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Hoeeg D, Frohlich KL, Christensen U, Grabowski D. Mechanisms of Stigmatization in Family-Based Prevention and Treatment of Childhood Overweight and Obesity. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1590. [PMID: 37892253 PMCID: PMC10605136 DOI: 10.3390/children10101590] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 09/15/2023] [Accepted: 09/19/2023] [Indexed: 10/29/2023]
Abstract
It is well established that overweight and obesity are often accompanied by stigmatization. However, the influence of stigmatization on interventions for overweight and obesity remains unknown. Stigma may be particularly harmful to children. This study aimed to examine how stigmatization affects efforts to reduce childhood overweight and obesity through family interventions. This research was conducted in a socially disadvantaged area in Denmark. Twenty-seven families and forty professionals participated in in-depth interviews or workshops. The data were analyzed using CMO configurations from a realist evaluation and the theory of stigmatization developed by Link and Phelan. Thus, an abductive approach was employed in the analysis, with its foundation rooted in the empirical data. The study found that the mechanisms of stigmatization could 1. restrain professionals and parents from approaching the problem-thereby challenging family recruitment; 2. prevent parents from working with their children to avoid eating unhealthy food for fear of labeling the child as overweight or obese; and 3. cause children with obesity to experience a separation from other slimmer family members, leading at times to status loss, discrimination, and self-stigmatization. The study showed how the mechanisms of stigmatization may obstruct prevention and treatment of childhood obesity through family interventions. It is suggested that the concept of stigma should be incorporated into the program theories of interventions meant to reduce childhood overweight and obesity.
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Affiliation(s)
- Didde Hoeeg
- Department of Health Promotion, Steno Diabetes Centre Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark;
| | - Katherine L. Frohlich
- École de Santé Publique & CRESP, Université de Montréal, 7101 Avenue du Parc, Montréal, QC H3C 3J7, Canada;
| | - Ulla Christensen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Gothersgade 160, 1123 Copenhagen, Denmark;
| | - Dan Grabowski
- Department of Health Promotion, Steno Diabetes Centre Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark;
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2
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Domino M, Borowska M, Zdrojkowski Ł, Jasiński T, Sikorska U, Skibniewski M, Maśko M. Application of the Two-Dimensional Entropy Measures in the Infrared Thermography-Based Detection of Rider: Horse Bodyweight Ratio in Horseback Riding. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22166052. [PMID: 36015813 PMCID: PMC9414866 DOI: 10.3390/s22166052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 05/08/2023]
Abstract
As obesity is a serious problem in the human population, overloading of the horse's thoracolumbar region often affects sport and school horses. The advances in using infrared thermography (IRT) to assess the horse's back overload will shortly integrate the IRT-based rider-horse fit into everyday equine practice. This study aimed to evaluate the applicability of entropy measures to select the most informative measures and color components, and the accuracy of rider:horse bodyweight ratio detection. Twelve horses were ridden by each of the six riders assigned to the light, moderate, and heavy groups. Thermal images were taken pre- and post-exercise. For each thermal image, two-dimensional sample (SampEn), fuzzy (FuzzEn), permutation (PermEn), dispersion (DispEn), and distribution (DistEn) entropies were measured in the withers and the thoracic spine areas. Among 40 returned measures, 30 entropy measures were exercise-dependent, whereas 8 entropy measures were bodyweight ratio-dependent. Moreover, three entropy measures demonstrated similarities to entropy-related gray level co-occurrence matrix (GLCM) texture features, confirming the higher irregularity and complexity of thermal image texture when horses worked under heavy riders. An application of DispEn to red color components enables identification of the light and heavy rider groups with higher accuracy than the previously used entropy-related GLCM texture features.
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Affiliation(s)
- Małgorzata Domino
- Department of Large Animal Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-787 Warsaw, Poland; (Ł.Z.); (T.J.)
- Correspondence: (M.D.); (M.M.)
| | - Marta Borowska
- Institute of Biomedical Engineering, Faculty of Mechanical Engineering, Białystok University of Technology, 15-351 Bialystok, Poland;
| | - Łukasz Zdrojkowski
- Department of Large Animal Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-787 Warsaw, Poland; (Ł.Z.); (T.J.)
| | - Tomasz Jasiński
- Department of Large Animal Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-787 Warsaw, Poland; (Ł.Z.); (T.J.)
| | - Urszula Sikorska
- Department of Animal Breeding, Institute of Animal Science, Warsaw University of Life Sciences, 02-787 Warsaw, Poland;
| | - Michał Skibniewski
- Department of Morphological Sciences, Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-776 Warsaw, Poland;
| | - Małgorzata Maśko
- Department of Animal Breeding, Institute of Animal Science, Warsaw University of Life Sciences, 02-787 Warsaw, Poland;
- Correspondence: (M.D.); (M.M.)
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3
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Koivusilta L, Alanne S, Kamila M, Ståhl T. A qualitative study on multisector activities to prevent childhood obesity in the municipality of Seinäjoki, Finland. BMC Public Health 2022; 22:1298. [PMID: 35794541 PMCID: PMC9258052 DOI: 10.1186/s12889-022-13658-z] [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: 06/14/2021] [Accepted: 06/16/2022] [Indexed: 11/26/2022] Open
Abstract
Background Multisector activities are needed to prevent childhood obesity due to its multifactorial background. The first aim was to identify the activities that had been undertaken for obesity prevention and deduce their main targets. Second, we analyzed the public health policy approaches (upstream, midstream, and downstream) which were followed. Finally, we studied the perception of interviewees regarding their sectors’ roles in implementing the local obesity program. Methods Deductive content analysis was used to analyze semi-structured interviews with 34 key professionals (from seven administrative sectors) who had participated in multisector health promotion during 2009–2016 and five representatives of other core parties. Results Several midstream and upstream activities were targeted at making physical activity (PA) and healthy eating (HE) integral parts of children’s lifestyle. One long-term strategy was to create environments for PA accessible to every inhabitant and build and renovate the interiors and yards of schools and day-care centers. The healthiness of meals was increased progressively. In addition to midstream and upstream activities, as a downstream activity, an intervention targeting children at risk of obesity was implemented. The impact of management on the activities was considerable; childhood obesity prevention was included in the city strategy and systematically coordinated at the highest managerial level. Altogether, various sectors operated efficiently to promote obesity-preventing lifestyles; however, not all (important) sectors recognized their role in the multisector process. Conclusion Most of the activities to guide children towards obesity-preventing lifestyles were either at the midstream or upstream level. Among the latter, considerable work is aimed at creating opportunities to practice PA and making it a natural part of the daily life. The aim of familiarizing children with lifestyles that include PA and HE was shared across sectors, including sectors that had not yet acknowledged their role in obesity prevention. Strong support from city management and systematic coordination of the activity are important factors that contribute to the engagement of several administrative sectors in working towards a shared aim, such as the prevention of childhood obesity.
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4
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Measuring social processes regarding eating, physical activity, and weight in higher-weight people: the weight-related interactions scale (WRIS). Eat Weight Disord 2022; 27:737-749. [PMID: 34041685 DOI: 10.1007/s40519-021-01208-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 05/07/2021] [Indexed: 02/07/2023] Open
Abstract
PURPOSE This study sought to develop a psychometrically sound measure to assess effective and ineffective forms of input from others regarding eating, physical activity, and weight in higher-weight people, namely, the Weight-Related Interactions Scale (WRIS). METHODS Participants (n = 736) were adults in the overweight/obese weight ranges who completed the WRIS and measures of weight-specific social support, emotional eating, weight stigma, eating-specific self efficacy, and social desirability. RESULTS Exploratory and confirmatory factor analyses of the WRIS supported a three-factor solution of 'Criticism', 'Minimization', and 'Collaboration' as forms of weight-related input from others. Support was found for the reliability and the concurrent, convergent, and divergent validity of the WRIS. CONCLUSIONS The WRIS is a promising new instrument for comprehensively assessing the input of others in relation to eating, physical activity, and weight among higher-weight individuals. LEVEL OF EVIDENCE Level III. Evidence obtained from well-designed cohort or case-control analytic studies.
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Song S, Ishdorj A, Dave JM. Gender Differences in Nutritional Quality and Consumption of Lunches Brought from Home to School. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413168. [PMID: 34948778 PMCID: PMC8700912 DOI: 10.3390/ijerph182413168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/08/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022]
Abstract
Gender difference in the lunches brought from home to school and the amount consumed by elementary and intermediate school students were examined using data collected from 12 schools in Texas. The amount and nutritional quality of food items brought and consumed was evaluated, by comparing the results to the 2012 school meal standards, and Dietary Reference Intakes (DRIs). Almost all lunches brought from home contained grain and meat/meat alternatives, and the amount brought and consumed exceeded the NSLP standards. The majority of students did not bring fruits, vegetables, and whole grain foods, but those who brought consumed most of what they brought. Among elementary school students, only 9% of boys and 14% of girls brought vegetables and the amount brought and consumed did not meet the standards. Although carbohydrate and protein consumption were adequate for boys and girls, the intakes of micronutrients and fiber did not meet the requirements across both genders at both school levels. Overall, lunches brought from home were not well balanced and did not meet NSLP standards and DRIs. It is imperative to identify strategies to improve the nutritional quality of lunches brought from home considering gender difference in food choice and educating parents and children on what is a healthy well-balanced lunch.
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Affiliation(s)
- Siwan Song
- Department of Agricultural Economics, Texas A&M University, 2124 TAMU, College Station, TX 77843, USA;
| | - Ariun Ishdorj
- Department of Agricultural Economics, Texas A&M University, 2124 TAMU, College Station, TX 77843, USA;
- Correspondence:
| | - Jayna M. Dave
- USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX 77030, USA;
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6
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Qiu Q, Sung J. The effects of graduated driver licensing on teenage body weight. HEALTH ECONOMICS 2021; 30:2829-2846. [PMID: 34448322 DOI: 10.1002/hec.4414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 06/20/2021] [Accepted: 07/30/2021] [Indexed: 06/13/2023]
Abstract
The graduated driver licensing (GDL) program requires teenage drivers to pass through an intermediate stage, which contains specific driving restrictions such as a night curfew or a limit on the number of teen passengers to be carried, before earning full driving privileges. Using individual data from the 1999 to 2017 biennial Youth Risk Behavior Surveillance System (YRBS) combined with state-level GDL policy variations, we estimate the effects of GDL on teenage body weight in the United States. We find that the presence of GDL raises adolescents' body mass index Z-score and their likelihood of being overweight or obese. Among the restrictions imposed, a night curfew implemented together with a passenger restriction makes the most significant impact. These estimated effects are concentrated among states with more restrictive GDL policies. We also find that the presence of GDL reduces adolescent physical activity and heavy smoking, while increasing their time spent watching TV and milk intake, perhaps contributing to youth weight gain. An event study analysis reveals that the effects of GDL on adolescent weight increase may be transitory.
