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Katanic B, Bjelica D, Stankovic M, Milosevic Z, Vukovic J, Mekic A. Anthropometric Characteristics and Weight Status of Early Adolescents (Aged 12-14) in Montenegro; Urban-Rural and Regional Differences. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1664. [PMID: 37892327 PMCID: PMC10605907 DOI: 10.3390/children10101664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 10/29/2023]
Abstract
The aim of this study was to determine urban-rural and regional differences in anthropometric characteristics among adolescents aged 12-14, as well as to present the prevalence of weight status. A total of 534 adolescents aged 12-14 from primary schools across Montenegro participated in this cross-sectional study (283 boys, aged 13.52 ± 0.42, body height 169.43 ± 8.89, body weight 60.54 ± 13.47; 251 girls, aged 13.51 ± 0.40, body height 165.54 ± 6.67, body weight 55.28 ± 9.27). The sample was divided by geographic region in Montenegro into northern, central, and coastal regions, and according to settlement type into urban and rural inhabitants. Anthropometric characteristics were assessed using a battery of seven variables: arm span (AS); body height (BH); body weight (BW); waist circumference (WC); hip circumference (HC); body mass index (BMI); and waist-to-hip ratio (WHR). BMI was categorized based on the World Health Organization's (WHO) cut-offs. The results indicate that girls from urban areas exhibited significantly greater body height and lower BMI values compared to their rural counterparts. Similarly, boys from urban areas also demonstrated lower BMI values compared to their rural peers. However, no statistically significant differences were observed in other anthropometric characteristics between these two groups of adolescents. Based on analysis of variance (ANOVA) and post-hoc analysis, it was found that girls from central areas had significantly greater body height compared to those from northern and coastal areas. Likewise, boys from northern areas showed higher body mass and BMI values compared to those from central areas. Additionally, both boys and girls from central areas had higher values compared to those from coastal areas. Nevertheless, no significant differences were detected in other anthropometric characteristics among adolescents from these regions. This study identified significant differences in anthropometric parameters among participants based on urban-rural status and within regional divisions. However, further research encompassing a larger sub-sample and a broader array of anthropometric variables is needed to draw a more comprehensive conclusion.
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Affiliation(s)
- Borko Katanic
- Faculty of Sport and Physical Education, University of Nis, 18000 Nis, Serbia;
| | - Dusko Bjelica
- Faculty for Sports and Physical Education, University of Montenegro, 81400 Niksic, Montenegro;
| | - Mima Stankovic
- Faculty of Sport and Physical Education, University of Nis, 18000 Nis, Serbia;
| | - Zoran Milosevic
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia; (Z.M.); (J.V.)
| | - Jovan Vukovic
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia; (Z.M.); (J.V.)
| | - Amel Mekic
- Faculty of Sports and Physical Education, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina;
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A new approach to dose reference levels in pediatric CT: Age and size-specific dose estimation. Radiat Phys Chem Oxf Engl 1993 2023. [DOI: 10.1016/j.radphyschem.2022.110698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Comparison of Glycosylated Haemoglobin, Blood Pressure, and Anthropometric Measurements Depending on Gender and Bodyweight State in Adolescents. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121922. [PMID: 36553365 PMCID: PMC9777222 DOI: 10.3390/children9121922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/01/2022] [Accepted: 12/01/2022] [Indexed: 12/13/2022]
Abstract
Background/Objective: The greatest anthropometric and physiological changes occur during adolescence. Assessment of growth patterns is necessary to prevent future health risks. Aims: To describe the values of glycosylated haemoglobin (HbA1c), systolic (SBP) and diastolic (DBP) blood pressure, triceps skinfold, and abdominal circumference according to gender and age (between 12 and 17 years), as well as explore the differences between body weight conditions. Methods: A descriptive cross-sectional study was carried out, including 4130 adolescents between 12 and 17 years old. SBP and DBP, HbA1c, triceps skinfold, and abdominal circumference were evaluated. Results: Significant differences were observed between males and females for HbA1c (p < 0.001), SBP (p < 0.001), triceps curl (p < 0.001), and abdominal circumference (p < 0.001), independently of the age group. Regardless of gender and age groups, significant differences were observed between overweight/obese and normal-weight adolescents in SBP (p < 0.001), DBP (p < 0.001 to 0.009), triceps skinfold (p < 0.001), and abdominal perimeter (p < 0.001). Conclusions: Our findings revealed higher SBP, DBP, triceps skinfold, and abdominal circumference in overweight/obese adolescents compared to normal-weight adolescents in both genders.
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Burris ME, Caceres E, Chester EM, Hicks KA, McDade TW, Sikkink L, Spielvogel H, Thornburg J, Vitzthum VJ. Socioeconomic impacts on Andean adolescents’ growth. Evol Med Public Health 2022; 10:409-428. [PMID: 36090675 PMCID: PMC9454678 DOI: 10.1093/emph/eoac033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 08/10/2022] [Indexed: 11/14/2022] Open
Abstract
Background/Objectives We evaluated potential socioeconomic contributors to variation in Andean adolescents’ growth between households within a peri-urban community undergoing rapid demographic and economic change, between different community types (rural, peri-urban, urban) and over time. Because growth monitoring is widely used for assessing community needs and progress, we compared the prevalences of stunting, underweight, and overweight estimated by three different growth references. Methods Anthropometrics of 101 El Alto, Bolivia, adolescents (Alteños), 11.0–14.9 years old in 2003, were compared between households (economic status assessed by parental occupations); to one urban and two rural samples collected in 1983/1998/1977, respectively; and to the WHO growth reference, a representative sample of Bolivian children (MESA), and a region-wide sample of high-altitude Peruvian children (Puno). Results Female Alteños’ growth was positively associated with household and maternal income indices. Alteños’ height averaged ∼0.8SD/∼0.6SD/∼2SDs greater than adolescents’ height in urban and rural communities measured in 1983/1998/1977, respectively. Overweight prevalence was comparable to the WHO, and lower than MESA and Puno, references. Stunting was 8.5/2.5/0.5 times WHO/MESA/Puno samples, respectively. Conclusions/Implications Both peri-urban conditions and temporal trends contributed to gains in Alteños’ growth. Rural out-migration can alleviate migrants’ poverty, partly because of more diverse economic options in urbanized communities, especially for women. Nonetheless, Alteños averaged below WHO and MESA height and weight medians. Evolved biological adaptations to environmental challenges, and the consequent variability in growth trajectories, favor using multiple growth references. Growth monitoring should be informed by community- and household-level studies to detect and understand local factors causing or alleviating health disparities.
