Stature and adiposity among children in contrasting neighborhoods in the city of Hamilton, Ontario, Canada

Investigating the linkages between food insecurity, psychological distress, and poor sleep outcomes among U.S. college students

OBJECTIVE

Research overwhelmingly demonstrates that sleep is key to human health and wellbeing. Several factors likely contribute to sleep quality, including factors, such as food security and low income. In addition, exposure to structural inequalities early in life likely have downstream effects upon multiple dimensions of health. The objective of this study is to fill gaps in literature by specifically examining the associations between childhood food insecurity, current food insecurity, psychological distress, and sleep among college students.

METHODS

QR codes were randomly distributed to students, linking them to an online quantitative survey. The survey measured sociodemographic variables, food security (current and childhood), diet, mental distress, and sleep quality. A total of n = 134 completed the entire survey. Data were analyzed using binary and multiple linear regressions, as well as cross-tabulations.

RESULTS

The findings revealed that psychological distress was the primary factor influencing sleep health (𝛽 = 1.51, p < .01). Students reporting higher childhood food insecurity were more likely to experience extreme psychological distress (OR = 4.61), food insecurity in college (OR = 8.41), and lack of stable housing (OR = 5.86).

CONCLUSION

This study demonstrates that potential linkages exist between childhood food insecurity, poor sleep, and greater psychological distress. While acknowledging the contribution of other factors, the study highlights the importance of addressing food insecurity in relation to sleep health, considering the significant impact of sleep to overall health and wellbeing.

Biological mortality bias in diaphyseal growth of contemporary children: Implications for paleoauxology

Objectives

Biological mortality bias is the idea that individuals who comprise skeletal samples (non‐survivors) are a specific subset of the overall population, who may have been exposed to greater stress during life. Because of this, it is possible that studying growth in a skeletal population misrepresents the growth and health of survivors in that population. Using a modern sample, this study investigates whether biological mortality bias in growth may be present in archaeological skeletal samples.

Materials and methods

Postmortem computed tomography scans of 206 children aged under 13 years were collected from two institutions in the United States and Australia. The sample was separated into children who died from natural causes as proxies for non‐survivors and from accidental causes as proxies for survivors. Differences in long bone length for age were assessed through analysis of covariance (ANCOVA) and z‐score analysis, and these results were compared with studies linking anthropometrics and mortality risk in nonindustrialized societies.

Results

Differences in growth favoring survivors were greater for girls than for boys and seemed to increase over age. The effect in nonindustrialized societies was 1.5 to 5 times the magnitude of that in our contemporary sample.

Conclusions

A greater growth delay in girls than in boys has been documented in historical identified collections, and skeletal samples consistently become more stunted relative to modern standards over the course of growth. Our findings on biological mortality bias could explain part of these growth delays and impact interpretations of past ontogenetic environments.

The Relation Between Household Food Insecurity and Children's Height in Canada and the United States: A Scoping Review

Household food insecurity is a determinant of health and marker of material deprivation. Although research has shown that food insecurity is associated with numerous adverse health, developmental and nutritional outcomes among children in high-income countries, little is known about its impact on children's height, an important marker of nutritional status and physical development. We reviewed evidence on the relation between experience-based measures of food insecurity and the height of children aged 0-18 y in Canada and the United States. The search, conducted in Embase, Medline, CINAHL, ProQuest, Web of Science, and EconLit from the inception of the databases to October 2017, identified 811 records that were screened for relevance. A total of 8 peer-reviewed studies, 2 from Canada and 6 from the United States, met the inclusion criteria and were summarized. Five studies found no association between food insecurity and children's height. One study found that having taller children in the household predicted more severe food insecurity, whereas 2 studies found that more severe experiences of food insecurity were associated with shorter height among children from ethnic minority populations. These results suggest that household food insecurity may not be associated with height inequalities among children in Canada and the United States, except perhaps in certain high-risk populations. However, the few studies identified for review provide insufficient evidence to determine whether food insecurity is or is not associated with children's height in these countries. Given the importance of optimal linear growth for current and future well-being, it is critical to understand how different modifiable environmental circumstances relate to children's height to help establish priorities for intervention. Families with children are disproportionately affected by food insecurity, and more research explicitly designed to examine the association between household food insecurity and children's height in high-income countries is needed.