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Affiliation(s)
- Qihua Qiu
- James M. Hull College of Business, Augusta University, Augusta, Georgia, USA
| | - Jaesang Sung
- Department of Economics, Andrew Young School of Policy Studies, Georgia State University, Atlanta, Georgia, USA
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7
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Zou Y, Ma Y, Wu Z, Liu Y, Xu M, Qiu G, Vos H, Jia P, Wang L. Neighbourhood residential density and childhood obesity. Obes Rev 2021; 22 Suppl 1:e13037. [PMID: 32406192 PMCID: PMC7988655 DOI: 10.1111/obr.13037] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/03/2020] [Accepted: 04/03/2020] [Indexed: 02/01/2023]
Abstract
Residential density is considered an important attribute of the built environment that may be relevant to childhood obesity. However, findings remain inconclusive, and there are no reviews yet on the association between residential density and childhood obesity. This study aimed to systematically review the associations between residential density and weight-related behaviours and outcomes. A comprehensive literature search was conducted using the Cochrane Library, PubMed and Web of Science for articles published before 1 January 2019. A total of 35 studies conducted in 14 countries were identified, including 33 cross-sectional studies, one longitudinal study and one containing both study designs. Residential density was measured by Geographic Information Systems in 28 studies within a varied radius from 0.25 to 2 km around the individual residence. Our study found a general positive association between residential density and physical activity (PA); no significant associations were observed. This study provided evidence for a supportive role of residential density in promoting PA among children. However, it remained difficult to draw a conclusion between residential density and childhood obesity. Future longitudinal studies are warranted to confirm this association.
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Affiliation(s)
- Yuxuan Zou
- School of Geographical Sciences, Guangzhou University, Guangzhou, China.,International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China
| | - Yanan Ma
- School of Public Health, China Medical University, Shenyang, China.,Institute of Health Sciences, China Medical University, Shenyang, China
| | - Zhifeng Wu
- School of Geographical Sciences, Guangzhou University, Guangzhou, China
| | - Yang Liu
- Institute of Health Sciences, China Medical University, Shenyang, China
| | - Min Xu
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China.,State Key Laboratory of Remote Sensing Science, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing, China
| | - Ge Qiu
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China.,West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Heleen Vos
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China.,Faculty of Geo-information Science and Earth Observation, University of Twente, Enschede, the Netherlands
| | - Peng Jia
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China.,Faculty of Geo-information Science and Earth Observation, University of Twente, Enschede, the Netherlands.,Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China
| | - Limin Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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8
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Xin J, Zhao L, Wu T, Zhang L, Li Y, Xue H, Xiao Q, Wang R, Xu P, Visscher T, Ma X, Jia P. Association between access to convenience stores and childhood obesity: A systematic review. Obes Rev 2021; 22 Suppl 1:e12908. [PMID: 31274248 PMCID: PMC7988541 DOI: 10.1111/obr.12908] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 05/21/2019] [Accepted: 05/22/2019] [Indexed: 02/05/2023]
Abstract
Childhood obesity increases the risk of adulthood obesity and is associated with other adverse health outcomes later in life. It may be influenced by environmental characteristics of neighborhoods where children live, particularly dietary supply-related environmental factors. This study aimed to systematically review the evidence on the association between access to convenience stores and childhood obesity. We searched and filtered relevant literature in PubMed, Embase, Web of Science, and Cochrane Library published before 1 January 2019. Data on the basic characteristics of studies, measures of access to convenience stores, and associations of convenience stores with weight-related behaviors and outcomes were extracted from 41 included studies. In general, the density of and proximity to convenience stores in children's residential and school neighborhoods were positively associated with unhealthy eating behaviors. However, their associations with children's weight status varied significantly by regions. The association between convenience store access and children's weight status was found to be negative in Canada, rather mixed in the United States and the United Kingdom, and not significant in East Asia. We suggest future research to clearly define the convenience store, better measure the access to convenience store, and also measure children's journey and food purchasing and consumption behaviors, to explain pathways from convenience store access to childhood obesity for designing effective interventions and policies.
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Affiliation(s)
- Junguo Xin
- Department of Health-Related Social and Behavioral Sciences, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.,School of Public Health, Chengdu Medical College, Chengdu, China.,International Institute of Spatial Lifecourse Epidemiology (ISLE), Enschede, the Netherlands
| | - Li Zhao
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Enschede, the Netherlands.,Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.,Healthy Food Evaluation Research Center, Sichuan University, Chengdu, China
| | - Tong Wu
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Enschede, the Netherlands.,Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, China
| | - Longhao Zhang
- Office of "Double First Class" Construction, West China Hospital of Sichuan University, Chengdu, China
| | - Yan Li
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, 10029.,Center for Health Innovation, The New York Academy of Medicine, New York, New York, 10029
| | - Hong Xue
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Enschede, the Netherlands.,Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, 23298
| | - Qian Xiao
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Enschede, the Netherlands.,Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa, 52242.,Department of Epidemiology, University of Iowa, Iowa City, Iowa, 52242
| | - Ruiou Wang
- Department of Health-Related Social and Behavioral Sciences, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Peiyao Xu
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Tommy Visscher
- Research Center for Healthy Cities, Windesheim University of Applied Sciences, Zwolle, the Netherlands.,European Association for the Study of Obesity, Patient Council and Prevention and Public Health Taskforce, Founding Chair New Investigators United, London, UK.,JOGG (Youth at a Healthy Weight), Chair Scientific Advisory Board, The Hague, the Netherlands
| | - Xiao Ma
- Department of Health-Related Social and Behavioral Sciences, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Peng Jia
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Enschede, the Netherlands.,Faculty of Geo-information Science and Earth Observation, University of Twente, Enschede, the Netherlands
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The relationship between body fat ratio and blood pressure in school-age children. J Hum Hypertens 2020; 34:826-832. [PMID: 33060798 DOI: 10.1038/s41371-020-00401-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 07/08/2020] [Accepted: 08/06/2020] [Indexed: 11/08/2022]
Abstract
Hypertension (HTN) and obesity prevalences are rising in childhood and it is important to evaluate associations of these situations. The objective of this study is to investigate the relationship between HTN and body fat ratios (BFR) in children. This cross-sectional study was conducted among 134 participants who were directed to pediatric nephrology outpatient clinic with the prediagnosis of primary HTN. Weight, height, body fat ratio, blood pressure, and ambulatory blood pressure monitor (ABPM) was carried out for all the participants. Of the participants, 70 of them were diagnosed as hypertension with ABPM and included in the patient group, 64 of them had elevated office blood pressure (BP) but normotensive according to ABPM were included in the control group. Body fat ratio (BFR) levels of the patient group were higher than the control group (p < 0.05). There were significant linear correlation between night systolic blood pressure (SBP), night diastolic blood pressure (DBP), night mean arterial pressure (MAP), and BFR in the patient group (p < 0.05). There was a negative correlation between BFR and dipper (p = 0.022; p < 0.05) in the patient group. There was no correlation between BFR and blood pressures or dipper in the control group. According to our results BFR levels have significant association with HTN. According to our findings high BFR especially effects night BP, pulses, nondipping, and nighttime values can be evaluated only with ABPM. For prevention of HTN in children, caution should be given to monitor and lower BFR values.
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Nabors L, Odar Stough C, Garr K, Merianos A. Predictors of victimization among youth who are overweight in a national sample. Pediatr Obes 2019; 14:e12516. [PMID: 30761770 DOI: 10.1111/ijpo.12516] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 01/21/2019] [Indexed: 01/26/2023]
Abstract
OBJECTIVES The current cross-sectional study examined whether children who are overweight experience greater levels of parent-reported bullying behaviors and victimization using a national sample. Additionally, the relations among child (mental health), family (parent-child sharing of information), and contextual factors (neighborhood safety, school engagement) and risk of victimization in children who are overweight were assessed. METHODS Caregivers provided data via the 2016 National Survey of Children's Health. A series of multinomial logistic regressions were conducted with the subsample of children aged 10 to 17 years (N = 26 094). RESULTS Youth who were overweight were more likely to be victimized, but not more likely to bully. Being engaged in school and neighborhood safety were protective factors among youth who were overweight, while living in families where information is shared and difficulty making friends were risk factors. CONCLUSIONS Children who were overweight were more likely to be victims, rather than perpetrators, of bullying. Health professionals should assess family and contextual factors in relation to victimization status when developing interventions.
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Affiliation(s)
- Laura Nabors
- Health Promotion and Education Program, School of Human Services, University of Cincinnati, Cincinnati, OH, USA
| | - Cathy Odar Stough
- Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
| | - Katlyn Garr
- Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
| | - Ashley Merianos
- Health Promotion and Education Program, School of Human Services, University of Cincinnati, Cincinnati, OH, USA
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Yin Z, Ullevig SL, Sosa E, Liang Y, Olmstead T, Howard JT, Errisuriz VL, Estrada VM, Martinez CE, He M, Small S, Schoenmakers C, Parra-Medina D. Study protocol for a cluster randomized controlled trial to test "¡Míranos! Look at Us, We Are Healthy!" - an early childhood obesity prevention program. BMC Pediatr 2019; 19:190. [PMID: 31179916 PMCID: PMC6556954 DOI: 10.1186/s12887-019-1541-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 05/16/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND One in three Head Start children is either overweight or obese. We will test the efficacy of an early childhood obesity prevention program, "¡Míranos! Look at Us, We Are Healthy!" (¡Míranos!), which promotes healthy growth and targets multiple energy balance-related behaviors in predominantly Latino children in Head Start. The ¡Míranos! intervention includes center-based (policy changes, staff development, gross motor program, and nutrition education) and home-based (parent engagement/education and home visits) interventions to address key enablers and barriers in obesity prevention in childcare. In partnership with Head Start, we have demonstrated the feasibility and acceptability of the proposed interventions to influence energy balance-related behaviors favorably in Head Start children. METHODS Using a three-arm cluster randomized controlled design, 12 Head Start centers will be randomly assigned in equal number to one of three conditions: 1) a combined center- and home-based intervention, 2) center-based intervention only, or 3) comparison. The interventions will be delivered by trained Head Start staff during the academic year. A total of 444 3-year-old children (52% females; n = 37 per center at baseline) in two cohorts will be enrolled in the study and followed prospectively 1 year post-intervention. Data collection will be conducted at baseline, immediately post-intervention, and at the one-year follow-up and will include height, weight, physical activity (PA) and sedentary behaviors, sleep duration and screen time, gross motor development, dietary intake and food and activity preferences. Information on family background, parental weight, PA- and nutrition-related practices and behaviors, PA and nutrition policy and environment at center and home, intervention program costs, and treatment fidelity will also be collected. DISCUSSION With endorsement and collaboration of two local Head Start administrators, ¡Míranos!, as a culturally tailored obesity prevention program, is poised to provide evidence of efficacy and cost-effectiveness of a policy and environmental approach to prevent early onset of obesity in low-income Latino preschool children. ¡Míranos! can be disseminated to various organized childcare settings, as it is built on the Head Start program and its infrastructure, which set a gold standard for early childhood education, as well as current PA and nutrition recommendations for preschool children. TRIAL REGISTRATION ClinicalTrials.Gov ( NCT03590834 ) July 18, 2018.