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Affiliation(s)
- Mecca E Burris
- Department of Anthropology, Indiana University , Bloomington, IN 47405, USA
| | | | - Emily M Chester
- Department of Anthropology, Indiana University , Bloomington, IN 47405, USA
- Evolutionary Anthropology Laboratory, Indiana University , Bloomington, IN 47405, USA
| | - Kathryn A Hicks
- Department of Anthropology, University of Memphis , Memphis, TN 38152, USA
| | - Thomas W McDade
- Department of Anthropology, Northwestern University , Evanston, IL 60208, USA
| | - Lynn Sikkink
- Department of Anthropology, Western Colorado University , Gunnison, CO 81231, USA
| | - Hilde Spielvogel
- Instituto Boliviano de Biología de Altura (IBBA) , La Paz , Bolivia
| | - Jonathan Thornburg
- Department of Astronomy & Center for Spacetime Symmetries, Indiana University , Bloomington, IN 47405, USA
| | - Virginia J Vitzthum
- Department of Anthropology, Indiana University , Bloomington, IN 47405, USA
- Evolutionary Anthropology Laboratory, Indiana University , Bloomington, IN 47405, USA
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Hancerliogullari N, Kansu-Celik H, Asli Oskovi Kaplan Z, Oksuzoglu A, Ozgu-Erdinc AS, Engin-Ustun Y. Correlation of Maternal Neck/Waist Circumferences and Fetal Macrosomia in Low-Risk Turkish Pregnant Women, a Preliminary Study. Fetal Pediatr Pathol 2021; 40:181-188. [PMID: 31603015 DOI: 10.1080/15513815.2019.1675831] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Goals: Our aim in this study was to determine if the maternal neck and waist circumference measured in the first three months of pregnancy were effective in prediction of fetal macrosomia.Material and methods In this retrospective cohort study; body mass index, neck circumference (NC) and waist circumference (WC) was measured in low risk pregnant women at 11-13+6th weeks of pregnancy.Results Among the 361 women, 8% of newborns were over 4000 grams. The rate of fetal macrosomia increased with the increased NC and WC. In ROC analysis, optimum cutoff value of NC was >36.5 cm to predict fetal macrosomia with 68.97% sensitivity and 66.97% specifity and for WC it was >88 cm with 62.07% sensitivity and 61.26% specifity.Conclusion Risk of fetal macrosomia increased with the increased maternal NC and WC.
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Affiliation(s)
| | | | | | | | - A Seval Ozgu-Erdinc
- Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Ankara, Turkey
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Lauer R, Traub M, Hansen S, Kilian R, Steinacker JM, Kesztyüs D. Longitudinal changes and determinants of parental willingness to pay for the prevention of childhood overweight and obesity. HEALTH ECONOMICS REVIEW 2020; 10:15. [PMID: 32468490 PMCID: PMC7257510 DOI: 10.1186/s13561-020-00266-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 03/27/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Willingness to Pay (WTP) is an alternative to measure quality-adjusted life years for cost-effectiveness analyses. The aim was to evaluate longitudinal changes and determinants of parental WTP for the prevention of childhood overweight and obesity. METHODS Longitudinal data from post- (T2) and follow-up (T3) measurements of a school-based health promotion program in Germany. Parental questionnaires included general WTP and the corresponding amount to reduce incidental childhood overweight and obesity by half. Longitudinal differences were examined with the McNemar test for general WTP and the Wilcoxon signed-rank test for the amount of WTP. Regression analyses were conducted to detect determinants. RESULTS General parental WTP significantly decreased from 48.9% to 35.8% (p < 0.001, n = 760). Logistic regression analysis (n = 561) showed that parents with a tertiary education level and a positive general WTP at T2, families with a higher monthly household income, and those with abdominally obese children were significant predictors of general WTP at T3. Median amount of WTP at T3 was €20.00 (mean = €27.96 ± 26.90, n = 274). Assuming a WTP of €0 for those who were generally not willing to pay or did not answer, resulted in a median amount of WTP at T3 of €0 (m = €8.45, sd = €19.58, n = 906). According to linear regression analysis WTP at T2 was the only significant predictor for the amount of WTP at T3 (p = 0.000, n = 181). CONCLUSIONS Despite the decline of general WTP, these results are a reflection of the public awareness of the problem and the need for action. Policy makers should recognize this and initiate sustainable public preventive strategies. TRIAL REGISTRATION DRKS, DRKS00000494. Registered 25 August 2010, https://www.drks.de/drks_web/.
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Affiliation(s)
- Romy Lauer
- Division of Sport and Rehabilitation Medicine, Ulm University Medical Center, Ulm, Germany
| | - Meike Traub
- Division of Sport and Rehabilitation Medicine, Ulm University Medical Center, Ulm, Germany
- Department of University Sports / Workplace Health Management, Ulm University, Ulm, Germany
| | - Sylvia Hansen
- Ceres - Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health, Unversity of Cologne, Cologne, Germany
| | - Reinhold Kilian
- Section Health Economics and Health Services Research, Department of Psychiatry II, Ulm University Medical Center, Günzburg, Germany
| | | | - Dorothea Kesztyüs
- Division of Sport and Rehabilitation Medicine, Ulm University Medical Center, Ulm, Germany
- Institute of General Practice, Ulm University Medical Center, Ulm, Germany
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Sampaio ADS, Epifanio M, Costa CAD, Bosa VL, Benedetti FJ, Sarria EE, Oliveira SG, Mundstock E, Mattiello R. Evidence on nutritional assessment techniques and parameters used to determine the nutritional status of children and adolescents: systematic review. CIENCIA & SAUDE COLETIVA 2019; 23:4209-4219. [PMID: 30540004 DOI: 10.1590/1413-812320182312.31502016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 02/05/2017] [Indexed: 01/10/2023] Open
Abstract
This article aims to review systematically the evidence on nutritional assessment techniques and parameters used to determine the nutritional status of children and adolescents. The literature review and the selection of publications were performed using the Medline, Lilacs, SciELO, Embase, personal files. 17 studies were identified, 7 addressed the anthropometric indices as the main outcome, 7 analyzed the growth and development of children and adolescents through growth curves, and the remainder surveyed body composition. In general, all met the quality criteria, unless 6 of the articles who did not discuss the limitations. The literature review suggests several techniques and parameters that can be applied to determine the nutritional status of children and adolescents from different countries. Growth graphs are essential to assess the health of children, but depend greatly of the growth tables used. Although BMI can be practical, it does not distinguish body fat from lean mass. The best interpretation of anthropometry will depend of valid reference values for age range of the study population. BIA is a quick feasible method, but the measurement has some various nationalities.
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Affiliation(s)
- Aline Dos Santos Sampaio
- Programa de Pós-Graduação em Pediatria e Saúde da Criança, Pontifícia Universidade Católica do Rio Grande do Sul. Av. Ipiranga 6690/2º, Partenon. 90610-000 Porto Alegre RS Brasil.
| | - Matias Epifanio
- Programa de Pós-Graduação em Pediatria e Saúde da Criança, Pontifícia Universidade Católica do Rio Grande do Sul. Av. Ipiranga 6690/2º, Partenon. 90610-000 Porto Alegre RS Brasil.
| | - Caroline Abud Drumond Costa
- Programa de Pós-Graduação em Pediatria e Saúde da Criança, Pontifícia Universidade Católica do Rio Grande do Sul. Av. Ipiranga 6690/2º, Partenon. 90610-000 Porto Alegre RS Brasil.
| | - Vera Lúcia Bosa
- Programa de Pós-Graduação em Alimentação, Nutrição e Saúde, Universidade Federal Federal do Rio Grande do Sul. Porto Alegre RS Brasil
| | | | - Edgar Enrique Sarria
- Hospital Santa Cruz, Universidade de Santa Cruz do Sul. Santa Cruz do Sul RS Brasil
| | - Suelen Goecks Oliveira
- Programa de Pós-Graduação em Pediatria e Saúde da Criança, Pontifícia Universidade Católica do Rio Grande do Sul. Av. Ipiranga 6690/2º, Partenon. 90610-000 Porto Alegre RS Brasil.
| | - Eduardo Mundstock
- Programa de Pós-Graduação em Pediatria e Saúde da Criança, Pontifícia Universidade Católica do Rio Grande do Sul. Av. Ipiranga 6690/2º, Partenon. 90610-000 Porto Alegre RS Brasil.
| | - Rita Mattiello
- Programa de Pós-Graduação em Pediatria e Saúde da Criança, Pontifícia Universidade Católica do Rio Grande do Sul. Av. Ipiranga 6690/2º, Partenon. 90610-000 Porto Alegre RS Brasil.
