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Cristi-Montero C, Martínez-Flores R, Porras F, Sadarangani KP, Ferrari G, Aguilar-Farias N, Silva ICM, Reyes-Amigo T, Rodriguez-Rodriguez F. A comparative study between traditional and sports school uniforms on cardiorespiratory and muscular fitness and waist-height-to-ratio in adolescents. Front Public Health 2023; 11:1213403. [PMID: 37457263 PMCID: PMC10349179 DOI: 10.3389/fpubh.2023.1213403] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 06/12/2023] [Indexed: 07/18/2023] Open
Abstract
Background Improving health of children and adolescents is crucial for their overall development. Therefore, it is essential to explore factors that may influence their health at both the public health and school system levels. Objective This study compares physical fitness components and waist-height-to-ratio (WHtR) in adolescents according to school uniforms, namely the traditional uniform (i.e., shirt and school necktie in boys and skirt and blouse in girls) and the sports uniform (i.e., polo shirts or t-shirts and sport or short trousers). Additionally, it seeks to investigate potential differences in these measures based on sex and school type (i.e., public, subsidized, and private). Methods This cross-sectional study used data from the Chilean national learning outcome assessment system (SIMCE)-2014 and involved 8,030 adolescents. Cardiorespiratory fitness (CRF) and muscular fitness (MF) were measured. WHtR was assessed as a health cardiovascular indicator. Mixed models and ANCOVA were performed to compare uniform types, adjusting for multiple covariates. value of p and effect size (ES) was used to establish significant results. Results Overall, sports uniforms (SU) were linked to higher CRF (p < 0.001) than the traditional uniform (TU). Boys from private schools wearing SU presented higher CRF (p = 0.016; ES = 0.37), and a positive trend was observed for MF (p = 0.645; ES = 0.21). In subsidized, a trend was found in CRF (p = 0.005; ES = 0.16). Girls wearing SU from private schools showed a positive trend in CRF (p = 0.167; ES = 0.28). Trends in WHtR were found in both sexes from private (p = 0.555; ES = 0.24; p = 0.444; ES = 0.25, respectively). Conclusion Wearing SU seems a promissory alternative to promote healthy physical fitness and body composition at the educational level. However, the relationship between higher physical activity and CRF, MF, and lower WHtR due to SU must be verified. Finally, when deciding to implement this measure, special attention must be paid to boys from public schools and girls from all types of schools.
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Affiliation(s)
- Carlos Cristi-Montero
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Ricardo Martínez-Flores
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Felipe Porras
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Kabir P. Sadarangani
- Escuela de Kinesiología, Facultad de Salud y Odontología, Universidad Diego Portales, Santiago, Chile
- Universidad Autónoma de Chile, Santiago, Chile
| | - Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago, Chile
| | - Nicolas Aguilar-Farias
- Department of Physical Education, Sports, and Recreation, Universidad de La Frontera, Temuco, Chile
| | - Inacio Crochemore M. Silva
- Escola Superiorde Educação Física, Programa de Pós Graduação emEducação Física, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Tomas Reyes-Amigo
- Observatório de Ciencias de la Actividad Física, Departamemto de Ciencias de la Actividad Física, Universidad de Playa Ancha, Valparaiso, Chile
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Mohd Saat NZ, Abd Talib R, Alarsan SF, Saadeh N, Shahrour G. Risk Factors of Overweight and Obesity Among School Children Aged 6 to 18 Years: A Scoping Review. NUTRITION AND DIETARY SUPPLEMENTS 2023; Volume 15:63-76. [DOI: 10.2147/nds.s420370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
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Nevill AM, Reuter CP, Brand C, Gaya AR, Mota J, Pollo Renner JD, Duncan MJ. Choose Where You Live Carefully: Built Environment Differences in Children's Cardiorespiratory Fitness and Cardiometabolic Risk. Sports (Basel) 2021; 9:sports9020031. [PMID: 33669931 PMCID: PMC7924861 DOI: 10.3390/sports9020031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/15/2021] [Accepted: 02/17/2021] [Indexed: 11/16/2022] Open
Abstract
Information regarding urban-rural differences in health indicators are scarce in Brazil. This study sought to identify rural-urban differences in cardiorespiratory fitness (CRF) and cardiometabolic risk (CMR) in Brazilian children and adolescents whilst controlling for the important confounding variables including social economic status (SES). This is a cross-sectional study developed with children and adolescents (n = 2250, age 11.54 ± 2.76) selected from a city in the south of Brazil. CRF was estimated using a 6-minute run/walk test. CMR scores were calculated by summing different cardiometabolic risk indicators. CRF was analysed assuming a multiplicative model with allometric body-size components. CMR differences in residential locations was assessed using Analysis of caovariance (ANCOVA) adopting SES, Body Mass Index (BMI), waist circumference (WC), age and fitness as covariates. Results indicated a main effect of location (p < 0.001) with children living a rural environment having the highest CRF, and children living in the periphery of towns having the lowest. Analysis also revealed significant main effects of location (p < 0.001) with children living a rural environment having the lowest CMR and children living in the centre of towns having the highest. Therefore, Brazilian children living in a rural environment appear to have superior health benefits.
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Affiliation(s)
- Alan M. Nevill
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Walsall WS1 3EZ, UK;
| | - Cézane Priscila Reuter
- Graduate Program in Health Promotion, University of Santa Cruz do Sul, 96816-501 Santa Cruz do Sul/RS, Brazil; (C.P.R.); (C.B.); (J.D.P.R.)
| | - Caroline Brand
- Graduate Program in Health Promotion, University of Santa Cruz do Sul, 96816-501 Santa Cruz do Sul/RS, Brazil; (C.P.R.); (C.B.); (J.D.P.R.)
| | - Anelise Reis Gaya
- School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, 90690-200 Porto Alegre/RS, Brazil;
| | - Jorge Mota
- Faculty of Sport, University of Porto, 4099-002 Porto, Portugal;
| | - Jane Dagmar Pollo Renner
- Graduate Program in Health Promotion, University of Santa Cruz do Sul, 96816-501 Santa Cruz do Sul/RS, Brazil; (C.P.R.); (C.B.); (J.D.P.R.)
| | - Michael J. Duncan
- Sport, Exercise and Life Sciences Research Centre, Coventry University, Coventry CV1 5FB, UK
- Correspondence: ; Tel.: +44-2476887688
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How Does the Family Influence the Physical Condition and Health of Children in a Rural Environment? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134622. [PMID: 32605025 PMCID: PMC7369752 DOI: 10.3390/ijerph17134622] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/17/2020] [Accepted: 06/24/2020] [Indexed: 01/17/2023]
Abstract
The aim of this cross-sectional study was to assess physical conditions related to health status and establish relationships with influencing factors such as family structure, educational level, and parental professional occupation in the infant stage of three to five years in a rural setting. The sample included 205 children between 3 and 5 years of age from rural areas (<10,000 inhabitants) from the region of Castilla-La Mancha (Spain). Fitness level was measured using the PREFIT battery; influencing factors were assessed with a family information questionnaire. The results showed significant differences in all the analyzed variables of physical condition and between genders at each of the educational levels except for body mass index. Boys performed better than girls on cardio-respiratory fitness tests, muscle strength in both hands, speed-agility, and longitudinal jump tests for boys aged three, while girls performed the test better at four years. The type of family structure was not correlated with any of the variables of physical condition; a lower level of education of the father and mother and the professional occupation of the mother were correlated with a higher body mass index. As a main conclusion, physical condition related to health seems to be affected by influencing factors such as educational level and family professional occupation, especially of the mother, but the type of family structure does not have as much influence. There are few studies in children from three to five years of age in exclusively rural areas, so the data in this study provides relevant and innovative information, while opening research to cater to this population group.
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Rajbhandari-Thapa J, Ingels J, Thapa K, Davis M, Corso P. Longitudinal evaluation of the impact of school characteristics on changes in physical activity opportunities. PLoS One 2020; 15:e0228716. [PMID: 32027725 PMCID: PMC7004365 DOI: 10.1371/journal.pone.0228716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 01/22/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Even as many states adopt physical activity policies to promote physical activity and prevent childhood obesity, little is known about differences in policy implementation based on school characteristics. We studied association of school characteristics and changes in physical activity opportunities at the school level during the implementation of a statewide physical activity policy in the state of Georgia. METHODS A web-based school survey was administered to elementary schools at two time points (before and during policy execution). Matched respondents (289 classroom teachers, 234 administrators) reported the frequency and duration of recess and integrated physical activity time. We used paired t-test to assess changes in physical activity opportunities and chi-square tests to assess the association of change in physical activity opportunities with school characteristics. We then constructed a multiple linear regression model following a change score method to identify school-level factors that predict the magnitude of change in physical activity opportunities. RESULTS There was an overall significant increase in total physical activity opportunities across time; however, schools with higher poverty showed a decrease in physical activity time by 5.3 minutes per day (95% CI: -9.2, -1.3). Further, the changes in physical activity time for schools in suburban Georgia were smaller (-5.7, 95% CI: -9.5, -1.9) compared to schools located in towns. CONCLUSIONS The change in physical activity opportunities was not the same across schools and school characteristics predicted the magnitude of change. Additional efforts at the local level might be needed for equitable policy implementation based on schools' geographical location and poverty level of the student population.
