1
|
Blasingame M, Samuels LR, Heerman WJ. The Combined Effects of Social Determinants of Health on Childhood Overweight and Obesity. Child Obes 2024; 20:107-118. [PMID: 36989504 DOI: 10.1089/chi.2022.0222] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
Background: To characterize the association between multiple social determinants of health (SDOH) and overweight and obesity among US children. Methods: We conducted a cross-sectional analysis using the 2016-2020 National Survey of Children's Health. SDOH domains consisted of Economic Stability, Social and Community Context, Neighborhood and Built Environment, and Health Care Access and Quality. We used ordinal logistic regression to model associations between SDOH and weight status and calculate predicted probabilities of having overweight or obesity for various SDOH profiles. Results: Data from 81,716 children represented a weighted sample of 29,415,016 children ages 10-17 years in the United States. Of these, 17% had overweight and 17% had obesity. Compared with children with the theoretically lowest-risk SDOH profile, children with the highest-risk SDOH profiles in all four domains had an odds ratio of having a higher BMI category of 4.38 (95% confidence interval 1.67-7.09). For the lowest risk profile, the predicted probability of obesity varied from 8% to 11%, depending on race. For the highest risk profile, the predicted probability of obesity varied from 26% to 34%, depending on race. Conclusions: While high-risk values in each SDOH domain were associated with higher predicted probability of overweight and obesity, it was the combination of highest risk values in all the SDOH domains that led to greatest increases. This suggests a complex and multilayered relationship between the SDOH and childhood obesity, necessitating a comprehensive approach to addressing health equity to reduce childhood obesity.
Collapse
Affiliation(s)
| | - Lauren R Samuels
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - William J Heerman
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| |
Collapse
|
2
|
Ye Q, Devarshi PP, Grant RW, Higgins KA, Mitmesser SH. Lower Intakes of Key Nutrients Are Associated with More School and Workplace Absenteeism in US Children and Adults: A Cross-Sectional Study of NHANES 2003-2008. Nutrients 2023; 15:4356. [PMID: 37892431 PMCID: PMC10609412 DOI: 10.3390/nu15204356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 09/26/2023] [Accepted: 10/05/2023] [Indexed: 10/29/2023] Open
Abstract
The influence of individual macro- and micronutrients on absenteeism in the United States is largely unknown. The objective of this study was to determine whether nutritional status or nutrient intake were associated with absenteeism from school and work due to illness or injury. Data from NHANES 2003-2008 were used to assess nutrient intake from food and food plus supplements, nutritional biomarker levels, and school and work absenteeism per year in children and adults. Negative binomial regression models were used to predict mean days of missed work per year and to estimate incidence rate ratios (IRRs) of absenteeism by nutrient biomarker status. Of 7429 children, 77% reported missing school days (mean 4.0 days). Of 8252 adults, 51% reported missing work days (mean 4.9 days). Children and adults who reported more absent days had a significantly lower intake of protein and several essential micronutrients from the diet. When nutrients from supplements were included, this negative association was retained for protein, selenium, choline, and DHA in children and for protein, selenium, vitamin K, choline, potassium, fiber, octadecatrienoic acid, and lycopene in adults. Future studies are needed to ascertain whether dietary interventions, such as access to healthier food options and/or dietary supplements, can reduce absenteeism.
Collapse
Affiliation(s)
- Qian Ye
- Science & Technology, Pharmavite LLC, West Hills, CA 91304, USA; (P.P.D.); (R.W.G.)
| | - Prasad P. Devarshi
- Science & Technology, Pharmavite LLC, West Hills, CA 91304, USA; (P.P.D.); (R.W.G.)
| | - Ryan W. Grant
- Science & Technology, Pharmavite LLC, West Hills, CA 91304, USA; (P.P.D.); (R.W.G.)
| | - Kelly A. Higgins
- Food Components and Health Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Beltsville, MD 20705, USA
| | - Susan H. Mitmesser
- Science & Technology, Pharmavite LLC, West Hills, CA 91304, USA; (P.P.D.); (R.W.G.)
| |
Collapse
|
3
|
Brero M, Meyer CL, Jackson-Morris A, Spencer G, Ludwig-Borycz E, Wu D, Espinosa De Candido AF, Ferre Eguiluz MI, Bonvecchio Arenas A, Jewell J, Nugent R. Investment case for the prevention and reduction of childhood and adolescent overweight and obesity in Mexico. Obes Rev 2023; 24:e13595. [PMID: 37464960 DOI: 10.1111/obr.13595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 04/11/2023] [Accepted: 05/21/2023] [Indexed: 07/20/2023]
Abstract
Despite efforts to curb the rise in Mexico's child and adolescent overweight and obesity rates, prevalence in Mexico has grown by 120% since 1990 to 43.3% in 2022. This investment case identifies policies that will produce the largest returns for Mexico. The investment case model builds beyond a cost-of-illness analysis by predicting the health and societal economic impact of implementing child and adolescent overweight and obesity interventions in a cohort aged 0-19 from 2025 to 2090. The Markov model's impacts include healthcare expenditures, years of life lost, and reduced wages and productivity. We projected and compared costs in a status quo scenario to an intervention scenario to estimate cost savings and calculate return-on-investment (ROI). Total lifetime health and economic costs amount to USD 1.8 trillion-USD 30 billion on average per year. Implementing five interventions can reduce lifetime costs by approximately 7%. Each intervention has a low cost per disability-adjusted life year averted over 30-year, 50-year, and lifetime horizons. The findings demonstrate that a package of interventions mitigating child and adolescent overweight and obesity offers a strong ROI. The novel investment case methods should be applied to other countries, particularly low- and middle-income countries.