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Interventions for treating children and adolescents with overweight and obesity: an overview of Cochrane reviews. Int J Obes (Lond) 2018; 42:1823-1833. [PMID: 30301964 DOI: 10.1038/s41366-018-0230-y] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 05/17/2018] [Accepted: 06/15/2018] [Indexed: 12/13/2022]
Abstract
Children and adolescents with overweight and obesity are a global health concern. This is an integrative overview of six Cochrane systematic reviews, providing an up-to-date synthesis of the evidence examining interventions for the treatment of children and adolescents with overweight or obesity. The data extraction and quality assessments for each review were conducted by one author and checked by a second. The six high quality reviews provide evidence on the effectiveness of behaviour changing interventions conducted in children <6 years (7 trials), 6-11 years (70 trials), adolescents 12-17 years (44 trials) and interventions that target only parents of children aged 5-11 years (20 trials); in addition to interventions examining surgery (1 trial) and drugs (21 trials). Most of the evidence was derived from high-income countries and published in the last two decades. Collectively, the evidence suggests that multi-component behaviour changing interventions may be beneficial in achieving small reductions in body weight status in children of all ages, with low adverse event occurrence were reported. More research is required to understand which specific intervention components are most effective and in whom, and how best to maintain intervention effects. Evidence from surgical and drug interventions was too limited to make inferences about use and safety, and adverse events were a serious consideration.
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Green MA, Radley D, Lomax N, Morris MA, Griffiths C. Is adolescent body mass index and waist circumference associated with the food environments surrounding schools and homes? A longitudinal analysis. BMC Public Health 2018; 18:482. [PMID: 29716577 PMCID: PMC5930416 DOI: 10.1186/s12889-018-5383-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 03/27/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There has been considerable interest in the role of access to unhealthy food options as a determinant of weight status. There is conflict across the literature as to the existence of such an association, partly due to the dominance of cross-sectional study designs and inconsistent definitions of the food environment. The aim of our study is to use longitudinal data to examine if features of the food environment are associated to measures of adolescent weight status. METHODS Data were collected from secondary schools in Leeds (UK) and included measurements at school years 7 (ages 11/12), 9 (13/14), and 11 (15/16). Outcome variables, for weight status, were standardised body mass index and standardised waist circumference. Explanatory variables included the number of fast food outlets, supermarkets and 'other retail outlets' located within a 1 km radius of an individual's home or school, and estimated travel route between these locations (with a 500 m buffer). Multi-level models were fit to analyse the association (adjusted for confounders) between the explanatory and outcome variables. We also examined changes in our outcome variables between each time period. RESULTS We found few associations between the food environment and measures of adolescent weight status. Where significant associations were detected, they mainly demonstrated a positive association between the number of amenities and weight status (although effect sizes were small). Examining changes in weight status between time periods produced mainly non-significant or inconsistent associations. CONCLUSIONS Our study found little consistent evidence of an association between features of the food environment and adolescent weight status. It suggests that policy efforts focusing on the food environment may have a limited effect at tackling the high prevalence of obesity if not supported by additional strategies.
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Affiliation(s)
- Mark A Green
- Department of Geography & Planning, University of Liverpool, Liverpool, UK.
| | - Duncan Radley
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Nik Lomax
- School of Geography, University of Leeds, Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, Leeds, UK
| | - Michelle A Morris
- Leeds Institute of Data Analytics, University of Leeds, Leeds, UK.,Leeds Institute for Biomedical and Clinical Services, University of Leeds, Leeds, UK
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Traub M, Lauer R, Kesztyüs T, Wartha O, Steinacker JM, Kesztyüs D. Skipping breakfast, overconsumption of soft drinks and screen media: longitudinal analysis of the combined influence on weight development in primary schoolchildren. BMC Public Health 2018; 18:363. [PMID: 29548323 PMCID: PMC5857087 DOI: 10.1186/s12889-018-5262-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/06/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Regular breakfast and well-balanced soft drink, and screen media consumption are associated with a lower risk of overweight and obesity in schoolchildren. The aim of this research is the combined examination of these three parameters as influencing factors for longitudinal weight development in schoolchildren in order to adapt targeted preventive measures. METHODS In the course of the Baden-Württemberg Study, Germany, data from direct measurements (baseline (2010) and follow-up (2011)) at schools was available for 1733 primary schoolchildren aged 7.08 ± 0.6 years (50.8% boys). Anthropometric measurements of the children were taken according to ISAK-standards (International Standard for Anthropometric Assessment) by trained staff. Health and lifestyle characteristics of the children and their parents were assessed in questionnaires. A linear mixed effects regression analysis was conducted to examine influences on changes in waist-to-height-ratio (WHtR), weight, and body mass index (BMI) measures. A generalised linear mixed effects regression analysis was performed to identify the relationship between breakfast, soft drink and screen media consumption with the prevalence of overweight, obesity and abdominal obesity at follow-up. RESULTS According to the regression analyses, skipping breakfast led to increased changes in WHtR, weight and BMI measures. Skipping breakfast and the overconsumption of screen media at baseline led to higher odds of abdominal obesity and overweight at follow-up. No significant association between soft drink consumption and weight development was found. CONCLUSION Targeted prevention for healthy weight status and development in primary schoolchildren should aim towards promoting balanced breakfast habits and a reduction in screen media consumption. Future research on soft drink consumption is needed. Health promoting interventions should synergistically involve children, parents, and schools. TRIAL REGISTRATION The Baden-Württemberg Study is registered at the German Clinical Trials Register (DRKS) under the DRKS-ID: DRKS00000494 .
