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Nikolaus CJ, Johnson S, Benally T, Maudrie T, Henderson A, Nelson K, Lane T, Segrest V, Ferguson GL, Buchwald D, Blue Bird Jernigan V, Sinclair K. Food Insecurity among American Indian and Alaska Native People: A Scoping Review to Inform Future Research and Policy Needs. Adv Nutr 2022; 13:1566-1583. [PMID: 35092417 PMCID: PMC9526849 DOI: 10.1093/advances/nmac008] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 01/11/2022] [Accepted: 01/24/2022] [Indexed: 01/28/2023] Open
Abstract
Food insecurity, defined as insufficient access to nutritious foods, is a social determinant of health that may underpin health disparities in the US. American Indian and Alaska Native (AI/AN) individuals experience many health inequities that may be related to food insecurity, but no systematic analyses of the existing evidence have been published. Thus, the objective of this scoping review was to assess the literature on food insecurity among AI/AN individuals and communities, with a focus on the prevalence of food insecurity and its relations to sociodemographic, nutrition, and health characteristics. Systematic search and data extraction processes were used. Searches were conducted on PubMed as well as peer-reviewed journal and government websites. Of 3174 identified references, 34 publications describing 30 studies with predominantly AI/AN sample populations were included in the final narrative synthesis. Twenty-two studies (73%) were cross-sectional and the remaining 8 (27%) described interventions. The weighted average prevalence of food insecurity across the studies was 45.7%, although estimates varied from 16% to 80%. Most studies used some version of the USDA Food Security Survey Modules, although evidence supporting its validity in AI/AN respondents is limited. Based on the review, recommendations for future research were derived, which include fundamental validity testing, better representation of AI/AN individuals in federal or local food security reports, and consideration of cultural contexts when selecting methodological approaches. Advances in AI/AN food insecurity research could yield tangible benefits to ongoing initiatives aimed at increasing access to traditional foods, improving food environments on reservations and homelands, and supporting food sovereignty.
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Affiliation(s)
- Cassandra J Nikolaus
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA
- Elson S Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Selisha Johnson
- Community-Oriented Public Health Practice Program, University of Washington School of Public Health, Seattle, WA, USA
| | - Tia Benally
- Community-Oriented Public Health Practice Program, University of Washington School of Public Health, Seattle, WA, USA
| | - Tara Maudrie
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Austin Henderson
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA
| | - Katie Nelson
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA
| | - Trevor Lane
- Community and Economic Development, Ferry County Extension, Washington State University, Republic, WA, USA
| | | | - Gary L Ferguson
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA
| | - Dedra Buchwald
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA
- Elson S Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Valarie Blue Bird Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Ka`imi Sinclair
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA
- College of Nursing, Washington State University, Spokane, WA, USA
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Dave C, Agarwal N, Patel R, Shukla R, Bajpai A. Determinants and Predictors of Body Fat in Indian Children and Adolescents. Indian J Pediatr 2022; 89:473-476. [PMID: 34236600 DOI: 10.1007/s12098-021-03815-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/17/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To study determinants and predictors of body fat in Indian children and adolescents. METHODS In this cross-sectional study, 5175 children and adolescents [3014 boys, age 12.8 (3) y, 5-18 y] participated. Determinants and predictors of body fat were assessed using partial correlation (corrected for age, and gender) and linear regression. RESULTS Fat percentage correlated negatively with the duration of physical activity (r = -0.091, p < 0.01) and sleep (r = -0.044, p = 0.01) and positively with parental body mass index (BMI) (r = 0.202, p < 0.01 for father and r = 0.235, p < 0.01 for mother), and birth weight (r = 0.050, p < 0.01). On linear regression, fat percentage was positively associated with parental BMI and birth weight, and negatively with physical activity and sleep duration. All adiposity markers [BMI standard deviation score (SDS) (r = 0.863, p < 0.01), weight SDS (r = 0.827, p < 0.01) waist to height ratio (r = 0.819, p < 0.01), waist circumference SDS (r = 0.765, p < 0.01) wrist circumference (r = 0.21, p < 0.01), and neck circumference (r = 0.19, p < 0.01)] correlated significantly with fat percentage, showing highest correlation with BMI SDS. CONCLUSION Reduced sleep and physical activity are the key modifiable risk factors for adiposity. BMI SDS is the best clinical surrogate of body fat in Indian children and adolescents. There is a need to explore the impact of lifestyle interventions targeting sleep and physical activity on adiposity.
