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Dakin M, Manneville F, Langlois J, Briançon S, Lecomte E, Spitz E, Legrand K, Böhme P, Guillemin F, Omorou A. Role of dietary intake and physical activity in reducing weight social inequalities among adolescents: an application of G-formula to PRALIMAP-INÈS trial. Br J Nutr 2024:1-10. [PMID: 38800976 DOI: 10.1017/s0007114524001090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Interventions aiming to reduce social inequalities of weight status in adolescents usually focus on lifestyle behaviours, but their effectiveness is limited. This study analysed the effect of achieving levels of dietary intake (DI) and/or physical activity (PA) guidelines on reducing social inequalities in weight status among adolescents. We included adolescents from the PRomotion de l'ALIMentation et de l'Activité Physique - INÉgalité de Santé (PRALIMAP-INÈS) trial with weight status data available at baseline and 1-year follow-up (n 1130). PA and DI were measured using the International Physical Activity Questionnaire and a validated FFQ, respectively. We estimated the likelihood of a 1-year reduction in BMI z-score (BMIz) and population risk difference (PRD) under hypothetical DI and PA levels and socio-economic status using the parametric G-formula. When advantaged and less advantaged adolescents maintained their baseline DI and PA, we found social inequalities in weight status, with a PRD of a 1-year reduction in BMIz of -1·6 % (-3·0 %, -0·5 %). These inequalities were not observed when less advantaged adolescents increased their proportion of achieving DI guidelines by 30 % (PRD = 2·2 % (-0·5 %, 5·0 %)) unlike the same increase in PA (PRD = -3·9 % (-6·8 %, -1·3 %)). Finally, social inequalities of weight status were not observed when levels of achievement of both PA and DI guidelines increased by 30 % (PRD = 2·2 % (-0·5 %, 4·0 %)). Enhancing DI rather than PA could be effective in reducing social inequalities in weight status among adolescents. Future interventions aiming to reduce these inequalities should mostly target DI to be effective.
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Affiliation(s)
- Mohamed Dakin
- Inserm, UMR 1319 INSPIIRE, Université de Lorraine, Nancy, Metz, France
| | - Florian Manneville
- Inserm, UMR 1319 INSPIIRE, Université de Lorraine, Nancy, Metz, France
- Inserm, CHRU Nancy, Université de Lorraine, CIC-Clinical Epidemiology, Nancy F-54000, France
| | - Johanne Langlois
- Conservatoire National des Arts et Métiers - Institut scientifique et technique de la nutrition et de l'alimentation (Cnam-ISTNA), Nancy, France
| | - Serge Briançon
- Inserm, UMR 1319 INSPIIRE, Université de Lorraine, Nancy, Metz, France
| | - Edith Lecomte
- Conservatoire National des Arts et Métiers - Institut scientifique et technique de la nutrition et de l'alimentation (Cnam-ISTNA), Nancy, France
| | - Elisabeth Spitz
- Inserm, UMR 1319 INSPIIRE, Université de Lorraine, Nancy, Metz, France
| | - Karine Legrand
- Inserm, UMR 1319 INSPIIRE, Université de Lorraine, Nancy, Metz, France
- Inserm, CHRU Nancy, Université de Lorraine, CIC-Clinical Epidemiology, Nancy F-54000, France
| | - Philip Böhme
- Service d'endocrinologie, diabétologie et nutrition, CHRU Nancy, Nancy, F-54000, France
| | - Francis Guillemin
- Inserm, UMR 1319 INSPIIRE, Université de Lorraine, Nancy, Metz, France
- Inserm, CHRU Nancy, Université de Lorraine, CIC-Clinical Epidemiology, Nancy F-54000, France
| | - Abdou Omorou
- Inserm, UMR 1319 INSPIIRE, Université de Lorraine, Nancy, Metz, France
- Inserm, CHRU Nancy, Université de Lorraine, CIC-Clinical Epidemiology, Nancy F-54000, France
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Pearson N, Griffiths P, van Sluijs E, Atkin AJ, Khunti K, Sherar LB. Associations between socioeconomic position and young people's physical activity and sedentary behaviour in the UK: a scoping review. BMJ Open 2022; 12:e051736. [PMID: 35501089 PMCID: PMC9062792 DOI: 10.1136/bmjopen-2021-051736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 04/16/2022] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE To examine the evidence on the associations between socioeconomic position and young people's physical activity and sedentary behaviours in the UK. DESIGN Scoping review. DATA SOURCES PubMed, SCOPUS and Web of Science databases were searched for articles published up to and including January 