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Affiliation(s)
- Zenong Yin
- Department of Kinesiology, Health and Nutrition, The University of Texas at San Antonio, San Antonio, TX USA
| | - Sarah L. Ullevig
- Department of Kinesiology, Health and Nutrition, The University of Texas at San Antonio, San Antonio, TX USA
| | - Erica Sosa
- Department of Kinesiology, Health and Nutrition, The University of Texas at San Antonio, San Antonio, TX USA
| | - Yuanyuan Liang
- Department of Epidemiology and Public Health, The University of Maryland, School of Medicine, Baltimore, MD USA
| | - Todd Olmstead
- Department of Mexican American and Latina/o Studies Austin, The University of Texas at Austin, Austin, TX USA
| | - Jeffrey T. Howard
- Department of Kinesiology, Health and Nutrition, The University of Texas at San Antonio, San Antonio, TX USA
| | - Vanessa L. Errisuriz
- Department of Mexican American and Latina/o Studies Austin, The University of Texas at Austin, Austin, TX USA
| | - Vanessa M. Estrada
- Department of Kinesiology, Health and Nutrition, The University of Texas at San Antonio, San Antonio, TX USA
| | - Cristina E. Martinez
- Department of Kinesiology, Health and Nutrition, The University of Texas at San Antonio, San Antonio, TX USA
| | - Meizi He
- Department of Kinesiology, Health and Nutrition, The University of Texas at San Antonio, San Antonio, TX USA
| | - Sharon Small
- Parent/Child Incorporated of San Antonio and Bexar County, San Antonio, TX USA
| | | | - Deborah Parra-Medina
- Department of Mexican American and Latina/o Studies Austin, The University of Texas at Austin, Austin, TX USA
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12
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Nimegeer A, Patterson C, Hilton S. Media framing of childhood obesity: a content analysis of UK newspapers from 1996 to 2014. BMJ Open 2019; 9:e025646. [PMID: 30948586 PMCID: PMC6500306 DOI: 10.1136/bmjopen-2018-025646] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 02/27/2019] [Accepted: 03/01/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Media can influence public and policy-makers' perceptions of causes of, and solutions to, public health issues through selective presentation and framing. Childhood obesity is a health issue with both individual-level and societal-level drivers and solutions, but public opinion and mass media representations of obesity have typically focused on individual-level framings, at the cost of acknowledgement of a need for regulatory action. OBJECTIVE AND SETTING To understand the salience and framing of childhood obesity across 19 years of UK national newspaper content. DESIGN AND OUTCOME MEASURES Quantitative content analysis of 757 articles about childhood obesity obtained from six daily and five Sunday newspapers. Articles were coded manually for definitions, drivers and potential solutions. Data were analysed statistically, including analysis of time trends and variations by political alignment of source. RESULTS The frequency of articles grew from a low of two in 1996 to a peak of 82 in 2008, before declining to 40 in 2010. Individual-level drivers (59.8%) and solutions (36.5%) were mentioned more frequently than societal-level drivers (28.3%) and solutions (28.3%) across the sample, but societal solutions were mentioned more frequently during the final 8 years, coinciding with a marked decline in yearly frequency of articles. CONCLUSIONS Increased focus on societal solutions aligns with public health goals, but coincided with a reduction in the issue's salience in the media. Those advocating public policy solutions to childhood obesity may benefit from seeking to raise the issue's media profile while continuing to promote structural conceptualisations of childhood obesity.
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Affiliation(s)
- Amy Nimegeer
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Chris Patterson
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Shona Hilton
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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13
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Rouse H, Goudie A, Rettiganti M, Leath K, Riser Q, Thompson J. Prevalence, Patterns, and Predictors: A Statewide Longitudinal Study of Childhood Obesity. THE JOURNAL OF SCHOOL HEALTH 2019; 89:237-245. [PMID: 30740717 DOI: 10.1111/josh.12741] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 06/03/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND We examined prevalence, incidence, and trajectory of obesity from kindergarten through grade 8 in one of the first states to implement annual surveillance. METHODS Participants included 16,414 children enrolled in kindergarten in Arkansas in 2004 with complete body mass index (BMI) measurements in kindergarten and eighth grade. Repeated measures of weight status were entered in multiple linear and logistic regression models with demographics and family poverty status. RESULTS The prevalence of obesity (BMI ≥ 95th percentile) was lowest in kindergarten (14.9%), with subsequent incidence rates consistent at 4%. Prevalence and incidence peaked in eighth grade (24.5% and 4.9%, respectively), with 33.8% of children measuring obese at least once by eighth grade. Kindergarten obesity was a significant predictor of eighth grade obesity (odds ratio, 17.5; 95% confidence interval, 15.8-19.3). We found statistically significant 3-way interactions for sex, race, and time, suggesting unique patterns for Hispanic boys and black girls. CONCLUSIONS Our study documents unique longitudinal patterns of obesity from kindergarten through eighth grade that expand our understanding of risk. It demonstrates the value of public school health systems that collect routine administrative data about student BMI that is integrated with education records to foster program and policy discussions.
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Affiliation(s)
- Heather Rouse
- Assistant Professor, , Iowa State University, 2360 Palmer, Ames, IA 50011
| | - Anthony Goudie
- Associate Professor, , University of Arkansas for Medical Sciences, 13 Children's Way, Little Rock, AR 72202
| | - Mallik Rettiganti
- Assistant Professor, , University of Arkansas for Medical Sciences, 13 Children's Way, Little Rock, AR 72202
| | - Katherine Leath
- Program Administrator for Health Literacy Services and Communication, , UAMS Center for Health Literacy, 5800 W 10th Street, Suite 502, Little Rock, AR 72204
| | - Quentin Riser
- NSF Graduate Research Fellow, , Iowa State University, 1089 Lebaron, Ames, IA 50011
| | - Joseph Thompson
- Director, , Arkansas Center for Health Improvement, 1401 West Capitol Avenue Suite 300, Little Rock, AR 72201
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14
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Exploring Women’s Experiences: Embodied Pathways and Influences for Exercise Participation. SOCIETIES 2019. [DOI: 10.3390/soc9010016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
It has been well-documented that women face pressures to conform to a slim, toned, and athletic body, becoming “tyrannised” by beauty ideals. Under these contemporary ideologies of perfectionism, women are placed under constant surveillance, evaluation and, objectification and are thus reduced to “being” their bodies. However, there is little known about the potential relationships between different types of exercise, body image, and exercise motivation. With this in mind, this paper contributes towards a small but developing body of research that utilises feminist phenomenology to reveal twelve women’s early embodied motivations for exercising and draws upon material gathered from a three-year ethnography into the embodied experiences of women in fitness cultures. This paper delves into the influences on their continued participation over time and explores how these experiences shape their understandings of the embodied self and the broader constructions of the gendered body. The discussion provided illuminates how early influences on exercise participation and how pressures on women to conform to dominant notions of the “feminine” body are imposed by structural, cultural, historical, and localised forces in ways that affect and shape future physical activity participation, and the physical cultures where these tensions are played out.
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15
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Gregory JW. Prevention of Obesity and Metabolic Syndrome in Children. Front Endocrinol (Lausanne) 2019; 10:669. [PMID: 31632348 PMCID: PMC6779866 DOI: 10.3389/fendo.2019.00669] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 09/16/2019] [Indexed: 02/06/2023] Open
Abstract
In recent decades, the prevalence of overweight and obesity has become increasingly common such that it is now the major nutritional problem worldwide. Obesity occurs when dietary energy intake exceeds energy expenditure and has arisen in many societies due to an increasingly "obesogenic" environment in which physical activity has declined and yet children continue to be exposed to unhealthy, energy-dense diets. Additional risks for the development of obesity also include psychological issues and genetic factors. Obesity has many adverse health consequences including development of insulin resistance, Type 2 diabetes, and the metabolic syndrome. There are also important genetic influences on the likelihood of developing insulin resistance. Given the limited success of therapeutic interventions to treat obesity and the metabolic syndrome, there has been an increased interest in preventative strategies. These are likely to be most successful when targeting the young and will require a combination of approaches which will need inter-disciplinary collaborations across health and local government to target families, schools, and local environments to facilitate behavior changes which influence young people's eating behaviors and habitual levels of physical activity.
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16
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Kemper KA, Pate SP, Powers AR, Fair M. Promoting Healthy Environments In Afterschool Settings: The LiveWell Greenville Afterschool Initiative. Prev Chronic Dis 2018; 15:E144. [PMID: 30468420 PMCID: PMC6266516 DOI: 10.5888/pcd15.180164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION LiveWell Greenville, a multi-organization community coalition, launched an initiative in 2011 to help afterschool programs promote environments that decrease the risk of obesity among children and adolescents. The objective of this study was to describe changes in nutrition and physical activity environments, policies, and practices among 37 afterschool programs after their participation in the LiveWell Greenville Afterschool Initiative. METHODS The study used a nonexperimental, pre- and postsurvey design. The survey was based on the Nutrition and Physical Activity Self-Assessment for Child Care questionnaire and modified for afterschool settings. Items addressed sedentary time, physical activity time, availability of sugar-sweetened beverages, sweet and salty snack consumption, fruit consumption, staff behaviors, and policies that support nutrition and physical activity practices. The self-assessment survey was completed by an afterschool program supervisor at each site. The 9-month intervention consisted of program staff members' completing the pre-assessment and goal-setting worksheet, receiving technical support and training from LiveWell Greenville staff, attending networking meetings about nutrition and physical activity promotion strategies, and completing a postassessment. RESULTS We found significant positive changes in afterschool environments in the type and frequency of snacks offered, duration of children's sedentary time, staff behaviors that supported healthy nutrition and physical activity practices, and education provided to staff, children, and parents. CONCLUSION We found the LiveWell Greenville Afterschool Initiative, which involved self-assessment, goal setting and technical support, to be a successful strategy to change nutrition and physical activity environments in afterschool settings.
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Affiliation(s)
- Karen A Kemper
- Department of Public Health Sciences, Clemson University, 533 Edwards Hall, Clemson, SC 29634. .,LiveWell Greenville, Greenville, South Carolina
| | | | - Alicia R Powers
- LiveWell Greenville, Greenville, South Carolina.,Supplemental Nutrition Assistance Program-Education, Alabama Cooperative Extension, Auburn University, Alabama
| | - Melissa Fair
- Institute for the Advancement of Community Health, Furman University, Greenville, South Carolina
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17
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Frondelius K, Oudin A, Malmqvist E. Traffic-Related Air Pollution and Child BMI-A Study of Prenatal Exposure to Nitrogen Oxides and Body Mass Index in Children at the Age of Four Years in Malmö, Sweden. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102294. [PMID: 30347657 PMCID: PMC6210059 DOI: 10.3390/ijerph15102294] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 09/28/2018] [Accepted: 10/16/2018] [Indexed: 12/21/2022]
Abstract
Traffic-related air pollution could be a danger to the health of children. Earlier studies have linked prenatal exposure to an increased risk of a range of diseases and negative health outcomes, including overweight and obesity. Presently, a knowledge gap exists in investigating the risk of overweight and obesity among children exposed to lower levels of air pollution in utero. This study aimed to investigate the relationship between prenatal traffic-related air pollution (nitrogen dioxides (NOx) and traffic density) and childhood overweight and obesity in Malmö, Sweden. A cohort, based on attendance of a four-year check-up examination at Swedish Child Health Care (CHC) centers, and a parent-assessed questionnaire provided data on body-mass index adjusted for four-year-old children (ISO-BMI) as well as socioeconomic and health variables. We estimated exposure by using traffic density and levels of NOx at the maternal geocoded residential level. Analysis of 5815 children was performed using binary logistic regression models. This study showed no associations of increased risk for childhood overweight or obesity through to prenatal exposure to NOx in this low-exposure setting. We further suggest analysis of risks related to exposure levels ranging between the ones presented here and those proposed in previous literature.
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Affiliation(s)
- Kasper Frondelius
- Occupational and Environmental Medicine, Department for Laboratory Medicine, Lund University, 221 85 Lund, Sweden.
| | - Anna Oudin
- Occupational and Environmental Medicine, Department for Laboratory Medicine, Lund University, 221 85 Lund, Sweden.
| | - Ebba Malmqvist
- Occupational and Environmental Medicine, Department for Laboratory Medicine, Lund University, 221 85 Lund, Sweden.