Collapse
Affiliation(s)
| | - Christina L Meyer
- Center for Global Noncommunicable Diseases, RTI International, Research Triangle Park, North Carolina, USA
| | - Angela Jackson-Morris
- Center for Global Noncommunicable Diseases, RTI International, Research Triangle Park, North Carolina, USA
| | - Garrison Spencer
- Center for Global Noncommunicable Diseases, RTI International, Research Triangle Park, North Carolina, USA
| | | | - Daphne Wu
- Center for Global Noncommunicable Diseases, RTI International, Research Triangle Park, North Carolina, USA
| | | | | | - Anabelle Bonvecchio Arenas
- Directora de Investigación en Políticas y Programas de Nutrición, Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | | | - Rachel Nugent
- Center for Global Noncommunicable Diseases, RTI International, Research Triangle Park, North Carolina, USA
| |
Collapse
|
4
|
Lee K, McMorris BJ, Chi CL, Looman WS, Burns MK, Delaney CW. Using data-driven analytics and ecological systems theory to identify risk and protective factors for school absenteeism among secondary students. J Sch Psychol 2023; 98:148-180. [DOI: 10.1016/j.jsp.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 12/13/2022] [Accepted: 03/15/2023] [Indexed: 04/09/2023]
|
5
|
Rahman MA, Renzaho AMN, Kundu S, Awal MA, Ashikuzzaman M, Fan L, Ahinkorah BO, Okyere J, Kamara JK, Mahumud RA. Prevalence and factors associated with chronic school absenteeism among 207,107 in-school adolescents: Findings from cross-sectional studies in 71 low-middle and high-income countries. PLoS One 2023; 18:e0283046. [PMID: 37163492 PMCID: PMC10171665 DOI: 10.1371/journal.pone.0283046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 02/28/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Despite the negative impact of chronic school absenteeism on the psychological and physical health of adolescents, data on the burden of adolescent chronic school absenteeism (ACSA) and interventions and programs to address it are lacking. We estimated the global, regional and national level prevalence of ACSA and its correlation with violence and unintentional injury, psychosocial, protective, lifestyle, and food security-related factors among in-school adolescents across low and middle-income, and high-income countries (LMICs-HICs). OBJECTIVES This study aimed to estimate the prevalence of chronic school absenteeism (CSA) as well as to determine its associated factors among in-school adolescents across 71 low-middle and high-income countries. METHODS We used data from the most recent Global School-based Student Health Survey of 207,107 in-school adolescents aged 11-17 years in 71 LMICs-HICs countries across six WHO regions. We estimated the weighted prevalence of ACSA from national, regional and global perspectives. Multiple binary logistic regression analyses were used to estimate the adjusted effect of independent factors on ACSA. RESULTS The overall population-weighted prevalence of CSA was 11·43% (95% confidence interval, CI: 11·29-11·57). Higher likelihood of CSA was associated with severe food insecurity, peer victimisation, loneliness, high level of anxiety, physically attack, physical fighting, serious injury, poor peer support, not having close friends, lack of parental support, being obese, and high levels of sedentary behaviours. Lower likelihood of CSA was associated with being female (odds ratio, OR = 0·76, 95% CI: 0·74-0·78). CONCLUSION Our findings indicate that a combination of different socio-economic factors, peer conflict and injury factors, factors exacerbate CSA among adolescents. Interventions should be designed to focus on these risk factors and should consider the diverse cultural and socioeconomic contexts.
Collapse
Affiliation(s)
- Md Ashfikur Rahman
- Development Studies Discipline, Social Science School, Khulna University, Khulna, Bangladesh
| | - Andre M N Renzaho
- Professor of Humanitarian and Development Studies, School of Medicine and Health, Western Sydney University, Campbelltown, Australia
| | - Satyajit Kundu
- Global Health Institute, North South University, Dhaka, Bangladesh
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Dumki, Patuakhali, Bangladesh
| | - Md Abdul Awal
- Electronics and Communication Engineering Discipline, Khulna University, Khulna, Bangladesh
| | - Md Ashikuzzaman
- Development Studies Discipline, Khulna University, Khulna, Bangladesh
| | - Lijun Fan
- School of Public Health, Southeast University, Nanjing, China
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | | | - Rashidul Alam Mahumud
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| |
Collapse
|
6
|
Carrello J, Lung T, Killedar A, Baur LA, Hayes A. Relationship between obesity and school absenteeism in Australian children: Implications for carer productivity. Obes Res Clin Pract 2021; 15:587-592. [PMID: 34625400 DOI: 10.1016/j.orcp.2021.09.006] [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] [Received: 06/15/2021] [Revised: 09/15/2021] [Accepted: 09/17/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Economic evaluations of childhood obesity interventions are often used to assist decision making when presented with alternative course of action. Including indirect costs related to productivity losses is recommended; in children this would include school absenteeism. Our aim was to determine the association between school absenteeism and weight status among Australian children and estimate the indirect costs of this. METHODS We used data from a nationally representative sample of 8551 Australian children in the Longitudinal study of Australian Children (LSAC) with follow-up between 2006 and 2018. A mixed-effects negative binomial regression model was used to investigate the relationship between school absenteeism and weight status, controlling for age, sex, socio-economic position, indigenous status, rural/remote status and long-term medical conditions. We used average daily wages for the year 2018 to value the indirect costs of school absenteeism (through caregiver lost productivity). RESULTS Australian children with obesity aged 6-13 years missed on average an extra day of school annually compared to children of a healthy weight (p = 0.004), while adolescents with obesity aged 14-17 years missed on average an extra 0.69 days of school annually (p = 0.006). The estimated national cost for children with obesity aged 6-13 years was approximately $64 million AUD ($43 million USD) or $338 AUD ($230 USD) per child through caregiver lost productivity in 2018. CONCLUSIONS There is a small but significant association between school absenteeism and childhood obesity in Australia which is estimated to generate a considerable national cost through caregiver productivity losses. Our results will assist health economists evaluating childhood obesity interventions capture the full extent of the associated costs with this condition.