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Affiliation(s)
- Meike Traub
- Medical Center, Division of Sports and Rehabilitation Medicine, University of Ulm, Frauensteige 6, Haus 58/33, 89075 Ulm, Germany
| | - Romy Lauer
- Medical Center, Division of Sports and Rehabilitation Medicine, University of Ulm, Frauensteige 6, Haus 58/33, 89075 Ulm, Germany
| | - Tibor Kesztyüs
- Department of Computer Science, Ulm University of Applied Sciences, 89081 Ulm, Germany
- Institute of Medical Systems Biology, Ulm University, 89081 Ulm, Germany
| | - Olivia Wartha
- Medical Center, Division of Sports and Rehabilitation Medicine, University of Ulm, Frauensteige 6, Haus 58/33, 89075 Ulm, Germany
| | - Jürgen Michael Steinacker
- Medical Center, Division of Sports and Rehabilitation Medicine, University of Ulm, Frauensteige 6, Haus 58/33, 89075 Ulm, Germany
| | - Dorothea Kesztyüs
- Medical Center, Division of Sports and Rehabilitation Medicine, University of Ulm, Frauensteige 6, Haus 58/33, 89075 Ulm, Germany
- Institute of General Medicine, Ulm University, 89081 Ulm, Germany
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Vorwieger E, Kelso A, Steinacker JM, Kesztyüs D. Cardio-metabolic and socio-environmental correlates of waist-to-height ratio in German primary schoolchildren: a cross-sectional exploration. BMC Public Health 2018; 18:280. [PMID: 29475449 PMCID: PMC5824571 DOI: 10.1186/s12889-018-5174-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 02/14/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Controversial messages of childhood obesity emerge: Levelling off in terms of body mass index (BMI) is foiled by increases in abdominal obesity. Waist-to-height ratio (WHtR) may be used as a screening tool for abdominal obesity in children. The aim of this study was to investigate clinical and socio-environmental correlates of abdominal obesity in primary schoolchildren. METHODS Cross-sectional data from 753 children participating in baseline assessments of the outcome evaluation of a school-based prevention program were analysed. Abdominal obesity was defined as WHtR ≥0.5. According to German age and sex-specific BMI-percentiles, overweight (>90th percentile) and obesity (>97th percentile) were determined. Anthropometric and sonographic measurements, blood pressure and blood samples were taken by clinical staff in a standardized manner. Socio-environmental and lifestyle data were assessed via parental questionnaires. Differences between abdominally obese children and others, and correlations of WHtR with clinical data were tested. Socio-environmental correlates of abdominal obesity were explored in a logistic regression analysis. RESULTS At the time of the examination children were 7.57 ± 0.42 years old. Abdominal obesity was observed in 132 (17.5%) children. According to BMI-percentiles, 22.9% of these children were obese, 38.2% overweight, and 38.2% normal weight. Affected children more often used screen media and less often participated in club sports. Abdominal obesity was associated with higher blood pressure, lower HDL- and higher LDL-cholesterol. WHtR significantly correlated with intra-abdominal fat thickness (IAF). The logistic regression model revealed migration background (odds ratio (OR) 2.12, 95% confidence interval (CI) [1.41, 3.19]), smoking during pregnancy (OR 2.30, 95% CI [1.37, 3.86]), parental obesity (OR 1.95, 95% CI [1.22, 3.10]) and higher educational level (OR 0.64, 95% CI [0.42, 0.98]) to be significantly associated with abdominal obesity in children. CONCLUSION WHtR correlates strongly with IAF. Abdominal obesity in primary schoolchildren is associated with cardio-metabolic risk factors and also occurs in otherwise normal weight children. Against the background of rising numbers of abdominal obesity in children, targeted preventive measures are long overdue. The focus of such measures should be used on children with migration background and involve parents, especially those who are obese and those with lower educational levels.
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Affiliation(s)
- Eva Vorwieger
- Division of Sports and Rehabilitation Medicine, Ulm University Medical Center, 89075 Ulm, Germany
| | - Anne Kelso
- Division of Sports and Rehabilitation Medicine, Ulm University Medical Center, 89075 Ulm, Germany
| | | | - Dorothea Kesztyüs
- Division of Sports and Rehabilitation Medicine, Ulm University Medical Center, 89075 Ulm, Germany
- Institute of General Medicine, Ulm University, Helmholtzstraße 20, 89081 Ulm, Germany
| | - on behalf of the URMEL-ICE study group
- Division of Sports and Rehabilitation Medicine, Ulm University Medical Center, 89075 Ulm, Germany
- Institute of General Medicine, Ulm University, Helmholtzstraße 20, 89081 Ulm, Germany
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12
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Gaya AR, Brand C, Dias AF, Gaya ACA, Lemes VB, Mota J. Obesity anthropometric indicators associated with cardiometabolic risk in Portuguese children and adolescents. Prev Med Rep 2017; 8:158-162. [PMID: 29057209 PMCID: PMC5643080 DOI: 10.1016/j.pmedr.2017.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 09/26/2017] [Accepted: 10/02/2017] [Indexed: 12/11/2022] Open
Abstract
The purpose of this study was to determine the association between cardiometabolic risk with body mass index and skinfold independently or in combination in youth. This cross-sectional study comprised a convenience sample of 450 children and adolescents (255 girls), aged 10 to 18 years old. Indicators of body composition were measured, and hemodynamic assessment completed. The association between body mass index and/or sum of skinfolds and cardiometabolic risk (z score of the sum of triglycerides/high density lipoprotein cholesterol, waist circumference, and mean blood pressure), was calculated using Generalized Linear Models Regression. The results showed that youngsters classified as overweight or obese with the highest skinfold measurements had the strongest association with cardiometabolic risk (< beta >: 2.60; IC 95%: 2.25–3.0) when compared with those exhibiting normal skinfold thickness (< beta >: 1.78; IC 95%: 1.30–2.20). Body mass index was most strongly associated with cardiometabolic risk (< beta >: 1.78; IC 95%: 1.3–2.2), in comparison to skinfold thickness, which was associated to a lesser extent (< beta >: 0.41; IC 95%: 0.34–0.49). Results of this cross-sectional study indicate that body mass index is more strongly associated with cardiometabolic risk than skinfold thickness. However when these two measures of overweight/obesity are combined, prediction of cardiometabolic risk is further improved. It is therefore important that public health professionals consider both body mass index and sum of skinfolds to better predict cardiometabolic risk in overweight and obese youth. Implications for future research include the use of longitudinal designs and inclusion of children from other racial/ethnic groups. Body mass index and skinfold improved the prediction of cardiometabolic risk. Body mass index seems to be the best indicator of cardiometabolic risk factors. Anthropometric indicators are cost-effective screening of overweight/obesity.