Translating human biology (introduction to special issue)

OBJECTIVES

Introducing a special issue on "Translating Human Biology," we pose two basic questions: Is human biology addressing the most critical challenges facing our species? How can the processes of translating our science be improved and innovated?

METHODS

We analyze articles published in American Journal of Human Biology from 2004-2013, and find there is very little human biological consideration of issues related to most of the core human challenges such as water, energy, environmental degradation, or conflict. There is some focus on disease, and considerable focus on food/nutrition. We then introduce this special volume with reference to the following articles that provide exemplars for the process of how translation and concern for broader context and impacts can be integrated into research.

CONCLUSIONS

Human biology has significant unmet potential to engage more fully in translation for the public good, through consideration of the topics we focus on, the processes of doing our science, and the way we present our domain expertise.

Measuring growth and obesity across childhood and adolescence

The dramatic rise in childhood obesity has driven the demand for tools better able to assess and define obesity and risk for related co-morbidities. In addition, the early life origins of non-communicable diseases including type 2 diabetes are associated with subtle alterations in growth and body composition, including total and regional body fatness, limb/trunk length and skeletal muscle mass (SMM). Consequently improved tools based on national reference data, which capture these body components must be developed as the limitations of BMI as a measure of overweight and obesity and associated cardiometabolic risk are now recognised. Furthermore, waist circumference as a measure of abdominal fatness in children is now endorsed by the International Diabetes Federation and National Institute for Clinical and Health Excellence for diagnostic and monitoring purposes. The present paper aims to review the research on growth-related variations in body composition and proportions, together with how national references for percentage body fat, SMM and leg/trunk length have been developed. Where collection of these measures is not possible, alternative proxy measures including thigh and hip circumferences are suggested. Finally, body ratios including the waist:height and muscle:fat ratios are highlighted as potential measures of cardiometabolic disease risk. In conclusion, a collection of national references for individual body measures have been produced against which children and youths can be assessed. Collectively, they have the capacity to build a better picture of an individual's phenotype, which represents their risk for cardiometabolic disease beyond that of the capability of BMI.

Children and adolescents with ALL are taller than expected at diagnosis

We investigated whether the relative increased height of childhood acute lymphoblastic leukemia (ALL) survivors at diagnosis was due to referral bias, the height of California children, socio-economic status, or race/ethnicity. We reviewed the records of all Pediatric Oncology referrals to our institution from 1988 to 2007. Height at diagnosis, sex, age at and date of diagnosis, date of birth, diagnosis, race/ethnicity, and socio-economic status were evaluated. Heights were standardized by z score from age and sex norms for US children. Of the 883 cases, 180 were excluded (Down syndrome, noncancer diagnosis, data at relapse only, incorrect height measurement, or major growth disturbance). ALL patients were taller than those with other cancers and US children. Age at and date of diagnosis and date of birth had no effect. Whites, boys, and those with private insurance had higher height z scores. Multivariable analysis identified diagnosis and race/ethnicity as significant. ALL children and adolescents were taller and black and Asian children shorter than white children. The mean height increase for those with ALL was 1.3 cm. The reason for the increased height of these patients is unknown, but is not due to referral patterns, having childhood cancer, or the racial/ethnic makeup of California children.

Anthropometric measurements in Canadian children: a scoping review

OBJECTIVE

The objective of the current study was to identify what forms of anthropometric measurement are currently being utilized with Canadian children and youth and what are the gaps in the literature on this topic.

METHODS

The current study utilized a scoping review methodology in order to achieve the study objectives. Online databases Medline and PubMed and CINAHL were used to search articles from the last decade (2002-2012) that addressed Canadian children aged 2-18 years.

