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Bertomeu-Gonzalez V, Sanchez-Ferrer F, Quesada JA, Nso-Roca AP, Lopez-Pineda A, Ruiz-Nodar JM. Prevalence of childhood obesity in Spain and its relation with socioeconomic status and health behaviors: Population-based cross-sectional study. Med Clin (Barc) 2024; 163:121-127. [PMID: 38714468 DOI: 10.1016/j.medcli.2024.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 05/09/2024]
Abstract
OBJECTIVES This study aims to assess the current state of childhood overweight and obesity in Spain, and its relationship with socioeconomic status and health-related behaviors. METHODS Population-based cross-sectional observational study, based on the 2017 National Health Survey in minors in Spain. This study included all children surveyed who were aged 1-14 years. Childhood obesity was estimated from the z-score of the body mass index. RESULTS The study included 4882 children aged 1-14 years (mean 7.5). The prevalence of obesity was 18.6% (95% confidence interval [CI] 18.5-18.7), while 13.5% (95% CI 13.4-13.6) were overweight. These figures represent over a million children in Spain who are obese and nearly 750,000 who are overweight. A north-south geographic gradient was apparent, with higher prevalence of unhealthy body weight in southern Spain. Factors associated with childhood obesity were low socioeconomic status, poor diet and sedentarism, among others. CONCLUSIONS Childhood overweight in Spain is strongly associated with socioeconomic status and other factors such as diet and sedentarism. Multidisciplinary public health interventions are needed to reduce this serious health problem in children.
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Affiliation(s)
- Vicente Bertomeu-Gonzalez
- GRINCAVA Research Group, Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Alicante, Spain; Cardiology Section, University Hospital of San Juan de Alicante, San Juan de Alicante, Alicante, Spain; Center for Biomedical Research Network Cardiovascular Diseases (CIBERCV), Spain
| | - Francisco Sanchez-Ferrer
- GRINCAVA Research Group, Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Alicante, Spain; Pharmacology, Pediatrics and Organic Chemistry Department, Miguel Hernandez University, San Juan de Alicante, Alicante, Spain.
| | - Jose Antonio Quesada
- GRINCAVA Research Group, Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Alicante, Spain
| | - Ana Pilar Nso-Roca
- GRINCAVA Research Group, Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Alicante, Spain
| | - Adriana Lopez-Pineda
- GRINCAVA Research Group, Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Alicante, Spain
| | - Juan Miguel Ruiz-Nodar
- GRINCAVA Research Group, Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Alicante, Spain; Center for Biomedical Research Network Cardiovascular Diseases (CIBERCV), Spain; Cardiology Service, General University Hospital of Alicante, Alicante, Spain
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Cobal S, Bender DV, Kljusurić JG, Rumora Samarin I, Krznarić Ž. Effect of School-Based Educational Intervention on Childhood Obesity in Croatian Urban and Rural Settings. CHILDREN (BASEL, SWITZERLAND) 2024; 11:867. [PMID: 39062316 PMCID: PMC11276343 DOI: 10.3390/children11070867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Childhood obesity is a global public health concern. Development of effective public health interventions represents the only viable option for decreasing the prevalence of childhood obesity. The objective of this study was to assess the effectiveness of a school-based "PETICA-Play for Health" obesity prevention program in urban and rural areas in Croatia. METHODS This before-and-after study included 28 elementary schools in Croatia focused on pupils (n = 753, 2nd grade) and their guardians (n = 753) during the school year 2022/2023. "PETICA" multicomponent lessons and workshops (10) were implemented in the school curriculum and home settings (parents) as part of the intervention. Knowledge and lifestyle habit changes were evaluated via the questionnaire on knowledge and habits regarding nutrition and physical activity pre-/post-education. The Wilcoxon test for paired samples, Student's t-test (dependent and independent samples), multiple Mann Whitney U tests (p < 0.05), Spearman's correlation, and heatmaps were used. RESULTS The analysis showed a significant increase in acquired knowledge among pupils (both settings) and habits in the rural setting (increase in sports activities participation, breakfast, and vegetables consumption (p < 0.001, p = 0.003, p = 0.004)), decrease of sweets and salty snacks intake (p = 0.027, p = 0.011), and also, the link between parents' and children's physical activity levels (p = 0.028 vs. p = 0.022), emphasizing the importance of parents as healthy lifestyle role-models. CONCLUSION The study shows that "PETICA" is an efficient school-based educational model that contributes to positive changes in children's knowledge and lifestyle habits that are a prerequisite for childhood obesity prevention.
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Affiliation(s)
- Sara Cobal
- Croatian Medical Association, Šubićeva 9, 10 000 Zagreb, Croatia;
| | - Darija Vranešić Bender
- Unit of Clinical Nutrition, Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital Centre Zagreb, Kišpatićeva 12, 10 000 Zagreb, Croatia;
| | - Jasenka Gajdoš Kljusurić
- Faculty of Food Technology and Biotechnology, University of Zagreb, Pierottijeva 6, 10000 Zagreb, Croatia; (J.G.K.); (I.R.S.)
| | - Ivana Rumora Samarin
- Faculty of Food Technology and Biotechnology, University of Zagreb, Pierottijeva 6, 10000 Zagreb, Croatia; (J.G.K.); (I.R.S.)
| | - Željko Krznarić
- Croatian Medical Association, Šubićeva 9, 10 000 Zagreb, Croatia;
- Unit of Clinical Nutrition, Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital Centre Zagreb, Kišpatićeva 12, 10 000 Zagreb, Croatia;
- School of Medicine, University of Zagreb, Šalata 2, 10000 Zagreb, Croatia
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Costa LDCF, Barboza BP, Rossi CE, Roberto DMT, Hinnig PDF, de Vasconcelos FDAG. Temporal trend of food consumption markers, breakfast consumption and association with overweight/obesity in schoolchildren aged 7 to 10 years between 2007 and 2019. NUTR BULL 2024; 49:168-179. [PMID: 38616357 DOI: 10.1111/nbu.12671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/18/2024] [Accepted: 03/19/2024] [Indexed: 04/16/2024]
Abstract
Obesity has a multifactorial origin. Among the behavioural risk factors, excessive consumption of unhealthy foods, skipping breakfast and reduced physical activity stand out. The main objective of this article was to identify trends in dietary habits and their association with overweight/obesity over a 12-year period in schoolchildren aged 7 to 10 years in Florianópolis, southern Brazil. A cross-sectional panel analysis study, using anthropometric, sociodemographic, physical activity and food consumption data of schoolchildren aged 7 to 10 years, collected in three waves of the Study of Prevalence of Obesity in Children and Adolescents (EPOCA), carried out during the years 2007, 2012/2013 and 2018/2019, was performed. To analyse the trend in dietary variables over the years, the 95% CIs were compared with the non-overlap of intervals indicating statistical significance. Multiple logistic regression analysis was performed to test the association of weight status with dietary markers. The prevalence of overweight/obesity was 34.4%, 37.2% and 34.2% in 2007, 2012/2013 and 2018/2019, respectively, and there were no statistically significant differences among waves. There was a progressive and significant reduction in the consumption of soft drinks and sweets and in eating breakfast by schoolchildren, from 2007 to 2019. Breakfast consumption was inversely associated with the chance of overweight/obesity (OR 0.74, 95% CI 0.59-0.93), and female students were less likely to have overweight/obesity when compared to boys (OR 0.70, 95% CI 0.61-0.81). The reduction in the consumption of soft drinks and sweets over the years might be caused by efforts in public policies that intended to reduce the consumption of unhealthy foods among schoolchildren. The progressive and significant reduction in having breakfast should be better elucidated in future studies, to minimise the potential impact of this practice on schoolchildren's bodyweight.
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Affiliation(s)
| | - Bernardo Paz Barboza
- Postgraduate Program in Nutrition, Universidade Federal de Santa Catarina, Florianópolis, Brazil
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Carrilero N, García-Altés A. Health inequalities in childhood diseases: temporal trends in the inter-crisis period. Int J Equity Health 2024; 23:76. [PMID: 38632575 PMCID: PMC11025183 DOI: 10.1186/s12939-024-02169-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 04/02/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Since 2008, children in Catalonia (Spain) have suffered a period of great economic deprivation. This situation has generated broad-ranging health inequalities in a variety of diseases. It is not known how these inequalities have changed over time. The aim of the present study is to determine trends in inequalities over this period in ten relevant diseases in children according to sex and age. METHODS A retrospective cross-sectional population-based study of all children under 15 years old resident in Catalonia during the 2014-2021 period (over 1.2 million children/year) and of their diagnoses registered by the Catalan Health System. Health inequalities were estimated by calculating the relative index of inequality and time trends using logistic regression models. Interaction terms were added to test for the effects of sex on time trends. RESULTS Increasing significant temporal trends in inequalities were shown for both sexes in almost all the diseases or adverse events studied (asthma, injuries, poisoning, congenital anomalies, overweight and obesity), in mood disorders in boys, and in adverse birth outcomes in girls. Adjustment and anxiety and mood disorders in girls showed a decreasing temporal trend in inequalities. More than half of the diseases and adverse events studied experienced significant annual increases in inequality. Poisoning stood out with an average annual increase of 8.65% [4.30, 13.00], p ≤ 0.001 in boys and 8.64% [5.76, 11.52], p ≤ 0.001) in girls, followed by obesity with increases of 5.52% [4.15, 6.90], p = < 0.001 in boys and 4.89% [4.26, 5.51], p ≤ 0.001) in girls. CONCLUSIONS Our results suggest that inequalities persist and have increased since 2014. Policy makers should turn their attention to how interventions to reduce Health inequalities are designed, and who benefits from them.
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Affiliation(s)
- Neus Carrilero
- Agència de Qualitat I Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, Spain.
- Department of Medicine and Life Sciences (MELIS-UPF), Pompeu Fabra University, Barcelona, Spain.
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS) , Barcelona, Spain.
- Research Group on Primary and Community Care in Barcelona (APICBA), Hospital del Mar Research Institute, Barcelona, Spain.
- Network for Research On Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain.
| | - Anna García-Altés
- Agència de Qualitat I Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain
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Moliterno P, Donhauser V, Widhalm K. Childhood Obesity Trends among 8-11-Year-Olds: Insights from a School Sample in Vienna, Austria (2017-2023). CHILDREN (BASEL, SWITZERLAND) 2024; 11:431. [PMID: 38671648 PMCID: PMC11049460 DOI: 10.3390/children11040431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 03/27/2024] [Accepted: 04/02/2024] [Indexed: 04/28/2024]
Abstract
In Austria, childhood obesity is a public health concern. This study examined time trends in the percentage of obesity among a sample of schoolchildren from Vienna (2017-2023). The body mass index percentiles of 326 children [9.3 years old (95% CI 8.3-10.5, min-max 8.0-10.9] from the EDDY study were calculated for trend analyses. Trend analysis was performed using a logistic regression using overweight and obesity as dependent binary variables, and study year and age as independent continuous variables. The percentage change over time was calculated, including the first period of the COVID-19 pandemic. Obesity percentages increased from 23.5 (95% CI 15.1-31.9)% in 2017 to 25.0 (95% CI 12.2-37.8)% in 2023. From 2017 to 2023, while overweight/obesity percentages decreased by 25.9 (-59.5-15.6)%, obesity increased by 6.4 (-51.2-94.9)%. A non-significant trend (p ≥ 0.38) was observed. During the first period of the pandemic, the percentage changes in overweight/obesity and obesity were 68.4 (5.6-187.9)% and 29.2 (-37.3-166.8)%, respectively. The current percentage of obesity in this sample is high and peaked in 2020 during the pandemic. These findings emphasize the need for future investigations considering the representativeness of the school-aged population in Austria to gain a broader picture of overweight and obesity trends.