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Key Words
- BMI, body mass index
- Body mass index
- CM, cardiometabolic
- DBP, diastolic blood pressure
- ESKF, average of skinfolds
- HDL-C, high density lipoprotein cholesterol
- Health
- LDL-C, low density lipoprotein cholesterol
- MAP, mean arterial pressure
- OW/OB, overweight/obese
- SBP, systolic blood pressure
- SKF, skinfolds
- Skinfold
- TG, triglycerides
- WC, waist circumference
- WHtR, waist-to-height ratio
- Youngsters
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Affiliation(s)
- Anelise Reis Gaya
- Project Esporte Brasil (PROESP-Br), School of Physical Education, Postgraduation Program in Human Movement Science, Federal University of Rio Grande do Sul, Felizardo, 750, Jardim botânico, Porto Alegre, Brazil
| | - Caroline Brand
- Project Esporte Brasil (PROESP-Br), School of Physical Education, Postgraduation Program in Human Movement Science, Federal University of Rio Grande do Sul, Felizardo, 750, Jardim botânico, Porto Alegre, Brazil
| | - Arieli Fernandes Dias
- Project Esporte Brasil (PROESP-Br), School of Physical Education, Postgraduation Program in Human Movement Science, Federal University of Rio Grande do Sul, Felizardo, 750, Jardim botânico, Porto Alegre, Brazil
| | - Adroaldo Cezar Araujo Gaya
- Project Esporte Brasil (PROESP-Br), School of Physical Education, Postgraduation Program in Human Movement Science, Federal University of Rio Grande do Sul, Felizardo, 750, Jardim botânico, Porto Alegre, Brazil
| | - Vanilson Batista Lemes
- Project Esporte Brasil (PROESP-Br), School of Physical Education, Postgraduation Program in Human Movement Science, Federal University of Rio Grande do Sul, Felizardo, 750, Jardim botânico, Porto Alegre, Brazil
| | - Jorge Mota
- Research Center on Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Dr. Plácido da Costa, 91, 4200-450 Porto, Portugal
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Kesztyüs D, Traub M, Lauer R, Kesztyüs T, Steinacker JM. Skipping breakfast is detrimental for primary school children: cross-sectional analysis of determinants for targeted prevention. BMC Public Health 2017; 17:258. [PMID: 28292281 PMCID: PMC5351158 DOI: 10.1186/s12889-017-4169-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 03/03/2017] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Skipping breakfast was found to be associated with abdominal obesity in primary school children. The aim of this research was to examine factors associated with skipping breakfast in primary school children in order to develop targeted preventive measures. METHODS Baseline data assessment (2010) of a cluster-randomized controlled trial for the evaluation of a school-based health promotion program in primary school children in the state of Baden-Württemberg, Germany. Anthropometric measures of 1,943 primary school children aged 7.1 ± 0.6 years (51.2% boys) were conducted according to ISAK-standards (International Standard for Anthropometric Assessment) by trained staff. Further information on the health and living conditions of the children and their parents were assessed in parental questionnaires. Generalized linear mixed regression analysis was calculated to define correlates for skipping breakfast in terms of odds ratios (OR) and 95% confidence intervals (CI). RESULTS According to the final regression models, significant correlates of skipping breakfast can be divided into modifiable behavioral components (high consumption of soft drinks (OR 2.49, 95% CI 1.81; 3.43), screen media (OR 2.48, 95% CI 1.77; 3.46) and high levels of physical activity (OR 0.64, 95% CI 0.44; 0.93)) on the one hand, and more or less static socio-economic factors (migration background (OR 2.81, 95% CI 2.02; 3.91), single parenting (OR 2.13, 95% CI 1.34; 3.40), and high family education level (OR 0.42, 95% CI 0.28; 0.64)) on the other hand, and finally individual factors (female gender (OR 1.43, 95% CI 1.03; 1.99) and having a percentage of body fat at or above the 95th percentile (OR 1.47, 95% CI 1.00; 2.17)). CONCLUSION Targeted prevention should aim at health-related behaviors accompanying the habit of skipping breakfast. Focusing on vulnerable groups, characterized by not so easily modifiable socio-economic as well as individual factors, may improve results. Interventions should synergistically promote children's health and involve their parents in order to be successful. To reach all children and to avoid skipping breakfast, schools should offer regular breakfast at the start of a school day. Policy makers should support healthy eating habits at all times.
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Affiliation(s)
- Dorothea Kesztyüs
- Division of Sport and Rehabilitation Medicine, Ulm University Medical Center, 89075, Ulm, Germany. .,Institute of General Medicine, Ulm University, Helmholtzstraße 20, D-89081, Ulm, Germany.
| | - Meike Traub
- Division of Sport and Rehabilitation Medicine, Ulm University Medical Center, 89075, Ulm, Germany
| | - Romy Lauer
- Division of Sport and Rehabilitation Medicine, Ulm University Medical Center, 89075, Ulm, Germany
| | - Tibor Kesztyüs
- Department of Computer Science, Ulm University of Applied Sciences, 89081, Ulm, Germany
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Kesztyüs D, Lauer R, Kesztyüs T, Kilian R, Steinacker JM. Costs and effects of a state-wide health promotion program in primary schools in Germany - the Baden-Württemberg Study: A cluster-randomized, controlled trial. PLoS One 2017; 12:e0172332. [PMID: 28222101 PMCID: PMC5319648 DOI: 10.1371/journal.pone.0172332] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 02/03/2017] [Indexed: 12/11/2022] Open
Abstract
AIM To evaluate the cost-effectiveness of the state-wide implementation of the health promotion program "Join the Healthy Boat" in primary schools in Germany. METHODS Cluster-randomized intervention trial with wait-list control group. Anthropometric data of 1733 participating children (7.1 ± 0.6 years) were taken by trained staff before and after a one year intervention period in the academic year 2010/11. Parents provided information about the health status, and the health behaviour of their children and themselves, parental anthropometrics, and socio-economic background variables. Incidence of abdominal obesity, defined as waist-to-height ratio (WHtR) ≥ 0.5, was determined. Generalized linear models were applied to account for the clustering of data within schools, and to adjust for baseline-values. Losses to follow-up and missing data were analysed. From a societal perspective, the overall costs, costs per pupil, and incremental cost-effectiveness ratio (ICER) to identify the costs per case of averted abdominal obesity were calculated. RESULTS The final regression model for the incidence of abdominal obesity shows lower odds for the intervention group after an adjustment for grade, gender, baseline WHtR, and breakfast habits (odds ratio = 0.48, 95% CI [0.25; 0.94]). The intervention costs per child/year were €25.04. The costs per incidental case of averted abdominal obesity varied between €1515 and €1993, depending on the different dimensions of the target group. CONCLUSION This study demonstrates the positive effects of state-wide, school-based health promotion on incidental abdominal obesity, at affordable costs and with proven cost-effectiveness. These results should support allocative decisions of policymakers. An early start to the prevention of abdominal obesity is of particular importance because of its close relationship to non-communicable diseases. TRIAL REGISTRATION German Clinical Trials Register (DRKS), Freiburg University, Germany, DRKS-ID: DRKS00000494.