Collapse
Affiliation(s)
- Joseph Carrello
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, Australia.
| | - Thomas Lung
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, Australia; The George Institute for Global Health, The University of New South Wales, Sydney, NSW, Australia
| | - Anagha Killedar
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Louise A Baur
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, Australia; Weight Management Services, The Children's Hospital at Westmead, Westmead, Australia
| | - Alison Hayes
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| |
Collapse
|
7
|
Lee J, Kubik MY, Fulkerson JA. Missed Work Among Caregivers of Children With a High Body Mass Index: Child, Parent, and Household Characteristics. J Sch Nurs 2019; 37:396-403. [PMID: 31514567 DOI: 10.1177/1059840519875506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
An underexamined consequence of childhood obesity is caregivers' missed work attributed to child absence from school due to a health condition. This secondary analysis (N = 123) reported the frequency of missed work among caregivers of children with a body mass index (BMI) at or above the 75th percentile and examined associations with select child, parent, and household characteristics. Caregivers missed work 1.3 (SD = 1.2) times in the past year with 41% reporting 2 or more times. A child visiting a health-care provider 2 or more times in the past year and parent perception of their child's health as good/fair/poor were significantly associated with caregivers' missing work 2 or more times in a year (OR = 5.8 and OR = 3.0, respectively). A significant association between children's physical and psychosocial well-being and caregivers' missed work emphasizes the school nurse role working with children with high BMI and families to address student absenteeism and caregivers' missed work.
Collapse
Affiliation(s)
- Jiwoo Lee
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | - Martha Y Kubik
- Department of Nursing, College of Public Health, Temple University, Philadelphia, PA, USA
| | | |
Collapse
|
8
|
Allison MA, Attisha E, Lerner M, De Pinto CD, Beers NS, Gibson EJ, Gorski P, Kjolhede C, O’Leary SC, Schumacher H, Weiss-Harrison A. The Link Between School Attendance and Good Health. Pediatrics 2019; 143:peds.2018-3648. [PMID: 30835245 DOI: 10.1542/peds.2018-3648] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
More than 6.5 million children in the United States, approximately 13% of all students, miss 15 or more days of school each year. The rates of chronic absenteeism vary between states, communities, and schools, with significant disparities based on income, race, and ethnicity. Chronic school absenteeism, starting as early as preschool and kindergarten, puts students at risk for poor school performance and school dropout, which in turn, put them at risk for unhealthy behaviors as adolescents and young adults as well as poor long-term health outcomes. Pediatricians and their colleagues caring for children in the medical setting have opportunities at the individual patient and/or family, practice, and population levels to promote school attendance and reduce chronic absenteeism and resulting health disparities. Although this policy statement is primarily focused on absenteeism related to students' physical and mental health, pediatricians may play a role in addressing absenteeism attributable to a wide range of factors through individual interactions with patients and their parents and through community-, state-, and federal-level advocacy.
Collapse
Affiliation(s)
- Mandy A. Allison
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Adult and Child Consortium for Health Outcomes Research and Delivery Science, School of Medicine, University of Colorado, and Children’s Hospital Colorado, Aurora, Colorado; and
| | - Elliott Attisha
- Detroit Public Schools Community District, Detroit, Michigan
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Kim TE, Jang CY. The relationship between children's flourishing and being overweight. J Exerc Rehabil 2018; 14:598-605. [PMID: 30276180 PMCID: PMC6165987 DOI: 10.12965/jer.1836208.104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 07/14/2018] [Indexed: 11/22/2022] Open
Abstract
This study examined the effect of children's flourishing on the pandemic of obesity from various aspects such as age, gender, race, family, school, and community. By using a subsample of the 2011-2012 National Survey of Children's Health, the Flourishing scale analyses were performed with a total of 45,309 children. Childhood obesity was diagnosed by calculating the percentile of the body mass index. Hispanic Americans were more likely to be overweight (P<0.01). Nonoverweight children were more likely to participate in after-school activities, less likely to have sedentary behavior, more likely to miss school, to be more active, and had more of flourishing than their counterpart (P<0.01). Parent's marital and health status also positively affect children's obesity status (P<0.01). Social capital and neighbor amenities significantly affect children's weight status (P<0.01). A multifaceted understanding of the role of family, school, and community (with proving children's flourishing environment) in terms of how and what could contribute to children's obesity status is important in order to bring about positive impact.
Collapse
Affiliation(s)
- Tae Eung Kim
- Department of Applied Health Science, Indiana University, Bloomington, IN, USA
| | - Chang-Yong Jang
- Institute of Sport Science, College of Arts and Physical Education, Incheon National University, Incheon, Korea
| |
Collapse
|
10
|
Millner V, McDermott RC, Eichold BH. Alabama Children's Body Mass Index, Nutritional Attitudes, and Food Consumption: An Exploratory Analysis. South Med J 2018; 111:274-280. [PMID: 29767219 DOI: 10.14423/smj.0000000000000808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This study had three aims: assess the extent to which middle school children in southern Alabama were classified as overweight or obese; determine the magnitude of the relation between children's attitudes toward healthy eating and their actual dietary choices; and examine the role of race, sex, and ZIP codes on children's eating attitudes and behaviors. METHODS Registered dietitians took height and weight measurements of middle school children in southern Alabama to establish body mass index (BMI). Children were given a Likert-type survey with multiple-choice items to assess the study's objectives. Descriptive statistics were generated, and structural equation modeling was used to examine potential moderating effects on the associations between a latent variable of healthy eating attitudes and a latent variable of healthy eating behaviors across race and ethnicity. A series of analyses of variance was used to determine any significant differences in the children's attitudes across schools. The χ2 tests were used to examine potential race differences in BMI. RESULTS A total of 630 children participated in the study. Their average age was 12 years. More than half (53%) of the children were girls, and more than half (61%) were White. Approximately one-third (29%) identified as Black/African America. A large proportion of children across the sample (42.3%) were classified as overweight or obese. The multigroup structural equation modeling yielded a significant direct path between healthy attitudes and healthy eating behaviors. Healthy eating attitudes strongly predicted intentions toward healthy eating behaviors for children classified as normal weight and for those children classified as overweight or obese. Children's BMI classifications did not differ significantly across schools, race, or sex. CONCLUSIONS A large percentage of children in south Alabama were classified as overweight or obese, conditions that are preventable. Moreover, evidence suggests a lack of nutritious food in their diets. Children overall endorsed healthy eating attitudes, and those attitudes were strongly related to healthy food choices; however, their level of healthy food consumption was not related to their BMI classification. Although children in this study were from three schools and represented a variety of racial, sex, and socioeconomic systems, there were more similarities than differences in their healthy eating attitudes or behavior. These similarities highlight the need for research to examine other factors, such as southern culture, as a potential contributor to childhood obesity.
