patterns.
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Affiliation(s)
- Lori A. Francis
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, United States
- *Correspondence: Lori A. Francis
| | - Brandi Y. Rollins
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, United States
| | - Kathleen L. Keller
- Department of Nutrition Sciences, The Pennsylvania State University, University Park, PA, United States
| | - Robert L. Nix
- Department of Human Development and Family Studies, University of Wisconsin-Madison, Madison, WI, United States
| | - Jennifer S. Savage
- Department of Nutrition Sciences, The Pennsylvania State University, University Park, PA, United States
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111
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Apperley LJ, Blackburn J, Erlandson-Parry K, Gait L, Laing P, Senniappan S. Childhood obesity: A review of current and future management options. Clin Endocrinol (Oxf) 2022; 96:288-301. [PMID: 34750858 DOI: 10.1111/cen.14625] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 02/02/2023]
Abstract
Obesity is becoming increasingly prevalent in paediatric populations worldwide. In addition to increasing prevalence, the severity of obesity is also continuing to rise. Taken together, these findings demonstrate a worrying trend and highlight one of the most significant challenges to public health. Childhood obesity affects multiple organs in the body and is associated with both significant morbidity and ultimately premature mortality. The prevalence of complications associated with obesity, including dyslipidaemia, hypertension, fatty liver disease and psychosocial complications are becoming increasingly prevalent within the paediatric populations. Treatment guidelines currently focus on intervention with lifestyle and behavioural modifications, with pharmacotherapy and surgery reserved for patients who are refractory to such treatment. Research into adult obesity has established pharmacological novel therapies, which have been approved and established in clinical practice; however, the research and implementation of such therapies in paediatric populations have been lagging behind. Despite the relative lack of widespread research in comparison to the adult population, newer therapies are being trialled, which should allow a greater availability of treatment options for childhood obesity in the future. This review summarizes the current evidence for the management of obesity in terms of medical and surgical options. Both future therapeutic agents and those which cause weight loss but have an alternative indication are also included and discussed as part of the review. The review summarizes the most recent research for each intervention and demonstrates the potential efficacy and limitations of each treatment option.
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Affiliation(s)
- Louise J Apperley
- Department of Paediatric Endocrinology, Alder Hey Children's Hospital, Liverpool, UK
| | - James Blackburn
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University of London, London, UK
| | | | - Lucy Gait
- Department of Paediatric Clinical Psychology, Alder Hey Children's Hospital, Liverpool, UK
| | - Peter Laing
- Department of Paediatric Endocrinology, Alder Hey Children's Hospital, Liverpool, UK
| | - Senthil Senniappan
- Department of Paediatric Endocrinology, Alder Hey Children's Hospital, Liverpool, UK
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112
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Fuligni GL, Gonzalez CJ, Figueroa R. Adolescents' proxy reports on obesity-related parenting practices: factorial validity and reliability across four behavioral domains. BMC Public Health 2022; 22:329. [PMID: 35172801 PMCID: PMC8848982 DOI: 10.1186/s12889-022-12745-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 02/09/2022] [Indexed: 11/18/2022] Open
Abstract
Background Adolescents’ energy balance behaviors are precursors to obesity shaped by the practices or strategies that many parents implement. Although key stakeholders to their families, adolescents are rarely considered to report on these obesity-related parenting practices. The aim of this study is to assess the factorial and predictive validity of adolescents’ proxy-report of parents’ obesity-related parenting across four behavioral domains. Methods This study used data from the Family Life, Activity, Sun, Health, and Eating (FLASHE) study. This study tests whether adolescents’ proxy reports about their parents’ obesity-related parenting are significantly associated with parents’ responses on their own obesity-related parenting, as well as whether these reports are significantly associated to parent-adolescent energy balance behaviors. Factorial validity was assessed using linear regression and Confirmatory Factor Analysis (CFA), whereas predictive validity was assessed using Actor-Partner Interdependence Modeling (APIM). Results Regression results indicated that adolescents’ proxy report is significantly associated with parents’ report of their own parenting in all four domains (β = .59—.71; p < 0.05). CFA results indicated a final factor structure that loaded significantly onto hypothesized obesity-related parenting domains (β > .30) in both adolescents and parents. APIM results indicated that both parent- (β = .32; p < 0.05) and adolescent-(β = .21; p < 0.05) reported obesity parenting for fruit and vegetable consumption were associated with their own fruit and vegetable intake. In addition, adolescent-reported physical activity parenting was significantly associated with adolescent physical activity (β = 0.23; p < 0.05). Regarding partner effects, only parent-reported parenting for fruit and vegetable consumption were significantly associated with adolescent intake of fruit and vegetables (β = 0.15, p < 0.05) and adolescent-reported physical activity parenting was significantly associated with parental physical activity (β = 0.16, p < 0.05). Neither adolescent nor parent reported parenting were significantly associated with screen time or junk food intake outcomes. Each final obesity-related parenting scale had good internal consistency (a = .74-.85). Conclusions We found that adolescent- and parent-reported obesity-related parenting were significantly associated, while adolescent-reported parenting were more explanatory of fruit and vegetable intake and physical activity than parent-reported parenting. These findings suggest that adolescent proxy reports may be a valid source of information on obesity-related parenting.
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Affiliation(s)
- Gabriel L Fuligni
- College of Human Ecology, Division of Nutritional Sciences, Cornell University, 244 Garden Avenue, Ithaca, NY, 14853, USA
| | - Christopher J Gonzalez
- Division of General Internal Medicine, Weill Cornell Medicine, 338 E 66th Street, New York, NY, USA.,Division of General Internal Medicine, 338 E 66th Street, New York, NY, 10065, USA
| | - Roger Figueroa
- College of Human Ecology, Division of Nutritional Sciences, Cornell University, 244 Garden Avenue, Ithaca, NY, 14853, USA.
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113
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Lai WK, Mohd Sidik S, Lekhraj R, Gan WY, Ismail SIF. Prevalence and Predictors of Overweight and Obesity Among Adolescents in Seremban, Negeri Sembilan, Malaysia. Cureus 2022; 14:e21795. [PMID: 35251862 PMCID: PMC8891721 DOI: 10.7759/cureus.21795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2022] [Indexed: 01/22/2023] Open
Abstract
Introduction: Obesity is recognized as a serious public health threat. Recent evidence has warned of the alarming rise in the prevalence of childhood overweight and obesity throughout the world. This study aimed to determine the prevalence of overweight and obesity, and its associations with socio-demographic, behavioral, and psychosocial factors among school-going adolescents in Seremban, Negeri Sembilan. Methods: Cross-sectional study was conducted. A total of 2,221 adolescents were randomly selected from eight secondary schools. A questionnaire was administered to assess socio-demographic profiles, meal patterns, physical activity level, self-efficacy, self-esteem, body size satisfaction, perception of body weight status, depression, anxiety, stress, and nutrition knowledge. Bodyweight and height were measured and BMI-for-age z scores were computed to determine the body weight status. Bivariate analysis and multivariate logistic regression were used for the data analysis. Results: The prevalence of overweight among the participants in this study was 17.0%, while the prevalence of obesity was 14.9%. The significant predictors of overweight and obesity in this study were breakfast skipping, low physical activity level, low self-efficacy scores in terms of healthy eating, weight and physical activity, body dissatisfaction, and perception of large body size. Conclusion: The results emphasize the need to broaden the scope of nutrition guidelines, public health policies, and programs to address overweight and obesity among adolescents in Malaysia. The findings also suggest that health education programs should cover practical advice for modifying healthy eating behaviors, increasing physical activity, as well as matters on body image and body satisfaction.
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114
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Fat-based studies for computer-assisted screening of child obesity using thermal imaging based on deep learning techniques: a comparison with quantum machine learning approach. Soft comput 2022. [DOI: 10.1007/s00500-021-06668-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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115
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Global Trends in Scientific Research on Pediatric Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031251. [PMID: 35162274 PMCID: PMC8834687 DOI: 10.3390/ijerph19031251] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 02/04/2023]
Abstract
(1) Introduction: The aim of this study was to analyze scientific production, collaboration among countries, and research topics focusing on pediatric obesity. (2) Methods: The papers that were included in the study were retrieved from the Web of Science Core Collection from Clarivate Analytics. A bibliometric analysis of several focuses, including journals of publication, subject categories, most frequent author keywords, and journal impact factors, was conducted. Social network analysis was used to recognize collaboration groups between countries and the co-occurrences of author keywords. (3) Results: A total of 12,171 research articles were published in 2036 journals classified under a variety of subject areas, with pediatrics (27.7%), nutrition and dietetics (18.5%), and public environmental and occupational health (18.4%) accounting for the most frequent study areas, and Pediatric Obesity (309), the International Journal of Obesity (299), and BMC Public Health being the most productive journals. The main challenges identified for pediatric obesity include general topics such as physical activity, nutrition, diet, and prevention as well as other more specific challenges such as metabolic syndrome, insulin resistance, eating behavior, and cardiovascular diseases. (4) Conclusions: We observed a growth rate in the number of published articles of 59.8%, which serves as evidence of the importance of the topic. The number of funded papers also doubled from 2010 to 2019. There has been significant global collaboration on the topic, with countries across five continents being involved. The results of the thematic analysis reveal the importance of exercise and nutrition-related topics along with specialized health terms and terms related to public health.
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116
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De-Jongh González O, Ojeda García A, Turnbull B, Cruz Torres CE, León Elizalde MA, Escalante Izeta EI. Don't take the context out of the picture: Contextually shaped parents' and children's obesogenic behaviors in a marginalized area of Mexico City. Appetite 2022; 171:105915. [PMID: 35007664 DOI: 10.1016/j.appet.2022.105915] [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: 08/02/2021] [Revised: 12/21/2021] [Accepted: 01/05/2022] [Indexed: 11/26/2022]
Abstract
Santa Fe Gully zone is a marginalized area of Mexico City where nearly 39% of children live with either overweight or obesity. Despite the extensive research on obesogenic behaviors, studies frequently overlook the contexts where such behaviors occur. This qualitative study described individual and familial obesogenic behaviors among children with obesity from Santa Fe Gully, and explained how these behaviors might be contextually shaped. We used a grounded theory approach to investigate the process of development/maintenance of obesity in our sample. Fifteen participants (seven 10-year-olds with overweight or obesity and their parents) participated in nine art-based focus groups, and parents completed individual semi-structured interviews. Data were analyzed using a structured thematic content analysis. Results showed children's weight status was part of their identity, providing children with a familial 'fitting' sense while increasing psychosocial difficulties, leading to emotional overeating as a coping strategy. Parents' use of controlling and low-structured parenting practices reinforced children's emotional overeating and failed to regulate children's dietary and physical activity behaviors. Some low-structured parenting practices were guilt-motivated or fostered by socioeconomic and cultural factors (e.g., limited food access, unhealthy food exposure, community unsafety). Future interventions in Santa Fe Gully aimed at modifying obesogenic behaviors should incorporate systemic and ecological approaches to help participants navigate through contextual obstacles, as their behaviors should be analized considering the context where they occur.
