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Sylvester AD, Zbijewski W, Shi G, Meckel LA, Chu EY, Cunningham DL, Wescott DJ. Macroscopic differences in adult human femora are linked to body mass index. Anat Rec (Hoboken) 2024; 307:2846-2857. [PMID: 38284320 DOI: 10.1002/ar.25397] [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: 07/28/2023] [Revised: 01/10/2024] [Accepted: 01/13/2024] [Indexed: 01/30/2024]
Abstract
Bone functional adaptation is routinely invoked to interpret skeletal morphology despite ongoing debate regarding the limits of the bone response to mechanical stimuli. The wide variation in human body mass presents an opportunity to explore the relationship between mechanical load and skeletal response in weight-bearing elements. Here, we examine variation in femoral macroscopic morphology as a function of body mass index (BMI), which is used as a metric of load history. A sample of 80 femora (40 female; 40 male) from recent modern humans was selected from the Texas State University Donated Skeletal Collection. Femora were imaged using x-ray computed tomography (voxel size ~0.5 mm), and segmented to produce surface models. Landmark-based geometric morphometric analyses based on the Coherent Point Drift algorithm were conducted to quantify shape. Principal components analyses were used to summarize shape variation, and component scores were regressed on BMI. Within the male sample, increased BMI was associated with a mediolaterally expanded femoral shaft, as well as increased neck-shaft angle and decreased femoral neck anteversion angle. No statistically significant relationships between shape and BMI were found in the female sample. While mechanical stimulus has traditionally been applied to changes in long bong diaphyseal shape it appears that bone functional adaptation may also result in fundamental changes in the shape of skeletal elements.
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Affiliation(s)
- Adam D Sylvester
- Center for Functional Anatomy and Evolution, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Wojciech Zbijewski
- Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, Maryland, USA
| | - Gengxin Shi
- Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, Maryland, USA
| | - Lauren A Meckel
- Department of Cell Biology and Anatomy, Louisiana State University Health Science Center, Baton Rouge, Louisiana, USA
| | - Elaine Y Chu
- Department of Anthropology, Texas State University, San Marcos, Texas, USA
| | | | - Daniel J Wescott
- Department of Anthropology, Texas State University, San Marcos, Texas, USA
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2
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Iwatate E, Atem FD, Jones EC, Hughes JL, Yokoo T, Messiah SE. Trends in the relationship between suicide behaviors and obesity among adolescents in the United States from 1999 to 2019. Eur Child Adolesc Psychiatry 2024; 33:725-737. [PMID: 36933151 DOI: 10.1007/s00787-023-02191-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 03/08/2023] [Indexed: 03/19/2023]
Abstract
Previous studies indicate that obesity is a risk factor of suicide behaviors among adolescents. Whether this association has remained consistent during the ongoing obesity epidemic remains unknown. The time trends of the obesity-suicide association were examined using the 1999-2019 biannual Youth Risk Behavior Survey data (n = 161,606). Prevalence odds ratio of suicide behaviors among adolescents with obesity (vs. adolescents with no obesity) for each survey year and time trends using National Cancer Institute Joinpoint regression analysis was calculated. For each year post-baseline, there was a significant increase of prevalence odds ratio of 1.4 (1.2-1.6)-1.6 (1.3-2.0) for suicide ideation, 1.3 (1.1-1.7) -1.7 (1.4-2.0) for plan, and 1.3 (1.0-1.7) -1.9 (1.5-2.4) for an attempt, except for the 2013 survey for attempt (1.19 [0.9-1.6]). Significant positive trends were found from1999 to 2019 for ideation and plan, with biannual %-changes of + 0.92 and + 1.22%, respectively. Adolescents with obesity have consistently higher odds of engaging in suicide behaviors than their peers without obesity since the beginning of the United States obesity epidemic, and this association grew stronger as the obesity epidemic continued.
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Affiliation(s)
- Eriko Iwatate
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas Regional Campus, Trinity Towers, 2777 N Stemmons Fwy, Dallas, TX, 75207, USA.