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Affiliation(s)
- Janani Rajbhandari-Thapa
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, United States of America
- * E-mail:
| | - Justin Ingels
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, United States of America
| | - Kiran Thapa
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, United States of America
| | - Marsha Davis
- Department of Health Promotion and Behavior, College of Public Health, University of Georgia, Athens, GA, United States of America
| | - Phaedra Corso
- Kennesaw State University, Kennesaw, GA, United States of America
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Coyne P, Vandenborn E, Santarossa S, Milne MM, Milne KJ, Woodruff SJ. Physical literacy improves with the Run Jump Throw Wheel program among students in grades 4-6 in southwestern Ontario. Appl Physiol Nutr Metab 2019; 44:645-649. [PMID: 31032623 DOI: 10.1139/apnm-2018-0495] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this study was to determine whether the introduction of a fundamental movement skills (FMS) program to grade 4-6 physical education (PE) classes could improve students' physical literacy (PL) and influence the amount of effort exerted in PE class. Athletics Canada's grassroots Run Jump Throw Wheel (RJTW) Program was delivered for 10 weeks during PE classes (2 schools: four grade 4, four grade 5, two grade 6, one split grade 5-6 class, and one split grade 6-7 class, totalling 310 students). Participants completed the Canadian Assessment of Physical Literacy (CAPL) and wore heart rate monitors and pre- and postintervention. The CAPL score increased 3.3 (±8.8) points from the pretest to the post-test (t = 6.47, p < 0.001). Improvements were not significantly different by grade or gender, but those in the suburban-area school improved more so than those attending the rural-area school (F[1,294] = 4.82, p < 0.004). Among those participants that increased their PL (n = 186), the CAPL scores increased by 8.6 (±5.9) points versus those that decreased (n = 110; -5.6 ± 4.8 points), F[1,294] = 452.11, p < 0.001. No significant differences in time spent in physical activity were observed between the pre- and post-test (i.e., 17.0 ± 7.0 min and 19.3 ± 7.0 min, respectively, t = 1.70, p = 0.091). The RJTW program increased participants' overall FMS, as well as their knowledge and understanding regarding these FMS, both key components of PL.
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Affiliation(s)
- Paige Coyne
- Faculty of Human Kinetics, University of Windsor, Windsor, Ontario, Canada
| | | | - Sara Santarossa
- Faculty of Human Kinetics, University of Windsor, Windsor, Ontario, Canada
| | - Marcia M Milne
- Faculty of Human Kinetics, University of Windsor, Windsor, Ontario, Canada
| | - Kevin J Milne
- Faculty of Human Kinetics, University of Windsor, Windsor, Ontario, Canada
| | - Sarah J Woodruff
- Faculty of Human Kinetics, University of Windsor, Windsor, Ontario, Canada
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Acton RB, Nguyen N, Minaker LM. School Food Policies and Student Eating Behaviors in Canada: Examination of the 2015 Cancer Risk Assessment in Youth Survey. THE JOURNAL OF SCHOOL HEALTH 2018; 88:936-944. [PMID: 30392189 DOI: 10.1111/josh.12702] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 01/11/2018] [Accepted: 07/05/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Limited evidence exists on effects of school-based nutrition policies. This study explored the influence of mandatory versus voluntary provincial school nutrition policies on student eating behaviors. METHODS A cross-sectional, school-based survey assessed student eating behaviors using self-report survey measures in a representative sample of Canadian high school students from 7 provinces (N = 12,110). Provincial school nutrition policies were characterized as mandatory or voluntary. Healthful and nonhealthful eating behaviors were analyzed across sociodemographic characteristics. Regression models were used to assess the association between policy type and eating behaviors, and to explore potential moderating variables. RESULTS Healthful and nonhealthful eating behaviors differed significantly across several sociodemographic characteristics. Overall, neither healthful nor nonhealthful eating behaviors differed significantly between schools with voluntary and mandatory nutrition policies (odds ratio [OR] = 0.83, 95% confidence interval [CI] 0.64-1.08; OR = 1.16, 95% CI 0.83-1.64). Frequency of buying lunch at school and buying lunch out moderated the association between policy enforcement level and healthful eating behaviors (p = .0472, p = .0119). Frequency of buying lunch out moderated the association between policy enforcement levels and nonhealthful eating behaviors (p = .0009). CONCLUSIONS This study documents nonhealthful components of Canadian adolescents' diets, and the results highlight important areas for future research in assessing the effectiveness of school nutrition policies.
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Affiliation(s)
- Rachel B Acton
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue, Waterloo, ON N2L 3G1, Canada
| | - Nghia Nguyen
- Propel Centre for Population Health Impact, Faculty of Applied Health Sciences, University of Waterloo, 200 University Avenue, Waterloo, ON N2L 3G1, Canada
| | - Leia M Minaker
- School of Planning, University of Waterloo, 200 University Avenue, Waterloo, Ontario N2L 3G1, Canada
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Kehm R, Davey CS, Kubik MY, Nanney MS. A comparison of the vending environment among three rural subtypes of secondary schools. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2018; 13:58-69. [PMID: 29479393 DOI: 10.1080/19320248.2015.1095147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The purpose of this study was to further explore the rural school food environment. This study assessed trends in prevalence of vending machines and vending items within and between Minnesota schools located in 3 rural subtypes: town/rural fringe, town/rural distant, and remote rural. Generalized estimating equation models were employed to analyze data from the 2006 through 2012 School Health Profiles Principal's Surveys (Profiles). All 3 rural subtypes had a statistically significant decrease in the prevalence of low nutrient energy dense (LNED) vending items between 2006 and 2012, with the exception of sports drinks. However, different vending practices were observed between rural subtypes, with town/rural fringe schools providing more LNED vending options and experiencing less positive change over time compared to town/rural distant and remote rural schools. Differences in vending machine practices emerge when rural schools are subtyped.
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Affiliation(s)
- Rebecca Kehm
- Division of Epidemiology & Community Health, University of Minnesota, 1300 S 2 St., Minneapolis MN, 515-771-1987
| | - Cynthia S Davey
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute University of Minnesota, Minneapolis, MN
| | - Martha Y Kubik
- School of Nursing, University of Minnesota, Minneapolis, MN
| | - Marilyn S Nanney
- Family Medicine and Community Health, University of Minnesota, Minneapolis, MN
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Abstract
Rural residents are less physically active than their urban counterparts and disproportionately affected by chronic diseases and conditions associated with insufficient activity. While the ecological model has been successful in promoting and translating active living research in urban settings, relatively little research has been conducted in rural settings. The resulting research gap prohibits a comprehensive understanding and application of solutions for active living in rural America. Therefore, the purpose of this article was to assess the evidence base for an ecological model of active living for rural populations and outline key scientific gaps that inhibit the development and application of solutions. Specifically, we reexamined the 4 domains conceptualized by the model and suggest that there is a dearth of research specific to rural communities across all areas of the framework. Considering the limited rural-specific efforts, we propose areas that need addressing to mobilize rural active living researchers and practitioners into action.
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Dietary Habits and Eating Practices and Their Association with Overweight and Obesity in Rural and Urban Black South African Adolescents. Nutrients 2018; 10:nu10020145. [PMID: 29382137 PMCID: PMC5852721 DOI: 10.3390/nu10020145] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 01/03/2018] [Accepted: 01/04/2018] [Indexed: 12/15/2022] Open
Abstract
The aim of this study was to investigate differences/similarities in dietary habits and eating practices between younger and older, rural and urban South African adolescents in specific environments (home, community and school) and their associations with overweight and obesity. Dietary habits, eating practices, and anthropometric measurements were performed on rural (n = 392, mean age = 13 years) and urban (n = 3098, mean age = 14 years) adolescents. Logistic regression analysis was used to examine the associations between dietary habits and eating practices, with overweight and obesity risk. Differences in dietary habits and eating practices by gender and by site within the three environments were identified. After adjusting for gender, site, dietary habits, and eating practices within the home, community and school environment, eating the main meal with family some days (OR = 1.78, 95% CI = 1.114-2.835; p ≤ 0.02), eating the main meal with family almost every day (OR = 1.61, 95% CI = 1.106-2.343; p ≤ 0.01), and irregular frequency of consuming breakfast on weekdays (OR = 1.38, 95% CI = 1.007-1.896; p ≤ 0.05) were all associated with increased risk of overweight and obesity. For "Year 15" adolescents, irregular frequency of consuming breakfast on weekends within the home environment (OR = 1.53, 95% CI = 1.099-2.129, p ≤ 0.01), was associated with increased risk of overweight and obesity. For both early- and mid-adolescents, being male (OR = 0.401, 95% CI = 0.299-0.537; p ≤ 0.00; OR = 0.29, 95% CI = 0.218-0.397; p ≤ 0.00) was associated with reduced risk of overweight and obesity, while residing in a rural setting (OR = 0.55, 95% CI = 0.324-0.924; p ≤ 0.02) was associated with reduced risk of overweight and obesity only among early-adolescents. Only dietary habits and eating practices within the home environment were associated with increased risk of overweight and obesity.