SYNTHESIS

50 studies were included in this review. A variety of anthropometric measurements were identified, including body mass index, waist circumference, hip-to-waist ratio, among others. Six of the included studies (12%) utilized nationally representative data from large-scale studies. BMI was the most reported form of measurement with 88% of studies collecting it. Waist circumference was a distant second with 20% of studies reporting it. Several gaps in the literature exist with regards to First Nations (FN) research; many of the measurement methods were not used. Additionally, FN accounted for only 2.5% of the study's sample. The majority of studies took place in Quebec (29%) and Ontario (27%).

CONCLUSION

Body mass index is the most reported method of anthropometric measurement used for children. Efforts should be taken by health care practitioners and researchers to collect other forms of measurement in order to assist in understanding the validity of other measures and their value when used with children. Furthermore, attention needs to be focused on utilizing and studying various forms of anthropometric measurement across all Canadian regions and populations.

Food consumption patterns in preschool children

PURPOSE

Healthy eating during early childhood is important for growth and development. Eating Well with Canada's Food Guide (CFG) provides dietary recommendations. We investigated patterns of food consumption among preschool children and attempted to determine whether these children's intakes met nutrition recommendations.

METHODS

Between 2005 and 2007, four- and five-year-old children (n=2015) attending 12 Edmonton-region public health units for immunization were recruited for a longitudinal study on determinants of childhood obesity. The children's dietary intake at baseline was assessed using parental reports.

RESULTS

Overall, 29.6%, 23.5%, 90.9%, and 94.2% of the children met recommendations for vegetables and fruit, grain products, milk and alternatives, and meat and alternatives, respectively. In addition, 79.5% consumed at least one weekly serving of foods in the "choose least often" group. Significant differences existed in consumption of food groups across socioeconomic and demographic groups. For example, 82.9%, 84.7%, and 75.9% of preschool children from neighbourhoods of low, medium, and high socioeconomic status, respectively, consumed at least one food in the "choose least often" group (χ² =16.2, p<0.001).

CONCLUSIONS

Consumption of vegetables and fruit and grain products was low among participants, and intake of "choose least often" foods was high. Consumption of foods also differed among socioeconomic and demographic groups. To encourage healthy eating among children, public health professionals should target groups who do not meet the CFG recommendations.

Neighborhood disparities in access to healthy foods and their effects on environmental justice

Environmental justice is concerned with an equitable distribution of environmental burdens. These burdens comprise immediate health hazards as well as subtle inequities, such as limited access to healthy foods. We reviewed the literature on neighborhood disparities in access to fast-food outlets and convenience stores. Low-income neighborhoods offered greater access to food sources that promote unhealthy eating. The distribution of fast-food outlets and convenience stores differed by the racial/ethnic characteristics of the neighborhood. Further research is needed to address the limitations of current studies, identify effective policy actions to achieve environmental justice, and evaluate intervention strategies to promote lifelong healthy eating habits, optimum health, and vibrant communities.

"Too much of that stuff can't be good": Canadian teens, morality, and fast food consumption

Recently, public health agents and the popular media have argued that rising levels of obesity are due, in part, to "obesogenic" environments, and in particular to the clustering of fast food establishments in Western urban centers that are poor and working class. Our findings from a multi-site, cross-national qualitative study of teenaged Canadians' eating practices in urban and rural areas offer another perspective on this topic, showing that fast food consumption is not simply a function of the location of fast food outlets, and that Canadian teens engage in complex ways with the varied dimensions of choosing (or rejecting) fast foods. Drawing on evidence gleaned from semi-structured interviews with 132 teenagers (77 girls and 55 boys, ages 13-19 years) carried out between 2007 and 2009, we maintain that no easy relationship exists between the geographical availability of fast food and teen eating behaviors. We use critical obesity literature that challenges widely accepted understandings about obesity prevalence and etiology, as well as Lamont's (1992, 2000) concept of "moral boundary work," to argue that teen fast food consumption and avoidance is multifaceted and does not stem exclusively nor directly from spatial proximity or social class. Through moral boundary work, in which teens negotiated with moralistic notions of healthy eating, participants made and re-made themselves as "good" and successful subjects by Othering those who were "bad" in references to socially derived discourses of healthy eating.