| | - Folefac D Atem
- Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth, Dallas Regional Campus, Dallas, TX, USA
- Center for Pediatric Population Health, Children's Health System of Texas and UTHealth School of Public Health, Dallas, TX, USA
| | - Eric C Jones
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, El Paso Regional Campus, El Paso, TX, USA
| | - Jennifer L Hughes
- Department of Psychiatry and Behavioral Health, College of Medicine and Division of Health Behavior and Health Promotion, College of Public Health, Big Lots Behavioral Health Services, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA
| | - Takeshi Yokoo
- Department of Radiology, University of Texas Southwestern, Dallas, TX, USA
| | - Sarah E Messiah
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas Regional Campus, Trinity Towers, 2777 N Stemmons Fwy, Dallas, TX, 75207, USA
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3
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Inoue K, Seeman TE, Nianogo R, Okubo Y. The effect of poverty on the relationship between household education levels and obesity in U.S. children and adolescents: an observational study. LANCET REGIONAL HEALTH. AMERICAS 2023; 25:100565. [PMID: 37559944 PMCID: PMC10407960 DOI: 10.1016/j.lana.2023.100565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/13/2023] [Accepted: 07/18/2023] [Indexed: 08/11/2023]
Abstract
Background Although ample evidence has shown the link between childhood obesity and socioeconomic status including family income and household education levels, the mediating role of poverty in the association between household education levels and childhood obesity is unclear. This study aimed to quantify the extent to which family poverty levels contribute to the association between household education levels and obesity among US children and adolescents. Methods This cohort study used the nationally representative data of 21,754 US children and adolescents aged 6-17 years (National Health and Nutrition Examination Survey 1999-2018). We applied mediation analysis of the association between household education levels (less than high school, high school, and college or above) and obesity mediated through poverty (≤138% vs. >138% federal poverty level), adjusting for demographic characteristics of household head and their offspring. Obesity was defined as age- and sex-specific body mass index in the 95th percentile or greater using the 2000 Centers for Disease Control and Prevention growth charts. Findings Among 21,754 children and adolescents (weighted N = 43,544,684; mean age, 11.6 years; female, 49%), 9720 (weighted percentage, 33.0%) were classified as living in poverty and 4671 (weighted percentage, 19.1%) met the criteria for obesity. Low household education level (less than high school) showed increased risks of poverty (adjusted relative risk [95% CI], 5.82 [4.90-6.91]) and obesity (adjusted relative risk [95% CI], 1.94 [1.68-2.25]) compared to high household education level (college or above). We also quantified that poverty mediated 18.9% of the association between household education levels and obesity among children and adolescents. The mediation effect was consistently observed across age, gender, and race/ethnicity. Interpretation Poverty mediated the association between the low educational status of household heads and their offspring's obesity. Our findings highlight the importance of reducing obesity risk among the low-income population to minimize the burden of intergenerational health disparities due to socioeconomic status. Funding Japan Society for the Promotion of Sciences (22K17392).
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Affiliation(s)
- Kosuke Inoue
- Department of Social Epidemiology, Graduate School of Medicine, Kyoto University, Japan
- Hakubi Center, Kyoto University, Japan
| | - Teresa E. Seeman
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Division of Geriatrics, Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Roch Nianogo
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Yusuke Okubo
- Department of Social Medicine, National Center for Child Health and Development, Japan
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Lim CS, Robinson J, Hinton E, Gordy XZ, Gamble A, Compretta C, Holmes ME, Ravola M. School-based obesity prevention programs in rural communities: a scoping review. JBI Evid Synth 2022; 20:2936-2985. [PMID: 36513382 PMCID: PMC10278058 DOI: 10.11124/jbies-21-00233] [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] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The objective of this review was to examine existing literature and conceptually map the evidence for school-based obesity prevention programs implemented in rural communities, as well as identify current gaps in the literature. INTRODUCTION Pediatric obesity is a significant public health condition worldwide. Rural residency places children at increased risk of obesity. Schools have been identified as an avenue for obesity prevention in rural communities. INCLUSION CRITERIA We considered citations focused on children (5 to 18 years of age) enrolled in a rural educational setting. We included obesity prevention programs delivered in rural schools that focused on nutrition or dietary changes, physical activity or exercise, decreasing screen time, or combined nutrition and physical activity that aimed to prevent childhood obesity. We included all quantitative, qualitative, and mixed methods research designs, as well as text and opinion data. METHODS A search was conducted of published and unpublished studies in English from 1990 through April 2020 using PubMed, CINAHL Complete, ERIC, Embase, Scopus, Academic Search Premier, Cochrane Register of Controlled Trials, and ClinicalTrials.gov. Gray literature was also searched. After title and abstract review, potentially relevant citations were retrieved in full text. The full texts were assessed in detail against the inclusion criteria by 2 independent reviewers. Included citations were reviewed and data extracted by 2 independent reviewers and captured on a spreadsheet targeting the review objectives. RESULTS Of the 105 studies selected for full-text review, 72 (68.6%) were included in the final study. Most of the studies (n = 50) were published between 2010 and 2019 and were conducted in the United States (n = 57). Most studies included children in rural elementary or middle schools (n = 57) and targeted obesity prevention (n = 67). Teachers implemented the programs in half of the studies (n = 36). Most studies included a combination of physical activity and nutrition components (n = 43). Other studies focused solely on nutrition (n = 9) or physical activity (n = 9), targeted obesity prevention policies (n = 9), or other components (n = 8). Programs ranged in length from weeks to years. Overall, weight-related, physical activity-specific, and nutrition-specific outcomes were most commonly examined in the included citations. CONCLUSIONS Obesity prevention programs that focused on a combination of physical activity and nutrition were the most common. Multiple outcomes were examined, but most programs included weight-specific and health behavior-specific outcomes. The length and intensity of rural school-based obesity prevention programs varied. More research examining scientific rigor and specific outcomes of rural school-based obesity prevention programs is needed.