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Observational studies in children and adolescents (aged 5-18 years) from the UK that had assessed associations between at least one indicator of socioeconomic position and at least one outcome of physical activity and/or sedentary behaviour. DATA EXTRACTION AND SYNTHESIS Data were extracted by one reviewer and 20% were double checked. Indicators of socioeconomic position were tabulated with domains of physical activity and sedentary behaviour. RESULTS Fifty-seven publications were included in the review; 37 publications from 19 studies (k=23) of children and 21 publications from 15 studies (k=23) of adolescents. Most studies were cross-sectional. 63% of studies of children, and 40% of studies of adolescents assessed Index of Multiple Deprivation. Eighteen studies measured physical activity in children, 13 measured sedentary behaviour. Eleven studies of adolescents included a measure of physical activity, 10 included a measure of sedentary behaviour. Among children and adolescents, the association between socioeconomic position and measures of either physical activity or sedentary behaviour was highly variable depending on the measure of both socioeconomic position used and the behavioural outcome, with the exception of higher family affluence which was consistently associated with higher reported physical activity among adolescents. CONCLUSION Physical activity and sedentary behaviours of children and adolescents in the UK are complex and influenced by multiple indicators of socioeconomic position that are, in most cases, different across age stages, outcomes examined and measurement tools. Greater consistency in the use and measures of socioeconomic position as well as outcomes of behaviour are required for robust country-specific meta-analyses.
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Affiliation(s)
- Natalie Pearson
- School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, UK
| | - Paula Griffiths
- School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, UK
| | | | - Andrew J Atkin
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Lauren B Sherar
- School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, UK
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Russell SJ, Hope S, Croker H, Crozier S, Packer J, Inskip H, Viner RM. Modeling the impact of calorie-reduction interventions on population prevalence and inequalities in childhood obesity in the Southampton Women's Survey. Obes Sci Pract 2021; 7:545-554. [PMID: 34631133 PMCID: PMC8488449 DOI: 10.1002/osp4.520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/26/2021] [Accepted: 05/02/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND In the United Kingdom, rates of childhood obesity are high and inequalities in obesity have widened in recent years. Children with obesity face heightened risks of living with obesity as adults and suffering from associated morbidities. Addressing population prevalence and inequalities in childhood obesity is a key priority for public health policymakers in the United Kingdom and elsewhere. Where randomized controlled trials are not possible, potential policy actions can be simulated using causal modeling techniques. OBJECTIVES Using data from the Southampton Women's Survey (SWS), a cohort with high quality dietary and lifestyle data, the potential impact of policy-relevant calorie-reduction interventions on population prevalence and inequalities of childhood obesity was investigated. METHODS Predicted probabilities of obesity (using UK90 cut-offs) at age 6-7 years were estimated from logistic marginal structural models adjusting for observed calorie consumption at age 3 years (using food diaries) and confounding. A series of policy-relevant intervention scenarios were modeled to simulate reductions in energy intake (differing in effectiveness, the targeting mechanisms, and level of uptake). RESULTS At age 6-7 years, 8.3% of children were living with obesity, after accounting for observed energy intake and confounding. A universal intervention to lower median energy intake to the estimated average requirement (a 13% decrease), with an uptake of 75%, reduced obesity prevalence by 1% but relative and absolute inequalities remained broadly unchanged. CONCLUSIONS Simulated interventions substantially reduced population prevalence of obesity, which may be useful in informing policymakers.