Collapse
Affiliation(s)
- Vaughn Millner
- From the Department of Counseling and Instructional Sciences, University of South Alabama, Mobile, and the Mobile County Health Department, Mobile, Alabama
| | - Ryon C McDermott
- From the Department of Counseling and Instructional Sciences, University of South Alabama, Mobile, and the Mobile County Health Department, Mobile, Alabama
| | - Bernard H Eichold
- From the Department of Counseling and Instructional Sciences, University of South Alabama, Mobile, and the Mobile County Health Department, Mobile, Alabama
| |
Collapse
|
11
|
An R, Yang Y. Response to "actual body weight or perceived body, comments on 'childhood obesity and school absenteeism: a systematic review and meta-analysis' ". Obes Rev 2018; 19:432-433. [PMID: 29239089 DOI: 10.1111/obr.12650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 10/30/2017] [Indexed: 12/01/2022]
Affiliation(s)
- R An
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Y Yang
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| |
Collapse
|
12
|
Zhang J, Hansen AR, Duncan DT, Li Y, Tedders SH. Actual body weight or perceived body weight? Comment on 'childhood obesity and school absenteeism: a systematic review and meta-analysis'. Obes Rev 2018; 19:430-431. [PMID: 29243337 DOI: 10.1111/obr.12651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 10/30/2017] [Indexed: 12/01/2022]
Affiliation(s)
- J Zhang
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - A R Hansen
- Department of Community Health Behavior and Education, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - D T Duncan
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Y Li
- DB Consulting Group, Atlanta, Georgia, USA
| | - S H Tedders
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| |
Collapse
|
13
|
An R, Yan H, Shi X, Yang Y. Childhood obesity and school absenteeism: a systematic review and meta-analysis. Obes Rev 2017; 18:1412-1424. [PMID: 28925105 DOI: 10.1111/obr.12599] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 07/11/2017] [Accepted: 07/13/2017] [Indexed: 12/01/2022]
Abstract
Regular school attendance is a key determinant of student's academic achievement and psychosocial development. Obesity may affect children's school attendance through its detrimental impact on their physical and mental health. A literature search was conducted in the PubMed, Web of Science and Cochrane Library for articles published until April 2017 that examined the relationship between unhealthy body weight and school absenteeism among children and adolescents. Thirteen studies total (10 cross-sectional and three longitudinal) conducted in seven countries were identified. The mean and median sample sizes were 24,861 and 3,113, respectively. Ten studies objectively measured children's height and weight, and three were based on parents' self-report. Four studies measured absenteeism using school administrative data, and nine administered questionnaires on children's parents. Among them, 11 reported a statistically significant positive association between childhood overweight/obesity and school absence, whereas two reported null effect. The meta-analysis found that the odds of being absent from school was 27% and 54% higher among children with overweight and obesity than among their normal weight counterparts, respectively. Future studies should adopt an experimental study design and accurate measures on school attendance and delineate the underlining pathways linking childhood obesity to school absenteeism through obesity-related illnesses and psychosocial problems.
Collapse
Affiliation(s)
- R An
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - H Yan
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - X Shi
- Nanjing Sport Institute, Nanjing, Jiangsu, China
| | - Y Yang
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| |
Collapse
|
14
|
Perceived not actual overweight is associated with excessive school absenteeism among U.S. adolescents. Obes Res Clin Pract 2017; 11:398-405. [DOI: 10.1016/j.orcp.2016.10.286] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 09/30/2016] [Accepted: 10/07/2016] [Indexed: 11/20/2022]
|
15
|
Chan HSK, Knight C, Nicholson M. Association between dietary intake and 'school-valued' outcomes: a scoping review. HEALTH EDUCATION RESEARCH 2017; 32:48-57. [PMID: 28087587 DOI: 10.1093/her/cyw057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 12/04/2016] [Indexed: 06/06/2023]
Abstract
Approximately one in four Australian children aged 5-17 years are overweight or obese. Most of the health effects of overweight and obesity in childhood do not eventuate until into adulthood; therefore, motivation for children to have a healthy diet may be low. This scoping review examined the literature for associations between diet quality in 5-18 year olds and 'school-valued' outcomes including student attendance, academic performance, behaviour at school and mental health. A literature search for studies that assessed dietary intake and at least one 'school-valued' outcome in schoolchildren, in highly developed countries was conducted. After applying selection criteria, 35 studies were included examining academic performance (46%), behaviour (11%), mental health (31%) and 11% examining two of these outcomes each. No relevant studies addressed attendance. In general, dietary factors including consumption of fruit and vegetables, discretionary foods and/or beverages, or overall diet quality, were suggested to be correlates of the 'school-valued' outcomes. However, the evidence is not comprehensive. This review elucidates the extent and nature of available literature, and provides a basis for future research where the potential benefits of diet on 'school-valued' outcomes can be thoroughly explored.
