151
|
Outcome Evaluation of a Policy-Mandated Lifestyle and Environmental Modification Program in a National Job Training Center. J Community Health 2016; 42:466-471. [PMID: 27757596 DOI: 10.1007/s10900-016-0278-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Excess weight gain is common when adolescents become young adults, but there are no obesity prevention or weight management interventions that have been tested for emerging adults who follow non-traditional post-secondary paths, such as enrolling in job training programs. We evaluated Healthy Eating & Active Lifestyles (HEALs), a policy-mandated lifestyle education/environmental modification program, at a job training center for low-income 16-24 year olds. We examined average change in body mass index (BMI) z-score from baseline to 6 months for emerging adults (aged 16-24 years) in pre-HEALs implementation (n = 125) and post-HEALs implementation (n = 126) cohorts living at the job training center, by baseline weight status. In both cohorts, average BMI z-score significantly increased from baseline to 6 months for students with BMI < 25. Average BMI z-score significantly decreased for the overweight (BMI 25 to <30; -0.11, p = .03) and obese (BMI ≥ 30; -0.11, p = .001) students only within the post-HEALs cohort; changes within the pre-HEALs cohort and between cohorts were not significant. HEALs may promote positive weight-related trends for overweight/obese students, but prevention efforts for non-overweight/obese students need to be improved.
Collapse
|
152
|
Titmuss AT, Srinivasan S. Metabolic syndrome in children and adolescents: Old concepts in a young population. J Paediatr Child Health 2016; 52:928-934. [PMID: 27301065 DOI: 10.1111/jpc.13190] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/16/2016] [Indexed: 01/01/2023]
Abstract
Many years after first being described, there is still no clear consensus on diagnostic criteria for metabolic syndrome, particularly in children. However, identification of this cluster of cardiovascular risk factors especially in children with co-morbidities, is important in order to reduce their future risk of chronic disease and morbidity. Sustained multidisciplinary and family-based early intervention is required, aiming primarily at life-style change.
Collapse
Affiliation(s)
- Angela Therese Titmuss
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Shubha Srinivasan
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
| |
Collapse
|
153
|
Miketinas D, Cater M, Bailey A, Craft B, Tuuri G. Exploratory and confirmatory factor analysis of the Adolescent Motivation to Cook Questionnaire: A Self-Determination Theory instrument. Appetite 2016; 105:527-33. [DOI: 10.1016/j.appet.2016.06.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 06/03/2016] [Accepted: 06/11/2016] [Indexed: 11/16/2022]
|
154
|
Sgambato MR, Cunha DB, Henriques VT, Estima CCP, Souza BSN, Pereira RA, Yokoo EM, Paravidino VB, Sichieri R. PAAPPAS community trial protocol: a randomized study of obesity prevention for adolescents combining school with household intervention. BMC Public Health 2016; 16:809. [PMID: 27534742 PMCID: PMC4989464 DOI: 10.1186/s12889-016-3473-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Accepted: 08/09/2016] [Indexed: 01/20/2023] Open
Abstract
Background The prevalence of childhood obesity is increasing at a high rate in Brazil, making prevention a health priority. Schools are the central focus of interventions aiming the prevention and treatment of childhood obesity, however, randomized trials and cohort studies have not yet provided clear evidence of strategies to reduce prevalence of obesity. The aim of this study is to present a protocol to evaluate the efficacy of combining school and household level interventions to reduce excessive weight gain among students. Methods The intervention target fifth and sixth graders from 18 public schools (9 interventions and 9 controls) in the municipality of Duque de Caxias, metropolitan area of Rio de Janeiro, Brazil. A sample size of 2500 students will be evaluated at school for their weight status and those from the intervention group who are overweight or obese will be followed monthly at home by community health agents. Demographic, socioeconomic, anthropometric, eating behavior and food consumption data will be collected at school using a standardized questionnaire programmed in personal digital assistant. At school, all students from the intervention group will be encouraged to change eating habits and food consumption and to increase physical activity and reducing sedentary behavior. Discussion This study will provide evidence whether integration of school with primary health care can prevent excessive weight gain among adolescents. Positive results will inform a sustainable strategy to be disseminated in the health care system in Brazil. Trial registration ClinicalTrials.gov, NCT02711488. Date of registration: March 11, 2016.
Collapse
Affiliation(s)
- Michele R Sgambato
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, São Francisco Xavier, 524 - 7° andar, Bloco D, Maracanã, CEP: 20550-900, Rio de Janeiro, RJ, Brazil.
| | - Diana B Cunha
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, São Francisco Xavier, 524 - 7° andar, Bloco D, Maracanã, CEP: 20550-900, Rio de Janeiro, RJ, Brazil
| | - Viviana T Henriques
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, São Francisco Xavier, 524 - 7° andar, Bloco D, Maracanã, CEP: 20550-900, Rio de Janeiro, RJ, Brazil
| | - Camilla C P Estima
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, São Francisco Xavier, 524 - 7° andar, Bloco D, Maracanã, CEP: 20550-900, Rio de Janeiro, RJ, Brazil
| | - Bárbara S N Souza
- Department of Epidemiology, Fluminense Federal University, Marques de Paraná, 303 - 3° andar, Prédio anexo, Centro -Niterói, CEP: 24030-210, Rio de Janeiro, RJ, Brazil
| | - Rosangela A Pereira
- Department of Social and Applied Nutrition, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho, 373 - 2° andar, Bloco J, Cidade Universitária, CEP: 21941-590, Rio de Janeiro, RJ, Brazil
| | - Edna M Yokoo
- Department of Epidemiology, Fluminense Federal University, Marques de Paraná, 303 - 3° andar, Prédio anexo, Centro -Niterói, CEP: 24030-210, Rio de Janeiro, RJ, Brazil
| | - Vitor B Paravidino
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, São Francisco Xavier, 524 - 7° andar, Bloco D, Maracanã, CEP: 20550-900, Rio de Janeiro, RJ, Brazil.,Department of Physical Education and Sports, Naval Academy - Brazilian Navy, Avenida Almirante Silvio de Noronha, s/n, Castelo, CEP: 20021-010, Rio de Janeiro, Brazil
| | - Rosely Sichieri
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, São Francisco Xavier, 524 - 7° andar, Bloco D, Maracanã, CEP: 20550-900, Rio de Janeiro, RJ, Brazil
| |
Collapse
|
155
|
Roura E, Milà-Villarroel R, Lucía Pareja S, Adot Caballero A. Assessment of Eating Habits and Physical Activity among Spanish Adolescents. The "Cooking and Active Leisure" TAS Program. PLoS One 2016; 11:e0159962. [PMID: 27463105 PMCID: PMC4962989 DOI: 10.1371/journal.pone.0159962] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 07/11/2016] [Indexed: 11/24/2022] Open
Abstract
Worldwide obesity has more than doubled in the last forty years. Even more worrying is the fact that the number of overweight and obese children and adolescents has considerably increased. Socioeconomic development, as well as educational, agricultural and marketing policies have significantly changed dietary and physical activity habits among the youngest, who are thus susceptible to develop chronic and disabling diseases such as diabetes, some cancers and cardiovascular disorders. Adolescence is a critical age, in which the adoption of healthy habits may have dramatic effects on the health state in adulthood. For this reason, prompt interventions are urgently required to prevent the onset of obesity in this time of life. In this regard, the CAL-TAS program from Alicia Foundation was born to combat obesity and promote healthy lifestyles in Spanish adolescents. A total of 2519 students, aged 13–14 years, from 79 schools distributed all over the 17 autonomous communities in Spain were asked to report through the CAL-TAS platform their food intake and physical activity over one week. The body mass index, the consumption of food and beverages, the intake of macronutrients and micronutrients, and the values obtained from the PAQ-A questionnaire, which evaluated physical activity, were analyzed. Twenty percent of the participants were overweight or obese. In general, adolescents did not or poorly respected the recommendations provided by the Spanish Society of Community Nutrition. For example, in more than half of the subjects, the ingestion of fruits and beverages was less than recommended, whereas the consumption of meat, baked goods and fried foods was excessive. Moreover, adolescents with higher body mass index also presented worse eating habits and more inactivity. In conclusion, Spanish adolescents present low adherence to recommendations provided by the Spanish Society of Community Nutrition (SENC) and by the World Health Organization. In order to prevent obesity-related disorders, effective educational programmes have to be designed. Indeed, adolescents and their families should be aware that the early adoption of healthy dietary habits and of a correct physical activity may strongly improve their future quality of life.
Collapse
Affiliation(s)
- Elena Roura
- Alicia Foundation, Barcelona, Spain
- * E-mail:
| | - Raimon Milà-Villarroel
- Research group on methodology, methods and models of health and social outcomes; Universitat de Vic-Universitat Central de Catalunya (UVic-UCC), Vic, Spain
| | | | | |
Collapse
|
156
|
Wilson DP, de la Torre A, Brautbar A, Hamilton L. Screening for genetic mutations in children and adolescents with dyslipidemia: importance of early identification and implications of missed diagnoses. Expert Opin Orphan Drugs 2016. [DOI: 10.1080/21678707.2016.1189824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Don P. Wilson
- Cardiovascular Health and Risk Reduction Program, Cook Children’s Medical Center, Fort Worth, TX, USA
| | - Alejandro de la Torre
- Cardiovascular Health and Risk Reduction Program, Cook Children’s Medical Center, Fort Worth, TX, USA
| | - Ariel Brautbar
- Cardiovascular Health and Risk Reduction Program, Cook Children’s Medical Center, Fort Worth, TX, USA
| | - Luke Hamilton
- Cardiovascular Health and Risk Reduction Program, Cook Children’s Medical Center, Fort Worth, TX, USA
| |
Collapse
|
157
|
Archuleta M, VanLeeuwen D, Turner C. Fit Families Program Improves Self-Perception in Children. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2016; 48:392-396.e1. [PMID: 27106778 DOI: 10.1016/j.jneb.2016.03.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Revised: 03/14/2016] [Accepted: 03/20/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To determine the impact of the Fit Families youth weight management program on self-perception of participants. METHODS Fit Families was delivered through Cooperative Extension and provided education to overweight and obese children and their families on healthful eating and physical activity along with building self-esteem and social competence. At the beginning and end of the 7-week program, a convenience sample of 46 youth completed the Self-Perception Profile for Children questionnaire to evaluate changes in self-perception. RESULTS Youth had improved self-perception in the areas of athletic competence (P = .04) and physical appearance (P = .007) after participating in Fit Families. CONCLUSIONS AND IMPLICATIONS Fit Families provides a holistic approach to weight management that promotes positive self-perception, which may decrease the burden of depression, anxiety, and low self-esteem obese youth face.
Collapse
Affiliation(s)
- Martha Archuleta
- Department of Nutrition, Dietetics and Food Sciences, Utah State University, Salt Lake City, UT.
| | - Dawn VanLeeuwen
- Department of Economics, Applied Statistics and International Business, New Mexico State University, Las Cruces, NM
| | - Carol Turner
- Food and Nutrition Services, Memorial Medical Center, Las Cruces, NM
| |
Collapse
|
158
|
Obesity prevention and obesogenic behavior interventions in child care: A systematic review. Prev Med 2016; 87:57-69. [PMID: 26876631 DOI: 10.1016/j.ypmed.2016.02.016] [Citation(s) in RCA: 131] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 01/26/2016] [Accepted: 02/06/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Review peer-reviewed interventions designed to reduce obesity and improve obesogenic behaviors, including physical activity, diet, and screen time, at child care centers. Interventions components and outcomes, study design, duration, use of behavioral theory, and level of social ecological influence are detailed. METHODS Article searches were conducted from March 2014, October 2014, March 2015, January 2016 across three databases. Eligible interventions were conducted in child care settings, included 3-to-5-year-old children, included an outcome measure of obesity or obesogenic behavior, and published in English. Study design quality was assessed using Stetler's Level of Quantitative Evidence. RESULTS All unique records were screened (n=4589): 237 articles were assessed for eligibility. Of these, 97 articles describing 71 interventions met inclusion criteria. Forty-four articles included multi-level interventions. Twenty-nine interventions included an outcome measure of obesity. Forty-one interventions included physical activity. Forty-five included diet. Eight included screen time. Fifty-five percent of interventions were Level II (randomized controlled trials), while 37% were Level III (quasi-experimental or pre-post only study design), and 8% were Level IV (non-experimental or natural experiments). Most interventions had the intended effect on the target: obesity 48% (n=14), physical activity 73% (n=30), diet 87% (n=39), and screen time 63% (n=5). CONCLUSION Summarizing intervention strategies and assessing their effectiveness contributes to the existing literature and may provide direction for practitioners and researchers working with young children in child care. Most interventions produced the targeted changes in obesity and obesity-associated behaviors, supporting current and future efforts to collaborate with early-care centers and professionals for obesity prevention.