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Silva DAS, Petroski EL, Gaya ACA. SECULAR CHANGES IN AEROBIC FITNESS LEVELS IN BRAZILIAN CHILDREN. REV BRAS MED ESPORTE 2017. [DOI: 10.1590/1517-869220172306150424] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Introduction: Aerobic fitness is a component of physical fitness related to health and has great importance in the prevention of cardiovascular diseases. Objective: To verify the secular changes in aerobic fitness levels and to identify factors over a decade related to low levels of aerobic fitness in Brazilian children. Methods: This secular change study was carried out from 1999 to 2010 with 11,083 children aged from six to nine years, of both sexes, living in all regions of Brazil. The aerobic fitness was assessed by the 9-minute run test. The independent variables were sex, age, geographic region, area of residence, and nutritional status. The “t” test was used for independent samples and analysis of variance, chi-square test, and Poisson regression were used to estimate prevalence ratio (PR) and confidence intervals of 95% (CI 95%). Results: No significant changes in the distance covered in the 9-minute run test and in the prevalence of low levels of aerobic fitness were observed from 1999 to 2010. The population subgroups most likely to have low aerobic fitness levels were students aged seven years, those in the Midwestern, Southeast, and South of Brazil, those living in rural areas and those with overweight and obesity. Conclusions: Over a decade, low levels of aerobic fitness were present in four fifths of Brazilian children and this picture did not change. Low levels of aerobic fitness affected more children above six years old, living in the economically most favored regions of Brazil, in rural areas and with overweight.
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Lilly CL, Umer A, Cottrell L, Pyles L, Neal W. Examination of cardiovascular risk factors and rurality in Appalachian children. Rural Remote Health 2017; 17:4200. [PMID: 28320207 DOI: 10.22605/rrh4200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTOIN The prevalence of childhood cardiovascular disease (CVD) risk factors often increases in more rural geographic regions in the USA. However, research on the topic often has conflicting results. Researchers note differences in definitions of rurality and other factors that would lead to differences in inference, including appropriate use of statistical clustering analysis, representative data, and inclusion of individual-level covariates. The present study's objective was to examine CVD risk factors during childhood by geographic distribution in the US Appalachian region as a first step towards understanding the health disparities in this area. METHODS Rurality and CVD risk factors (including blood pressure, body-mass index (BMI), and cholesterol) were examined in a large, representative sample of fifth-grade students (<i>N=</i>73 014) from an Appalachian state in the USA. A six-category Rural-Urban Continuum Codes classification system was used to define rurality regions. Mixed modeling analysis was used to appropriately cluster individuals within 725 unique zip codes in each of these six regions, and allowed for including several individual-level socioeconomic factors as covariates. RESULTS Rural areas had better outcomes for certain CVD risk factors (lowest low-density lipoprotein cholesterol (LDL-C), and blood pressure (BP) and highest high-density lipoprotein cholesterol (HDL-C)) whereas mid-sized metro and town areas presented with the worst CVD risk factors (highest BMI% above ideal, mean diastolic BP, LDL-C, total cholesterol, triglyceride levels and lowest HDL-C) outcomes in children and adolescence in this Appalachian state. CONCLUSIONS Counter to the study hypothesis, mid-sized metro areas presented with the worst CVD risk factors outcomes in children and adolescence in the Appalachian state. This data contradicts previous literature suggesting a straightforward link between rurality and cardiovascular risk factors. Future research should include a longitudinal design and explore some of the mechanisms between cardiovascular risk factors and rurality.
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Affiliation(s)
| | - Amna Umer
- West Virginia University, Morgantown, West Virginia, USA.
| | | | - Lee Pyles
- West Virginia University, Morgantown, West Virginia, USA.
| | - William Neal
- West Virginia University, Morgantown, West Virginia, USA.
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Bai Y, Saint-Maurice PF, Welk GJ, Allums-Featherston K, Candelaria N. Explaining Disparities in Youth Aerobic Fitness and Body Mass Index: Relative Impact of Socioeconomic and Minority Status. THE JOURNAL OF SCHOOL HEALTH 2016; 86:787-793. [PMID: 27714871 DOI: 10.1111/josh.12434] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 02/29/2016] [Accepted: 03/06/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND To advance research on youth fitness promotion it is important to understand factors that may explain the disparities in fitness. METHODS We evaluated data from the FitnessGram NFL PLAY60 Partnership Project to examine school factors influencing aerobic capacity (AC) and body mass index (BMI) in schoolchildren. Individual observations for AC (157,971 students from 675 schools) and BMI (178,274 students from 630 schools) were aggregated to compute the percentage of students achieving the Healthy Fitness Zone (HFZ). We examined achievements using adjusted linear regression models with socioeconomic status (SES), minority status, region, enrollment, and grade as factors. RESULTS The mean HFZ for AC and BMI were 51.6% and 56.9%, respectively. SES, minority status, and enrollment were all significantly associated with AC HFZ among boys, and SES and enrollment were significant predictors of AC HFZ in girls. SES and location were significantly related to BMI HFZ among boys but only SES significantly predicted BMI HFZ in girls. Schools with higher SES had higher AC and BMI HFZ achievements. CONCLUSIONS SES was consistently associated with health-related fitness, independent of sex, but not minority status.
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Affiliation(s)
- Yang Bai
- Department of Rehabilitation and Movement Science, University of Vermont, 305 Rowell Building, Burlington, VT 05405.
| | - Pedro F Saint-Maurice
- Department of Kinesiology, Iowa State University, 283 Forker Building, Ames, IA 50010.
| | - Gregory J Welk
- Department of Kinesiology, Iowa State University, 257 Forker Building, Ames, IA 50010.
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Jayawardene WP, Lohrmann DK, Dickinson S, Torabi MR. Population-Level Measures to Predict Obesity Burden in Public Schools: Looking Upstream for Midstream Actions. Am J Health Promot 2016; 32:708-717. [PMID: 27708069 DOI: 10.1177/0890117116670305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To estimate school-level obesity burden, as reflected in prevalence of obesity, based on the characteristics of students' socioeconomic and geographic environments. DESIGN Secondary analysis of cross-sectional data. SETTING Public schools (N = 504) from 43 of 67 counties in Pennsylvania. PARTICIPANTS Kindergarten through grade 12 students (N = 255 949). MEASURES School-level obesity prevalence for the year 2014 was calculated from state-mandated student body mass index (BMI) measurements. Eighteen aggregate variables, characterizing schools and counties, were retrieved from federal data sources. ANALYSIS Three classification variables-excess weight (BMI ≥ 85th percentile), obesity (BMI ≥ 95th percentile), and severe obesity (BMI > 35% or 120% of 95th percentile)-each with 3 groups of schools (low-, average-, and high-prevalence) were created for discriminant function analysis, based on state mean and standard deviation of school distribution. Analysis tested each classification model to reveal school- and county-level dimensions on which school groups differed from each other. RESULTS Discriminant functions for obesity, which contained school enrollment, percentage of students receiving free/reduced-price lunch, percentage of black/Hispanic students, school location (suburban/other), percentage of county adults with postsecondary education, and percentage of county adults with obesity, yielded 67.86% correct classification (highest accuracy), compared to 34.23% schools classified by chance alone. CONCLUSION In the absence of mandated student BMI screenings, the model developed in this study can be used to identify schools most likely to have high obesity burden and, thereafter, determine dissemination of enhanced resources for the implementation of proven prevention policies and programs.
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Affiliation(s)
- Wasantha P Jayawardene
- 1 Applied Health Science, School of Public Health Bloomington, Indiana University, Bloomington, IN, USA
| | - David K Lohrmann
- 1 Applied Health Science, School of Public Health Bloomington, Indiana University, Bloomington, IN, USA
| | - Stephanie Dickinson
- 2 Epidemiology and Biostatistics, School of Public Health Bloomington, Indiana University, Bloomington, IN, USA
| | - Mohammad R Torabi
- 1 Applied Health Science, School of Public Health Bloomington, Indiana University, Bloomington, IN, USA
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15
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Quadros TMBD, Gordia AP, Silva LR, Silva DAS, Mota J. [Epidemiological survey in schoolchildren: determinants and prevalence of cardiovascular risk factors]. CAD SAUDE PUBLICA 2016; 32:e00181514. [PMID: 26958824 DOI: 10.1590/0102-311x00181514] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 06/26/2015] [Indexed: 11/22/2022] Open
Abstract
This study focused on the prevalence of dyslipidemia, high blood glucose, and high blood pressure in scho-olchildren and the associations with demographic, socioeconomic, biological, and behavior factors using a cross-sectional design with 1,139 schoolchildren from six to 18 years of age in Amargosa, Bahia State, Brazil. Prevalence ratio (PR) was used as the measure of association. Prevalence rates for dyslipidemia, high blood glucose, and high blood pressure were 62.1%, 6.6%, and 27%, respectively. Dyslipidemia was associated with the school's geographic location (PR = 1.52) and child's waist circumference (PR = 1.20), and high blood glucose with the school's geographic location (PR = 3.41) and child's peripheral adiposity (PR = 3.13). High blood pressure was associated with age bracket (PR = 2.34), waist-for-height ratio (PR = 1.62), sexual ma-turation (PR = 2.06), and physical activity (PR = 1.32). Intervention programs are needed to change life habits in schoolchildren.
