Lifestyle risk factors for obesity in 7-year-old children

The impact of maternal influences on childhood obesity

There was a lack of detailed information about maternal influences on their children’s body mass index (BMI) in Taiwan. The aim of this study was to find the evidence to describe how mothers’ factors could affect their 2 to 9-year-old children’s BMI, with data collected from May 2021 to June 2021. Anonymous self-administered questionnaires were completed by 1035 participants from Taiwan’s six metropolitan cities and eight counties. After controlling for children’s factors, such as number of children in a family, children’s constitution, children’s age and gender, hierarchical regression models were used to analyze the effects of five maternal factors on their children’s BMI: maternal BMI, age, education level, monthly household income, and marital status (single parent or not). The results were found as follow: maternal BMI [β = .24], maternal educational level [β = −.141], and monthly household income [β = .071], significantly (p < 0.05) influenced their children’s BMI. Higher maternal BMI was associated with a higher children’s BMI. Mothers with lower levels of education background were more likely to have children with a higher BMI. Monthly household income was a positive factor influencing children’s BMI. In conclusion, this study is the first detailed description of maternal influences on their 2–9 years old children’s BMI in Taiwan. Although the study could not cover all of the factors influencing Taiwan’s childhood obesity, we have discovered maternal BMI, education level, and monthly household income were significant factors associated with children’s BMI.

Identification of the minimum data set to design a mobile-based application on overweight and obesity management for children and adolescents

PURPOSE

Designing mobile-based applications is one of the tools to raise the awareness of patients and the care team. Aim of this study is to identify the data elements of a mobile-based application to overweight and obesity management for children and adolescents from the experts' point of view.

METHODS

In this descriptive-analytical article, data collection was conducted through library and Internet research. The research population comprised 30 nutritionists selected via simple sampling method. The research instrument was a questionnaire developed by the researcher in four sections: demographic data, assessment data, therapeutic recommendations and application capabilities. Validity and reliability were confirmed by Content Validity Ratio (CVR) and Delphi method respectively.

RESULTS

The Minimum Data Set (MDS) required for overweight and obesity management in children and adolescents was designed based on the data from the guidelines of the United States, Canada, Australia, Britain, Iran, and experts' opinions. The importance of this MDS suggested was calculated based on the percentage points given by experts for the demographic data of 100%, the assessment data of 88.33%, the therapeutic recommendations of 97.67%, and the application capabilities of 88.94%.

CONCLUSION

Identifying prevention and control minimum data set of overweight and obesity in children and adolescents from the point of view of experts will be effective in improving the applications in this field. This MDS has two parts of data elements: the first for recognition of the framework of evaluating and applying therapeutic methods that can empower parents to manage the child's body mass and the second as a patient's personal record for storage a set of data that can be used by nutritionists in visits to healthcare centers.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40200-021-00807-1.

A Study on the Knowledge, Attitude, and Practices of Iranian Mothers towards Childhood Obesity

OBJECTIVES

In the recent decades, a dramatic increase in childhood obesity is one of the main public health problems. The aim of the study was to assess the knowledge, attitude, and practices (KAP) of Iranian mothers towards childhood obesity.

METHODS

This cross-sectional descriptive research was conducted on KAP of 432 mothers and their children aged 6-7 years (214 boys and 218 girls) who were referred to the Zarandieh health centers, Iran, in 2017. The participants were selected via multistage random sampling. Demographic and KAP data were obtained by self-report using standard questionnaires. The weight and height of the subjects were measured according to standard methods and body mass index was calculated. Data were analyzed by inferential statistics using SPSS18 software.

RESULTS

The prevalence of obesity (OB) was 11.5% in boys and 7% in girls. The mean score for attitude for mothers with normal-weight children was higher than for mothers with obese children. Food habits like consumption of breakfast, having fast food at least twice a week, and eating in front of TV were associated with OB. Physical activity habits like duration of TV watching/computer games/sleep and regular physical exercise were associated with OB.