Collapse
|
159
|
Cunningham-Sabo L, Lohse B, Smith S, Browning R, Strutz E, Nigg C, Balgopal M, Kelly K, Ruder E. Fuel for Fun: a cluster-randomized controlled study of cooking skills, eating behaviors, and physical activity of 4th graders and their families. BMC Public Health 2016; 16:444. [PMID: 27230565 PMCID: PMC4882848 DOI: 10.1186/s12889-016-3118-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 05/14/2016] [Indexed: 02/04/2023] Open
Abstract
Background Childhood obesity remains a serious concern in the United States and in many other countries. Direct experience preparing and tasting healthful foods and increasing activity during the school day are promising prevention approaches. Engaging parents and families remains an important challenge. Fuel for Fun: Cooking with Kids Plus Parents and Play is a multi-component school- and family-based intervention for 4th graders and their families intended to promote positive food and activity environments, policies and behaviors at the individual, family and school levels. This paper describes the design and evaluation plan. Methods/Design Four cohorts of 4th-graders and their parents from 8 schools in 2 districts in the same Northern Colorado region are participating in a 4-arm cluster randomized controlled trial. Theory-based Fuel for Fun consists of 5 components delivered over 1 school year: 1) Cooking with Kids - Colorado; an experiential classroom-based cooking and tasting curriculum, 2) Cafeteria Connections; cafeteria-based reinforcements of classroom food experiences using behavioral economic strategies, 3) SPARK active recess; a playground intervention to engage children in moderate to vigorous activity, 4) Fuel for Fun Family; multi-element supports targeting parents to reinforce the 3 school-based components at home, and 5) About Eating; an online interactive program for parents addressing constructs of eating competence and food resource management. Outcomes include child and parent measures of fruit and vegetable preferences and intake, cooking, physical activity, sedentary behaviors and attitudes. School level data assess lunch plate waste and physical activity at recess. In-depth diet and accelerometry assessments are collected with a subsample of parent-child dyads. Data are collected at baseline, immediately post-intervention at 7 months, and at 12 month follow-up. We anticipate recruiting 1320–1584 children and their parents over the length of the project. Discussion The Fuel for Fun study design allows for impact assessment of school-, family- and online parent-based intervention components separately and in combination. Study strengths include use of theory- and evidence-based programs, valid child and parent self-report instruments, and objective measures of food, cooking, and physical activity behaviors at the individual, family and school levels. Parent involvement and engagement is examined through multiple strategies. Trial registration Clinicaltrials.gov registration number NCT02491294. Registered 7 July, 2015.
Collapse
Affiliation(s)
- Leslie Cunningham-Sabo
- Department of Food Science and Human Nutrition, Colorado State University, 234 Gifford Building, Fort Collins, Colorado, 80523-1571, USA.
| | - Barbara Lohse
- Wegmans School of Nutrition and Health, Rochester Institute of Technology, Rochester, New York, 14623, USA
| | - Stephanie Smith
- Department of Food Science and Human Nutrition, Colorado State University, 1571 Campus Delivery, Fort Collins, Colorado, 80523-1571, USA
| | | | - Erin Strutz
- Aims Community College, 5401 W 20th, Greeley, Colorado, 80634, USA
| | - Claudio Nigg
- Department of Public Health Studies, University of Hawaii at Manoa, 1960 East-west Road, Honolulu, Hawaii, 96822, USA
| | - Meena Balgopal
- Department of Biology, Colorado State University, 1878 Campus Delivery, Fort Collins, Colorado, 80523-1878, USA
| | - Kathleen Kelly
- Department of Marketing, Colorado State University, 1278 Campus Delivery, Fort Collins, Colorado, 80523-1278, USA
| | - Elizabeth Ruder
- Wegmans School of Nutrition and Health, Rochester Institute of Technology, Rochester, New York, 14623, USA
| |
Collapse
|
160
|
European Obesity Summit (EOS) - Joint Congress of EASOand IFSO-EC, Gothenburg, Sweden, June 1 - 4, 2016: Abstracts. Obes Facts 2016; 9 Suppl 1:1-376. [PMID: 27238363 PMCID: PMC5672850 DOI: 10.1159/000446744] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
|
161
|
The Healthy Children, Strong Families intervention promotes improvements in nutrition, activity and body weight in American Indian families with young children. Public Health Nutr 2016; 19:2850-9. [PMID: 27211525 PMCID: PMC5039403 DOI: 10.1017/s1368980016001014] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE American Indian children of pre-school age have disproportionally high obesity rates and consequent risk for related diseases. Healthy Children, Strong Families was a family-based randomized trial assessing the efficacy of an obesity prevention toolkit delivered by a mentor v. mailed delivery that was designed and administered using community-based participatory research approaches. DESIGN During Year 1, twelve healthy behaviour toolkit lessons were delivered by either a community-based home mentor or monthly mailings. Primary outcomes were child BMI percentile, child BMI Z-score and adult BMI. Secondary outcomes included fruit/vegetable consumption, sugar consumption, television watching, physical activity, adult health-related self-efficacy and perceived health status. During a maintenance year, home-mentored families had access to monthly support groups and all families received monthly newsletters. SETTING Family homes in four tribal communities, Wisconsin, USA. SUBJECTS Adult and child (2-5-year-olds) dyads (n 150). RESULTS No significant effect of the mentored v. mailed intervention delivery was found; however, significant improvements were noted in both groups exposed to the toolkit. Obese child participants showed a reduction in BMI percentile at Year 1 that continued through Year 2 (P<0·05); no change in adult BMI was observed. Child fruit/vegetable consumption increased (P=0·006) and mean television watching decreased for children (P=0·05) and adults (P=0·002). Reported adult self-efficacy for health-related behaviour changes (P=0·006) and quality of life increased (P=0·02). CONCLUSIONS Although no effect of delivery method was demonstrated, toolkit exposure positively affected adult and child health. The intervention was well received by community partners; a more comprehensive intervention is currently underway based on these findings.
Collapse
|
162
|
Shaffer LA, Brothers KB, Burkhead TA, Yeager R, Myers JA, Sweeney B. Factors Associated with Attendance after Referral to a Pediatric Weight Management Program. J Pediatr 2016; 172:35-9. [PMID: 26947949 DOI: 10.1016/j.jpeds.2016.02.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 01/11/2016] [Accepted: 02/03/2016] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To evaluate factors affecting attendance or nonattendance at an initial interprofessional pediatric weight management visit after referral. We hypothesized that increased severity of obesity, farther distance from the program, lower education level of the primary caregiver, public insurance or no insurance, and lower socioeconomic status would all decrease likelihood of attending initial visit after referral. STUDY DESIGN We examined referral and visit data over 4 years and 5 months. We used geocoding and multivariable logistic regression to analyze links between attendance and demographic factors, baseline body mass index, insurance type, and distance from patients' homes to the program site. RESULTS Over the study period, 41.2% of the 4783 children referred to the pediatric weight management clinic attended at least 1 visit. A total of 4086 children were included in the full analyses. Factors associated with attendance were female sex, higher body mass index severity class, private health insurance, residence in areas with higher median income, and residence in areas with a higher prevalence of high school completion. CONCLUSIONS The current project expands our understanding of factors linked to children's attendance at an initial pediatric weight management visit. Despite limitations including missing data, results have important implications for pediatric weight management clinics, referring providers, and policymakers to target populations with low attendance and optimize use of these evidence-based programs.
Collapse
Affiliation(s)
- Laura A Shaffer
- University of Virginia School of Medicine, Charlottesville, VA
| | - Kyle B Brothers
- University of Louisville School of Medicine, Louisville, KY.
| | | | - Ray Yeager
- University of Louisville School of Public Health and Information Sciences, Louisville, KY
| | - John A Myers
- University of Louisville School of Medicine, Louisville, KY
| | - Brooke Sweeney
- Children's Mercy Hospitals and Clinics, Kansas City, MO; Department of Pediatrics, University of Missouri Kansas City School of Medicine, Kansas City, MO
| |
Collapse
|
163
|
Aloia CR, Shockey TA, Nahar VK, Knight KB. Pertinence of the recent school-based nutrition interventions targeting fruit and vegetable consumption in the United States:a systematic review. Health Promot Perspect 2016; 6:1-9. [PMID: 27123430 PMCID: PMC4847108 DOI: 10.15171/hpp.2016.01] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Accepted: 03/08/2016] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Schools are the major locations for implementing children's dietary behavior related educational or interventional programs. Recently, there has been an increase in school-based nutrition interventions. The objective of this systematic review was to overview the evidence for the effectiveness of school-based nutrition intervention on fruit and vegetable consumption. METHODS PubMed was used to search for articles on school-based nutrition interventions that measured students' fruit and vegetable consumption. Our search yielded 238 articles.The article was included if published in a peer-reviewed journal, written in English language,administered in the United States, and conducted among a population-based sample of children in Kindergarten through eighth grade. A total of 14 publications met the inclusion criteria. RESULTS Eight articles successfully showed the positive effect on increasing fruit and or vegetable consumption while the other six did not. Several factors, including (but not limited to) intervention duration, type of theory used, style of intervention leadership, and positively affecting antecedents of fruit and vegetable consumption were compared; however, no dominant factor was found to be shared among the studies with significant findings. Given that the criteria for selection were high, the lack of consistency between interventions and positive outcomes was surprising. CONCLUSION With high levels of scrutiny and budget constraints on school nutrition, it is imperative that more research be conducted to identify the effective intervention components.
Collapse
Affiliation(s)
- Christopher R Aloia
- Department of Nutrition and Hospitality Management, University of Mississippi, 108 Lenoir Hall, PO Box 1848, University, MS 38677, USA
| | - Taylor A Shockey
- Department of Nutrition and Hospitality Management, University of Mississippi, 108 Lenoir Hall, PO Box 1848, University, MS 38677, USA
| | - Vinayak K Nahar
- Department of Health, Physical Education, and Exercise Science, Lincoln Memorial University, Mary Mars, 6965 Cumberland Gap Parkway, Harrogate, TN 37752, USA; Department of Health, Exercise Science & Recreation Management, The University of Mississippi, 215 Turner Center, PO Box 1848, University, MS 38677, USA
| | - Kathy B Knight
- Department of Nutrition and Hospitality Management, University of Mississippi, 108 Lenoir Hall, PO Box 1848, University, MS 38677, USA
| |
Collapse
|
164
|
Shashaj B, Graziani MP, Contoli B, Ciuffo C, Cives C, Facciolini S, Rigoni ML, Spaterna S, Taucci M, Raponi M, Manco M. Energy Balance-Related Behaviors, Perinatal, Sociodemographic, and Parental Risk Factors Associated with Obesity in Italian Preschoolers. J Am Coll Nutr 2016; 35:362-71. [PMID: 26933953 DOI: 10.1080/07315724.2015.1070699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The obesity epidemic stems from the complex interplay between genetics and environmental factors. Identifying age-specific risk factors in preschoolers may allow implementing more effective intervention strategies. The aim of the present investigation was to examine the association of overweight/obesity with several perinatal, parental, socioeconomic status (SES), and lifestyle-related risk factors in a large sample of Italian preschoolers. METHODS One thousand eleven children (age 2.0 to 5.7 years) were included in the study. Family pediatricians measured weight and height and collected information on obesity risk factors by means of questionnaires. Perinatal risk factors were recalled from electronic medical records. Weight status was defined according to cutoffs of the International Obesity Task Force (IOTF). RESULTS Seven hundred sixty-four children (75.6%) were normal weight, and 247 (24.4%) were overweight/obese. Multivariate analysis showed that skipping breakfast (odds ratio [OR] = 3.7; 95% confidence interval [CI], 1.32-10.51), daily drinking of sugar-sweetened beverages (OR = 2.0; 95% CI, 1.02-4.03), meat consumption <5 times/week (OR = 2.2; 95% CI, 1.11-4.57), and formula feeding (OR = 2.1; 95% CI, 0.8-4.5) were significantly (p < 0.05) associated with increased risk of obesity. CONCLUSIONS Though exclusive formula or mixed feeding represents an age-specific risk factor for overweight/obesity, lifestyle factors associated with increased risk in Italian preschoolers include habits that are common to school-age children, such as skipping breakfast and consumption of sugar-sweetened beverages. The reduced consumption of meat emerged as a risk factor for overweight/obesity, but future research is required to better understand this relationship. Our data suggest, on the whole, that prevention of such unhealthy behaviors must be pursued in preschoolers by means of age-specific interventions.