School level correlates with adiposity in 9-10 year old children

We examined the associations between the physical, social, and policy environments of schools and adiposity in 9-10 year old children in Norfolk, UK. The relationships between 56 school-level variables and Fat Mass Index (FMI; fat mass (kg)/height (m(2))) were investigated among 1724 well characterised children from 92 schools in this cross-sectional study. After stepwise removal of variables from multilevel linear regression models stratified by gender, only three variables were significantly associated with FMI. Among girls, attending a school with more pupils in the year group was associated with lower FMI, and attending a school with better cycle provision was associated with higher FMI. In boys being allowed to eat any food at break-time was associated with higher FMI. There was some evidence of moderation of the relationship between cycle provision and FMI by urban-rural location. These data suggest that few school factors are associated with FMI, and provide limited pointers to inform potential future school-based interventions to reduce obesity.

"Pause-2-Play": a pilot schoolbased obesity prevention program

OBJECTIVES: "Pause-2-Play" is an obesity prevention program targeting screen-related sedentary behaviours and increasing physical activity among elementary school students. The program consisted of a Behavioural Modification Curriculum and a Health Promoting Afterschool Program. This pilot study reports program feasibility, practicability, and impact. METHODS: the 12-week pilot program was implemented with 32 grade five and six students. Program feasibility and practicability were assessed using a qualitative approach. Intervention effects were assessed by comparing pre-post changes in BMI, body composition, fitness scores, screen time, and cognitive variables related to screening viewing behaviours. RESULTS: "Pause-2-Play" was perceived as a useful, fun program with numerous benefits including: children trying new snacks, feeling fitter and better about one's own body shape, and becoming more aware of a healthy lifestyle. The intervention resulted in a statistically significant reduction in percent body fat and an increase in fat-free mass index in overweight children; a decrease in waist circumference and an increase in fat-free mass index were observed in normal weight children. The intervention also statistically improved fitness scores in both normal weight and overweight children. CONCLUSIONS: "Pause-2-Play" was feasible, practical, and favourably changed body composition and fitness level.

Comparison of children's body fatness between two contrasting income groups: contribution of height difference

OBJECTIVE

To compare measures of growth and body fatness (body mass index (BMI) and % body fat) in children from two contrasting income backgrounds and to examine the contribution of height difference to these measures.

DESIGN

Cross-sectional study.

SETTING

Schools in inner East London ('low income') and West London, Hertfordshire and Cambridgeshire ('high income'), UK.

PARTICIPANTS

A total of 2298 children aged 5-14 years.

MAIN OUTCOME MEASURES

Height, weight, BMI (weight per height(2)) and percentage body fat (%BF, by bioelectrical impedance analysis).

RESULTS

Children from the 'lower income' background were significantly shorter, heavier and fatter (%BF) with a higher BMI for their age compared with those from a 'higher income' background. Prevalence of overweight/obesity was greater in the 'lower income' group children, assessed on the basis of BMI, and this income group difference was magnified when based on %BF (overfat/obese). Irrespective of the assessment tool used, overweight/overfat/obese children as a group were significantly taller for their age compared with children categorized as normal weight/normal fat. Despite the overfat/obese children being taller for their age, an 'income group' difference in height remained within this category.

CONCLUSION

These findings confirm the income group influence on obesity prevalence. They also illustrate that BMI underestimates the true number of children having excess body fat, particularly in 'low income' children. Exactly why BMI seems to function differently along income group divisions in unclear, but a shorter height-for-age of the 'lower income' group children could be one explanation. These findings raise important questions about the causes and consequences of obesity in children from 'lower income' backgrounds.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

The "childhood obesity epidemic": health crisis or social construction?

There has been a meteoric rise over the past two decades in the medical research and media coverage of the so-called global childhood obesity epidemic. Recently, in response to this phenomenon, there has been a spate of books and articles in the fields of critical sociology and cultural studies that have argued that this "epidemic" is socially constructed, what Natalie Boero (2007) dubs a "postmodern epidemic." As an anthropologist who has studied child nutrition and obesity in relation to poverty and the school environment, I am concerned about both the lack of reflexivity among medical researchers as well as critical scholars' treatment of the problem as entirely socially constructed. In this article I present both sides of this debate and then discuss how wee can attempt to navigate a middle course that recognizes this health issue but also offers alternative approaches to those set by the biomedical agenda.