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Affiliation(s)
- Crystal S. Lim
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
- Mississippi Centre for Evidence Based Practice: A JBI Centre of Excellence, Jackson, MS, USA
| | - Jennifer Robinson
- Mississippi Centre for Evidence Based Practice: A JBI Centre of Excellence, Jackson, MS, USA
- School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA
| | - Elizabeth Hinton
- Mississippi Centre for Evidence Based Practice: A JBI Centre of Excellence, Jackson, MS, USA
- School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA
- Rowland Medical Library, University of Mississippi Medical Center, Jackson, MS, USA
| | - Xiaoshan Z. Gordy
- School of Health Related Professions, University of Mississippi Medical Center, Jackson, MS, USA
| | - Abigail Gamble
- School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA
| | - Caroline Compretta
- Department of Preventive Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Megan E. Holmes
- Department of Kinesiology, Mississippi State University, Starkville, MS, USA
| | - Martha Ravola
- School of Agriculture and Applied Sciences, Alcorn State University, Lorman, MS, USA
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Relationship between teacher fidelity to an early childhood obesity prevention program and the Child care center nutrition and physical activity environment. Prev Med Rep 2022; 30:102024. [PMID: 36262774 PMCID: PMC9574711 DOI: 10.1016/j.pmedr.2022.102024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 10/10/2022] [Accepted: 10/12/2022] [Indexed: 11/07/2022] Open
Abstract
The child care center is an optimal setting for obesity prevention. Yet, little attention has been paid to teacher fidelity to obesity prevention programs. Measuring teacher fidelity may provide guidance for further improvements to sustainability. Teacher fidelity was correlated with the nutrition but not the physical environment. Childcare center teachers may require continued support for obesity prevention.
Background Child care centers (CCC) can be strategic settings to establish healthy lifestyle behaviors through obesity prevention programs. Fidelity to the implementation of such programs is a vital evaluation component, but is often not measured. This study assessed CCC teacher fidelity to the implementation of “Healthy Caregivers, Healthy Children (HC2)”, a CCC-based obesity prevention intervention. Methods CCCs serving low-resource, ethnically diverse families with ≥ 50 children ages 2-to-5 years old that were randomized to the HC2 intervention and that had teacher fidelity data collected (n = 9 CCC) were included in this analysis. The Environment and Policy Assessment and Observation (EPAO) tool assessed the CCC nutrition and physical activity (PA) environment at the beginning/end of the school year. Fidelity assessments were conducted in CCCs randomized to HC2 in Spring 2016 (n = 33 teachers) and 2017 (n = 39 teachers) by a trained observer. The relationship between teacher fidelity and EPAO was assessed via mixed models. Results For every-one unit rise in teacher fidelity, EPAO nutrition increased 0.055 points (p =.006). No significant relationship was shown between teacher fidelity and EPAO PA score (p =.14). Conclusion Teacher fidelity to obesity prevention program implementation may support a healthy CCC obesity prevention and nutrition environment but might require continued support for all components.