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Affiliation(s)
- Simon J. Russell
- Obesity Policy Research UnitPopulation, Policy and PracticeGreat Ormond Street Institute of Child HealthUniversity College LondonLondonUK
| | - Steven Hope
- Obesity Policy Research UnitPopulation, Policy and PracticeGreat Ormond Street Institute of Child HealthUniversity College LondonLondonUK
| | - Helen Croker
- Obesity Policy Research UnitPopulation, Policy and PracticeGreat Ormond Street Institute of Child HealthUniversity College LondonLondonUK
| | - Sarah Crozier
- MRC Lifecourse Epidemiology UnitMedicineUniversity of SouthamptonSouthamptonUK
- NIHR Applied Research Collaboration WessexSouthampton Science ParkInnovation CentreSouthamptonUK
| | - Jessica Packer
- Obesity Policy Research UnitPopulation, Policy and PracticeGreat Ormond Street Institute of Child HealthUniversity College LondonLondonUK
| | - Hazel Inskip
- MRC Lifecourse Epidemiology UnitMedicineUniversity of SouthamptonSouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Russell M. Viner
- Obesity Policy Research UnitPopulation, Policy and PracticeGreat Ormond Street Institute of Child HealthUniversity College LondonLondonUK
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Hope S, Pearce A, Cortina-Borja M, Chittleborough C, Barlow J, Law C. Modelling the potential for parenting skills interventions to reduce inequalities and population prevalence of children's mental health problems: Evidence from the Millennium Cohort Study. SSM Popul Health 2021; 14:100817. [PMID: 34169135 PMCID: PMC8209401 DOI: 10.1016/j.ssmph.2021.100817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 03/30/2021] [Accepted: 05/08/2021] [Indexed: 12/03/2022] Open
Abstract
Parenting programmes can improve parenting quality and, in turn, children's mental health. If scaled-up, they have the potential to reduce population inequalities and prevalence in child mental health problems (MHP). However, this cannot be investigated with trials. Using data from the UK Millennium Cohort Study (18,000 children born 2000-2002), we simulated population impact of scale-up of seven parenting programmes. Predicted probabilities of child MHP (Strengths and Difficulties Questionnaire) by household income quintile (Risk ratios [RRs] and differences [RDs], 95% confidence intervals [CI]) were estimated from logistic marginal structural models, adjusting for parenting quality scores (Child-Parent Relationship Scale at 3 years) and confounders. The impact of scaling-up parenting programmes was simulated by re-estimating predicted probabilities of child MHP after increasing parenting scores according to intervention intensity, targeting mechanisms and programme uptake levels. Analyses included data from 14,399 children, with survey weights and multiple imputation addressing sampling design, attrition and item missingness. Prevalence of child MHP at 5 years was 11.3% (11.4% unadjusted), with relative and absolute income inequalities (RR = 4.8[95%CI:3.6-5.9]; RD = 15.8%[13.4-18.2]). In simulations, universal, non-intensive parenting programmes reduced prevalence (9.4%) and absolute inequalities (RR = 5.0[95%CI:3.8-6.2]; RD = 13.6%[11.5-15.7]). Intensive programmes, targeting a range of potential risk criteria (e.g. receipt of means-tested benefits), reduced inequalities (RR = 4.0[95%CI:3.0-4.9]; RD = 12.4%[10.3-14.6] and, to a lesser extent, prevalence (10.3%). By simulating implementation of parenting programmes, we show that universal non-intensive and targeted intensive approaches have the potential to reduce child MHP at population level, and to reduce but not eliminate inequalities, with important implications for future policy and practice.