Collapse
Affiliation(s)
| | | | | | | | - Claudia Cives
- b Federazione Italiana Medici Pediatri, FIMP , Rome , ITALY
| | | | - Maria L Rigoni
- b Federazione Italiana Medici Pediatri, FIMP , Rome , ITALY
| | | | - Mauro Taucci
- b Federazione Italiana Medici Pediatri, FIMP , Rome , ITALY
| | | | - Melania Manco
- a Bambino Gesù Children's Hospital, IRCCS , Rome , ITALY
| |
Collapse
|
165
|
Davis RE, Cole SM, Blake CE, McKenney-Shubert SJ, Peterson KE. Eat, play, view, sleep: Exploring Mexican American mothers' perceptions of decision making for four behaviors associated with childhood obesity risk. Appetite 2016; 101:104-13. [PMID: 26944228 DOI: 10.1016/j.appet.2016.02.158] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 02/22/2016] [Accepted: 02/24/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This mixed methods study sought to understand who makes decisions about whether preschool-aged Mexican American children engage in eating, outdoor play, sleep, and screen time behaviors. METHODS Forty Mexican American mothers of children ages 3-4 participated in two interviews, during which both closed- and open-ended questions elicited perceptions of who made decisions for the four behaviors, as well as who was present, mealtime rules, and food choice values. Interviews were transcribed, coded for emergent themes, and compared across participants. RESULTS Participants generally perceived themselves to be primary decision makers for all four behaviors; however, food decisions often seemed to be made collaboratively with the child. Fathers were most likely to participate in evening television decisions. Other family members were rarely mentioned. Selecting foods that children liked was a strong food choice value, while cost was rarely mentioned. Participants appeared to have low perceived control over their child's behaviors relative to their perceived roles in decision making. CONCLUSIONS Mothers may be the primary audience for obesity prevention messages for preschool-aged, Mexican American children; however, health promotion programs may need to increase mothers' awareness of their control over children's behaviors. Understanding how children's behaviors are regulated is an important aspect of obesity prevention for low-income, Mexican American children.
Collapse
Affiliation(s)
- Rachel E Davis
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I, 915 Greene Street, Room 529, Columbia, SC 29208, USA.
| | - Suzanne M Cole
- Department of Nutritional Sciences, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA.
| | - Christine E Blake
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I, 915 Greene Street, Room 529, Columbia, SC 29208, USA.
| | | | - Karen E Peterson
- Department of Nutritional Sciences, School of Public Health, University of Michigan, 1415 Washington Heights, I-1867, Ann Arbor, MI 48109-2029, USA.
| |
Collapse
|
166
|
Hurley KM, Yousafzai AK, Lopez-Boo F. Early Child Development and Nutrition: A Review of the Benefits and Challenges of Implementing Integrated Interventions. Adv Nutr 2016; 7:357-63. [PMID: 26980819 PMCID: PMC4785470 DOI: 10.3945/an.115.010363] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Poor nutrition (substandard diet quantity and/or quality resulting in under- or overnutrition) and the lack of early learning opportunities contribute to the loss of developmental potential and life-long health and economic disparities among millions of children aged <5 y. Single-sector interventions representing either early child development (ECD) or nutrition have been linked to positive child development and/or nutritional status, and recommendations currently advocate for the development and testing of integrated interventions. We reviewed the theoretical and practical benefits and challenges of implementing integrated nutrition and ECD interventions along with the evidence for best practice and benefit-cost and concluded that the strong theoretical rationale for integration is more nuanced than the questions that the published empirical evidence have addressed. For example, further research is needed to 1) answer questions related to how integrated messaging influences caregiver characteristics such as well-being, knowledge, and behavior and how these influence early child nutrition and development outcomes; 2) understand population and nutritional contexts in which integrated interventions are beneficial; and 3) explore how varying implementation processes influence the efficacy, uptake, and cost-benefit of integrated nutrition and ECD interventions.
Collapse
Affiliation(s)
- Kristen M Hurley
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD;
| | - Aisha K Yousafzai
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan; and
| | - Florencia Lopez-Boo
- Social Protection and Health Division, Inter-American Development Bank, Washington, DC
| |
Collapse
|
167
|
Vinci DM, Whitt-Glover MC, Wirth CK, Kraus C, Venezia AP. Let's Wiggle with 5-2-1-0: Curriculum Development for Training Childcare Providers to Promote Activity in Childcare Settings. J Obes 2016; 2016:8967092. [PMID: 27462468 PMCID: PMC4947646 DOI: 10.1155/2016/8967092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 05/03/2016] [Accepted: 05/09/2016] [Indexed: 11/21/2022] Open
Abstract
Overweight and obesity are increasing in preschool children in the US. Policy, systems, and environmental change interventions in childcare settings can improve obesity-related behaviors. The aim of this study was to develop and pilot an intervention to train childcare providers to promote physical activity (PA) in childcare classrooms. An evidence scan, key informant (n = 34) and focus group (n = 20) interviews with childcare directors and staff, and environmental self-assessment of childcare facilities (n = 22) informed the design of the training curriculum. Feedback from the interviews indicated that childcare providers believed in the importance of teaching children about PA and were supportive of training teachers to incorporate PA into classroom settings. The Promoting Physical Activity in Childcare Setting Curriculum was developed and training was implemented with 16 teachers. Participants reported a positive experience with the hands-on training and reported acquiring new knowledge that they intended to implement in their childcare settings. Our findings highlight the feasibility of working with childcare staff to develop PA training and curriculum. Next steps include evaluating the curriculum in additional childcare settings and childcare staff implementation of the curriculum to understand the effectiveness of the training on PA levels of children.
Collapse
Affiliation(s)
- Debra M. Vinci
- Health Promotion, Department of Exercise Science and Community Health, University of West Florida, 11000 University Parkway, Pensacola, FL 32514, USA
- *Debra M. Vinci:
| | | | - Christopher K. Wirth
- Physical Education, Department of Exercise Science and Community Health, University of West Florida, 11000 University Parkway, Pensacola, FL 32514, USA
| | - Caroline Kraus
- Gramercy Research Group, 7990 N. Point Boulevard, Suite 108, Winston-Salem, NC 27106, USA
| | - Alexandra P. Venezia
- Department of Exercise Science and Community Health, University of West Florida, 11000 University Parkway, Pensacola, FL 32514, USA
| |
Collapse
|
168
|
Linnell JD, Zidenberg-Cherr S, Briggs M, Scherr RE, Brian KM, Hillhouse C, Smith MH. Using a Systematic Approach and Theoretical Framework to Design a Curriculum for the Shaping Healthy Choices Program. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2016; 48:60-69.e1. [PMID: 26547274 DOI: 10.1016/j.jneb.2015.09.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 09/15/2015] [Accepted: 09/22/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To examine the use of a systematic approach and theoretical framework to develop an inquiry-based, garden-enhanced nutrition curriculum for the Shaping Healthy Choices Program. METHODS Curriculum development occurred in 3 steps: identification of learning objectives, determination of evidence of learning, and activity development. Curriculum activities were further refined through pilot-testing, which was conducted in 2 phases. Formative data collected during pilot-testing resulted in improvements to activities. RESULTS Using a systematic, iterative process resulted in a curriculum called Discovering Healthy Choices, which has a strong foundation in Social Cognitive Theory and constructivist learning theory. Furthermore, the Backward Design method provided the design team with a systematic approach to ensure activities addressed targeted learning objectives and overall Shaping Healthy Choices Program goals. CONCLUSIONS AND IMPLICATIONS The process by which a nutrition curriculum is developed may have a direct effect on student outcomes. Processes by which nutrition curricula are designed and learning objectives are selected, and how theory and pedagogy are applied should be further investigated so that effective approaches to developing garden-enhanced nutrition interventions can be determined and replicated.
Collapse
Affiliation(s)
- Jessica D Linnell
- Department of Nutrition, University of California, Davis, CA; Center for Nutrition in Schools, University of California, Davis, CA
| | - Sheri Zidenberg-Cherr
- Department of Nutrition, University of California, Davis, CA; Center for Nutrition in Schools, University of California, Davis, CA; University of California Cooperative Extension, Division of Agriculture and Natural Resources, Davis, CA
| | - Marilyn Briggs
- Department of Nutrition, University of California, Davis, CA; Center for Nutrition in Schools, University of California, Davis, CA
| | - Rachel E Scherr
- Department of Nutrition, University of California, Davis, CA; Center for Nutrition in Schools, University of California, Davis, CA
| | - Kelley M Brian
- Department of Nutrition, University of California, Davis, CA; University of California Cooperative Extension, Division of Agriculture and Natural Resources, Davis, CA
| | - Carol Hillhouse
- Agricultural Sustainability Institute, School Garden, University of California, Davis, CA
| | - Martin H Smith
- University of California Cooperative Extension, Division of Agriculture and Natural Resources, Davis, CA; Department of Human Ecology, University of California, Davis, CA; Department of Population Health and Reproduction, University of California, Davis, CA.
| |
Collapse
|
169
|
Chamay-Weber C, Farpour-Lambert NJ, Saunders Gasser C, Martin XE, Gal C, Maggio AB. Obesity Management in Adolescents: Comparison of a Low-Intensity Face-to-Face Therapy Provided by a Trained Paediatrician with an Intensive Multidisciplinary Group Therapy. Obes Facts 2016; 9:112-20. [PMID: 27054560 PMCID: PMC5644868 DOI: 10.1159/000443694] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 12/23/2015] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE This study aimed to compare the effects of a low-intensity face-to-face therapy provided by a trained paediatrician to an intensive group therapy provided by a multidisciplinary team on the BMI of adolescents with obesity. METHODS This longitudinal cohort study included 233 adolescents aged 11-18 years (mean 13.1 ± 1.7 years). Patients and their parents choose either a low-intensity face-to-face therapy or an intensive group therapy (total 88 h). RESULTS At baseline, the mean BMI was 29.4 ± 4.9 kg/m2. Within groups changes of BMI z-scores were significant at the end of follow-up both in the face-to-face (-0.2 ± 0.5) and the group therapy (-0.24 ± 0.5). There was no difference among groups. Younger age (12-14 years), gender, follow-up duration as well as BMI z-score at inclusion were significantly related to BMI z-score changes, independently of the type of intervention. As expected, the face-to-face therapy was far less expensive than the group therapy (USD 1,473.00 ± 816.00 vs. USD 6,473.00 ± 780.00). CONCLUSION A low-intensity face-to-face therapy resulted in similar changes of the BMI z-score of adolescents than an intensive multidisciplinary group therapy. This approach could be easily disseminated in primary care settings with a specific training in obesity care.
Collapse
|
170
|
Ziegler J, Hughes CV. Weighing in on pediatric obesity: Weight screening at the dental visit. J Am Dent Assoc 2015; 147:146-50. [PMID: 26651435 DOI: 10.1016/j.adaj.2015.10.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 10/02/2015] [Accepted: 10/26/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND OVERVIEW Pediatric obesity is a public health concern requiring an interprofessional approach to care. Weight screening in the dental office can promote healthy behaviors to improve weight and oral health status and reduce systemic and oral health risks. CONCLUSIONS Oral health care professionals can perform weight screenings quickly. Routine weight screening of pediatric patients and early intervention through education and referral of patients to a registered dietitian nutritionist and a physician for more in-depth evaluation may help reduce disease risk. PRACTICAL IMPLICATIONS Oral health care professionals can measure a patient's height and weight and can easily calculate body mass index percentile according to a patient's age and sex to detect weight status that does not fall within the normal range. Oral health care professionals should refer patients who are underweight, overweight, or obese to a registered dietitian nutritionist and the patient's physician for follow-up.
