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Dhanjani S, Allen H, Varman B, Callender C, Dave JM, Thompson D. Community-Based Participatory Obesity Prevention Interventions in Rural Communities: A Scoping Review. Nutrients 2024; 16:2201. [PMID: 39064643 PMCID: PMC11279648 DOI: 10.3390/nu16142201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 06/25/2024] [Accepted: 06/27/2024] [Indexed: 07/28/2024] Open
Abstract
Child obesity is a worldwide public health concern. In America, children from rural areas have greater odds of obesity in comparison to those from urban areas. Community-engaged research is important for all communities, particularly under-represented communities. This paper reports the results of a scoping review investigating community-engaged research in obesity prevention programs tested with school-aged children in rural America. A literature search of Medline Ovid was conducted to identify interventions reporting the results of obesity prevention interventions that promoted a healthy diet or physical activity (PA) behaviors to school-age children in rural communities of the United States (US). After title and abstract review, potentially relevant citations were further examined by assessing the full text. Each stage of review was conducted by two independent reviewers. Twelve studies met the inclusionary criteria and are included in this review. Most of the studies focused on elementary school participants (n = 7) and improving both diet and PA (n = 9). Out of the twelve studies, only five included the target audience in intervention development or implementation. The most popular type of community engagement was community participation (n = 4). This review revealed that community-engaged research is under-utilized in obesity prevention interventions tested with school-aged children in rural US communities.
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Affiliation(s)
- Saagar Dhanjani
- Department of Natural Science, Rice University, Houston, TX 77005, USA; (S.D.); (H.A.)
| | - Haley Allen
- Department of Natural Science, Rice University, Houston, TX 77005, USA; (S.D.); (H.A.)
| | - Beatriz Varman
- The Texas Medical Center Library, Houston, TX 77030, USA;
| | - Chishinga Callender
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; (C.C.); (J.M.D.)
| | - Jayna M. Dave
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; (C.C.); (J.M.D.)
| | - Debbe Thompson
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; (C.C.); (J.M.D.)
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Dave JM, Chen TA, Castro AN, White MA, Onugha EA, Zimmerman S, Thompson D. Urban-Rural Disparities in Food Insecurity and Weight Status among Children in the United States. Nutrients 2024; 16:2132. [PMID: 38999879 PMCID: PMC11243017 DOI: 10.3390/nu16132132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/01/2024] [Accepted: 07/03/2024] [Indexed: 07/14/2024] Open
Abstract
Place of residence (urban versus rural) is a contextual determinant of health that has received less attention in the food insecurity literature. The purpose of this study was to assess the urban-rural disparity in the prevalence of food insecurity and weight status among US children. Using data from the National Health and Nutrition Examination Survey (NHANES) 2013-2016 with three age groups of children (2-5, 6-11, and 12-17 years old), the associations of weight status and child and household food security status by urban-rural residence were examined using Rao-Scott Chi-square tests. Statistical significance was set at p < 0.05. Children living in urban areas were significantly more likely to experience household food insecurity (29.15%) compared to their rural counterparts (19.10%), among those aged 6-11 years. The associations between children's weight status and child and household food security status were significant for children living in urban areas overall and different age groups but not for children living in rural areas. These trends were more pronounced in older age groups. Given the link between food insecurity and higher obesity rates, particularly among urban children, this study highlights the importance of incorporating food security interventions into future obesity prevention programs.
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Affiliation(s)
- Jayna M Dave
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030, USA
| | - Tzuan A Chen
- Department of Psychological, Health, and Learning Sciences, University of Houston, 3657 Cullen Boulevard, Houston, TX 77204, USA
- HEALTH Research Institute, University of Houston, 4349 Martin Luther King Boulevard, Houston, TX 77204, USA
| | - Alexandra N Castro
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030, USA
| | - Mamie A White
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030, USA
| | - Elizabeth A Onugha
- Renal Services, Texas Children's Hospital, 1102 Bates Avenue, Houston, TX 77030, USA
- Department of Pediatrics-Nephrology, Baylor College of Medicine, 1102 Bates Avenue, Houston, TX 77030, USA
| | - Sloane Zimmerman
- Department of Pediatrics-Gastroenterology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
| | - Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030, USA
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Dave JM, Chen TA, Castro AN, White M, Onugha EA, Zimmerman S, Thompson D. Regional Variability in the Prevalence of Food Insecurity and Diet Quality among United States Children. Nutrients 2024; 16:224. [PMID: 38257117 PMCID: PMC10819603 DOI: 10.3390/nu16020224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/29/2023] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
Understanding the association between food security status (FSS) and diet quality in children is crucial. This study investigated regional variability in FSS, participation in the federal nutrition assistance program (FNAP), and diet quality among US children. National Health and Nutrition Examination Survey (NHANES) data from 2013 to 2016 were analyzed. The association between FSS, FNAP participation, and diet quality (Healthy Eating Index-HEI-2015) was assessed using multiple linear/logistic regression models. The sample included 6403 children (mean age: 7.5 years; 51% male; 33% Hispanic). Within the sample, 13% reported child food insecurity, and 30% reported household food insecurity. Additionally, 90% participated in the FNAP, and 88% were enrolled in school lunch programs. Children in urban areas were significantly more likely to report household food insecurity than those in rural areas (29.15% vs. 19.10%). The overall HEI-2015 score was 48.2. The associations between child/household FSS and FNAP participation as well as between child/household FSS and diet quality did not differ by urban/rural residence status, irrespective of the children's age groups. There is a need for improvement in children's diet quality, regardless of age or urban/rural residence. The findings suggest that improving children's diets requires broader action as well as the prioritizing of children in urban areas experiencing food insecurity in future dietary interventions.