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16
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Li Y, Robinson LE, Carter WM, Gupta R. Childhood obesity and community food environments in Alabama's Black Belt region. Child Care Health Dev 2015; 41:668-76. [PMID: 25324035 DOI: 10.1111/cch.12204] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/01/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Childhood obesity has been rising rapidly in the USA. The rate is higher among those at a lower socioeconomic status and racial/ethnic minority groups. In Alabama, nearly half of the children from rural African American families are overweight or obese. Studies suggest that children's eating behaviours and weight could be influenced by surrounding food environments. The purpose of this paper is to assess the community food environment and examine the associations with childhood obesity in Alabama's Black Belt region. METHODS This research uses both qualitative and quantitative methods. Weight status of 613 African American students in four elementary schools in a rural county of Alabama was assessed. We examined community food environments around children's home through GIS (Geographic Information System) and statistical methods. The interrelations between children's weight and community food environments are explored with multi-level models. RESULTS Approximately 42.1% of surveyed children were overweight or obese, much higher than the national average, 30.6%. In Model 1, convenience stores (3.44; P < 0.01), full service restaurants (8.99; P < 0.01) and supermarkets (-37.69; P < 0.01) were significantly associated with the percentile of body mass index. Fast food stores (-0.93; P = 0.88) were not related to children's weight. In Model 2, the additions of sociodemographic factors and school effects cause significant changes of the relationships between children's weight and four types of food outlets. The percentage of African American population (90.23, P < 0.01) and school (6.68, P < 0.01) were positively associated with children's weight; while median household income (-39.6; P < 0.01) was negatively related to it. CONCLUSION Children's weight is influenced by community food environments, sociodemographic factors and school context. Findings suggest that policymakers and planners need to improve community food environments of low-income minority communities. Parents and schools should pay more attention to reduce the negative impacts of food environments on children.
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Affiliation(s)
- Y Li
- Department of Geology and Geography, Auburn University, Auburn, AL, USA
| | - L E Robinson
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - W M Carter
- Department of Geology and Geography, Auburn University, Auburn, AL, USA
| | - R Gupta
- Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern Feinberg School of Medicine, Chicago, IL, USA
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17
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Johnson JA, Johnson AM. Urban-rural differences in childhood and adolescent obesity in the United States: a systematic review and meta-analysis. Child Obes 2015; 11:233-41. [PMID: 25928227 DOI: 10.1089/chi.2014.0085] [Citation(s) in RCA: 217] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND A systematic literature review and subsequent meta-analysis were performed to investigate differences in childhood obesity between urban and rural areas in the United States. METHODS A search of published studies comparing childhood obesity in urban and rural settings was undertaken by probing PubMed and Cumulative Index to Nursing and Allied Health Literature (CINAHL) for articles that met predetermined inclusion criteria. A subsequent meta-analysis was conducted to determine the combined effect size and significance of differences in childhood obesity between urban and rural areas. RESULTS Ten studies were identified for systematic review, five of which contributed to the meta-analysis. All but one study suggested that residence in rural areas was associated with higher prevalence or increased odds of childhood obesity, compared to children living in urban areas. A meta-analysis of 74,168 pooled participants ages 2-19 found that rural children have 26% greater odds of obesity, compared to urban children (odds ratio=1.26; 95% confidence interval, 1.21-1.32). CONCLUSIONS Obesity rates are higher among rural children than urban children in the United States. To ensure successful targeted interventions and effective resource allocation, practitioners and policy makers alike should be cognizant of this disparity in childhood obesity.
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18
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Davis AM, Sampilo M, Gallagher KS, Dean K, Saroja MB, Yu Q, He J, Sporn N. Treating rural paediatric obesity through telemedicine vs. telephone: Outcomes from a cluster randomized controlled trial. J Telemed Telecare 2015; 22:86-95. [PMID: 26026186 DOI: 10.1177/1357633x15586642] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 04/16/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The objective of the current study was to examine the feasibility of telemedicine vs. telephone for the delivery of a multidisciplinary weekly family-based behavioural group intervention to treat paediatric obesity delivered to families living in rural areas using a randomized controlled trial methodology. METHODS 103 rural children and their families were recruited. Feasibility measures included participant satisfaction, session attendance and retention. Treatment outcome measures included child Body Mass Index z-score (BMIz), parent BMI, 24-hour dietary recalls, accelerometer data, the child behavior checklist and the behavioral pediatrics feeding assessment scale. RESULTS Participants were highly satisfied with the intervention both via telemedicine and via telephone. Completion rates were much higher than for other paediatric obesity intervention programmes, and both methodologies were highly feasible. There were no differences in telemedicine and telephone groups on primary outcomes. CONCLUSION Both telemedicine and telephone intervention appear to be feasible and acceptable methods of delivering paediatric obesity treatment to rural children.
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Affiliation(s)
- Ann M Davis
- University of Kansas Medical Center, Department of Pediatrics, USA Center for Children's Healthy Lifestyles & Nutrition, USA
| | - Marilyn Sampilo
- Center for Children's Healthy Lifestyles & Nutrition, USA University of Kansas, Department of Clinical Child Psychology, USA
| | | | - Kelsey Dean
- University of Kansas Medical Center, Department of Pediatrics, USA
| | | | - Qing Yu
- University of Kansas Medical Center, Department of Biostatistics, USA
| | - Jianghua He
- University of Kansas Medical Center, Department of Biostatistics, USA
| | - Nora Sporn
- University of Kansas, Department of Psychology, USA
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19
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Jeffries JK, Thayer LM, Hennink-Kaminski H, Noar SM. Rural adults' perspectives on school food in a North Carolina county. Prev Chronic Dis 2015; 12:E54. [PMID: 25906435 PMCID: PMC4415412 DOI: 10.5888/pcd12.140484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION To address alarming rates of youth obesity, multiple stakeholder perspectives must be understood and considered when developing nutrition interventions. The purpose of this qualitative study was to examine adults' perceptions of school food in rural North Carolina and their opinions about potential changes to encourage students to eat more fruits and vegetables in school meals. METHODS We conducted semistructured key informant interviews by telephone from February through March 2013 to determine adult opinions regarding elementary school food and child health. Participants included parents, teachers, school administrators, and a cafeteria staff member. Interview transcripts were thematically analyzed using Dedoose qualitative analysis software. RESULTS Four themes emerged from key informant interviews regarding school meals and increasing fruit and vegetable consumption: 1) schools are an appropriate place for nutritious food, 2) current school food is bland and unappealing, 3) school cafeterias can use simple strategies to increase fruit and vegetable intake, and 4) federal school meal guidelines are perceived as barriers to increased fruit and vegetable intake during school meals. CONCLUSION Study findings suggest that training and support for cafeteria staff on healthy food preparation and presentation are critical and that there should be a "meeting in the middle" between child appeal and health. Nutritious and appealing school food options may have the potential to greatly increase fruit and vegetable consumption in rural elementary schools in North Carolina.
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Affiliation(s)
- Jayne K Jeffries
- The Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Dr, Chapel Hill, NC 27599.
| | - Linden M Thayer
- The Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Heidi Hennink-Kaminski
- School of Journalism and Mass Communications, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Seth M Noar
- School of Journalism and Mass Communications, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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20
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Tyler DO, Horner SD. A primary care intervention to improve weight in obese children: A feasibility study. J Am Assoc Nurse Pract 2015; 28:98-106. [PMID: 25782163 DOI: 10.1002/2327-6924.12246] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 01/20/2015] [Indexed: 11/06/2022]
Abstract
PURPOSE Examine the effects of a primary care weight management program, which used a parent-child-provider collaborative negotiation intervention, among rural-dwelling families with obese children. DATA SOURCES Health histories, physical examinations, fasting blood samples, interviews, and questionnaires. CONCLUSIONS Feasibility of implementing a family weight management intervention in a rural primary care setting was demonstrated. Few differences between the treatment and comparison groups were found; however, more favorable trends and outcomes occurred in those who received the intervention. IMPLICATIONS FOR PRACTICE Positive provider-patient communication in helping families with obese children make difficult lifestyle changes should be encouraged in primary care clinics as small changes in behavior can result in reducing risk and improving health outcomes.
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Affiliation(s)
- Diane O Tyler
- American Academy of Nurse Practitioners Certification Program, Austin, Texas.,The University of Texas at Austin School of Nursing, Austin, Texas
| | - Sharon D Horner
- The University of Texas at Austin School of Nursing, Austin, Texas
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21
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Abstract
Within most developed countries, rural residents are more likely to be obese and overweight compared to their urban counterparts. Studies of specific rural communities have found that the limited availability of healthy foods in the community and home as well as individual characteristics and preferences contribute to poor diet and overweight. The rural food environment is varied and may be affected by climate, regional and cultural preferences, transportation access, and remoteness among other factors. Given this diversity and the vulnerabilities of rural residents, who are more likely to have low-income, substandard housing or low educational attainment compared to their urban counterparts, policy and programmatic interventions should target specific needs and communities. This review will describe the rural community, home, and individual food environments and what is known about their roles in healthy eating.
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Affiliation(s)
- Jennifer D Lenardson
- Maine Rural Health Research Center, University of Southern Maine, 432B Wishcamper Center, 34 Bedford Street, Portland, ME, 04104, USA.
| | - Anush Y Hansen
- Maine Rural Health Research Center, University of Southern Maine, 404G Wishcamper Center, 34 Bedford Street, Portland, ME, 04104, USA.
| | - David Hartley
- Maine Rural Health Research Center, University of Southern Maine, 418 Wishcamper Center, 34 Bedford Street, Portland, ME, 04104, USA.
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22
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Prevalence and risk factors of abdominal obesity in Polish rural children. HOMO-JOURNAL OF COMPARATIVE HUMAN BIOLOGY 2015; 66:357-68. [PMID: 25796137 DOI: 10.1016/j.jchb.2014.09.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 09/03/2014] [Indexed: 02/07/2023]
Abstract
Secular trends of body mass index (BMI) and waist circumference indicate greater increase in abdominal obesity compared to general obesity. Determinants of obesity described by BMI are relatively well documented in various populations, unlike abdominal obesity described by waist-to-height ratio (WHtR). The aim of the study was to determine prevalence and abdominal obesity (WHtR) risk factors in a cohort of 3048 rural children aged 7-12 years from southern Poland. Biological, socio-demographic and lifestyle factors were analysed, and odds ratio and 95% confidence interval were calculated using a logistic regression analysis. The prevalence of abdominal obesity in rural boys and girls in the sample was 11% and 9% respectively. Obesity in both parents, irregular breakfasts, irregular meals during the day and regularly consumed tea were significant factors of abdominal obesity risks in rural girls. Being the only child, low number of people in a household, obesity in both parents, high energy-dense food index and no exercise significantly increased the risk of abdominal obesity in rural boys. The study demonstrated tendencies similar to other European countries in the prevalence of abdominal obesity among sexes. Lifestyle behaviours should be changed and adapted to each sex since risk factors differ between the sexes and indicate higher eco-sensitivity in boys.