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Affiliation(s)
- Chetankumar Dave
- Department of Pediatric Endocrinology, Regency Center for Diabetes Endocrinology & Research, Regency City Clinic, The Mall, Kanpur, Uttar Pradesh, 208001, India.,GROW Society, Growth & Obesity Workforce, Kanpur, Uttar Pradesh, India
| | - Neha Agarwal
- Department of Pediatric Endocrinology, Regency Center for Diabetes Endocrinology & Research, Regency City Clinic, The Mall, Kanpur, Uttar Pradesh, 208001, India.,GROW Society, Growth & Obesity Workforce, Kanpur, Uttar Pradesh, India
| | - Riddhi Patel
- GROW Society, Growth & Obesity Workforce, Kanpur, Uttar Pradesh, India
| | - Rishi Shukla
- Department of Pediatric Endocrinology, Regency Center for Diabetes Endocrinology & Research, Regency City Clinic, The Mall, Kanpur, Uttar Pradesh, 208001, India
| | - Anurag Bajpai
- Department of Pediatric Endocrinology, Regency Center for Diabetes Endocrinology & Research, Regency City Clinic, The Mall, Kanpur, Uttar Pradesh, 208001, India. .,GROW Society, Growth & Obesity Workforce, Kanpur, Uttar Pradesh, India.
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Zamora-Kapoor A, Hebert LE, Montañez M, Buchwald D, Sinclair K. Risk Factors in Adolescence for the Development of Elevated Blood Pressure and Hypertension in American Indian and Alaskan Native Adults. J Immigr Minor Health 2021; 23:717-724. [PMID: 33247795 PMCID: PMC8160022 DOI: 10.1007/s10903-020-01130-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2020] [Indexed: 12/12/2022]
Abstract
To examine risk factors for elevated blood pressure and hypertension in American Indians and Alaska Natives (AI/ANs), compared to three other ethnic groups in the US. Weighted relative risk regression models, stratified by race/ethnicity, were used to measure the associations between risk factors and elevated blood pressure and hypertension in AI/ANs, compared to non-Hispanic Whites, non-Hispanic Blacks and Hispanics, with data from the National Longitudinal Study of Adolescent to Adult Health. In all groups, females had a lower risk of both elevated blood pressure and hypertension than males. Increasing body mass index raised hypertension risk in all groups. In AI/ANs, financial instability increased the risk of hypertension by 88% (95% CI: 1.27-2.77), but not in other groups. No other statistically significant associations were found. Future interventions should include socio-economic factors in efforts to prevent hypertension in AI/ANs.
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Affiliation(s)
- Anna Zamora-Kapoor
- Departments of Sociology and Medical Education and Clinical Sciences, Washington State University, Pullman, WA, USA.