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Affiliation(s)
- Jayna M. Dave
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030, USA; (A.N.C.); (M.W.); (D.T.)
| | - Tzuan A. Chen
- Department of Psychological, Health, and Learning Sciences, University of Houston, 3657 Cullen Boulevard, Houston, TX 77204, USA;
- HEALTH Research Institute, University of Houston, 4349 Martin Luther King Boulevard, Houston, TX 77204, USA
| | - Alexandra N. Castro
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030, USA; (A.N.C.); (M.W.); (D.T.)
| | - Mamie White
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030, USA; (A.N.C.); (M.W.); (D.T.)
| | - Elizabeth A. Onugha
- Renal Services, Texas Children’s Hospital, 1102 Bates Avenue, Houston, TX 77030, USA;
- Department of Pediatrics—Nephrology, Baylor College of Medicine, 1102 Bates Avenue, Houston, TX 77030, USA
| | - Sloane Zimmerman
- Department of Pediatrics—Gastroenterology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA;
| | - Debbe Thompson
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030, USA; (A.N.C.); (M.W.); (D.T.)
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Johnson AM, Bocarro JN, Saelens BE. Youth Sport Participation by Metropolitan Status: 2018-2019 National Survey of Children's Health (NSCH). RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2023; 94:895-904. [PMID: 35580038 DOI: 10.1080/02701367.2022.2069662] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 04/18/2022] [Indexed: 06/15/2023]
Abstract
Purpose: This cross-sectional study used data from the 2018-2019 National Survey of Children's Health to examine the association between metropolitan statistical area (MSA) status and sports participation among American youth ages 6-17. Methods: Weighted prevalence statistics were computed for sports participation by MSA status (non-MSA, MSA), overall and by child sex and age. Modified Poisson regression was used to estimate prevalence ratios (PR) for non-MSA versus MSA youth, before and after adjusting for special health-care needs, race/ethnicity, household income, parent education, and family structure. Results: The final sample included 30,029 youth [Mage = 11.6 years (SD = 0.4), 51.4% female, 49.0% White]. About 56% participated in sports in the past year. Sports participation was significantly higher among females versus males [59.1% (95% CI: 57.4%-60.7%) versus 52.1% (95% CI: 50.4%-53.8%), p < .001]. Among ages 6-11, those in non-MSAs (versus MSAs) were less likely to participate in sports [PR 0.92 (95% CI: 0.86-0.99), p = .033], which was non-significant after adjustment. In adjusted models, youth ages 12-17 in non-MSAs (versus in MSAs) were more likely to participate in sports overall [aPR 1.07 (95% CI: 1.00-1.15), p = .042] and among males [aPR 1.12 (95% CI: 1.01-1.23), p = .026]. Conclusion: The relationship between MSA status and sports participation may be largely driven by factors that affect youth's ability to participate in sports. Sports participation was higher among females versus males overall. In the models adjusted for demographics, non-MSA youth ages 12-17 were more likely to participate, particularly males. Efforts promoting youth sports should consider differences in socio-demographic factors between MSA versus non-MSA areas to help increase participation.