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Affiliation(s)
- Steven Hope
- UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Anna Pearce
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | | | | | - Jane Barlow
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
| | - Catherine Law
- UCL Great Ormond Street Institute of Child Health, London, United Kingdom
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Arciuli J, Emerson E. Type of disability, gender, and age affect school satisfaction: Findings from the UK Millennium Cohort Study. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2020; 90:870-885. [PMID: 32150645 PMCID: PMC7496611 DOI: 10.1111/bjep.12344] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 02/04/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Self-reported school satisfaction is an important indicator of child and adolescent well-being. Few studies have examined how disability, gender, and age affect school satisfaction. AIM We sought to determine whether the interaction between disability and gender with regard to self-reported school satisfaction might be specific to particular types of disability and particular ages. METHODS We undertook secondary analysis of Waves 5 and 6 of the UK's Millennium Cohort Study (MCS), a nationally representative sample of children born 2000-2002. MCS is the fourth in the series of British birth cohort studies. RESULT At 11 years of age (n = 12,207), school satisfaction was significantly higher for girls and those without disabilities. By contrast, at 14 (n = 10,933), school satisfaction was significantly higher for boys and those without disabilities. Subsequent analyses of gender moderation of the association between disability and school satisfaction revealed a significant interaction between gender and disabilities associated with mental health and with dexterity, respectively, at 14 years but not at age 11. CONCLUSION These findings will inform future research endeavours, policy, and practice in psychology, education, and other areas associated with child development and disability.
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Affiliation(s)
- Joanne Arciuli
- Centre for Disability Research and Policy, The University of Sydney, New South Wales, Australia
| | - Eric Emerson
- Centre for Disability Research and Policy, The University of Sydney, New South Wales, Australia.,Lancaster University, UK
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Mireku MO, Rodriguez A. Family Income Gradients in Adolescent Obesity, Overweight and Adiposity Persist in Extremely Deprived and Extremely Affluent Neighbourhoods but Not in Middle-Class Neighbourhoods: Evidence from the UK Millennium Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E418. [PMID: 31936305 PMCID: PMC7013671 DOI: 10.3390/ijerph17020418] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 01/03/2020] [Accepted: 01/04/2020] [Indexed: 01/22/2023]
Abstract
We investigated whether family income gradients in obesity, overweight, and adiposity persist at geographic-level deprivation quintiles using a nationally representative cohort of UK adolescents. Data from 11,714 eligible adolescents from the sixth sweep of the Millennium Cohort Study (14 years old) were analysed in this study. The International Obesity Task Force age- and sex-specific thresholds were used to define obesity and overweight. Self-reported family income was standardized using the Organisation for Economic Co-operation and Development (OECD)'s equivalised income scale. Geographic-level deprivation was defined by the index of multiple deprivation 2004. Results showed that the prevalence of obesity and overweight was 8.0% and 27.2%, respectively. Mean percentage body fat was 16.9% (standard error, SE = 0.2%) in male and 27.3% (SE = 0.1%) in female adolescents. Risk of obesity, overweight, and adiposity increased with decreasing family income quintiles (p for trend <0.001). After stratifying by geographic-level deprivation quintiles, a U-shaped association emerged, whereby family income gradients in the risk of adolescent obesity and adiposity persisted in extremely affluent and extremely deprived neighbourhoods but attenuated to non-significance in middle-class neighbourhoods. These results focus on the findings from England. Recognition of the persistence of inequalities in the risk of obesity in the most deprived and affluent neighbourhoods may be necessary in planning public health resources and interventions.