Collapse
Affiliation(s)
- H S K Chan
- School of Life and Environmental Sciences, University of Sydney, Sydney, NSW 2006, Australia
| | - C Knight
- Healthy Kids Association, Suite 104, 16-18 Cambridge St, Epping, NSW 2121, Australia
| | - M Nicholson
- School of Life and Environmental Sciences, University of Sydney, Sydney, NSW 2006, Australia
| |
Collapse
|
16
|
Kesztyüs D, Lauer R, Traub M, Kesztyüs T, Steinacker JM. Effects of statewide health promotion in primary schools on children's sick days, visits to a physician and parental absence from work: a cluster-randomized trial. BMC Public Health 2016; 16:1244. [PMID: 27955648 PMCID: PMC5153907 DOI: 10.1186/s12889-016-3903-2] [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: 08/31/2016] [Accepted: 12/03/2016] [Indexed: 11/23/2022] Open
Abstract
Background Based on the World Health Organization’s global school health initiative we investigate intervention effects of statewide health promotion in schools on the numbers of children’s sick days and visits to a physician, and parental days off work due to child illness. Methods Cluster-randomized trial with 1-year follow-up in primary schools in the state of Baden-Württemberg, Germany. Anthropometric measurements of first and second grade school children were taken by trained staff. Parents filled in questionnaires for information about socio-demographics, health-related variables, numbers of children’s sick days, visits to a physician, and days parents had to stay off work to care for a sick child. Longitudinal differences in the outcome variables were calculated between baseline and follow-up. Intraclass correlation coefficients were determined to quantify a possible clustering of data in schools. Accordingly, linear models and linear mixed models were applied to identify relationships and ascertain significances. Results Data from 1943 children (1st grade n = 1024, 6.6 ± 0.4 years old; 2nd grade n = 919, 7.6 ± 0.4 years old) were available at baseline. Unadjusted differences regarding both grades were found between mean longitudinal changes in intervention and control group in children’s sick days (−3.2 ± 7.1 vs. -2.3 ± 5.6, p = 0.013), and maternal days off work (−0.9 ± 2.4 vs. -0.5 ± 2.8, p = 0.019). The intervention effect on sick days was adjusted in a linear regression for baseline values, gender and migration background and confirmed for first grade children (B = −0.83, p = 0.003). The intervention effect on maternal days off work lost its significance after adjusting for baseline values. No significant differences were detected in the numbers of children’s visits to a physician and paternal days off work. Conclusions School-based health promotion slightly reduces sick days in first grade children. Subsequently, parents may not need to stay off work themselves. Small individual effects add up to larger benefits in a statewide implementation of health promotion. Additionally, health promotion may also positively contribute to school success. Trial Registration The study was registered on the German Clinical Trials Register (DRKS), Freiburg University, Germany, under the DRKS-ID: DRKS00000494. Registered: 25 August 2010.
Collapse
Affiliation(s)
- Dorothea Kesztyüs
- Division of Sport and Rehabilitation Medicine, Ulm University Medical Center, 89075, Ulm, Germany. .,Ulm University, Institute of General Medicine, Helmholtzstraße 20, D-89081, Ulm, Germany.
| | - Romy Lauer
- Division of Sport and Rehabilitation Medicine, Ulm University Medical Center, 89075, Ulm, Germany
| | - Meike Traub
- 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
| | | |
Collapse
|
17
|
Hansen AR, Pritchard T, Melnic I, Zhang J. Physical activity, screen time, and school absenteeism: self-reports from NHANES 2005-2008. Curr Med Res Opin 2016; 32:651-9. [PMID: 26700770 DOI: 10.1185/03007995.2015.1135112] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The purpose of this study was to examine how lifestyle behaviors in the context of physical activity levels and screen time are associated with school absenteeism. METHODS We analyzed 2005-2008 NHANES data of proxy interviews for 1048 children aged 6-11 years and in-person self-reports of 1117 adolescents aged 12-18 years. Missing 10% of school days during the past school year was defined as severe school absenteeism (SSA). RESULTS Watching TV ≥2 hours a day was significantly associated with SSA among both children (OR = 3.51 [1.03-12.0]) and adolescents (OR = 3.96 [1.84-8.52]) compared with their peers watching <2 hours a day. A U-shaped association was identified between the level of physical activity and SSA among children. Both inactive children (OR = 12.4 [1.43-108]) and highly active children (14.8 [2.82-77.7]) had higher odds of SSA compared with children with medium levels of physical activity. No associations were observed for either children 0.57 ([0.16-1.99]) or adolescents (0.94 [0.44-2.03]) using a computer ≥3 hours a day. LIMITATIONS Cross-sectional study involving self-reports. Transportation to and from school not included in physical activity assessment. Absenteeism was not validated with report cards. Unable to account for the absence type or frequency of illness or injury. No psychometric properties provided for subjective measures regarding participants' attitudes and characteristic traits towards physical activity, TV viewing, and school attendance. CONCLUSIONS Excessive TV watching among children and adolescents, and inactivity and high activity levels (≥7 times per week) among children are independently associated with severe school absenteeism.