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Affiliation(s)
- Olivia De-Jongh González
- Psychology Department, Universidad Iberoamericana of Mexico City, 880 Prolongación Paseo de la Reforma, Lomas de Santa Fe, Álvaro Obregón, Mexico City, CP 01219, Mexico; School of Population and Public Health, University of British Columbia, BC Children's Hospital Research Institute, F514-4490 Oak Street, Vancouver, British Columbia, V6H 3V4, Canada.
| | - Angélica Ojeda García
- Psychology Department, Universidad Iberoamericana of Mexico City, 880 Prolongación Paseo de la Reforma, Lomas de Santa Fe, Álvaro Obregón, Mexico City, CP 01219, Mexico.
| | - Bernardo Turnbull
- Psychology Department, Universidad Iberoamericana of Mexico City, 880 Prolongación Paseo de la Reforma, Lomas de Santa Fe, Álvaro Obregón, Mexico City, CP 01219, Mexico.
| | - Christian E Cruz Torres
- Psychology Department, Universidad de Guanajuato Campus León, Blvd. Puente Milenio No. 1001 Fracción del Predio San Carlos, CP 37670, Guanajuato, México.
| | - M Angélica León Elizalde
- School of Population and Public Health, University of British Columbia, BC Children's Hospital Research Institute, F514-4490 Oak Street, Vancouver, British Columbia, V6H 3V4, Canada.
| | - Ericka I Escalante Izeta
- Health Department, Universidad Iberoamericana of Puebla. 2901 Blvd. del Niño Poblano, Reserva Territorial Atlixcáyotl, San Andrés Cholula, Puebla, CP 72820, Mexico.
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Evaluation of the effect of physical activity on the prevalence of overweight and obesity in school-aged children. CENTRAL EUROPEAN JOURNAL OF SPORT SCIENCES AND MEDICINE 2022. [DOI: 10.18276/cej.2022.4-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
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118
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Wang X, Liu J, Gao D, Li Y, Ma Q, Chen L, Chen M, Ma T, Ma Y, Zhang Y, Yang J, Dong Y, Song Y, Ma J. Effectiveness of national multicentric school-based health lifestyles intervention among chinese children and adolescents on knowledge, belief, and practice toward obesity at individual, family and schools' levels. Front Pediatr 2022; 10:917376. [PMID: 36061391 PMCID: PMC9433560 DOI: 10.3389/fped.2022.917376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study aims to evaluate the effectiveness of the trial of national multicentric school-based health lifestyles intervention toward childhood obesity on the KBP at individual, family and schools' levels. METHODS The national trial was a multi-centered, cluster-controlled trial, which was conducted in seven provinces from September 2013 to February 2014, aiming at preventing childhood overweight and obesity. Integrated intervention strategies focused on changing specific practice related to energy intake and expenditure, such as decreasing the consumption of sweetened fizzy drinks, increasing the consumption of vegetables, ensuring proper protein intake, reducing sedentary practice including screen time, and maintaining at least 1 h of moderate to vigorous physical activity. A total of 27,477 children and adolescents in the control group and 30,997 in the intervention group were recruited with a mean follow-up period of 6.7 months. The binomial response mixed-effects model was used for assessing the effects of the national school-based health lifestyles intervention on obesity-related KBP at students individual, parents' and schools' levels. RESULTS Children and adolescents in the intervention group mastered better obesity-related knowledge, and they had higher correct response rates to all questions about obesity-related knowledge compared to the control group (P < 0.05). In terms of obesity-related belief, individuals in the intervention group was more motivated than the control group, participants in the intervention group had higher correctness of 71.18, 52.94, and 56.60% than the control group of 68.61, 49.86, and 54.43%, (P < 0.05). In addition, healthier habits of eating breakfast and drinking milk every day were observed in the intervention group. For the beliefs toward obesity, parents of the intervention group had higher correctness than the control group. At the same time except for the fruit consumption, other obesity-related practice in the intervention group were healthier than the control group (P < 0.05). Except for some beliefs and practice, the intervention effect at the parent level was not significant in other aspects. CONCLUSION The obesity-related knowledge and beliefs of children and adolescents got improved significantly. However, the effects on the knowledge, beliefs and certain practices of their parents and school administrators failed to reach significance.
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Affiliation(s)
- Xinxin Wang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, China.,Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, China
| | - Jieyu Liu
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Di Gao
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Yanhui Li
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Qi Ma
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Li Chen
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Manman Chen
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Tao Ma
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Ying Ma
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Yi Zhang
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Jianjun Yang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, China.,Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, China
| | - Yanhui Dong
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Yi Song
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Jun Ma
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Beijing, China
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Koyuncu Z, Kadak MT, Tarakçıoğlu MC, Bingöl Çağlayan RH, Doğangün B, Ercan O. Eating behaviors and alexithymic features of obese and overweight adolescents. Pediatr Int 2022; 64:e15008. [PMID: 34599634 DOI: 10.1111/ped.15008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 07/26/2021] [Accepted: 08/18/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND In this study, eating behaviors and alexithymia levels in obese adolescents were investigated. Relationships between alexithymia, eating behavior and insulin resistance were studied. METHODS The patient group consisted of 87 obese adolescents or overweight adolescents (O + OW). The comparison group consisted of 101 normal weight adolescents (N). Alexithymia Questionnaire for Children, Dutch Eating Behavior Questionnaire, and Revised Child Anxiety and Depression Scale-Child Version, are used for assessing adolescents. The homeostasis model assessment-estimated insulin resistance was calculated to determine insulin resistance. RESULTS Alexithymia Questionnaire for Children scores were significantly higher in O + OW than N (P = 0.009). Both emotional and restrained eating scores are higher in O + OW (P < 0.001 for both). On the other hand, external eating scores were not significantly different. In O + OW, external eating was positively associated with homeostasis model assessment-estimated insulin resistance (r: 035, P = 0.006), but is not associated with fasting blood glucose and the hemoglobin A1c (HbA1c) (r: -0.05, P = 0.62; r: -0.05, P = 0.73). Regression analysis showed that restrained and emotional eating were predictors of O + OW (B: 0.1, P < 0.001; B: 0.06, P = 0.001). Emotional eating was positively correlated with the Alexithymia Questionnaire for Children and Revised Child Anxiety and Depression Scale-Child Version in O + OW (r: 0.29, P = 0.008; r: 0.48, P < 0.001). CONCLUSIONS Obese and overweight adolescents were more alexithymic than normal weight adolescents. Alexithymia scores were also positively associated with emotional eating. On the other hand, alexithymia was not a predictor of obesity/overweight. Restrained and emotional eating were predictors of obesity/overweight. Emotional and restrained eating were more common in obese and overweight adolescents than normal-weight adolescents. External eating is not significantly associated with obesity but is related to insulin resistance.
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Affiliation(s)
- Zehra Koyuncu
- Department of Child and Adolescent Psychiatry, Cerrahpasa Medical Faculty, Istanbul University-C, Istanbul, Turkey
| | - Muhammed Tayyib Kadak
- Department of Child and Adolescent Psychiatry, Cerrahpasa Medical Faculty, Istanbul University-C, Istanbul, Turkey
| | - Mahmut Cem Tarakçıoğlu
- Department of Child and Adolescent Psychiatry, Cerrahpasa Medical Faculty, Istanbul University-C, Istanbul, Turkey
| | - Rahime Hülya Bingöl Çağlayan
- Department of Child and Adolescent Psychiatry, Cerrahpasa Medical Faculty, Istanbul University-C, Istanbul, Turkey
| | - Burak Doğangün
- Department of Child and Adolescent Psychiatry, Cerrahpasa Medical Faculty, Istanbul University-C, Istanbul, Turkey
| | - Oya Ercan
- Pediatric Endocrinology and Adolescent Divisions, Cerrahpasa Medical Faculty, Istanbul University-C, Istanbul, Turkey
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Bhattacharya S, Agarwal P, Bera OP, Saleem SM, Shikha D, Vallabh V, Juyal R, Singh A. COVID-19 and childhood obesity (CO-BESITY) in the era of new normal life: A need for a policy research. J Public Health Res 2021; 10. [PMID: 34918498 PMCID: PMC9131485 DOI: 10.4081/jphr.2021.2673] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 11/11/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND In the era of new normal life (after Coronavirus Disease 2019 (COVID-19)), our children are experiencing the double threat of COVID-19 and Childhood Obesity (CO-BESITY). The rate of childhood obesity has been rapidly increasing in developed as well as low middle-income countries during the pandemic. DESIGN AND METHODS The current paper aims to identify the probable reasons of increase in childhood obesity during this pandemic and offers suggestions to reduce the burden of it. Literature search was done using PubMed, Google Scholar, and Scopus databases for the key terms "childhood obesity," "obesity," "pandemic," and/or childhood obesity. All the relevant articles were included to support the argument for this viewpoint. RESULTS Childhood obesity is a complicated disorder having diverse outcomes. The incidence of childhood obesity is clearly analysed from Bronfenbrenner's model of child development. The model examines an overabundance of bio-psycho-social backgrounds, risks, and probable outcomes on the development of a child. COVID-19 pandemic has disrupted the ecosystem of this dynamic model and has created an economic and social-cultural crisis that has ignited a chain reaction of stressors upon children and their families. In this paper, we have described how this Bronfenbrenner's model of child development also known as the Bioecological Model can be effective for the estimation and prevention of childhood obesity. CONCLUSION We propose that this Bioecological Model will help the children and their families further to understand and manage the problem of childhood obesity during this pandemic on their own.
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Affiliation(s)
| | | | | | | | - Deep Shikha
- Department of Community Medicine, HIMS, SRHU, Dehradun.
| | | | - Ruchi Juyal
- Department of Community Medicine, HIMS, SRHU, Dehradun.
| | - Amarjeet Singh
- Department of Community Medicine and SPH, PGIMER, Chandigarh.