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Affiliation(s)
- Paula Moliterno
- Austrian Academic Institute for Clinical Nutrition, 1090 Vienna, Austria; (P.M.); (V.D.)
| | - Victoria Donhauser
- Austrian Academic Institute for Clinical Nutrition, 1090 Vienna, Austria; (P.M.); (V.D.)
| | - Kurt Widhalm
- Austrian Academic Institute for Clinical Nutrition, 1090 Vienna, Austria; (P.M.); (V.D.)
- Division of Clinical Nutrition and Prevention, Department of Pediatrics, Medical University of Vienna, 1090 Vienna, Austria
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Gutiérrez-González E, Andreu-Ivorra B, Rollán-Gordo A, Tejedor-Romero L, Sánchez-Arenas F, García-Solano M. Differences in the temporal trends of childhood overweight and obesity in Spain in the 2011-2019 period by sex, age and socioeconomic level: results of the ALADINO study. An Pediatr (Barc) 2024; 100:233-240. [PMID: 38538511 DOI: 10.1016/j.anpede.2024.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/31/2024] [Indexed: 04/28/2024] Open
Abstract
INTRODUCTION Childhood excess weight is a growing public health problem. The aim of this study was to assess temporal trends in the prevalence of overweight, obesity and central obesity in schoolchildren aged 6-9 years in Spain between 2011 and 2019 based on demographic and socioeconomic characteristics. METHODOLOGY The analysis included data from the 2011, 2015 and 2019 rounds of the cross-sectional observational and descriptive ALADINO study in schoolchildren of both sexes aged 6-9 years. We conducted a descriptive analysis of the trends in the prevalence of overweight and obesity (defined according to the criteria of the World Health Organization and the International Obesity Task Force) and of central obesity, in addition to associated demographic and socioeconomic variables. RESULTS Between 2011 and 2019, the prevalence of overweight (WHO criteria) decreased in boys aged 6, 7 and 8 years (by -5.4%, -5.7% and -5.3%, respectively) and boys whose parents had a higher educational attainment (by -5.3%). In relation to the socioeconomic level, overweight in boys declined at all income levels. However, between 2011 and 2019, both the prevalence of overweight in girls and the prevalence of obesity (applying the WHO and IOTF criteria) and the prevalence of central obesity in both sexes remained stable. CONCLUSIONS The prevalence of overweight and the prevalence of obesity in schoolchildren aged 6-9 years in Spain remain high. Between 2011 and 2019, the prevalence of overweight in children aged 6-8 years and in children whose parents had university degrees decreased, whereas obesity in boys, overweight and obesity in girls and central obesity in both sexes remained stable.
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Affiliation(s)
- Enrique Gutiérrez-González
- Subdirección General de Nutrición, Agencia Española de Seguridad Alimentaria y Nutrición, Ministerio de Sanidad, Madrid, Spain
| | - Blanca Andreu-Ivorra
- Servicio de Epidemiología, Consejería de Salud de la Región de Murcia, Murcia, Spain
| | - Almudena Rollán-Gordo
- Subdirección General de Nutrición, Agencia Española de Seguridad Alimentaria y Nutrición, Ministerio de Sanidad, Madrid, Spain
| | - Laura Tejedor-Romero
- Servicio de Medicina Preventiva, Hospital Universitario de La Princesa, Madrid, Spain
| | | | - Marta García-Solano
- Subdirección General de Nutrición, Agencia Española de Seguridad Alimentaria y Nutrición, Ministerio de Sanidad, Madrid, Spain.
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Santos IKSD, Conde WL. [Quality of anthropometric data of children under 5 years in the Brazilian National Food and Nutrition Surveillance System, 2008-2020]. CAD SAUDE PUBLICA 2024; 40:e00070523. [PMID: 38324867 PMCID: PMC10841354 DOI: 10.1590/0102-311xpt070523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 09/06/2023] [Accepted: 09/18/2023] [Indexed: 02/09/2024] Open
Abstract
The planning, monitoring, and evaluation of food and nutrition actions depend on reliable estimates based on adequate anthropometric data. The study aimed to analyze the quality of anthropometric data of children aged under 5 years in the Brazilian National Food and Nutrition Surveillance System (SISVAN) from 2008 to 2020. The sample comprised 23,453,620 children aged under 5 years. Initially, we evaluated the distribution of missing values and values outside the spectrum of the instrument, and calculated the digit preference index for weight and height. The nutritional indexes height for age (HAZ), weight for age (WAZ), and body mass index for age (BAZ) were calculated according to the World Health Organization 2006 child growth standards. Then, we identified the biologically implausible values (BIV) and calculated the standard deviation (SD) of the nutritional indexes. For each municipality, we calculated the mean and SD of HAZ and WAZ; and plotted the SD values as a function of the mean. In all Federative Units, the digit preference index reached a minimum value of 80 for height and 20 for weight. For the three nutritional indexes, there was a reduction in the frequency of BIV in the 2008-2020 period. Even after the exclusion of BIV, we identified high variability for the three nutritional indexes. The indicators evaluated showed low quality of measurement, especially in the North and Northeast regions. Our results indicate insufficient quality of anthropometric data in children aged under 5 years, and reinforce the need to invest in actions to improve the collection and recording of anthropometric information.
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Affiliation(s)
- Iolanda Karla Santana Dos Santos
- Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brasil
- Fundação Universidade Federal do ABC, Santo André, Brasil
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Warkentin S, de Bont J, Abellan A, Pistillo A, Saucy A, Cirach M, Nieuwenhuijsen M, Khalid S, Basagaña X, Duarte-Salles T, Vrijheid M. Changes in air pollution exposure after residential relocation and body mass index in children and adolescents: A natural experiment study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 334:122217. [PMID: 37467916 DOI: 10.1016/j.envpol.2023.122217] [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: 04/26/2023] [Revised: 06/16/2023] [Accepted: 07/16/2023] [Indexed: 07/21/2023]
Abstract
Air pollution exposure may affect child weight gain, but observational studies provide inconsistent evidence. Residential relocation can be leveraged as a natural experiment by studying changes in health outcomes after a sudden change in exposure within an individual. We aimed to evaluate whether changes in air pollution exposure due to residential relocation are associated with changes in body mass index (BMI) in children and adolescents in a natural experiment study. This population-based study included children and adolescents, between 2 and 17 years, who moved during 2011-2018 and were registered in the primary healthcare in Catalonia, Spain (N = 46,644). Outdoor air pollutants (nitrogen dioxides (NO2), particulate matter <10 μm (PM10) and <2.5 μm (PM2.5)) were estimated at residential census tract level before and after relocation; tertile cut-offs were used to define changes in exposure. Routinely measured weight and height were used to calculate age-sex-specific BMI z-scores. A minimum of 180 days after moving was considered to observe zBMI changes according to changes in exposure using linear fixed effects regression. The majority of participants (60-67% depending on the pollutant) moved to areas with similar levels of air pollution, 15-49% to less polluted, and 14-31% to more polluted areas. Moving to areas with more air pollution was associated with zBMI increases for all air pollutants (β NO2 = 0.10(95%CI 0.09; 0.12), β PM2.5 0.06(0.04; 0.07), β PM10 0.08(0.06; 0.10)). Moving to similar air pollution areas was associated with decreases in zBMI for all pollutants. No associations were found for those moving to less polluted areas. Associations with moving to more polluted areas were stronger in preschool- and primary school-ages. Associations did not differ by area deprivation strata. This large, natural experiment study suggests that increases in outdoor air pollution may be associated with child weight gain, supporting ongoing efforts to lower air pollution levels.
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Affiliation(s)
| | - Jeroen de Bont
- Institute of Environmental Medicine, Karolinska Institutet, Sweden
| | - Alicia Abellan
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Andrea Pistillo
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Marta Cirach
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Sara Khalid
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, Oxfordshire, UK; Centre for Statistics in Medicine, University of Oxford, Oxford, Oxfordshire, UK
| | - Xavier Basagaña
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Martine Vrijheid
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Homs C, Berruezo P, Arcarons A, Wärnberg J, Osés M, González-Gross M, Gusi N, Aznar S, Marín-Cascales E, González-Valeiro MÁ, Serra-Majem L, Terrados N, Tur JA, Segú M, Fitó M, Benavente-Marín JC, Labayen I, Zapico AG, Sánchez-Gómez J, Jiménez-Zazo F, Alcaraz PE, Sevilla-Sanchez M, Herrera-Ramos E, Pulgar-Muñoz S, Bouzas C, Milà R, Schröder H, Gómez SF. Independent and Joined Association between Socioeconomic Indicators and Pediatric Obesity in Spain: The PASOS Study. Nutrients 2023; 15:nu15081987. [PMID: 37111206 PMCID: PMC10143028 DOI: 10.3390/nu15081987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/14/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
Childhood obesity is a public health problem worldwide. An important determinant of child and adolescent obesity is socioeconomic status (SES). However, the magnitude of the impact of different SES indicators on pediatric obesity on the Spanish population scale is unclear. The aim of this study was to assess the association between three SES indicators and obesity in a nationwide, representative sample of Spanish children and adolescents. A total of 2791 boys and girls aged 8 to 16 years old were included. Their weight, height, and waist circumference were measured. SES was assessed using two parent/legal guardian self-reported indicators (educational level -University/non-University- and labor market status -Employed/Unemployed-). As a third SES indicator, the annual mean income per person was obtained from the census section where the participating schools were located (≥12.731€/<12.731€). The prevalence of obesity, severe obesity, and abdominal obesity was 11.5%, 1.4%, and 22.3%, respectively. Logistic regression models showed an inverse association of both education and labor market status with obesity, severe obesity, and abdominal obesity (all p < 0.001). Income was also inversely associated with obesity (p < 0.01) and abdominal obesity (p < 0.001). Finally, the highest composite SES category (University/Employed/≥12.731€ n = 517) showed a robust and inverse association with obesity (OR = 0.28; 95% CI: 0.16-0.48), severe obesity (OR = 0.20; 95% CI: 0.05-0.81), and abdominal obesity (OR = 0.36; 95% CI: 0.23-0.54) in comparison with the lowest composite SES category (Less than University/Unemployed/<12.731€; n = 164). No significant interaction between composite SES categories and age and gender was found. SES is strongly associated with pediatric obesity in Spain.