| | - Luciana E Hebert
- Department of Medical Education and Clinical Sciences, Washington State University, Spokane, WA, USA
| | - Morgan Montañez
- Department of Sociology, Washington State University, Pullman, WA, USA
| | - Dedra Buchwald
- Department of Medical Education and Clinical Sciences, Washington State University, Spokane, WA, USA
| | - Ka'imi Sinclair
- College of Nursing, Washington State University, Spokane, WA, USA
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Maudrie TL, Colón-Ramos U, Harper KM, Jock BW, Gittelsohn J. A Scoping Review of the Use of Indigenous Food Sovereignty Principles for Intervention and Future Directions. Curr Dev Nutr 2021; 5:nzab093. [PMID: 34345758 PMCID: PMC8321882 DOI: 10.1093/cdn/nzab093] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 05/11/2021] [Accepted: 06/28/2021] [Indexed: 12/19/2022] Open
Abstract
Indigenous food sovereignty (IFS) represents a community-led movement with potential to reduce health inequities, but no scoping review of the impact of taking an IFS approach on intervention research has been conducted. This review sought to: 1) describe intervention studies that employ IFS principles, and 2) describe the impact of studies using IFS principles on food access, eating patterns, diet quality, physical activity, and health. Through a literature review, 4 IFS principles were identified: 1) community ownership, 2) inclusion of traditional food knowledge, 3) inclusion and promotion of cultural foods, and 4) environmental/intervention sustainability. Twenty intervention studies published between January 1, 2000 and February 5, 2020 were included. Most of the studies that scored high in IFS principles saw a positive impact on diet. This review found evidence supporting the value of IFS principles in the development, implementation, and evaluation of health interventions for Indigenous communities.
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Affiliation(s)
- Tara L Maudrie
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Uriyoán Colón-Ramos
- Department of Global Health, Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health at The George Washington University, Washington, DC, USA
| | - Kaitlyn M Harper
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Brittany W Jock
- School of Human Nutrition, Centre for Indigenous Peoples’ Nutrition and Environment (CINE), McGill University, Montreal, Quebec, Canada
| | - Joel Gittelsohn
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Stotz SA, Charron-Prochownik D, Terry MA, Marshall G, Fischl AR, Moore KR. Stopping Gestational Diabetes in American Indian and Alaska Native Girls: Nutrition as a Key Component to Gestational Diabetes Risk Reduction. Curr Dev Nutr 2021; 5:13-21. [PMID: 34222764 PMCID: PMC8242493 DOI: 10.1093/cdn/nzaa081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/20/2020] [Accepted: 05/05/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND American Indian and Alaska Native (AI/AN) women have a higher risk of gestational diabetes mellitus (GDM) and subsequent diagnosis of diabetes than do non-Hispanic White women. Healthy eating is key to weight management both prior to pregnancy and between pregnancies and can reduce the risk of developing GDM. Our research team developed an innovative preconception counseling and diabetes risk-reduction program, which includes nutrition and weight-management principles and is culturally tailored for adolescent AI/AN women. The program is entitled Stopping Gestational Diabetes Mellitus (SGDM). OBJECTIVE The purpose of this article is to examine nutrition-related information collected as a part of the formative qualitative research conducted for the development of a preconception counseling and gestational diabetes risk-reduction program, SGDM. METHODS This in-depth secondary analysis explored the original qualitative data from the needs assessment for SGDM program development. Participants included AI/AN women with a history of GDM (n = 5); AI/AN girls at risk of GDM (n = 14), and their mothers (n = 11), health care providers, and health administrators who care for AI/AN girls (n = 16); AI/AN elected leaders; and Indian health system administrators (n = 12). All focus groups and interviews were reanalyzed utilizing the following research question: "How do key stakeholders discuss food and/or nutrition in terms of gestational diabetes risk reduction for AI/AN adolescent girls?" RESULTS Three primary nutrition themes emerged: 1) AI/AN women were aware of healthy nutrition, healthy weight gainduring pregnancy, and healthy nutrition for people with type 2 diabetes, but these principles were not linked to reducing the risk of GDM; 2) participants expressed the need for education on the role of nutrition and weight management in GDM risk reduction; 3) participants shared challenges of healthful eating during and before pregnancy for AI/AN women. CONCLUSIONS These stakeholders' comments informed the development of the nutrition components of SGDM.