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Affiliation(s)
| | | | - Brian E Saelens
- Seattle Children's Research Institute
- University of Washington
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Androutsos O, Tsiampalis T, Kouvari M, Manou M, Dimopoulou M, Georgiou A, Kosti RI, Charmandari E. Assessment of Diet Quality in Children and Adolescents with Overweight or Obesity in Greece. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1261. [PMID: 37508758 PMCID: PMC10378587 DOI: 10.3390/children10071261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023]
Abstract
The adoption of healthy nutritional habits constitutes one of the most important determinants of healthy growth and development in childhood. Few studies in Greece have examined children's diet quality using diet indices. The present study aimed to assess the diet quality of a large cohort of children and adolescents with overweight or obesity. Study participants (n = 1335), aged 2-18, were recruited through the Out-patient Clinic for the Prevention and Management of Overweight and Obesity in Childhood and Adolescence, Aghia Sophia Children's Hospital, Athens, Greece. Anthropometric, socio-demographic, and behavioral data were collected using standard methods and equipment. The Diet Quality Index (DQI), which includes four subcomponents (i.e., dietary diversity, dietary quality, dietary equilibrium, and meal index), was calculated to assess each subject's diet quality. According to the results of this study, children's total DQI score was 63.1%. It was observed that 66.7% of the children had at least moderate diet quality (total DQI ≥ 59.34%). Boys had higher values of the total DQI and certain components of the DQI (i.e., dietary equilibrium score and meal index) compared to girls. Three out of ten children with overweight/obesity had poor diet quality (i.e., DQI ≤ 59.33). Younger children (2-5 years old) were found to have the lowest values of dietary equilibrium compared to older children (6-9 and 12-18 years old). Moreover, boys had higher values of the total DQI score and of specific components of this index (i.e., dietary equilibrium and meal index) compared to girls. Children living in urban areas had higher values in the dietary quality score compared to those living in rural areas. Children with overweight had higher values of the dietary quality score and the total DQI score compared to children with obesity. The present study highlighted that children and adolescents with overweight or obesity have poor diet quality. Multilevel and higher intensity interventions should be designed specifically for this group to achieve tangible outcomes.
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Affiliation(s)
- Odysseas Androutsos
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, University of Thessaly, 42132 Trikala, Greece
| | - Thomas Tsiampalis
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, University of Thessaly, 42132 Trikala, Greece
| | - Matina Kouvari
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Canberra, ACT 2617, Australia
| | - Maria Manou
- Division of Endocrinology, Metabolism, and Diabetes, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, 'Aghia Sophia' Children's Hospital, 11527 Athens, Greece
| | - Maria Dimopoulou
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, University of Thessaly, 42132 Trikala, Greece
| | - Alexandra Georgiou
- Division of Endocrinology, Metabolism, and Diabetes, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, 'Aghia Sophia' Children's Hospital, 11527 Athens, Greece
| | - Rena I Kosti
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, University of Thessaly, 42132 Trikala, Greece
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism, and Diabetes, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, 'Aghia Sophia' Children's Hospital, 11527 Athens, Greece
- Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
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Head KC, Morella K, Lugo MP, Key JD. Participation in a School-Based Wellness Initiative Associated With Improved K-12 Student Body Mass Index Trends. THE JOURNAL OF SCHOOL HEALTH 2023; 93:547-556. [PMID: 36575648 DOI: 10.1111/josh.13292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 11/03/2022] [Accepted: 11/11/2022] [Indexed: 06/06/2023]
Abstract
BACKGROUND Associations between school participation in an academic medical center-supported school-based wellness initiative and programmatic components implemented with change in average student body mass index (BMI) over time were examined. METHODS This was an observational study of 103 K-12 South Carolina schools over school years 2014-2018, classified as participating (n = 87 schools, 27,855 students) or non-participating (n = 16 schools; 3608 students). Associations between students' BMI z-score (BMIz) and school participation were evaluated by linear multilevel mixed-effects modeling using data from FitnessGram and the School Wellness Checklist© (SWC), respectively. RESULTS One-third of the students had a BMI percentile ≥85. Average student BMIz decreased in participating schools (p = .026) and increased in non-participating schools (p = .004) over time. For schools that participated two or more years, there was an inverse relationship between SWC score and student BMIz (p = .002) that did not differ by school type, rural/urban location, Title 1 status, or student sex. Physical activity and stress management interventions for students, as well as employee wellness and establishing a wellness committee at the school level were significantly associated with decreased average student BMIz (all p < .05). CONCLUSION Implementation of similar comprehensive school-based wellness programs focused on improving physical activity, stress management, and employee engagement may help prevent and reduce pediatric obesity in diverse communities.