Collapse
|
171
|
Howie EK, McVeigh JA, Abbott RA, Olds TS, Straker LM. Multiple components of fitness improved among overweight and obese adolescents following a community-based lifestyle intervention. J Sports Sci 2015; 34:1581-7. [PMID: 26654751 DOI: 10.1080/02640414.2015.1123285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Fitness is an important component of health, and obese adolescents regularly have poor fitness. Unfortunately, few have assessed the impact of community-based lifestyle interventions on multiple components of fitness. The purpose of this study was to assess the impact of participation in a community-based intervention involving adolescents and parents on multiple components of fitness of obese adolescents. In a within-subject, waitlist controlled clinical trial with 12 months follow-up in Western Australia, participants (n = 56) completed multiple fitness measures at baseline, immediately prior to beginning an 8-week intervention and at 3, 6 and 12 months during a maintenance period. Performance on the shuttle walk was improved immediately post-intervention (increase of 42.8 m, 95% CI: 7.5, 78.2) and at 12 months post-intervention (increase of 44.6 m, 95% CI: 1.3, 87.8) compared with pre-intervention. Muscle performance of quadriceps and deltoids were improved post-intervention (increase of 1.1 (95% CI: 0.1, 2.1) kg · F and 1.0 (0.02, 2.1) kg · F, respectively) and all muscle performance measures were improved at 12 months following the intervention. There were no changes in waist circumference. A community-based lifestyle programme such as Curtin University's Activity, Food and Attitudes Program (CAFAP) may be a viable strategy for improving fitness in overweight adolescents.
Collapse
Affiliation(s)
- Erin K Howie
- a School of Physiotherapy and Exercise Science , Curtin University , Perth , Australia
| | - Joanne A McVeigh
- a School of Physiotherapy and Exercise Science , Curtin University , Perth , Australia
| | - Rebecca A Abbott
- a School of Physiotherapy and Exercise Science , Curtin University , Perth , Australia
| | - Tim S Olds
- b Health and Use of Time (HUT) Group , University of South Australia , Adelaide , Australia
| | - Leon M Straker
- a School of Physiotherapy and Exercise Science , Curtin University , Perth , Australia
| |
Collapse
|
172
|
Jacobson TA, Maki KC, Orringer CE, Jones PH, Kris-Etherton P, Sikand G, La Forge R, Daniels SR, Wilson DP, Morris PB, Wild RA, Grundy SM, Daviglus M, Ferdinand KC, Vijayaraghavan K, Deedwania PC, Aberg JA, Liao KP, McKenney JM, Ross JL, Braun LT, Ito MK, Bays HE, Brown WV. National Lipid Association Recommendations for Patient-Centered Management of Dyslipidemia: Part 2. J Clin Lipidol 2015; 9:S1-122.e1. [DOI: 10.1016/j.jacl.2015.09.002] [Citation(s) in RCA: 315] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
173
|
Kelley GA, Kelley KS, Pate RR. Exercise and BMI in Overweight and Obese Children and Adolescents: A Systematic Review and Trial Sequential Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2015; 2015:704539. [PMID: 26579538 PMCID: PMC4633529 DOI: 10.1155/2015/704539] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Revised: 09/11/2015] [Accepted: 09/13/2015] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Determine the effects of exercise on body mass index (BMI in kg · m(-2)) among overweight and obese children and adolescents. METHODS Trial sequential meta-analysis of randomized controlled exercise intervention trials ≥ 4 weeks and published up to November 11, 2014. RESULTS Of the 5,436 citations screened, 20 studies representing 971 boys and girls were included. Average length, frequency, and duration of training were 13 weeks, 3 times per week, for 46 minutes per session. Overall, random-effects models showed that exercise decreased BMI by 3.6% (mean: -1.08; 95% CI: -0.52 to -1.64; Q = 231.4; p < 0.001; I (2) = 90.9%; 95% CI: 87.6% to 93.4%; D (2) = 91.5%). Trial sequential meta-analysis showed that changes in BMI crossed the monitoring boundary for a type 1 error in 2010, remaining stable thereafter. The number needed to treat was 5 while the percentile improvement was 26.9. It was estimated that approximately 2.5 million overweight and obese children in the US and 22.0 million overweight and obese children worldwide could reduce their BMI by participating in a regular exercise program. Overall quality of evidence was rated as moderate. CONCLUSIONS Exercise is associated with improvements in BMI among overweight and obese children and adolescents. This trial is registered with PROSPERO Trial Registration #CRD42015017586.
Collapse
Affiliation(s)
- George A. Kelley
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, WV 26506, USA
| | - Kristi S. Kelley
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, WV 26506, USA
| | - Russell R. Pate
- Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA
| |
Collapse
|
174
|
Ritchie LD, Wakimoto P, Woodward-Lopez G, Thompson FE, Loria CM, Wilson DK, Kao J, Crawford PB, Webb KL. The Healthy Communities Study Nutrition Assessments: Child Diet and the School Nutrition Environment. Am J Prev Med 2015; 49:647-52. [PMID: 26384936 PMCID: PMC4575770 DOI: 10.1016/j.amepre.2015.06.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 05/22/2015] [Accepted: 06/17/2015] [Indexed: 12/14/2022]
Abstract
Multifaceted community interventions directed at improving food environments are emerging, but their impact on dietary change and obesity prevalence has not been adequately documented. The Healthy Communities Study (HCS) is seeking to identify characteristics and combinations of programs and policies that are associated with children's diets and obesity-related outcomes in various types of communities across the U.S. The purpose of this paper is to describe the methods used in 2013-2015 in the HCS to assess dietary intake, school nutrition environments, and other nutrition-related behaviors. The conceptual framework of the HCS is based on the socioecological model and behaviors shown in previous studies to be related to obesity in children guided selection of domains. Nine domains were identified as essential measures of nutrition in the HCS: (1) intake of selected foods and beverages; (2) food patterns and behaviors; (3) social support; (4) home environment; (5) school environment; (6) community environment; (7) breastfeeding history; (8) household food insecurity; and (9) dieting behaviors and body image. Children's dietary intake was assessed using a dietary screener and up to two automated 24-hour recalls. Dietary-related behaviors were assessed by a survey administered to the parent, child, or both, depending on child age. School nutrition measures were obtained from a combination of school staff surveys and researcher observations. Information from these measures is expected to contribute to a better understanding of "what is working" to improve the dietary behaviors that are likely to prevent obesity and improve health in children.
Collapse
Affiliation(s)
- Lorrene D Ritchie
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, California; Atkins Center for Weight and Health, University of California, Berkeley, California.
| | - Patricia Wakimoto
- Atkins Center for Weight and Health, University of California, Berkeley, California
| | - Gail Woodward-Lopez
- Atkins Center for Weight and Health, University of California, Berkeley, California
| | | | - Catherine M Loria
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Dawn K Wilson
- Department of Psychology, University of South Carolina, Columbia, South Carolina
| | - Janice Kao
- Atkins Center for Weight and Health, University of California, Berkeley, California
| | - Patricia B Crawford
- Atkins Center for Weight and Health, University of California, Berkeley, California
| | - Karen L Webb
- Atkins Center for Weight and Health, University of California, Berkeley, California
| |
Collapse
|
175
|
Nam EW, Sharma B, Kim HY, Paja DJV, Yoon YM, Lee SH, Kim EH, Oh CH, Kim YS, Song CH, Kim JK. Obesity and Hypertension among School-going Adolescents in Peru. J Lifestyle Med 2015; 5:60-7. [PMID: 26770892 PMCID: PMC4711960 DOI: 10.15280/jlm.2015.5.2.60] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 08/01/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Adolescent obesity and hypertension are global public health issues. The burden of adolescent obesity and hypertension in Peru is unclear. The aim of this study was to determine the prevalence of obesity and hypertension and their relationship among school-attending adolescents and to assess the need for health-promoting school programs in the study area. METHODS A cross-sectional school-based survey was conducted in a randomly selected sample of 952 secondary school adolescents from 11 schools in Lima or Callao, Peru, in 2014. Weight, height, and blood pressure (BP) were measured and categorized. Obesity was defined as ≥ 95(th) percentile in body mass index (BMI) for age and sex. Hypertension was defined as average systolic blood pressure and/or diastolic blood pressure ≥95(th) percentile in BP for sex, age, and height. Chi-square test and univariate logistic regressions were used at a 5% significance level to determine the relationship between BMI and BP category. RESULTS The mean age of subjects was 14.6 years; 46.4% were boys and 53.6% were girls. The prevalence of overweight and obesity was 20.2% and 9.5% overall, 17.4% and 11.1% for boys, and 22.5% and 8.0% for girls, respectively. The prevalence of hypertension was 26.7% overall, 34.8% for boys, and 19.6% for girls. In both sexes, BMI was strongly associated with BP (p < 0.01). CONCLUSION The prevalence of obesity and hypertension observed in the study area is relatively high. Overweight and obesity are strongly associated with BP status among adolescents. Health-promoting school programs may reduce the burdens of obesity and hypertension among school-going adolescents.
Collapse
Affiliation(s)
- Eun Woo Nam
- Yonsei Global Health Center, Yonsei University, Wonju, Korea; Institute for Poverty Alleviation and International Development, Yonsei University, Wonju, Korea; Department of Health Administration, Graduate School, Yonsei University, Korea
| | - Bimala Sharma
- Yonsei Global Health Center, Yonsei University, Wonju, Korea; Institute for Poverty Alleviation and International Development, Yonsei University, Wonju, Korea; Department of Health Administration, Graduate School, Yonsei University, Korea
| | - Ha Yun Kim
- Yonsei Global Health Center, Yonsei University, Wonju, Korea; Department of Health Administration, Graduate School, Yonsei University, Korea
| | | | - Young Min Yoon
- Yonsei Global Health Center, Yonsei University, Wonju, Korea; Department of Health Administration, Graduate School, Yonsei University, Korea
| | - Sun Ha Lee
- Yonsei Global Health Center, Yonsei University, Wonju, Korea
| | - Eun Hwan Kim
- Yonsei Global Health Center, Yonsei University, Wonju, Korea
| | | | - Yun Seop Kim
- Yonsei Global Health Center, Yonsei University, Wonju, Korea
| | | | - Jong Koo Kim
- Yonsei Global Health Center, Yonsei University, Wonju, Korea; Department of Family Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| |
Collapse
|
176
|
Peterson KE, Spadano-Gasbarro JL, Greaney ML, Austin SB, Mezgebu S, Hunt AT, Blood EA, Horan C, Feldman HA, Osganian SK, Bettencourt MF, Richmond TK. Three-Year Improvements in Weight Status and Weight-Related Behaviors in Middle School Students: The Healthy Choices Study. PLoS One 2015; 10:e0134470. [PMID: 26295837 PMCID: PMC4546621 DOI: 10.1371/journal.pone.0134470] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 07/10/2015] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Few dissemination evaluations exist to document the effectiveness of evidence-based childhood obesity interventions outside the research setting. OBJECTIVE Evaluate Healthy Choices (HC), a multi-component obesity prevention program, by examining school-level changes in weight-related behaviors and weight status and the association of implementation components with odds of overweight/obesity. METHODS We compared baseline and Year 3 school-level behavioral and weight status outcomes with paired t-tests adjusted for schools' socio-demographic characteristics. We used generalized estimating equations to examine the odds of overweight/obesity associated with program components. SETTING/PARTICIPANTS Consecutive sample of 45 of 51 middle schools participating in the HC program with complete baseline and follow-up survey data including a subsample of 35 schools with measured anthropomentry for 5,665 7th grade students. INTERVENTION Schools developed a multi-disciplinary team and implemented an obesity prevention curriculum, before and after school activities, environmental and policy changes and health promotions targeting a 5-2-1 theme: eat ≥ 5 servings/day of fruits and vegetables (FV), watch ≤ 2 hours of television (TV) and participate in ≥ 1 hours/day of physical activity (PA) on most days. MAIN OUTCOME MEASURES 1) School-level percent of students achieving targeted behaviors and percent overweight/obese; and 2) individual odds of overweight/obesity. RESULTS The percent achieving behavioral goals over three years increased significantly for FV: 16.4 to 19.4 (p = 0.001), TV: 53.4 to 58.2 (p = 0.003) and PA: 37.1 to 39.9 (p = 0.02), adjusting for school size, baseline mean age and percent female, non-Hispanic White, and eligible for free and reduced price lunch. In 35 schools with anthropometry, the percent of overweight/obese 7th grade students decreased from 42.1 to 38.4 (p = 0.016). Having a team that met the HC definition was associated with lower odds of overweight/obesity (OR = 0.83, CI: 0.71-0.98). CONCLUSIONS AND RELEVANCE The HC multi-component intervention demonstrated three-year improvements in weight-related behaviors and weight status across diverse middle schools. Team building appears important to the program's effectiveness.