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Affiliation(s)
- Sarah A Stotz
- University of Colorado Anschutz Medical Campus; Colorado School of Public Health, Centers for American Indian and Alaska Native Health, Aurora, CO, USA
| | - Denise Charron-Prochownik
- University of Pittsburgh, Nursing and Graduate School of Public Health, Department of Health Promotion and Development, Pittsburgh, PA, USA
| | - Martha A Terry
- University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | | | - Andrea R Fischl
- University of Pittsburgh, Nursing and Graduate School of Public Health, Department of Health Promotion and Development, Pittsburgh, PA, USA
| | - Kelly R Moore
- University of Colorado Anschutz Medical Campus; Colorado School of Public Health, Centers for American Indian and Alaska Native Health, Aurora, CO, USA
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Tomayko EJ, Webber EJ, Cronin KA, Prince RJ, Adams AK. Use of Text Messaging and Facebook Groups to Support the Healthy Children, Strong Families 2 Healthy Lifestyle Intervention for American Indian Families. Curr Dev Nutr 2021; 5:32-39. [PMID: 34222765 PMCID: PMC8242221 DOI: 10.1093/cdn/nzaa110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 05/14/2020] [Accepted: 06/23/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Few obesity interventions have been developed for American Indian (AI) families despite the disproportionate risk of obesity experienced within AI communities. The emergence of mobile technologies to enhance intervention delivery could particularly benefit AI communities, many of which are hard to reach and underserved. OBJECTIVES This study aimed to assess the use and perceptions of text messaging and Facebook to support delivery of the Healthy Children, Strong Families 2 (HCSF2) mailed healthy lifestyle/obesity prevention intervention and discuss lessons learned regarding intervention support via these platforms among AI participants. METHODS From among AI families with young children (ages 2-5 y), 450 adult-child dyads were recruited from 5 rural and urban communities for a year-long intervention. Intervention content was delivered by mail and supported by text messaging and optional Facebook groups. Participants provided feedback on text message and Facebook components post-intervention, and Facebook analytic data were tracked. RESULTS Self-report feedback indicated high satisfaction with both text messaging and Facebook, with tangible content (e.g., recipes, physical activity ideas) cited as most useful. Overall, participants reported higher satisfaction with and perceived efficacy of Facebook content compared with text messaging. Analytic data indicate the optional HCSF2 Facebook groups were joined by 67.8% of adult participants. Among those who joined, 78.4% viewed, 50.8% "liked," and 22.6% commented on ≥1 post. Engagement levels differed by urban-rural status, with more urban participants "liking" (P = 0.01) and commenting on posts (P = 0.01). Of note, nearly one-third of participants reported changing phone numbers during the intervention. CONCLUSIONS This study demonstrates high satisfaction regarding mobile delivery of HCSF2 intervention support components. Best practices and challenges in utilizing different mobile technologies to promote wellness among AI families are discussed, with particular focus on urban-rural differences. Future mobile-based interventions should consider the context of unstable technology maintenance, especially in low-resource communities.This work is part of the HCSF2 trial, which is registered at clinicaltrials.gov (NCT01776255).