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Affiliation(s)
- Michael Osei Mireku
- School of Psychology, University of Lincoln, Lincoln LN6 7TS, UK
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, UK;
| | - Alina Rodriguez
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, UK;
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Chigogora S, Pearce A, Law C, Viner R, Chittleborough C, Griffiths LJ, Hope S. Could Greater Physical Activity Reduce Population Prevalence and Socioeconomic Inequalities in Children's Mental Health Problems? A Policy Simulation. Epidemiology 2020; 31:115-125. [PMID: 31789939 PMCID: PMC6889907 DOI: 10.1097/ede.0000000000001113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 09/26/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND One in four children 5-16 years (y) of age shows signs of mental health problems in the United Kingdom; risk is higher in economically disadvantaged groups. Greater physical activity is associated with lower risk of internalizing problems such as depression and anxiety. We simulated the potential impact of population-wide physical activity interventions on overall prevalence of internalizing problems, and by family income. Interventions were based on the World Health Organization (WHO) children's target of 60 minutes (min) of moderate-to-vigorous physical activity per day and trial evidence. METHODS Data were from the UK Millennium Cohort Study, a population-representative cohort of children born in 2000-2002. Household income (5 y) was the exposure; internalizing problems (outcome) were measured using the Strengths and Difficulties Questionnaire (11 y). Of 18,296 singletons, 6,497 had accelerometer physical activity data (mediator, manipulated to simulate interventions) at 7 y. We predicted probabilities of outcome according to exposure in marginal structural models, weighted for attrition and confounding, and adjusted for observed mediator. We then re-estimated probabilities in different physical activity intervention scenarios, assessing income inequalities in internalizing problems with risk ratios (RRs) and differences (RDs) according to income quintile. RESULTS Simulating universal achievement of the WHO target led to little change in prevalence (10% [95% CI = 8%, 12%]) and socioeconomic inequalities in internalizing problems; RR: 2.2 (1.1, 3.4); RD: 8% [5%,13%]). More modest increases in physical activity achieved weaker results. CONCLUSIONS Our simulations suggest that large increases in moderate-to-vigorous physical activity in the United Kingdom would have little effect on prevalence and inequalities in child mental health problems.
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Affiliation(s)
- Sungano Chigogora
- From the Population, Policy and Practice Programme, Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Anna Pearce
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Catherine Law
- From the Population, Policy and Practice Programme, Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Russell Viner
- From the Population, Policy and Practice Programme, Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Catherine Chittleborough
- School of Public Health, Robinson Research Institute, The University of Adelaide, Adelaide Health and Medical Sciences Building, South Australia, Australia
| | - Lucy J. Griffiths
- Health Data Research UK, Wales and Northern Ireland, Swansea University Medical School, Wales, United Kingdom
| | - Steven Hope
- From the Population, Policy and Practice Programme, Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
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Tyler R, Mackintosh KA, Spacey HL, Stratton G. A cross-sectional study on the deprivation and sex differences in health-related fitness measures in school children. J Sports Sci 2019; 38:70-78. [PMID: 31631780 DOI: 10.1080/02640414.2019.1681230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This study aimed to investigate deprivation and sex differences in selected health-relatedfitness measures in 9-12-year-old children. Data were captured on 3,407 children (49.3% boys; aged 10.5 ± 0.6 years). Cardiorespiratory fitness(20 m multistage shuttle run test; 20 m MSRT), muscular strength (handgrip strength) and body mass index (BMI) were measured. Welsh Index of Multiple Deprivation (WIMD) scores were used to make quintile groups. A two-way Analysis of Variance examined differences in BMI z-score by sex and WIMD quintiles. Two-wayAnalysis of Covariances investigated the effect of sex and WIMD quintiles on grip strength and shuttles achieved in 20 m MSRT, adjusting for BMI z-score and maturation, repectively. Independent of sex, children in the middle quintile had a significantly higher mean BMI z-score (p = 0.029) than their least deprived counterparts. There was a significant increase in grip strength (p = 0.005) and20 m MSRT (boys p < 0.001; girls p = 0.028) between most and least deprived quintiles. Significant differences in 20 m MSRT score were more apparent with decreases in deprivation in boys.Overall, inequalities exist in health-related fitness by sex and deprivation. These results can be used to inform focused services to improve current and future health.
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Affiliation(s)
- Richard Tyler
- Sport and Physical Activity Department, Edge Hill University, Ormskirk, UK
| | - Kelly A Mackintosh
- Applied Sports Technology Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Swansea University, Swansea, UK
| | - Hannah L Spacey
- Applied Sports Technology Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Swansea University, Swansea, UK
| | - Gareth Stratton
- Applied Sports Technology Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Swansea University, Swansea, UK
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