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Affiliation(s)
- Clara Homs
- Gasol Foundation Europe, 08830 Sant Boi de Llobregat, Spain
- Global Research on Wellbeing (GroW), Faculty of Health Sciences, Blanquerna Ramon Llull University, 08025 Barcelona, Spain
| | - Paula Berruezo
- Gasol Foundation Europe, 08830 Sant Boi de Llobregat, Spain
| | - Albert Arcarons
- Office of the High Commissioner against Child Poverty, 28079 Madrid, Spain
- Department of Sociology, National Distance Education University (UNED), 28012 Madrid, Spain
| | - Julia Wärnberg
- Physiopathology of Obesity and Nutrition Networking Biomedial Research Center (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
- EpiPHAAN Research Group, School of Health Sciences, Instituto de Investigación Biomédica en Málaga (IBIMA), University of Málaga, 29590 Málaga, Spain
| | - Maddi Osés
- IS-FOOD-Institute for Sustainability & Food Chain Innovation, Universidad Pública de Navarra (UPNA), IDISNA, 31006 Pamplona, Spain
| | - Marcela González-Gross
- Physiopathology of Obesity and Nutrition Networking Biomedial Research Center (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politecnica de Madrid, 28003 Madrid, Spain
| | - Narcis Gusi
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Susana Aznar
- PAFS Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha-Toledo Campus, 45071 Toledo, Spain
- Biomedical Research Networking Center on Frailty and Healthy Aging (CIBERFES), 28029 Madrid, Spain
| | - Elena Marín-Cascales
- UCAM Research Center for High Performance Sport, UCAM Universidad Católica de Murcia, 30107 Murcia, Spain
- Facultad de Deporte, UCAM Universidad Católica de Murcia, 30107 Murcia, Spain
- Strength & Conditioning Society, 30008 Murcia, Spain
| | | | - Lluis Serra-Majem
- Physiopathology of Obesity and Nutrition Networking Biomedial Research Center (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
- Preventive Medicine Service, Canarian Health Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), 35016 Las Palmas de Gran Canaria, Spain
| | - Nicolás Terrados
- Regional Unit of Sports Medicine-Municipal Sports Foundation of Avilés, 33402 Avilés, Spain
| | - Josep A Tur
- Physiopathology of Obesity and Nutrition Networking Biomedial Research Center (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
- Research Group of Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS & Health Research Institute of the Balearic Islands (IDISBA), 07122 Palma de Mallorca, Spain
| | - Marta Segú
- Barça Foundation, 08028 Barcelona, Spain
| | - Montserrat Fitó
- Physiopathology of Obesity and Nutrition Networking Biomedial Research Center (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - Juan Carlos Benavente-Marín
- Physiopathology of Obesity and Nutrition Networking Biomedial Research Center (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
- EpiPHAAN Research Group, School of Health Sciences, Instituto de Investigación Biomédica en Málaga (IBIMA), University of Málaga, 29590 Málaga, Spain
| | - Idoia Labayen
- Physiopathology of Obesity and Nutrition Networking Biomedial Research Center (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
- IS-FOOD-Institute for Sustainability & Food Chain Innovation, Universidad Pública de Navarra (UPNA), IDISNA, 31006 Pamplona, Spain
| | - Augusto G Zapico
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politecnica de Madrid, 28003 Madrid, Spain
- Department of Language, Arts and Physical Education, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Jesús Sánchez-Gómez
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Fabio Jiménez-Zazo
- PAFS Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha-Toledo Campus, 45071 Toledo, Spain
| | - Pedro E Alcaraz
- UCAM Research Center for High Performance Sport, UCAM Universidad Católica de Murcia, 30107 Murcia, Spain
- Facultad de Deporte, UCAM Universidad Católica de Murcia, 30107 Murcia, Spain
- Strength & Conditioning Society, 30008 Murcia, Spain
| | - Marta Sevilla-Sanchez
- Faculty of Sports Sciences and Physical Education, Universida de da Coruña, 15001 A Coruña, Spain
| | - Estefanía Herrera-Ramos
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
| | - Susana Pulgar-Muñoz
- Health Research Institute of the Principality of Asturias (ISPA), 33011 Oviedo, Spain
| | - Cristina Bouzas
- Physiopathology of Obesity and Nutrition Networking Biomedial Research Center (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
- Research Group of Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS & Health Research Institute of the Balearic Islands (IDISBA), 07122 Palma de Mallorca, Spain
| | - Raimon Milà
- Global Research on Wellbeing (GroW), Faculty of Health Sciences, Blanquerna Ramon Llull University, 08025 Barcelona, Spain
| | - Helmut Schröder
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, 28029 Madrid, Spain
| | - Santiago F Gómez
- Gasol Foundation Europe, 08830 Sant Boi de Llobregat, Spain
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, 28029 Madrid, Spain
- Nursing and Physiotherapy Department, University of Lleida, 25198 Lleida, Spain
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10
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Daniels L, Haszard JJ, Taylor RW, Taylor BJ. Prevalence of low and high BMI during the first 3 years of life: using New Zealand national electronic health data. Pediatr Obes 2023; 18:e13013. [PMID: 36811268 DOI: 10.1111/ijpo.13013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 12/14/2022] [Accepted: 01/30/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Data on body mass index (BMI) in infants and toddlers worldwide are lacking, relative to older age groups. OBJECTIVES To describe the growth (weight, length/height, head circumference, and BMI z-score) of New Zealand children under the age of 3 years, and examine differences by sociodemographic characteristics (sex, ethnicity, and deprivation). METHODS Electronic health data were collected by Whānau Āwhina Plunket, who provide free 'Well Child' services for approximately 85% of newborn babies in New Zealand. Data from children under the age of 3, who had their weight and length/height measured between 2017 and 2019, were included. The prevalence of BMI (WHO child growth standards) ≤2nd, ≥85th, and ≥95th percentiles were determined. RESULTS Between 12 weeks and 27 months of age, the percentage of infants ≥85th BMI percentile increased from 10.8% (95% CI, 10.4%-11.2%) to 35.0% (34.2%-35.9%). The percentage of infants with high BMI (≥95th percentile) also increased, particularly between 6 months (6.4%; 95% CI, 6.0%-6.7%) and 27 months (16.4%; 15.8%-17.1%). By contrast, the percentage of infants with low BMI (≤2nd percentile) appeared steady between 6 weeks and 6 months, and declined at older ages. The prevalence of infants with a high BMI appears to increase substantially from 6 months across sociodemographic characteristics, with a widening prevalence gap by ethnicity occurring from 6 months, mirroring that of infants with a low BMI. CONCLUSIONS The number of children with high BMI increases rapidly between 6 months and 27 months of age, suggesting this is an important timeframe for monitoring and preventive action. Future work should investigate the longitudinal growth trajectories of these children to determine if any particular patterns predict later obesity and what strategies could effectively change them.
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Affiliation(s)
- Lisa Daniels
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.,Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Jillian J Haszard
- Biostatistics Centre, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Rachael W Taylor
- Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Barry J Taylor
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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Wang S, Liu B, Liu J. EFFECTS OF SCHOOL SOCCER TRAINING ON THE HEALTH AND FITNESS OF OBESE CHILDREN. REV BRAS MED ESPORTE 2023. [DOI: 10.1590/1517-8692202329012022_0794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
ABSTRACT Introduction Based on the representative data reflecting the level of physical development and athletic quality, such as the “National Physical Health Test for Students”, it is shown that the physical health status of adolescents and children in China is decreasing annually, and the trend of obesity is gradually increasing. Objective Analyze and study the effect of training on the physical fitness of obese children aged 12 to 14 through school soccer training. Methods The effect of school soccer training on the health and physical fitness of obese children aged 12-14 years was studied, and conclusions were drawn by the literature method, experimental method, mathematical statistical method, and logical analysis method. Forty-eight screened obese children were randomly assigned to the experimental and control groups, 24 in each group. The experimental group underwent 12 weeks of soccer training, and the control group underwent 12 weeks of no training control. The subjects’ body composition and flexibility quality indices were measured post-intervention. Results The visceral fat index, body fat rate, and muscle rate of boys and girls progressed expressively, with a significant difference (P <0.05). Muscle weight is also known as lean body weight, with an expressive increase in muscle tone. In comparison, the increase in fat weight and muscle ratio in boys was expressively higher than in girls. Conclusion Regular long-term school soccer training can increase mobility in obese children, increase physical flexibility, and help promote physical health and prevent injury. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
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Affiliation(s)
| | - Baiqing Liu
- Zhongnan University of Economics and Law, China
| | - Jingle Liu
- Zhongnan University of Economics and Law, China
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12
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Zhang Y, Lou H, Huang Y, Wang R, Wen X, Wu C, Hao C, Li R, Gao G, Lou X, Wang X. Trends of overweight and obesity prevalence in school-aged children among Henan Province from 2000 to 2019. Front Public Health 2022; 10:1046026. [PMID: 36544796 PMCID: PMC9760942 DOI: 10.3389/fpubh.2022.1046026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
Objectives Overweight and obesity are harmful to human health. However, the latest trends of Chinese childhood overweight and obesity prevalence are not available. The aim of this study was to examine the trends from 2000 to 2019 among students in China. Methods We analyzed data of 66,072 students in the Chinese National Survey on Students' Constitution and Health from 2000 to 2019. Overweight and obesity were defined based on the standard formulated by the International Obesity Task Force (IOTF standard), the World Health Organization (WHO standard), and the Working Group on Obesity in China (WGOC standard), respectively. The χ2-test was used to test the trends of overweight and obesity prevalence and logistic regression was conducted to evaluate the prevalence odds ratios of boys vs. girls and urban vs. rural areas. Results The prevalence of obesity/overweight and obesity combined was 6.03/23.58% (IOTF standard), 10.56/25.88% (WGOC standard) and 10.75/29.69% (WHO standard) in 2019. From 2000 to 2019, according to the WGOC standard, the prevalence increased from 2.51 to 10.56% for obesity and increased from 9.81 to 25.88% for overweight and obesity combined (P for trend < 0.001). Obesity/overweight and obesity were greater problems in boys than girls and urban than rural areas, but urban-rural differences decreased over time. Conclusion Overweight and obesity prevalence increased significantly in children and adolescents in China from 2000 to 2019. The prevalence of overweight and obesity in rural areas may contribute to a large percentage of children with overweight and obesity.
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Affiliation(s)
- Yuhao Zhang
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Hao Lou
- Department of Nosocomial Infection Management, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Ye Huang
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Ruijuan Wang
- Zhengzhou Hospital of Traditional Chinese Medicine, Zhengzhou, Henan, China
| | - Xiao Wen
- Zhengzhou Hospital of Traditional Chinese Medicine, Zhengzhou, Henan, China
| | - Cuiping Wu
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Changfu Hao
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Ran Li
- Zhengzhou Station for Students' Health, Zhengzhou, Henan, China
| | - Genli Gao
- The Education Department of Henan Province, Zhengzhou, Henan, China
| | - Xiaomin Lou
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Xian Wang
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China,*Correspondence: Xian Wang
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Sánchez-Valdivia N, Pérez-del-Pulgar C, de Bont J, Anguelovski I, López-Gay A, Pistillo A, Triguero-Mas M, Duarte-Salles T. Residential Proximity to Urban Play Spaces and Childhood Overweight and Obesity in Barcelona, Spain: A Population-Based Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13676. [PMID: 36294256 PMCID: PMC9603004 DOI: 10.3390/ijerph192013676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
Findings on the relationship between play spaces and childhood overweight and obesity are mixed and scarce. This study aimed to investigate the associations between residential proximity to play spaces and the risk of childhood overweight or obesity and potential effect modifiers. This longitudinal study included children living in the city of Barcelona identified in an electronic primary healthcare record database between 2011 and 2018 (N = 75,608). Overweight and obesity were defined according to the WHO standards and we used 300 m network buffers to assess residential proximity to play spaces. We calculated the risk of developing overweight or obesity using Cox proportional hazard models. A share of 29.4% of the study population developed overweight or obesity, but we did not find consistent associations between play space indicators and overweight or obesity. We did not find any consistent sign of effect modification by sex, and only some indications of the modifying role of area socioeconomic status and level of exposure. Although it is not possible to draw clear conclusions from our study, we call for cities to continue increasing and improving urban play spaces with an equitable, healthy, and child-friendly perspective.