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Affiliation(s)
- Kathleen C Head
- Boeing Center for Children's Wellness, Departments of Pediatrics and Internal Medicine, Medical University of South Carolina, 125 Doughty St., MSC 561, Charleston, SC, 29425-5610
| | - Kristen Morella
- Department of Public Health Sciences, Medical University of South Carolina, 135 Rutledge Ave MSC 835, Charleston, SC, 29425-5610
| | - Michael P Lugo
- Department of Pediatrics, Medical University of South Carolina, 10 McClennan Banks Drive MSC 915, Charleston, SC, 29425-5610
| | - Janice D Key
- Boeing Center for Children's Wellness, Department of Pediatrics, Medical University of South Carolina, 125 Doughty St., MSC 561, Charleston, SC, 29425-5610
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Hajebi A, Nasserinejad M, Azadnajafabad S, Ghasemi E, Rezaei N, Yoosefi M, Ghamari A, Keykhaei M, Ghanbari A, Mohammadi E, Rashidi MM, Gorgani F, Moghimi M, Namazi Shabestari A, Farzadfar F. Physical Inactivity, Inequalities, and Disparities Across Districts of Iran: A STEPs Survey-Based Analysis. J Phys Act Health 2023:1-7. [PMID: 37172954 DOI: 10.1123/jpah.2022-0113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 12/13/2022] [Accepted: 03/27/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND We aimed to estimate the prevalence of physical inactivity in all districts of Iran and the disparities between subgroups defined by various measures. METHODS Small area estimation method was employed to estimate the prevalence of physical inactivity in districts based on the remaining districts in which data on the level of physical inactivity were available. Various comparisons on the estimations were done based on socioeconomic, sex, and geographical stratifications to determine the disparities of physical inactivity among districts of Iran. RESULTS All districts of Iran had a higher prevalence of physical inactivity compared with the world average. The estimated prevalence of physical inactivity among all men in all districts was 46.8% (95% uncertainty interval, 45.9%-47.7%). The highest and lowest estimated disparity ratio of physical inactivity were 1.95 and 1.14 in males, and 2.25 and 1.09 in females, respectively. Females significantly had a higher prevalence of 63.5% (62.7%-64.3%). Among both sexes, the poor population and urban residents significantly had higher prevalence of physical inactivity than rich population and rural residents, respectively. CONCLUSIONS The high prevalence of physical inactivity among Iranian adult population suggests the urgent need to adopt population-wide action plans and policies to handle this major public health problem and avert the probable burden.
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Affiliation(s)
- Amirali Hajebi
- Endocrinology and Metabolism Population Sciences Institute, Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran,Iran
| | - Maryam Nasserinejad
- Endocrinology and Metabolism Population Sciences Institute, Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran,Iran
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Science, Tehran,Iran
| | - Sina Azadnajafabad
- Endocrinology and Metabolism Population Sciences Institute, Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran,Iran
| | - Erfan Ghasemi
- Endocrinology and Metabolism Population Sciences Institute, Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran,Iran
| | - Negar Rezaei
- Endocrinology and Metabolism Population Sciences Institute, Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran,Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran,Iran
| | - Moein Yoosefi
- Endocrinology and Metabolism Population Sciences Institute, Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran,Iran
| | - Azin Ghamari
- Endocrinology and Metabolism Population Sciences Institute, Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran,Iran
| | - Mohammad Keykhaei
- Endocrinology and Metabolism Population Sciences Institute, Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran,Iran
- Feinberg Cardiovascular Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL,USA
| | - Ali Ghanbari
- Endocrinology and Metabolism Population Sciences Institute, Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran,Iran
| | - Esmaeil Mohammadi
- Endocrinology and Metabolism Population Sciences Institute, Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran,Iran
| | - Mohammad-Mahdi Rashidi
- Endocrinology and Metabolism Population Sciences Institute, Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran,Iran
| | - Fateme Gorgani
- Endocrinology and Metabolism Population Sciences Institute, Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran,Iran
| | - Mana Moghimi
- Endocrinology and Metabolism Population Sciences Institute, Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran,Iran
| | - Alireza Namazi Shabestari
- Department of Geriatric Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran,Iran
| | - Farshad Farzadfar
- Endocrinology and Metabolism Population Sciences Institute, Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran,Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran,Iran
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Galán-Arroyo C, Mendoza-Muñoz DM, Pérez-Gómez J, Hernández-Mosqueira C, Rojo-Ramos J. Analysis of Self-Perceived Physical Fitness of Physical Education Students in Public Schools in Extremadura (Spain). CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10030604. [PMID: 36980162 PMCID: PMC10047493 DOI: 10.3390/children10030604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/15/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023]
Abstract
Adolescence is a stage of crucial physiological and psychological changes within the individual's life cycle, where fitness work is important. With self-perception being crucial in relation to adolescent health and well-being, a positive perception of fitness is directly related to increased practice or higher level of physical activity (PA). Thus, the aims were: (1) to analyze, with the Visual Analogue Fitness Perception Scale for Adolescents (FP VAS A), the self-perceived physical fitness (PF) of high school students, (2) to investigate if there are differences according to sex and school location, and (3) to study the correlations between the items of the FP VAS A with age and body mass index (BMI). For this purpose, a cross-sectional study was designed with a total of 961 participants, 48.8% boys and 51.2% girls in secondary education, where 31.9% studied in rural schools and 68.1% in urban schools. The FP VAS A scale was used to assess self-reported PF. Regarding the results, there were statistically significant differences between sexes (p < 0.001), with boys showing higher scores than girls in all the items of the FP VAS A scale, with the exception of global flexibility. Inverse, mean and significant correlations were established between BMI and self-perceived overall PF (r = -0.202; p < 0.001), cardiorespiratory endurance (r = -0.226; p < 0.001) and movement speed (r = -0.268; p < 0.001). Between age and self-perceived cardiorespiratory endurance (r = -0.138; p < 0.001) an inverse, mean and significant correlation was also observed. In conclusion, boys showed a better self-perception of PF than girls for all physical abilities, with the exception of flexibility. School location was not shown to influence students' self-perceived PF. In addition, most of the self-perceived PF abilities for overall fitness correlated inversely with BMI.