Collapse
Affiliation(s)
- Karen E. Peterson
- Department of Nutritional Sciences, School of Public Health and Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, United States of America
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Jennifer L. Spadano-Gasbarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Mary L. Greaney
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Center for Community-Based Research, Dana Farber Cancer Institute, Boston, Massachusetts, United States of America
- Department of Kinesiology, University of Rhode Island, Kingston, Rhode Island, United States of America
| | - S. Bryn Austin
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Division of Adolescent and Young Adult Medicine, Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts, United States of America
| | - Solomon Mezgebu
- Nutrition Program North East Region, United States Department of Agriculture (USDA), Boston, Massachusetts, United States of America
| | - Anne T. Hunt
- Hunt Consulting Associates, Logan, Utah, United States of America
| | - Emily A. Blood
- Clinical Research Center, Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Chrissy Horan
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States of America
| | - Henry A. Feldman
- Clinical Research Center, Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Stavroula K. Osganian
- Clinical Research Center, Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Maria F. Bettencourt
- Massachusetts Department of Public Health, Boston, Massachusetts, United States of America
| | - Tracy K. Richmond
- Division of Adolescent and Young Adult Medicine, Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts, United States of America
| |
Collapse
|
177
|
Abstract
Prevention of obesity requires policies that work. In this Series paper, we propose a new way to understand how food policies could be made to work more effectively for obesity prevention. Our approach draws on evidence from a range of disciplines (psychology, economics, and public health nutrition) to develop a theory of change to understand how food policies work. We focus on one of the key determinants of obesity: diet. The evidence we review suggests that the interaction between human food preferences and the environment in which those preferences are learned, expressed, and reassessed has a central role. We identify four mechanisms through which food policies can affect diet: providing an enabling environment for learning of healthy preferences, overcoming barriers to the expression of healthy preferences, encouraging people to reassess existing unhealthy preferences at the point-of-purchase, and stimulating a food-systems response. We explore how actions in three specific policy areas (school settings, economic instruments, and nutrition labelling) work through these mechanisms, and draw implications for more effective policy design. We find that effective food-policy actions are those that lead to positive changes to food, social, and information environments and the systems that underpin them. Effective food-policy actions are tailored to the preference, behavioural, socioeconomic, and demographic characteristics of the people they seek to support, are designed to work through the mechanisms through which they have greatest effect, and are implemented as part of a combination of mutually reinforcing actions. Moving forward, priorities should include comprehensive policy actions that create an enabling environment for infants and children to learn healthy food preferences and targeted actions that enable disadvantaged populations to overcome barriers to meeting healthy preferences. Policy assessments should be carefully designed on the basis of a theory of change, using indicators of progress along the various pathways towards the long-term goal of reducing obesity rates.
Collapse
Affiliation(s)
| | - Trenton G Smith
- Department of Economics, University of Otago, Dunedin, New Zealand
| | - Jo Jewell
- World Cancer Research Fund International, London, UK
| | - Jane Wardle
- Health Behaviour Research Centre, Department of Epidemiology & Public Health, University College London, London, UK
| | - Ross A Hammond
- Center on Social Dynamics and Policy, The Brookings Institution, Washington, DC, USA
| | - Sharon Friel
- Regulatory Institutions Network, The Australian National University, Canberra, ACT, Australia
| | - Anne Marie Thow
- Menzies Centre for Health Policy, University of Sydney, Sydney, NSW, Australia
| | - Juliana Kain
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| |
Collapse
|
178
|
Kirk S, Woo JG, Jones MN, Siegel RM. Increased frequency of dietitian visits is associated with improved body mass index outcomes in obese youth participating in a comprehensive pediatric weight management program. Child Obes 2015; 11:202-8. [PMID: 25710601 DOI: 10.1089/chi.2014.0079] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Comprehensive weight management (CWM) interventions are most effective for obese youth when they include multiple components, such as nutrition, physical activity, and behavioral strategies. However, effectiveness of different approaches to delivering the nutrition component is unknown. Our aim was to evaluate two dietary approaches and extent of registered dietitian (RD) involvement on outcomes of obese youth participating in a CWM program. METHODS A retrospective review of CWM patients was conducted before and after redesign of the nutrition component. The earlier clinical model (CM1) introduced a portion-controlled diet at an RD visit after the initial medical visit, whereas the later clinical model (CM2) introduced a reduced glycemic load diet at the initial medical visit. CWM patients were included if they had at least one RD visit and an initial and 3- to 6-month medical follow-up visit during CM1 or CM2. Differences between CM1 and CM2 groups regarding changes in BMI and programmatic success (BMI change ≤0) were evaluated. RESULTS Median BMI change during follow-up did not differ between CM1 (n=41) and CM2 (n=51) groups (p=0.41). In a multiple logistic regression model combining study groups, each additional RD visit was associated with a 28% increased odds of success (odds ratio [95% confidence interval]: 1.28 [1.00, 1.64]; p=0.05). The probability of success exceeded 78% with ≥1 RD visit/month versus 43% with minimal RD exposure. CONCLUSIONS Increased frequency of RD visits is associated with improved BMI outcomes in obese youth participating in a CWM program regardless of dietary intervention implemented.
Collapse
Affiliation(s)
- Shelley Kirk
- 1 Heart Institute, Cincinnati Children's Hospital Medical Center , Cincinnati, OH
| | | | | | | |
Collapse
|
179
|
Ayala GX, Ibarra L, Binggeli-Vallarta A, Moody J, McKenzie TL, Angulo J, Hoyt H, Chuang E, Ganiats TG, Gahagan S, Ji M, Zive M, Schmied E, Arredondo EM, Elder JP. Our Choice/Nuestra Opción: the Imperial County, California, Childhood Obesity Research Demonstration study (CA-CORD). Child Obes 2015; 11:37-47. [PMID: 25584664 PMCID: PMC4323021 DOI: 10.1089/chi.2014.0080] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Despite recent declines among young children, obesity remains a public health burden in the United States, including among Latino/Hispanic children. The determining factors are many and are too complex to fully address with interventions that focus on single factors, such as parenting behaviors or school policies. In this article, we describe a multisector, multilevel intervention to prevent and control childhood obesity in predominantly Mexican-origin communities in Southern California, one of three sites of the CDC-funded Childhood Obesity Research Demonstration (CA-CORD) study. METHODS CA-CORD is a partnership between a university-affiliated research institute, a federally qualified health center, and a county public health department. We used formative research, advisory committee members' recommendations, and previous research to inform the development of the CA-CORD project. Our theory-informed multisector, multilevel intervention targets improvements in four health behaviors: fruit, vegetable, and water consumption; physical activity; and quality sleep. Intervention partners include 1200 families, a federally qualified health center (including three clinics), 26 early care and education centers, two elementary school districts (and 20 elementary schools), three community recreation centers, and three restaurants. Intervention components in these sectors target changes in behaviors, policies, systems, and the social and physical environment. Evaluation activities include assessment of the primary outcome, BMI z-score, at baseline, 12-, and 18-months post-baseline, and sector evaluations at baseline, 12, and 24 months. CONCLUSIONS Identifying feasible and effective strategies to prevent and control childhood obesity has the potential to effect real changes in children's current and future health status.
Collapse
Affiliation(s)
- Guadalupe X. Ayala
- Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, and the Institute for Behavioral and Community Health, San Diego, CA
| | - Leticia Ibarra
- Programs Department, Clínicas de Salud Del Pueblo, Inc., Brawley, CA
| | | | - Jamie Moody
- Institute for Behavioral and Community Health, San Diego, CA
| | - Thomas L. McKenzie
- School of Exercise and Nutrition Sciences, San Diego State University, and the Institute for Behavioral and Community Health, San Diego, CA
| | | | - Helina Hoyt
- College of Nursing, San Diego State University, Imperial Valley Campus, Calexico, CA
| | - Emmeline Chuang
- Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA
| | - Theodore G. Ganiats
- Department of Family and Preventive Medicine, School of Medicine, University of California San Diego, La Jolla, CA
| | - Sheila Gahagan
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, CA
| | - Ming Ji
- College of Nursing, University of South Florida, Tampa, FL
| | - Michelle Zive
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, CA
| | - Emily Schmied
- San Diego State University–University of California at San Diego, Joint Doctoral Program in Public Health (Health Behavior) and the Institute for Behavioral and Community Health, San Diego, CA
| | - Elva M. Arredondo
- Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, and the Institute for Behavioral and Community Health, San Diego, CA
| | - John P. Elder
- Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, and the Institute for Behavioral and Community Health, San Diego, CA
| |
Collapse
|
180
|
Hoelscher DM, Butte NF, Barlow S, Vandewater EA, Sharma SV, Huang T, Finkelstein E, Pont S, Sacher P, Byrd-Williams C, Oluyomi AO, Durand C, Li L, Kelder SH. Incorporating primary and secondary prevention approaches to address childhood obesity prevention and treatment in a low-income, ethnically diverse population: study design and demographic data from the Texas Childhood Obesity Research Demonstration (TX CORD) study. Child Obes 2015; 11:71-91. [PMID: 25555188 PMCID: PMC4696423 DOI: 10.1089/chi.2014.0084] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND There is consensus that development and evaluation of a systems-oriented approach for child obesity prevention and treatment that includes both primary and secondary prevention efforts is needed. This article describes the study design and baseline data from the Texas Childhood Obesity Research Demonstration (TX CORD) project, which addresses child obesity among low-income, ethnically diverse overweight and obese children, ages 2-12 years; a two-tiered systems-oriented approach is hypothesized to reduce BMI z-scores, compared to primary prevention alone. METHODS Our study aims are to: (1) implement and evaluate a primary obesity prevention program; (2) implement and evaluate efficacy of a 12-month family-centered secondary obesity prevention program embedded within primary prevention; and (3) quantify the incremental cost-effectiveness of the secondary prevention program. Baseline demographic and behavioral data for the primary prevention community areas are presented. RESULTS Baseline data from preschool centers, elementary schools, and clinics indicate that most demographic variables are similar between intervention and comparison communities. Most families are low income (≤$25,000) and Hispanic/Latino (73.3-83.8%). The majority of parents were born outside of the United States. Child obesity rates exceed national values, ranging from 19.0% in preschool to 35.2% in fifth-grade children. Most parents report that their children consume sugary beverages, have a television in the bedroom, and do not consume adequate amounts of fruits and vegetables. CONCLUSIONS Interventions to address childhood obesity are warranted in low-income, ethnically diverse communities. Integrating primary and secondary approaches is anticipated to provide sufficient exposure that will lead to significant decreases in childhood obesity.
