Excessive body weight of children and adolescents in the spotlight of their parents' overweight and obesity, physical activity, and screen time

Prevalence of overweight/obesity, and associated factors among adolescents aged 12 ∼ 15 in Shandong Province, China: A cross-sectional study

Overweight/obesity among adolescents in Shandong Province, China, has been rising, posing significant public health challenge. Comprehensive investigation is needed to develop effective interventions. Following the Strengthening the Reporting of Observational Studies in Epidemiology guidelines, a stratified random cluster sampling approach was used from September to October 2023 across 17 cities in Shandong Province. The study included 165 middle schools, surveying 99,638 students aged 12 ∼ 15. After applying exclusion criteria, 97,356 students (97.71% effective rate) completed anthropometric measurements and questionnaires. Overweight/obesity were assessed based on national and international standards. Univariable chi-square test and multivariable logistic regression were used to analyze factors influencing overweight/obesity. In 2023, the overweight/obesity rate among 12 ∼ 15-year-olds in Shandong was 19.75%. Significant factors included sex, age, residence, family income, parental weight status and activity, mother's gestational diabetes history, birth weight, physical activity, sleep, screen time, homework, and diet. Girls, older adolescents, and those with physically active parents or who themselves engaged in over 1.5 h of daily physical activity had lower odds of being overweight/obese. Adequate sleep and frequent consumption of vegetable and fruit were also protective. Higher odds were associated with urban residence, high family income, overweight/obese parents, maternal gestational diabetes, high birth weight, excessive screen time, extensive homework, and frequent fast food consumption. Overweight/obesity in Shandong adolescents is influenced by multiple determinants. Holistic interventions addressing genetic, behavioral, and environmental factors are essential for promoting healthier lifestyles and reducing the prevalence in this demographic.

Maternal-child overweight relationship, assessment of maternal perception of child weight status and feeding behaviours

BACKGROUND

Parents play a key role in constructing children' behaviours. We studies maternal-child overweight relationship and compared maternal perception of child weight status and feeding behaviours between groups of normal-weight and overweight children.

METHODS

The cross-sectional study was conducted on 192 girls aged 10-13 years and their mothers. They were divided to two groups of overweight (n = 94) and normal-weight (n = 98) children. Anthropometric characteristics were measured for children and mothers. Logistic regression analysis was used to examine the association between child overweight and tertiles of maternal body mass index (BMI). Maternal perception of child's weight status and her engagement in promoting child's healthy behaviours was assessed.

RESULTS

BMI and waist circumference was significantly higher in children (P < 0.001) and mothers (P < 0.01) of overweight compared to normal-weight group. There was a significant relationship between children's overweight and tertiles of maternal BMI, which remained significant after adjusting for potential confounders. Mothers of overweight children were more concerned for their child's overeating and overweight, and for compelling the child to diet to maintain a desirable weight (P < 0.001). In contrast, mothers of normal-weight children restricted sugar-sweetened drinks (P = 0.008), offered fruit and vegetables (P = 0.035), and helped their children to get enough physical activity (P = 0.022) and night sleep (P = 0.001) more than mothers in other group.

CONCLUSIONS

This study showed a strong relationship between children and mothers' overweight. Despite being more concerned about their child weight status, mothers of overweight children reported behaviours which were less encouraging the children for healthy eating and lifestyle than mothers of normal-weight children.

Accelerometer-measured sleep behaviour and parent-child sleep guideline adherence and sleep quality in Czech families with children aged 3-8 years: the FAMIly Physical Activity, Sedentary behaviour and Sleep (FAMIPASS) study