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Affiliation(s)
- Emily J Tomayko
- Center for American Indian and Rural Health Equity, Montana State University, Bozeman, MT, USA
| | - Eliza J Webber
- Center for American Indian and Rural Health Equity, Montana State University, Bozeman, MT, USA
| | - Kate A Cronin
- Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Ronald J Prince
- Department of Population Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Alexandra K Adams
- Center for American Indian and Rural Health Equity, Montana State University, Bozeman, MT, USA
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7
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Zhang Z, Sousa-Sá E, Pereira JR, Okely AD, Feng X, Santos R. Correlates of Sleep Duration in Early Childhood: A Systematic Review. Behav Sleep Med 2021; 19:407-425. [PMID: 32496141 DOI: 10.1080/15402002.2020.1772264] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE This systematic review aimed to summarize correlates of sleep duration in children under 5 years of age. METHODS Six electronic databases (PubMed, PsycINFO, MEDLINE, CINAHL, SPORTDiscus, and Scopus) were searched from inception to May 2019. Observational studies and intervention studies reporting cross-sectional results from baseline data were considered. Data were extracted using a predesigned form and potential correlates were categorized following a sociological framework. RESULTS One-hundred and sixteen studies, representing 329,166 children, met the inclusion criteria, with a high risk of bias in 62 included studies. A total of 83 correlates of sleep duration were identified. Among the associations studied four or more times, correlates of nap duration were child's age and nighttime sleep onset/bedtime; correlates of nighttime sleep duration were household income, parent marital status, parental adiposity level, nighttime sleep duration at younger age, nighttime sleep onset/bedtime, nighttime sleep wakeup time, and frequency of current bedtime routine; correlate of total sleep duration was screen time. CONCLUSIONS Young children from low-income households, single families, or having overweight parents may be at risk for short sleep duration. Promoting healthy sleep duration from an early age appears essential. Effective practices may include encouraging an earlier bedtime, limiting screen time, and establishing a regular bedtime routine. The absence of consistent evidence in the psychological, cognitive, and emotional domain as well as the physical environmental domain warrants further research.
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Affiliation(s)
- Zhiguang Zhang
- Early Start, Faculty of Social Sciences, University of Wollongong, Australia
| | - Eduarda Sousa-Sá
- Early Start, Faculty of Social Sciences, University of Wollongong, Australia.,Illawarra Health and Medical Research Institute, Australia
| | - João R Pereira
- Early Start, Faculty of Social Sciences, University of Wollongong, Australia.,CIDAF (Uid/dtp/04213/2016), University of Coimbra, Coimbra, Portugal
| | - Anthony D Okely
- Early Start, Faculty of Social Sciences, University of Wollongong, Australia.,Illawarra Health and Medical Research Institute, Australia
| | - Xiaoqi Feng
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Australia.,Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
| | - Rute Santos
- Early Start, Faculty of Social Sciences, University of Wollongong, Australia.,Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal.,Universidade Lusófona de Humanidades e Tecnologia, Lisboa, Portugal
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Fruh S, Williams S, Hayes K, Hauff C, Hudson GM, Sittig S, Graves RJ, Hall H, Barinas J. A practical approach to obesity prevention: Healthy home habits. J Am Assoc Nurse Pract 2021; 33:1055-1065. [PMID: 33534281 PMCID: PMC8313625 DOI: 10.1097/jxx.0000000000000556] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 11/06/2020] [Indexed: 12/11/2022]
Abstract
ABSTRACT Families have the potential to foster a healthy home environment aimed at reducing the risk of overweight and obesity. Establishing habits associated with reduced risk of obesity and overweight early in childhood can have lasting effects into adulthood. Nurse practitioners can encourage families to participate in healthy habits by addressing areas of growth for obesity prevention within the home. A review of the most recent literature, approximately over the past decade, was used to provide a consolidated source of reference for healthy home habits for the nurse practitioner. The search included terms such as "obesity," "overweight," "healthy habits," "physical activity," "obesogenic behaviors," "family meals," "screen time," "depression," "sugary beverages," and "portion sizes." The information was synthesized into three content areas: nutrition and consumption, patterns of activity, and stress within the home. Establishing healthy habits early in life can protect against the development of overweight and obesity. Nurse practitioners can serve a vital role in the prevention of pediatric, adolescent, and adult obesity. Equipped with the unique role of assisting those from a diverse patient base, nurse practitioners can inform patients how to improve healthy habits to decrease the likelihood of obesity or overweight. Encouraging behavior change related to the healthy habits associated with the prevention of overweight and obesity can have a long-term impact on the health of an entire family.