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El Mikati HK, Boateng AO, McKinney BM, Haberlin-Pittz K, Pike J, Perry P, Hannon TS, Yazel-Smith L. Forever-Fit Summer Camp: The Impact of a 6-Week Summer Healthy Lifestyle Day Camp on Anthropometric, Cardiovascular, and Physical Fitness Measures in Youth With Obesity. J Prim Care Community Health 2021; 11:2150132720903888. [PMID: 31994432 PMCID: PMC6990606 DOI: 10.1177/2150132720903888] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Pediatric obesity is a public health concern with lifestyle intervention as the first-line treatment. Forever-Fit Summer Camp (FFSC) is a 6-week summer day program offering physical activity, nutrition education, and well-balanced meals to youth at low cost. The aim of the study was to assess the efficacy of this program that does not emphasize weight loss rather emphasizes healthy behaviors on body mass index, cardiovascular and physical fitness. Methods: The inclusion criteria were adolescents between 8 and 12 years and body mass index (BMI) ≥85th percentile. The data were collected at baseline and week 6 (wk-6) and was analyzed for 2013-2018 using paired-sample t tests. Results: The participants’ (N = 179) average age was 10.6 ± 1.6 years with a majority of females (71%) and black race/ethnicity (70%). At wk-6, BMI and waist circumference decreased by 0.8 ± 0.7 kg/m2 and 1.0 ± 1.3 in, respectively. Resting heart rate, diastolic and systolic blood pressure decreased by 8.5 ± 11.0 bpm, 6.3 ± 8.8 mmHg, and 6.4 ± 10.1 mmHg, respectively. The number of pushups, curl-ups, and chair squats were higher by 5.8 ± 7.5, 6.7 ± 9.1, and 7.7 ± 8.5, respectively. Conclusion: The FFSC is efficacious for improving BMI, cardiovascular, and physical fitness in the short term. The effect of similar episodic efforts that implement healthy lifestyle modifications throughout the school year should be investigated.
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Affiliation(s)
| | | | | | | | - Julie Pike
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Patrick Perry
- American Foundation for Preventive Medicine, Indianapolis, IN, USA
| | - Tamara S Hannon
- Indiana University School of Medicine, Indianapolis, IN, USA
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7
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Huang G, Aroner SA, Bay CP, Gilman SE, Ghassabian A, Loucks EB, Buka SL, Handa RJ, Lasley BL, Bhasin S, Goldstein JM. Sex-dependent associations of maternal androgen levels with offspring BMI and weight trajectory from birth to early childhood. J Endocrinol Invest 2021; 44:851-863. [PMID: 32776198 PMCID: PMC7873156 DOI: 10.1007/s40618-020-01385-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 08/02/2020] [Indexed: 01/06/2023]
Abstract
CONTEXT In preclinical studies, high androgen levels during pregnancy are associated with low birth weight and rapid postnatal weight gain in the offspring. However, human data linking prenatal androgens with birth weight and early life weight gain in the offspring are scarce. DESIGN We evaluated 516 mother-child pairs enrolled in the New England birth cohorts of the Collaborative Perinatal Project (1959-1966). We assayed androgen bioactivity in maternal sera during third-trimester using a receptor-mediated luciferase expression bioassay. Age and sex-specific BMI Z-scores (BMIz), defined using established standards, were assessed at birth, 4 months, 1 year, 4 years, and 7 years. We used linear mixed models to evaluate the relation of maternal androgens with childhood BMIz overall and by sex. We examined the association of maternal androgens with fetal growth restriction. The association of weight trajectories with maternal androgens was examined using multinomial logistic regression. RESULTS Higher maternal androgen levels associated with lower BMIz at birth (β = - 0.39, 95% CI: - 0.73, - 0.06); this relation was sex-dependent, such that maternal androgens significantly associated with BMIz at birth in girls alone (β = - 0.72, 95% CI: - 1.40, - 0.04). The relation of maternal androgens with fetal growth restriction revealed dose threshold effects that differed by sex. There was no significant association between maternal androgens and weight trajectory overall. However, we found a significant sex interaction (p = 0.01); higher maternal androgen levels associated with accelerated catch-up growth in boys (aOR = 2.14, 95% CI: 1.14, 4.03). CONCLUSION Our findings provide evidence that maternal androgens may have differential effects on the programming of intrauterine growth and postnatal weight gain depending on fetal sex.