Collapse
Affiliation(s)
- Andrew R Hansen
- a Department of Community Health Behavior and Education , Jiann-Ping Hsu College of Public Health, Georgia Southern University , Statesboro , GA , USA
| | - Tony Pritchard
- b School of Health and Kinesiology, Georgia Southern University , Statesboro , GA , USA
| | - Irina Melnic
- c Immigrant Health and Cancer Disparities Services, Memorial Sloan Kettering Cancer Center , New York , NY , USA
| | - Jian Zhang
- d Department of Epidemiology , Jiann-Ping Hsu College of Public Health, Georgia Southern University , Statesboro , GA , USA
| |
Collapse
|
18
|
Rodríguez-Escobar G, Vargas-Cruz SL, Ibáñez-Pinilla E, Matiz-Salazar MI, Jörgen-Overgaard H. [Relationship between nutritional status and school absenteeism among students in rural schools]. Rev Salud Publica (Bogota) 2015; 17:861-873. [PMID: 28453140 DOI: 10.15446/rsap.v17n6.48709] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 09/12/2015] [Indexed: 11/09/2022] Open
Abstract
Objective To determine the nutritional status and prevalence of malnutrition and overweight in students in rural schools and their relationship with school absence rates. Methods Descriptive study carried out in 34 rural schools in Anapoima and La Mesa in 2013. A sample of 785 (82.4 %) students was selected by convenience sampling. The inclusion criteria were students registered for the period 2013 in grades 0-5 (ages 5-16) with parental consent and student assent. Weight and height of all subjects were taken. Overall absence rates and illness-related absence rates were recorded. Results 422 pupils were male (53.8 %) and 524 (66.8 %) had between 5-9 years old. A lower than average height for age occurred in 10.1 %(n=79) of the students. The thinness was recorded at 1.75 %(n=13), the overweight at 14.3 %(n=112) and the obesity at 4.5 %(n=45) of the students. The number of absence episodes per child per year due to any reason and due to disease was 5.7 and 1.4, respectively. Stunted growth and overweight students had a significantly higher number of absence days compared to students with adequate nutritional status (p <0.01). Stunted growth had the highest absence rates. Conclusions Malnutrition and obesity coexist in the study area. There is a significant relationship between school absence days (both general and illness-related) and stunting and overweight in students.
Collapse
|
19
|
Lanza HI, Huang DYC. Is Obesity Associated With School Dropout? Key Developmental and Ethnic Differences. THE JOURNAL OF SCHOOL HEALTH 2015; 85:663-70. [PMID: 26331748 PMCID: PMC4603989 DOI: 10.1111/josh.12295] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 02/16/2015] [Accepted: 04/12/2015] [Indexed: 05/05/2023]
Abstract
BACKGROUND We aimed to expand the literature on child obesity and school outcomes by examining associations between obesity and high school dropout, including the role of obesity onset and duration as well as ethnicity. METHODS Data on 5066 children obtained between 1986 and 2010 from the child cohort of the 1979 National Longitudinal Study of Youth (NLSY79) were analyzed. Group-based trajectory analysis identified obesity trajectories from 6 to 18 years. School completion information from age 14 into young adulthood was used to calculate school dropout. Chi-square and pairwise comparison tests were used to identify significant associations between obesity trajectories and school dropout. RESULTS Adolescents belonging to an increasing trajectory (adolescent-onset obesity) had a higher likelihood of dropping out of high school compared with those belonging to chronic, decreasing (childhood-only obesity), and nonobese trajectories. This association was particularly salient among white adolescents. CONCLUSIONS Obesity onset during early adolescence increased risk of high school dropout. White adolescents were particularly vulnerable. Given that early adolescence is marked by significant biological and social changes, future research should seek to identify the underlying processes linking adolescent obesity and school dropout to decrease school dropout risk among this vulnerable population.
Collapse
Affiliation(s)
- H Isabella Lanza
- California State University, Long Beach, Human Development, 1250 Bellflower Blvd., LA3-202, Long Beach, CA 90804.
| | - David Y C Huang
- University of California, Los Angeles, Semel Institute for Neuroscience and Human Behavior, Integrated Substance Abuse Programs, 11075 Santa Monica Blvd., Suite 200, Los Angeles, CA 90025.
| |
Collapse
|
20
|
Carey FR, Singh GK, Brown III HS, Wilkinson AV. Educational outcomes associated with childhood obesity in the United States: cross-sectional results from the 2011-2012 National Survey of Children's Health. Int J Behav Nutr Phys Act 2015; 12 Suppl 1:S3. [PMID: 26222699 PMCID: PMC4663995 DOI: 10.1186/1479-5868-12-s1-s3] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Past research examining the effects of childhood obesity has largely focused on its projected effects into adulthood. However, there is emerging evidence that childhood obesity may have more immediate effects on school-related outcomes. We examine a range of educational attainment indicators to examine the possible pathway between obesity status and academic performance, while investigating the proximal effects of childhood obesity on health and utilization of health services, and whether these variables attenuate the relationship between obesity status and educational outcomes. METHODS Data for the current study come from the 2011-2012 National Survey of Children’s Health, which details the impacts of childhood obesity on a range of outcomes among a nationally representative sample of children and adolescents aged 10-17 years (N=45,255). Educational outcomes (school absences, school problems, repeating a grade and school engagement) were modeled by logistic regression as a function of BMI, overall health status, health care utilization, and a range of sociodemographic variables. RESULTS BMI status was significantly associated with all educational outcomes (p<0.001 for all), overall health status (p<0.001), and health care utilization (p=0.016). Prior to adjustment for covariates, obese children were significantly more likely to have school absences and school problems, to repeat a grade, and to have lower school engagement than non-overweight children. After adjustment for sociodemographic and health/healthcare variables, these outcomes remained significant for all but repeating a grade. The odds of having school problems, repeating a grade, and low school engagement that were associated with obesity were attenuated by the addition of sociodemographic variables into the model, while the addition of health and health care variables in the model decreased the odds of school absences. CONCLUSIONS This study provides evidence that increased weight status in children is associated with poorer educational outcomes. While recognizing that these are cross-sectional data, we suggest that 1) health-related and sociodemographic factors should be a focus point of intervention, and 2) a socio-structural approach including Coordinated School Health intervention is crucial to reducing childhood obesity and improving educational outcomes in this population.