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18
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Johnson BJ, Zarnowiecki D, Hendrie GA, Mauch CE, Golley RK. How to reduce parental provision of unhealthy foods to 3- to 8-year-old children in the home environment? A systematic review utilizing the Behaviour Change Wheel framework. Obes Rev 2018; 19:1359-1370. [PMID: 30092606 DOI: 10.1111/obr.12702] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 04/04/2018] [Accepted: 04/11/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVE The effectiveness of obesity prevention interventions to improve children's diet can be enhanced. Deconstructing past interventions can identify components with potential to change behaviour. This systematic review using the Behaviour Change Wheel aimed to examine the behaviour change content of interventions supporting parents of 3- to 8-year olds to reduce provision of unhealthy foods to children. METHODS Ebscohost, Ovid, Scopus and Web of Science were searched. Eligible studies included controlled interventions with active parent involvement, at least one intervention strategy and outcome measure for unhealthy foods ≥3 months from baseline. Seventeen interventions were included describing 18 intervention arms. RESULTS Interventions frequently targeted parents' reflective motivation (n = 17) and psychological capability (n = 15), through education (n = 15) or enablement (n = 15) intervention functions and service provision (n = 18) policy category. Only 24 of the 93 behaviour change techniques were used with an average of five techniques used per intervention. CONCLUSIONS Existing interventions achieving small reductions in unhealthy food intake are homogenous in approach. There is potential to utilize untapped behaviour change techniques, through comprehensive intervention design and behavioural analysis guided by the Behaviour Change Wheel. Interventions targeting opportunity through persuasion, modelling or environmental restructuring, and using different policy categories are urgently needed to provide an evidence base to inform policy and practice.
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Affiliation(s)
- B J Johnson
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
| | - D Zarnowiecki
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.,Early Prevention of Obesity in Childhood Centre for Research Excellence, Sydney, Australia
| | - G A Hendrie
- Health and Biosecurity Flagship, Commonwealth Scientific Industrial Research Organisation Adelaide, Adelaide, Australia
| | - C E Mauch
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.,Early Prevention of Obesity in Childhood Centre for Research Excellence, Sydney, Australia
| | - R K Golley
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.,Early Prevention of Obesity in Childhood Centre for Research Excellence, Sydney, Australia
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19
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Pakpour AH, Chen CY, Lin CY, Strong C, Tsai MC, Lin YC. The relationship between children's overweight and quality of life: A comparison of Sizing Me Up, PedsQL and Kid-KINDL. Int J Clin Health Psychol 2018; 19:49-56. [PMID: 30619497 PMCID: PMC6300711 DOI: 10.1016/j.ijchp.2018.06.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 06/19/2018] [Indexed: 01/17/2023] Open
Abstract
Background/Objective: Overweight and obese children are likely to encounter negative impact on psychological well-being and quality of life (QoL). Hence, for overweight and obese children, measuring QoL could go beyond simply assessing objective medical parameters and cover their physical health, psychological well-being, and social interaction. Generic (Kid-KINDL and Pediatric Quality of Life Inventory [PedsQL]) and weight-related (Sizing Me Up) measures are two major types of QoL measurement instruments; however, little is known about the differences between them. Method: We recruited 569 3rd to 6th graders from eleven schools in Southern Taiwan. In addition to the three QoL questionnaires, the Child Depression Inventory and Rosenberg Self-Esteem Scale were applied. Results: Depression had significantly negative associations with all three QoL questionnaires. Self-esteem was only associated with Kid-KINDL. Body mass index had a significantly stronger relationship with Sizing Me Up than its relationships with PedsQL and Kid-KINDL. In other words, the items related to body size concerns in Size Me Up significantly contributed to impaired overweight/obese children’s QoL. Conclusions: The study further identified the characters and strength of these QoL measures for better suggestions on evaluating physical and psychological issues for overweight/obese children.
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Affiliation(s)
- Amir H Pakpour
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Iran.,Department of Nursing, School of Health and Welfare, Jönköping University, Sweden
| | - Chao-Ying Chen
- Department of Rehabilitations Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Chung-Ying Lin
- Department of Rehabilitations Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Carol Strong
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Taiwan
| | - Meng-Che Tsai
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Taiwan
| | - Yi-Ching Lin
- Department of Early Childhood and Family Education, National Taipei University of Education, Taiwan
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20
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Understanding Out-of-Home Food Environment, Family Restaurant Choices, and Childhood Obesity with an Agent-Based Huff Model. SUSTAINABILITY 2018. [DOI: 10.3390/su10051575] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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21
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D'Adamo CR, McArdle PF, Balick L, Peisach E, Ferguson T, Diehl A, Bustad K, Bowden B, Pierce BA, Berman BM. Spice MyPlate: Nutrition Education Focusing Upon Spices and Herbs Improved Diet Quality and Attitudes Among Urban High School Students. Am J Health Promot 2018; 30:346-56. [PMID: 27404643 DOI: 10.1177/0890117116646333] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To determine whether an experiential nutrition education intervention focusing on spices and herbs ("Spice MyPlate") is feasible and improves diet quality and healthy eating attitudes among an urban and predominantly African-American sample of adolescents more than standard nutrition education alone. DESIGN A nonrandomized controlled trial compared standard nutrition education in U.S. Department of Agriculture MyPlate guidelines (control group) with standard nutrition education plus adjuvant Spice MyPlate curriculum (intervention group). Data were collected at baseline and after 3, 6, and 10 weeks. SETTING Study setting was two public high schools in Baltimore, Maryland. SUBJECTS A total of 110 students in grades 9 to 12 participated. INTERVENTION The 6-week school-based intervention conducted during health class focused on cooking using spices and herbs to eat healthier diets according to MyPlate. MEASURES Dietary intake reported on 3-day food records and healthy eating attitudes questionnaires was analyzed. ANALYSIS Differences in diet quality and healthy eating attitudes between study groups were estimated by t-tests, Wilcoxon-Mann-Whitney tests, and covariate-adjusted regression models. RESULTS Spice MyPlate was feasible and there were modest but significant improvements (p ≤ .05) in the Spice MyPlate group compared with control in whole grains (31.2 g/wk) and protein foods (13.2 ounces per week) intake, and attitudes toward eating vegetables, whole grains, lean protein, and low-fat dairy. CONCLUSIONS Although randomized trials are needed, experiential nutrition education focusing on spices and herbs may help urban and predominantly African-American adolescent populations eat healthier diets.
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Affiliation(s)
- Christopher R D'Adamo
- The Departments of Family and Community Medicine, and Epidemiology and Public Health, and with the Center for Integrative Medicine, University of Maryland, Baltimore, MD, USA
| | - Patrick F McArdle
- The Departments of Medicine, and Epidemiology and Public Health, University of Maryland, Baltimore, MD, USA
| | - Lyssa Balick
- The Nutrition and Wellness at Mind Body Well, Catonsville, MD, USA
| | - Erin Peisach
- The Center for Integrative Medicine, University of Maryland, Baltimore, MD, USA
| | | | | | | | - Brandin Bowden
- The Institute for Integrative Health, Baltimore, MD, USA
| | | | - Brian M Berman
- The Department of Family and Community Medicine, and Center for Integrative Medicine, University of Maryland, Baltimore, MD, USA
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22
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Jones A. Parental Socioeconomic Instability and Child Obesity. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2018; 64:15-29. [PMID: 29741412 DOI: 10.1080/19485565.2018.1449630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Using data from the 1986 to 2010 National Longitudinal Study of Youth (NLSY) and the NLSY Child and Young Adult Supplement, this research explores how changes in parental socioeconomic status relate to child obesity over time. Results from linear mixed-effects models indicate that maternal educational gains and maternal employment transitions significantly increased their child's body mass index (BMI). This finding suggests that mothers who work may have less time to devote to monitoring their child's food intake and physical activity, which places their children at higher risks of becoming overweight or obese over time. Conversely, father's work transitions and educational gains contribute to decreases in child's BMI. Thus, work instability and increasing educational attainment for the traditional breadwinner of the household corresponds to better child weight outcomes. Results also suggest that there are racial differences in child BMI that remain after adjusting for changes in socioeconomic status, which indicate that the same structural disadvantages that operate to keep minorities in lower social class standings in society also work to hinder minorities from advancing among and out of their social class. Policy implications related to curbing child obesity are discussed.
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Affiliation(s)
- Antwan Jones
- a Department of Sociology , The George Washington University , Washington , DC , USA
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23
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Lee JE, Pope Z, Gao Z. The Role of Youth Sports in Promoting Children's Physical Activity and Preventing Pediatric Obesity: A Systematic Review. Behav Med 2018; 44:62-76. [PMID: 27337530 DOI: 10.1080/08964289.2016.1193462] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Youth sport participation plays an important role in promoting physical activity among children and may be a possible venue for the prevention of pediatric obesity. To design effective physical activity interventions, it is imperative to understand how different aspects of sport participation influence physical activity (PA). The purpose of this article is to present a comprehensive review of the impact of youth sport participation on children's PA and obesity status. A total of 44 studies published up to January 2014 concerning youth sport participation, PA, and obesity status were identified. Inclusion criteria were studies comparing PA levels of sport participants to nonparticipants or those comparing PA levels in different sport types and settings. Studies with the outcome variables of obesity status (e.g., body mass index, fat percentage, waist circumference) were also included. Participation in youth sport was positively associated with children's PA levels, and youth participating in sports were more likely to persist in their PA. However, the relationship between youth sport participation and obesity status was inconclusive. Educators and sports professionals should find ways to involve children in various sports settings and policies and help obese children engage more in sports.
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Affiliation(s)
- Jung Eun Lee
- a School of Kinesiology, University of Minnesota
| | - Zachary Pope
- a School of Kinesiology, University of Minnesota
| | - Zan Gao
- a School of Kinesiology, University of Minnesota
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24
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Lydecker JA, Izzo A, Spielberger G, Grilo CM. "I only watch for the commercials": Messages about weight, eating and race in Super Bowl advertisements. Int J Clin Pract 2017; 71:10.1111/ijcp.13026. [PMID: 28941009 PMCID: PMC5728649 DOI: 10.1111/ijcp.13026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 09/08/2017] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Health experts and communication experts assert that the media influence individuals' health. Yet, incongruously, the public, policy-makers and the media themselves appear reticent to accept that the media could have extensive negative influence on health. METHODS The current study examined all ads that aired from Super Bowl XLVI through Super Bowl XLIX (N = 241) using a detailed, multistep coding process. RESULTS Ads had similar racial/ethnic diversity in the full sample and food/beverage ads. A minority (14.5%) of advertisements contained actors with overweight/obesity, who were more likely to be White and less likely to be Hispanic compared with race/ethnicity in all ads. Humour and tone were similarly present whether or not the ads included actors with overweight/obesity. CONCLUSIONS Findings are striking given the high prevalence of overweight/obesity in the USA, particularly among Black and Hispanic populations, and the comparatively low representation of actors with overweight/obesity in Super Bowl advertisements. Surprising weight findings may signal a change in how the media portray body-size norms (away from exclusively thin), although representations remain disproportionate from actual body-size distributions in the USA.