CONCLUSIONS

This study identified the importance of educating Iranian mothers to change of lifestyle (eating and physical activity habits) and attitudes towards weight control in their children. Therefore, it seems that these results may be valuable in the development of educational programs and strategies for the prevention of childhood obesity.

Epidemiology of childhood overweight, obesity and their related factors in a sample of preschool children from Central Iran

BACKGROUND

Childhood overweight and obesity are strongly associated with the psychological and physical health of those for the duration of the lifetime. The purpose of this study was to assess the epidemiology of childhood overweight and obesity and their related factors in Zarandieh city, of Iran, in 2017.

METHODS

In a cross-sectional study, 572 preschool-mother dyads from primary care Clinics were selected by multi-stage sampling method. BMI of the children and mothers were calculated using standard method and the demographic, children nutrition and physical activity habits; the mothers perceived threat toward obesity, and their life style data were collected by self-report questionnaires for the literate mothers and interviewing for illiterate mothers.

RESULT

The prevalence of overweight and obesity in mothers was 30.8 and 20.3% respectively. This rate in children was 15.5 and 9.9% respectively. The multiple logistic regression analysis showed that variables of mother's BMI, Birth weight, Mother's employment, watching TV > 2 h/day, Computer games> 2 h/day and daily breakfast eating (≥4/week), perceived threat, health responsibility, stress management, physical activity, and healthy eating were the significant predictors of the child's BMI respectively.

CONCLUSIONS

Our results indicated that the prevalence of overweight and obesity are high in preschool children and their mothers. It seems that necessary to have suitable intervention programs to help mothers understand the serious risk of childhood obesity and the importance of creating a healthy lifestyle by them in childhood.

A scoping review of epidemiologic risk factors for pediatric obesity: Implications for future childhood obesity and dental caries prevention research

RESEARCH QUESTIONS

What are the non-modifiable (socioeconomic, genetic) and modifiable factors (physical activity, dietary behaviors) related to childhood (under age 12) obesity? How can this knowledge be applied to oral health professionals' efforts to prevent or manage dental caries in children?

OBJECTIVES

Studies have identified risk factors for childhood obesity. The purpose of this scoping review was to develop a conceptual model to identify non-modifiable and modifiable risk factors for childhood obesity and to illustrate how these findings are relevant in developing interventions aimed at preventing obesity and dental caries in children.

METHODS

The authors searched PubMed and Embase and limited the study to English-language publications. A total of 2,572 studies were identified. After de-duplication, 2,479 studies remained and were downloaded into a citation-management tool. Two authors screened the titles and abstracts for relevance. Two hundred and sixty studies remained and were retrieved for a full-text review, and 80 studies were excluded, resulting in 180 studies included in the scoping review. An inductive content analytic methods was used to organize all statistically significant obesity risk factors into seven domains, which were classified as non-modifiable or modifiable; then a conceptual model of common risk factors associated with childhood obesity and dental caries was developed.

RESULTS

Non-modifiable obesity risk factors include biological and developmental (e.g., genes, developmental conditions, puberty), sociodemographic and household (e.g., race/ethnicity, socioeconomic status, parent education, unemployment), cultural (e.g., degree of acculturation), and community (e.g., neighborhood composition). Modifiable risk factors included behavioral (e.g., diet, physical activity, weight), psychosocial (e.g., maternal stress, family functioning, parenting practices, child temperament), and medical (e.g., parent smoking, maternal health, child health).

CONCLUSIONS

Identifying common risk factors has important implications for future oral health research aimed at preventing childhood obesity and dental caries. Epidemiologic knowledge gleaned from the literature can be used to develop rigorous interventions and programs aimed at preventing these highly prevalent diseases and improving health outcomes for children.

Comparison of two visual methods for detecting caries among obese and non-obese children

OBJECTIVE

The study aimed to compare two visual methods for detecting caries among obese and non-obese children in Salvador, Brazil.