Food consumption patterns in elementary school children

PURPOSE

Food consumption was investigated in children attending three elementary schools in urban Hamilton, Ontario.

METHODS

Dietary data were collected from 92 children in grades 2 to 4 through 24-hour dietary recalls (39% participation rate). Servings of four food groups were compared with recommended daily servings in Canada's Food Guide.

RESULTS

The majority of students did not consume the recommended five daily servings of vegetables and fruit. On average, they consumed a high number of servings of "other foods," which were not included in the four food groups. More than 50% of the students did not consume the recommended daily servings of milk products, and only a small proportion (21%) drank milk during school lunch.

CONCLUSIONS

We recommend that primary school educators promote the consumption of vegetables and fruits and milk products at school, either through healthy snack programs or educational programs.

Dietary intake, overweight status, and perceptions of food insecurity among homeless Minnesotan youth

Youth, 9-18 years (n = 202), living in homeless shelters in Minneapolis, Minnesota, were assessed for height, weight, dietary intake, and perceptions of food insecurity. Perceptions of food security were measured by asking youth to respond to the statements (1) "There are times when we do not have enough food in the house," (2) "I go to bed hungry at night," (3) "I do not get enough to eat at home," and (4) "Have you ever had to miss a meal (or not been able to eat) because there was no food at home?" Additionally, questions evaluated coping mechanisms used by children to ward off hunger. Fifty-five percent of the children reported not enough food in the house and 25% reported going to bed hungry. Youth had inadequate intakes of vitamin D, calcium, and potassium and the majority consumed less than the estimated average requirements (EAR) for vitamins A, C, and E, phosphorus, folate, and zinc. Fruits, vegetables, and dairy were also consumed below recommended levels. Forty-five percent of boys and 50% of girls were at risk-for-overweight or were overweight. Overeating, eating anything, eating disliked foods, and eating at the homes of family and friends were identified as strategies to cope with food insecurity. Overeating when food is available may explain why we see a hunger-obesity paradigm to the magnitude that we do among the poorest Americans. These strategies protect children from the immediate negative associations of poverty and hunger, but they may contribute to long-term weight problems currently found in the US.

Elevated blood pressure in relation to overweight and obesity among children in a rural Canadian community

OBJECTIVE

Childhood overweight and obesity may result in premature onset of cardiovascular risk factors such as hypertension. Rural populations in North America may be at increased risk for overweight. We evaluated whether overweight and obesity were associated with prehypertension and hypertension in a well-characterized population of children in rural Canada.

METHODS

The study population for this cross-sectional study was composed of children (aged 4-17 years) who were participants of the Walkerton Health Study (Canada) in 2004. Prehypertension and hypertension were defined on the basis of percentiles from the average of 3 blood pressure measures taken on a single occasion. Percentiles for BMI and blood pressure were calculated by using the 2000 Centers for Disease Control and Prevention growth charts. Multinomial logistic regression was used to evaluate the odds for prehypertension and hypertension resulting from overweight and obesity.

RESULTS

Of 675 children (98.7% white), 122 (18.1%) were overweight and 77 (11.4%) were obese. Prehypertension and hypertension were detected in 51 (7.6%) and 50 (7.4%), respectively. After adjustment for family history of hypertension and kidney disease, obesity was associated with both prehypertension and hypertension. Overweight was associated with hypertension but not prehypertension. These associations were observed across the genders and children aged <13 and >or=13 years, except that overweight was not associated with hypertension among girls.

CONCLUSIONS

In this population of children who lived in a rural community in Canada, overweight and obesity were strongly associated with elevated blood pressure. Whether blood pressure normalizes with improvements in diet, physical activity, and environment is an area for additional study.