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Affiliation(s)
- Sharon Fruh
- Research, Evaluation, and Development, College of Nursing, University of South Alabama, Mobile, Alabama
| | - Susan Williams
- College of Nursing, University of South Alabama, Mobile, Alabama
| | - Katey Hayes
- Department of Psychology, University of South Alabama, Mobile, Alabama
| | - Caitlyn Hauff
- Department of Health, Kinesiology, and Sport, University of South Alabama, Mobile, Alabama
| | - Geoffrey M. Hudson
- Department of Health, Kinesiology, and Sport, University of South Alabama, Mobile, Alabama
| | - Scott Sittig
- Department of Information Systems and Technology, University of South Alabama, Mobile, Alabama
| | - Rebecca J. Graves
- Special Projects and Evaluation, College of Nursing, University of South Alabama, Mobile, Alabama
| | - Heather Hall
- College of Nursing, University of South Alabama, Mobile, Alabama
| | - Jennifer Barinas
- Combined-Integrated Clinical & Counseling Psychology Program, University of South Alabama, Mobile, Alabama
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Scott-Sheldon LAJ, Hedges LV, Cyr C, Young-Hyman D, Khan LK, Magnus M, King H, Arteaga S, Cawley J, Economos CD, Haire-Joshu D, Hunter CM, Lee BY, Kumanyika SK, Ritchie LD, Robinson TN, Schwartz MB. Childhood Obesity Evidence Base Project: A Systematic Review and Meta-Analysis of a New Taxonomy of Intervention Components to Improve Weight Status in Children 2-5 Years of Age, 2005-2019. Child Obes 2020; 16:S221-S248. [PMID: 32936038 PMCID: PMC7482126 DOI: 10.1089/chi.2020.0139] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objective: To evaluate the efficacy of childhood obesity interventions and conduct a taxonomy of intervention components that are most effective in changing obesity-related health outcomes in children 2-5 years of age. Methods: Comprehensive searches located 51 studies from 18,335 unique records. Eligible studies: (1) assessed children aged 2-5, living in the United States; (2) evaluated an intervention to improve weight status; (3) identified a same-aged comparison group; (4) measured BMI; and (5) were available between January 2005 and August 2019. Coders extracted study, sample, and intervention characteristics. Effect sizes [ESs; and 95% confidence intervals (CIs)] were calculated by using random-effects models. Meta-regression was used to determine which intervention components explain variability in ESs. Results: Included were 51 studies evaluating 58 interventions (N = 29,085; mean age = 4 years; 50% girls). Relative to controls, children receiving an intervention had a lower BMI at the end of the intervention (g = 0.10, 95% CI = 0.02-0.18; k = 55) and at the last follow-up (g = 0.17, 95% CI = 0.04-0.30; k = 14; range = 18-143 weeks). Three intervention components moderated efficacy: engage caregivers in praise/encouragement for positive health-related behavior; provide education about the importance of screen time reduction to caregivers; and engage pediatricians/health care providers. Conclusions: Early childhood obesity interventions are effective in reducing BMI in preschool children. Our findings suggest that facilitating caregiver education about the importance of screen time reduction may be an important strategy in reducing early childhood obesity.