Assessing parent-child relationship in sleep behaviours is important for facilitating changes in the sleep guideline compliance in preschool age children. The aim of this study was to examine accelerometer-measured sleep quantity and quality in families with children aged 3-8 years and investigate the parents' influence on the child's sleep. The data were obtained from the Czech cross-sectional FAMIly Physical Activity, Sedentary behaviour and Sleep (FAMIPASS) study, with a final sample of 374 families. Families were recruited through the enrolment of their children in kindergartens/primary schools between March 2022 and May 2023. The sleep time window and total sleep time were assessed using a wrist-worn ActiGraph accelerometer. Participants wore this device continuously for 24 h/day over a period of 7 consecutive days. Demographic data and potential correlates were obtained via questionnaires completed by parents. Statistical analyses were completed using logistic regression and independent-samples Mann-Whitney U test. In all, 65.5% of children (60% boys, 70.9% girls) and 58.3% of parents (52.4% fathers, 64.3% mothers) achieved the recommended sleep duration. Greater sleep quantity and duration in good-quality sleep were significantly higher in girls/mothers, compared to boys/fathers. Preschoolers were more likely to comply with sleep guidelines if their mother (but not father) met the sleep recommendation and their mothers did not have a higher education level. Adhering to sleep guidelines in children was also associated with children's female gender, absence of screen device in the bedroom, and being more active. Given the high concurrence in mother-child sleep quantity, it is important to promote healthy sleep behaviours in the whole family.

Which behaviour change techniques are associated with interventions that increase physical activity in pre-school children? A systematic review

BACKGROUND

Insufficient physical activity (PA) is a significant risk factor that contributes to several health problems and there is a need to improve our understanding of how to increase PA, particularly among young children. This review (PROSPERO registration: CRD42022328841) investigated the relationship between behaviour change techniques (BCTs) and interventions that increased PA among pre-school children aged < 6 years old.

METHODS

Systematic searches of six databases were undertaken from inception to July 2022, updated in December 2022, to locate studies that evaluated interventions and reported a positive change in PA levels in children aged < 6 years old.

RESULTS

A total of 5,304 studies were screened, and 28 studies involving 10,605 subjects aged 2.5 to 5.9 years met the eligibility criteria. Each eligible study (n = 28) was independently appraised by two researchers using the Cochrane risk of bias tool. The BCT Taxonomy v1 and the Template for Intervention Description and Replication (TIDieR) guided the extraction and analysis of data, and this process led to the identification of 27 BCTs.

CONCLUSIONS

Potentially promising BCTs for increasing PA among young children included 'shaping knowledge,' 'antecedents,' 'goals and planning,' and 'comparison of behaviour.' Future PA interventions that target young children should consider integrating these promising BCTs into their programmes. However, such consideration needs to be tempered by the fact that most of the reviewed studies were deemed to have a high or unclear risk of bias and/or were limited with respect to the populations that they targeted. Further research using rigorous methodologies is required to establish a higher standard that addresses the needs of young children who are expected to have insufficient levels of physical activity.

FAMIly Physical Activity, Sedentary behaviour and Sleep (FAMIPASS) study: protocol for a cross-sectional study

INTRODUCTION

The development of children's healthy and active lifestyles, including habit formation for optimal 24-hour movement behaviour, is associated with their family environment. A whole-family study collecting comprehensive data that can evaluate family lifestyle behaviours in different settings in depth has the potential to provide the evidence-based information needed for national guidelines, for designing interventions and for supporting policy-makers' decisions.

METHODS AND ANALYSIS

The FAMIly Physical Activity, Sedentary behaviour and Sleep (FAMIPASS) study is a nationally representative cross-sectional study that will recruit 500 families (with at least 1 child aged between 3 and 8 years) from the urban and rural parts of all three regions of the Czech Republic. To examine the relationship between family environment and children's healthy development (eg, healthy weight) and children's active lifestyle behaviour, anthropometric measures, parents' health-related behaviour (including dietary habits, alcohol and tobacco use, screen time and bedtime rules and 24-hour movement behaviour), socioeconomic data and data about the characteristics of the home and neighbourhood will be collected from parents and children. The 24-hour movement behaviour (eg, sleep, sedentary behaviour and physical activity) will be monitored using wGT3X-BT and GT9X Link ActiGraph accelerometers placed on the non-dominant wrist of the children and their parents for 7 consecutive days. The accelerometers will be set up for each family separately, using the group proximity mode, allowing proximity tagging between devices and establishing the time spent together and parent-child coactivities.