MATERIALS AND METHODS

A cross-sectional study was conducted from 2011-2012, which evaluated 180 paediatric patients, 6-14 years old, girls and boys, categorized into two groups: obese and non-obese (healthy weight), according to the body mass index. For the evaluation of dental caries, the decayed, missing or filled teeth index (DMFT/dmft) and International Caries Detection and Assessment System II (ICDAS II) visual criteria were used.

RESULTS

The mean DMFT value was 0.98 in obese children and 0.57 in the non-obese children, without significant differences between groups (p = 0.206). The mean dmft value in the non-obese children (1.66) was higher than in obese children (0.95), with significant differences between groups (p = 0.021). According to ICDAS II criteria, there was a higher prevalence of non-cavitated enamel lesions (D1-3) in obese children (n = 156, 10.5%) compared to the non-obese children (n = 55, 1.9%), with significant differences between the groups (p < 0.001).

CONCLUSIONS

The inclusion of non-cavitated lesions during the caries evaluation represents a challenge in diagnosis, which allows for control of this process before the evolution of these lesions to cavitation.

Longitudinal evaluation of 100% fruit juice consumption on BMI status in 2-5-year-old children

BACKGROUND

Obesity in childhood is related to multiple lifestyle factors. Our objective was to evaluate the relationship between consumption of 100% fruit juice and weight status over time among pre-school children.

METHODS

We used linear and logistic multivariable regression to evaluate body mass index (BMI) z-score and overweight/obese status as a function of 100% fruit juice intake for 8950 children examined at ages 2, 4 and 5 years as part of the Early Childhood Longitudinal Study-Birth Cohort, a representative sample of the United States.

RESULTS

Cross-sectional analysis at ages 4 and 5 years showed no difference in the prevalence of overweight and obesity between consistent juice drinkers and inconsistent/non-drinkers. Longitudinal analysis found that children who drank 100% juice consistently at age 2 years had greater increases in BMI z-score by age 4 years than infrequent/non-drinkers (P < 0.0001), a difference driven by lesser increases in height z-score (P = 0.0003) and slightly greater increases in weight z-score (P = 0.0550) among consistent juice drinkers over the 2 to 4 year time period. Additionally, consistent juice drinkers at age 2 had higher odds of becoming overweight by age 4 (adjusted odds ratio 1.30; CI 1.06-1.60). These differences in growth parameters were not noted between ages 4 and 5 years.

CONCLUSIONS

Drinking 100% fruit juice regularly at age 2 is associated with higher odds of becoming overweight between 2 and 4 years. Paediatricians and parents can discourage excessive fruit juice consumption as part of a larger effort to avoid unhealthy gain in BMI in young children.

Healthy hearts: a cross-sectional study of clinical cardiovascular disease risk factors in Northern Colorado school children (1992-2013)

Background

Despite significant declines in cardiovascular disease (CVD), it remains the number one cause of death in the United States. Determining factors that may be associated with CVD risk at a young age may allow us to better prevent CVD deaths in the future. The purpose of this paper is to determine the prevalence of CVD risk factors among 4^th grade children who participated in a community-wide CVD education program; as well as the association of these risk factors with weight status and the prevalence of CVD risk factors among family members.

Methods

The Poudre Valley Health Systems, Healthy Hearts Club has provided a cardiovascular screening program (1992–2013) to identify risk factors among students in six Northern Colorado school districts. There were 9,694 children (mean age, 10.3 years, 50 % female) included. Data were collected cross-sectionally with objective measures of total and high-density lipoprotein cholesterol (HDL-C), blood pressure and body mass index (BMI). Surveys were filled out by the parent and/or legal guardian and included questions about risk factors among family members. Means and frequencies were compared using SPSS software version 22 (IBM, Inc.).