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Affiliation(s)
- Nacho Sánchez-Valdivia
- Barcelona Lab for Urban Environmental Justice and Sustainability, Institute of Environmental Science and Technology (ICTA), Universitat Autònoma de Barcelona (UAB), 08003 Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Carrer Doctor Aiguader, 88, 08003 Barcelona, Spain
| | - Carmen Pérez-del-Pulgar
- Barcelona Lab for Urban Environmental Justice and Sustainability, Institute of Environmental Science and Technology (ICTA), Universitat Autònoma de Barcelona (UAB), 08003 Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Carrer Doctor Aiguader, 88, 08003 Barcelona, Spain
- Helmholtz Centre for Environmental Research—UFZ Department Environmental Politics, 04318 Leipzig, Germany
- Department for Political Science, Friedrich-Schiller-University, 07737 Jena, Germany
| | - Jeroen de Bont
- Institute of Environmental Medicine, Karolinska Institute, 171 77 Stockholm, Sweden
| | - Isabelle Anguelovski
- Barcelona Lab for Urban Environmental Justice and Sustainability, Institute of Environmental Science and Technology (ICTA), Universitat Autònoma de Barcelona (UAB), 08003 Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Carrer Doctor Aiguader, 88, 08003 Barcelona, Spain
- ICREA (Institució Catalana de Recerca i Estudis Avançats), 08010 Barcelona, Spain
| | - Antonio López-Gay
- Department of Geography, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
- Center for Demographic Studies, 08193 Bellaterra, Spain
| | - Andrea Pistillo
- Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
| | - Margarita Triguero-Mas
- Barcelona Lab for Urban Environmental Justice and Sustainability, Institute of Environmental Science and Technology (ICTA), Universitat Autònoma de Barcelona (UAB), 08003 Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Carrer Doctor Aiguader, 88, 08003 Barcelona, Spain
- Mariana Arcaya’s Research Lab, Department of Urban Studies and Planning, Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02139, USA
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
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Mahmoodi Z, Gill P, Qorbani M, Mohammadian Khonsari N, Sheidaei A, Heshmat R, Heidari-Beni M, Kelishadi R. Socioeconomic inequality in different phenotypes of childhood obesity and its determinants in Iran: a Blinder-Oaxaca decomposition method. BMC Public Health 2022; 22:1580. [PMID: 35986309 PMCID: PMC9392315 DOI: 10.1186/s12889-022-13997-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 08/11/2022] [Indexed: 11/25/2022] Open
Abstract
Background Childhood obesity has become a significant public health issue worldwide. Socioeconomic status is among its key determinants. This study examined the socioeconomic inequality in different phenotypes of childhood obesity at the national level in Iran. Methods This national, multistage school cross-sectional study was undertaken in 2015 on 14,400 students aged 7–18 years from urban and rural areas of 30 provinces of Iran. Using principal component analysis, socioeconomic status (SES) was categorized into tertiles. SES inequality in different phenotypes of obesity (i.e., generalized obesity", "abdominal obesity", and combined obesity) was estimated using the concentration index. The determinants of this inequality were assessed by the Blinder-Oaxaca decomposition method. Results Overall, 14,274 students completed the study (response rate: 99%). The mean age was 12.28 years, 50.6% were boys, and 71.42% lived in urban areas. The prevalence of generalized obesity and abdominal obesity was 20.8% and 11.3%, respectively. The concentration index for different phenotypes of obesity was positive, indicating that inequality is more common amongst the low SES groups. High SES, being male, living in a rural, and having a positive family history of obesity were associated with general obesity. Moderate physical activity and living in a rural area were associated with abdominal obesity. In addition, living in a rural area, having a high SES, being male, and having a positive family history of obesity were associated with combined obesity. Conclusion According to the present study findings, all childhood obesity phenotypes were more prevalent in Iranian children with high SES. Therefore, due to obesity and other diseases, it is essential to implement environmental changes in addition to designing macro-educational programs and prevention strategies.
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Le GB, Dinh DX. Prevalence and associated factors of overweight and obesity among primary school children: a cross-sectional study in Thanhhoa City, Vietnam. BMJ Open 2022; 12:e058504. [PMID: 35459674 PMCID: PMC9036463 DOI: 10.1136/bmjopen-2021-058504] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To determine the prevalence and associated factors of overweight and obesity among primary school children (6-11 years old) in Thanhhoa city in 2021. DESIGN Cross-sectional study. SETTING Seven primary schools in Thanhhoa city, Vietnam. PARTICIPANTS 782 children (and their parents). PRIMARY AND SECONDARY OUTCOME MEASURES Two-stage cluster random sampling was used for selecting children and data were collected from January to February 2021. A self-administrated questionnaire was designed for children and their parents. Children's height and weight were measured and body mass index (BMI)-for-age z-scores were computed using the WHO Anthro software V.1.0.4. Data were analysed using R software V.4.1.2. The associations between potential factors and childhood overweight/obesity were analysed through univariate and multivariate logistic regression analyses. Variables were selected using the Bayesian Model Averaging method. RESULTS The prevalence of overweight/obesity among primary school children in Thanhhoa city was 35.93% (overweight 21.61% and obesity 14.32%). The proportion of overweight girls was nearly equal to that of boys (20.78% and 22.52%, respectively, p=0.6152) while the proportion of boys with obesity was four times as many as that of girls (23.86% and 5.62%, respectively, p<0.0001). Child's sex was the factor significantly associated with childhood overweight/obesity. Boys had double the risk of being overweight/obese than girls (adjusted OR: aOR=2.48, p<0.0001). Other potential factors which may be associated with childhood overweight/obesity included mode of transport to school, the people living with the child, mother's occupation, father's education, eating confectionery, the total time of doing sports, and sedentary activities. CONCLUSION One in every three primary school children in Thanhhoa city were either overweight or obese. Parents, teachers and policy-makers can implement interventions in the aforementioned factors to reduce the rate of childhood obesity. In forthcoming years, longitudinal studies should be conducted to determine the causal relationships between potential factors and childhood overweight/obesity.
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Affiliation(s)
- Giang Ba Le
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
| | - Dai Xuan Dinh
- Department of Pharmaceutical Management and Pharmacoeconomics, Hanoi University of Pharmacy, Hanoi, Viet Nam
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Dietary Intake of Individual (Intrinsic and Added) Sugars and Food Sources from Spanish Children Aged One to <10 Years—Results from the EsNuPI Study. Nutrients 2022; 14:nu14081667. [PMID: 35458229 PMCID: PMC9024444 DOI: 10.3390/nu14081667] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 02/01/2023] Open
Abstract
Currently, in Spain there are no studies assessing the intakes and sources of intrinsic and added sugars by both children consuming standard milks and children regularly consuming adapted milk formulas. Our goal was to evaluate current sugar intake levels (intrinsic and added) and their major dietary sources within the EsNuPI study participants by applying two 24-h dietary recalls that were completed by 1448 children (1 to <10 years) divided into two subsamples: One “Spanish Reference Sample” (SRS) of the general population (n = 707) and another sample which included children consuming adapted milks including follow-on milk, toddler’s or growing up milk and fortified and enriched milks, here called “Adapted Milk Consumers Sample” (AMS) (n = 741). Estimates of intrinsic and added sugar intakes from the Spanish EsNuPI population as well as the adherence to recommendations varied notably according to age segment, but no major differences between subsamples were found. Younger children (1 to <3 years) showed the highest added sugar contribution to total energy intake (TEI) (SRS: 12.5% for boys and 11.7% for girls; AMS: 12.2% for boys and 11.3% for girls) and the lowest adherence to recommendations set at <10% TEI (SRS: 27.4% for boys and 37.2% for girls; AMS: 31.3% for boys and 34.7% for girls). Adherence increased with age but remains inadequate, with approximately one in two children from the older age segment (6 to <10 years) exceeding the recommendations. Main food sources of intrinsic sugars for both subsamples were milk and dairy products, fruits, vegetables and cereals, while for added sugars, these were milk and dairy products (mainly yogurts), sugars and sweets (mainly sugary cocoa and nougat), bakery products (mainly cookies) and cereals (mainly bread and wheat flour). However, for the AMS, the groups milk and dairy products and cereals showed a significantly lower contribution to intrinsic sugar intake but a significantly higher contribution to that of added sugars. These results demonstrate that sugar intake and the adherence to recommendations in the studied population varied notably according to age but not to the type of milk consumed. In addition, our results highlight the need to monitor the consumption of added sugars by the infant population, as well as the need to make efforts to facilitate this task, such as harmonizing the recommendations regarding free/added sugars and the inclusion of information on their content on the nutritional labeling of products in order to incorporate them into food composition databases.
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Ortiz-Marrón H, Ortiz-Pinto MA, Cabañas Pujadas G, Martínez Mosquera JG, Lorente Miñarro M, Menchero Pinos F, Ordobás Gavín M, Galán I. Tracking and risk of abdominal and general obesity in children between 4 and 9 years of age. The Longitudinal Childhood Obesity Study (ELOIN). BMC Pediatr 2022; 22:198. [PMID: 35413845 PMCID: PMC9004048 DOI: 10.1186/s12887-022-03266-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/04/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Studies have shown that overweight and obesity conditions tend to be stable from childhood and adolescence to adulthood. Unfortunately, little is known about the evolution of abdominal obesity during childhood. The aim of this study was to evaluate the temporal variations and risk of general and abdominal obesity between 4, 6, and 9 years of age. METHODS Measurements of children in the ELOIN study taken at the three follow-ups of 4, 6, and 9 years of age were included (N = 1,902). Body mass index and waist circumference were recorded via physical examination. General obesity was determined according to the criteria of the World Health Organization (WHO) and abdominal obesity according to the cut-off points proposed by the International Diabetes Federation (IDF). Prevalence ratios (PRs) were estimated by sex and family affluence using generalized estimating equation models and relative risks (RRs) of obesity were obtained via Poisson regression. RESULTS The prevalence of general obesity was 5.1%, 9.1%, and 15.6% at 4, 6, and 9 years, respectively, yielding a PR of 3.05 (95%CI: 2.55-3.60) (9 years old relative to 4 years). The prevalence of abdominal obesity was 6.8%, 8.4%, 14.5% at 4, 6, and 9 years, respectively, and the PR was 2.14 (95%CI: 1.82-2.51) (9 years old relative to 4 years). An inverse correlation was observed between both general and abdominal obesity and socioeconomic status. Among participants with general or abdominal obesity at 4 years of age, 77.3% and 63.6% remained in their obesity classification at 9 years, respectively, and 3.4% and 3.5% presented general or abdominal obesity also at 6 and 9 years of age, respectively. The RRs of general and abdominal obesity at 9 years were 4.61 (95%CI: 2.76-7.72) and 4.14 (95%CI: 2.65-6.48) for children classified with obesity at 4 years of age, increased to 9.36 (95%CI: 7.72-11.35) and 9.56 (95%CI: 7.79-11.74) for children who had obesity at 6 years, and up to 10.27 (95%CI: 8.52-12.37) and 9.88 (95%CI: 8.07-12.11) for children with obesity at both 4 and 6 years, respectively. CONCLUSIONS General and abdominal obesity begin at an early age and increase over time, showing an inverse correlation with socioeconomic status. In addition, general and abdominal obesity at 9 years are strongly associated with being classified with obesity at 4 and 6 years, so preventive interventions should be established at very early ages.