Collapse
Affiliation(s)
- Deanna M. Hoelscher
- Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Austin, TX
| | - Nancy F. Butte
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX
| | - Sarah Barlow
- Department of Pediatric Medicine, GI, Hepatology and Nutrition, Texas Children's Hospital, Baylor College of Medicine, Houston, TX
| | - Elizabeth A. Vandewater
- Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Austin, TX
| | - Shreela V. Sharma
- Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Houston, TX
| | - Terry Huang
- Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE
| | - Eric Finkelstein
- Program in Health Services Systems Research, Duke University Global Health Institute, Singapore
| | - Stephen Pont
- Texas Center for the Prevention and Treatment of Childhood Obesity, Dell Children's Medical Center, University of Texas Southwestern–Austin, Austin, TX
| | - Paul Sacher
- Childhood Nutrition Research Center, University College, London, United Kingdom
| | - Courtney Byrd-Williams
- Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Austin, TX
| | - Abiodun O. Oluyomi
- Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Austin, TX
| | - Casey Durand
- Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Houston, TX
| | - Linlin Li
- Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Austin, TX
| | - Steven H. Kelder
- Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Austin, TX
| |
Collapse
|
181
|
Horodyska K, Luszczynska A, van den Berg M, Hendriksen M, Roos G, De Bourdeaudhuij I, Brug J. Good practice characteristics of diet and physical activity interventions and policies: an umbrella review. BMC Public Health 2015; 15:19. [PMID: 25604454 PMCID: PMC4306239 DOI: 10.1186/s12889-015-1354-9] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 01/05/2015] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND This umbrella review aimed at eliciting good practice characteristics of interventions and policies aiming at healthy diet, increasing physical activity, and lowering sedentary behaviors. Applying the World Health Organization's framework, we sought for 3 types of characteristics, reflecting: (1) main intervention/policy characteristics, referring to the design, targets, and participants, (2) monitoring and evaluation processes, and (3) implementation issues. This investigation was undertaken by the DEDPIAC Knowledge Hub (the Knowledge Hub on the DEterminants of DIet and Physical ACtivity), which is an action of the European Union's joint programming initiative. METHODS A systematic review of reviews and stakeholder documents was conducted. Data from 7 databases was analyzed (99 documents met inclusion criteria). Additionally, resources of 7 major stakeholders (e.g., World Health Organization) were systematically searched (10 documents met inclusion criteria). Overall, the review yielded 74 systematic reviews, 16 position review papers, and 19 stakeholders' documents. Across characteristics, 25% were supported by ≥ 4 systematic reviews. Further, 25% characteristics were supported by ≥ 3 stakeholders' documents. If identified characteristics were included in at least 4 systematic reviews or at least 3 stakeholders' documents, these good practice characteristics were classified as relevant. RESULTS We derived a list of 149 potential good practice characteristics, of which 53 were classified as relevant. The main characteristics of intervention/policy (n = 18) fell into 6 categories: the use of theory, participants, target behavior, content development/management, multidimensionality, practitioners/settings. Monitoring and evaluation characteristics (n = 18) were grouped into 6 categories: costs/funding, outcomes, evaluation of effects, time/effect size, reach, the evaluation of participation and generalizability, active components/underlying processes. Implementation characteristics (n = 17) were grouped into eight categories: participation processes, training for practitioners, the use/integration of existing resources, feasibility, maintenance/sustainability, implementation partnerships, implementation consistency/adaptation processes, transferability. CONCLUSIONS The use of the proposed list of 53 good practice characteristics may foster further development of health promotion sciences, as it would allow for identification of success vectors in the domains of main characteristics of interventions/policies, their implementation, evaluation and monitoring processes.
Collapse
Affiliation(s)
- Karolina Horodyska
- grid.433893.60000000121840541Department of Psychology, University of Social Sciences and Humanities, 30b Ostrowskiego St, 53238 Wroclaw, Poland
| | - Aleksandra Luszczynska
- grid.433893.60000000121840541Department of Psychology, University of Social Sciences and Humanities, 30b Ostrowskiego St, 53238 Wroclaw, Poland
- Trauma, Health, & Hazards Center, University of Colorado, 1861 Austin Bluffs Pkwy, Colorado Springs, CO 80933-7150 USA
| | - Matthijs van den Berg
- grid.31147.300000000122080118National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 Bilthoven, the Netherlands
| | - Marieke Hendriksen
- grid.31147.300000000122080118National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 Bilthoven, the Netherlands
| | - Gun Roos
- SIFO – National Institute for Consumer Research, Sandakerveien 24 C, Building B Oslo, P.O. BOX 4682, Nydalen, N-0405, Oslo Norway
| | - Ilse De Bourdeaudhuij
- grid.5342.00000000120697798Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium
| | - Johannes Brug
- grid.16872.3a000000040435165XVU University Medical Center, Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands
| |
Collapse
|
182
|
Peirson L, Fitzpatrick-Lewis D, Morrison K, Warren R, Usman Ali M, Raina P. Treatment of overweight and obesity in children and youth: a systematic review and meta-analysis. CMAJ Open 2015; 3:E35-46. [PMID: 25844368 PMCID: PMC4382035 DOI: 10.9778/cmajo.20140047] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Childhood obesity is a public health concern. One-third of North American children and youth are overweight or obese. We reviewed the evidence of behavioural and pharmacological weight-management interventions on body mass index (BMI), BMI z-score and the prevalence of overweight and obesity in children and youth. METHODS We updated the search of a previous review. We searched 4 databases up to August 2013. We included randomized trials of primary care-relevant behavioural (diet, exercise, lifestyle) and pharmacological (orlistat) interventions for treating overweight and obesity in children and youth aged 2-18 years if 6-month post-baseline data were provided for BMI, BMI z-score or prevalence of overweight and obesity. In addition, we examined secondary health outcomes such as lipid and glucose levels, blood pressure, quality of life and physical fitness. We included any study reporting harms. We performed meta-analyses when possible, and we examined the features of interventions that showed benefits. RESULTS Thirty-one studies (29 behavioural, 2 pharmacological and behavioural) were included. Both intervention types showed a significant effect on BMI or BMI z-score in favour of treatment (behavioural: standardized mean difference [SMD] -0.54, 95% confidence interval [CI] -0.73 to -0.36; orlistat plus behavioural: SMD -0.43, 95% CI -0.60 to -0.25). Studies reported no significant difference between groups in the likelihood of reduced prevalence of overweight or overweight and obesity. Pooled estimates for blood pressure and quality of life showed significant benefits in favour of treatment (systolic blood pressure mean difference [MD] -3.42, 95% CI -6.65 to -0.29; diastolic blood pressure MD -3.39, 95% CI -5.17 to -1.60; quality of life MD 2.10, 95% CI 0.60 to 3.60). Gastrointestinal difficulties were more common in youth taking orlistat than in the control group (risk ratio 3.77, 95% CI 2.56 to 5.55). We saw much variability across efficacious interventions. INTERPRETATION Low- to moderate-quality evidence suggests behavioural treatments are associated with a medium effect in terms of reduced BMI or BMI z-score compared with a small effect shown by combined pharmacological-behavioural interventions. Future research should evaluate active weight maintenance interventions in adolescents with longer follow-up and examine the effectiveness of combined pharmacological and behavioural interventions. REGISTRATION PROSPERO no. CRD42012002754.
Collapse
Affiliation(s)
- Leslea Peirson
- McMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ontario
- School of Nursing, McMaster University, Hamilton, Ontario
| | - Donna Fitzpatrick-Lewis
- McMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ontario
- School of Nursing, McMaster University, Hamilton, Ontario
| | | | - Rachel Warren
- McMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ontario
- School of Nursing, McMaster University, Hamilton, Ontario
| | - Muhammad Usman Ali
- McMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ontario
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario
| | - Parminder Raina
- McMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ontario
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario
| |
Collapse
|
183
|
Abstract
Type 2 diabetes (T2D) in youth is a relatively novel condition facing paediatric health care providers. Few experimental trials exist to guide clinical management in this population. Supporting and prescribing modifiable lifestyle behaviours is cornerstone in the management of T2D in adults. Clinical trials in obese adolescents suggest that intensive lifestyle interventions that include both dietary changes and increased physical activity elicit clinically meaningful reductions in weight and improve cardiovascular risk profiles. Observational studies in youth with T2D suggest that better diet quality and increased physical activity are associated with better metabolic control; however, the limited experimental data available does not support these observations. Trials evaluating lifestyle monotherapy for the treatment of hyperglycaemia in youth with T2D do not exist, and the only study evaluating combined lifestyle and pharmacologic therapy did not show additional benefit over pharmacologic treatment with metformin alone. Physiological and psychosocial differences between youth and adults with T2D likely contribute to the differences in the effectiveness of lifestyle therapy for improving glycaemic control. The current review describes these topics in detail and provides recommendations for paediatric health care providers for the promotion of lifestyle therapy for the management of hyperglycaemia and cardiovascular risk factors for youth with T2DM.
Collapse
Affiliation(s)
- Jonathan McGavock
- Department of Pediatrics and Child Health, Faculty of Medicine, Manitoba Institute of Child Health, University of Manitoba, 511 JBRC 715 McDermot ave., Winnipeg, MB, R3E 3P4, Canada,
| | | | | |
Collapse
|
184
|
Farpour-Lambert NJ, Baker JL, Hassapidou M, Holm JC, Nowicka P, O'Malley G, Weiss R. Childhood Obesity Is a Chronic Disease Demanding Specific Health Care--a Position Statement from the Childhood Obesity Task Force (COTF) of the European Association for the Study of Obesity (EASO). Obes Facts 2015; 8:342-9. [PMID: 26469067 PMCID: PMC5644867 DOI: 10.1159/000441483] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 09/04/2015] [Indexed: 12/26/2022] Open
Abstract
Childhood obesity is one of the greatest health challenges of the 21st century. The EASO COTF is convinced that classifying obesity as a chronic disease in children and adolescents is a crucial step for increasing individual and societal awareness, and for improving early diagnosis and intervention. Such a classification will enhance the development of novel preventive and treatment approaches, health care policies and systems, and the education of healthcare workers. The management of obesity prior to the appearance of co-morbidities may prevent their escalation into significant medical and psychosocial problems, and reduce their economic and societal impact. Childhood is a unique window of opportunity to influence lifetime effects on health, quality of life, prevention of non-communicable chronic diseases and disabilities. The Convention on the Rights of the Child by UNICEF states that parties shall strive to ensure that no child is deprived of his or her right of access to health care services. The EASO COTF is aiming to address these issues via educational activities for health care workers, identification of research agendas, and the promotion of collaborations among clinicians, researchers, health institutions, organizations and states across Europe.
Collapse
Affiliation(s)
- Nathalie J. Farpour-Lambert
- Obesity Prevention and Care Program Contrepoids, Service of Therapeutic Education for Chronic Diseases, Department of Community Medicine, Primary Care and Emergency, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland
- *Nathalie J. Farpour-Lambert, Obesity Prevention and Care Program Contrepoids, Service of Therapeutic Education for Chronic Diseases, Department of Community Medicine, Primary Care and Emergency, University Hospitals of Geneva and University of Geneva, 1211 Geneva 14, Switzerland,
| | - Jennifer L. Baker
- Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Maria Hassapidou
- Alexander Technological Educational Institute of Thessaloniki, Department of Nutrition and Dietetics, Thessaloniki, Greece
| | - Jens Christian Holm
- The Children's Obesity Clinic, Department of Paediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark
| | - Paulina Nowicka
- Division of Pediatrics, Karolinska Institute, Stockholm, Sweden
| | - Grace O'Malley
- Physiotherapy Department; Temple Street Children's University Hospital, Dublin, Ireland
| | - Ram Weiss
- Department of Human Metabolism and Nutrition and the Department of Pediatrics, The Hadassah Hebrew University School of Medicine Jerusalem, Israel
| |
Collapse
|
185
|
Peirson L, Fitzpatrick-Lewis D, Morrison K, Ciliska D, Kenny M, Usman Ali M, Raina P. Prevention of overweight and obesity in children and youth: a systematic review and meta-analysis. CMAJ Open 2015; 3:E23-33. [PMID: 25844367 PMCID: PMC4382039 DOI: 10.9778/cmajo.20140053] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND One-third of Canadian children are overweight or obese. This problem carries considerable concern for negative impacts on current and future health. Promoting healthy growth and development is critical. This review synthesized evidence on the effectiveness of behavioural interventions for preventing overweight and obesity in children and adolescents. METHODS We updated the search of a previous Cochrane review. Five databases were searched up to August 2013. Randomized trials of primary care-relevant behavioural (diet, exercise and lifestyle) interventions for preventing overweight and obesity in healthy normal- or mixed-weight children or youth aged 0-18 years were included if 12-week postbaseline data were provided for body mass index (BMI), BMI z-score, or prevalence of overweight or obesity. Any study reporting harms was included. Meta-analyses were performed if possible. Features of interventions showing significant benefits were examined. RESULTS Ninety studies were included, all with mixed-weight populations. Compared with controls, interventions showed a small but significant effect on BMI and BMI z-score (standardized mean difference -0.07, 95% confidence interval [CI] -0.10 to -0.03, I (2) = 74%), a reduction in BMI (mean difference -0.09 kg/m(2), 95% CI -0.16 to -0.03, I (2) = 76%) and a reduced prevalence of overweight and obesity (risk ratio [RR]; RRintervention - RRcontrol 0.94, 95% CI 0.89 to 0.99, I (2) = 0%; number needed to treat 51, 95% CI 29 to 289). Little evidence was available on harms. There was variability across efficacious interventions, although many of the interventions were short-term, involved school-aged children and were delivered in educational settings. INTERPRETATION Behavioural prevention interventions are associated with small improvements in weight outcomes in mixed-weight populations of children and adolescents. No intervention strategy consistently produced benefits. REGISTRATION PROSPERO no. CRD42012002754.