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Affiliation(s)
- G Huang
- Section of Men's Health, Aging and Metabolism, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - S A Aroner
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - C P Bay
- Center for Clinical Investigation, Brigham and Women's Hospital, Boston, MA, USA
| | - S E Gilman
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Health, Bethesda, MD, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - A Ghassabian
- Departments of Pediatrics, Environmental Medicine, and Population Health, New York University School of Medicine, New York, NY, USA
| | - E B Loucks
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - S L Buka
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - R J Handa
- Department of Biomedical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
- Department of Basic Medical Sciences, University of Arizona College of Medicine, Phoenix, AZ, USA
| | - B L Lasley
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
- Department of Obstetrics and Gynecology, School of Medicine, Center for Health and the Environment, University of California Davis, Davis, CA, USA
- Center for Health and the Environment, University of California, Davis, CA, USA
| | - S Bhasin
- Section of Men's Health, Aging and Metabolism, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - J M Goldstein
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Rambaran K, Teelucksingh S, Gowrie Sankar S, Boyne M, Xuereb G, Giorgetti A, Zimmermann MB. High prevalence of childhood overweight and obesity in ten Caribbean countries: 2018 cross-sectional data and a narrative review of trends in Trinidad and Tobago. CHILD AND ADOLESCENT OBESITY 2020. [DOI: 10.1080/2574254x.2020.1847632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
- Kirin Rambaran
- Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Surujpal Teelucksingh
- Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Sesh Gowrie Sankar
- Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Michael Boyne
- Department of Medicine, The University of the West Indies, Mona, Jamaica
| | - Godfrey Xuereb
- Regional Office for the Americas, Pan American Health Organization, Washington, DC, USA
| | - Ambra Giorgetti
- Human Nutrition, ETH Zurich, Swiss Federal Institute of Technology, Zurich, Switzerland
| | - Michael B. Zimmermann
- Human Nutrition, ETH Zurich, Swiss Federal Institute of Technology, Zurich, Switzerland
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Muchira JM, Gona PN, Mogos MF, Stuart‐Shor E, Leveille SG, Piano MR, Hayman LL. Temporal Trends and Familial Clustering of Ideal Cardiovascular Health in Parents and Offspring Over the Life Course: An Investigation Using The Framingham Heart Study. J Am Heart Assoc 2020; 9:e016292. [PMID: 32486880 PMCID: PMC7429037 DOI: 10.1161/jaha.120.016292] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background Evidence suggests familial aggregation and intergenerational associations for individual cardiovascular health (CVH) metrics. Over a 53‐year life course, we examined trends and association of CVH between parents and their offspring at similar mean ages. Methods and Results We conducted a series of cross‐sectional analyses of the FHS (Framingham Heart Study). Parent‐offspring pairs were assessed at exams where their mean age distributions were similar. Ideal CVH was defined using 5 CVH metrics: blood pressure (<120/<80 mm Hg), fasting blood glucose (<100 mg/dL), blood cholesterol (<200 mg/dL), body mass index (<25 kg/m2), and non‐smoking. Joinpoint regression and Chi‐squared test were used to assess linear trend; proportional‐odds regression was used to examine the association between parents and offspring CVH. A total of 2637 parents were paired with 3119 biological offspring throughout 6 exam cycles. Similar patterns of declining ideal CVH with advancing age were observed in parents and offspring. Small proportions of parents (4%) and offspring (17%) achieved 5 CVH metrics at ideal levels (P‐trend <0.001). Offspring of parents with poor CVH had more than twice the odds of having poor CVH (pooled odds ratio, 2.59; 95% CI, 1.98–3.40). Over time, elevated glucose levels and obesity doubled among the offspring and were the main drivers for declining ideal CVH trends. Conclusions Parental CVH was positively associated with offspring CVH. However, intergenerational CVH gains from declining smoking rates, cholesterol, and blood pressure were offset by rising offspring obesity and elevated glucose levels. This suggests an intergenerational phenotypic shift of risk factors and the need for a family‐centered approach to cardiovascular care.