Results

There were a significant number of children with elevated risk factors, including 35 % with total cholesterol ≥ 170 mg/dl, 22 % with HDL-C < 40 mg/dl, 13 % with Non-HDL-C ≥ 145 mg/dL, 6 % and 7 % with systolic and diastolic blood pressure ≥ 120 mmHg, and ≥ 80 mmHg respectively, and 21 % with BMI ≥ 85 % for age and sex. All the risk factors increased significantly when comparing normal weight to overweight and obese children. Further, among children with zero risk factors, 32.2 % reported a family member (other than the child) being overweight, while 56.5 % reported such among those children with five or six risk factors.

Conclusions

Overall, the prevalence of CVD risk factors in these children is similar to national levels and these factors are meaningfully associated with overweight and obesity, both within the child as well as within the family. This data suggests CVD risk factor reduction and prevention must focus on overweight and obesity and not be done in isolation of the family.

Skipping breakfast in early childhood and its associations with maternal and child BMI: a study of 2-5-year-old Australian children

BACKGROUND/OBJECTIVES

Evidence supporting the association between skipping breakfast and children's body mass index (BMI) has been widely reported, and some consideration has been given to children aged 2-5 years. However, no evidence has considered an association between children skipping breakfast and mother's BMI. This study therefore investigated associations between skipping breakfast, child's BMI and mother's BMI in a large cohort of Australian children.

SUBJECTS/METHODS

Data were drawn from wave 2 (2-3 years, n=4601) and wave 3 (4-5 years, n=4381) of the Longitudinal Study of Australian Children. The primary outcome was skipping breakfast. Child's and mother's BMI was assessed by trained professionals.

RESULTS

Girls at 4-5 years were significantly more likely to skip breakfast compared with boys (56.9% versus 43.1%; P=0.031). In cross-sectional data analysis, obese boys at 2-3 years (odds ratio (OR) 2.38; P=0.039) and at 4-5 years (OR 2.32; P=0.046), and also obese girls at 4-5 years (OR 2.26; P=0.018), were more likely to skip breakfast. Skipping breakfast was positively associated with boys at 2-3 years (OR 2.04; P=0.042) whose mothers were overweight and with girls at 4-5 years (OR 2.60; P=0.001) whose mothers were obese. In longitudinal cross-lagged analysis, boys at 2-3 years whose mothers were obese were more likely to skip breakfast 2 years later at age 4-5 years (OR 2.36; P=0.045).

CONCLUSIONS

Skipping breakfast was associated with higher BMI in children and mothers. Future interventions should target obese mothers to promote breakfast intake among children. The interventions may involve changes to dietary and lifestyle habits and provision of education on the benefits of breakfast intake.

Description of the EUROBIS program: a combination of an Epode community-based and a clinical care intervention to improve the lifestyles of children and adolescents with overweight or obesity

The present paper describes the Epode Umbria Region Obesity Prevention Study (EUROBIS) and aims to implement the C.U.R.I.A.MO. model through the EPODE methodology. The main goal of the EUROBIS is to change the pendency of slope of the actual trend towards the increase in the yearly rates of childhood overweight and obesity in Umbria and to improve healthy lifestyles of children and their parents. The project is the first EPODE program to be performed in Italy. The aims of the Italian EUROBIS study are: (1) a community-based intervention program (CBP) carrying out activities in all primary schools of the Umbria Region and family settings as first step, to reverse the current obesity trend on a long-term basis, and (2) a clinical care program for childhood and adolescent by C.U.R.I.A.MO. model. C.U.R.I.A.MO. model is a multidisciplinary approach to improve three key aspects of healthy lifestyles: nutrition, exercise, and psychological aspects with the strategy of a family-based approach. The community-based intervention and clinical trial provide an innovative valuable model to address the childhood obesity prevention and treatment in Italy.

Is what Filipino children eat between meals associated with body mass index?

