Etiology of Obesity Over the Life Span: Ecological and Genetic Highlights from Asian Countries

Intergenerational Transmission of Obesity from Mothers to Their Offspring: Trends and Associated Factors Derived from the Malaysian National Health and Morbidity Survey (NHMS)

Along with the increasing overweight and obesity trends among adults and children globally, numerous studies have suggested a strong association between maternal overweight and obesity among their offspring. We sought to report the prevalence and associated factors of intergenerational overweight and obesity among mother–child pairs in Malaysia from 2006 to 2015. Data were analysed from three waves of the Malaysian National Health and Morbidity Survey, a population-based cross-sectional study conducted in 2006, 2011 and 2015. A mother and the youngest child from each household formed ‘mother–child pairs’ and were grouped according to their body mass index categories. A multivariable logistic regression model was performed to determine the factors associated with overweight mother/overweight child pairs (OWM/OWC), with normal weight mother/normal weight child pairs (NWM/NWC) as the reference group. The prevalence of OWM/OWC increased from 15.3% to 21.7%, while the prevalence of NWM/NWC decreased from 28.4% to 23.8% between 2006 and 2015. Older maternal age and having primary and secondary education levels were positively associated with OWM/OWC. Conversely, older child age, Chinese ethnicity, large household size and low-income households were inversely associated with OWM/OWC. In conclusion, intergenerational weight gain is a worrisome trend in Malaysia. These findings may help in guiding priority setting for obesity prevention strategies in Malaysia.

Oral processing behaviours that promote children's energy intake are associated with parent-reported appetitive traits: Results from the GUSTO cohort

Oral processing behaviours associated with faster eating rates have been consistently linked to increased energy intakes, but little is known about their links to children's appetitive traits. This study used the Child Eating Behaviour Questionnaire (CEBQ) to explore cross-sectional and prospective associations between parent-reported appetitive traits and observed oral processing behaviours. Participants were 195 children from the Growing Up in Singapore Towards healthy Outcomes cohort, who participated in a video-recorded ad libitum lunch at 4.5 (Time 1) and 6 years (Time 2). Their mothers completed the CEBQ around the same time points. Children's bites, chews and swallows were coded, and used to calculate their eating rate, bite size, chews per bite, chew rate, oral exposure time and oral exposure per bite. At Time 1, children with higher scores in slowness in eating had lower eating and chew rates. At Time 2, higher scores for food enjoyment and lower for satiety responsiveness, slowness in eating, and food fussiness were linked with higher eating rates and greater energy intakes (r > 0.16, p < 0.05). Post-hoc analyses revealed that these associations were moderated by BMI and only present among children with higher BMI. Faster eating rates mediated the associations between greater food enjoyment, lower slowness in eating, lower food fussiness and higher intakes of energy. Children with higher slowness in eating scores had lower increases in eating rates over time, and children with higher BMI who had greater food enjoyment and food responsiveness scores had greater increases in eating rates over time. The findings suggest that oral processing behaviours linked with increased obesity risk may be underpinned by appetitive traits and may be one of the behavioural pathways through which these appetitive traits influence energy intakes.

Validity and Reliability of a Nutrition Knowledge Questionnaire in an Adult Student Population

OBJECTIVE

To assess the validity and reliability of the Kuwait Adult Nutrition Knowledge Questionnaire (KANKQ) in adult students as an initial step to validation in the general adult population.

METHODS

Participants (n = 253; aged ≥21 years) were categorized based on academic background and designated into groups known to differ in nutrition knowledge. Participants completed the questionnaire twice. Independent-samples t test, Pearson correlation coefficients, and Cronbach α were used to assess reliability and validity (P < .05).

RESULTS

Participants with health-related (n = 144) and nutrition-training backgrounds (n = 58) scored significantly higher than did those without them (n = 109 and 178, respectively; P < .001), indicating good construct validity of the KANKQ. Test-retest reliability (r = .67; P < .001) and internal consistency (α = .81) of the questionnaire were moderate to high.

CONCLUSIONS AND IMPLICATIONS

Further testing of the KANKQ in workplaces and public areas is required for validation in the general adult population. Applicability to neighboring countries of similar background is warranted.

Physical Activity Environment and Japanese Adults' Body Mass Index

Evidence about the impacts of the physical activity environment on adults’ weight in the context of Asian countries is scarce. Likewise, no study exists in Asia examining whether Walk Score^®—a free online walkability tool—is related to obesity. This study aimed to examine associations between multiple physical activity environment measures and Walk Score^® ratings with Japanese adults’ body mass index (BMI). Data from 1073 adults in the Healthy Built Environment in Japan study were used. In 2011, participants reported their height and weight. Environmental attributes, including population density, intersection density, density of physical activity facilities, access to public transportation, and availability of sidewalks, were calculated using Geographic Information Systems. Walk Scores^® ratings were obtained from the website. Multiple linear regression analysis was conducted to examine the association between each environmental attribute and BMI. Adjusting for covariates, all physical activity environmental attributes were negatively associated with BMI. Similarly, an increase of one standard deviation of Walk Score^® was associated with a 0.29 (95% confidence interval (CI) of −0.49–−0.09) decrease in BMI. An activity-friendly built environment was associated with lower adults’ BMI in Japan. Investing in healthy community design may positively impact weight status in non-Western contexts.

Children's exposure to food advertising on free-to-air television: an Asia-Pacific perspective

There is an established link between food promotions and children's food purchase and consumption. Children in developing countries may be more vulnerable to food promotions given the relative novelty of advertising in these markets. This study aimed to determine the scope of television food advertising to children across the Asia-Pacific to inform policies to restrict this marketing. Six sites were sampled, including from China, Indonesia, Malaysia and South Korea. At each site, 192 h of television were recorded (4 days, 16 h/day, three channels) from May to October 2012. Advertised foods were categorized as core/healthy, non-core/unhealthy or miscellaneous, and by product type. Twenty-seven percent of advertisements were for food/beverages, and the most frequently advertised product was sugar-sweetened drinks. Rates of non-core food advertising were highest during viewing times most popular with children, when between 3 (South Korea) and 15 (Indonesia) non-core food advertisements were broadcast each hour. Children in the Asia-Pacific are exposed to high volumes of unhealthy food/beverage television advertising. Different policy arrangements for food advertising are likely to contribute to regional variations in advertising patterns. Cities with the lowest advertising rates can be identified as exemplars of good policy practice.