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Affiliation(s)
- James M. Muchira
- Center for Research Development and ScholarshipVanderbilt University, School of NursingNashvilleTN
- College of Nursing and Health SciencesUniversity of Massachusetts BostonBostonMA
| | - Philimon N. Gona
- College of Nursing and Health SciencesUniversity of Massachusetts BostonBostonMA
| | - Mulubrhan F. Mogos
- Center for Research Development and ScholarshipVanderbilt University, School of NursingNashvilleTN
| | - Eileen Stuart‐Shor
- College of Nursing and Health SciencesUniversity of Massachusetts BostonBostonMA
- Beth Israel Deaconess Medical CenterBostonMA
| | - Suzanne G. Leveille
- College of Nursing and Health SciencesUniversity of Massachusetts BostonBostonMA
- Beth Israel Deaconess Medical CenterBostonMA
- Harvard Medical SchoolBostonMA
| | - Mariann R. Piano
- Center for Research Development and ScholarshipVanderbilt University, School of NursingNashvilleTN
| | - Laura L. Hayman
- College of Nursing and Health SciencesUniversity of Massachusetts BostonBostonMA
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10
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Robinson JC, Lim CS, Hinton E, Pintado I, Gamble A, Compretta C, Ravola M. School-based obesity prevention programs in rural communities: a scoping review protocol. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2019; 17:1326-1333. [PMID: 31169774 PMCID: PMC7201295 DOI: 10.11124/jbisrir-2017-003957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The objective of this scoping review is to map the available literature on school-based obesity prevention programs in rural communities. INTRODUCTION Significant health disparities are associated with childhood obesity, and these disparities disproportionately affect children in disadvantaged communities, such as rural areas. Youth in rural areas are 26% more likely to be obese than youth in urban communities. To combat obesity in children, schools have become an avenue for educating children about the importance of healthy diet and physical activity. Although many school-based obesity prevention programs have been implemented in recent years, more information is needed on programs in rural communities. INCLUSION CRITERIA This scoping review will consider studies that include children 5 to 18 years of age who are enrolled in elementary, middle or high school in a rural setting and that investigate school-based obesity prevention programs. Studies that include children who are in non-rural areas, who are home-schooled, who are in an alternative setting (e.g. juvenile detention) or who are hospitalized will be excluded. Studies published in English since 1990 will be included. METHODS Multiple databases will be searched, including PubMed, CINAHL, ERIC, Embase, Scopus and Academic Search Premier. Trials registers and gray literature will also be searched. After screening the titles and abstracts of identified citations, potentially relevant studies will be retrieved in full. Data will be extracted by independent reviewers and presented in a diagrammatic or tabular form, accompanied by a narrative summary.
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Affiliation(s)
- Jennifer C. Robinson
- School of Nursing, University of Mississippi Medical
Center, Jackson, USA
- Mississippi Centre for Evidence Based Practice: a Joanna
Briggs Institute Centre of Excellence
| | - Crystal S. Lim
- School of Medicine, University of Mississippi Medical
Center, Jackson, USA
- Mississippi Centre for Evidence Based Practice: a Joanna
Briggs Institute Centre of Excellence
| | - Elizabeth Hinton
- School of Nursing, University of Mississippi Medical
Center, Jackson, USA
- Rowland Medical Library, University of Mississippi Medical
Center, Jackson, USA
- Mississippi Centre for Evidence Based Practice: a Joanna
Briggs Institute Centre of Excellence
| | - Irene Pintado
- College of Nursing & Health Sciences, Mississippi
University for Women, Columbus, USA
| | - Abigail Gamble
- School of Population Health, University of Mississippi
Medical Center, Jackson, USA
| | - Caroline Compretta
- School of Medicine, University of Mississippi Medical
Center, Jackson, USA
- Mississippi Centre for Evidence Based Practice: a Joanna
Briggs Institute Centre of Excellence
| | - Martha Ravola
- School of Agriculture and Applied Sciences, Alcorn State
University, Lorman, USA
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11
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Bradbury D, Chisholm A, Watson PM, Bundy C, Bradbury N, Birtwistle S. Barriers and facilitators to health care professionals discussing child weight with parents: A meta-synthesis of qualitative studies. Br J Health Psychol 2018; 23:701-722. [PMID: 29700900 PMCID: PMC6099303 DOI: 10.1111/bjhp.12312] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 03/13/2018] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Childhood obesity is one of the most serious global public health challenges. However, obesity and its consequences are largely preventable. As parents play an important role in their children's weight-related behaviours, good communication between parents and health care professionals (HCPs) is essential. This systematic review provides a meta-synthesis of qualitative studies exploring the barriers and facilitators experienced by HCPs when discussing child weight with parents. METHODS Searches were conducted using the following databases: MEDLINE (OVID), Psych INFO (OVID), EMBASE (OVID), Web of Knowledge and CINAHL. Thirteen full-text qualitative studies published in English language journals since 1985 were included. Included studies collected data from HCPs (e.g., nurses, doctors, dieticians, psychologists, and clinical managers) concerning their experiences of discussing child weight-related issues with parents. An inductive thematic analysis was employed to synthesize findings. FINDINGS Emerging subthemes were categorized using a socio-ecological framework into intra/interpersonal factors, organizational factors, and societal factors. Perceived barriers and facilitators most commonly related to intra/interpersonal level factors, that is, relating to staff factors, parental factors, or professional-parent interactions. HCPs also attributed a number of barriers, but not facilitators, at the organizational and societal levels. CONCLUSION The findings of this review may help to inform the development of future weight-related communication interventions. Whilst intra/interpersonal interventions may go some way to improving health care practice, it is crucial that all stakeholders consider the wider organizational and societal context in which these interactions take place. Statement of contribution What is already known on the subject? Childhood obesity is one of the United Kingdom's most serious current public health challenges. Health care professionals are in a prime position to identify child weight issues during routine consultations. However, they often feel unable or unequipped to raise the topic and provide information on child weight management. What does this study add? To our knowledge, this is the first review to synthesize barriers and facilitators to discussing child weight. This review interprets key barriers and facilitators in the context of the socio-ecological model. Supports the development of interventions matched to the appropriate level of the socio-economic model.