Collapse
Affiliation(s)
- Felicia R Carey
- Michael and Susan Dell Center for Healthy Living, The University of Texas School of Public Health Austin Regional Campus, Austin, TX, 78701, USA
| | - Gopal K Singh
- U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, Rockville, MD, 20857, USA
| | - H Shelton Brown III
- Michael and Susan Dell Center for Healthy Living, The University of Texas School of Public Health Austin Regional Campus, Austin, TX, 78701, USA
| | - Anna V Wilkinson
- Michael and Susan Dell Center for Healthy Living, The University of Texas School of Public Health Austin Regional Campus, Austin, TX, 78701, USA
| |
Collapse
|
21
|
Bobanga ID, Vogt BA, Woodside KJ, Cote DR, Dell KM, Cunningham RJ, Noon KA, Barksdale EM, Humphreville VR, Sanchez EQ, Schulak JA. Outcome differences between young children and adolescents undergoing kidney transplantation. J Pediatr Surg 2015; 50:996-9. [PMID: 25805006 DOI: 10.1016/j.jpedsurg.2015.03.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 03/10/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND/PURPOSE Although graft loss remains the biggest challenge for all pediatric kidney transplant (KT) recipients, unique challenges exist within different age groups. We aim to evaluate the different characteristics and graft survival outcomes of young children and adolescents undergoing KT. METHODS Children who underwent isolated KT between 2000 and 2013 at our institution were included in this retrospective analysis. Patient characteristics and outcomes were compared using student's t-test, chi-square test, Kaplan-Meier curve and Cox proportional hazards model. RESULTS Of 73 children who underwent KT, 31 were <12 (young children), and 42 were ≥ 12 years old (adolescents). Overall patient survival was 100%. The younger group had superior 5-year (100% vs. 75.5%) and 10-year (94.4% vs. 43.8%) graft survival (p=0.008). Factors predictive of poor graft survival on multivariate analysis were older age at transplantation (HR 1.2, CI 1-1.4, p=0.047), female gender (HR 9.0, CI 1.9-43, p=0.006), and acute rejection episodes (HR 13, CI 2-90, p=0.008). The most common causes of graft loss were acute and chronic rejection episodes and immunosuppression nonadherence. CONCLUSION Adolescents undergoing KT have inferior graft survival compared to younger children. In adjusted modeling, children with older age, female gender, and acute rejection episodes have inferior graft survival.
Collapse
Affiliation(s)
- Iuliana D Bobanga
- Department of Surgery, Case Western Reserve University & University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH
| | - Beth A Vogt
- Departments of Pediatrics, Case Western Reserve University & University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH
| | - Kenneth J Woodside
- Department of Surgery, Case Western Reserve University & University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH.
| | - Devan R Cote
- Department of Surgery, Case Western Reserve University & University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH
| | - Katherine M Dell
- Departments of Pediatrics, Case Western Reserve University & University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH
| | - Robert J Cunningham
- Departments of Pediatrics, Case Western Reserve University & University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH
| | - Kelly A Noon
- Department of Surgery, Case Western Reserve University & University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH
| | - Edward M Barksdale
- Department of Surgery, Case Western Reserve University & University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH
| | - Vanessa R Humphreville
- Department of Surgery, Case Western Reserve University & University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH
| | - Edmund Q Sanchez
- Department of Surgery, Case Western Reserve University & University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH
| | - James A Schulak
- Department of Surgery, Case Western Reserve University & University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH
| |
Collapse
|
22
|
Eating behaviors and quality of life in preadolescents at risk for obesity with and without abdominal pain. J Pediatr Gastroenterol Nutr 2015; 60:217-23. [PMID: 25272321 PMCID: PMC4308479 DOI: 10.1097/mpg.0000000000000585] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVES We evaluated eating behaviors and quality of life (QOL) in preadolescent children at risk for obesity, with and without abdominal pain (AP). METHODS Participants were parent-child dyads enrolled in a randomized, controlled obesity prevention trial. The children were between 5 and 10 years of age and at risk for obesity (70th-95th percentile of body mass index, n = 420). Parents completed measures of their child's eating behaviors, QOL, AP, and bowel function and their own depression status, concern about child weight, and feeding practices. Children's height and weight were also measured. RESULTS Children with frequent AP (≥2/month, n = 103) were compared with children reporting infrequent AP (<2/month, n = 312). Age and body mass index did not differ between groups, but AP was more prevalent in girls. Child emotional overeating and parental depression scores were higher in the frequent AP group (P < 0.01), and child QOL was lower (P < 0.01). In multivariable analysis, female gender (odds ratio [OR] 2.18, 95% confidence interval [CI] 1.20-3.97), emotional overeating (OR 2.28, 95% CI 1.37-3.81), and parental depression (OR 1.23, 95% CI 1.12-1.35) were associated with more frequent AP. Secondary analyses were completed for children who met Rome III criteria for irritable bowel syndrome. CONCLUSIONS Clinicians working with children with AP at risk for obesity should consider assessing for and, when appropriate, addressing parent and child factors that could exacerbate AP.
Collapse
|
23
|
Malone SK, Zemel BS. Measurement and Interpretation of Body Mass Index During Childhood and Adolescence. J Sch Nurs 2014; 31:261-71. [PMID: 25199628 DOI: 10.1177/1059840514548801] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The landscape of childhood health and disease has changed over the past century, and school nurses are now in a unique position to address the conditions that lead to chronic disease, such as obesity. Measuring body mass index (BMI) during childhood and adolescence is the recommended method for screening and/or monitoring obesity in school communities. Yet changes in the size, proportion, and distribution of fat mass and fat-free mass during growth and development introduce challenges to interpreting BMI measurements. Understanding these challenges and ensuring accurate measurement techniques are the foundation for implementing school-based BMI measurement programs. This article will provide an overview of body composition during childhood and adolescence, introduce strategies to improve the accuracy of BMI measurements, and explore the school nurse's role in BMI surveillance and/or screening activities.