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Affiliation(s)
- Honorato Ortiz-Marrón
- Epidemiology Service, Directorate-General of Public Health, Ministry of Health, Community of Madrid, Madrid, Spain.
| | - Maira Alejandra Ortiz-Pinto
- Epidemiology Service, Directorate-General of Public Health, Ministry of Health, Community of Madrid, Madrid, Spain
| | - Gloria Cabañas Pujadas
- Epidemiology Service, Directorate-General of Public Health, Ministry of Health, Community of Madrid, Madrid, Spain
| | | | | | | | - María Ordobás Gavín
- Epidemiology Service, Directorate-General of Public Health, Ministry of Health, Community of Madrid, Madrid, Spain
| | - Iñaki Galán
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,Department of Preventive Medicine and Public Health, Faculty of Medicine, Autonomous University of Madrid (IdiPaz), Madrid, Spain
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de Bont J, Bennett M, León-Muñoz LM, Duarte-Salles T. Prevalencia e incidencia de sobrepeso y obesidad en 2,5 millones de niños y adolescentes en España. Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2021.06.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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López-Gil JF. The Eating Healthy and Daily Life Activities (EHDLA) Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:370. [PMID: 35327742 PMCID: PMC8947596 DOI: 10.3390/children9030370] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/18/2021] [Accepted: 03/03/2022] [Indexed: 12/21/2022]
Abstract
BACKGROUND Childhood obesity is one of the greatest public health concerns facing advanced societies, Spain being one of the countries with the highest incidence. In this sense, the Region of Murcia has been pointed out as the Spanish autonomous community with the highest prevalence of excess weight among young people. More specifically, the Valle de Ricote has shown an even greater proportion of excess weight among young people. Several sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors are related to excess weight. Based on the lack of information, this research project will try to provide relevant information to design intervention programs, as well as to implement effective public policies to try and reverse this alarming situation. Therefore, this research project aims (1) to obtain cross-sectional and longitudinal data on the excess weight and their potential sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors associated among adolescents from the Valle de Ricote (Region of Murcia, Spain) (aged 12-17 years), and (2) to examine the association between excess weight and their potential sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors associated among this population. METHODS A cross-sectional study and follow-up study will be performed. This research project will involve adolescents using a simple random sampling technique. A total of three secondary schools from the Valle de Ricote (Region of Murcia, Spain) will be included in this project. The minimum sample size will be 1138, establishing a 95% confidence interval, a 40% prevalence of excess weight, a 3% margin of error, and a non-response rate of 10%. Primary outcome measures will be: (1) anthropometric measurements, (2) sociodemographic factors, (3) environmental factors, (4) lifestyle factors, (5) health-related factors, (6) cognitive factors, and (7) psychological factors. CONCLUSION This research project will aim to determine the prevalence of excess weight and interrelate their potential sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors associated. The obtained results will help to manage and propose possible multidisciplinary interventions and strategies in order to prevent and reduce the excess weight in adolescents from the Valle de Ricote. Furthermore, orientations will be given to transfer the obtained results to the public sector to evaluate or change the adopted policies.
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Affiliation(s)
- José Francisco López-Gil
- Departamento de Expresión Plástica, Musical y Dinámica, Facultad de Educación, Universidad de Murcia (UM), 30100 Murcia, Spain;
- Health and Social Research Center, Universidad de Castilla-La Mancha (UCLM), 16071 Cuenca, Spain
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20
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Further reductions in the prevalence of obesity in 4-year-old New Zealand children from 2017 to 2019. Int J Obes (Lond) 2022; 46:1176-1187. [PMID: 35217835 PMCID: PMC9151386 DOI: 10.1038/s41366-022-01095-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/31/2022] [Accepted: 02/04/2022] [Indexed: 11/23/2022]
Abstract
Objective To examine whether the prevalence of age- and sex-adjusted BMI at, or above, the 85th, 95th and 99.7th percentiles continues to decline in New Zealand preschool children, over time. Methods As part of a national screening programme, 438,972 New Zealand 4-year-old children had their height and weight measured between 2011 and 2019. Age- and sex-adjusted BMI was calculated using WHO Growth Standards and the prevalence of children at, or above, the 85th, 95th, and 99.7th percentiles and at, or below, the 2nd percentile were determined. Log-binomial models were used to estimate linear time trends of ≥85th, ≥95th and ≥99.7th percentiles for the overall sample and separately by sex, deprivation, ethnicity and urban-rural classification. Results The percentage of children at, or above, the 85th, 95th and 99.7th percentile reduced by 4.9% [95% CI: 4.1%, 5.7%], 3.5% [95% CI: 2.9%, 4.1%], and 0.9% [95% CI: 0.7%, 1.2%], respectively, between ‘2011/12’ and ‘2018/19’. There was evidence of a decreasing linear trend (risk reduction, per year) for the percentage of children ≥85th (risk ratio (RR): 0.980 [95% CI: 0.978, 0.982]), ≥95th (RR: 0.966 [95% CI: 0.962, 0.969]) and ≥99.7th (RR: 0.957 [95% CI: 0.950, 0.964]) percentiles. Downward trends were also evident across all socioeconomic indicators (sex, ethnicity, deprivation, and urban-rural classification), for each of the BMI thresholds. Larger absolute decreases were evident for children residing in the most deprived compared with the least deprived areas, at each BMI threshold. There appeared to be no consistent trend for the percentage of children ≤2nd percentile. Conclusions Reassuringly, continued declines of children with age- and sex-adjusted BMI at, or above, the 85th, 95th and 99.7th percentiles are occurring over time, overall and across all sociodemographic indicators, with little evidence for consistent trends in the prevalence of children at, or below, the 2nd percentile.
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21
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A reversal in the obesity epidemic? A quasi-cohort and gender-oriented analysis in Spain. DEMOGRAPHIC RESEARCH 2022. [DOI: 10.4054/demres.2022.46.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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22
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Overweight and obesity in the Mexican school-age population from 2015 to 2019. NUTR HOSP 2022; 39:1076-1085. [DOI: 10.20960/nh.04028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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23
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Zou XL, Wang S, Wang LY, Xiao LX, Yao TX, Zeng Y, Zhang L. Childhood Obesity and Risk of Stroke: A Mendelian Randomisation Analysis. Front Genet 2021; 12:727475. [PMID: 34868204 PMCID: PMC8638161 DOI: 10.3389/fgene.2021.727475] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/05/2021] [Indexed: 12/03/2022] Open
Abstract
Background: The causal relationship between childhood obesity and stroke remains unclear. Our objective was to elucidate the causal relationship between childhood obesity and the risk of stroke and its subtypes by performing Mendelian randomisation (MR) analyses. Methods: Genetic instruments for childhood obesity were obtained from a genome-wide association study (GWAS) of 13,848 European participants. Summary level data for stroke, intracerebral haemorrhage, ischaemic stroke (IS), and its subtypes were evaluated using the MEGASTROKE GWAS dataset, which included 446,696 European adults. Inverse-variance weighting, weighted-median analysis, MR-Egger regression, MR Pleiotropy RESidual Sum and Outlier test (MR-PRESSO), and MR-Robust Adjusted Profile Score were applied in this MR analysis. The leave-one-out sensitivity test, MR-PRESSO Global test, and Cochran’s Q test were conducted to confirm the accuracy and robustness of our results. Results: Genetic evaluations revealed that childhood obesity was associated with a higher risk of stroke (OR = 1.04, 95%CI: 1.01–1.07, p = 0.005) and IS (OR = 1.05, 95%CI: 1.02–1.08, p = 0.003), but not with intracerebral haemorrhage (ICH, OR = 0.93, 95%CI: 0.80–1.09, p = 0.39). In the subtype analysis, childhood obesity was also associated with large artery stroke (LAS, OR = 1.12, 95%CI: 1.02–1.22, p = 0.016) but not with cardioembolic stroke (OR = 1.06, 95%CI: 0.96–1.18, p = 0.21) and small vessel stroke (OR = 1.06, 95%CI: 0.98–1.15, p = 0.17). These results were stable in the sensitivity analysis and remained significant after Bonferroni correction. Conclusion: Our study provides evidence that childhood obesity is associated with a higher risk of stroke, IS, and LAS. The prevention of stroke, especially IS and LAS, should be promoted in populations with childhood obesity.
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Affiliation(s)
- Xue-Lun Zou
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Sai Wang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Lei-Yun Wang
- Department of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics, Xiangya Hospital, Institute of Clinical Pharmacology, Central South University, Changsha, China
| | - Lin-Xiao Xiao
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Tian-Xing Yao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Yi Zeng
- Department of Geriatrics, Second Xiangya Hospital, Central South University, Changsha, China
| | - Le Zhang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
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Bygdell M, Célind J, Lilja L, Martikainen J, Simonson L, Sjögren L, Ohlsson C, Kindblom JM. Prevalence of overweight and obesity from 5 to 19 years of age in Gothenburg, Sweden. Acta Paediatr 2021; 110:3349-3355. [PMID: 34464992 DOI: 10.1111/apa.16089] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/22/2021] [Accepted: 08/30/2021] [Indexed: 12/16/2022]
Abstract
AIM The aim of this study was to present prevalence data for overweight and obesity across school age in a large, recent, population-based cohort of children in Gothenburg, Sweden. METHODS We included 66,807 children (48.5% girls) aged 5-18.9 years who had their height and weight measured in school health care 2015-2018. The BMI values were categorised according to the age-dependent cut-offs for overweight and obesity from the International Obesity Task Force (IOTF). RESULTS Overall, the prevalence of overweight and obesity for girls and boys was 18.1% and 18.0%, respectively. We observed increasing proportions of overweight (girls 11.5-17.1% and boys 8.4-17.4%) and obesity (girls 3.0-4.2% and boys 2.7-6.1%) with increasing age (p < 0.001 for trend in both sexes). Moreover, girls had higher prevalence of overweight during ages 5.0 to 8.9 years compared with boys (p < 0.001), while boys had higher prevalence of obesity 15.0-18.9 years compared with girls (p < 0.001). CONCLUSION In conclusion, we demonstrate increasing prevalence of overweight and obesity across the entire school age range, as well as differences in prevalences between boys and girls, in a population-based sample of 67,000 children in Gothenburg city, Sweden. Continuous monitoring of schoolchildren, together with effective preventive measures, is crucial to curb the obesity epidemic and its consequences.