ETHICS AND DISSEMINATION

The overarching methodological protocol of the FAMIPASS project was approved by the Ethics Committee of the Faculty of Physical Culture, Palacký University Olomouc, Czech Republic (reference number: 25/2021). The results and findings will be reported to: (1) the participating families and (2) school representatives and will be (3) presented at national and international conferences and (4) disseminated via peer-reviewed publications.

Dietary Patterns in Adolescent Obesity as Predictors of Long-Term Success Following an Intensive Inpatient Lifestyle Programme

(1) Background: Lifestyle interventions for adolescents with obesity show minor long-term effects on anthropometric parameters. The persistence of dietary changes after obesity inpatient rehabilitation has not been sufficiently investigated. (2) Objectives: To analyse dietary patterns in German adolescents with obesity as predictors of long-term success following an intensive inpatient lifestyle programme regarding food choices as well as body weight and comorbidities. (3) Methods: Food consumption data of 137 German adolescents with obesity aged 10-17 years were collected by a nutrition interview. Cluster analysis was used to group the participants according to their food consumption. Dietary patterns, changes in body weight and insulin resistance were compared over a 2-year-period. (4) Results: Three dietary patterns were identified. Big Eaters (n = 32) consume high amounts of total sugar and meat, Moderate Eaters (n = 66) have a diet comparable to the national average, and Snackers (n = 39) have a particularly high consumption of total sugar. Big Eaters and Snackers significantly reduced the consumption of total sugar. Among Moderate Eaters, no persistent changes were observed. (5) Conclusion: Weight reduction interventions can induce long-lasting changes in the diet of adolescents with obesity. Therefore, the success of a weight reduction intervention should not be determined by weight reduction only.

Association of Cardiovascular Risk Factors between Adolescents and Their Parents Is Mitigated by Parental Physical Activity-A Cross-Sectional Study

INTRODUCTION

It is hypothesized that children's habits can be modulated by their parent's lifestyle. However, it is still not established whether the relationship between cardiovascular risk factors (CVRF) in adolescents and their parents could be attenuated by parental physical activity levels.

OBJECTIVE

This study aimed to analyze the relationship of CVRF between adolescents and their parents according to parental physical activity level.

METHODS

A school-based sample of 1231 adolescents, 1202 mothers and 871 fathers were included (n = 3304). The CVRF assessed were overweight, hypertension, smoking and alcohol consumption. The parental physical activity level was assessed using a validated questionnaire, being classified into physically active and inactive parents. The statistical analysis considered all parents and stratification by physical activity level.

RESULTS

The prevalence of CVRF was higher in fathers than in mothers (70.6% vs. 54.9% for overweight, 23.3% vs. 19.7% for hypertension, 17.9% vs. 12.4% for smoking and 60.4% vs. 28.5% for alcohol consumption). Adolescents with active mothers showed lower prevalence of overweight (13.9% vs. 19.6%), while adolescents with active fathers showed higher prevalence of alcohol consumption (23.5% vs. 16.9%). The CVRF of both fathers and mothers were positively associated with CVRF of adolescents. However, the association of CVRF between adolescents and their parents was mitigated among active parents, while all the CVRF remained associated in physically inactive parents.

CONCLUSION

The parental physical activity level seems to mitigate the association of CVRF between adolescents and their parents. The promotion of an active lifestyle at the family level can contribute to reduce CVRF among adolescents.

Prevalence and Correlates of Overweight, Obesity and Physical Activity in Italian Children and Adolescents from Lombardy, Italy

Investigating pediatric overweight and physical activity correlates is essential to design effective preventive programs. We used regional data (Lombardy, northern Italy) from the 2019 survey “OKKio alla Salute” (3093 children aged 8–9 years with measured anthropometric data), and from the 2018 wave of the “Health Behaviour in School-aged Children” survey (2916 adolescents aged 11–15 years with self-reported anthropometric data). In both the surveys, a cluster sampling methodology was used. Unconditional multiple logistic regression models were applied to estimate the odds ratios (OR) and corresponding 95% confidence intervals (CI) of overweight, obesity and poor physical activity. The prevalence of overweight (including obesity) was 22.4% for children aged 8–9 years and 14.4% for adolescents aged 11–15 years. A higher prevalence of overweight was observed among males, children with greater birth weight and those with obese parents. Scant physical activity was higher among females and older adolescents. There was a direct relationship between obesity and increased psychological distress (OR = 2.44; 95% CI: 1.12–5.27) or being victims of bullying (OR = 2.25; 95% CI: 1.17–4.34). Increasing physical activity significantly decreased the frequency of mental health outcomes. Prevention campaigns should be promoted to safeguard childhood physical and psychological wellbeing.