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Affiliation(s)
- Dorothea Kesztyüs
- Section Sports and Rehabilitation Medicine, Department of Internal Medicine II, Ulm University, Ulm, Germany
- Institute of General Medicine, Ulm University, Ulm, Germany
| | - Romy Lauer
- Section Sports and Rehabilitation Medicine, Department of Internal Medicine II, Ulm University, Ulm, Germany
| | - Tibor Kesztyüs
- Department of Computer Science, Ulm University of Applied Sciences, Ulm, Germany
| | - Reinhold Kilian
- Section Health Economics and Health Services Research, Department of Psychiatry II, Ulm University, Günzburg, Germany
| | - Jürgen M Steinacker
- Section Sports and Rehabilitation Medicine, Department of Internal Medicine II, Ulm University, Ulm, Germany
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McInnes A, Blackwell D. Self-reported Perceptions of Weight and Eating Behavior of School Children in Sunderland, England. Front Public Health 2017; 5:17. [PMID: 28261577 PMCID: PMC5306376 DOI: 10.3389/fpubh.2017.00017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 01/30/2017] [Indexed: 11/25/2022] Open
Abstract
The main aim of this study was to determine the self-reported perceptions of weight and eating behaviors of school-age children in Sunderland in the North East of England. The results presented are derived from data collected by a Health-Related Behaviour Survey developed by Schools and Students Health Education Unit at Exeter University, and this study is based on analysis of the data set collected for Sunderland. A total of 12,213 pupils from nine secondary schools completed the questionnaire biennially from 1996 to 2012. The sample included 12 and 13 year olds and 14 and 15 year olds. Various health and social issues related to perceptions of weight and eating behaviors were determined. Trends related to these issues were identified according to age and gender of respondents, and differences between the groups were highlighted. From the analysis, some interesting findings relating to eating patterns and weight perception amongst young people were ascertained. Females of both age groups reported a greater desire to lose weight than their male counterparts. The percentage of school children who reported having breakfast at home has increased progressively, as have those having lunch at school. The percentage of school children purchasing lunch from takeaway outlets has dramatically decreased. This is pleasing since health policy of limiting take out provision is high on government agenda and these trends can be used by policy makers to focus on continuing to improve school meals. The findings partly support other national data but also contradict the widely held beliefs around food and obesity in the North East of England.
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Affiliation(s)
- Alison McInnes
- Faculty of Health and Life Sciences, Northumbria University , Newcastle upon Tyne , UK
| | - David Blackwell
- Faculty of Applied Sciences, The David Goldman Informatics Centre, The University of Sunderland , Sunderland , UK
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Physical Activity and Anthropometric Characteristics Among Urban Youth in Mexico: A Cross-Sectional Study. J Phys Act Health 2016; 13:1063-1069. [PMID: 27256635 DOI: 10.1123/jpah.2015-0463] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Obesity is a critical problem among Mexican youth, but few studies have investigated associations among physical activity (PA) modes and anthropometrics in this population. This study examined associations among active commuting to school (ACS), sports or other organized PA, outdoor play, and body mass index (BMI) percentile and waist circumference (WC) among Mexican youth. METHODS Parents of school children (N = 1996, ages 6 to 14 years, 53.1% female) in 3 Mexican cities reported PA participation using the (modified) fourth grade School Physical Activity and Nutrition Survey. Trained assessors measured BMI percentile and WC in person. RESULTS Parents reported that 52.3% of children engaged in ACS, 57.3% participated in sports or organized PA, and a median of 2 days in the previous week with at least 30 minutes of outdoor play. In complete case analyses (n = 857), ACS was negatively associated with BMI percentile, and outdoor play was negatively associated with WC after adjusting for school, age, sex, and income. In analyses incorporating data from multiple imputation (N = 1996), outdoor play was negatively associated with WC (all Ps < . 05). CONCLUSIONS ACS and outdoor play are favorably associated with anthropometrics and may help prevent childhood obesity in Mexico. ACS and outdoor play should be priorities for increasing youth PA in Mexico.
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Weston KL, Azevedo LB, Bock S, Weston M, George KP, Batterham AM. Effect of Novel, School-Based High-Intensity Interval Training (HIT) on Cardiometabolic Health in Adolescents: Project FFAB (Fun Fast Activity Blasts) - An Exploratory Controlled Before-And-After Trial. PLoS One 2016; 11:e0159116. [PMID: 27486660 PMCID: PMC4972319 DOI: 10.1371/journal.pone.0159116] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 06/24/2016] [Indexed: 01/09/2023] Open
Abstract
Background Low-volume high-intensity interval training holds promise for cardiometabolic health promotion in adolescents, but sustainable interventions must be practical and engaging. We examined the effect of a school-based multi-activity low-volume high-intensity interval training intervention on adolescents’ cardiometabolic health. Methods In an exploratory controlled before-and-after design, 101 adolescents (mean age ± standard deviation [SD] 14.0 ± 0.3 years) were recruited from four schools; two were designated as intervention sites (n = 41), and two as control (n = 60). The intervention comprised 4 to 7 repetitions of 45 s maximal effort exercise (basketball, boxing, dance and soccer drills) interspersed with 90-s rest, thrice weekly for 10 weeks. Outcomes were non-fasting blood lipids and glucose, waist circumference, high sensitivity C-reactive protein, resting blood pressure, physical activity, twenty-metre shuttle-run test performance and carotid artery intima-media thickness. The difference in the change from baseline (intervention minus control) was estimated for each outcome. Using magnitude-based inferences, we calculated the probability that the true population effect was beneficial, trivial, and harmful against a threshold for the minimum clinically important difference of 0.2 between-subject SDs. Results and Discussion Mean (± SD) attendance for the intervention (expressed as percentage of available intervention sessions [n = 30]) was 77 ± 13%. Post-intervention, there were likely beneficial effects for triglycerides (-26%; 90% confidence interval -46% to 0%), waist circumference (-3.9 cm; -6.1 cm to -1.6 cm) and moderate-to-vigorous physical activity (+16 min; -5 to 38 min), and a possibly beneficial effect for twenty-metre shuttle-run test performance (+5 shuttles; -1 to 11 shuttles) in intervention participants (vs controls). The role of elevated triglycerides and waist circumference in cardiovascular disease and metabolic syndrome development underlines the importance of our findings. We also demonstrated that school-based low-volume high-intensity interval training can be delivered as intended, thus representing a novel and scalable means of improving aspects of adolescents’ cardiometabolic health. Trial Registration ClinicalTrials.gov NCT02626767
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Affiliation(s)
- Kathryn L. Weston
- Health and Social Care Institute, Teesside University, Middlesbrough, United Kingdom
- * E-mail:
| | - Liane B. Azevedo
- Health and Social Care Institute, Teesside University, Middlesbrough, United Kingdom
| | - Susan Bock
- School of Applied Social Sciences, Durham University, Durham, United Kingdom
| | - Matthew Weston
- School of Social Sciences, Business & Law, Teesside University, Middlesbrough, United Kingdom
| | - Keith P. George
- Research Institute for Sport and Exercise Sciences, Liverpool John Moore’s University, Liverpool, United Kingdom
| | - Alan M. Batterham
- Health and Social Care Institute, Teesside University, Middlesbrough, United Kingdom
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Kesztyüs D, Traub M, Lauer R, Kesztyüs T, Steinacker JM. Correlates of longitudinal changes in the waist-to-height ratio of primary school children: Implications for prevention. Prev Med Rep 2016; 3:1-6. [PMID: 26844178 PMCID: PMC4733070 DOI: 10.1016/j.pmedr.2015.11.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To investigate correlates of changes in waist-to-height ratio (WHtR) in primary school children in order to identify modifiable factors usable for prevention. METHODS Outcome evaluation of a statewide health promotion program in Baden-Württemberg, Germany. Baseline (2010) and follow-up (2011) measurements provided data for the calculation of changes in WHtR. Further information on the health and living conditions of the children were assessed in parental questionnaires. Anthropometric measures were taken in 1733 (50.8% male) first and second grade children (age at baseline 7.1 ± 0.6 years) by staff trained according to ISAK-standards. Stepwise linear regression analysis was applied to identify variables with influence on changes in WHtR. RESULTS According to the resulting regression model, changes in WHtR towards an increase were influenced by at least one parent being overweight/obese, at least one parent who smoked, low household income, higher age of the child and the skipping of breakfast. There was no clustering effect in schools observed. CONCLUSION A promising target for prevention of gain in WHtR in primary school children is to ensure the regularity of breakfast. Smoking cessation as well as dietary improvements would not only help children's health but also the health of their parents. The socioeconomic influence on the development of an unhealthy weight status has already been acknowledged and should be extensively targeted by all of society and policy makers.