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Affiliation(s)
- Daisy Bradbury
- Physical Activity ExchangeResearch Institute for Sport and Exercise SciencesLiverpool John Moores UniversityUK
| | | | - Paula M. Watson
- Physical Activity ExchangeResearch Institute for Sport and Exercise SciencesLiverpool John Moores UniversityUK
| | | | | | - Sarah Birtwistle
- Physical Activity ExchangeResearch Institute for Sport and Exercise SciencesLiverpool John Moores UniversityUK
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Association between serum uric acid and metabolic syndrome components in prepubertal obese children (Tanner Stage I) from Nuevo León, Mexico - a preliminary study. BMC OBESITY 2017; 4:25. [PMID: 28690854 PMCID: PMC5496402 DOI: 10.1186/s40608-017-0160-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 06/22/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND Metabolic syndrome (MetS) is a major risk factor for cardiovascular disease and diabetes. Previous studies in obese children demonstrating a positive association between serum uric acid (sUA) and components of MetS are confounded by lack of uniformity in age and pubertal status of children. Therefore, we have examined the role of sUA in MetS and its components in pre-pubertal children (Tanner Stage I, age ≤ 9 years). METHODS Pre-pubertal obese children (32 boys, 27 girls, age 6-9 years) were recruited from Nuevo Leon, Mexico. For comparison, an equal number of children with normal body mass index (BMI) in the same age range (22 Boys, 39 girls, age 6-9 years) were also recruited from the same community. Presence of MetS and its components was defined according to the criteria of International Diabetes Federation. Fasting blood was analyzed for lipids, glucose, insulin, and uric acid. RESULTS Among the obese children, sUA was positively associated with insulin resistance and hypertriglyceridemia and negatively associated with high density lipoprotein-cholesterol (HDLc). Subjects were three times more likely to have a MetS diagnosis per one unit (md/dL) difference in sUA. Of the 59 obese pre-pubertal children, 20 were classified as having MetS defined by the presence of abdominal obesity and two or more of other components described under methods. Of these, 57.1% (20/61) had sUA between 5.1 and 7.1 mg/dl. CONCLUSIONS The findings of this study clearly indicate a positive relationship between uric acid and MetS and its components in pre-pubertal obese children with Tanner stage I and ≤9 years of age.
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Do LM, Tran TK, Eriksson B, Petzold M, Ascher H. Prevalence and incidence of overweight and obesity among Vietnamese preschool children: a longitudinal cohort study. BMC Pediatr 2017. [PMID: 28629345 PMCID: PMC5477312 DOI: 10.1186/s12887-017-0904-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background A plateau in childhood overweight and obesity has been reported in some developed countries while in almost all developing countries this problem is on the rise. The aim of this paper is to describe the changes in prevalence of overweight and obesity within a cohort of preschool children followed for 3 years, and to estimate and compare the incidences in urban and rural children of Hanoi, Vietnam. Methods A longitudinal study of a cohort of 2677 children aged 3 to 6 years old at the beginning of the study was conducted in urban DodaLab and rural FilaBavi, Hanoi, Vietnam. Overall, 2602 children, 1311 urban and 1291 rural, were followed for 3 years with identical measurements of weight and height in 2013, 2014 and 2016. Standard methods were used to estimate prevalence and incidence as well as confidence intervals. Results During the three-year follow-up, the overall estimated prevalence of overweight increased from 9.1% to 16.7%. For the urban children, the increase was considerably higher. The overall prevalence of obesity decreased from 6.4% to 4.5% with less decrease in the urban children. In the group of children who were overweight and obese at the start of the study, 41.4% and 30.7%, respectively, remained in the same state three years later. The incidence of overweight and obesity during the three years were 12.4% and 2.7%, respectively. Boys were more likely to develop obesity than girls. Conclusions Already in preschool age, the prevalence of overweight is high and it continues to increase with age, especially in the urban area. Prevention and intervention programs need to start at early preschool age and actions in urban areas deserve priority.