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Affiliation(s)
- Janet A. Lydecker
- Yale School of Medicine, Department of Psychiatry, 301 Cedar Street, New Haven CT 06519
| | - Antonio Izzo
- Yale School of Medicine, Department of Psychiatry, 301 Cedar Street, New Haven CT 06519
- Quinnipiac University, Department of Psychology, 301 Cedar Street, New Haven CT 06519
| | - Gail Spielberger
- Yale School of Medicine, Department of Psychiatry, 301 Cedar Street, New Haven CT 06519
- Quinnipiac University, Department of Psychology, 301 Cedar Street, New Haven CT 06519
| | - Carlos M. Grilo
- Yale School of Medicine, Department of Psychiatry, 301 Cedar Street, New Haven CT 06519
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25
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Abstract
A new model of diagnostics and treatment for overweight in children is used for implementation of a new approach toward childhood obesity. Although based in a hospital setting, it is part of a cure and care network with other professionals. By psycho-education about the body at a 6-year-old level, parents and children become informed and competent partners. This knowledge increases their autonomy and ability to make choices. Collaboration with the family's support group or network reduces isolation and increases the feeling of being connected and supported. Together with their support network, they can maintain this healthier lifestyle or adjust it where needed. Family workbooks and worksheets support the child and parents and increase their autonomy, self management skills, and motivation to take part in the cure and care network. The approach is a based on the three basic needs that determine motivation, namely autonomy, competence, and connectedness.
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26
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Ulijaszek SJ, Pentecost M, Marcus C, Karpe F, Frühbeck G, Nowicka P. Inequality and childhood overweight and obesity: a commentary. Pediatr Obes 2017; 12:195-202. [PMID: 26990034 DOI: 10.1111/ijpo.12128] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 02/17/2016] [Indexed: 02/02/2023]
Abstract
Statements on childhood overweight and obesity (COO) have focused on different avenues for prevention and treatment, critical stages of the life cycle, including pregnancy and lactation, individual, family, school and community-based interventions, multidisciplinary family programmes and multicomponent interventions. This commentary is concerned with the less-addressed relationship between COO and inequality. It describes current global patterns of inequality and COO and the ways in which those inequalities are linked to COO at micro-level, meso-level and macro-level. It then describes current programmatic approaches for COO inequality, preventive and medical, and considers important pitfalls in the framing of the problem of COO and inequality. It ends with describing how childhood and adolescent overweight and obesity prevention and treatment programmes might be formulated within broader socio-political frameworks to influence outcomes.
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Affiliation(s)
- S J Ulijaszek
- School of Anthropology, University of Oxford, Oxford, UK
| | - M Pentecost
- School of Anthropology, University of Oxford, Oxford, UK
| | - C Marcus
- Karolinska Institutet, Stockholm, Sweden
| | - F Karpe
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - G Frühbeck
- Department of Endocrinology and Nutrition, Clinica Universidad de Navarra, CIBEROBN, IdiSNA, Pamplona, Spain
| | - P Nowicka
- Karolinska Institutet, Stockholm, Sweden.,Department of Food, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
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27
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Abstract
BACKGROUND Obesity and functional constipation seem to share a common biopsychosocial model of causation. Though chronic constipation can significantly affect the quality of life of an overweight child, this association has not been highlighted in the literature. The purpose of this study was to compare the proportion of overweight children among children with chronic constipation with a control group of children with normal bowel habits. METHODS Retrospective chart review with a control population. One hundred one consecutive children 5-18 years of age referred to the Subspecialty Clinic for functional constipation were the study group. The control group consisted of 100 consecutive children from the general pediatric practice seen for physicals and minor illnesses. Children with a body mass index (BMI) of >85 percentile from the National Institutes of Health (NIH) 2000 chart were classified as overweight. RESULTS The control and study groups were statistically comparable in mean age (10.97 +/- 3.83 years and 8.07 +/- 2.56 years, respectively) and gender ratio (58 males in each group). Thirty children in the control group and 44 in the study population were overweight (p < .05). Among children with chronic constipation, the group of overweight children was male predominant (70.45% vs 47.36%, p < .05), had increased incidence of psychological/behavioral problems (45.45% vs 22.8%, p < .05), and was more likely to fail treatment (40.9% vs 21.05%, p < .05). There was no significant difference in the clinical profile of constipation, such as mean duration of constipation before presentation, sex ratio, incidence of painful defecation, and soiling and frequency of defecation between these 2 groups. CONCLUSIONS There appears to be an association between chronic severe constipation and being overweight. Children with constipation are more likely to be overweight when compared with controls. Among children with chronic constipation, overweight individuals seem to constitute a distinct clinical group. This group is male predominant, has increased incidence of psychological/behavioral disorders, and is more likely to fail treatment.
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Affiliation(s)
- Sudipta Misra
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, UIC College of Medicine at Peoria, 320 E. Armstrong, Peoria, IL, USA.
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Group model building: a framework for organizing healthy community program and policy initiatives in Columbia, Missouri. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2016; 21 Suppl 3:S79-83. [PMID: 25828226 DOI: 10.1097/phh.0000000000000209] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Between 2008 and 2012, the multidisciplinary Healthy Community Partnership of Columbia, Missouri, participated in a national program to address child obesity. This article describes a systems-level evaluation of their work to implement healthy eating and active living policy, system, and environmental changes to support healthier communities for children. METHODS In 2011, the partnership participated in a Group Model Building session, consisting of 2 primary activities. First, participants sketched behavior-over-time graphs, illustrating the evolution of community variables related to child obesity, such as prevalence of walking to school or the marketing of high-sugar drinks. Later, the graphs were arranged on a large area of wall space and connections were drawn between those variables that were believed to influence each other--either positively (reinforcing connections) or negatively (opposing connections). The resulting causal loop diagram is a visual representation of the interacting systems, as perceived by the partnership. RESULTS In reviewing the diagram, the group identified areas where they felt the diagram "made sense" and other areas where there were inconsistencies between the diagram and their own mental model of the processes at work. To address the inconsistencies, participants were surveyed to determine which specific modifications should be made to the diagram so it would become an accurate representation of the group's shared concept of the relevant relationships. DISCUSSION The group felt that the final Modified causal loop diagram achieved this goal and that it provides useful insight into how their work addresses child obesity. They believe the diagram also has the potential to improve community engagement by serving as a visual model, improve planning through better resource allocation, improve implementation by identifying policy leverage points, and increase resources when used in grant applications.
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Using group model building to understand factors that influence childhood obesity in an urban environment. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2016; 21 Suppl 3:S74-8. [PMID: 25828225 DOI: 10.1097/phh.0000000000000219] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite increased attention, conventional views of obesity are based upon individual behaviors, and children and parents living with obesity are assumed to be the primary problem solvers. Instead of focusing exclusively on individual reduction behaviors for childhood obesity, greater focus should be placed on better understanding existing community systems and their effects on obesity. The Milwaukee Childhood Obesity Prevention Project is a community-based coalition established to develop policy and environmental change strategies to impact childhood obesity in Milwaukee, Wisconsin. The coalition conducted a Group Model Building exercise to better understand root causes of childhood obesity in its community. METHODS Group Model Building is a process by which a group systematically engages in model construction to better understand the systems that are in place. It helps participants make their mental models explicit through a careful and consistent process to test assumptions. This process has 3 main components: (1) assembling a team of participants; (2) conducting a behavior-over-time graphs exercise; and (3) drawing the causal loop diagram exercise. RESULTS The behavior-over-time graph portion produced 61 graphs in 10 categories. The causal loop diagram yielded 5 major themes and 7 subthemes. CONCLUSIONS Factors that influence childhood obesity are varied, and it is important to recognize that no single solution exists. The perspectives from this exercise provided a means to create a process for dialogue and commitment by stakeholders and partnerships to build capacity for change within the community.
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Pan L, Grummer-Strawn LM, McGuire LC, Park S, Blanck HM. Trends in state/territorial obesity prevalence by race/ethnicity among U.S. low-income, preschool-aged children. Pediatr Obes 2016; 11:397-402. [PMID: 26463118 PMCID: PMC9017711 DOI: 10.1111/ijpo.12078] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 09/09/2015] [Accepted: 09/10/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Understanding state/territorial trends in obesity by race/ethnicity helps focus resources on populations at risk. OBJECTIVE This study aimed to examine trends in obesity prevalence among low-income, preschool-aged children from 2008 through 2011 in U.S. states and territories by race/ethnicity. METHODS We used measured weight and height records of 11.1 million children aged 2-4 years who participated in federally funded health and nutrition programmes in 40 states, the District of Columbia and two U.S. territories. We used logistic regression to examine obesity prevalence trends, controlling for age and sex. RESULTS From 2008 through 2011, the aggregated obesity prevalence declined among all racial/ethnic groups (decreased by 0.4-0.9%) except American Indians/Alaska Natives (AI/ANs); the largest decrease was among Asians/Pacific Islanders (A/PIs). Declines were significant among non-Hispanic whites in 14 states, non-Hispanic blacks in seven states/territories, Hispanics in 13 states, A/PIs in five states and AI/ANs in one state. Increases were significant among non-Hispanic whites in four states, non-Hispanic blacks in three states, Hispanics in two states and A/PIs in one state. The majority of the states/territories had no change in obesity prevalence. CONCLUSIONS Our findings indicate slight reductions in obesity prevalence and variations in obesity trends, but disparities exist for some states and racial/ethnic groups.
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Affiliation(s)
- L. Pan
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - L. C. McGuire
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - S. Park
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - H. M. Blanck
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Mendez N, Vera-Aviles M, Gonzalez-Herrera L, Dickinson F, Palma-Solis M, Prelip M. School Grades and Standardized Test Scores of Children with and Without Obesity in South-East Mexico. INTERNATIONAL JOURNAL OF SCHOOL HEALTH 2016. [DOI: 10.17795/intjsh-36356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Falbe J, Cotterman C, Linchey J, Madsen KA. Ethnic Disparities in Trends in High BMI Among California Adolescents, 2003-2012. Am J Prev Med 2016; 51:e45-e55. [PMID: 27067033 PMCID: PMC4958536 DOI: 10.1016/j.amepre.2016.02.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 01/19/2016] [Accepted: 02/02/2016] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Because California is home to one in eight U.S. children and accounts for the highest Medicaid and Children's Health Insurance Program spending, childhood obesity trends in California have important implications for the entire nation. California's racial/ethnic diversity and large school-based data set provide a unique opportunity to examine trends by race/ethnicity, including understudied Asian and American Indian youth, which has not been possible using national data sets. This study examined racial/ethnic disparities in prevalence of high BMI from 2003 to 2012. METHODS This observational study included 11,624,865 BMI records from repeated cross-sections of fifth-, seventh-, and ninth-graders who underwent California's school-based fitness testing. Analyses conducted in 2015 used logistic regression to identify trends in prevalence of high BMI (BMI ≥85th, 95th, and 97th percentiles) and differences in trends by race/ethnicity from 2003 to 2012. RESULTS African American and Hispanic girls and American Indian boys increased in prevalence of high BMI, whereas non-Hispanic white and Asian youth and Hispanic boys decreased in prevalence of high BMI (p-values<0.05) from 2003 to 2012. Over this period, African American, Hispanic, and American Indian youth had higher slopes for trends in high BMI than non-Hispanic white youth (p-values<0.05). CONCLUSIONS Based on California's statewide data, there is evidence that racial/ethnic disparities in prevalence of high BMI have widened over time. Minority youth have either decreased more slowly or increased in prevalence compared with non-Hispanic white youth. There continues to be an urgent need for policies and interventions that effectively reduce racial/ethnic obesity prevalence disparities.