Collapse
Affiliation(s)
| | - Babette S Zemel
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| |
Collapse
|
24
|
The role of poverty status and obesity on school attendance in the United States. J Adolesc Health 2014; 55:402-7. [PMID: 24813400 DOI: 10.1016/j.jadohealth.2014.03.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 03/17/2014] [Accepted: 03/18/2014] [Indexed: 11/22/2022]
Abstract
PURPOSE Several studies have shown that obesity influences school performance. Little is known about the joint effect of poverty and obesity associated with school attendance. METHODS Data are from the National Survey of Children's Health (N = 93,151), a nationally representative sample of U.S. youth aged 10-17 years. Our dependent variable was ≥11 days of school days missed per year. Body mass index was classified as normal, overweight, and obese using age- and sex-specific criteria. Federal poverty level (FPL) was classified as <200%, 200%-399%, and ≥400% (high income). Covariates included gender, age, child's race or ethnicity, maternal physical and mental health, child's health, family composition, and household tobacco use. Logistic regression models and prevalence ratios were estimated, accounting for the complex survey design. RESULTS The odds of missing ≥11 days of school among overweight youth was 1.5 times that of normal-weight youth (95% confidence interval (CI) = 1.22-1.85) and 1.7 (95% CI = 1.35-2.13) times among obese youth in fully adjusted models. In joint effects models, the probability of missing school was significantly greater for obese youth in both the <200% FPL group (prevalence ratio = 1.78, CI = 1.36-2.34) and the ≥400% FPL group (prevalence ratio = 2.88, CI = 1.91-4.35), when compared with their normal-weight, higher income peers. Predicted probabilities revealed sharper gradients for higher income youth. CONCLUSIONS Obesity influences school absenteeism across all income categories. Nonetheless, there may be distinct reasons for missing school for lower and higher income youth, and the long-term consequences of school absences may also differ for these populations.
Collapse
|
25
|
Ward DS, Vaughn A, Story M, He M, Trummer V, Sosa E, Gallion KJ, Sintes-Yallen A, Huang Y, Wu X, Acosta D, Kibbe D, Ramirez A. Míranos! Look at us, we are healthy! An environmental approach to early childhood obesity prevention. Child Obes 2013; 8:429-39. [PMID: 23061498 PMCID: PMC3621338 DOI: 10.1089/chi.2012.0125] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Obesity prevention research is sparse in young children at risk for obesity. This study tested the effectiveness of a culturally tailored, multicomponent prevention intervention to promote healthy weight gain and gross motor development in low-income preschool age children. METHODS Study participants were predominantly Mexican-American children (n = 423; mean age = 4.1; 62% in normal weight range) enrolled in Head Start. The study was conducted using a quasi-experimental pretest/posttest design with two treatment groups and a comparison group. A center-based intervention included an age-appropriate gross motor program with structured outdoor play, supplemental classroom activities, and staff development. A combined center- and home-based intervention added peer-led parent education to create a broad supportive environment in the center and at home. Primary outcomes were weight-based z-scores and raw scores of gross motor skills of the Learning Achievement Profile Version 3. RESULTS Favorable changes occurred in z-scores for weight (one-tailed p < 0.04) for age and gender among children in the combined center- and home-based intervention compared to comparison children at posttest. Higher gains of gross motor skills were found in children in the combined center- and home-based (p < 0.001) and the center-based intervention (p < 0.01). Children in both intervention groups showed increases in outdoor physical activity and consumption of healthy food. Process evaluation data showed high levels of protocol implementation fidelity and program participation of children, Head Start staff, and parents. CONCLUSION The study demonstrated great promise in creating a health-conducive environment that positively impacts weight and gross motor skill development in children at risk for obesity. Program efficacy should be tested in a randomized trial.
Collapse
Affiliation(s)
- Dianne S. Ward
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.,Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC
| | - Amber Vaughn
- Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC
| | - Mary Story
- University of Minnesota School of Public Health, Minneapolis, MN
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Kesztyüs D, Wirt T, Kobel S, Schreiber A, Kettner S, Dreyhaupt J, Kilian R, Steinacker JM. Is central obesity associated with poorer health and health-related quality of life in primary school children? Cross-sectional results from the Baden-Württemberg Study. BMC Public Health 2013; 13:260. [PMID: 23521780 PMCID: PMC3652747 DOI: 10.1186/1471-2458-13-260] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Accepted: 03/05/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Childhood obesity and its consequences are a growing threat to national economies and health services. The aim of this study was to determine associations between waist-to-height ratio (WHtR) as a measure of central obesity, and health-related quality of life (HRQoL) and absenteeism of primary school children in the state of Baden-Württemberg, Germany. METHODS Cross-sectional data from 1888 first and second grade children (7.1±0.6 years) participating in the baseline measurements of the Baden-Württemberg Study were analyzed. Parents completed questionnaires including a rating of their children's HRQoL using KINDLR and EQ5D-Y VAS. Days of absence because of illness, and number of visits to a physician during the last year of school/kindergarten were asked, as well as the number of days parents took off work to care for their sick child. Anthropometric measurements were taken by trained staff. The Mann-Whitney-U test was used for statistical analysis of differences between WHtR groups. Logistic regression models were used to identify factors associated with sick days. RESULTS A total of 158 (8.4%) children were centrally obese (WHtR ≥0.5). These children had significantly more sick days (9.05 vs. 6.84, p < 0.001) and visits to a physician (3.58 vs. 2.91, p < 0.05), but not days of parental absence than other children. According to regression analysis, sick days were also associated with age, migration status, physical activity pattern, maternal health awareness and family education level. Parent-rated HRQoL was significantly lower in centrally obese children for the EQ5D-Y VAS (88.1 vs. 91.6, p < 0.001), and the KINDLR subscales 'school' (79.9 vs. 82.5, p < 0.05) and 'friends' (75.4 vs. 78.3, p < 0.05), but not for the total score. CONCLUSIONS Cross-sectional results show higher rates of absence, more visits to a physician and lower HRQoL in children with central obesity. Each missed day at school implies a hazard to academic achievement and each additional visit to a physician is related to higher health care costs. Thus, the negative impact of central obesity is already measurable in primary school children, which emphasizes the urgent need for early delivery of health promotion and targeted prevention.
Collapse
Affiliation(s)
- Dorothea Kesztyüs
- Division of Sports and Rehabilitation, Department of Internal Medicine II, Ulm University Medical Center, Frauensteige 6, 89075 Ulm, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|