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Affiliation(s)
- Loan Minh Do
- Outpatient Department, National Hospital of Paediatrics, 18/879 La Thanh Road, Dong Da District, Hanoi, Vietnam.
| | - Toan Khanh Tran
- Family Medicine Department, Hanoi Medical University, No.1 Ton That Tung Street, Hanoi, Vietnam
| | - Bo Eriksson
- Health Metrics, Department of Public Health and Community Medicine, Institute of Medicine at the Sahlgrenska Academy, University of Gothenburg, PO Box 440, -405 30, Gothenburg, SE, Sweden
| | - Max Petzold
- Health Metrics, Department of Public Health and Community Medicine, Institute of Medicine at the Sahlgrenska Academy, University of Gothenburg, PO Box 440, -405 30, Gothenburg, SE, Sweden.,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Henry Ascher
- Section for Epidemiology and Social Medicine (EPSO), Department of Public Health and Community Medicine, Institute of Medicine at the Sahlgrenska Academy, University of Gothenburg, PO Box 453, -405 30, Gothenburg, SE, Sweden.,Angered Hospital, Gothenburg, Sweden
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von Hippel PT, Nahhas RW, Czerwinski SA. How much do children's body mass indices change over intervals of 6-12 months? Statistics from before and during the obesity epidemic. Pediatr Obes 2015; 10:468-75. [PMID: 25704952 DOI: 10.1111/ijpo.12008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 11/20/2014] [Accepted: 12/05/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND Researchers need to evaluate changes in children's body mass index (BMI) over periods of 6 or 12 months, yet reference statistics are limited for change in BMI. OBJECTIVES We aim to estimate the distribution of changes in children's BMIs over periods of 6 and 12 months. METHODS We analyze data on two cohorts of children in the Fels Longitudinal Study: an older cohort born 1946-1970 and a recent cohort born 1971-1995. Between ages 3 and 18 years, we calculate changes in BMI over intervals of 6 and 12 months. For each age, sex and cohort, we estimate the mean, standard deviation, skewness, kurtosis and percentiles of change in BMI. RESULTS Median BMI growth peaks around age 12-13 years for girls and 13-15 years for boys. Large BMI gains are common in adolescence, and BMI losses are not uncommon at any age. Percentiles of BMI change are quite dispersed, especially for girls and especially in adolescence. In the recent cohort, the adiposity rebound is earlier and BMI gains are larger, especially at the high percentiles. CONCLUSIONS Researchers can use these estimates to evaluate data quality, evaluate effect sizes and calculate the sample size needed to detect an effect.
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Affiliation(s)
- P T von Hippel
- LBJ School of Public Affairs, University of Texas at Austin, Austin, TX, USA
| | - R W Nahhas
- Division of Morphological Sciences and Biostatistics, Lifespan Health Research Center, Department of Community Health, Boonshoft School of Medicine, Wright State University, Kettering, OH, USA
| | - S A Czerwinski
- Division of Epidemiology, Lifespan Health Research Center, Department of Community Health, Boonshoft School of Medicine, Wright State University, Kettering, OH, USA
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Lucan SC. Concerning limitations of food-environment research: a narrative review and commentary framed around obesity and diet-related diseases in youth. J Acad Nutr Diet 2014; 115:205-212. [PMID: 25443565 DOI: 10.1016/j.jand.2014.08.019] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 08/15/2014] [Indexed: 10/24/2022]
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Zhou SS, Zhou Y. Excess vitamin intake: An unrecognized risk factor for obesity. World J Diabetes 2014; 5:1-13. [PMID: 24567797 PMCID: PMC3932423 DOI: 10.4239/wjd.v5.i1.1] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 12/07/2013] [Accepted: 12/17/2013] [Indexed: 02/05/2023] Open
Abstract
Over the past few decades, food fortification and infant formula supplementation with high levels of vitamins have led to a sharp increase in vitamin intake among infants, children and adults. This is followed by a sharp increase in the prevalence of obesity and related diseases, with significant disparities among countries and different groups within a country. It has long been known that B vitamins at doses below their toxicity threshold strongly promote body fat gain. Studies have demonstrated that formulas, which have very high levels of vitamins, significantly promote infant weight gain, especially fat mass gain, a known risk factor for children developing obesity. Furthermore, ecological studies have shown that increased B vitamin consumption is strongly correlated with the prevalence of obesity and diabetes. We therefore hypothesize that excess vitamins may play a causal role in the increased prevalence of obesity. This review will discuss: (1) the causes of increased vitamin intake; (2) the non-monotonic effect of excess vitamin intake on weight and fat gain; and (3) the role of vitamin fortification in obesity disparities among countries and different groups within a country.
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