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Hanssen H, Moholdt T, Bahls M, Biffi A, Siegrist M, Lewandowski AJ, Biondi-Zoccai G, Cavarretta E, Kokkvoll A, Løchen ML, Maestrini V, Pinto RS, Palermi S, Thivel D, Wojcik M, Hansen D, Van Craenenbroeck EM, Weghuber D, Kraenkel N, Tiberi M. Lifestyle interventions to change trajectories of obesity-related cardiovascular risk from childhood onset to manifestation in adulthood: a joint scientific statement of the task force for childhood health of the European Association of Preventive Cardiology and the European Childhood Obesity Group. Eur J Prev Cardiol 2023; 30:1462-1472. [PMID: 37491406 DOI: 10.1093/eurjpc/zwad152] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/20/2023] [Accepted: 05/06/2023] [Indexed: 07/27/2023]
Abstract
There is an immediate need to optimize cardiovascular (CV) risk management and primary prevention of childhood obesity to timely and more effectively combat the health hazard and socioeconomic burden of CV disease from childhood development to adulthood manifestation. Optimizing screening programs and risk management strategies for obesity-related CV risk in childhood has high potential to change disease trajectories into adulthood. Building on a holistic view on the aetiology of childhood obesity, this document reviews current concepts in primary prevention and risk management strategies by lifestyle interventions. As an additional objective, this scientific statement addresses the high potential for reversibility of CV risk in childhood and comments on the use of modern surrogate markers beyond monitoring weight and body composition. This scientific statement also highlights the clinical importance of quantifying CV risk trajectories and discusses the remaining research gaps and challenges to better promote childhood health in a population-based approach. Finally, this document provides an overview on the lessons to be learned from the presented evidence and identifies key barriers to be targeted by researchers, clinicians, and policymakers to put into practice more effective primary prevention strategies for childhood obesity early in life to combat the burden of CV disease later in life.
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Affiliation(s)
- Henner Hanssen
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Grosse Allee 6, 4052 Basel, Switzerland
| | - Trine Moholdt
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Women's Clinic, St. Olavs Hospital, Trondheim, Norway
| | - Martin Bahls
- Department of Internal Medicine B University Medicine Greifswald, University of Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Alessandro Biffi
- Med-Ex Medicine & Exercise, Medical Partner Scuderia Ferrari, Rome, Italy
| | - Monika Siegrist
- Department of Prevention and Sports Medicine, School of Medicine, University Hospital 'rechts der Isar', Technical University of Munich, Munich, Germany
| | - Adam J Lewandowski
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Giuseppe Biondi-Zoccai
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
- Mediterranea Cardiocentro, Napoli, Italy
| | - Elena Cavarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
- Mediterranea Cardiocentro, Napoli, Italy
| | - Ane Kokkvoll
- Department of Paediatrics, Finnmark Hospital Trust, Hammerfest, Norway
| | - Maja-Lisa Løchen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Viviana Maestrini
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, 'Sapienza' University of Rome, Policlinico Umberto I, Rome, Italy
| | | | - Stefano Palermi
- Med-Ex Medicine & Exercise, Medical Partner Scuderia Ferrari, Rome, Italy
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Malgorzata Wojcik
- Department of Pediatric and Adolescent Endocrinology, Jagiellonian University Medical College, Krakow, Poland
| | - Dominique Hansen
- Department of Cardiology, Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
- UHasselt, Faculty of Rehabilitation Sciences, BIOMED-REVAL-Rehabilitation Research Centre, Hasselt University, Hasselt, Belgium
| | - Emeline M Van Craenenbroeck
- Research Group Cardiovascular Diseases, GENCOR Department, University of Antwerp, Campus Drie Eiken, Antwerp, Belgium
- Department of Cardiology, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Daniel Weghuber
- Obesity Research Unit, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - Nicolle Kraenkel
- Deutsches Herzzentrum der Charité (DHZC), Department of Cardiology, Angiology and Intensive Care, Campus Benjamin-Franklin (CBF), Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), Partner site Berlin, Germany
- Friede Springer- Cardiovascular Prevention Center @ Charité, Charite- Universitätsmedizin Berlin, Berlin, Germany
| | - Monica Tiberi
- Department of Public Health, Azienda Sanitaria Unica Regionale Marche AV 1, Pesaro, Italy