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Affiliation(s)
- Jennifer Falbe
- Division of Community Health and Human Development, School of Public Health, University of California, Berkeley, California.
| | - Carolyn Cotterman
- Interdepartmental Group in Biostatistics, University of California, Berkeley, California
| | - Jennifer Linchey
- Division of Community Health and Human Development, School of Public Health, University of California, Berkeley, California
| | - Kristine A Madsen
- Division of Community Health and Human Development, School of Public Health, University of California, Berkeley, California
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Geier DA, Kern JK, Homme KG, Sykes LK, Geier MR. Thimerosal-containing Hepatitis B Vaccine Exposure is Highly Associated with Childhood Obesity: A Case-control Study Using the Vaccine Safety Datalink. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2016; 8:297-306. [PMID: 27583238 PMCID: PMC4982359 DOI: 10.4103/1947-2714.187148] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Obesity among children and adolescents in the United States has tripled since 1980, and has become a major public health concern. AIMS The purpose of this study was to evaluate the potential relationship between exposure to organic mercury from Thimerosal-containing hepatitis B vaccines and the children's subsequent risk of an obesity diagnosis. MATERIALS AND METHODS A hypothesis-testing, case-control study was undertaken to evaluate exposure to organic mercury from Thimerosal-containing hepatitis B vaccines, which were administered at specific intervals in the first 6 months of life, among cases diagnosed with childhood obesity and controls by examining automated medical records for children born from 1991 to 2000 who were continuously enrolled in the Vaccine Safety Datalink database. RESULTS This study found highly significant associations as follows. Cases diagnosed with obesity were significantly (P < 0.00001) more likely to have received greater exposure to organic mercury from Thimerosal-containing hepatitis B vaccines administered within the first month of life (odds ratio (OR) =1.511), first 2 months of life (OR = 1.486), and first 6 months of life (OR = 3.795) than the controls. Similar outcomes were observed when the overall data were separated by gender. In a dose-response manner, cases diagnosed with obesity were significantly more likely than controls to have received greater exposure to organic mercury from Thimerosal-containing hepatitis B vaccines, which were administered within the first 6 months of life (OR = 1.0375 per μg of mercury, P < 0.00001). CONCLUSIONS In a dose-response manner, the present study associates an increased organic mercury exposure from Thimerosal-containing hepatitis B vaccines with an increased risk of obesity diagnosis, and suggests that Thimerosal is an obesogen. The results are biologically plausible and future studies are needed to examine this phenomenon.
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Affiliation(s)
- David A. Geier
- Department of Research, Institute of Chronic Illnesses Inc., MD, USA
- Department of Research, CoMeD, Inc., Silver Spring, MD, USA
| | - Janet K. Kern
- Department of Research, Institute of Chronic Illnesses Inc., MD, USA
- Department of Research, CoMeD, Inc., Silver Spring, MD, USA
- CONEM US Autism Research Group, Allen, TX, USA
| | - Kristin G. Homme
- International Academy of Oral Medicine and Toxicology, Champions Gate, FL, USA
| | - Lisa K. Sykes
- Department of Research, CoMeD, Inc., Silver Spring, MD, USA
| | - Mark R. Geier
- Department of Research, Institute of Chronic Illnesses Inc., MD, USA
- Department of Research, CoMeD, Inc., Silver Spring, MD, USA
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Smith KJ, Pohle-Krauza R, Uhas S, Barkley JE. Meals of differing caloric content do not alter physical activity behavior during a subsequent simulated recess period in children. SPRINGERPLUS 2016; 5:498. [PMID: 27186462 PMCID: PMC4840127 DOI: 10.1186/s40064-016-2160-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 04/13/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Research on adults and animals has demonstrated that chronic and acute overfeeding can alter physical activity behavior. However, there are no assessments of the acute effects of high-calorie (HC) meals on physical activity behavior in children. This is of importance as a typical school lunch is HC. If this type of meal negatively impacts subsequent physical activity behavior, the ability of post-lunch recess periods as a means to increase energy expenditure may be lessened. PURPOSE To assess the effect of two meals of differing caloric content, HC and low calorie (LC), on children's subsequent physical activity behavior. METHODS Nineteen healthy children (aged 6-10) completed two laboratory sessions where they were fed lunch with HC or LC content, but equivalent macronutrient distribution. Children had 15 min to consume as much of the meal as possible per session. Children consumed 659.5 ± 101.3 kcal in the HC condition and 291.8 ± 12.1 kcal in the LC condition. After the meal, children went to a gymnasium for 40 min. In the gymnasium children had free-choice access to obstacle courses, various sports equipment, and a table with sedentary activities. Children could play with any of the activities in any amount they wished for the entire activity session. Children's physical activity was monitored with accelerometers and that data was converted into caloric expenditure. Each child ate all meals and participated in the free-choice activity sessions with no other children present. RESULTS Caloric expenditure during the free-choice activity sessions was not significantly different (p = 0.4) between the HC (89.2 ± 27.3 kcals) and LC (83.4 ± 34.9 kcals) conditions. However, caloric balance (kcals eaten-kcals expended) was 2.74-fold greater (p < 0.001) in the HC condition (Δ 570.3 ± 92.2 kcals) than the LC condition (Δ 208.4 ± 32.0 kcals). CONCLUSION Children did not alter their physical activity behavior during a free-choice activity session after consuming a HC meal versus a LC meal. Because activity was not different across the two conditions, children had a much greater caloric surplus during the HC condition than the LC condition.
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Affiliation(s)
- Kelly J. Smith
- />Kent State University, 163E MACC Annex, 350 Midway Drive, Kent, OH 44242 USA
| | | | - Samantha Uhas
- />Kent State University, 163E MACC Annex, 350 Midway Drive, Kent, OH 44242 USA
| | - Jacob E. Barkley
- />Kent State University, 163E MACC Annex, 350 Midway Drive, Kent, OH 44242 USA
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Pesch MH, Rizk M, Appugliese DP, Rosenblum KL, Miller A, Lumeng JC. Maternal concerns about children overeating among low-income children. Eat Behav 2016; 21:220-7. [PMID: 27010491 PMCID: PMC4851563 DOI: 10.1016/j.eatbeh.2016.03.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 02/05/2016] [Accepted: 03/01/2016] [Indexed: 10/22/2022]
Abstract
Addressing overeating is essential to obesity treatment and prevention. The objectives of this study were to investigate maternal concern for child overeating, to identify associated participant characteristics and to determine if concern for child overeating is associated with maternal feeding practices. Low-income mothers (N=289) of children (mean age 70.8months) participated in a semi-structured interview. Themes of maternal concern for child overeating were identified and a coding scheme was reliably applied. Maternal feeding practices were measured by questionnaire and videotaped eating interactions. Logistic regressions were used to test the associations of participant characteristics with the presence of each theme, and bivariate analyses were used to test the associations of the presence of each theme with feeding practices. Three themes were identified: 1) mothers worry that their child does overeat, 2) mothers acknowledge that their child may overeat but indicate that it is not problematic because they manage their child's eating behavior, and 3) mothers acknowledge that their child may overeat but indicate that it is not problematic because of characteristics inherent to the child. Child obesity predicted the themes; mothers of obese and overweight children are more likely to be concerned about overeating. Themes were associated with lower levels of observed pressure to eat. Only Theme 2 was associated with greater restrictive feeding practices. Interventions that provide parents' practical, healthy ways to prevent child overeating may be helpful.
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Affiliation(s)
- Megan H. Pesch
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan
| | - Monika Rizk
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan
| | | | - Katherine L. Rosenblum
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan,Department of Psychiatry, Medical School, University of Michigan. Ann Arbor, Michigan
| | - Alison Miller
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan,Department of Psychology, University of Michigan. Ann Arbor, Michigan,Department of Health Behavior and Health Education, School of Public Health, University of Michigan. Ann Arbor, Michigan
| | - Julie C. Lumeng
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan,Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan,Department of Nutritional Sciences, School of Public Health, University of Michigan. Ann Arbor, Michigan
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Thamotharan S, Lange K, Ramos A, Fields S. Examining weight concern and delay discounting in adolescent females. Eat Behav 2016; 21:228-31. [PMID: 27010492 PMCID: PMC4851586 DOI: 10.1016/j.eatbeh.2016.03.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 01/26/2016] [Accepted: 03/01/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Pediatric obesity is a growing public health concern that contributes to high rates of negative long-term physical and mental health outcomes. Research focused on identifying risk for pediatric obesity has linked delay discounting, or an inclination for immediate rewards, as well as weight concern to individuals with greater Body Mass Index (BMI). The current study seeks to fill a void in the literature by examining how these two variables interact to promote higher BMI in female adolescents. METHOD Adolescent (n=60) females between the ages of 13-19years (mage=17.45, SD=1.74) of age completed the Eating Disorder Examination Questionnaire (EDE-Q) and the Delay Discounting Questionnaire. RESULTS A mediation model examined whether delay discounting accounted for the relationship between weight concern and BMI. Results indicate that in the current study weight concern was negatively related to delay discounting and delay discounting was negatively related to BMI. The overall model revealed that a partial mediation occurred [b=1.28, t(60)=4.92, p<0.01]. DISCUSSION These results suggest that while impulsivity is an important factor to consider, other constructs may also be influential in how weight concerns contribute to greater BMI. Nevertheless, the results indicate that prevention and interventions should identify females with high levels of both weight concern and impulsivity as an increased risk for experiencing pediatric obesity and long-term negative health outcomes.
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Affiliation(s)
| | | | | | - Sherecce Fields
- Health Behavior Research Group, Department of Psychology, Texas A&M University, USA.
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Kim K, Ok G, Jeon S, Kang M, Lee S. Sport-based physical activity intervention on body weight in children and adolescents: a meta-analysis. J Sports Sci 2016; 35:369-376. [PMID: 27018616 DOI: 10.1080/02640414.2016.1166389] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Controversial results reported in past research pertaining to the effectiveness of sport-based physical activity interventions on weight loss. The purpose of this study was to assess the impact of sport-based physical activity intervention on body weight in children and adolescents using a meta-analysis. Academic Search Complete, Education Source, ERIC, Medline, ProQuest, PsycINFO and SportDiscus databases were searched from January 2000 to April 2015. Eighteen studies met following inclusion criteria: sport-based intervention studies; subjects aged 6-18 years; reported body weight; published in peer-reviewed journals written in English. The mean intervention duration was 17.72 weeks. The overall effect size (ES) was 0.52 (Cohen's d (ES) = 0.52, 95% CI = 0.08, 0.95, P = 0.021), using a random effects model. Moderator analyses results showed that the Q statistic for the sport type (individual sport or team sport, Qbetween (Qb) = 14.52, df = 1, P = 0.001) and diet control (Qbetween (Qb) = 8.85, df = 1, P = 0.001), explained the heterogeneity of ESs. Our study showed that there was a moderate overall effect of sport-based physical activity intervention on body weight reduction. The team sport type (ES = 1.05, 95% CI = 0.44, 1.66) and diet control group (ES = 0.84, 95% CI = 0.26, 1.41) appeared to be more effective in reducing body weight.