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Affiliation(s)
- Lori A J Scott-Sheldon
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Larry V Hedges
- Department of Statistics, Northwestern University, Evanston, IL, USA
| | - Chris Cyr
- Impact Genome Project, Mission Measurement, Chicago, IL, USA
| | - Deborah Young-Hyman
- Office of Behavioral and Social Sciences, Office of the Director, National Institutes of Health, Bethesda, MD, USA
| | - Laura Kettel Khan
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Heather King
- Impact Genome Project, Mission Measurement, Chicago, IL, USA
| | - Sonia Arteaga
- Office of the Director, National Institutes of Health, National Institutes of Health, Bethesda, MD, USA
| | - John Cawley
- Department of Policy Analysis and Management, Cornell University, Ithaca, NY, USA
- Department of Economics, Cornell University, Ithaca, NY, USA
| | - Christina D Economos
- Division of Nutrition Interventions, Communication, and Behavior Change, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Debra Haire-Joshu
- Center for Obesity Prevention and Policy Research, Brown School, Washington University, Saint Louis, MO, USA
| | - Christine M Hunter
- Office of Behavioral and Social Sciences, Office of the Director, National Institutes of Health, Bethesda, MD, USA
| | - Bruce Y Lee
- CUNY Graduate School of Public Health and Policy, New York, NY, USA
| | - Shiriki K Kumanyika
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Lorrene D Ritchie
- Nutrition Policy Institute, University of California, Division of Agriculture and Natural Resources, Berkeley, CA, USA
| | - Thomas N Robinson
- Departments of Pediatrics and Medicine, Stanford Solutions Science Lab, Stanford University, Stanford, CA, USA
| | - Marlene B Schwartz
- Department of Human Development and Family Studies, University of Connecticut, Hartford, CT, USA
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10
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Deal BJ, Huffman MD, Binns H, Stone NJ. Perspective: Childhood Obesity Requires New Strategies for Prevention. Adv Nutr 2020; 11:1071-1078. [PMID: 32361757 PMCID: PMC7490151 DOI: 10.1093/advances/nmaa040] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 03/10/2020] [Accepted: 03/13/2020] [Indexed: 02/06/2023] Open
Abstract
The prevalence of obesity among youth in the USA is currently >18% with projections that more than half of today's children will be obese as adults. The growth trajectory of children more likely to become obese is determined by weight in earliest childhood, and childhood body mass index (BMI) tracks through adolescence and adulthood. Childhood consequences of obesity include increased risk of asthma, type 2 diabetes mellitus, orthopedic disorders, and reduced academic performance. Health implications of obesity in adulthood include premature coronary artery disease, hypertension, type 2 diabetes, stroke, and certain cancers, contributing to the leading causes of adult mortality. Early childhood obesity is influenced by prenatal exposure to maternal obesity and environmental obesogens, and is associated with poverty, food insecurity, and poor nutritional quality. New strategies for primordial prevention of early childhood obesity require focusing attention on growth parameters during the first 2 y of life, with support for increasing the duration of breastfeeding, and improvements in dietary quality and availability, particularly the reduced consumption of added sugars. Reducing the prevalence of obesity among adolescent females and reducing exposure to environmental obesogens may reduce the prevalence of transgenerational obesity. The reduction of early childhood obesity could improve population health, quality of life, and longevity throughout the life course.
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Affiliation(s)
- Barbara J Deal
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Mark D Huffman
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- The George Institute for Global Health, Sydney, Australia
| | - Helen Binns
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Neil J Stone
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Julien Sweerts S, Fouques D, Lignier B, Apfeldorfer G, Kureta-Vanoli K, Romo L. Relation between cognitive restraint and weight: Does a content validity problem lead to a wrong axis of care? Clin Obes 2019; 9:e12330. [PMID: 31243927 DOI: 10.1111/cob.12330] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 05/02/2019] [Accepted: 06/03/2019] [Indexed: 01/10/2023]
Abstract
The aim of this research is to examine the relation between weight and cognitive restraint (CR), which is the intention to control food intake in order to maintain or lose weight, in a general French population sample. Is CR more prevalent in individuals with obesity than overweight, underweight or normal-weight subjects in this cross-sectional study? Are people affected by obesity non-restrained eaters? A total of 507 French people (80.2% women and 19.8% men), aged 18-78 years, responded to an online questionnaire. It appears that the most used questionnaire measuring CR has content validity problems as it seems to measure effective control and not the intention. Therefore, a numeric scale was used to answer the questions. Even if it is not possible in this study to test a causal link with latent variable modelling, our results seem to show that people with obesity more frequently intend to eat less or to eat healthier and/or to eat less sugar and fat than other people in order to control their weight. However, people affected by obesity do not succeed in so doing. These results raise the question of treatments advocating the increase of self-control. Finally, it would be necessary to obtain a real, scientific consensus on what CR is and on how to measure it in order to study the most effective treatments for people with overweight or obesity.