Collapse
Affiliation(s)
- Leslea Peirson
- McMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ont
- School of Nursing, Master University, Hamilton, Ont
| | - Donna Fitzpatrick-Lewis
- McMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ont
- School of Nursing, Master University, Hamilton, Ont
| | | | - Donna Ciliska
- McMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ont
- School of Nursing, Master University, Hamilton, Ont
| | - Meghan Kenny
- McMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ont
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont
| | - Muhammad Usman Ali
- McMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ont
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont
| | - Parminder Raina
- McMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ont
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont
| |
Collapse
|
186
|
Eli K, Howell K, Fisher PA, Nowicka P. "A little on the heavy side": a qualitative analysis of parents' and grandparents' perceptions of preschoolers' body weights. BMJ Open 2014; 4:e006609. [PMID: 25500371 PMCID: PMC4265138 DOI: 10.1136/bmjopen-2014-006609] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES Parents' difficulties in perceiving children's weight status accurately pose a barrier for family-based obesity interventions; however, the factors underlying weight misinterpretation still need to be identified. This study's objective was to examine parents and grandparents' perceptions of preschoolers' body sizes. Interview questions also explored perceptions of parental responsibility for childhood obesity and appropriate contexts in which to discuss preschoolers' weights. DESIGN Semistructured interviews, which were videotaped, transcribed and analysed qualitatively. SETTING Eugene and the Springfield metropolitan area, Oregon, USA PARTICIPANTS: Families of children aged 3-5 years were recruited in February-May 2011 through advertisements about the study, published in the job seekers' sections of a classified website (Craigslist) and in a local newspaper. 49 participants (22 parents and 27 grandparents, 70% women, 60% with overweight/obesity) from 16 low-income families of children aged 3-5 years (50% girls, 56% with overweight/obesity) were interviewed. RESULTS There are important gaps between clinical definitions and lay perceptions of childhood obesity. While parents and grandparents were aware of their preschoolers' growth chart percentiles, these measures did not translate into recognition of children's overweight or obesity. The participants spoke of obesity as a problem that may affect the children in the future, but not at present. Participants identified childhood obesity as being transmitted from one generation to the next, and stigmatised it as resulting from 'lazy' parenting. Parents and grandparents avoided discussing the children's weights with each other and with the children themselves. CONCLUSIONS The results suggest that clinicians should clearly communicate with parents and grandparents about the meaning and appearance of obesity in early childhood, as well as counteract the social stigma attached to obesity, in order to improve the effectiveness of family-based interventions to manage obesity in early childhood.
Collapse
Affiliation(s)
- Karin Eli
- Unit for Biocultural Variation and Obesity, Institute of Social and Cultural Anthropology, University of Oxford, Oxford, UK
| | - Kyndal Howell
- Department of Psychology, University of Oregon, Eugene, USA
| | | | - Paulina Nowicka
- Unit for Biocultural Variation and Obesity, Institute of Social and Cultural Anthropology, University of Oxford, Oxford, UK
- Unit of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
187
|
"Those comments last forever": parents and grandparents of preschoolers recount how they became aware of their own body weights as children. PLoS One 2014; 9:e111974. [PMID: 25393236 PMCID: PMC4230937 DOI: 10.1371/journal.pone.0111974] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 10/10/2014] [Indexed: 12/12/2022] Open
Abstract
Background Parents' and grandparents' willingness to talk about children's body weights may be influenced by their own childhood experiences of body weight awareness and ‘weight talk’ in the family; however, little is known about how adults describe their recollected weight-related childhood experiences. Aims This paper examines how parents and grandparents of preschoolers describe the emergence of their own body weight awareness in childhood or adolescence. The analysis highlights the sources that participants identify as having instigated their body weight awareness, the feelings and experiences participants associate with the experience of becoming aware of their body weights, and their framings of potential links between childhood experiences and attitudes and practices in adulthood. Methods 49 participants (22 parents, 27 grandparents, 70% women, 60% with overweight/obesity) from sixteen low-income families of children aged 3–5 years (50% girls, 56% with overweight/obesity) in the Pacific Northwest were interviewed. The interviews were videotaped, transcribed, and analyzed qualitatively. Results Twenty-five participants (51%) said they became aware of their body weights in childhood or adolescence. Fourteen participants said their body weight awareness emerged through comments made by others, with the majority citing parents or peers. No participant described the emergence of body weight awareness in positive terms. Four participants directly linked their own negative experiences to the decision not to discuss body weight with their preschoolers. All four cited critical comments from their parents as instigating their own body weight awareness in childhood. Conclusions In most cases, participants associated their emergent awareness of body weight with overtly negative feelings or consequences; some participants said these negative experiences continued to affect them as adults. Since family-based childhood obesity interventions involve open discussion of children's body sizes, the results suggest that clinicians should reframe the discussion to deconstruct obesity stigma and emphasize inclusive, affirmative, and health-focused messages.
Collapse
|
188
|
Straker LM, Howie EK, Smith KL, Fenner AA, Kerr DA, Olds TS, Abbott RA, Smith AJ. The impact of Curtin University's activity, food and attitudes program on physical activity, sedentary time and fruit, vegetable and junk food consumption among overweight and obese adolescents: a waitlist controlled trial. PLoS One 2014; 9:e111954. [PMID: 25375109 PMCID: PMC4222962 DOI: 10.1371/journal.pone.0111954] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 09/30/2014] [Indexed: 01/26/2023] Open
Abstract
Background To determine the effects of participation in Curtin University's Activity, Food and Attitudes Program (CAFAP), a community-based, family-centered behavioural intervention, on the physical activity, sedentary time, and healthy eating behaviours of overweight and obese adolescents. Methods In this waitlist controlled clinical trial in Western Australia, adolescents (n = 69, 71% female, mean age 14.1 (SD 1.6) years) and parents completed an 8-week intervention followed by 12 months of telephone and text message support. Assessments were completed at baseline, before beginning the intervention, immediately following the intervention, and at 3-, 6-, and 12- months follow-up. The primary outcomes were physical activity and sedentary time assessed by accelerometers and servings of fruit, vegetables and junk food assessed by 3-day food records. Results During the intensive 8-week intervention sedentary time decreased by −5.1 min/day/month (95% CI: −11.0, 0.8) which was significantly greater than the rate of change during the waitlist period (p = .014). Moderate physical activity increased by 1.8 min/day/month (95% CI: −0.04, 3.6) during the intervention period, which was significantly greater than the rate of change during the waitlist period (p = .041). Fruit consumption increased during the intervention period (monthly incidence rate ratio (IRR) 1.3, 95% CI: 1.10, 1.56) and junk food consumption decreased (monthly IRR 0.8, 95% CI: 0.74, 0.94) and these changes were different to those seen during the waitlist period (p = .004 and p = .020 respectively). Conclusions Participating in CAFAP appeared to have a positive influence on the physical activity, sedentary and healthy eating behaviours of overweight and obese adolescents and many of these changes were maintained for one year following the intensive intervention. Trial Registration Australia and New Zealand Clinical Trials Registry ACTRN12611001187932
Collapse
Affiliation(s)
- Leon M. Straker
- School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia
- * E-mail:
| | - Erin K. Howie
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Kyla L. Smith
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Ashley A. Fenner
- School of Psychology and Speech Pathology, Curtin University, Perth, Australia
| | - Deborah A. Kerr
- School of Public Health, Curtin University, Perth, Australia
| | - Tim S. Olds
- Health and Use of Time (HUT) Group, University of South Australia, Adelaide, Australia
| | - Rebecca A. Abbott
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Anne J. Smith
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| |
Collapse
|
189
|
Hersch D, Perdue L, Ambroz T, Boucher JL. The impact of cooking classes on food-related preferences, attitudes, and behaviors of school-aged children: a systematic review of the evidence, 2003-2014. Prev Chronic Dis 2014; 11:E193. [PMID: 25376015 PMCID: PMC4222785 DOI: 10.5888/pcd11.140267] [Citation(s) in RCA: 130] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Introduction Cooking programs have been used to promote healthful eating among people of all ages. This review assesses the evidence on childhood cooking programs and their association with changes in food-related preferences, attitudes, and behaviors of school-aged children. Methods We systematically searched PubMed, Ovid-Medline, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases. We included primary research articles that involved cooking education programs for children and searched reference lists for eligible articles. Studies considered for review contained a hands-on cooking intervention; had participants aged 5 to 12 years; were published in a peer-reviewed journal on or after January 1, 2003; and were written in English. We used the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies to rate the strength of each article and assess bias. The following information was extracted from each study: study design, sample size, location, duration, intervention components, data collection methods, and outcomes. Results Eight studies met the inclusion criteria and used cooking education to influence children’s food-related preferences, attitudes, and behaviors. Programs varied in duration, evaluation methods, and outcomes of interest. Self-reported food preparation skills, dietary intake, cooking confidence, fruit and vegetable preferences, attitudes toward food and cooking, and food-related knowledge were among the outcomes measured. Program exposure ranged from 2 sessions to regular instruction over 2 years, and the effect of cooking programs on children’s food-related preferences, attitudes, and behaviors varied among the reviewed studies. Conclusions Findings suggest that cooking programs may positively influence children’s food-related preferences, attitudes, and behaviors. However, because study measurements varied widely, determining best practices was difficult. Further research is needed to fill knowledge gaps on ideal program length, long-term effects, and usefulness of parent engagement, tasting lessons, and other intervention components.
Collapse
Affiliation(s)
- Derek Hersch
- Minneapolis Heart Institute Foundation, 920 East 28th St, Suite 100, Minneapolis, MN 55407. E-mail:
| | - Laura Perdue
- University of Minnesota Extension Regional Center, St. Cloud, Minnesota
| | - Teresa Ambroz
- Minneapolis Heart Institute Foundation, Minneapolis, Minnesota
| | | |
Collapse
|
190
|
Castetbon K. [Recent prevalence of child and adolescent overweight and obesity in France and abroad]. Arch Pediatr 2014; 22:111-5. [PMID: 25435272 DOI: 10.1016/j.arcped.2014.10.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 09/22/2014] [Accepted: 10/29/2014] [Indexed: 10/24/2022]
Abstract
During the 2000s, surveillance of child overweight and obesity experienced a large expansion and provided an opportunity to document such a public health issue using standardized procedures in France and abroad. Nowadays, in France, it has been estimated that just less than one child out of five is overweight and among them, 3 to 4 % are obese. Like in other developed countries, these frequencies have reached a plateau during the 2000s and set France belonging to a group of countries in which the situation looks as fairly favorable. Nevertheless, they also hide huge disparities across social groups and the number of concerned children remains too high, while care possibilities are rather inconclusive. Therefore, prevention actions are still needed.
Collapse
Affiliation(s)
- K Castetbon
- Unité de surveillance périnatale et nutritionnelle, institut de veille sanitaire, université Paris 13, 74, rue Marcel-Cachin, 93017 Bobigny cedex, France.
| |
Collapse
|
191
|
Aldrich H, Gance-Cleveland B, Schmiege S, Dandreaux D. School-based health center providers' treatment of overweight children. J Pediatr Nurs 2014; 29:521-7. [PMID: 24947663 DOI: 10.1016/j.pedn.2014.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 05/15/2014] [Accepted: 05/16/2014] [Indexed: 11/18/2022]
Abstract
This descriptive study was to determine self-reported treatment practices of school-based health center (SBHC) providers when caring for overweight/obese children. Providers (N=33) from SBHCs in 6 states (AZ, CO, NM, MI, NY, and NC) completed a baseline survey before being trained on obesity recommendations. SBHC providers reported patient/parent barriers to be more significant to treatment than clinician/setting barriers (p<0.0001). Most providers (97%) indicated childhood overweight needs treatment, yet only 36% said they initiate treatment in children who do not want to control their weight. SBHC providers also did not commonly refer overweight/obese children to specialists.