The study aimed to assess the association between childhood obesity and snacking. A total of 396 students in grades 4 to 6 enrolled in an elementary school in the Philippines were the participants in this study. Demographic profile; anthropometric measures of height, weight, body mass index; and information about snacking were gathered. Obese group had statistically more servings of sweetened drinks and low-quality snacks. Female obese subjects have statistically more servings at nighttime and greater total snack servings. For the whole cohort, the odds ratio of being overweight with high total snack servings was 2.12 (95% confidence interval = 1.25-3.62) whereas the odds ratio of being obese with calories obtained from snacking was 2.08 (95% confidence interval = 1.01-4.26). Nighttime snacks and bad-quality foods should be minimized. Moreover, reducing food portions at any snack time will protect children from being overweight.

Body size and growth in 0- to 4-year-old children and the relation to body size in primary school age

Excess weight in early life is believed to increase susceptibility to obesity, and in support of such theory, excess weight and fast weight gain in early childhood have been related to overweight later in life. The aim of this study was to review the literature on body size and growth in 0- to 4-year-old children and the association with body size at age 5-13 years. In total, 43 observational studies on body size and/or growth were included, of which 24 studies had been published in 2005 or later. Twenty-one studies considered body size at baseline, and 31 studies considered growth which all included assessment of weight gain. Eight (38%) studies on body size, and 15 (48%) on weight gain were evaluated as high-quality studies. Our results support conclusions in previous reviews of a positive association between body size and weight gain in early childhood, and subsequent body size. Body size at 5-6 months of age and later and weight gain at 0-2 years of age were consistently positively associated with high subsequent body size. Results in this review were mainly based on studies from developed Western countries, but seven studies from developing countries showed similar results to those from developed countries.

Personalization algorithm for real-time activity recognition using PDA, wireless motion bands, and binary decision tree

Inactive and sedentary lifestyle is a major problem in many industrialized countries today. Automatic recognition of type of physical activity can be used to show the user the distribution of his daily activities and to motivate him into more active lifestyle. In this study, an automatic activity-recognition system consisting of wireless motion bands and a PDA is evaluated. The system classifies raw sensor data into activity types online. It uses a decision tree classifier, which has low computational cost and low battery consumption. The classifier parameters can be personalized online by performing a short bout of an activity and by telling the system which activity is being performed. Data were collected with seven volunteers during five everyday activities: lying, sitting/standing, walking, running, and cycling. The online system can detect these activities with overall 86.6% accuracy and with 94.0% accuracy after classifier personalization.

Bone and body segment lengthening and widening: a 7-year follow-up study in pubertal girls

During growth bone increases in length and width as does the body size. The aim of this paper was to examine the growth pattern of body height and weight, and the width and length of various body segments, and to establish the timing of peak growth velocity (PV) in relation to time of menarche in a cohort of Finnish girls followed from age 10 until 18. The study was a 7-year longitudinal cohort study. Widths and lengths of body segments and bones were measured from DXA scan images using bone landmarks in 396 girls aged 10 to 13 years at baseline, and in 255 mothers and 159 grandmothers. The girls' growth velocities (rate of change with time) peaked at 13.5 months prior to menarche for height, 14.4 months for weight, and 15.4 months for BMI. Shoulder width peaked at 18.2 months, lesser pelvis width at 13.5 months and greater pelvis width at 11.6 months prior to menarche. The PV of various body segment lengths showed that the femur peaked earliest at 20.7 months prior to menarche, followed by the humerus (at 18.0 months), radius (at 17.4 months), tibia (at 17.5 months), and trunk (at 11.8 months), respectively. All the long bones were linearly correlated with height while the flat and irregular bones had a nonlinear growth relationship with height (r(2)=0.73-0.88). By the age of 18 years the girls had reached their mothers' height (101%) and humerus, radius, femur and tibia lengths (100-101%), but not their mothers' shoulder, great pelvis and lesser pelvis widths (98%, 95% and 93%, respectively). Our data confirmed that, after bone elongation had ceased, segment width continued to increase, although at a slower speed, into early adulthood. The wide variations in growth velocity of these anthropomorphic measurements underscore the need to optimize nutrition and physical activity from early puberty onward in order to maximize bone development.