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Petrovics P, Nagy A, Sandor B, Palfi A, Szekeres Z, Toth K, Szabados E. Examination of Self-Esteem, Body Image, Eating Attitudes and Cardiorespiratory Performance in Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413172. [PMID: 34948781 PMCID: PMC8701836 DOI: 10.3390/ijerph182413172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/10/2021] [Accepted: 12/11/2021] [Indexed: 11/24/2022]
Abstract
Self-esteem, body image and eating attitudes are important characteristics regarding adolescent mental health. In our present work, we aimed to investigate these psychological items in adolescent boys and girls examining gender differences and correlations with the BMI-for-age and cardiorespiratory performance. 374 students (209 girls with an average age of 16.4 ± 1.08 years, and 165 boys with an average age of 16.5 ± 1.03 years) underwent investigation using the Rosenberg self-esteem scale, EAT-26 and BAT questionnaires. The BMI-for-age was calculated with BMI growth charts and the cardiorespiratory performance was measured with the 20 m shuttle run test. Our results showed that adolescent girls scored lower self-esteem and higher values for BAT and each scale of eating behaviors, such as uncontrolled eating, cognitive restraints and emotional eating compared to boys despite the fact, that obesity and overweight were more common among boys. No significant correlation was found between BMI and psychological test results in either boys or girls, however, subjective body shape and gender predicted self-esteem and BAT scores and the cognitive restraints in the eating attitudes. Uncontrolled and emotional eating were primarily influenced by gender, in which BMI played only a weaker role. Cardiorespiratory performance was positively associated with self-esteem and body image among boys, and it had a negative correlation regarding BMI in both genders.
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Affiliation(s)
- Peter Petrovics
- Institute of Physical Education and Sport Sciences, Faculty of Sciences, University of Pecs, H-7624 Pecs, Hungary;
| | - Alexandra Nagy
- State Hospital for Cardiology, H-8230 Balatonfüred, Hungary;
| | - Barbara Sandor
- Division of Preventive Cardiology and Rehabilitation, 1st Department of Medicine, Medical School, University of Pecs, H-7623 Pecs, Hungary; (B.S.); (A.P.); (Z.S.)
| | - Anita Palfi
- Division of Preventive Cardiology and Rehabilitation, 1st Department of Medicine, Medical School, University of Pecs, H-7623 Pecs, Hungary; (B.S.); (A.P.); (Z.S.)
| | - Zsolt Szekeres
- Division of Preventive Cardiology and Rehabilitation, 1st Department of Medicine, Medical School, University of Pecs, H-7623 Pecs, Hungary; (B.S.); (A.P.); (Z.S.)
| | - Kalman Toth
- Division of Cardiology, 1st Department of Medicine, Medical School, University of Pecs, H-7624 Pecs, Hungary;
| | - Eszter Szabados
- Division of Preventive Cardiology and Rehabilitation, 1st Department of Medicine, Medical School, University of Pecs, H-7623 Pecs, Hungary; (B.S.); (A.P.); (Z.S.)
- Correspondence:
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Smirk E, Mazahery H, Conlon CA, Beck KL, Gammon C, Mugridge O, von Hurst PR. Sugar-sweetened beverages consumption among New Zealand children aged 8-12 years: a cross sectional study of sources and associates/correlates of consumption. BMC Public Health 2021; 21:2277. [PMID: 34903202 PMCID: PMC8670206 DOI: 10.1186/s12889-021-12345-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 11/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background The benefit of reducing sugar-sweetened beverage (SSB) consumption is widely accepted, but updated and in-depth data on New Zealand (NZ) children’s SSB consumption is lacking. The aims of this study were to describe beverage consumption, focusing on SSBs in primary school age children living in Auckland; to examine the association of selected socio-demographic, home, community and school factors and children’s beverage knowledge/attitudes with regards to beverage consumption; to explore the relationship between SSBs consumption and adiposity in children. Methods A cross-sectional, Auckland-wide survey of 578 school age children (8-12 years) was conducted using questionnaires to collect data on beverage consumption, beverage knowledge/attitudes, and selected socio-demographic and home, community, school factors. Body fat percentage (BF%) was assessed using bioelectrical impedance (BIA). Results Ninety-six percent of children consumed ≥1 serving of SSBs a week; with ≥5 servings reported by 62% of children. Of all SSBs assessed, consumption of ≥1 serving of sugar sweetened milk-based beverages (85%, mainly milk drinks made from powder) was most prevalent, followed by fruit juice (46%) and sugar-containing carbonated drinks (39%, mainly soft/fizzy drinks). Among unsweetened beverages, plain water was reported to be consumed < 2 times a day by 22% of children, and plain milk < 1 serving a day by 53%. Higher consumption of SSBs was associated with socio-economic disadvantage, non-NZ European ethnicities (Māori, Pacific, Asian, others), availability of SSBs in the home, frequent takeaway/convenience shop visits, children’s incorrect perception of adequate SSBs consumption frequency, and higher BF% (females only). School health policy and encouragement of children to consume un-sweetened beverages was not associated with SSBs consumption. Conclusions The consumption of SSBs is prevalent in NZ school age children, with higher consumption rates observed among those from socially disadvantaged areas. This high consumption is associated with higher BF% in females. Multi-contextual interventions to decrease SSBs should target children, and their families/environment, particularly those from socially disadvantaged areas. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12345-9.
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Affiliation(s)
- Emma Smirk
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, 0745, New Zealand
| | - Hajar Mazahery
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, 0745, New Zealand
| | - Cathryn A Conlon
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, 0745, New Zealand
| | - Kathryn L Beck
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, 0745, New Zealand
| | - Cheryl Gammon
- School of Health Sciences, College of Health, Massey University, Auckland, 0745, New Zealand
| | - Owen Mugridge
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, 0745, New Zealand
| | - Pamela R von Hurst
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, 0745, New Zealand.
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Cook EJ, Powell FC, Ali N, Penn-Jones CP, Ochieng B, Constantinou G, Randhawa G. 'They Are Kids, Let Them Eat': A Qualitative Investigation into the Parental Beliefs and Practices of Providing a Healthy Diet for Young Children among a Culturally Diverse and Deprived Population in the UK. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413087. [PMID: 34948698 PMCID: PMC8700847 DOI: 10.3390/ijerph182413087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/04/2021] [Accepted: 12/07/2021] [Indexed: 11/16/2022]
Abstract
In the UK, ethnic minority children are at greater risk of obesity and weight-related ill health compared to the wider national population. The factors that influence the provision of a healthy diet among these populations remain less understood. An interpretive qualitative study with a phenomenological perspective comprised of 24 single sex semi-structured focus groups was conducted with 110 parents (63 mothers and 47 fathers) of young children (aged 0-5 years). The participants were recruited from deprived and ethnically diverse wards in Luton, UK and self-identified as being white British, Pakistani, Bangladeshi, black African-Caribbean or Polish. The findings highlighted a wide range of inter-relating psychological and sociocultural factors that underpin parental beliefs and practices in providing children with a healthy diet. Parents, whilst aware of the importance of providing children with a healthy diet, faced challenges such as lack of time and balancing competing responsibilities, which were clear barriers to providing children with a healthy diet. Access to and affordability of healthy food and the overexposure of cheap, convenient, and unhealthy processed foods made it increasingly difficult for parents to provide a healthy diet for their growing families. Household food practices were also found to be situated within the wider context of sociocultural and religious norms around cooking and eating, along with cultural identity and upbringing.
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Affiliation(s)
- Erica Jane Cook
- School of Psychology, University of Bedfordshire, Luton LU1 3JU, UK;
- Correspondence: ; Tel.: +44-(0)-1582-489217
| | | | - Nasreen Ali
- Institute for Health Research, University of Bedfordshire, Luton LU1 3JU, UK; (N.A.); (G.C.); (G.R.)
| | - Catrin Pedder Penn-Jones
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, UK;
| | - Bertha Ochieng
- School of Nursing and Midwifery, De Montford University, Leicester LE1 9BH, UK;
| | - Georgina Constantinou
- Institute for Health Research, University of Bedfordshire, Luton LU1 3JU, UK; (N.A.); (G.C.); (G.R.)
| | - Gurch Randhawa
- Institute for Health Research, University of Bedfordshire, Luton LU1 3JU, UK; (N.A.); (G.C.); (G.R.)
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Philippe K, Chabanet C, Issanchou S, Monnery-Patris S. Young Children's Eating in the Absence of Hunger: Links With Child Inhibitory Control, Child BMI, and Maternal Controlling Feeding Practices. Front Psychol 2021; 12:653408. [PMID: 34867571 PMCID: PMC8635239 DOI: 10.3389/fpsyg.2021.653408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 10/19/2021] [Indexed: 12/05/2022] Open
Abstract
This study aimed to gain a better understanding of the associations between young children’s eating in the absence of hunger (EAH), inhibitory control, body mass index (BMI) and several maternal controlling feeding practices (food as reward, restriction for health, restriction for weight control). In addition, to more properly assess the relationship between children’s and maternal variables, the link between EAH and restriction was explored separately in two directionalities: “child to parent” or “parent to child.” To do this, mothers of 621 children aged 2.00–6.97years (51% boys, M=4.11years, SD=1.34) filled in a questionnaire with items from validated questionnaires. Structural equation modeling (SEM) was used to analyze the data. The results showed, whatever the directionality considered, a positive association between children’s eating in the absence of hunger and their BMI z-scores. Restriction for health and restriction for weight control were differently linked to EAH and to children’s BMI z-scores. Namely, low child inhibitory control, food as reward and restriction for health were identified as risk factors for EAH. Restriction for weight control was not linked to EAH, but was predicted by child BMI z-scores. Interventions aiming to improve children’s abilities to self-regulate food intake could consider training children’s general self-regulation, their self-regulation of intake, and/or promoting adaptive parental feeding practices.