Using routine growth data to determine overweight and obesity prevalence estimates in preschool children in the Capital Health Region of Alberta

BACKGROUND

Overweight and obesity prevalence is increasing in Canadian children. In the Capital Health region of Alberta, there is a need to examine this public health issue and implement strategies to overcome it. Two growth references, one provided by the US Centers for Disease Control and Prevention (CDC), and the other by the International Obesity Task Force (IOTF), are available to assess individuals and screen populations for overweight and obesity. The prevalence can vary as a function of the reference used. The primary objective of this study is to determine prevalence estimates of overweight and obesity in 4-6 year olds in the Capital Health region. The secondary objective is to explore differences in estimates using both classification systems.

METHODS

Anthropometric measurements were incorporated into regular preschool immunization visits. Body Mass Index (BMI), defined as the bodyweight in kilograms divided by height in metres squared was calculated for each record and percentiles for age and sex were determined using cut-offs from the IOTF and CDC. The prevalence estimates of overweight and obesity using both classification systems were determined and compared.

RESULTS

Out of 7,369 children, 13.8% were overweight and 11.4% were obese according to the CDC reference. The IOTF reference classified 11.5% as overweight and 6.8% as obese. The two reference systems had moderate agreement (kappa 0.69, p<0.01).

CONCLUSION

The results indicate a lower prevalence estimate of overweight and obesity among young children in the Capital Health region compared to other parts of Canada. The IOTF reference provides more conservative estimates than the CDC reference, accounted for more by the difference in estimates of obesity than by the difference in estimates for overweight.

Effects of neighbourhood income on reported body mass index: an eight year longitudinal study of Canadian children

BACKGROUND

This study investigates the effects of neighbourhood income on children's Body Mass Index (BMI) from childhood (ages 2-3) to early adolescence (ages 10-11) using longitudinal data.

METHODS

Five cycles of data from the Canadian National Longitudinal Survey of Children and Youth are analyzed for a sub-sample of children (n = 2152) aged 2-3 at baseline (1994) and assessed at two year intervals to 2002. Body mass index percentiles are based on height/weight estimates reported by proxy respondents (child's person most knowledgeable). Family and neighbourhood factors were assessed at baseline. The prevalence of neighbourhood low income was obtained from the 1996 Census and divided into three categories from 'most poor' to 'least poor'. Longitudinal modelling techniques were applied to the data.

RESULTS

After controlling for individual/family factors (age, sex, income, education, family structure) living in the 'most poor' neighbourhood was associated with increasing BMI percentile (1.46, 95% CI 0.16 to 2.75) over time compared to a 'middle' income neighbourhood. Living in an urban (vs. rural) neighbourhood was associated with a decreased BMI percentile (-3.57, 95% CI -6.38 to -0.76) across all time periods.

CONCLUSION

These findings provide evidence that effects of neighbourhood disadvantage on children's BMI occur between childhood and early adolescence and suggest that policies should target the conditions of childhood, including the neighbourhood environment.

Gender differences in growth and nutrition in a sample of rural ontario schoolchildren

This paper reports findings of a cross-sectional study of the growth and nutrition of children living in rural Ontario, Canada. The objectives of the research were threefold: (1) to obtain data on obesity prevalence and nutrient intake in a sample of rural Canadian schoolchildren, (2) to compare findings with rural and national-level data on obesity prevalence and nutrient intake, and (3) to provide data to school board and public health agencies planning and implementing nutrition policy and programs to this population. Measures of height and weight were obtained for 504 children ages 7-13 years. Height for age and body mass index scores were calculated and compared with 2000 data from the Centers for Disease Control (Kuczmarski et al. [2002]: Vital Health Stat 246:1-190). Weekday 24-h dietary recall was conducted on a subsample of 352 children and the results compared with Canada's Food Guide (Health Canada,1997) and dietary reference data from the US Institute of Medicine (2000). Prevalence of overweight and obesity were high in this sample, with 17.7% of children classified as overweight and 10.9% of children classified as obese. Fifteen percent of boys were classified as obese, compared to 6.8% of girls. Boys consumed significantly more servings from the grain and meat food groups than girls. While mean daily intake of fiber and micronutrients was significantly low for both boys and girls, there were significant gender differences in nutrient intake, with boys consuming greater energy, protein, carbohydrate, calcium, iron, phosphorus, and sodium than girls. A number of limitations are discussed, in particular issues arising from the use of Dietary Reference Intakes.