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23
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Carraway ME, Lutes LD, Crawford Y, Pratt KJ, McMillan AG, Scripture LG, Henes S, Cox J, Vos P, Collier DN. Camp-based immersion treatment for obese, low socioeconomic status, multi-ethnic adolescents. Child Obes 2014; 10:122-31. [PMID: 24628415 DOI: 10.1089/chi.2013.0111] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Immersion treatment (IT) provided in a camp setting has been shown to promote short-term improvements in weight and health status in obese adolescents. However, evidence of IT's long-term efficacy and efficacy for multi-ethnic and lower socioeconomic status (SES) adolescents is limited. METHODS This was a cohort study with a pre/post design and longitudinal follow-up. The intervention was a 19-day camp-based IT program comprising (1) a nutrition curriculum and ad-lib access to a nutritious diet, (2) several hours of physical activity daily, (3) group therapy, and (4) cognitive-behavioral therapy (CBT). This analysis included 52 low-SES adolescents that participated in 2009 and 2010. A subgroup of 33 campers and their families was offered follow-up monthly for 10 months. Primary outcome measures were change in weight-related parameters immediately postcamp and after 10 months of follow-up. RESULTS Campers had significant short-term improvements in mean waist circumference (mean [M], 2.6; standard deviation [SD], 3.2 cm), weight (M, 2.6; SD, 1.9 kg), BMI (M, 1.1; SD, 0.9 kg/m2), BMI z-score (M, 0.06; SD, 0.07), and percent overweight (M, 6.1; SD, 4.7). Campers offered follow-up had a modest increase in mean percent overweight (M, 2.0; SD, 8.4) during 10 months of follow-up. However, 33% experienced continuing decline in percent overweight during follow-up, and long-term follow-up was associated with significant overall (precamp vs. end of follow-up) improvements in percent overweight (M, 4.9; SD, 7.2). CONCLUSIONS Camp-based IT with CBT is a promising intervention for improving short- and long-term weight status of low-SES adolescents. Additional research is needed to increase long-term efficacy.
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24
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Moore JB, Beets MW, Morris SF, Kolbe MB. Comparison of objectively measured physical activity levels of rural, suburban, and urban youth. Am J Prev Med 2014; 46:289-92. [PMID: 24512868 DOI: 10.1016/j.amepre.2013.11.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 10/28/2013] [Accepted: 11/14/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Nationally, youth are generally not achieving 60 minutes of daily moderate-to-vigorous physical activity (MVPA). Studies suggest that rural adults are less active than their urban counterparts, although studies of children are equivocal. PURPOSE To compare objectively measured physical activity across the rural-urban continuum in a sample of fourth- to eighth-grade youth. METHODS In fall 2010, youth from 20 North Carolina counties wore an accelerometer a minimum of 4 monitored days (n=804, 54% female, 25% African American, 54% urban). In spring 2013, two random-effects regression models were estimated separately for boys and girls. Comparisons among minutes of MVPA/day continuous and binary (≥60 minutes vs <60 minutes MVPA/day) among rural, suburban, and urban children were made, controlling for race, monitor wear time, and grade. RESULTS For boys, there were no differences in MVPA/day among urbanicity categories. However, a 4.2 minutes/day decrease in MVPA occurred with each increase in grade. For girls, rural girls accumulated 9.3 minutes MVPA/day and 8.0 minutes MVPA/day more than suburban and urban girls, respectively. A 3 minutes/day decrease in MVPA occurred with each increase in grade. Rural girls were 4.6 times and 2.8 times more likely to accumulate ≥60 minutes MVPA/day compared to suburban and urban girls, respectively. No interactions across all models were significant for boys or girls. CONCLUSIONS The relationship between urbanicity and MVPA in youth appears to be more complex than previously envisioned. Rural residence appears to be supportive of MVPA in girls but not boys. Future research should consider urbanicity when investigating correlates/determinants of MVPA in youth.
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Affiliation(s)
- Justin B Moore
- Department of Health Promotion, Education, and Behavior and Office of Public Health Practice, Columbia, South Carolina.
| | - Michael W Beets
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
| | - Sara F Morris
- Durham Epidemiologic Research and Information Center, Durham Veterans Affairs Medical Center, Durham
| | - Mary Bea Kolbe
- Chronic Disease and Injury Section, North Carolina Division of Public Health, DHHS, Raleigh, North Carolina
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25
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Tambalis KD, Panagiotakos DB, Kavouras SA, Papoutsakis S, Sidossis LS. Higher prevalence of obesity in Greek children living in rural areas despite increased levels of physical activity. J Paediatr Child Health 2013; 49:769-74. [PMID: 23724863 PMCID: PMC3773292 DOI: 10.1111/jpc.12253] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/14/2013] [Indexed: 11/30/2022]
Abstract
AIM The purpose of the present study was to evaluate whether levels of physical activity (PA) and sedentary behaviours could explain observed differences in the prevalence of childhood obesity in a sample of Greek children. METHODS Epidemiological study. PA and sedentary behaviours were assessed by a self-administrated PA checklist. Body mass index (BMI) was calculated from measured weight and height. A representative sample of Greek children aged 10-12 years attending fifth and sixth grade (n = 3195), living in rural and urban areas, were enrolled. Maturation status was not evaluated due to technical reasons. RESULTS Prevalence of obesity was higher among children living in rural areas as compared with urban areas (12.1% vs. 10.7%, P < 0.01). Surprisingly, children living in rural areas had higher levels of self-reported PA (P < 0.001) and met current PA guidelines to a greater extent than their urban counterparts (P < 0.05). Furthermore, boys had higher levels of total, low-to-moderate intensity and vigorous intensity physical activity, as well as sedentary behaviours, than girls (all P-values <0.05). Stratified analysis by BMI category revealed that normal weight boys and girls had higher levels of total PA and vigorous intensity physical activity compared with overweight and obese boys from the same type of setting (all P-values <0.05). CONCLUSIONS Children living in rural areas have higher levels of PA and more frequently met PA guidelines than their urban counterparts, despite a higher prevalence of obesity.
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Affiliation(s)
- Konstantinos D. Tambalis
- Department of Nutrition - Dietetics, Harokopio University, Athens, Greece,Department of Sport Medicine and Biology of Physical Activity, University of Athens, Athens, Greece
| | | | | | - Sofia Papoutsakis
- Department of Nutrition - Dietetics, Harokopio University, Athens, Greece
| | - Labros S. Sidossis
- Department of Nutrition - Dietetics, Harokopio University, Athens, Greece,Department of Internal Medicine, Sealy Center on Aging, Institute for Translational Sciences and Shriners Hospitals for Children, University of Texas Medical Branch at Galveston, Texas, USA
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26
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Kenney MK, Wang J, Iannotti R. Residency and racial/ethnic differences in weight status and lifestyle behaviors among US youth. J Rural Health 2013; 30:89-100. [PMID: 24383488 PMCID: PMC4696387 DOI: 10.1111/jrh.12034] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE Elevated risk for obesity is found in rural environments and in some minority populations. It is unclear whether living in rural or nonmetropolitan areas and being a minority compound the risk of obesity beyond that of either factor acting alone. Our purpose was to examine adolescent obesity in light of the potential concomitant influences of race/ethnicity, residency, and obesity-related lifestyle behaviors. METHODS We assessed obesity prevalence, physical activity, consumption of fatty snack foods, and screen time in 8,363 US adolescents based on variation in race/ethnicity and residency. Descriptive, bivariate, and multivariate statistics were used to: (1) calculate race- and residency-based rates of obesity and obesity-related lifestyle behaviors and (2) generate race- and residency-based obesity odds ratios as a function of those same behaviors. FINDINGS The results indicated that nonmetropolitan black youth had the highest risk of obesity (26%), rate of consuming fatty snack foods on more than 2 days/week (86%), and rate of spending more than 2 hours/day in screen time (91%) compared to white metropolitan youth. Compared to their metropolitan counterparts, black nonmetropolitan youth had greater odds of being obese if they exercised less than daily (1.71 times), ate fatty snack foods on more than 2 days/week (1.65 times), or spent more than 2 hours/day in screen time (1.64 times). CONCLUSIONS Race/ethnicity and residency may have a compounding effect on the risk of obesity. Prevention and intervention must be viewed in a socioecological framework that recognizes the importance of culture and community on obesity-related behaviors.