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Affiliation(s)
| | - Damien Fouques
- EA4430 CLIPSYD, UFR SPSE, Paris Nanterre University, Nanterre, France
| | - Baptiste Lignier
- Department of Psychology, Laboratoire Psy-DREPI, EA 7458, University of Bourgogne Franche-Comté, Dijon, France
- Psychotherapy Area, pôle B Côte-d'Or South of General Psychiatry, La Chartreuse, Dijon, France
| | - Gérard Apfeldorfer
- Groupe de Réflexion sur l'obésité et le surpoids (G.R.O.S.), Think Tank on Obesity and Overweight, Paris, France
| | - Katherine Kureta-Vanoli
- Groupe de Réflexion sur l'obésité et le surpoids (G.R.O.S.), Think Tank on Obesity and Overweight, Paris, France
| | - Lucia Romo
- EA4430 CLIPSYD, UFR SPSE, Paris Nanterre University, Nanterre, France
- CMME, Sainte-Anne's Hospital, Unité Inserm U 894 CPN, Paris, France
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Tomayko EJ, Prince RJ, Cronin KA, Kim K, Parker T, Adams AK. The Healthy Children, Strong Families 2 (HCSF2) Randomized Controlled Trial Improved Healthy Behaviors in American Indian Families with Young Children. Curr Dev Nutr 2019; 3:53-62. [PMID: 31453428 PMCID: PMC6700460 DOI: 10.1093/cdn/nzy087] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 09/13/2018] [Accepted: 11/09/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND American Indian (AI) families experience a disproportionate risk of obesity due to a number of complex reasons, including poverty, historic trauma, rural isolation or urban loss of community connections, lack of access to healthy foods and physical activity opportunities, and high stress. Home-based obesity prevention interventions are lacking for these families. OBJECTIVE Healthy Children, Strong Families 2 (HCSF2) was a randomized controlled trial of a healthy lifestyle promotion/obesity prevention intervention for AI families. METHODS Four hundred and fifty dyads consisting of an adult primary caregiver and a child ages 2 to 5 y from 5 AI communities were randomly assigned to a monthly mailed healthy lifestyle intervention toolkit (Wellness Journey) with social support or to a child safety control toolkit (Safety Journey) for 1 y. The Wellness Journey toolkit targeted increased fruit/vegetable (F/V) intake and physical activity, improved sleep, decreased added sugar intake and screen time, and improved stress management (adults only). Anthropometrics were collected, and health behaviors were assessed via survey at baseline and at the end of Year 1. Adults completed surveys for themselves and the participating child. Repeated measures analysis of variance was used to assess change over the intervention period. RESULTS Significant improvements to adult and child healthy diet patterns, adult F/V intake, adult moderate-to-vigorous physical activity, home nutrition environment, and adult self-efficacy for health behavior change were observed in Wellness Journey compared with Safety Journey families. No changes were observed in adult body mass index (BMI), child BMI z-score, adult stress measures, adult/child sleep and screen time, or child physical activity. Qualitative feedback suggests the intervention was extremely well-received by both the families and our community partners across the 5 participating sites. CONCLUSIONS This multi-site community-engaged intervention addressed key gaps regarding family home-based approaches for early obesity prevention in AI communities and showed several significant improvements in health behaviors. Multiple communities are working to sustain intervention efforts. This trial was registered at clinicaltrials.gov as NCT01776255.
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Affiliation(s)
- Emily J Tomayko
- Nutrition, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR
| | - Ronald J Prince
- Departments of Population Health, University of Wisconsin, Madison, WI
| | - Kate A Cronin
- Departments of Surgery, University of Wisconsin, Madison, WI
| | - KyungMann Kim
- Departments of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin, Madison, WI
| | - Tassy Parker
- Department of Family and Community Medicine, School of Medicine, University of New Mexico, Albuquerque, NM
| | - Alexandra K Adams
- Center for American Indian and Rural Health Equity, Montana State University, Bozeman, MT
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