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Affiliation(s)
- Kaat Philippe
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, Dijon, France
| | - Claire Chabanet
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, Dijon, France
| | - Sylvie Issanchou
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, Dijon, France
| | - Sandrine Monnery-Patris
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, Dijon, France
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Interrelation between weight and weight stigma in youth: is there evidence for an obesogenic vicious cycle? Eur Child Adolesc Psychiatry 2021; 32:697-704. [PMID: 34853910 PMCID: PMC10115675 DOI: 10.1007/s00787-021-01922-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 11/21/2021] [Indexed: 10/19/2022]
Abstract
Many children and adolescents are confronted with weight stigma, which can cause psychological and physical burden. While theoretical frameworks postulate a vicious cycle linking stigma and weight status, there is a lack of empirical evidence. The aim was to analyze the longitudinal bidirectional relationship between body weight and weight stigma among children and adolescents. The sample consisted of 1381 children and adolescents, aged 9-19 years at baseline (49.2% female; 78% normal weight), from a prospective study encompassing three measurement points over 6 years. Participants provided self-reported data on experienced weight-related teasing and weight/height (as indicators for weight status). Latent structural equation modelling was used to examine the relationship between weight-related teasing experiences and weight. Additionally, gender-related differences were analyzed. Between the first two waves, there was evidence for a bidirectional relationship between weight and weight-related teasing. Between the last two waves, teasing predicted weight, but there was no reverse association. No gender-related differences were found. The data indicate a reciprocal association between weight stigma and body weight across weight groups and independent of gender. To prevent vicious cycles, approaches that simultaneously promote healthy weight and reduce weight stigma are required.
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Dettmer E, Grewal S, Regina A, Phung N, Steinegger C, Hamilton J, Toulany A. Development and Implementation of a Pilot Integrative Day Hospital Program for Youth with Severe Obesity and Mental Health Issues. Child Obes 2021; 17:563-572. [PMID: 34542323 DOI: 10.1089/chi.2021.0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Adolescents with severe obesity and comorbid mental health issues are the most resistant to traditional weight management approaches and have poor treatment outcomes. Our objective was to implement and evaluate a pilot day hospital treatment program for adolescents with severe obesity, or risk for severe obesity, and significant mental health comorbidities. Methods: This was a prospective cohort study of adolescents 12-18 years of age with severe obesity (BMI >99th percentile), or at risk for severe obesity, and comorbid mental health issues. The intervention, focused on healthy lifestyle and mental health support, was implemented within an existing psychiatric day hospital at a pediatric quaternary care hospital. Anthropometric and mental health measures were analyzed pre- and postintervention. Results: Thirty-two adolescents with a mean age of 14.9 years [standard deviation (SD) 1.6] participated in the pilot integrative day hospital program for a mean duration of 5.2 months (SD 2.3). Eleven participants had primary severe obesity and comorbid mental health conditions (obesity subgroup) and 21 participants had primary mental illness and were at risk for obesity (psychiatry subgroup). We did not observe a significant difference between BMI pre- and postprogram among adolescents in both subgroups. In other words, adolescents in both subgroups achieved weight maintenance. Fear in losing control of overeating and/or being seen by others when eating decreased significantly in the obesity subgroup [mean difference (MD) 0.99; 95% confidence interval (CI): 0.27 to 1.71]. There was a significant decrease in participant-reported depression symptom severity, both overall and within program subgroups. Quality-of-life scores of study participants improved significantly within the obesity subgroup (MD -12.31; 95% CI: -21.69 to -2.93), but not within the psychiatry subgroup (MD -6.35; 95% CI: -13.37 to 0.67). Conclusions and Implications: A day hospital model of care may result in weight maintenance, decreased eating concerns, and improved mental health in adolescents with severe obesity or risk for severe obesity, and significant mental health comorbidities.
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Affiliation(s)
- Elizabeth Dettmer
- Department of Pediatrics and University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.,Department of Psychology and The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Seena Grewal
- Department of Psychiatry, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.,Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Andrea Regina
- Department of Psychology and The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Natalie Phung
- Divisions of Adolescent Medicine and Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Cathleen Steinegger
- Department of Pediatrics and University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.,Divisions of Adolescent Medicine and Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jill Hamilton
- Department of Pediatrics and University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.,Divisions of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Alene Toulany
- Department of Pediatrics and University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.,Divisions of Adolescent Medicine and Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
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Mariam A, Miller‐Atkins G, Pantalone KM, Iyer N, Misra‐Hebert AD, Milinovich A, Bauman J, Mocarski M, Ramasamy A, Smolarz BG, Hobbs TM, Zimmerman RS, Burguera B, Kattan MW, Rotroff DM. Associations of weight loss with obesity-related comorbidities in a large integrated health system. Diabetes Obes Metab 2021; 23:2804-2813. [PMID: 34472680 PMCID: PMC9292723 DOI: 10.1111/dom.14538] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 08/27/2021] [Accepted: 08/29/2021] [Indexed: 01/01/2023]
Abstract
AIMS To determine the health outcomes associated with weight loss in individuals with obesity, and to better understand the relationship between disease burden (disease burden; ie, prior comorbidities, healthcare utilization) and weight loss in individuals with obesity by analysing electronic health records (EHRs). MATERIALS AND METHODS We conducted a case-control study using deidentified EHR-derived information from 204 921 patients seen at the Cleveland Clinic between 2000 and 2018. Patients were aged ≥20 years with body mass index ≥30 kg/m2 and had ≥7 weight measurements, over ≥3 years. Thirty outcomes were investigated, including chronic and acute diseases, as well as psychological and metabolic disorders. Weight change was investigated 3, 5 and 10 years prior to an event. RESULTS Weight loss was associated with reduced incidence of many outcomes (eg, type 2 diabetes, nonalcoholic steatohepatitis/nonalcoholic fatty liver disease, obstructive sleep apnoea, hypertension; P < 0.05). Weight loss >10% was associated with increased incidence of certain outcomes including stroke and substance abuse. However, many outcomes that increased with weight loss were attenuated by disease burden adjustments. CONCLUSIONS This study provides the most comprehensive real-world evaluation of the health impacts of weight change to date. After comorbidity burden and healthcare utilization adjustments, weight loss was associated with an overall reduction in risk of many adverse outcomes.
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Affiliation(s)
- Arshiya Mariam
- Department of Quantitative Health SciencesLerner Research Institute, Cleveland ClinicClevelandOhioUSA
| | - Galen Miller‐Atkins
- Department of Quantitative Health SciencesLerner Research Institute, Cleveland ClinicClevelandOhioUSA
| | | | | | - Anita D. Misra‐Hebert
- Department of Quantitative Health SciencesLerner Research Institute, Cleveland ClinicClevelandOhioUSA
- Department of Internal Medicine, Cleveland Clinic Community CareCleveland ClinicClevelandOhioUSA
- Healthcare Delivery and Implementation Science CenterCleveland ClinicClevelandOhioUSA
| | - Alex Milinovich
- Department of Quantitative Health SciencesLerner Research Institute, Cleveland ClinicClevelandOhioUSA
| | - Janine Bauman
- Department of Quantitative Health SciencesLerner Research Institute, Cleveland ClinicClevelandOhioUSA
| | | | | | | | | | | | | | - Michael W. Kattan
- Department of Quantitative Health SciencesLerner Research Institute, Cleveland ClinicClevelandOhioUSA
| | - Daniel M. Rotroff
- Department of Quantitative Health SciencesLerner Research Institute, Cleveland ClinicClevelandOhioUSA
- Endocrinology and Metabolism InstituteCleveland ClinicClevelandOhioUSA
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Zeiler M, Philipp J, Truttmann S, Waldherr K, Wagner G, Karwautz A. Psychopathological Symptoms and Well-Being in Overweight and Underweight Adolescents: A Network Analysis. Nutrients 2021; 13:4096. [PMID: 34836351 PMCID: PMC8624115 DOI: 10.3390/nu13114096] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/08/2021] [Accepted: 11/12/2021] [Indexed: 12/24/2022] Open
Abstract
Overweight and underweight adolescents have an increased risk of psychological problems and reduced quality of life. We used a network analysis approach on a variety of psychopathology and well-being variables to identify central factors in these populations. The network analysis was conducted on data of 344 overweight adolescents (>90th BMI-percentile) and 423 underweight adolescents (<10th BMI-percentile) drawn from a large community sample (10-19 years) including behavioral and emotional problems (Youth Self-Report), eating disorder risk (SCOFF) and well-being variables (KIDSCREEN). Additionally, psychopathology and well-being scores of overweight and underweight individuals were compared with 1.560 normal weight adolescents. Compared to their normal weight peers, overweight adolescents showed elevated psychopathology and eating disorder risk as well as reduced well-being. Underweight adolescents reported increased levels of internalizing problems but no increased eating disorder risk or reduced well-being. The network analysis revealed that anxious/depressed mood and attention problems were the most central and interconnected nodes for both overweight and underweight subsamples. Among underweight individuals, social problems and socially withdrawn behavior additionally functioned as a bridge between other nodes in the network. The results support psychological interventions focusing on improving mood, coping with negative emotions and tackling inner tension.
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Affiliation(s)
- Michael Zeiler
- Eating Disorder Unit, Department for Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (J.P.); (S.T.); (G.W.); (A.K.)
| | - Julia Philipp
- Eating Disorder Unit, Department for Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (J.P.); (S.T.); (G.W.); (A.K.)
| | - Stefanie Truttmann
- Eating Disorder Unit, Department for Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (J.P.); (S.T.); (G.W.); (A.K.)
| | - Karin Waldherr
- Department for Research and Development, Ferdinand Porsche FernFH-Distance Learning University of Applied Sciences, 2700 Wiener Neustadt, Austria;
| | - Gudrun Wagner
- Eating Disorder Unit, Department for Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (J.P.); (S.T.); (G.W.); (A.K.)
| | - Andreas Karwautz
- Eating Disorder Unit, Department for Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (J.P.); (S.T.); (G.W.); (A.K.)
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Taş Torun Y, İçen S, Gül H, Döğer E. A cross-sectional study on the correlates of food addiction symptoms in adolescents seeking treatment for obesity: eating attitudes and gender differences. J Addict Dis 2021; 40:326-335. [PMID: 34783640 DOI: 10.1080/10550887.2021.1990638] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Multidisciplinary approach including psychiatric support, have come to the fore in the treatment of obesity. Food addiction and disordered eating behaviors are among major psychiatric problems that have important effects on both clinical manifestation and response to treatment. This study aimed to investigate correlates of food addiction among adolescents who are seeking treatment for obesity. METHOD This study included 126 adolescents between 11 and 18 years of age, 48 patients in the "study group" who are seeking treatment for obesity (BMI for age greater than 95th percentile) and 78 adolescents (BMI for age under 85th percentile) in the "control group" who were reached via online survey. All participants were requested to complete self-report based measurement tools of Yale Food Addiction Scale (YFAS) and Eating Attitude Test-40 (EAT-40). RESULTS 47.9% adolescents (n = 23) in the study group met food addiction diagnosis according to diagnostic evaluation of YFAS; which was significantly higher than 5.1% (n = 4) adolescents in the control group (p < 0.001). EAT-40 total scores and the scores in subscales of "anxiety of gaining weight," "dieting," and "thin body preoccupation" were significantly higher in the study group. Gender differences were observed when food addiction symptoms were correlated with eating attitudes among the study group. CONCLUSIONS Comparing to the controls, food addiction and disordered eating behaviors were more common in adolescents seeking treatment for obesity. Gender differences in the correlates of food addiction symptoms imply that different approaches might be needed for psychological interventions.