Surveillance of physical activity and sedentary behaviour in czech children and adolescents: a scoping review of the literature from the past two decades

BACKGROUND

This study aimed to map the available evidence related to physical activity (PA) and sedentary behaviour (SB) in Czech children and adolescents and suggest future directions and improvements to strengthen the surveillance of PA and SB in the Czech Republic.

METHODS

The search of articles published between January 2000 and December 2020 included the Medline and Medvik databases and a manual search in eight Czech journals related to the topic. This review followed the "Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews".

RESULTS

Out of 350 identified articles, 79 articles met the criteria for selection and referred to 27 studies. The majority of the articles were cross-sectional (89%), approximately two-thirds of the articles (61%) examined only PA, and half of the articles (51%) employed device-based assessments. Approximately 47% of the articles reported the prevalence of physical inactivity on the basis of inconsistently defined recommendations. Approximately 14%, 23%, and 10% of the articles focused on active transportation, organized PA (including physical education or leisure-time PA), and parent-child PA, respectively.

CONCLUSIONS

Future studies need to focus on longitudinal design and interventions, randomly selected samples, a mix of device-based and self-reported methods, and the recognition of health-related 24-hour time use patterns. This review advocates the government-supported development of a national surveillance system that will help to reduce insufficient PA and excessive SB.

Examining current physical activity interventions in Black school-age children and parents: A systematic review

Obesity is prevalent in Black children and adults; increasing physical activity (PA) can aid in reducing childhood obesity in both age groups. The purpose of this systematic review is to examine current research on PA interventions in school-age Black children. Adhering to PRISMA guidelines, a systematic search was conducted in six databases for PA interventions in Black children. A total of 13 articles met inclusion criteria (n = 7 randomized controlled trial, n = 5 quasi-experimental, n = 1 cross-sectional). The majority of the articles were on a combination of diet and PA programs (n = 9). Four articles targeted PA and parental role modeling of PA as the outcome showing positive intervention effects. Nine additional studies included PA as an outcome variable along with at least one additional obesity-related predictor. PA interventions for Black school-age children typically use a parent-child dyadic approach (n = 13), are guided by theory (n = 11) and are high quality. However, continued investigation is warranted to draw definitive conclusions and determine how to best involve parents within the PA interventions. Theory-driven higher quality trials that clearly describe the structured PA component and outcomes among Black parent-child dyads are needed.

The Relationship between Obesity and Physical Activity of Children in the Spotlight of Their Parents' Excessive Body Weight

Background: The study reveals the relationships between daily physical activity (PA) and the prevalence of obesity in family members separated according to the participation of their offspring in organized leisure-time physical activity (OLTPA), and answers the question of whether the participation of children in OLTPA is associated with a lower prevalence of obesity in offspring with respect to parental PA and body weight level. Methods: The cross-sectional study included 1493 parent-child dyads (915/578 mother/father-child aged 4–16 years) from Czechia selected by two-stage stratified random sampling with complete data on body weight status and weekly PA gathered over a regular school week between 2013 and 2019. Results: The children who participated in OLTPA ≥ three times a week had a significantly lower (p < 0.005) prevalence of obesity than the children without participation in OLTPA (5.0% vs. 11.1%). Even in the case of overweight/obese mothers/fathers, the children with OLTPA ≥ three times a week had a significantly lower (p < 0.002) prevalence of obesity than the children without OLTPA (6.7%/4.2% vs. 14.9%/10.7%). Conclusions: The cumulative effect of regular participation in OLTPA and a child’s own PA is a stronger alleviator of children’s obesity than their parents’ risk of overweight/obesity.