Collapse
Affiliation(s)
- Heather Aldrich
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO.
| | | | - Sarah Schmiege
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO.
| | - Danielle Dandreaux
- Center for Improving Health Outcomes in Children, Teens, and Families, College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ.
| |
Collapse
|
192
|
Training in Dietary Practices and Physical Activity to Improve Health among South Asian Medical Students. Adv Prev Med 2014; 2014:610180. [PMID: 25343047 PMCID: PMC4197887 DOI: 10.1155/2014/610180] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 09/17/2014] [Accepted: 09/19/2014] [Indexed: 12/03/2022] Open
Abstract
Introduction. We designed a pilot intervention to test the effect of a training program on the dietary and physical activities of medical students after weekly group discussions about healthy living, maintaining a healthy diet, and healthy lifestyle. Methods. Two groups of students from first and second years of medical school were selected with the intervention group having high BMI (overweight or obese) while control group had normal BMI. An eight-week educational intervention was completed. A closed Facebook group ensured continuous communication. Results. Out of 42 participants, 19 were controls and 21 received educational training. Male : female ratio was 1 : 1.7 in control group and 1 : 1.3 in intervention group. The mean (SD) weight gain in controls (1.16 Kg, SD = 1.51) was higher than that in intervention (0.13 Kg, SD = 3.22) group (P = 0.2). The average reduction in caloric intake was higher in control group (117.85, SD = 258.48) vis-a-vis the intervention group (73.22, SD = 266.84) (P = 0.61). Conclusion. Educational intervention in small groups for bringing about behavioral changes towards dietary, nutrition, and physical activity can lead to changes in the target population. The short duration of our study was a limitation which should be overcome in future studies.
Collapse
|
193
|
Paul DR, Scruggs PW, Goc Karp G, Ransdell LB, Robinson C, Lester MJ, Gao Y, Petranek LJ, Brown H, Shimon JM. Developing a statewide childhood body mass index surveillance program. THE JOURNAL OF SCHOOL HEALTH 2014; 84:661-667. [PMID: 25154530 DOI: 10.1111/josh.12194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 01/07/2014] [Accepted: 02/03/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Several states have implemented childhood obesity surveillance programs supported by legislation. Representatives from Idaho wished to develop a model for childhood obesity surveillance without the support of state legislation, and subsequently report predictors of overweight and obesity in the state. METHODS A coalition comprised of the Idaho State Department of Education and 4 universities identified a randomized cluster sample of schools. After obtaining school administrator consent, measurement teams traveled to each school to measure height and weight of students. Sex and race/ethnicity data were also collected. RESULTS The collaboration between the universities resulted in a sample of 6735 students from 48 schools and 36 communities. Overall, 29.2% of the youth in the sample were classified as overweight or obese, ranging from 24.0% for grade 1 to 33.8% for grade 5. The prevalence of overweight and obesity across schools was highly variable (31.2 ± 7.58%). Hierarchical logistic regression indicated that sex, age, race/ethnicity, socioeconomic status, and region were all significant predictors of overweight and obesity, whereas school was not. CONCLUSIONS This coalition enabled the state of Idaho to successfully estimate the prevalence of overweight and obesity on a representative sample of children from all regions of the state, and subsequently identify populations at greatest risk.
Collapse
Affiliation(s)
- David R Paul
- University of Idaho, P.O. Box 442401, Moscow, ID 83844.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
194
|
Moffat T, Thrasher D. School meal programs and their potential to operate as school-based obesity prevention and nutrition interventions: case studies from France and Japan. CRITICAL PUBLIC HEALTH 2014. [DOI: 10.1080/09581596.2014.957654] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
195
|
Smart CE, Annan F, Bruno LPC, Higgins LA, Acerini CL. ISPAD Clinical Practice Consensus Guidelines 2014. Nutritional management in children and adolescents with diabetes. Pediatr Diabetes 2014; 15 Suppl 20:135-53. [PMID: 25182313 DOI: 10.1111/pedi.12175] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 06/11/2014] [Indexed: 12/13/2022] Open
Affiliation(s)
- Carmel E Smart
- Department of Endocrinology, John Hunter Children's Hospital, Newcastle, Australia
| | | | | | | | | | | |
Collapse
|
196
|
Manios Y, Androutsos O, Katsarou C, Iotova V, Socha P, Geyer C, Moreno L, Koletzko B, De Bourdeaudhuij I. Designing and implementing a kindergarten-based, family-involved intervention to prevent obesity in early childhood: the ToyBox-study. Obes Rev 2014; 15 Suppl 3:5-13. [PMID: 25047374 DOI: 10.1111/obr.12175] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 04/08/2014] [Accepted: 04/08/2014] [Indexed: 11/28/2022]
Abstract
The development of the ToyBox-intervention was based on the outcomes of the preliminary phase of the ToyBox-study, aiming to identify young children's key behaviours and their determinants related to early childhood obesity. The ToyBox-intervention is a multi-component, kindergarten-based, family-involved intervention with a cluster-randomized design, focusing on the promotion of water consumption, healthy snacking, physical activity and the reduction/ breaking up of sedentary time in preschool children and their families. The intervention was implemented during the academic year 2012-2013 in six European countries: Belgium, Bulgaria, Germany, Greece, Poland and Spain. Standardized protocols, methods, tools and material were used in all countries for the implementation of the intervention, as well as for the process, impact, outcome evaluation and the assessment of its cost-effectiveness. A total sample of 7,056 preschool children and their parents/caregivers, stratified by socioeconomic level, provided data during baseline measurements and participated in the intervention. The results of the ToyBox-study are expected to provide a better insight on behaviours associated with early childhood obesity and their determinants and identify effective strategies for its prevention. The aim of the current paper is to describe the design of the ToyBox-intervention and present the characteristics of the study sample as assessed at baseline, prior to the implementation of the intervention.
Collapse
Affiliation(s)
- Y Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | | | | | | | | | | | | | | | | |
Collapse
|
197
|
Must A, Curtin C, Hubbard K, Sikich L, Bedford J, Bandini L. Obesity Prevention for Children with Developmental Disabilities. Curr Obes Rep 2014; 3:156-70. [PMID: 25530916 PMCID: PMC4267572 DOI: 10.1007/s13679-014-0098-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The prevention of obesity in children with DD is a pressing public health issue, with implications for health status, independent living, and quality of life. Substantial evidence suggests that children with developmental disabilities (DD), including those with intellectual disabilities (ID) and autism spectrum disorder (ASD), have a prevalence of obesity at least as high if not higher than their typically developing peers. The paper reviews what is known about the classic and unique risk factors for childhood obesity in these groups of children, including dietary, physical activity, sedentary behavior, and family factors, as well as medication use. We use evidence from the literature to make the case that primary prevention at the individual/family, school and community levels will require tailoring of strategies and adapting existing intervention approaches.
Collapse
Affiliation(s)
- Aviva Must
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111
| | - Carol Curtin
- Eunice Kennedy Shriver Center, University of Massachusetts Medical School, 465 Medford Street, Suite 500, Charlestown, MA 02129
| | - Kristie Hubbard
- Friedman School of Nutrition Science and Policy, Tufts University, 75 Kneeland Street, 8 Floor, Boston, MA 02111
| | - Linmarie Sikich
- Department of Psychiatry, University of North Carolina at Chapel Hill, CB 7167 UNC-CH, Chapel Hill, NC 27599-7167
| | - James Bedford
- Department of Psychiatry, University of North Carolina at Chapel Hill, CB 7160 UNC-CH, Chapel Hill, NC 27599-7160
| | - Linda Bandini
- Eunice Kennedy Shriver Center, University of Massachusetts Medical School, 465 Medford Street, Suite 500, Charlestown, MA 02129
- Department of Health Sciences, Boston University, 635 Commonwealth Ave. Boston, MA 02115
| |
Collapse
|
198
|
Nasreddine L, Naja F, Akl C, Chamieh MC, Karam S, Sibai AM, Hwalla N. Dietary, lifestyle and socio-economic correlates of overweight, obesity and central adiposity in Lebanese children and adolescents. Nutrients 2014; 6:1038-62. [PMID: 24618510 PMCID: PMC3967177 DOI: 10.3390/nu6031038] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Revised: 02/11/2014] [Accepted: 02/17/2014] [Indexed: 11/16/2022] Open
Abstract
The Eastern Mediterranean region is characterized by one of the highest burdens of paediatric obesity worldwide. This study aims at examining dietary, lifestyle, and socio-economic correlates of overweight, obesity, and abdominal adiposity amongst children and adolescents in Lebanon, a country of the Eastern Mediterranean basin. A nationally representative cross-sectional survey was conducted on 6-19-year-old subjects (n = 868). Socio-demographic, lifestyle, dietary, and anthropometric data (weight, height, waist circumference) were collected. Overweight and obesity were defined based on BMI z-scores. Elevated waist circumference (WC) and elevated waist to height ratio (WHtR) were used as indices of abdominal obesity. Of the study sample, 34.8% were overweight, 13.2% were obese, 14.0% had elevated WC, and 21.3% had elevated WHtR. Multivariate logistic regression analyses showed that male gender, maternal employment, residence in the capital Beirut, sedentarity, and higher consumption of fast food and sugar sweetened beverages were associated with increased risk of obesity, overweight, and abdominal adiposity, while regular breakfast consumption, higher intakes of milk/dairies and added fats/oils were amongst the factors associated with decreased risk. The study's findings call for culture-specific intervention strategies for the promotion of physical activity, healthy lifestyle, and dietary practices amongst Lebanese children and adolescents.
Collapse
Affiliation(s)
- Lara Nasreddine
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut 1107-2020, Lebanon.
| | - Farah Naja
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut 1107-2020, Lebanon.
| | - Christelle Akl
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut 1107-2020, Lebanon.
| | - Marie Claire Chamieh
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut 1107-2020, Lebanon.
| | - Sabine Karam
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut 1107-2020, Lebanon.
| | - Abla-Mehio Sibai
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut 1107-2020, Lebanon.
| | - Nahla Hwalla
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut 1107-2020, Lebanon.
| |
Collapse
|
199
|
A socio-ecological approach promoting physical activity and limiting sedentary behavior in adolescence showed weight benefits maintained 2.5 years after intervention cessation. Int J Obes (Lond) 2014; 38:936-43. [PMID: 24509504 PMCID: PMC4088336 DOI: 10.1038/ijo.2014.23] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 01/21/2014] [Accepted: 01/24/2014] [Indexed: 01/17/2023]
Abstract
Background: Obesity in youth remains a major public health issue. Yet no effective long-term preventive strategy exists. We previously showed that a school-based socio-ecological approach targeting behavior and social/environmental influences on physical activity (PA) prevented 4-year excessive weight gain in 12-year olds. In this study, we investigated if this efficacy persists 30 months after intervention cessation. Methods and Findings: The program targeted students, family, school and the living environment to promote/support PA and prevent sedentary behavior (SB). A total of 732 students from eight randomized middle schools completed the 4-year trial. At the 30-month post-trial follow-up, body mass index (BMI), fat mass index (FMI), leisure PA (LPA), home/school/workplace active commuting, TV/video time (TVT), and attitudes toward PA were measured in 531 adolescents. The beneficial effects of the intervention on the excess BMI increase (+0.01 vs +0.34 kg m−2 in the intervention and control groups, respectively) and on the overweight incidence in initially non-overweight students (4.3% vs 8.6% odds ratio=0.48 (95% confidence interval: 0.23–1.01)) were maintained at the post-trial follow-up. LPA was not maintained at the level achieved during the trial. However, we still observed a prevention of the age-related decrease of the adolescents' percentage reporting regular LPA (−14.4% vs −26.5%) and a higher intention to exercise in the intervention group. The intervention promoted lower TVT (−14.0 vs +13.6 min per day) and higher active commuting changes (+11.7% vs −4.8%). Trends in higher BMI reduction in students with high initial TVT and in the least wealthy group were noted. TVT changes throughout the follow-up predicted excess BMI and FMI changes. Conclusions: Long-term multilevel approach targeting PA and SB prevents excessive weight gain up to 30 months after intervention cessation. The efficacy may be higher in the most sedentary and least wealthy adolescents. Healthy PA-related behavior inducing long-lasting weight effects can be promoted in youth providing that an ecological approach is introduced in the prevention strategy.
Collapse
|