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Affiliation(s)
- Yasemin Taş Torun
- Department of Child and Adolescent Psychiatry, Gazi University, Ankara, Turkey
| | - Sarper İçen
- Department of Child and Adolescent Psychiatry, Gazi University, Ankara, Turkey
| | - Hesna Gül
- Department of Child and Adolescent Psychiatry, Gulhane Research and Training Hospital, Ankara, Turkey
| | - Esra Döğer
- Department of Pediatric Endocrinolgy and Metabolism, Gazi University, Ankara, Turkey
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Breakfast Dietary Pattern Is Inversely Associated with Overweight/Obesity in European Adolescents: The HELENA Study. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8111044. [PMID: 34828758 PMCID: PMC8621138 DOI: 10.3390/children8111044] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/02/2021] [Accepted: 11/08/2021] [Indexed: 12/30/2022]
Abstract
Obesity in children and adolescents is a public health problem and diet can play a major role in this condition. We aimed to identify sex-specific dietary patterns (DP) and to evaluate the association with overweight/obesity in European adolescents. We conducted a cross-sectional analysis with 2327 adolescents aged between 12.5 to 17.5 years from a multicenter study across Europe. The body mass index was categorized in “normal weight” and “overweight/obesity”. Two non-consecutive 24-h dietary recalls were collected with a computerized self-reported software. Principal component factor analysis was used to identify DP. Mixed-effect logistic regression models were used to evaluate the association between the sex-specific DP and overweight/obesity outcome. As a result, we found three DP in boys (snacking and bread, Mediterranean diet, and breakfast) and four DP in girls (convenience, plant-based and eggs, Western, and breakfast). The association between DP and overweight/obesity highlights that those adolescents with higher adherence to the breakfast DP had lower odds for overweight/obesity, even after the inclusion of covariables in the adjustments. In European adolescents, the breakfast DP positively characterized by breakfast cereals, fruit, milk, and dairy and negatively characterized by sugar-sweetened beverages in boys and negatively characterized by cereals (pasta, rice, and others) in girls, was inversely associated with overweight/obesity.
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131
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Mahumud RA, Sahle BW, Owusu-Addo E, Chen W, Morton RL, Renzaho AMN. Association of dietary intake, physical activity, and sedentary behaviours with overweight and obesity among 282,213 adolescents in 89 low and middle income to high-income countries. Int J Obes (Lond) 2021; 45:2404-2418. [PMID: 34274952 DOI: 10.1038/s41366-021-00908-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 06/28/2021] [Accepted: 07/06/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Adolescent overweight and obesity are well documented in high-income countries (HICs). They are also emerging as a global public health concern in low-and middle-income countries (LMICs), yet there is a lack of reliable, national-level data to inform policies and interventions. This study aimed to estimate the prevalence of overweight and obesity and assess associated lifestyle risk factors amongst school-going adolescents in LMICs as well as HICs. METHODS A total of 282,213 samples were drawn from 89 LMICs and HICs in the 'latest Global School-based Student Health Survey' of school children, aged 11-17 years, during 2003 to 2015, in the six World Health Organisation (WHO) regions. The prevalence of adolescent overweight and obesity were estimated using the WHO BMI-for-age growth standards. A multinomial logistic regression model was employed to estimate the adjusted (age and sex) association of food patterns, physical activity, and sedentary behaviours with adolescent overweight and obesity. RESULTS The pooled prevalence of overweight and obesity amongst adolescents was 10.12%, and 4.96%, respectively, ranging from 2.40% in Sri Lanka to 29.08% in Niue for overweight and 0.40% in Sri Lanka to 34.66% in the Cook Islands for obesity. Overweight and obesity were associated with unhealthy dietary intake and lifestyles including respectively fast-food intake (adjusted relative risk ratio, RRR = 1.09; 95% CI: 1.05-1.12 and RRR = 1.32; 95% CI: 1.26-1.38), a high level of carbonated soft drinks consumption (RRR = 1.19; 1.12-1.24 and RRR = 1.28; 1.18-1.38), a low level of physical activity (RRR = 1.11; 1.06-1.17 and 1.20; 1.12-1.28), and high level of sedentary behaviours (RRR = 1.33; 1.27-1.39 and RRR = 1.73; 1.63-1.84). Adolescents who consumed vegetables at least two times per day had a lower risk of overweight (22%) and obesity (17%) than those who did not consume vegetables per day. CONCLUSIONS Adolescent overweight and obesity represent a global public health problem and can possibly track into adult weight status and morbidity. School-based obesity prevention that promotes environmental and policy changes related to healthy dietary practices and active living are urgently needed to curb the trend.
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Affiliation(s)
- Rashidul Alam Mahumud
- Faculty of Medicine and Health, NHMRC Clinical Trials Centre, The University of Sydney, Camperdown, NSW, Australia. .,Centre for Health Research, University of Southern Queensland, Toowoomba, QLD, Australia.
| | - Berhe W Sahle
- School of Nursing and Midwifery, Deakin University, Geelong, VIC, Australia.,Centre for Quality and Patient Safety Research (QPS), Alfred Health Partnership, Melbourne, VIC, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Ebenezer Owusu-Addo
- Bureau of Integrated Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Wen Chen
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| | - Rachael Lisa Morton
- Faculty of Medicine and Health, NHMRC Clinical Trials Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Andre M N Renzaho
- School of Medicine, Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia.,Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
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Tatlow-Golden M, Jewell J, Zhiteneva O, Wickramasinghe K, Breda J, Boyland E. Rising to the challenge: Introducing protocols to monitor food marketing to children from the World Health Organization Regional Office for Europe. Obes Rev 2021; 22 Suppl 6:e13212. [PMID: 34184400 DOI: 10.1111/obr.13212] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 12/31/2020] [Indexed: 11/28/2022]
Abstract
Unhealthy marketing has been unequivocally linked to children's food preferences, requests, purchases and eating behaviors and hence to childhood obesity. Regulating children's exposure to such marketing has been identified as a key challenge to which States must rise. Regulation mandates the need for monitoring and hence for credible data that are comparable between countries, regions and across time. However, there are major challenges presented by the complexity of the digital marketing ecosystem including the personalized targeting with persuasive, exploitative advertising to which children are subject. This narrative review identifies challenges faced by researchers in the digital ecosystem; reviews recent papers attempting to address these and specifies benefits and limitations; and introduces a set of WHO protocols with templates and guidance for studies of food marketing to children.
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Affiliation(s)
- Mimi Tatlow-Golden
- Faculty of Wellbeing, Education and Language Studies, The Open University, Milton Keynes, UK
| | - Jo Jewell
- World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark
| | - Olga Zhiteneva
- World Health Organization (WHO) European Office for Prevention and Control of Noncommunicable Diseases, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Kremlin Wickramasinghe
- World Health Organization (WHO) European Office for Prevention and Control of Noncommunicable Diseases, WHO Regional Office for Europe, Moscow, Russian Federation
| | - João Breda
- World Health Organization (WHO) European Office for Prevention and Control of Noncommunicable Diseases, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Emma Boyland
- Institute of Population Health, University of Liverpool, Liverpool, UK
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Liu J, Mu C, Li K, Luo H, Liu Y, Li Z. Estimating Global Prevalence of Metabolic Dysfunction-Associated Fatty Liver Disease in Overweight or Obese Children and Adolescents: Systematic Review and Meta-Analysis. Int J Public Health 2021; 66:1604371. [PMID: 34690666 PMCID: PMC8527331 DOI: 10.3389/ijph.2021.1604371] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/17/2021] [Indexed: 02/05/2023] Open
Abstract
Objectives: Metabolic dysfunction-associated fatty liver disease (MAFLD) is a new terminology updated from non-alcoholic fatty liver disease (NAFLD). We aim to estimate the global prevalence of MAFLD in overweight or obese children and adolescents, by repurposing existing data on fatty liver disease. Methods: We screened relevant articles published up to December 2020. Pooled prevalence was calculated using Logit transformations. Results: Our search returned 35,441 records, of which 156 studies fulfilled the inclusion criteria. The overall prevalence of MAFLD was 33.78% in the general population and 44.94% in a special population based on child obesity clinics, regardless of the diagnostic techniques. For subgroup analysis, MAFLD prevalence was significantly higher in boys compared to girls (36.05 vs. 26.84% in the general population; 50.20 vs. 35.34% in the child obesity clinics-based population). Interestingly, based on study source, the pooled prevalence of MAFLD was 1.5-fold higher in other “fatty liver disease” studies compared to the classical “NAFLD” studies in the general population. Conclusion: MAFLD is highly prevalent in overweight or obese children and adolescents. Raising awareness and urgent actions are warranted to control the MAFLD pandemic across the globe.