Determinants of variation in food cost and availability in two socioeconomically contrasting neighbourhoods of Hamilton, Ontario, Canada

This study addresses links between economic and nutritional variation in an urban North American setting. We employed a mixed-methods approach including mapping, semi-structured interviews, and food outlet surveys to investigate the public health impact of variation in the cost and availability of food between two socioeconomically distinct neighbourhoods of the City of Hamilton, Ontario, Canada. Food cost in supermarkets was not found to be higher in the low-income neighbourhood, though it was much higher in the variety stores that predominate in the low-income neighbourhood. Moreover, there was a very low availability of produce in the variety stores. Reduced fresh produce availability and lower incomes have the potential to negatively influence public health in the less-affluent study area by increasing the difficulty of acquiring healthy foods.

Adverse environments: Investigating local variation in child growth

Epigenetic and life history approaches to child growth are centered on the relationship between the organism and its environment. However, defining and operationalizing the concept of environment is challenging, in light of the multiple variables that influence growth. Moreover, the concept of adaptation as it applies to child growth is seldom considered in the developed country context. This paper presents a study of children living in three neighborhoods in the City of Hamilton, Ontario, Canada. Two of the communities are considered adverse environments on the basis of low socioeconomic status, and their inner city, industrial location. In contrast to children living in the higher socioeconomic status area, children in these adverse environments display negative growth indicators, i.e., somewhat constrained linear growth in one and risk for overweight and obesity in both. Although both these inner city neighborhoods constitute adverse environments, they differ in ways that have a significant impact on children's growth. We argue for a definition of "adverse environment" that is broadly based, incorporating a range of physical, social, and temporal factors that are highly localized and sensitive to community-level influences on growth and health. As well, we consider whether higher prevalence of overweight and obesity is adaptive in any way to these adverse environments and conclude that they are more likely to be deleterious than adaptive in either the long or short term.

Obesity rates among rural Ontario schoolchildren

BACKGROUND

The majority of existing studies of obesity risk among Canadian children come from urban populations. The purpose of this study is to assess the prevalence of obesity in a sample of rural Ontario children.

METHODS

Measures of height and weight were obtained for 504 children attending seven public elementary schools in Grey and Bruce Counties, a predominantly rural area of Southern Ontario. Body mass index (BMI, or weight/height2) scores were calculated and compared with reference data from the Centers for Disease Control.

RESULTS

Rates of overweight and obesity were high in this sample, with 17.7% of children classified as overweight and 10.9% classified as obese. There was a significantly high prevalence of overweight for both boys (17.8%) and girls (17.5%) (Chi-square = 75.70, p < 0.001). However there was a significant gender difference in obesity prevalence: 15.0% of boys were obese, compared with 6.8% of girls (Mann-Whitney U = 29133.0, p > 0.05).

CONCLUSION

Findings indicate that among rural children--particularly boys--risk of overweight and obesity are at least as high as in their urban Canadian counterparts. There appear to be fewer girls than boys at the extreme high end of the distribution of BMI, which may indicate differences in the growth environment of rural boys and girls.

Methodological issues in the anthropometric assessment of Hmong children in the United States

The effectiveness of the body mass index (BMI; kg/m2) in assessing overweight/obesity may be diminished in populations of short stature. In a sample (n = 79) of Hmong refugee children in the United States, of age 4-11 years, median z scores for height, BMI, and the triceps skinfold were -1.04z, +0.53z, and +0.18z, respectively. Further, 41.7% of children were above the NHANES 85th percentile for BMI-for-age, categorizing them as overweight/obese. Assessment of obesity by other established criteria for children, such as the triceps skinfold and body fat percentage, produced significantly lower estimates than did BMI. This is consistent with patterns found in other stunted populations, suggesting that BMI be employed in conjunction with other methods when assessing overweight/obesity in these groups. Finally, although stunting and overweight/obesity were both common in this study, at the individual level height z scores were positively correlated to z scores of various measures of adiposity.