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Affiliation(s)
- Dorothea Kesztyüs
- Ulm University Medical Center, Division of Sport and Rehabilitation Medicine, 89075 Ulm, Germany
| | - Meike Traub
- Ulm University Medical Center, Division of Sport and Rehabilitation Medicine, 89075 Ulm, Germany
| | - Romy Lauer
- Ulm University Medical Center, Division of Sport and Rehabilitation Medicine, 89075 Ulm, Germany
| | - Tibor Kesztyüs
- Ulm University of Applied Sciences, Department of Computer Science, 89081 Ulm, Germany
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Al-Yateem N, Attia AKN, AL-Yafei T, Mohammed A, Mahmood B. The impact of a school nurse intervention on adolescents' knowledge about healthy eating. ACTA ACUST UNITED AC 2015. [DOI: 10.12968/bjsn.2015.10.6.280] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Nabeel Al-Yateem
- Assistant Professor, University of Sharjah, College of Health Sciences, Department of Nursing, United Arab Emirates
| | - Amal Kadry Nicola Attia
- Professor of Nursing, University of Sharjah, College of Health Sciences, Department of Nursing, United Arab Emirates
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Griffin TL, Jackson DM, McNeill G, Aucott LS, Macdiarmid JI. A Brief Educational Intervention Increases Knowledge of the Sugar Content of Foods and Drinks but Does Not Decrease Intakes in Scottish Children Aged 10-12 Years. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2015; 47:367-73.e1. [PMID: 25956017 DOI: 10.1016/j.jneb.2015.03.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 03/20/2015] [Accepted: 03/23/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To assess the effectiveness of an educational intervention to improve children's knowledge of the sugar content of food and beverages. METHODS Cluster-randomized, controlled trial with 268 children (aged 10-12 years) from 14 primary schools in Aberdeen, Scotland. The intervention group received 2 interactive classroom sessions about sugar. A questionnaire to assess knowledge was completed at baseline and 4, 10, and 34 weeks postintervention. Dietary intake was assessed by food frequency questionnaire at baseline and on weeks 10 and 34. RESULTS After the intervention, the intervention group demonstrated greater knowledge of sugar than did the control group (P < .001), which was sustained at week 34 (P < .001). Dietary intakes of sugar did not change postintervention. Pre-intervention children underestimated the sugar content of fruit-based beverages. CONCLUSIONS AND IMPLICATIONS Children's knowledge of sugar in food and beverages is limited but can be improved through a simple educational intervention. Further intervention would be needed to encourage a change in dietary intake.
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Affiliation(s)
- Tania L Griffin
- Learning Centre, University of Birmingham, Birmingham, United Kingdom.
| | - Diane M Jackson
- Rowett Institute of Nutrition and Health, University of Aberdeen, Bucksburn, Aberdeen, United Kingdom
| | - Geraldine McNeill
- Rowett Institute of Nutrition and Health, University of Aberdeen, Bucksburn, Aberdeen, United Kingdom; Institute of Applied Health Sciences, University of Aberdeen, Foresterhill, Aberdeen, United Kingdom
| | - Lorna S Aucott
- Institute of Applied Health Sciences, University of Aberdeen, Foresterhill, Aberdeen, United Kingdom
| | - Jennie I Macdiarmid
- Institute of Applied Health Sciences, University of Aberdeen, Foresterhill, Aberdeen, United Kingdom
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Al Mahrooqi KMS, Ng CKC, Sun Z. Pediatric Computed Tomography Dose Optimization Strategies: A Literature Review. J Med Imaging Radiat Sci 2015; 46:241-249. [PMID: 31052099 DOI: 10.1016/j.jmir.2015.03.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 02/20/2015] [Accepted: 03/23/2015] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Computed tomography (CT) dose optimization is an important issue in radiography because CT is the largest contributor to medical radiation dose and its use is increasing. However, CT dose optimization for pediatric patients could be more challenging than their adult counterparts. The purpose of this literature review was to identify and discuss the current pediatric CT dose saving techniques. Optimized pediatric protocols were also proposed. METHODS A comprehensive literature search was conducted using the Medline, ProQuest Health and Medical Complete, PubMed, ScienceDirect, Scopus, Springer Link, and Web of Science databases and the keywords CT, pediatric, optimization, protocol, and radiation dose to identify articles focusing on pediatric CT dose optimization strategies published between 2004 and 2014. RESULTS AND SUMMARY Seventy-seven articles were identified in the literature search. Strategies for optimizing a range of scan parameters and technical considerations including tube voltage and current, iterative reconstruction, diagnostic reference levels, bowtie filters, scout view, pitch, scan collimation and time, overscanning, and overbeaming for pediatric patients with different ages and body sizes and compositions were discussed. An example of optimized pediatric protocols specific to age and body size for the 64-slice CT scanners was devised. It is expected that this example could provide medical radiation technologists, radiologists, and medical physicists with ideas to optimize their pediatric protocols.
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Affiliation(s)
| | - Curtise Kin Cheung Ng
- Department of Medical Radiation Sciences, Curtin University, Perth, Western Australia, Australia.
| | - Zhonghua Sun
- Department of Medical Radiation Sciences, Curtin University, Perth, Western Australia, Australia
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Abstract
OBJECTIVES To explore pupils' and teachers' experiences of physical education (PE). STUDY DESIGN A qualitative investigation employing semistructured interviews. Self Determination Theory was used as a guiding theory and Template Analysis was used to analyse the data. SETTING A secondary school in the North East of England. PARTICIPANTS 14 pupils (aged 13 and 14, boys and girls) with a range of self-perceived competencies regarding PE and four PE teachers of the pupils (3 male, 1 female). PRIMARY AND SECONDARY OUTCOMES (1) Attitudes and perceptions of PE pupils regarding their experiences of compulsory school PE lessons. (2) PE teachers' experiences of teaching PE. RESULTS Key results from pupils and teachers suggest pupils enjoy participation in PE when they feel competent, in control and supported by others. Feeling competent depended on (1) the activity within PE and (2) the pupils perceived physical capabilities/aptitude. Feeling in control related to (1) having a choice of activities, (2) being able to set exertion levels and (3) control over clothes worn while taking part. Relationships within pupil groups and between pupils and teachers were perceived as important. Teachers could positively influence their pupils' enjoyment by understanding and supporting their personal goals, as opposed to dictating and controlling what they did and for how long, and by promoting a non-threatening atmosphere between pupils. CONCLUSIONS Rising obesity levels and concerns over the fitness of children and young people has returned the focus of PE to its potential as a vehicle for promoting health. This study suggests schools and PE teachers in particular can positively influence the PE experience of both boys and girls by providing more choice of activities and letting pupils make their own decisions based on their personal needs.