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Affiliation(s)
- Jiaye Liu
- Department of Thyroid and Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, China.,Laboratory of Thyroid and Parathyroid Diseases, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Chunyang Mu
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Kewei Li
- Department of Pediatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Han Luo
- Department of Thyroid and Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, China.,Laboratory of Thyroid and Parathyroid Diseases, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Yong Liu
- Department of Gastroenterological Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Zhihui Li
- Department of Thyroid and Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, China.,Laboratory of Thyroid and Parathyroid Diseases, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
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Eisenburger N, Friesen D, Haas F, Klaudius M, Schmidt L, Vandeven S, Joisten C. Predicting Psychosocial Health of Children and Adolescents with Obesity in Germany: The Underappreciated Role of Physical Fitness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11188. [PMID: 34769706 PMCID: PMC8583523 DOI: 10.3390/ijerph182111188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/19/2021] [Accepted: 10/22/2021] [Indexed: 12/17/2022]
Abstract
Background: The aim of this study was to analyze the inhibitory and promotive factors of psychosocial health in the context of childhood obesity, incorporating physical fitness as an additional, potentially relevant predictor. Methods: The sample comprised cross-sectional data of 241 children and adolescents with obesity and overweight from the German Children's Health InterventionaL TriaL III program (12.5 ± 2.1 years; 51.9% girls). Demographics and lifestyle patterns were assessed via parent reports. Anthropometric data and physical fitness in relation to body weight (W/kg) were measured. Children and adolescents completed standardized questionnaires (GW-LQ-KJ, FSK-K) to assess health-related quality of life (HRQOL) and five dimensions of self-concept (scholastic, social, physical, behavioral, and self-worth). Results: Multiple linear regression analysis showed that HRQOL was significantly related to relative physical fitness (W/kg; β = 0.216, p = 0.011) as were scholastic (β = 0.228, p = 0.008) and social self-concept (β = 0.197, p = 0.023). Increasing body mass index (BMI) Z-scores, age, physical activity (hours/day), low parental educational levels, and/or migration background were negatively associated with three subdomains of self-concept (physical, behavioral, self-worth; all p < 0.05). Conclusion: The results emphasize BMI Z-scores, age, physical activity, migration background, and parents' educational level as relevant predictors of psychosocial health in the context of childhood obesity. Additionally, this study adds physical fitness as a key determinant of HRQOL and self-concept. To enable the development of more effective weight management, therapeutic strategies should therefore consider addressing these aspects and improving physical fitness in particular not only for weight loss but also to strengthen psychosocial health.
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Affiliation(s)
- Nina Eisenburger
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany; (D.F.); (F.H.); (M.K.); (L.S.); (S.V.); (C.J.)
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Memarian S, Moradi A, Hasani J, Mullan B. Can sweet food-specific inhibitory control training via a mobile application improve eating behavior in children with obesity? Br J Health Psychol 2021; 27:645-665. [PMID: 34676624 DOI: 10.1111/bjhp.12566] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 02/20/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Consumption of excess sugar, a common energy-dense nutrient-poor food, is a risk factor for obesity in school-aged children. Food-specific inhibition training, where responses to palatable food stimuli, such as sweet foods, are consistently and repeatedly inhibited, reduces sweet food intake in adults. However, no studies have yet examined the effectiveness of inhibitory control training specifically targeting sweet foods among children with high sugar cravings. We examined whether sweet food-specific inhibitory control training (SF-ICT), administered via a mobile app, reduced choice and consumption of sweet foods, and weight in a sample of children aged 7-11 with overweight or obesity and who had high sugar cravings (N = 46). DESIGN This study was designed as a 2 × 3 between-within design. METHODS Participants were randomly allocated to a single-blind design with two conditions: they either received 7 sessions of active or control go/no-go training in which either sweet foods or non-food cues were paired with no-go signals. Participants' weight, sweet food choice, and consumption were measured pre and post-training, and at three-month follow-up. RESULTS The results revealed that participants in the active group showed a significant reduction in sweet food choice and intake from pre to post-training relative to the control group. The effects of the training on reducing sweet food intake persisted over the 3-month follow-up No significant changes in weight loss were observed. CONCLUSIONS These results provide preliminary evidence that sweet food-specific inhibitory control training (SF-ICT) via a mobile app is effective in modifying eating behavior among children with excessive consumption of sugary foods. Further research is required to clarify under what conditions the benefits of training would expand to weight loss.
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Affiliation(s)
- Sepideh Memarian
- Health Psychology, Department of Clinical Psychology, Kharazmi University, Iran
| | - Alireza Moradi
- Psychology, Department of Clinical Psychology, Kharazmi University and the Institute for Cognitive Sciences Studies, Tehran, Iran
| | - Jafar Hasani
- Psychology, Department of Clinical Psychology, Kharazmi University, Iran
| | - Barbara Mullan
- Psychology, Health Psychology and Behavioral Medicine Research Group, School of Psychology, Curtin University, Western Australia, Australia
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Mattey-Mora PP, Nelson EJ. Sleep Disturbances, Obesity, and Cognitive Function in Childhood: A Mediation Analysis. Curr Dev Nutr 2021; 5:nzab119. [PMID: 34661044 PMCID: PMC8513758 DOI: 10.1093/cdn/nzab119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/07/2021] [Accepted: 09/13/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Childhood cognitive development is influenced by biological and environmental factors. One such factor, obesity, impairs cognitive development and is associated with sleep disturbances. OBJECTIVES We aimed to examine the mediating role of sleep disturbances on the relation between BMI and cognitive function in children. METHODS A total of 9951 children aged 9-10 y were included in this cross-sectional study. Children were recruited from the longitudinal ABCD (Adolescent Brain Cognitive Development) Study. Cognitive development was assessed using metrics for fluid, crystallized, and total cognitive function. Mediation analyses were conducted via linear regression modeling, with adjustment for potential confounders (sex, age, ethnicity, household income, parental education, and self-reported physical activity) for each of the 3 outcomes. Mediation significance was determined by bootstrapping. RESULTS A statistically significant inverse association was found between BMI and total (β = -0.41, P < 0.001) and fluid (β = -0.49, P < 0.001) cognition, but not for crystallized cognition. Total sleep disturbances partially mediated the association between BMI and fluid cognition (indirect effect: -0.02, P = 0.002; proportion of the total effect: 0.05, P = 0.002), but no mediation was found in the association between BMI and total cognition. CONCLUSIONS Sleep disturbances partially mediate the effect of childhood obesity on cognitive function, particularly in fluid cognitions. Future work is necessary to understand the effects of sleep disturbances and obesity on reduced childhood cognition throughout time, predominantly across the life course.
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Affiliation(s)
- Paola P Mattey-Mora
- Department of Epidemiology and Biostatistics, School of Public Health—Bloomington, Indiana University, Bloomington, IN, USA
| | - Erik J Nelson
- Department of Public Health, Brigham Young University, Provo, UT, USA
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Dastgheib SA, Bahrami R, Setayesh S, Salari S, Mirjalili SR, Noorishadkam M, Sadeghizadeh-Yazdi J, Akbarian E, Neamatzadeh H. Evidence from a meta-analysis for association of MC4R rs17782313 and FTO rs9939609 polymorphisms with susceptibility to obesity in children. Diabetes Metab Syndr 2021; 15:102234. [PMID: 34364300 DOI: 10.1016/j.dsx.2021.102234] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 07/24/2021] [Accepted: 07/26/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIM The aim of this study was to evaluate the association of MC4R rs17782313 and FTO rs9939609 polymorphisms with childhood obesity. METHODS A universal search was performed up to May 2021. RESULTS A total of 31 studies including 13 studies with 9565 cases and 11956 controls on MC4R rs17782313 and 18 studies with 4789 cases and 15918 controls on FTO rs9939609 were selected. CONCLUSIONS Pooled data showed that FTO rs9930506 and MC4R rs17782313 polymorphisms were significantly associated with obesity in children. Stratified analyses revealed that these genetic variants were associated with childhood obesity in Caucasian and Asian children.
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Affiliation(s)
- Seyed Alireza Dastgheib
- Department of Medical Genetics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Bahrami
- Neonatal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Sepideh Setayesh
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyedali Salari
- Department of Biology, Science and Arts University, Yazd, Iran
| | - Seyed Reza Mirjalili
- Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahmood Noorishadkam
- Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Jalal Sadeghizadeh-Yazdi
- Department of Food Science and Technology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Elahe Akbarian
- Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hossein Neamatzadeh
- Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Department of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Jebeile H, Cardel MI, Kyle TK, Jastreboff AM. Addressing psychosocial health in the treatment and care of adolescents with obesity. Obesity (Silver Spring) 2021; 29:1413-1422. [PMID: 34431234 DOI: 10.1002/oby.23194] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/12/2021] [Accepted: 03/01/2021] [Indexed: 01/22/2023]
Abstract
Obesity affects 158 million youth worldwide and is associated with psychosocial comorbidity. This review describes weight management options utilized by adolescents, including both self-directed weight loss and medically supervised obesity treatment interventions, and associated psychosocial impacts. A majority of adolescents with obesity attempt to manage weight on their own, primarily through attempting weight loss, sometimes with supplement use. Approaches such as these are associated with a degree of risk, disordered eating behaviors, and further weight gain. In contrast, medically supervised multicomponent interventions are associated with improved psychosocial health, including quality of life, self-esteem, and body image, and reduced symptoms of depression, anxiety, and eating disorders. Few studies utilizing antiobesity pharmacotherapy have reported psychosocial outcomes, and trials of bariatric surgery show some early improvements with a need for sustained psychological support following surgery. Greater access to medically supervised treatment services is required to facilitate obesity care for adolescents. Early data on psychosocial health and obesity treatment offer promising outcomes; however, larger randomized controlled trials and longer-term data are needed. Future research should include both physiological and psychosocial outcomes to assess impact of interventions on the holistic health of adolescents with obesity.
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Affiliation(s)
- Hiba Jebeile
- Children's Hospital Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Michelle I Cardel
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida, USA
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, Florida, USA
| | | | - Ania M Jastreboff
- Department of Internal Medicine (Endocrinology & Metabolism), Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Pediatrics (Pediatric Endocrinology), Yale University School of Medicine, New Haven, Connecticut, USA
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139
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Bullying experiences, body esteem, body dissatisfaction, and the moderating role of weight status among adolescents. J Adolesc 2021; 91:59-70. [PMID: 34333320 DOI: 10.1016/j.adolescence.2021.07.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The present study examined the relationships between bullying victimization experiences, body esteem (BE), and body dissatisfaction (BD) by obesity status. METHODS Using a cross-sectional design, adolescents (10-16y) from the U.S. completed surveys. Weight and height were objectively assessed. Bullying was assessed using the Personal Experiences Checklist, with a total score that included three subscales (cyber, verbal-relational, and physical). BE was assessed using total score on the BE Scale, and BD was assessed using the Body Image Assessment for Pre-Adolescents, operationalized as the discrepancy between current and ideal body figure. Linear regression models, controlling for sociodemographics, were used to examine obesity status (with vs. without obesity) and sex as moderators of the relationships between bullying, BE, and BD. RESULTS On average, adolescents (n = 328) were 12.6 ± 1.9 y, 45.4% male, 58.2% White, 35.7% Black, and 36.0% had obesity. Obesity status moderated the relationship between bullying experiences and BE, such that these relationships were only significant (B = -0.38, p<.05) among adolescents with obesity compared to adolescents without obesity. In both groups, greater verbal-relational bullying experiences were associated with lower BE, while greater physical bullying experiences were related to higher BE only among adolescents with obesity. In adolescent girls without obesity, greater cyberbullying experiences were associated with lower BD. CONCLUSIONS The findings suggest different associations between sub-types of bullying victimization experiences and BE and BD, highlighting the importance of examining these associations separately by obesity status.