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Affiliation(s)
- Kyungun Kim
- a Kinesiology and Health Education , The University of Texas at Austin , Austin , TX , USA
| | - Gina Ok
- b Counseling, Health, and Kinesiology , Texas A&M University - San Antonio , San Antonio , TX , USA
| | - Soeun Jeon
- b Counseling, Health, and Kinesiology , Texas A&M University - San Antonio , San Antonio , TX , USA
| | - Minsoo Kang
- c Health and Human Performance , Middle Tennessee State University , Murfreesboro , TN , USA
| | - Sukho Lee
- b Counseling, Health, and Kinesiology , Texas A&M University - San Antonio , San Antonio , TX , USA
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Militello L, Melnyk BM, Hekler EB, Small L, Jacobson D. Automated Behavioral Text Messaging and Face-to-Face Intervention for Parents of Overweight or Obese Preschool Children: Results From a Pilot Study. JMIR Mhealth Uhealth 2016; 4:e21. [PMID: 26976387 PMCID: PMC4810011 DOI: 10.2196/mhealth.4398] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 09/11/2015] [Accepted: 11/11/2015] [Indexed: 12/15/2022] Open
Abstract
Background Children are 5 times more likely to be overweight at the age of 12 years if they are overweight during the preschool period. Objective The purpose of this study was to establish the feasibility, acceptability, and preliminary effects of a cognitive behavioral intervention (TEXT2COPE) synergized with tailored mobile technology (mHealth) on the healthy lifestyle behaviors of parents of overweight and obese preschoolers delivered in a primary care setting. Methods Fifteen preschooler-parent dyads recruited through primary care clinics completed a manualized 7-week cognitive behavioral skills building intervention. Beck’s Cognitive Theory guided the TEXT2COPE intervention content and Fogg’s Behavior Model guided the implementation. The intervention employed a combination of face-to-face clinic visits and ecological momentary interventions using text messaging (short message service, SMS). To enhance the intervention’s relevance to the family’s needs, parents dictated the wording of the text messages and also were able to adapt the frequency and timing of delivery throughout program implementation. Results Self-reported findings indicate that the program is feasible and acceptable in this population. The intervention showed preliminary effects with significant improvements on parental knowledge about nutrition (P=.001) and physical activity (P=.012) for their children, parental beliefs (P=.001) toward healthy lifestyles, and parental behaviors (P=.040) toward engaging in healthy lifestyle choices for their children. Effect sizes were medium to large for all variables. The timing, frequency, and wording of the text messages were tailored to the individual families, with 69% of parents (9/13) increasing the frequency of the tailored SMS from being sent once weekly to as many as 5 times a week. Conclusions Utilizing a cognitive behavioral skills intervention with SMS has great potential for supporting clinical care of overweight and obese preschool children and their families. Further exploration of the potential effects on health and behavioral outcomes is warranted.
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Affiliation(s)
- Lisa Militello
- The Ohio State University, College of Nursing, Columbus, OH, United States.
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Susanto F. Nutrient intake evaluation among school age children in Jakarta, Indonesia. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2015. [DOI: 10.3233/mnm-150050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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How parents process child health and nutrition information: A grounded theory model. Appetite 2015; 97:138-45. [PMID: 26626822 DOI: 10.1016/j.appet.2015.11.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 10/23/2015] [Accepted: 11/21/2015] [Indexed: 01/21/2023]
Abstract
The aim of the present study was to investigate low-income parents' experiences receiving, making meaning of, and applying sociocultural messages about childhood health and nutrition. Semi-structured interviews were conducted with parents from 16 low-income Early Head Start families. Verbatim interview transcripts, observations, field notes, documentary evidence, and follow-up participant checks were used during grounded theory analysis of the data. Data yielded a potential theoretical model of parental movement toward action involving (a) the culture and context influencing parents, (b) parents' sources of social and cultural messages, (c) parental values and engagement, (d) parental motivation for action, (e) intervening conditions impacting motivation and application, and (f) parent action taken on the individual and social levels. Parent characteristics greatly impacted the ways in which parents understood and applied health and nutrition information. Among other implications, it is recommended that educators and providers focus on a parent's beliefs, values, and cultural preferences regarding food and health behaviors as well as his/her personal/family definition of "health" when framing recommendations and developing interventions.
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Phillips KL, Schieve LA, Visser S, Boulet S, Sharma AJ, Kogan MD, Boyle CA, Yeargin-Allsopp M. Prevalence and impact of unhealthy weight in a national sample of US adolescents with autism and other learning and behavioral disabilities. Matern Child Health J 2015; 18:1964-75. [PMID: 24553796 DOI: 10.1007/s10995-014-1442-y] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We estimated the prevalence of obesity, overweight, and underweight among US adolescents with and without autism and other learning and behavioral developmental disabilities (DDs) and assessed the health consequences of obesity among adolescents with DDs. From the 2008 to 2010 National Health Interview Survey, we selected 9,619 adolescents ages 12-17 years. Parent respondents reported weight, height, presence of DDs and health conditions. We calculated body mass index (BMI) and defined obesity, overweight, and underweight as ≥95th, ≥85th to <95th, and <5th percentiles, respectively, using established criteria. We created mutually-exclusive DD subgroups using the following order of precedence: autism; intellectual disability; attention-deficit-hyperactivity-disorder; learning disorder/other developmental delay. We compared BMI outcomes among adolescents in each DD group versus adolescents without DDs using multivariable logistic regression. Socio-demographic factors and birthweight were included as confounders. Estimates were weighted to reflect the US population. Both obesity and underweight prevalences were higher among adolescents with than without DDs [adjusted prevalence ratios (aPR) 1.5 (1.25-1.75) and 1.5 (1.01-2.20), respectively]. Obesity was elevated among adolescents with all DD types, and was highest among the autism subgroup [aPR 2.1 (1.44-3.16)]. Adolescents with either a DD or obesity had higher prevalences of common respiratory, gastrointestinal, dermatological and neurological conditions/symptoms than nonobese adolescents without DDs. Adolescents with both DDs and obesity had the highest estimates for most conditions. Obesity is high among adolescents with autism and other DDs and poses added chronic health risks. Obesity prevention and management approaches for this vulnerable population subgroup need further consideration.
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Affiliation(s)
- Keydra L Phillips
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd, Mailstop E-86, Atlanta, GA, 30333, USA
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Eisenberg ME, Carlson-McGuire A, Gollust SE, Neumark-Sztainer D. A content analysis of weight stigmatization in popular television programming for adolescents. Int J Eat Disord 2015; 48:759-66. [PMID: 25139262 PMCID: PMC4765318 DOI: 10.1002/eat.22348] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 07/20/2014] [Accepted: 07/24/2014] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study provides updated information regarding the prevalence and characteristics of weight stigma in popular adolescent television programming, using a sample of favorite shows named by diverse adolescents. METHOD Participants in a large, population-based study of Minnesota adolescents (N = 2,793, mean age = 14.4) listed their top three favorite television shows. A coding instrument was developed to analyze randomly selected episodes from the most popular 10 programs. Weight-stigmatizing incidents were compared across television show characteristics and characters' gender and weight status. RESULTS Half (50%) of the 30 episodes analyzed contained at least one weight-stigmatizing incident. Both youth- and adult-targeted shows contained weight-stigmatizing comments, but the percent of these comments was much higher for youth-targeted (55.6%) than general audience-targeted shows (8.3%). Male characters were more likely than females to engage in (72.7% vs. 27.3%), and be the targets of, weight stigma (63.6% vs. 36.4%), and there was no difference in the amount of weight stigmatizing directed at average weight females compared to overweight females. Targets of these instances showed a negative response in only about one-third of cases, but audience laughter followed 40.9% of cases. DISCUSSION The portrayal of weight stigmatization on popular television shows-including targeting women of average weight-sends signals to adolescents about the wide acceptability of this behavior and the expected response, which may be harmful. Prevention of weight stigmatization should take a multi-faceted approach and include the media. Future research should explore the impact that weight-related stigma in television content has on viewers.
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Affiliation(s)
- Marla E. Eisenberg
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota,Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota,Correspondence to: Marla E. Eisenberg, Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN 55414.
| | - Ashley Carlson-McGuire
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Sarah E. Gollust
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
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Relation of intelligence quotient and body mass index in preschool children: a community-based cross-sectional study. Nutr Diabetes 2015; 5:e176. [PMID: 26258767 PMCID: PMC4558558 DOI: 10.1038/nutd.2015.27] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 06/18/2015] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE Overweight and obesity in children is a global problem. Besides physical effects, obesity has harmful psychological effects on children. METHODS We carried out cross-sectional community-based study to investigate the relation between body mass index (BMI) and cognitive functioning in preschool children. Thirteen socioeconomical elements of 1151 children were measured and analyzed based on their intelligence quotient (IQ) test results. Thirteen out of 33 provinces were selected randomly, and schools were selected as clusters in rural and urban areas. Descriptive statistics, t-test, analysis of variance and regression were used when appropriate. RESULTS Our analysis showed that IQ was associated with household income, place of residence, delivery type, type of infant feeding and father's and mother's education level (P<0.001 for all). Using penalized linear regression for eliminating the impact of confounding factor, our study shows that, living in metropolitan (β=2.411) and urban areas (β=2.761), the level of participants' father's education (β=5.251) was positively and BMI (β=-0.594) was negatively related with IQ test results.ConclusionsThe findings of the present study showed that a lower IQ score is associated with higher BMI. However, this relation appears to be largely mediated when the socioeconomic status was considered.
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Lonner BS, Toombs CS, Husain QM, Sponseller P, Shufflebarger H, Shah SA, Samdani AF, Betz RR, Cahill PJ, Yaszay B, Newton PO. Body Mass Index in Adolescent Spinal Deformity: Comparison of Scheuermann's Kyphosis, Adolescent Idiopathic Scoliosis, and Normal Controls. Spine Deform 2015; 3:318-326. [PMID: 27927476 DOI: 10.1016/j.jspd.2015.02.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 02/13/2015] [Accepted: 02/18/2015] [Indexed: 10/23/2022]
Abstract
STUDY DESIGN Prospective, multicenter study of Scheuermann's kyphosis (SK) and adolescent idiopathic scoliosis (AIS) compared to a control group. OBJECTIVES Compare body mass index (BMI) and Scoliosis Research Society Questionnaire-22 (SRS-22) scores among two diagnosis and one control group. SUMMARY OF BACKGROUND DATA BMI has been reported as increased in SK patients; however, there are few recent data on this subject or comparing SK to AIS. METHODS Ninety-two SK patients (37 female, 55 male, average age 16 years), 1,051 AIS patients (814 female, 237 male, average age 15 years), and 380 adolescents without scoliosis (controls) were compared based on age, gender, race, height (m), weight (kg), BMI, and SRS-22 scores. An analysis of variance was used to test differences in BMI and SRS-22 scores between the groups and between males and females. Pearson correlations determined the relationship between AIS T5-T12 kyphosis and BMI, SK max kyphosis and BMI, and to determine the relationship between BMI and SRS-22 scores in each group. RESULTS More SK patients were "obese" and "overweight" (28% and 22%) compared to the AIS (6% and 9%) and Control groups (5.8% and 17.9%) (p < .001). More AIS patients were "underweight" (27%, SK: 13%, Control: 12.1%; p < .03). T5-T12 kyphosis was weakly correlated with BMI (r = 0.17), whereas max kyphosis correlated well with BMI (r = 0.39, p < .00). The SK group had significantly lower (worse) SRS-22 scores than AIS patients in the Pain (3.97 vs. 4.10), Self-Image (2.86 vs. 3.35), Mental Health (3.72 vs. 4.02), and Total Score domains (3.62 vs. 3.92, p < .001). Increased pain scores were weakly correlated with decreasing BMI in all three groups. CONCLUSIONS SK patients are at increased risk for elevated BMI and worse SRS-22 scores, indicating that they may suffer from delayed diagnosis and increased surgical complications. AIS patients are at increased risk for issues related to low BMI and should also be monitored.