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Patel AI, Schmidt LA, McCulloch CE, Blacker LS, Cabana MD, Brindis CD, Ritchie LD. Effectiveness of a School Drinking Water Promotion and Access Program for Overweight Prevention. Pediatrics 2023; 152:e2022060021. [PMID: 37545466 PMCID: PMC10471511 DOI: 10.1542/peds.2022-060021] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Drinking water promotion and access shows promise for preventing weight gain. This study evaluated the impact of Water First, a school-based water promotion and access intervention on changes in overweight. METHODS Low-income, ethnically diverse elementary schools in California's Bay Area were cluster-randomized to intervention and control groups. Water First includes classroom lessons, water stations, and schoolwide water promotion over 1 school year. The primary outcome was overweight prevalence (BMI-for-age-and-sex ≥85th percentile). Students (n = 1249) in 56 fourth-grade classes in 18 schools (9 intervention, 9 control) from 2016 to 2019 participated in evaluation at baseline, 7, and 15 months. Data collection was interrupted in 8 additional recruited schools because of coronavirus disease 2019. RESULTS Of 1262 students from 18 schools, 1249 (47.4% girls; mean [SD] age, 9.6 [0.4] years; 63.4% Hispanic) were recruited. From baseline to 7 months, there was no significant difference in changes in overweight prevalence in intervention schools (-0.2%) compared to control schools (-0.4%) (adjusted ratio of odds ratios [ORs]: 0.7 [confidence interval (CI): 0.2-2.9] P = 0.68). From baseline to 15-months, increases in overweight prevalence were significantly greater in control schools (3.7%) compared to intervention schools (0.5%). At 15 months, intervention students had a significantly lower change in overweight prevalence (adjusted ratio of ORs: 0.1 [CI: 0.03-0.7] P = .017) compared to control students. There were no intervention effects for obesity prevalence. CONCLUSIONS Water First prevented increases in the prevalence of overweight, but not obesity, in elementary school students.
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Affiliation(s)
- Anisha I. Patel
- Department of Pediatrics, Stanford University, Palo Alto, California
| | - Laura A. Schmidt
- Philip R. Lee Institute for Health Policy Studies
- Department of Humanities and Social Sciences
| | | | - Lauren S. Blacker
- Department of Pediatrics, Stanford University, Palo Alto, California
| | - Michael D. Cabana
- Department of Pediatrics, Division of General Pediatrics, Albert Einstein College of Medicine, Children’s Hospital at Montefiore, Bronx, New York
| | - Claire D. Brindis
- Philip R. Lee Institute for Health Policy Studies
- Division of Adolescent and Young Adult Health, Department of Pediatrics, University of California, San Francisco, California
| | - Lorrene D. Ritchie
- Nutrition Policy Institute, University of California Division of Agriculture and Natural Resources, Davis, California
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Merlo C, Smarsh BL, Xiao X. School Nutrition Environment and Services: Policies and Practices That Promote Healthy Eating Among K-12 Students. THE JOURNAL OF SCHOOL HEALTH 2023; 93:762-777. [PMID: 37670594 PMCID: PMC10502941 DOI: 10.1111/josh.13365] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/06/2023] [Accepted: 06/22/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Changes to policies at the federal, state, and local levels over the last decade have influenced the school nutrition environment and services. METHODS This systematic review includes an analysis of individual research articles and government reports published from 2010 to 2021 that examine interventions to improve the school nutrition environment and services and increase the availability, selection, and consumption of healthier foods and beverages in K-12 schools in the United States. RESULTS Nutrition standards for school meals and food outside of meals improved access to healthier options in school. Providing school nutrition professionals with professional development, improving the palatability of school meals, offering taste tests, pre-slicing fruit, providing recess before lunch, offering incentives for trying healthier options, and providing access to drinking water resulted in increased selection and consumption of healthier items. There were inconclusive or mixed findings for some intervention strategies including adequate seat time for meals. CONCLUSIONS Despite demonstrated improvements to school meal programs and competitive foods, more work is needed to change the selection and consumption of healthier options among K-12 students. Schools can use multiple interventions to improve the school nutrition environment and services and help students adopt food and beverage choices that support health.