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Affiliation(s)
- Maria Bygdell
- Centre for Bone and Arthritis Research Department of Internal Medicine and Clinical Nutrition Institute of Medicine The Sahlgrenska AcademyUniversity of Gothenburg Gothenburg Sweden
| | - Jimmy Célind
- Centre for Bone and Arthritis Research Department of Internal Medicine and Clinical Nutrition Institute of Medicine The Sahlgrenska AcademyUniversity of Gothenburg Gothenburg Sweden
- Department of Pediatrics Institute of Clinical Sciences The Sahlgrenska AcademyUniversity of Gothenburg Gothenburg Sweden
| | - Lina Lilja
- Centre for Bone and Arthritis Research Department of Internal Medicine and Clinical Nutrition Institute of Medicine The Sahlgrenska AcademyUniversity of Gothenburg Gothenburg Sweden
- Region Västra Götaland Research and Development Primary Health Care and Kungshöjd Pediatric Clinic Gothenburg Sweden
| | - Jari Martikainen
- Bioinformatics Core Facility The Sahlgrenska AcademyUniversity of Gothenburg Gothenburg Sweden
| | - Lena Simonson
- School Health Services The City of Gothenburg Sweden
| | - Lovisa Sjögren
- Centre for Bone and Arthritis Research Department of Internal Medicine and Clinical Nutrition Institute of Medicine The Sahlgrenska AcademyUniversity of Gothenburg Gothenburg Sweden
- Department of Pediatrics Institute of Clinical Sciences The Sahlgrenska AcademyUniversity of Gothenburg Gothenburg Sweden
- Hallands Hospital Halmstad Department of Pediatrics Halmstad Sweden
| | - Claes Ohlsson
- Centre for Bone and Arthritis Research Department of Internal Medicine and Clinical Nutrition Institute of Medicine The Sahlgrenska AcademyUniversity of Gothenburg Gothenburg Sweden
- Region Västra Götaland Department of Drug Treatment Sahlgrenska University Hospital Gothenburg Sweden
| | - Jenny M. Kindblom
- Centre for Bone and Arthritis Research Department of Internal Medicine and Clinical Nutrition Institute of Medicine The Sahlgrenska AcademyUniversity of Gothenburg Gothenburg Sweden
- Region Västra Götaland Pediatric Clinical Research Center Sahlgrenska University Hospital Gothenburg Sweden
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Papadopoulou E, Stratakis N, Basagaña X, Brantsæter AL, Casas M, Fossati S, Gražulevičienė R, Småstuen Haug L, Heude B, Maitre L, McEachan RRC, Robinson O, Roumeliotaki T, Sabidó E, Borràs E, Urquiza J, Vafeiadi M, Zhao Y, Slama R, Wright J, Conti DV, Vrijheid M, Chatzi L. Prenatal and postnatal exposure to PFAS and cardiometabolic factors and inflammation status in children from six European cohorts. ENVIRONMENT INTERNATIONAL 2021; 157:106853. [PMID: 34500361 DOI: 10.1016/j.envint.2021.106853] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 05/14/2023]
Abstract
Developing children are particularly vulnerable to the effects of exposure to per- and polyfluoroalkyl substances (PFAS), a group of endocrine disrupting chemicals. We hypothesized that early life exposure to PFASs is associated with poor metabolic health in children. We studied the association between prenatal and postnatal PFASs mixture exposure and cardiometabolic health in children, and the role of inflammatory proteins. In 1,101 mothers-child pairs from the Human Early Life Exposome project, we measured the concentrations of PFAS in blood collected in pregnancy and at 8 years (range = 6-12 years). We applied Bayesian Kernel Machine regression (BKMR) to estimate the associations between exposure to PFAS mixture and the cardiometabolic factors as age and sex- specific z-scores of waist circumference (WC), systolic and diastolic blood pressures (BP), and concentrations of triglycerides (TG), high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C) cholesterol. We measured thirty six inflammatory biomarkers in child plasma and examined the underlying role of inflammatory status for the exposure-outcome association by integrating the three panels into a network. Exposure to the PFAS mixture was positively associated with HDL-C and systolic BP, and negatively associated with WC, LDL-C and TG. When we examined the independent effects of the individual chemicals in the mixture, prenatal PFHxS was negatively associated with HDL-C and prenatal PFNA was positively associated with WC and these were opposing directions from the overall mixture. Further, the network consisted of five distinct communities connected with positive and negative correlations. The selected inflammatory biomarkers were positively, while the postnatal PFAS were negatively related with the included cardiometabolic factors, and only prenatal PFOA was positively related with the pro-inflammatory cytokine IL-1beta and WC. Our study supports that prenatal, rather than postnatal, PFAS exposure might contribute to an unfavorable lipidemic profile and adiposity in childhood.
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Affiliation(s)
| | - Nikos Stratakis
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA; Department of Complex Genetics and Epidemiology, CAPHRI School for Public Health and Primary Care, University of Maastricht, Maastricht, the Netherlands
| | - Xavier Basagaña
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Maribel Casas
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - Serena Fossati
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | | | | | - Barbara Heude
- Centre for Research in Epidemiology and Statistics, INSERM, Université de Paris, INRAe, Paris, France
| | - Léa Maitre
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - Rosemary R C McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Oliver Robinson
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK
| | - Theano Roumeliotaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Eduard Sabidó
- Proteomics Unit, Centre de Regulació Genòmica, Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Eva Borràs
- Proteomics Unit, Centre de Regulació Genòmica, Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Jose Urquiza
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - Marina Vafeiadi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Yinqi Zhao
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Rémy Slama
- Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Inserm, CNRS, University Grenoble Alpes, Institute of Advanced Biosciences, Joint research center (U1209), La Tronche, Grenoble, France
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - David V Conti
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Martine Vrijheid
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - Lida Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA
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26
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de Bont J, Márquez S, Fernández-Barrés S, Warembourg C, Koch S, Persavento C, Fochs S, Pey N, de Castro M, Fossati S, Nieuwenhuijsen M, Basagaña X, Casas M, Duarte-Salles T, Vrijheid M. Urban environment and obesity and weight-related behaviours in primary school children. ENVIRONMENT INTERNATIONAL 2021; 155:106700. [PMID: 34144474 DOI: 10.1016/j.envint.2021.106700] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 06/03/2021] [Accepted: 06/05/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Urban environments are characterised by many factors that may influence children's lifestyle and increase the risk of childhood obesity, but multiple urban exposures have scarcely been studied. OBJECTIVE We evaluated the association between multiple urban exposures and childhood obesity outcomes and weight-related behaviours. METHODS We conducted a cross-sectional study including 2213 children aged 9-12 years in Sabadell, Spain. We estimated ambient air pollution, green spaces, built and food environment, road traffic and road traffic noise at residential addresses through a total of 28 exposure variables in various buffers. Childhood obesity outcomes included body mass index (BMI), waist circumference and body fat. Weight-related behaviours included diet (fast food and sugar-sweetened beverage consumption), physical activity, sedentary behaviour, sleep duration and well-being. Associations between exposures (urban environment) and outcomes (obesity and behaviours) were estimated in single and multiple-exposure regression models and in a hierarchical clustering on principal components (HCPC) analysis. RESULTS Forty percent of children were overweight or obese. In single exposure models, very few associations were observed between the urban exposures and obesity outcomes or weight-related behaviours after correction for multiple testing. In multiple exposure models, PMcoarse, denser unhealthy food environment and land use mix were statistically significant associated with childhood obesity outcomes (e.g 17.7 facilities/km2 increase of unhealthy food environment (OR overweight/obesity status) = 1.20 [95% CI: 1.01; 1.44]). Cluster analysis identified 5 clusters of urban exposures. Compared to the most neutral cluster, the cluster with high air pollution, road traffic, and road noise levels was associated with a higher BMI and higher odds of overweight and obesity (β (zBMI) = 0.17, [95% CI: 0.01, 0.17]; OR (overweight/obesity) = 1.36, [95% CI: 0.99, 1.85]); the clusters were not associated with the weight-related behaviours. CONCLUSIONS This systematic study of many exposures in the urban environment suggests that an exposure pattern characterised by higher levels of ambient air pollution, road traffic and road traffic noise is associated with increased childhood obesity risk and that PMcoarse, land use mix and food environment are separately associated with obesity risk. These findings require follow-up in longitudinal studies and different settings.
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Affiliation(s)
- Jeroen de Bont
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain; Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - Sandra Márquez
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Sílvia Fernández-Barrés
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Charline Warembourg
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Sarah Koch
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Cecilia Persavento
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Silvia Fochs
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Núria Pey
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Montserrat de Castro
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Serena Fossati
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Xavier Basagaña
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Maribel Casas
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Martine Vrijheid
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain.
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Ferreira CM, Reis NDD, Castro ADO, Höfelmann DA, Kodaira K, Silva MT, Galvao TF. Prevalence of childhood obesity in Brazil: systematic review and meta-analysis. J Pediatr (Rio J) 2021; 97:490-499. [PMID: 33577757 PMCID: PMC9432074 DOI: 10.1016/j.jped.2020.12.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/09/2020] [Accepted: 12/09/2020] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE To estimate the prevalence of childhood obesity in Brazil by means of a systematic review of representative studies. SOURCES We searched for population-based studies that assessed obesity in Brazilian children aged < 10 years in MEDLINE, EMBASE, Scopus and other sources up to September, 2019. Paired researchers selected studies, extracted data and assessed the quality of these studies. Meta-analysis of prevalence and confidence interval (95% CI) was calculated, weighted by the population sizes using Freeman-Tukey double-arccosine transformation. Heterogeneity (I2) and publication bias were investigated by meta-regression and Egger's test, respectively. SUMMARY OF THE FINDINGS 53 studies were included (n = 122,395), which were held from 1986 to 2015 and limited mainly due to inadequate response rates. Prevalence of obesity in the three-decade period was of 8.2% ([95% CI]: 8.1-8.4%, I2 = 98.5%). Higher prevalence was observed in boys (9.7% [9.4-9.9%], I2 = 97.4%) than girls (7.3% [7.1-7.5%], I2 = 96.1%). Prevalence increased according to the decade (1990: 6.5% [6.0-7.0 %], I2 = 96.8%; 2000: 7.9% [7.7-8.0 %], I2 = 98.8%; 2010: 12.0% [11.5-12.6 %], I2 = 95.8%), and Brazilian region (Northeast: 6.4% [6.2-6.7%], I2 = 98.1%; North: 6.7% [6.3-7.2%], I2 = 98.8%; Southeast:10.6% [10.2-11.0%], I2 = 98.2%; South: 10.1 [9.7-10.4%], I2 = 97.7%). Heterogeneity was affected by age and region (p < 0.05) and publication bias was discarded (p = 0.746). CONCLUSION For every 100 Brazilian children, over eight had obesity in the three-decade period and 12 in each 100 had childhood obesity in more recent estimates. Higher prevalence occurred in boys, recent decades and more developed Brazilian regions.
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Affiliation(s)
| | - Natália Dutra Dos Reis
- Universidade Estadual de Campinas, Faculdade de Ciências Farmacêuticas, Campinas, SP, Brazil
| | | | | | - Kátia Kodaira
- Universidade de Sorocaba, Programa de Pós-Graduação em Ciências Farmacêuticas, Sorocaba, SP, Brazil
| | - Marcus Tolentino Silva
- Universidade de Sorocaba, Programa de Pós-Graduação em Ciências Farmacêuticas, Sorocaba, SP, Brazil
| | - Tais Freire Galvao
- Universidade Estadual de Campinas, Faculdade de Ciências Farmacêuticas, Campinas, SP, Brazil.
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de Bont J, Bennett M, León-Muñoz LM, Duarte-Salles T. The prevalence and incidence rate of overweight and obesity among 2.5 million children and adolescents in Spain. ACTA ACUST UNITED AC 2021; 75:300-307. [PMID: 34384717 DOI: 10.1016/j.rec.2021.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 06/24/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION AND OBJECTIVES Childhood obesity trends are plateauing in Spain, but limited information is available about how they differ by region. This study assessed childhood and adolescent the prevalence and incidence of overweight and obesity from 2005 to 2017 across 8 Spanish regions. METHODS This longitudinal study used height and weight measurements from 2.5 million children aged 2 to 17 years to calculate overweight and obesity, according to the World Health Organization (WHO) guidelines. Data were obtained from The Base de datos para la Investigación Farmacoepidemiológica en Atención Primaria, and the Information System for Research in Primary Care. Prevalence and incidence rates and trends from 2005 to 2017 were calculated and stratified by age, sex, and region. RESULTS The overall obesity prevalence increased in boys and girls from age 2 (0.8%; 95%CI, 0.8-0.9 in both sexes) until peaking at age 7 in girls (17.3%; 95%CI, 17.1-17.5) and age 9 in boys (24.1%; 95%CI 23.9-24.3). The highest and lowest obesity prevalences were observed in Murcia and Navarre. Overall obesity prevalence trends decreased from 2005 to 2017 in all age-sex groups and in most regions. Highest obesity incidence rates were found in children aged 6 to 7 years, (4.5 [4.5-4.5] and 3.5 [3.5-3.5] new obesity cases per 100 person-years in boys and girls, respectively). Boys had higher prevalence and incidence rates than girls across all regions. Overweight/obesity prevalence and incidence rates and their trends were consistently higher than the obesity results, although a similar pattern was observed across sex and age. CONCLUSIONS Overweight and obesity prevalence slightly decreased in Spain from 2005 to 2017, but regional, sex, and age differences persisted. Because incidence peaked around the age of 6 years, it may be important to begin health promotion programs at an early age.