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Affiliation(s)
- Baron S Lonner
- Department of Orthopaedic Surgery, Beth Israel Medical Center, New York, NY 10003, USA.
| | - Courtney S Toombs
- Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY 10003, USA
| | - Qasim M Husain
- Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY 10003, USA
| | - Paul Sponseller
- Department of Orthopaedic Surgery, Johns Hopkins Hospital, Baltimore, MD 21287, USA
| | - Harry Shufflebarger
- Department of Orthopaedic Surgery, Miami Children's Hospital, Miami, FL 33155, USA
| | - Suken A Shah
- Department of Orthopaedic Surgery, Nemours Children's Clinic, Wilmington, DE 19803, USA
| | - Amer F Samdani
- Department of Orthopaedic Surgery, Shriners Hospitals for Children, Philadelphia, PA 19140, USA
| | - Randal R Betz
- Department of Orthopaedic Surgery, Shriners Hospitals for Children, Philadelphia, PA 19140, USA
| | - Patrick J Cahill
- Department of Orthopaedic Surgery, Shriners Hospitals for Children, Philadelphia, PA 19140, USA
| | - Burt Yaszay
- Department of Orthopaedic Surgery, Rady Children's Hospital San Diego, San Diego, CA 92123, USA
| | - Peter O Newton
- Department of Orthopaedic Surgery, Rady Children's Hospital San Diego, San Diego, CA 92123, USA
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Yavuz HM, van Ijzendoorn MH, Mesman J, van der Veek S. Interventions aimed at reducing obesity in early childhood: a meta-analysis of programs that involve parents. J Child Psychol Psychiatry 2015; 56:677-92. [PMID: 25292319 DOI: 10.1111/jcpp.12330] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/14/2014] [Indexed: 01/13/2023]
Abstract
BACKGROUND Obesity is a growing problem even in very young childhood, resulting in high costs for individuals and society. As a response, numerous obesity prevention and intervention programs have been developed. Previous research has shown that early intervention programs are more effective when parents are involved, but the effectiveness of specific aspects of programs with parental involvement has not been investigated. This meta-analysis aims to investigate the features related to the effectiveness of different types of obesity intervention programs involving parents and targeting young children (0-6-year-olds). METHODS The Web of Science, PubMed, PsycInfo, CINAHL, and ERIC databases were searched for childhood obesity prevention and intervention programs involving parents. Data were analyzed using the Comprehensive Meta-analysis (CMA) software. RESULTS Fifty studies with effect sizes measured at short-term follow-up (within 3 months from the end of the intervention) and 26 studies with effect sizes measured at long-term follow-up (all reported in a total of 49 publications) were identified. The combined effect size of interventions was small but significant at short-term follow-up (d = .08, p < .01). The results suggested the presence of a potential publication bias in studies providing results at long-term follow-up, with a nonsignificant adjusted effect size (d = .02), which indicated that obesity interventions were not effective at long-term follow-up. Multivariate meta-regression analyses showed that interventions were more effective when including either interactive sessions or educational materials as opposed to those including both interactive sessions and noninteractive educational materials. No other moderators regarding sample characteristics, study design, or methodological quality were significant. CONCLUSION Interventions targeting young children that require parental involvement are effective at short-term follow-up, specifically when interventions include one mode of intervention rather than two. However, results were not retained in the long run.
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Affiliation(s)
- H Melis Yavuz
- Department of Psycholog, Koc University, Istanbul, Turkey
| | | | - Judi Mesman
- Department of Psycholog, Koc University, Istanbul, Turkey
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Farris AR, Misyak S, Duffey KJ, Mann GR, Davis GC, Hosig K, Atzaba-Poria N, McFerren MM, Serrano EL. A comparison of fruits, vegetables, sugar-sweetened beverages, and desserts in the packed lunches of elementary school children. Child Obes 2015; 11:275-80. [PMID: 25747503 DOI: 10.1089/chi.2014.0134] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND An estimated 40% of children bring a packed lunch to school. These lunches are not required to meet nutrition standards. The aim of this study was to compare differences in the nutritional quality of elementary packed lunches by the presence or absence of sugar-sweetened beverages (SSB), desserts, and fruits and vegetables (FVs). METHODS Observational data for prekindergarten and kindergarten packed lunches were collected from three schools in rural Virginia for 5 consecutive school days and analyzed for macro- and micronutrients and by the presence or absence of food and beverage items. RESULTS Of the 561 packed lunch observations collected, 41.7% contained no FV, 41.2% contained an SSB, and 61.1% contained a dessert. The nutrient profile of packed lunches with at least one fruit or vegetable had significantly higher levels of carbohydrate, fiber, sugar, vitamin A, and vitamin C. Packed lunches containing an SSB had significantly higher levels of sugar and vitamin C and significantly lower levels of protein, fiber, vitamin A, calcium, and iron. Packed lunches containing a dessert had significantly higher levels of energy, carbohydrate, fat, saturated fat, sodium, sugar, vitamin C, and iron and significantly lower levels of vitamin A. CONCLUSIONS Additional research is needed to fully understand parent and child motivations for packing lunches and the decision processes that influence the inclusion of food items. The development of packed lunch interventions, encouragement of National School Lunch Program participation, or enactment of school policies to increase the nutritional value of packed lunches is warranted.
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Affiliation(s)
- Alisha R Farris
- 1Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blackburg, VA
| | - Sarah Misyak
- 1Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blackburg, VA
| | - Kiyah J Duffey
- 1Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blackburg, VA
| | - Georgianna R Mann
- 1Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blackburg, VA
| | - George C Davis
- 2Department of Agricultural and Applied Economics, Virginia Tech, Blacksburg, VA
| | - Kathy Hosig
- 3Department of Population Health Sciences, Director, Center of Public Health Practice and Research, Virginia Tech, Blacksburg, VA
| | | | - Mary M McFerren
- 5Family Nutrition Program Project Director, Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA
| | - Elena L Serrano
- 1Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blackburg, VA
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Chen S, Zhu X, Welk GJ, Kim Y. Tracking energy balance in adolescents: Levels of compliance, energy flux, and learning. J Exerc Sci Fit 2015. [PMID: 29541097 DOI: 10.1016/j.jesf.2015.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background/Objective Advancing knowledge about energy balance (EB) is important for helping to reverse the obesity epidemic in many modern societies. This study examined adolescents' experience and perception of using an objective self-monitoring tool (SenseWear armband; SWA) and a portable diet journal to track EB for 7 days. Methods Forty-five 6th grade students in a midwestern state of the United States [Caucasian: n = 34, 76%; age: 11.7 ± 1.8 years; body mass index (BMI): 20.84 ± 3.94] participated in the study. The SWA, diet journal, and semistructured individual interview were used to measure energy expenditure (EE) and physical activity (PA), energy intake (EI), and perception of the experience, respectively. Mixed methods were used to analyze quantitative and qualitative data. Results It was found that the participants were physically active over the week (moderate-to-vigorous PA: 218.06 ± 26.50 minutes per day). Both SWA (% of wearing time: 85 ± 5%) and diet journal (days of using: 5.58 ± 2.15 days), especially the latter, were found to be under-used. A conceptual model depicting the adolescents' experience and perception was established based on the results. Conclusion The study indicates that the majority of adolescents were able to effectively use the SWA and the diet journal to track EB over time. Qualitative observations revealed that tracking EI and EE with these tools provided a valuable, experiential way for youth to learn about EB. The findings support the continued exploration of self-monitoring EB for promoting knowledge and awareness about EB among adolescents.
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Affiliation(s)
- Senlin Chen
- Department of Kinesiology, Iowa State University, Ames, IA, USA
| | - Xihe Zhu
- Department of Human Movement Sciences, Old Dominion University, Norfolk, VA, USA
| | - Gregory J Welk
- Department of Kinesiology, Iowa State University, Ames, IA, USA
| | - Youngwon Kim
- Department of Kinesiology, Iowa State University, Ames, IA, USA
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Abstract
Using data from the 1994-2008 National Longitudinal Study of Adult Health (Add Health), this research examines the relationship between residential mobility and weight gain over time among urban and non-urban young adults. It is theorized that changes in residence act as a barrier to achieving an active lifestyle, which would increase an individual's body mass index (BMI) over time. Relying on linear mixed-effects growth curve models, the results indicate that mobility is protective against weight gain over time after controlling for sociodemographic characteristics. For young adults who are residentially stable in urban neighborhoods, increases in physical activity are associated with a linear decline in BMI. In non-urban areas where respondents are residentially mobile, body weight does not fluctuate as sedentary behavior increases. However, in those areas, weight increases as sedentary behavior increases for those who did not move. Overall, the results suggest that the effect of mobility on weight gain is partially due to the kind of health behaviors that one engages in as well as whether or not one lives in an urban area. Policies geared toward relocating residents (such as Moving to Opportunity), and neighborhood processes that can lead individuals to change residences (such as foreclosures or gentrification) may have adverse health effects depending on whether they are occurring in urban or non-urban areas.
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Affiliation(s)
- Antwan Jones
- The George Washington University, Washington, DC, USA,
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49
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Kindergarten food familiarization. An exploratory study of teachers' perspectives on food and nutrition in kindergartens. Appetite 2015; 87:46-55. [DOI: 10.1016/j.appet.2014.12.200] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 12/07/2014] [Accepted: 12/09/2014] [Indexed: 11/20/2022]
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50
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Foltz JL, Belay B, Dooyema CA, Williams N, Blanck HM. Childhood Obesity Research Demonstration (CORD): the cross-site overview and opportunities for interventions addressing obesity community-wide. Child Obes 2015; 11:4-10. [PMID: 25679059 PMCID: PMC4322789 DOI: 10.1089/chi.2014.0159] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND This is the first of a set of articles in this issue on the Childhood Obesity Research Demonstration (CORD) project and provides an overview of the multisite approach and community-wide interventions. Innovative multisetting, multilevel approaches that integrate primary healthcare and public health interventions to improve outcomes for children with obesity need to be evaluated. The CORD project aims to improve BMI and obesity-related behaviors among underserved 2- to 12-year-old children by utilizing these approaches. METHODS The CORD consortium, structure, model terminology and key components, and common measures were solidified in year 1 of the CORD project. Demonstration sites applied the CORD model across communities in years 2 and 3. Evaluation plans for year 4 include site-specific analyses as well as cross-site impact, process, and sustainability evaluations. RESULTS The CORD approach resulted in commonalities and differences in participant, intervention, comparison, and outcome elements across sites. Products are to include analytic results as well as cost assessment, lessons learned, tools, and materials. DISCUSSION Foreseen opportunities and challenges arise from the similarities and unique aspects across sites. Communities adapted interventions to fit their local context and build on strengths, but, in turn, this flexibility makes cross-site evaluation challenging. CONCLUSION The CORD project represents an evidence-based approach that integrates primary care and public health strategies and evaluates multisetting multilevel interventions, thus adding to the limited research in this field. CORD products will be disseminated to a variety of stakeholders to aid the understanding, prevention, and management of childhood obesity.
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Affiliation(s)
- Jennifer L. Foltz
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
- U.S. Public Health Service Commissioned Corps, Atlanta, GA
| | - Brook Belay
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Carrie A. Dooyema
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Nancy Williams
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
- U.S. Public Health Service Commissioned Corps, Atlanta, GA
| | - Heidi M. Blanck
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
- U.S. Public Health Service Commissioned Corps, Atlanta, GA
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