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Affiliation(s)
- Caitlin Merlo
- Healthy Schools Branch, Division of Population Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
| | - Brianna L Smarsh
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
| | - Xiangxue Xiao
- Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada Las Vegas, Las Vegas, NV
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Moliterno P, Matjazic J, Widhalm K. Improvement of body composition in 8- to 11-year-old schoolboys: effects of a 6-months lifestyle intervention A retrospective evaluation of the “EDDY-Kids” prevention study. CHILD AND ADOLESCENT OBESITY 2022. [DOI: 10.1080/2574254x.2022.2140576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
| | - Julia Matjazic
- Austrian Academic Institute for Clinical Nutrition. Austria
| | - Kurt Widhalm
- Austrian Academic Institute for Clinical Nutrition. Austria
- Medical University of Vienna. Vienna Austria
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Li G, Yang L, Xu X, Chen M, Cai Y, Wen Y, Xie X, Lu X, Luo S, Lin S, Li H, Wu S. Physical Changes of Preschool Children during COVID-19 School Closures in Fujian, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13699. [PMID: 36294276 PMCID: PMC9602639 DOI: 10.3390/ijerph192013699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/14/2022] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic may constitute an "obesogenic lifestyle" that results in exacerbating childhood obesity. However, studies investigating regional sociodemographic factors including different age groups or sexes in children with obesity are lacking. We aimed to clarify the high obesity prevalence populations of preschool children to provide a regional basis for children's health policy during the COVID-19 school closures. From May to September 2019, a total of 29,518 preschool children were included in a large sample, multicenter cross-sectional study to explore physical status in Fujian Province by stratified cluster random sampling. In October 2019 and October 2020, we also conducted a cross-sectional study exploring physical development including changes in height, weight, and BMI of 1688 preschool children in Fuzhou before and after the COVID-19 school closures. Student' s t-test, Mann-Whitney U test, or chi-square test was used to assess differences in physical development and overweight and obesity rates among preschool children before and after school closures. For regional factors, the weight of urban preschool children of all ages became higher after the outbreak (p (age 3-4) = 0.009; p (age 4-5) < 0.001; p (age 5-6) = 0.002). For sex factors, overweight and obesity in boys had a greater prevalence than in girls before and after the outbreak. In four age groups, overweight and obesity rates in the 5-year-old group (15.5% and 9.9%) were higher than before (11.4% and 6.0%). The weight and BMI of 4- to 5-year-old children also increased faster than before (p < 0.001). The COVID-19 pandemic has promoted the epidemic of childhood obesity. Living in urban/coastal (economically developed) areas, boys, and aged 4-6 years old may be a susceptible population to obesity development after the outbreak.
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Affiliation(s)
- Guobo Li
- Department of Child Healthcare Centre, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou 350001, China
| | - Le Yang
- School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Xingyan Xu
- School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Mingjun Chen
- School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Yingying Cai
- Department of Developmental and Behavioral Pediatrics, Fujian Children’s Hospital, Fuzhou 350014, China
| | - Yeying Wen
- School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Xiaoxu Xie
- School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Xinyue Lu
- School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Suping Luo
- School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Shaowei Lin
- School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Huangyuan Li
- School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Siying Wu
- School of Public Health, Fujian Medical University, Fuzhou 350122, China
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Hoelscher DM, Brann LS, O’Brien S, Handu D, Rozga M. Prevention of Pediatric Overweight and Obesity: Position of the Academy of Nutrition and Dietetics Based on an Umbrella Review of Systematic Reviews. J Acad Nutr Diet 2022; 122:410-423.e6. [DOI: 10.1016/j.jand.2021.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/27/2021] [Accepted: 11/03/2021] [Indexed: 01/08/2023]
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Hawkins GT, Lee SH, Michael SL, Merlo CL, Lee SM, King BA, Rasberry CN, Underwood JM. Individual and Collective Positive Health Behaviors and Academic Achievement Among U.S. High School Students, Youth Risk Behavior Survey 2017. Am J Health Promot 2021; 36:651-661. [PMID: 34967223 PMCID: PMC10150493 DOI: 10.1177/08901171211064496] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE We examined associations between academic grades and positive health behaviors, individually and collectively, among U.S. high school students. DESIGN Cross-sectional study design. SETTING Data were from the 2017 national Youth Risk Behavior Survey. Response rates were 75% for schools, 81% for students, and 60% overall (n = 14,765 students). SUBJECTS Youth in grades 9th-12th. MEASURES We focused on youth behaviors that can prevent or delay the onset of chronic health conditions. Seven dietary, 3 physical activity, 2 sedentary screen time, and 4 tobacco product use behaviors were assessed. Variables were dichotomized (0/1) to indicate that a score was given to the positive health behavior response (e.g.,, did not smoke cigarettes = 1). A composite score was created by summing each positive health behavior response among 16 total health behaviors. ANALYSIS Multivariable logistic regression analyses for each individual health behavior, and a multivariable negative binomial regression for the composite score, were conducted with self-reported academic grades, controlling for sex, grade in school, race/ethnicity, and body mass index (BMI) categories. RESULTS Controlling for covariates, students who reported mostly A's had 2.0 (P < .001) more positive health behaviors; students who reported mostly B's had 1.3 (P < .001) more positive health behaviors; and students who reported mostly C's had .78 (P < .001) more positive health behaviors, compared to students who reported mostly D's/F's. CONCLUSIONS Higher academic grades are associated with more positive individual and cumulative health behaviors among high school students. Understanding these relationships can help inform efforts to create a healthy and supportive school environment and strive for health equity.
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Affiliation(s)
- Georgianne Tiu Hawkins
- 1242Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Seung Hee Lee
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Shannon L Michael
- 1242Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Caitlin L Merlo
- 1242Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sarah M Lee
- 1242Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Brian A King
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Catherine N Rasberry
- Division of Adolescent and School Health, 1242Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - J M Underwood
- 1242Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
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