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Affiliation(s)
- Jeroen de Bont
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; Departament de Pediatria, d'Obstetrícia i Ginecologia i de Medicina Preventiva, Universitat Autònoma de Barcelona (UAB), Bellaterra, Barcelona, Spain; ISGlobal, Barcelona, Spain; Centro de Investigación en Red de Epidemiología y Salud Pública (CIBERESP), Spain; Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain
| | - Matthew Bennett
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; Departament de Pediatria, d'Obstetrícia i Ginecologia i de Medicina Preventiva, Universitat Autònoma de Barcelona (UAB), Bellaterra, Barcelona, Spain
| | - Luz M León-Muñoz
- División de Farmacoepidemiología y Farmacovigilancia, Agencia Española de Medicamentos y Productos Sanitarios (AEMPS), Madrid, Spain
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.
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[Weight status in the 6- to 9-year-old school population in Spain: results of the ALADINO 2019 Study]. NUTR HOSP 2021; 38:943-953. [PMID: 34304573 DOI: 10.20960/nh.03618] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
INTRODUCTION childhood obesity is a public health problem whose prevalence has grown steadily in recent decades. OBJECTIVE to describe the weight status of schoolchildren aged 6 to 9 years in Spain in 2019, and their associated factors. METHODS ALADINO is a cross-sectional study in schoolchildren aged 6 to 9 years, representative of the Spanish population, and aligned with the Child Obesity Surveillance Initative of the WHO Regional Office for Europe. Participants' weight, height, and abdominal circumference were measured, defining weight status according to different standards (WHO, IOTF, and Orbegozo). A questionnaire on lifestyle and socio-demographic characteristics was administered to parents. RESULTS a total of 16,665 schoolchildren from 276 schools were measured. Excess weight was observed in 40.6 %: 23.3 % overweight and 17.3 % obesity, with obesity being more prevalent in boys and overweight in girls, both increasing with age. The prevalence of abdominal obesity was 22.6 %. Excess weight decreased by 3.9 percentage points since 2011, mainly due to overweight in boys. Obesity remained stable. Excess weight was more prevalent in schoolchildren with less healthy eating and physical activity habits, and in families with a lower socioeconomic status. CONCLUSIONS the prevalence of excess weight is high, although it has declined since 2011 and remains stable since 2015 among schoolchildren aged 6-9 years in Spain, this reduction being mainly due to a decrease in overweight in children. It is necessary to continue promoting healthy habits from the earliest stages of life, thus reducing health inequalities.
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Homs C, Berruezo P, Según G, Estrada L, de Bont J, Riera-Romaní J, Carrillo-Álvarez E, Schröder H, Milà R, Gómez SF. Family-based intervention to prevent childhood obesity among school-age children of low socioeconomic status: study protocol of the FIVALIN project. BMC Pediatr 2021; 21:246. [PMID: 34020614 PMCID: PMC8139065 DOI: 10.1186/s12887-021-02697-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 05/04/2021] [Indexed: 12/12/2022] Open
Abstract
Background Childhood obesity represents a global public health crisis: the number of obese children and adolescents (aged 519years) worldwide has risen tenfold in the past four decades. The vast majority of overweight and obese children live in high-income countries, and low socio-economic status (SES) is a significant risk factor. Family Based Interventions (FBI) have demonstrated positive results in preventing obesity, although these results are strongly influenced by SES. Moreover, we still poorly understand how FBI can determine a positive trend in weight status in low-income communities. Therefore, there is an urgent need to define and evaluate innovative and multi-target projects to reduce obesity risk behaviors and health inequalities and the present study aims to present the study protocol of FIVALIN a FBI that pretends to achieve this goal. Methods We will conduct a quasi-experimental design within 60 Community Child Centers (CCC) in Barcelona metropolitan area. Each cluster (CCC) will be assigned by convenience to the intervention and control groups. For the whole study, a total of 810 children aged 812years and 600 parents will be recruited during 3 consecutive editions (1st 2019/2020; 2nd 2020/2021; 3rd 2021/2022) of 10months each. The action is a regular multicomponent health-promotion intervention targeting children, families, and CCC. All activities are based on the Motivational Interviewing (MI) approach and will focus on promoting good dietary habits, physical activity, appropriate screen time and sleep duration, and psychological well-being. The control group participate in a unique workshop on general awareness of healthy lifestyles for families. We will perform a comparative analysis of the evolution of weight status, healthy lifestyles, and socioeconomic variables, between the intervention and control groups. Discussion There is a need for more evidence on how to target and evaluate holistic interventions in low SES families. Our multi-targeting intervention for obesity prevention tackles risky behaviors that go beyond diet and physical activity (PA). Therefore, future interventions can effectively promote all the behavioral domains that determine trends in the weight status. Trial registration ISRCTN Registry: ISRCRN12682870. Registered 9 July 2020. Retrospectively registered. Protocol version: 30 April 2021, version 5. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02697-x.
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Affiliation(s)
- C Homs
- Gasol Foundation, Sant Boi de Llobregat, Spain.,Faculty of Psychology, PSITIC Research Group, Education and Sport Sciences Blanquerna - Universitat Ramon Llull, Císter, 34 08032, Barcelona, Spain
| | - P Berruezo
- Gasol Foundation, Sant Boi de Llobregat, Spain
| | - G Según
- Gasol Foundation, Sant Boi de Llobregat, Spain
| | - L Estrada
- Gasol Foundation, Los Angeles, CA, USA
| | - J de Bont
- ISGlobal, Barcelona, Spain.,CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, Madrid, Spain.,Universitat Pompeu Fabra, Barcelona, Spain.,Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.,Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - J Riera-Romaní
- Faculty of Psychology, PSITIC Research Group, Education and Sport Sciences Blanquerna - Universitat Ramon Llull, Císter, 34 08032, Barcelona, Spain
| | - E Carrillo-Álvarez
- Global Research on Wellbeing (GRoW) research group, Blanquerna School of Health Sciences - Universitat Ramon Llull, Padilla, 326-332 08025, Barcelona, Spain
| | - H Schröder
- CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, Madrid, Spain.,Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - R Milà
- Global Research on Wellbeing (GRoW) research group, Blanquerna School of Health Sciences - Universitat Ramon Llull, Padilla, 326-332 08025, Barcelona, Spain
| | - S F Gómez
- Gasol Foundation, Sant Boi de Llobregat, Spain. .,GREpS, Health Education Research Group, Nursing and Physiotherapy Department, University of Lleida, Lleida, Spain.
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de Bont J, Díaz Y, de Castro M, Cirach M, Basagaña X, Nieuwenhuijsen M, Duarte-Salles T, Vrijheid M. Ambient air pollution and the development of overweight and obesity in children: a large longitudinal study. Int J Obes (Lond) 2021; 45:1124-1132. [PMID: 33627774 DOI: 10.1038/s41366-021-00783-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 12/22/2020] [Accepted: 02/01/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Ambient air pollution may play a role in childhood obesity development, but evidence is scarce, and the modifying role of socioeconomic status (SES) is unclear. We aimed to examine the association between exposure to air pollution during early childhood and subsequent risk of developing overweight and obesity, and to evaluate whether SES is a modifier of this association. METHODS This longitudinal study included 416,955 children identified as normal weight between 2-5 years old and registered in an electronic primary healthcare record between 2006 and 2016 in Catalonia (Spain). Children were followed-up until they developed overweight or obesity, reached 15 years of age, died, transferred out, or end of study period (31/12/2018). Overweight and obesity were defined following the WHO reference obtained from height and weight measures. We estimated annual residential census levels of nitrogen dioxide (NO2) and particulate matter <10 μm (PM10), <2.5 μm (PM2.5), and 2.5-10 μm (PMcoarse) at study entry. We estimated the risk of developing overweight and obesity per interquartile range increase in air pollution exposure with Cox proportional hazard models. RESULTS A total of 142,590 (34.2%) children developed overweight or obesity. Increased exposure to NO2, PM10, and PMcoarse was associated with a 2-3% increased risk of developing overweight and obesity (hazard ratio [HR] per 21.8 μg/m3 NO2 = 1.03 [95% CI: 1.02-1.04]; HR per 6.4 μg/m3 PM10 = 1.02 [95% CI: 1.02-1.03]; HR per 4.6 µg/m3 PMcoarse = 1.02, [95% CI: 1.01-1.02]). For all air pollutants, associations were stronger among children living in most compared to least deprived areas. CONCLUSIONS This study suggests that early life exposure to air pollution may be associated with a small increase in the risk of developing overweight and obesity in childhood, and that this association may be exacerbated in the most deprived areas. Even these small associations are of potential global health importance because air pollution exposure is widespread and the long-term health consequences of childhood obesity are clear.
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Affiliation(s)
- Jeroen de Bont
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Spain.,ISGlobal, Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Yesika Díaz
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Montserrat de Castro
- ISGlobal, Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Marta Cirach
- ISGlobal, Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Xavier Basagaña
- ISGlobal, Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Martine Vrijheid
- ISGlobal, Barcelona, Spain. .,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain. .,Universitat Pompeu Fabra, Barcelona, Spain.
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Influence of weight status on bone mineral content measured by DXA in children. BMC Pediatr 2021; 21:185. [PMID: 33879114 PMCID: PMC8056645 DOI: 10.1186/s12887-021-02665-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/12/2021] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Childhood obesity is a public health problem with repercussions in later life. As tissue formation peaks in childhood we determined how weight status influences bone mineral content. MATERIAL AND METHODS We studied 553 children aged 4-18 years over 10 years (46.8% girls). We measured age, weight, height and through bone densitometry (DXA), bone mineral content (BMC), bone mineral density (BMD), and waist, arm and hip circumferences. The patients were divided into groups using the body mass index z-score: underweight, normal weight, overweight, obese and very obese. RESULTS BMC and BMD values were highest in the normal-weight and overweight groups. Logistic regression showed bone mineralization was inversely associated with waist circumference, the association being positive for weight and age. No differences were found according to sex. DISCUSSION Studies of the relationship between weight and bone mineralization report contradictory results, often because of different study designs. Moreover, studies in children are either few or with small samples. Our findings in a large sample show the importance of weight status in bone mineralization given the risk of bone fractures or osteoporosis. CONCLUSIONS Weight status influenced bone mineralization. BMC and BMD decreased in children with a higher degree of obesity. Waist circumference correlated negatively with bone mineralization.
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Reversal of the Upward Trend of Obesity in Boys, but Not in Girls, in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041842. [PMID: 33672817 PMCID: PMC7918759 DOI: 10.3390/ijerph18041842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/06/2021] [Accepted: 02/11/2021] [Indexed: 01/22/2023]
Abstract
(1) Background: To compare the prevalence of overweight and obesity in boys and girls and to estimate socioeconomic differences associated with obesity in Spain in 1997, 2007, and 2017. (2) Methods: Data were drawn from national health interview surveys. For each year of study, the prevalence of overweight and obesity was measured, and these results were compared by gender (boy/girl) and socioeconomic status (low/high education). (3) Results: The prevalence of overweight and obesity rose from 1997 to 2007 but then fell in 2017 in all subgroups except in girls aged 10 to 15 years. In this group, there was a steady increase in the prevalence of both overweight (1997, 14.6%; 2007, 17.7%; 2017, 19.6%) and obesity (1.1, 3.2, and 3.7%, respectively). The decrease in prevalence of overweight in both sexes and of obesity in boys, along with the increase in prevalence of obesity in girls, was of a higher magnitude in children whose parents had a lower educational level. (4) Conclusions: The apparent turnaround in the obesity epidemic in Spain should be interpreted with caution. Children’s body weight is influenced by both gender and socioeconomic status—considerations that should be kept in mind when designing health promotion interventions.