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Badesha HS, Bagri G, Nagra A, Nijran K, Singh G, Aiyegbusi OL. Tackling childhood overweight and obesity after the COVID-19 pandemic. THE LANCET CHILD & ADOLESCENT HEALTH 2021; 5:687-688. [PMID: 34303420 PMCID: PMC8443223 DOI: 10.1016/s2352-4642(21)00204-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 06/29/2021] [Accepted: 07/06/2021] [Indexed: 11/01/2022]
Affiliation(s)
| | - Gurvir Bagri
- University of Birmingham, Birmingham B15 2TT, UK
| | - Amrit Nagra
- University of Birmingham, Birmingham B15 2TT, UK
| | | | | | - Olalekan Lee Aiyegbusi
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, Birmingham B15 2TT, UK.
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Escrivá D, Moreno-Latorre E, Caplliure-Llopis J, Benet I, Barrios C. Relationship of Overweight and Obesity with Body Self-Image Dissatisfaction in Urban Mediterranean Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157770. [PMID: 34360067 PMCID: PMC8345661 DOI: 10.3390/ijerph18157770] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/14/2021] [Accepted: 07/14/2021] [Indexed: 12/27/2022]
Abstract
The aim of this study was to analyze whether weight status has a relationship with the prevalence of body self-image dissatisfaction in Mediterranean urban teenagers. A series of 809 adolescents aged 11 to 17 years underwent anthropometric measurements according to ISAK protocols and completed the Body Shape Questionnaire (BSQ). The overall overweight prevalence according to International Obesity Task Force (IOTF) criteria was 11.5%, and 2.7% for obesity. Girls showed higher overweight prevalence than boys (18.4% vs. 12.9%; p < 0.05). At the late adolescence period (16–17 y), obesity was observed in the boys but not in the girls (8.7% vs. 0%; p < 0.01). There was a relative low prevalence of body image (BI) dissatisfaction among participants (boys 17.3%; girls 22.7%). In the late adolescence period, the girls were more often classified as being dissatisfied (31%). A weak correlation between the BSQ scores and all the anthropometric variables related to the adiposity profile was detected only in the boys. A logistic regression confirmed that female adolescents and the late pubertal period had a significant association with body dissatisfaction, regardless of their weight status. As BI are not related to weight status measured by body mass index (BMI) percentiles, other factors beyond anthropometry deserve further research to explain BI concerns specifically in girls.
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Affiliation(s)
- Dolores Escrivá
- Intensive Care Unit, La Fe Polytechnic and University Hospital, 46026 Valencia, Spain;
- Nursing Department, School of Medicine and Health Sciences, Valencia Catholic University, 46001 Valencia, Spain
| | - Esther Moreno-Latorre
- School of Psychology and Education Sciences, Valencia Catholic University, 46110 Godella, Spain;
| | - Jordi Caplliure-Llopis
- Institute for Research on Musculoskeletal Disorders, School of Medicine and Health Sciences, Valencia Catholic University, 46001 Valencia, Spain;
- Primary Health Care Services, La Ribera University Hospital, 46600 Alzira, Spain
| | - Inmaculada Benet
- Surgical Nursing Division, Valencia Clinic Hospital, 46010 Valencia, Spain;
| | - Carlos Barrios
- Primary Health Care Services, La Ribera University Hospital, 46600 Alzira, Spain
- Correspondence: ; Tel.: +96-610-408-001
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Posch N, Semlitsch T, Wratschko K, Siebenhofer A. [Factors promoting and hindering the use of an evidence-based clinical pathway for the management of overweight or obese children and adolescents]. ZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN 2021; 165:21-26. [PMID: 34303649 DOI: 10.1016/j.zefq.2021.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/20/2021] [Accepted: 06/24/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND/OBJECTIVE Evidence-based clinical pathways can be a useful tool for guideline implementation. However, there seem to be barriers to the use of clinical pathways. The aim of the present questionnaire survey was to assess the perceived usability of the clinical pathway "Overweight/obesity in children and adolescents at primary care level" and to identify factors promoting and hindering the use of the clinical pathway. METHODS In January 2020, an online questionnaire survey was sent out to 3,916 general practitioners and 470 pediatricians in Austria. The data collected were analysed descriptively. RESULTS A total of 148 people took part in the questionnaire survey (response rate 3.7 %). The majority of respondents indicated that they, in general, perceive evidence-based clinical pathways as helpful (90 %) and also make use of them (57 %). Few respondents (9 %) felt well-informed about new clinical pathways developed in Austria. Most of the respondents considered the clinical pathway "Overweight/obesity in children and adolescents at primary care level" as a useful support (60 %), as a reference work (72 %) or as a facilitator for justifying their approach to their patients (68 %). However, a large proportion of the respondents stated that the clinical pathway is not easily applicable in everyday practice. The three most frequently cited barriers to using the clinical pathway were lack of time resources, lack of structures and lack of financial incentives. Other display and access options (e. g., individualisation, integration into practice software) were most frequently cited as factors that might promote the use of the pathway. CONCLUSION Although the majority of the respondents had positive expectations regarding the use of the clinical pathway "Overweight/obesity in children and adolescents at primary care level", many of them still perceived its usability in everyday clinical practice as difficult. The necessary next steps to improve the use of evidence-based clinical pathways seem to be: an economic and practicable design, easy accessibility of clinical pathways and the creation of framework conditions that facilitate their use in everyday practice.
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Affiliation(s)
- Nicole Posch
- Institut für Allgemeinmedizin und evidenzbasierter Versorgungsforschung, Medizinische Universität Graz, Graz, Österreich
| | - Thomas Semlitsch
- Institut für Allgemeinmedizin und evidenzbasierter Versorgungsforschung, Medizinische Universität Graz, Graz, Österreich.
| | - Kerstin Wratschko
- Institut für Allgemeinmedizin und evidenzbasierter Versorgungsforschung, Medizinische Universität Graz, Graz, Österreich
| | - Andrea Siebenhofer
- Institut für Allgemeinmedizin und evidenzbasierter Versorgungsforschung, Medizinische Universität Graz, Graz, Österreich; Institut für Allgemeinmedizin, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt am Main, Deutschland
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Blaine RE, Bowling A, Kaur R, Davison KK. Promoting Sleep and Balanced Screen Time among School-Aged Children with Neurodevelopmental and Mental Health Disorders: A Parent Perspective. Child Obes 2021; 17:329-341. [PMID: 33877906 DOI: 10.1089/chi.2020.0335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Children with neurodevelopmental and mental health disorders (N/MHD), such as autism spectrum, mood disorders, and anxiety, are more likely to engage in excessive screen time, receive insufficient sleep, and to have obesity than neurotypical peers. However, little is known about how parents of these children approach promoting sleep and balanced screen time. Methods: We conducted semistructured interviews with 24 parents of children aged 8-15 years with a diagnosis of N/MHD to assess barriers and facilitators to promoting sleep and balanced screen time. Interviews were transcribed, double-coded using constant comparative methods, and summarized into themes using NVivo 11. Results: Many parents described children's chronic sleep challenges, often compounded by screen use and no clear solutions. When feeling overwhelmed, some parents reluctantly reported co-sleeping or allowing gaming devices in bed. Nearly all participants reported chronic, occasionally severe, conflict when managing children's screen time, with some parents experiencing opposition and physical aggression. Parents struggled to weigh the benefits of screen use (i.e., behavior management, learning, and social connection) with the costs (i.e., reduced self-care and limited physical activity). To combat barriers, parents described firm routines (i.e., "screens off" time and consistent bedtime on weekdays and weekends), moderating access (i.e., shutting down internet and no device in bedroom), verbal priming, and coping strategies (i.e., music and books). Conclusions: Parents of children with N/MHD face unique challenges in promoting sleep and balanced screen time. Given these behaviors may impact weight status and mental health, future interventions should examine ways to support parents in reducing conflict while promoting healthy habits.
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Affiliation(s)
- Rachel E Blaine
- Department of Family and Consumer Sciences, California State University, Long Beach, Long Beach, CA, USA
| | - April Bowling
- Merrimack College School of Health Sciences, North Andover, MA, USA
| | - Raghbir Kaur
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Kranjac AW, Kranjac D. Child obesity moderates the association between poverty and academic achievement. PSYCHOLOGY IN THE SCHOOLS 2021. [DOI: 10.1002/pits.22497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | - Dinko Kranjac
- Department of Psychology University of La Verne La Verne California USA
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Çaynak S, Boyacıoğlu NE, Temel M. Body perception and sexuality of bariatric surgery patients. Perspect Psychiatr Care 2021; 57:1266-1272. [PMID: 33184907 DOI: 10.1111/ppc.12683] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/28/2020] [Accepted: 10/31/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study aims to determine how body perception and sexual life are affected in obese individuals who are hospitalized to undergo bariatric surgery. DESIGN AND METHODS Descriptive research design and the cross-sectional method were used. The study was conducted with 53 individuals who consented to participate. The data were analyzed with the SPSS software package. FINDINGS Low body perception and sexual dysfunction were detected, particularly in women. PRACTICE IMPLICATIONS In obesity treatment, the psychological and social problems that individuals experience due to obesity should be handled and evaluated with a multidisciplinary approach.