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Affiliation(s)
- Mary Kay Kenney
- US Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, Rockville, Maryland
| | - Jing Wang
- US Department of Health and Human Services, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland
| | - Ron Iannotti
- US Department of Health and Human Services, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland
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27
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Socioeconomic status, body mass index and prevalence of underweight and overweight among Polish girls aged 7-18: a longitudinal study. J Biosoc Sci 2013; 46:449-61. [PMID: 23768733 DOI: 10.1017/s002193201300031x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The aim of this paper was to establish whether the influence of socioeconomic factors on BMI and the prevalence of underweight and overweight changes with age. The data were obtained from 1008 schoolgirls aged 16-18 years for whom earlier data on weight and height were available. Their height and body mass were measured and their BMIs calculated. Height and weight in early life were assessed by medical records review. The girls were measured by trained school nurses at 7, 9, 14 years of age. Socioeconomic differences in BMI were found to increase with age. Parents' higher education and urban environment were associated with smaller BMI gain between the ages of 7 and 18 years. Among subjects whose mother and/or father had higher education the prevalence of underweight increased with age, and in other groups it remained at a similar level. In the younger age categories (7- and 9-year-olds) underweight was less frequent in subjects from towns than those from rural areas, while in the older categories (14, 16-18 years of age) the opposite tendency was found. As subjects grew up, there was a decline in the prevalence of overweight and obesity in all groups. Parental education and place of residence seem to influence weight status in a different way in childhood than during adolescence.
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Janicke DM, Lim CS, Mathews AE, Shelnutt KP, Boggs SR, Silverstein JH, Brumback BA. The community-based healthy-lifestyle intervention for rural preschools (CHIRP) study: design and methods. Contemp Clin Trials 2013; 34:187-95. [PMID: 23183252 PMCID: PMC3594534 DOI: 10.1016/j.cct.2012.11.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 11/14/2012] [Accepted: 11/18/2012] [Indexed: 11/23/2022]
Abstract
The CHIRP study is a two-arm, pilot randomized controlled trial assessing the effectiveness of a behavioral family weight management intervention in an important and at-risk population, overweight young children, 3 to 6 years of age, and their parents from underserved rural counties. Participants will include 96 parent-child dyads living in rural counties in north central Florida. Families will be randomized to one of two conditions: (a) behavioral family based intervention or (b) a waitlist control. Child and parent participants will be assessed at baseline (month 0), post-treatment (month 4), and follow-up (month 10). Assessments and intervention sessions will be held at the Cooperative Extension office in each participating rural county. The primary outcome measure is change in child body mass index (BMI) z-score. Additional key outcome measures include child dietary intake, physical activity, and parent BMI. This study is unique because (1) it is one of the few randomized controlled trails examining a behavioral family intervention to address healthy habits and improved weight status in young overweight and obese children, (2) addresses health promotion in rural settings, and (3) examines intervention delivery in real world community settings through the Cooperative Extension Service offices. If successful, this research has potential implications for medically underserved rural communities and preventative health services for young children and their families.
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Affiliation(s)
- David M Janicke
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL 32610-0165, USA.
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29
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Holm JE, Lilienthal KR, Poltavski DV, Vogeltanz-Holm N. Relationships between health behaviors and weight status in American Indian and white rural children. J Rural Health 2013; 29:349-59. [PMID: 24088209 DOI: 10.1111/jrh.12010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE Preventing obesity in childhood is an increasingly important public health goal. Prevention efforts can be improved by better understanding relationships between health behaviors and overweight and obesity. This study examined such relationships in young American Indian and white children living in the rural United States. METHODS Self-report measures of diet, screen time (passive and active), and physical activity were combined with cardiovascular fitness in cross-sectional analyses to predict weight categories based on body mass index percentiles in 306 American Indian and white children (aged 8-9 years) from a rural area in the upper Midwestern United States. FINDINGS Multinomial logistic regression models were statistically significant for girls (χ2 [20] = 42.73, P < .01), boys (χ2 [20] = 50.44, P < .001), American Indian (χ2 [20] = 36.67, P < .05), and white children (χ2 [20] = 55.99, P < .001). Obesity was associated with poorer cardiovascular fitness in girls (OR = 0.82), boys (OR = 0.83), American Indian (OR = 0.79), and white children (OR = 0.85), and with passive screen time in girls (OR = 1.69), boys (OR = 2.1), and white children (OR = 1.81). Overweight was associated with passive screen time (OR = 2.24) and inversely with active screen time (OR = 0.54), but only in boys. CONCLUSIONS Logistic regression models were more successful at predicting obesity than overweight in all groups of participants. Poorer cardiovascular fitness showed the strongest and most consistent association with obesity, but passive screen time was also a significant and important contributor to the prediction of obesity in most prediction models. Prediction models were similar in girls, boys, American Indian, and white children.
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Affiliation(s)
- Jeffrey E Holm
- Department of Psychology and Center for Health Promotion and Prevention Research, University of North Dakota, Grand Forks, North Dakota
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Measuring the retail food environment in rural and urban North Carolina counties. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2013; 16:432-40. [PMID: 20689393 DOI: 10.1097/phh.0b013e3181bdebe4] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Development of accurate and sensitive methods to characterize the food environment is needed. Thus, we examined convergent and criterion validity of 2 retail food environment data sources and then examined differences in predictive validity between 3 ways of measuring the rural and urban food environment. METHODS Ten counties were selected in each of 3 North Carolina regions (n = 30). Number of fast-food restaurants and chain supermarkets were calculated using 2 data sources. Convergent validity was percent agreement between the 2 sources. Criterion validity was percent agreement between each source and the most accurate venue count. Predictive validity of food environment measures (Retail Food Environment Index, fast-food restaurants/capita, and supermarkets/capita) was calculated by associations with county-level mean-weighted body mass index (BMI). RESULTS Percent agreement for fast-food restaurants ranged from 50% to 100% (mean = 87%) and for supermarkets ranged from 58% to 100% (mean = 89%). The 2 data sources had similar percent agreement with the most accurate count. Retail Food Environment Index was positively associated with BMI, while fast-food restaurants per capita were negatively associated with BMI. CONCLUSIONS Our results lend support to studies using both food environment data sources examined.
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Itoi A, Yamada Y, Watanabe Y, Kimura M. Physical activity, energy intake, and obesity prevalence among urban and rural schoolchildren aged 11–12 years in Japan. Appl Physiol Nutr Metab 2012; 37:1189-99. [DOI: 10.1139/h2012-100] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The prevalence of childhood overweight and obesity has been shown to differ among regions, including rural–urban regional differences within nations. This study obtained simultaneous accelerometry-derived physical activity, 24 h activity, and food records to clarify the potential contributing factors to rural–urban differences in childhood overweight and obesity in Japan. Sixth-grade children (n = 227, 11–12 years old) from two urban elementary schools in Kyoto and four rural elementary schools in Tohoku participated in the study. The children were instructed to wear a pedometer that included a uniaxial accelerometer and, assisted by their parents, keep minute-by-minute 24 h activity and food records. For 12 children, the total energy expenditure was measured by the doubly labeled water method that was used to correct the Lifecorder-predicted activity energy expenditure and physical activity level. The overweight and obesity prevalence was significantly higher in rural than in urban children. The number of steps per day, activity energy expenditure, physical activity level, and duration of walking to school were significantly lower in rural than in urban children. In contrast, the reported energy intake did not differ significantly between the regions. The physical activity and duration of the walk to school were significantly correlated with body mass index. Rural children had a higher prevalence of overweight and obesity, and this may be at least partly caused by lower physical activity, especially less time spent walking to school, than urban children.
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Affiliation(s)
- Aya Itoi
- Department of Health, Sports and Nutrition, Faculty of Health and Welfare, Kobe Women’s University, 4-7-2 Minatojimanakamachi, Chuo-ku, Kobe, Japan
- Department of Epidemiology for Community Health and Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Yosuke Yamada
- Laboratory of Applied Health Science, Graduate School of Nursing for Health Care Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
- Research Fellow, Japan Society for the Promotion of Science, Tokyo, Japan
| | - Yoshiyuki Watanabe
- Department of Epidemiology for Community Health and Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Misaka Kimura
- Laboratory of Applied Health Science, Graduate School of Nursing for Health Care Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
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Duran M, Gillespie J, Malina RM, Little BB. Growth and weight status of rural Texas school youth. Am J Hum Biol 2012; 25:71-7. [DOI: 10.1002/ajhb.22343] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Revised: 10/02/2012] [Accepted: 10/10/2012] [Indexed: 11/06/2022] Open
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Liu JH, Jones SJ, Sun H, Probst JC, Merchant AT, Cavicchia P. Diet, physical activity, and sedentary behaviors as risk factors for childhood obesity: an urban and rural comparison. Child Obes 2012; 8:440-8. [PMID: 23061499 DOI: 10.1089/chi.2012.0090] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND The aim of this study was to examine the differences in diet, physical activity, and weight status among children living in rural and urban America and to study the roles of obesity-related behaviors in residence-based differences in childhood obesity. METHODS We performed cross-sectional analysis of the 1999-2006 National Health and Nutrition Examination Survey data, restricted to 14,332 children aged 2-19 years old (2771 rural, 13,766 urban). Residence was measured at the census tract level using Rural-Urban Commuting Areas. Age-specific questions were used to assess physical activity, and the 24-hour diet recall was used to measure dietary intake. RESULTS Among 2- to 11-year-olds, rural children consumed 90 more kcal/day on average than urban children (p < 0.05) and were more likely to consume the recommended two to three cups of dairy per day (p < 0.05). More 2- to 11-year-old rural children also reported participating in exercise five or more times per week than urban children of the same age (79.7% vs. 73.8%). Among 12- to 19-year-olds, rural children were less likely to consume any fruit or meet the recommendation of two cups of fruit. Using measured height and weight data, proportionately more rural than urban children were overweight/obese (35.4% v. 29.3%) and obese (18.6% v. 15.1%). Rural children had 30% higher odds of being overweight and/or obese even after adjustment for sociodemographics, health, diet, and exercise behaviors. CONCLUSIONS The persistently higher odds of overweight and obesity among rural children even after adjustment suggest that rural environments may be "obesogenic" in ways that a person-level analysis cannot discern. Future research should examine disparities in the accessibility and affordability of healthy food and beverage choices and safe physical activity locales in rural areas.