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Forner-Cordero I, Forner-Cordero A. Lipoedema – a growing problem in Spain. PHLEBOLOGIE 2021. [DOI: 10.1055/a-1306-7626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AbstractLipoedema is a chronic disease frequent in women, that causes an abnormal fat deposition in their lower limbs, with a remarkable disproportion between the upper and lower part of the body, easy bruising and pain. Despite the lack of pathognomonic tests for lipoedema, more and more patients in social networks are claiming they suffer from it, giving the disease more visibility but allowing a lot of fake information about lipoedema. Information for self-care and realistic expectations are important. Depending on the severity, the treatment includes: physical therapies, compression garments, exercise, diet, psychological support and surgical treatment.
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Affiliation(s)
- Isabel Forner-Cordero
- Lymphedema Unit. Hospital Universitari i Politècnic La Fe, Associate professor, University of Valencia, Valencia, Spain
| | - Angeles Forner-Cordero
- Rehabilitation Service. Sagunto Hospital, Associate professor, University of Valencia, Valencia, Spain
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Kachi Y, Abe A, Eguchi H, Inoue A, Tsutsumi A. Mothers' nonstandard work schedules and adolescent obesity: a population-based cross-sectional study in the Tokyo metropolitan area. BMC Public Health 2021; 21:237. [PMID: 33509145 PMCID: PMC7845102 DOI: 10.1186/s12889-021-10279-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 01/19/2021] [Indexed: 11/10/2022] Open
Abstract
Background Many wage earners in developed countries have irregular shift patterns and work evenings, nights, and weekends. Some studies have demonstrated that the nonstandard work schedules of parents have adverse effects on their children’s weight, specifically leading to or worsening obesity. However, no such study has been conducted in adolescents of high school age. This study examined the association between mothers’ nonstandard work schedules and adolescent obesity. Methods A cross-sectional study of adolescents aged 16–17 years (n = 1743) used paired matches of self-administered questionnaires for adolescents and their mothers from Tokyo, Japan. Obesity was defined by International Obesity Task Force cut-offs. Nonstandard work schedules were defined as working early mornings, nights, overnights, or weekends. Chi-square tests were conducted to examine the association between the mothers’ work schedules and their adolescent children’s poor lifestyles, overall and stratified by income levels. Then, logistic regression analyses were conducted to examine the association between mothers’ work schedules and obesity of their adolescent children, overall and stratified by income levels. Results Overall, 6.5% of adolescents had obesity. The prevalence of obesity was higher among adolescents from low-middle income groups (8.2%) than that among those from high-income groups (5.9%). No clear patterns were found between mothers’ work schedules and adolescents’ poor lifestyles when stratified by income levels. Mothers’ nonstandard work schedules were significantly associated with adolescent obesity (odds ratio [OR]: 1.56, 95% confidence interval [CI]: 1.02–2.40). However, this association was not significant after adjustment for confounders. After stratification by income levels, mothers’ nonstandard work schedules significantly associated with their children’s obesity (OR: 2.93, 95% CI: 1.45–5.92) only in high-income groups. This association remained after adjustment of the adolescents’ lifestyles and their mothers’ working hours. Conclusions Our results suggest that mothers’ nonstandard work schedules have adverse effects on adolescent obesity only in high-income families. Low-middle income families experienced higher levels of adolescent obesity, regardless of the mothers’ work schedules. Policy makers should consider mothers’ work schedules as a factor in preventing adolescent obesity. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10279-w.
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Affiliation(s)
- Yuko Kachi
- Department of Public Health, Kitasato University School of Medicine, Kanagawa, Japan. .,School of Humanities and Social Sciences, Tokyo Metropolitan University, Tokyo, Japan.
| | - Aya Abe
- School of Humanities and Social Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Hisashi Eguchi
- Department of Public Health, Kitasato University School of Medicine, Kanagawa, Japan.,Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Akiomi Inoue
- Department of Public Health, Kitasato University School of Medicine, Kanagawa, Japan.,Institutional Research Center, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Akizumi Tsutsumi
- Department of Public Health, Kitasato University School of Medicine, Kanagawa, Japan
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Baniissa W, Radwan H, Rossiter R, Fakhry R, Al-Yateem N, Al-Shujairi A, Hasan S, Macridis S, Farghaly AA, Naing L, Awad MA. Prevalence and determinants of overweight/obesity among school-aged adolescents in the United Arab Emirates: a cross-sectional study of private and public schools. BMJ Open 2020; 10:e038667. [PMID: 33310793 PMCID: PMC7735131 DOI: 10.1136/bmjopen-2020-038667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To estimate the prevalence and predictors of obesity among adolescents in the United Arab Emirates. DESIGN Cross-sectional study. SETTING Private and public secondary schools. PARTICIPANTS Adolescents aged 13-19 years; 434 (46.6%) from private schools and 498 (53.4%) from public schools. MEASURES Self-report questionnaires were used to assess adolescents' sociodemographic factors, fruit/vegetable (F/V) intake and physical activity. Participants' weight, height, waist circumference (WC), hip circumference and body fat percentage (%BF) were measured, and waist-to-height ratio (WHtR), waist-to-hip ratio (WHR) and body mass index (BMI) were calculated. Overweight/obesity was determined by BMI ≥85th percentile for age, abdominal obesity (AO) (WC, WHtR and WHR) and %BF. RESULTS A total of 34.7% of participants were overweight/obese (BMI ≥85th percentile) and 378 (40.6%) had high %BF. AO was noted in 47.3%, 22.7% and 27.1% of participants, based on WC, WHR and WHtR, respectively. Significantly more participants from public schools were overweight/obese (37.8% vs 31.1%) and had greater AO (based on WC, WHR, WHtR) compared with those from private schools. Predictors of obesity based on BMI were: consuming less than five servings of F/V (adjusted OR (AOR) 2.41, 95% CI: 1.73 to 3.36), being physically inactive (AOR 2.09, CI: 1.36 to 3.22) and being men (AOR 3.35, 95% CI: 2.20 to 5.10). Predictors of AO were being men (WC: AOR 1.42, 95% CI: 1.01 to 2.00; WHtR: AOR 2.72, 95% CI: 1.81 to 4.08); studying at public school (WHR: AOR 1.67, 95% CI: 1.06 to 2.66); being Emirati (WHR: AOR 0.62, 95% CI: 0.43 to 0.90); consuming less than five servings of F/V (WC: AOR 1.71, 95% CI: 1.27 to 2.30; WHtR: AOR 1.46, 95% CI: 1.05 to 2.03), and being physically inactive (WC: AOR 1.63; 95% CI: 1.13 to 2.35). CONCLUSIONS Focused interventions are needed to combat obesity while considering AO indicators and BMI to diagnose obesity in adolescents.
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Affiliation(s)
- Wegdan Baniissa
- College of Health Sciences, Department of Nursing, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, UAE
| | - Hadia Radwan
- College of Health Sciences, Clinical Nutrition and Dietetics, University of Sharjah, Research Institute of Medical and Health Sciences, Sharjah, UAE
| | - Rachel Rossiter
- School of Nursing, Midwifery and Indigenous Health, Faculty of Science, Charles Sturt University, Orange, New South Wales, Australia
| | - Randa Fakhry
- College of Health Sciences, Department of Nursing, Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, UAE
| | - Nabeel Al-Yateem
- College of Health Sciences, Department of Nursing, Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, UAE
| | - Arwa Al-Shujairi
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, UAE
| | - Sanah Hasan
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, UAE
| | - Soultana Macridis
- Centre for Active Living, Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Abeer A Farghaly
- Department of Cardiology and Geriatric Physical Therapy, Faculty of Physical therapy, Cairo University, Cairo, Egypt
| | - Lin Naing
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Brunei, Darussalam
| | - Manal A Awad
- College of Dental Medicine-Department of Preventive and Restorative Dentistry, Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, UAE
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López-Gil JF, López-Benavente A, Tárraga López PJ, Yuste Lucas JL. Sociodemographic Correlates of Obesity among Spanish Schoolchildren: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2020; 7:E201. [PMID: 33126639 PMCID: PMC7692605 DOI: 10.3390/children7110201] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/20/2020] [Accepted: 10/22/2020] [Indexed: 12/27/2022]
Abstract
Some studies have been conducted in order to assess the association between weight status (assessed by body mass index) and socio-demographic factors. Nevertheless, only a few of them have indicated these associations by other anthropometric parameters (e.g., skinfolds). The aim of this study was to determine, compare, and examine the influence of age, sex, type of the schooling, per capita income, area of residence, and immigrant status on obesity parameters in schoolchildren aged 6-13 from the Region of Murcia. A cross-sectional study was carried out in six different Primary schools of the Region of Murcia (Spain). A total sample of 370 children (166 girls) aged 6-13 (8.7 ± 1.8) were selected. In order to determine participants' body composition, body mass index, waist circumference, waist-to-height ratio, and skinfold measurements were calculated. Higher associations of excess of weight (OR = 1.96; 95%CI = 1.19-3.20) and abdominal obesity (OR = 3.12; 95CI% = 1.49-6.94) were shown in the case of children from public schools. A greater association of high trunk fat mass was found in children from municipalities with high per capita income (OR = 3.20; 95%CI = 1.05-9.77). Therefore, lower association of having an inadequate %BF was found in the participants aged 6-9 (OR = 0.38; 95%CI = 0.24-0.54), and immigrant students (OR = 2.63; 95%CI = 1.69-4.10). Our study suggested that overweight/obesity among schoolchildren in the Region of Murcia is higher than the overall prevalence of Spain. The results of the adjusted analyses showed that age, type of schooling, per capita income, and immigrant status were associated with obesity parameters.
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Affiliation(s)
- José Francisco López-Gil
- Departamento de Actividad Física y Deporte, Facultad de Ciencias del Deporte, Universidad de Murcia (UM), San Javier, 30720 Murcia, Spain
| | - Alba López-Benavente
- Departamento de Expresión Plástica, Musical y Dinámica, Facultad de Educación, Universidad de Murcia (UM), Espinardo, 30100 Murcia, Spain; (A.L.-B.); (J.L.Y.L.)
| | - Pedro Juan Tárraga López
- Departamento de Ciencias Médicas, Facultad de Medicina, Universidad Castilla-La Mancha (UCLM), 02008 Albacete, Spain;
| | - Juan Luis Yuste Lucas
- Departamento de Expresión Plástica, Musical y Dinámica, Facultad de Educación, Universidad de Murcia (UM), Espinardo, 30100 Murcia, Spain; (A.L.-B.); (J.L.Y.L.)
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Abstract
The relationship between obesity and puberty remains controversial. Whereas cross-sectional and longitudinal studies show a clear shift toward earlier puberty in obese girls, the trend in obese boys remains less obvious. Overweight boys mature earlier whereas obese boys mature later compared to healthy weight boys. Newer epidemiologic studies attempt to address these knowledge gaps. This review provides a detailed overview of the recent literature regarding secular trends in pubertal onset and tempo, and the connection with obesity. Additionally, this review summarizes potential mediators that permit obesity to promote early puberty. Other factors such as socioeconomic status, in utero exposures, nutritional, and even endocrine disrupting chemicals can cause perturbation of both metabolism and the endocrine axis that can ultimately have effects on pubertal development.
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Pastor-Fajardo MT, Bosch-Giménez VM, Larqué E, Solano Navarro C, Fuentes-Castelló MÁ, Pastor-Rosado J. Prevalence and secular trend of childhood overweight and obesity in a Mediterranean area of Southeast Spain. CHILD AND ADOLESCENT OBESITY 2020. [DOI: 10.1080/2574254x.2020.1784640] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
| | | | - Elvira Larqué
- Department of Physiology, University of Murcia, Murcia, Spain
| | - Carmen Solano Navarro
- Department of Pediatrics, Hospital Universitario Virgen De La Arrixaca, Murcia, Spain
| | | | - José Pastor-Rosado
- Department of Pediatrics, Hospital General Universitario De Elche, Elche, Spain
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