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Affiliation(s)
- Kiara Lewis
- Division of Health and Wellbeing, University of Huddersfield, Huddersfield, UK
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Sugar-sweetened beverage consumption and central and total adiposity in older children: a prospective study accounting for dietary reporting errors. Public Health Nutr 2014; 18:1155-63. [PMID: 25166959 DOI: 10.1017/s1368980014001700] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To determine the prospective relationship between changes in sugar-sweetened beverage (SSB) intake and central adiposity in older children. DESIGN Dietary intakes of children were obtained by 3 d food records at ages 10 and 13 years. Waist circumference (WC) and weight and height to determine BMI were measured at 10 and 13 years and total body fat mass (TBFM) at 13 years by dual-energy X-ray absorptiometry. Analyses were conducted using multivariable linear regression. Reporting errors were measured and participants were categorized as under-, plausible and over-reporters of dietary intakes. SETTING Community-based British cohort of children participating in the Avon Longitudinal Study of Parents and Children. RESULTS Among 2455 older children, increased SSB consumption from ages 10 to 13 years was associated with higher WC (standardized β=0.020, P=0.19), BMI (β=0.028, P=0.03) and TBFM (β=0.017, P=0.20) at 13 years. Effects were strengthened among plausible dietary reporters (n 1059): WC (β=0.097, P<0.001), BMI (β=0.074, P<0.001) and TBFM (β=0.065, P=0.003). The association between change in SSB and WC was weakened, but remained statistically significant after accounting for BMI (β=0.042, P=0.02) and TBFM (β=0.048, P=0.01). CONCLUSIONS Higher consumption of SSB from ages 10 to 13 years was associated with a larger WC at age 13 years independent of differences in total adiposity. Accounting for dietary reporting errors strengthened associations. Our findings further support recommendations to limit intakes of SSB to reduce excess weight gain in children and suggest that SSB have an additional deleterious effect on central adiposity.
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Weichenthal S, Hoppin JA, Reeves F. Obesity and the cardiovascular health effects of fine particulate air pollution. Obesity (Silver Spring) 2014; 22:1580-9. [PMID: 24639433 PMCID: PMC4238790 DOI: 10.1002/oby.20748] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 03/13/2014] [Indexed: 12/19/2022]
Abstract
OBJECTIVE This review examines evidence related to the potential impact of obesity on the cardiovascular health effects of fine particulate air pollution (PM₂.₅). METHODS A PubMed search was conducted in December, 2013 and studies were included if they examined the relationship between PM₂.₅ and cardiovascular health as well as effect modification by obesity. RESULTS One hundred twenty-one citations were reviewed; three large prospective cohort studies and 14 panel studies with short-term follow-up met the above criteria. All three cohort studies reported stronger associations between PM₂.₅ and cardiovascular mortality among obese subjects and one reported a significant trend of increased risk with increased body mass index. Similarly, 11 of 14 panel studies reported stronger associations between PM₂.₅ and acute changes in physiological measures of cardiovascular health among obese subjects including outcomes such as blood pressure and arrhythmia. Although interactions were not always statistically significant, the consistent pattern of stronger associations among obese subjects suggests that obesity may modify the impact of PM2.5 on cardiovascular health. CONCLUSIONS Epidemiological evidence suggests that obesity may increase susceptibility to the cardiovascular health effects of PM₂.₅. This an important area of research as the public health impacts of air pollution could increase with increasing prevalence of obesity.
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Affiliation(s)
- Scott Weichenthal
- Health Canada, Air Health Sciences DivisionOttawa, Ontario, Canada
- Department of Occupational and Environmental Health, University of Montreal (CHUM) and Cité de la santé de LavalQuebec, Canada
| | - Jane A Hoppin
- Department of Biological Sciences, North Carolina State UniversityRaleigh, North Carolina, USA
| | - Francois Reeves
- Department of Occupational and Environmental Health, University of Montreal (CHUM) and Cité de la santé de LavalQuebec, Canada
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Kohyama J. The possible long-term effects of early-life circadian rhythm disturbance on social behavior. Expert Rev Neurother 2014; 14:745-55. [PMID: 24902476 DOI: 10.1586/14737175.2014.927735] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Sleep loss impairs brain function. As late sleep onset can reduce sleep, this sleep/circadian rhythm disturbance may cause brain impairment. Specific data on the long-term effects of sleep/circadian rhythm disturbance on subsequent brain function are lacking. Japan, a sleep-deprived society from infancy to adulthood, provides an ideal platform to investigate the association of these disturbances in early life with subsequent functioning. In this article, several current problematic behaviors among youth in Japan (dropping out from high school, school absenteeism, early resignation from employment, and suicide) are discussed in relation to early life sleep/circadian rhythm patterns. We hypothesize that daily habits of modern society during early stages of life produce unfavorable effects on brain function resulting in problematic behaviors in subsequent years.
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Affiliation(s)
- Jun Kohyama
- Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32 Todaijima, Urayasu 279-0001, Japan
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O'Dea JA, Chiang H, Peralta LR. Socioeconomic patterns of overweight, obesity but not thinness persist from childhood to adolescence in a 6-year longitudinal cohort of Australian schoolchildren from 2007 to 2012. BMC Public Health 2014; 14:222. [PMID: 24592991 PMCID: PMC3974000 DOI: 10.1186/1471-2458-14-222] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Accepted: 02/20/2014] [Indexed: 11/12/2022] Open
Abstract
Background The prevalence of childhood overweight and obesity increased during the 1980s to the late 1990s. The prevalence of obesity is higher in socially and economically disadvantaged communities in most Westernised countries. The purpose of this study was to examine how the socioeconomic gradient in weight status, namely thinness, overweight and obesity, changes over time in a longitudinal cohort of Australian schoolchildren, from 2007–2012. Methods 939 Australian children in school grades 2–6 from 10 primary schools initially participated in the study in 2007. Height and weight were directly measured by research assistants each year. Obesity/overweight and thinness were defined by using the International Obesity Task Force BMI cut-offs. Chi-square analyses were used to test associations between categorical variables and linear mixed models were used to estimate whether the differences in SES groups were statistically significant over time. Results Results found both males and females in the low SES group were more likely to be obese (6-7%) than middle (4-5%) and high (2-3%) SES groups and this pattern tended to be similar over the 6 year study period. There appeared to be no particular SES pattern for thinness with all SES groups having 4-5% of participants who were thin. The gender and SES patterns were also similar over 6 years for BMI with low and middle SES participants having significantly greater BMI than their high SES peers. Conclusions Patterns of obesity and overweight in children from socially and economically disadvantaged communities in regional NSW are identifiable from a young age and the socioeconomic pattern persists into adolescence. Obesity prevention and intervention programs should be designed, implemented and evaluated with the social determinants of health in mind and in collaboration with community members. Community programs should continue to be based on positive rather than negative messages in order to avoid unintended stigma and other potentially harmful outcomes.
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Affiliation(s)
- Jennifer A O'Dea
- Faculty of Education & Social Work, University of Sydney, Building A35, Sydney, NSW 2006, Australia.
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