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Affiliation(s)
- Ji-Hong Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, 29208, USA.
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Abstract
SummarySeveral studies have documented increased prevalence of overweight and obesity in inhabitants of rural regions, but determinants of their prevalence are complex and not always in one direction. The aim of this study was to estimate both the prevalence and extent of overweight and obesity among rural girls in Poland between 1987 and 2001, as well as to assess differentiation of the phenomenon between regions of different social structures. The data come from two series of cross-sectional studies; the first in 1987 included 7764 girls, and the second in 2001 included 9431 girls aged 9–18. Body mass index (according to the International Obesity Task Force, IOTF) and the EOW index (extent of overweight), which shows by what mean BMI value the overweight boundaries are exceeded, were calculated. Overweight and obesity prevalences in the whole sample, were, respectively, 14.9% and 2.7% in 1987 and 15.5% and 2.5% in 2001, but significant differentiation in the direction of the changes was observed between the examined regions. In one of them, characterized by sudden, mass and long-term unemployment, there was a considerable decrease in overweight and obesity prevalence, whereas in a relatively wealthier region no changes were observed during the 14-year period. Two other regions with a relatively low standard of living and low incomes and education status presented a significant increase in overweight and obesity prevalence. The EOW index increased from 1.9 to 2.1 in the whole examined sample, and it also confirmed significant differences in expansion of overweight and obesity between the examined regions. The complex character of political and socioeconomic changes in Poland during the 1990s has resulted in two-directional changes in biological measures of living conditions. The analysis of the whole sample led to different results in comparison to separate analyses of each of the examined regions.
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Musa DI, Toriola AL, Monyeki MA, Lawal B. Prevalence of childhood and adolescent overweight and obesity in Benue State, Nigeria. Trop Med Int Health 2012; 17:1369-75. [PMID: 22974459 DOI: 10.1111/j.1365-3156.2012.03083.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Geography influences dietary intake, physical activity and weight status of adolescents. J Nutr Metab 2012; 2012:816834. [PMID: 22685637 PMCID: PMC3366226 DOI: 10.1155/2012/816834] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Revised: 02/16/2012] [Accepted: 02/19/2012] [Indexed: 11/17/2022] Open
Abstract
Purpose. The purpose of this study was to assess rural and urban differences in the dietary intakes, physical activity levels and weight status of a large sample of Canadian youth in both 2005 and 2008. Materials and Methods. A cross-sectional study of rural and urban adolescents (n = 10, 023) in Alberta was conducted in both 2005 and 2008 using a web-based survey. Results. There was an overall positive change in nutrient intakes between 2005 and 2008; however, rural residents generally had a poorer nutrient profile than urban residents (P < .001). They consumed less fibre and a greater percent energy from saturated fat. The mean physical activity scores increased among rural youth between 2005 and 2008 (P < .001), while remaining unchanged among urban youth. Residence was significantly related to weight status in 2005 (P = .017), but not in 2008. Conclusion. Although there were small improvements in nutrient intakes from 2005 to 2008, several differences in the lifestyle behaviours of adolescents living in rural and urban areas were found. The results of this study emphasize the importance of making policy and program recommendations to support healthy lifestyle behaviours within the context of the environments in which adolescents live.
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Lynch WC, Martz J, Eldridge G, Bailey SJ, Benke C, Paul L. Childhood obesity prevention in rural settings: background, rationale, and study design of '4-Health,' a parent-only intervention. BMC Public Health 2012; 12:255. [PMID: 22471650 PMCID: PMC3404898 DOI: 10.1186/1471-2458-12-255] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Revised: 03/15/2012] [Accepted: 04/02/2012] [Indexed: 11/10/2022] Open
Abstract
Background Childhood obesity in rural communities is a serious but understudied problem. The current experiment aims to assess a wide range of obesity risk factors among rural youth and to offer an 8-month intervention program for parents to reduce obesity risk in their preteen child. Methods/Design A two-group, repeated measures design is used to assess the effectiveness of the 4-Health intervention program. Assessments include anthropometric measures, child self-evaluations, parent self-evaluations, and parent evaluations of child. County Extension agents from 21 rural Montana counties recruit approximately 150 parent–child dyads and counties are semi-randomly assigned to the active intervention group (4-Health Educational Program) or a “best-practices” (Healthy Living Information) control group. Discussion This study will shed light on the effectiveness of this parent-only intervention strategy in reducing obesity risk factors among rural preteens. The 4-Health program is designed to provide information and skills development for busy rural parents that will increase healthy lifestyles of their preteen children and improve the parents’ ability to intervene effectively in the lives of their families during this critical developmental period. Trial registration ClinicalTrials.gov ID: NCT01510587
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Affiliation(s)
- Wesley C Lynch
- Department of Psychology, Montana State University, Bozeman, 59717-3440, USA.
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Findholt NE, Michael YL, Jerofke LJ, Brogoitti VW. Environmental influences on children's physical activity and eating habits in a rural Oregon County. Am J Health Promot 2012; 26:e74-85. [PMID: 22040399 DOI: 10.4278/ajhp.100622-qual-210] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE. To identify environmental barriers and facilitators of children's physical activity and healthy eating in a rural county. DESIGN. Community-based participatory research using mixed methods, primarily qualitative. SETTING. A rural Oregon county. SUBJECTS. Ninety-five adults, 6 high school students, and 41 fifth-grade students. MEASURES. In-depth interviews, focus groups, Photovoice, and structured observations using the Physical Activity Resource Assessment, System for Observing Play and Leisure Activity, Community Food Security Assessment Toolkit, and School Food and Beverage Marketing Assessment Tool. ANALYSIS. Qualitative data were coded by investigators; observational data were analyzed using descriptive statistics. The findings were triangulated to produce a composite of environmental barriers and assets. RESULTS. Limited recreational resources, street-related hazards, fear of strangers, inadequate physical education, and denial of recess hindered physical activity, whereas popularity of youth sports and proximity to natural areas promoted physical activity. Limited availability and high cost of healthy food, busy lifestyles, convenience stores near schools, few healthy meal choices at school, children's being permitted to bring snacks to school, candy used as incentives, and teachers' modeling unhealthy eating habits hindered healthy eating, whereas the agricultural setting and popularity of gardening promoted healthy eating. CONCLUSIONS. This study provides data on a neglected area of research, namely environmental determinants of rural childhood obesity, and points to the need for multifaceted and multilevel environmental change interventions.
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Affiliation(s)
- Nancy E Findholt
- Oregon Health & Science University, Schoolof Nursing–La Grande Campus, La Grande, USA.
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Hessler K, Siegrist M. Nurse practitioner attitudes and treatment practices for childhood overweight: How do rural and urban practitioners differ? ACTA ACUST UNITED AC 2011; 24:97-106. [DOI: 10.1111/j.1745-7599.2011.00673.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Sandercock GRH, Ogunleye A, Voss C. Comparison of cardiorespiratory fitness and body mass index between rural and urban youth: findings from the East of England Healthy Hearts Study. Pediatr Int 2011; 53:718-724. [PMID: 21410596 DOI: 10.1111/j.1442-200x.2011.03354.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The aim of the present study was to determine if there were differences in cardiorespiratory fitness (CRF) and body mass index (BMI) in rural versus urban youth. METHODS We measured BMI in 6628 10.0-15.9-year-olds and classified them as normal weight, overweight or obese. CRF was assessed with a 20-m shuttle-run test and subjects were classified as unfit, fit or highly fit. Rural or urban dwelling was calculated from postcodes. RESULTS There were no differences in frequency of BMI categories or CRF between rural and urban children (<13 years) or adolescents (>13 years). Rural adolescents were less likely to be fit (OR = 0.80; 95%CI 0.67-0.96) or highly fit (OR = 0.69; 95%CI 0.55-0.86) independent of their age, sex, race or level of deprivation. CONCLUSIONS Whilst there were no differences evident in children <13 years, rural adolescents were significantly less likely to meet criterion-based cut-off points for CRF. Research to elucidate why such differences exist is warranted.
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Affiliation(s)
- Gavin R H Sandercock
- Centre for Sports and Exercise Science, Department of Biological Sciences, University of Essex, Colchester, UK
| | - Ayodele Ogunleye
- Centre for Sports and Exercise Science, Department of Biological Sciences, University of Essex, Colchester, UK
| | - Christine Voss
- Centre for Sports and Exercise Science, Department of Biological Sciences, University of Essex, Colchester, UK
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Reed DB, Patterson PJ, Wasserman N. Obesity in rural youth: looking beyond nutrition and physical activity. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2011; 43:401-408. [PMID: 21906552 DOI: 10.1016/j.jneb.2010.12.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2010] [Revised: 11/11/2010] [Accepted: 12/15/2010] [Indexed: 05/31/2023]
Abstract
Contributors to excessive obesity in rural youth include well-documented nutrition and physical activity behaviors. However, emerging research suggests that preventing excessive weight gain and smoking during pregnancy, teen pregnancy, and child abuse also could reduce obesity in this vulnerable population. These traditional and emerging, nontraditional factors need to be addressed within the confines of current challenges faced by rural communities. An enhanced ecological model provides a framework for combining traditional and nontraditional factors into a more comprehensive approach that addresses the complexity of the issues contributing to youth obesity.