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Affiliation(s)
- Sibel Çaynak
- Department of Psychiatric Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - Nur E Boyacıoğlu
- Department of Gerontology, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Münire Temel
- Department of Nursing, School of Health, Tekirdağ Namık Kemal University, Tekirdağ, Turkey
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146
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Koetsier LW, van Mil MMA, Eilander MMA, van den Eynde E, Baan CA, Seidell JC, Halberstadt J. Conducting a psychosocial and lifestyle assessment as part of an integrated care approach for childhood obesity: experiences, needs and wishes of Dutch healthcare professionals. BMC Health Serv Res 2021; 21:611. [PMID: 34183008 PMCID: PMC8238479 DOI: 10.1186/s12913-021-06635-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/14/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The causes and consequences of childhood obesity are complex and multifaceted. Therefore, an integrated care approach is required to address weight-related issues and improve children's health, societal participation and quality of life. Conducting a psychosocial and lifestyle assessment is an essential part of an integrated care approach. The aim of this study was to explore the experiences, needs and wishes of healthcare professionals with respect to carrying out a psychosocial and lifestyle assessment of childhood obesity. METHODS Fourteen semi-structured interviews were conducted with Dutch healthcare professionals, who are responsible for coordinating the support and care for children with obesity (coordinating professionals, 'CPs'). The following topics were addressed in our interviews with these professionals: CPs' experiences of both using childhood obesity assessment tools and their content, and CPs' needs and wishes related to content, circumstances and required competences. The interviews comprised open-ended questions and were recorded and transcribed verbatim. The data was analysed using template analyses and complemented with open coding in MAXQDA. RESULTS Most CPs experienced both developing a trusting relationship with the children and their parents, as well as establishing the right tone when engaging in weight-related conversations as important. CPs indicated that visual materials were helpful in such conversations. All CPs used a supporting assessment tool to conduct the psychosocial and lifestyle assessment but they also indicated that a more optimal tool was desirable. They recognized the need for specific attributes that helped them to carry out these assessments, namely: sufficient knowledge about the complexity of obesity; having an affinity with obesity-related issues; their experience as a CP; using conversational techniques, such as solution-focused counselling and motivational interviewing; peer-to-peer coaching; and finally, maintaining an open-minded, non-stigmatizing stance and harmonizing their attitude with that of the child and their parents. CONCLUSIONS Alongside the need for a suitable tool for conducting a psychosocial and lifestyle assessment, CPs expressed the need for requisite knowledge, skills and attitudes. Further developing a supporting assessment tool is necessary in order to facilitate CPs and thereby improve the support and care for children with obesity and their families.
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Affiliation(s)
- L W Koetsier
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - M M A van Mil
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - M M A Eilander
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - E van den Eynde
- Erasmus MC, University Medical Center Rotterdam, Obesity Center CGG, Rotterdam, The Netherlands
| | - C A Baan
- Tilburg University, Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg, The Netherlands
| | - J C Seidell
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - J Halberstadt
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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147
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Spiroski I, Mikik V, Miloradovska N, Veljanovski M, Shaqiri J, Petrova A, Dzikovska B, Shahini B, Kitanovska Spasev J. Changes in weight status of 7-year-old children in North Macedonia between 2010 and 2019. Arch Public Health 2021. [DOI: 10.3889/aph.2021.5828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Childhood obesity is growing as one of the most important public health issues that affects individual and population health but also puts heavy burden on the health systems. It is frequently associated with immediate adverse consequences, such as psychological problems, and a higher risk of many harmful comorbidities later in life, such as type 2 diabetes, dyslipidemia, non-alcoholic fatty liver disease, hypertension, and coronary heart disease. Comparability of anthropometric data is crucial to track the changes over time. The aim of this paper was to present prevalence of thinness, overweight, and obesity in 7-year-old schoolchildren in North Macedonia in 2010 and 2019, and the changes in their nutritional status during thatperiod. Material and methods: Anthropometric measurements of body height and body weight were performed to the nationally representative sample of 7-year-oldchildren in school years 2010/2011 and 2018/2019. Measurements followed the Childhood Obesity Surveillance Initiative (COSI) protocol and data collecting procedures. In total, 2737 children (1317 girls and 1420 boys) in 2010 and 2059 children (1045 girls and 1014 boys) in 2019 were measured. WHO Growth references were used to determine the growth and nutritional status of children. Results: The average height of children in the observed period has increased by 1.7 cm, weight for 1.2 kg and the BMI for 0.3 kg/m2. As for the weight classification, thinness prevalence is significantly increased for 0.3%. Overweight (including obesity) significantly increased (p=0.0377) from 34.4% (95% CI 32.6%-36.2%) in 2010 to 37.3% (95% CI 35.2%-39.5%) in 2019. Obesity significantly increased (p=0.040) from 16.3% (95% CI 14.9%-17.7%) in 2010 to 18.4% (95% CI 16.7%-20.1%) in 2019. The main driver of that increase was the highly significant (p=0.0004) increase of almost 7% of overweight (including obesity) in girls. Conclusion: There is unfavorable rising trend which indicates deterioration of the situation with childhood obesity in the country. Focused and more comprehensive public health nutrition actions are needed to plateau or reverse the trends. The childhood obesity national monitoring system is well established and should continue to beone of the key public health monitoring systems that provide evidence for actions.
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148
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Halbeisen G, Walther E. How to promote healthy eating in preschool children: Evidence from an associative conditioning procedure with non-food stimuli. Appetite 2021; 166:105472. [PMID: 34153424 DOI: 10.1016/j.appet.2021.105472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 10/21/2022]
Abstract
Given the increasing rates and severe consequences of childhood obesity, how to encourage children to eat low-calorie and healthy foods is an important question. Building on evaluative conditioning research, this study investigated how associating fruits and vegetables with positive, non-food stimuli influences preschool children's food choice and consumption. Consistent with this idea, it was found in two experiments that 3- to 6-year-old children's healthy food choice and consumption increased by pairing a healthy food's picture systematically with a positive, non-food image. These findings highlight a simple yet effective means of changing young children's eating behavior, which may complement existing intervention procedures.
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Affiliation(s)
- Georg Halbeisen
- Department of Psychology, University of Trier, Universitätsring 15, 54296, Trier, Germany.
| | - Eva Walther
- Department of Psychology, University of Trier, Universitätsring 15, 54296, Trier, Germany
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149
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Guerrini Usubini A, Cattivelli R, Bertuzzi V, Varallo G, Rossi AA, Volpi C, Bottacchi M, Tamini S, De Col A, Pietrabissa G, Mannarini S, Castelnuovo G, Molinari E, Sartorio A. The ACTyourCHANGE in Teens Study Protocol: An Acceptance and Commitment Therapy-Based Intervention for Adolescents with Obesity: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126225. [PMID: 34207494 PMCID: PMC8296029 DOI: 10.3390/ijerph18126225] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/18/2021] [Accepted: 06/04/2021] [Indexed: 12/21/2022]
Abstract
This Randomized Controlled Trial [(RCT) aims to evaluate the effectiveness of a brief Acceptance and Commitment Therapy (ACT)-based intervention combined with treatment as usual (TAU) compared to TAU only in improving psychological conditions in a sample of adolescents with obesity (body mass index, BMI > 97th percentile for age and sex) within the context of a wider multidisciplinary rehabilitation program for weight loss. Fifty consecutive adolescents (12-17 years) of both genders with obesity will be recruited among the patients hospitalized in a clinical center for obesity rehabilitation and randomly allocated into two experimental conditions: ACT + TAU vs. TAU only. Both groups will attend a three-week in-hospital multidisciplinary rehabilitation program for weight loss. The ACT + TAU condition comprises a psychological intervention based on ACT combined with a standard psychological assessment and support to the hospitalization. The TAU comprises the standard psychological assessment and support to the hospitalization. At pre- to post-psychological intervention, participants will complete the Avoidance and Fusion Questionnaire for Youth, the Psychological Well-Being Scale, the Depression Anxiety Stress Scale, the Difficulties in Emotion Regulation Scale, and the Emotional Eating subscale of the Dutch Eating Behavior Questionnaire to assess psychological well-being as the primary outcome and experiential avoidance, psychological distress, emotional dysregulation, and emotional eating as secondary outcomes. Repeated-measures ANOVAs (2 × 2) will be conducted. The study will assess the effectiveness of a brief ACT-based intervention for adolescents with obesity in improving their psychological conditions by targeting specific core processes of the ACT framework (openness, awareness, and engagement). Future directions of the study will assess whether these psychological processes will contribute to addressing long-term weight loss.
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Affiliation(s)
- Anna Guerrini Usubini
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20145 Milan, Italy; (R.C.); (G.V.); (C.V.); (M.B.); (G.P.); (G.C.); (E.M.)
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy;
- Correspondence:
| | - Roberto Cattivelli
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20145 Milan, Italy; (R.C.); (G.V.); (C.V.); (M.B.); (G.P.); (G.C.); (E.M.)
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy;
| | - Vanessa Bertuzzi
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy;
| | - Giorgia Varallo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20145 Milan, Italy; (R.C.); (G.V.); (C.V.); (M.B.); (G.P.); (G.C.); (E.M.)
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy;
| | - Alessandro Alberto Rossi
- Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, 35139 Padova, Italy; (A.A.R.); (S.M.)
- Interdepartmental Center for Family Research, University of Padova, 35139 Padova, Italy
| | - Clarissa Volpi
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20145 Milan, Italy; (R.C.); (G.V.); (C.V.); (M.B.); (G.P.); (G.C.); (E.M.)
| | - Michela Bottacchi
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20145 Milan, Italy; (R.C.); (G.V.); (C.V.); (M.B.); (G.P.); (G.C.); (E.M.)
| | - Sofia Tamini
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, 28824 Piancavallo (VB), Italy; (S.T.); (A.D.C.); (A.S.)
| | - Alessandra De Col
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, 28824 Piancavallo (VB), Italy; (S.T.); (A.D.C.); (A.S.)
| | - Giada Pietrabissa
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20145 Milan, Italy; (R.C.); (G.V.); (C.V.); (M.B.); (G.P.); (G.C.); (E.M.)
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy;
| | - Stefania Mannarini
- Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, 35139 Padova, Italy; (A.A.R.); (S.M.)
- Interdepartmental Center for Family Research, University of Padova, 35139 Padova, Italy
| | - Gianluca Castelnuovo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20145 Milan, Italy; (R.C.); (G.V.); (C.V.); (M.B.); (G.P.); (G.C.); (E.M.)
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy;
| | - Enrico Molinari
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20145 Milan, Italy; (R.C.); (G.V.); (C.V.); (M.B.); (G.P.); (G.C.); (E.M.)
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy;
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, 28824 Piancavallo (VB), Italy; (S.T.); (A.D.C.); (A.S.)
- Istituto Auxologico Italiano, IRCCS, Division of Auxology, 28824 Piancavallo (VB), Italy
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150
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Situación ponderal de la población escolar de 6 a 9 años en España: resultados del estudio ALADINO 2015. An Pediatr (Barc) 2021. [DOI: 10.1016/j.anpedi.2020.05.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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