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Affiliation(s)
- Debra B Reed
- Department of Nutrition, Hospitality, and Retailing, Texas Tech University, Lubbock, TX 79409-1240, USA.
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Shriver LH, Harrist AW, Hubbs-Tait L, Topham G, Page M, Barrett A. Weight status, physical activity, and fitness among third-grade rural children. THE JOURNAL OF SCHOOL HEALTH 2011; 81:536-544. [PMID: 21831066 DOI: 10.1111/j.1746-1561.2011.00624.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Rural children are at a particular high risk for obesity. Given the importance of exercise in obesity and chronic disease prevention, this study evaluated the level and relationship between physical activity and fitness in a sample of rural third graders. The second purpose of the study was to determine potential differences in physical activity and fitness level by weight status in this sample. METHODS Twelve schools participating in a multidisciplinary research project were randomly selected for the study. Body mass index-for-age percentile, the modified Self-administered Physical Activity Checklist, and the FITNESSGRAM battery tests were utilized to determine children's weight status, physical activity, and fitness level, respectively. RESULTS Thirty-eight percent of the 237 participating children (9.2 ± 0.4 years) were overweight or obese. Nearly 15% were extremely obese. Children spent 91.8 ± 83.8 and 32.2 ± 47.7 minutes in moderate- and vigorous-intensity activities. Obese children spent less time in moderate-intensity activity (p < .01) and combined moderate- and vigorous-intensity activity more than other children (p < .05). Forty-three percent of all children failed to meet the fitness standard for muscular strength and 36% failed to meet it for flexibility. CONCLUSIONS Rural children in this sample had higher rates of obesity compared to the national average; they had poor fitness and 30% failed to meet the minimum physical activity recommendations on the previous day. Future interventions should focus on increasing physical activity, especially of moderate-intensity, and improving physical fitness in order to reduce obesity and decrease the risk of future chronic diseases in this high-risk population.
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Affiliation(s)
- Lenka H Shriver
- Department of Nutritional Sciences, Human Environmental Sciences, Oklahoma State University, Stillwater, USA.
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Janicke DM, Davis AM. Introduction to the Special Section: Rural Health Issues in Pediatric Psychology. J Pediatr Psychol 2011; 36:647-51. [DOI: 10.1093/jpepsy/jsr037] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Physical fitness in rural and urban children and adolescents from Spain. J Sci Med Sport 2011; 14:417-23. [PMID: 21620767 DOI: 10.1016/j.jsams.2011.04.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2010] [Revised: 04/14/2011] [Accepted: 04/21/2011] [Indexed: 11/23/2022]
Abstract
OBJECTIVE We aimed to examine the differences in fitness components between rural and urban Spanish children and adolescents. DESIGN/METHOD A sample of 2569 school children (1068) and adolescents (1501) from urban and rural areas from the region of Aragón (Spain). Physical fitness was assessed by 7 tests: 20 m shuttle run, speed shuttle run, sit and reach, standing long jump, handgrip strength, bent arm hang and sit-ups in 30s (s). Differences (in fitness and anthropometry) by place of residence were examined by one-way analysis of covariance. RESULTS Rural young people had higher cardiorespiratory fitness, but lower speed-agility and flexibility than urban young people (all p<0.001; mean differences=1.5 mL/kg per min, 0.4s and 0.9 cm respectively). Regarding muscular fitness, rural young people had a better performance in handgrip strength (mean difference=0.8 kg), bent arm hang (mean difference=2.3s), and a lower performance in sit-ups in 30s (mean difference=0.9s) (all p<0.001), compared to their urban peers. Rural young people had a lower body mass, body mass index (BMI) and sum of skinfolds (all p<0.05; mean differences=1.1 kg, 0.3 kg/m(2) and 4.9 mm respectively) than their urban peers. Effect size was small-medium (Cohen's d=0.1-0.3). CONCLUSION Rural Spanish children and adolescents had overall a healthier profile than their urban peers in terms of cardiorespiratory fitness, upper- and lower-limb muscular fitness and adiposity, while they performed worse in speed-agility and flexibility. The place of residence should be taken into account when implementing effective interventions to promote physical activity and health.
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Gallagher KS, Davis AM, Malone B, Landrum Y, Black W. Treating rural pediatric obesity through telemedicine: baseline data from a randomized controlled trial. J Pediatr Psychol 2011; 36:687-95. [PMID: 21372069 DOI: 10.1093/jpepsy/jsr011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To describe baseline characteristics of participants in a pediatric obesity intervention tailored specifically to rural families delivered via telemedicine. METHODS Randomized-control trial comparing a family-based behavioral intervention to a usual care condition. Participants Fifty-eight first through fifth graders and their parents from the rural Midwest. Measures Demographic, body mass index (BMI), Actigraph activity monitor information, 24-h dietary recalls, Child Behavior Checklist, Behavioral Pediatrics Feeding Assessment Scale. RESULTS Child mean BMI was in the 94th percentile for weight. Average daily dietary intake exceeded 2,000 kcal and children consumed over eight servings of high-calorie, low-nutrient-dense foods. Children are engaged in approximately 65 min of moderate, 12 min of vigorous and over 300 min of sedentary physical activity daily. CONCLUSIONS Baseline data suggest children in rural areas may engage in adequate physical activity but eat many daily servings of energy-dense foods. Rural families may benefit from a comprehensive, rurally tailored obesity-related health behavior intervention.
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Leal C, Chaix B. The influence of geographic life environments on cardiometabolic risk factors: a systematic review, a methodological assessment and a research agenda. Obes Rev 2011; 12:217-30. [PMID: 20202135 DOI: 10.1111/j.1467-789x.2010.00726.x] [Citation(s) in RCA: 261] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Recent environmental changes play a role in the dramatic increase in the prevalence of cardiometabolic risk factors (CMRFs) such as obesity, hypertension, type 2 diabetes, dyslipidemias and the metabolic syndrome in industrialized countries. Therefore, identifying environmental characteristics that are associated with risk factors is critical to develop more effective public health interventions. We conducted a systematic review of the literature investigating relationships between characteristics of geographic life environments and CMRFs (131 articles). Most studies were published after 2006, relied on cross-sectional designs, and examined whether sociodemographic and physical environmental characteristics, and more recently service environment characteristics, were associated with obesity or, to a lesser extent, hypertension. Only 14 longitudinal studies were retrieved; diabetes, dyslipidemias and the metabolic syndrome were rarely analysed; and aspects of social interactions in the neighbourhood were critically underinvestigated. Environmental characteristics that were consistently associated with either obesity or hypertension include low area socioeconomic position; low urbanization degree; low street intersection, service availability and residential density; high noise pollution; low accessibility to supermarkets and high density of convenience stores; and low social cohesion. Intermediate mechanisms between environmental characteristics and CMRFs have received little attention. We propose a research agenda based on the assessment of underinvestigated areas of research and methodological limitations of current literature.
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Affiliation(s)
- C Leal
- Inserm, U707, Research Unit in Epidemiology, Information Systems, and Modeling, Paris, France.
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Tambalis KD, Panagiotakos DB, Sidossis LS. Greek Children Living in Rural Areas Are Heavier but Fitter Compared to Their Urban Counterparts: A Comparative, Time-Series (1997-2008) Analysis. J Rural Health 2010; 27:270-7. [DOI: 10.1111/j.1748-0361.2010.00346.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Rodriguez R, Mowrer J, Romo J, Aleman A, Weffer SE, Ortiz RM. Ethnic and gender disparities in adolescent obesity and elevated systolic blood pressure in a rural US population. Clin Pediatr (Phila) 2010; 49:876-84. [PMID: 20522603 DOI: 10.1177/0009922810368135] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A cross-sectional study was conducted to assess the prevalence of overweight, obesity, and elevated systolic blood pressure (SBP) in ethnically diverse adolescents (1064 males; 974 females; 13-17 years) in a rural community. Prevalence of overweight was 20.4% in females and 17.5% in males. In contrast, the prevalence of obesity was 29.4% in males and 14.5% in females. African American males had the highest prevalence of obesity (33.3%) compared with non-Hispanic whites (26.3%). Prevalence of elevated SBP was higher than pre-elevated SBP in males regardless of race/ethnicity, but not in females. Obese females had 4-fold and 9-fold greater odds of developing pre-elevated SBP and elevated SBP, respectively, than their normal weight cohorts. Prevalence of obesity is almost twice that of overweight in males in our rural population suggesting that adolescent males from disadvantaged, rural populations are potentially at a greater risk for metabolic disorders than those in major metropolitan areas.
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Affiliation(s)
- Ruben Rodriguez
- School of Natural Sciences, University of California-Merced, 5200 N. Lake Road, Merced, CA 95343, USA.
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Evans AE, Springer AE, Evans MH, Ranjit N, Hoelscher DM. A Descriptive Study of Beverage Consumption among an Ethnically Diverse Sample of Public School Students in Texas. J Am Coll Nutr 2010; 29:387-96. [DOI: 10.1080/07315724.2010.10719856] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Shores KA, Moore JB, Yin Z. An Examination of Triple Jeopardy in Rural Youth Physical Activity Participation. J Rural Health 2010; 26:352-60. [PMID: 21029170 DOI: 10.1111/j.1748-0361.2010.00301.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Kindal A Shores
- Department of Recreation and Leisure Studies, East Carolina University, Greenville, North Carolina 27858-4353, USA.
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