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Affiliation(s)
- Carmen Galán-Arroyo
- Physical and Health Literacy and Health-Related Quality of Life (PHYQoL), Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain
| | - David Manuel Mendoza-Muñoz
- Physical Activity for Education, Performance and Health, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Jorge Pérez-Gómez
- Health Economy Motricity and Education (HEME), Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain
| | | | - Jorge Rojo-Ramos
- Physical Activity for Education, Performance and Health, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
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Vieira D, Gomes EC, Negrão ÂS, Thuany M, Gomes TN. Movement Behaviour and Health Outcomes in Rural Children: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2514. [PMID: 36767880 PMCID: PMC9915981 DOI: 10.3390/ijerph20032514] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/27/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Studies with rural children are limited, and results are divergent regarding the information on movement behaviours. PURPOSE to (i) describe the physical activity and sedentary behaviour in children; (ii) synthetize the year and place of publication, methodological quality, and instruments used to measure physical activity and sedentary behaviour; and (iii) to analyse the relationship between physical activity, sedentary behaviour, and health outcomes in these children. METHODS We use the databases PubMed, Web of Science, SPORTDiscus, Scopus, Virtual Health Library, and SciELO, considering papers published until October 2021. A total of 12,196 studies were identified, and after the exclusion of duplicate, title and abstract screening, and the full-text assessment, a total of 68 were included in the study. RESULTS A cross-sectional design was dominant among the studies, with sample sizes ranging from 23 to 44,631 children of both sexes. One-third of the studies were conducted in North America and Europe, and most of them used device-based measurements. Inequalities were observed regarding sex, age, economic level, race, and physical activity domains within and between the places of residence. Sociodemographic characteristics were also related to health outcomes for children living in rural and urban areas. CONCLUSION It is necessary to increase the evidence on movement behaviours among children living in the countries of South America and Oceania, as well as to increase the level of evidence on the role of school for physical activity in children in rural areas, given the inconsistent findings.
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Affiliation(s)
- Douglas Vieira
- Post-Graduation Program of Physical Education, Department of Physical Education, Federal University of Sergipe, São Cristóvão 49100-000, Brazil
| | - Elenir Campelo Gomes
- Post-Graduation Program of Human Movement Sciences, Federal University of Pará, Belém 66075-110, Brazil
| | - Ângelo Solano Negrão
- Post-Graduation Program of Anthropic Studies in the Amazon, Federal University of Pará, Belém 66075-110, Brazil
| | - Mabliny Thuany
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - Thayse Natacha Gomes
- Post-Graduation Program of Physical Education, Department of Physical Education, Federal University of Sergipe, São Cristóvão 49100-000, Brazil
- Department of Physical Education and Sports Science, University of Limerick, V94 T9PX Limerick, Ireland
- Physical Activity for Health Cluster, Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland
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Bonnell LN, Clifton J, Rose GL, Waddell EN, Littenberg B. Urban-Rural Differences in Mental and Physical Health among Primary Care Patients with Multiple Chronic Conditions: A Secondary Analysis from a Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15580. [PMID: 36497657 PMCID: PMC9741371 DOI: 10.3390/ijerph192315580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 11/20/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
PURPOSE Rural health disparities are largely attributable to access to healthcare, socioeconomic status, and health behaviors. Little is known about the persistence of these disparities when differences in access to care are eliminated. We sought to investigate urban-rural differences in physical and mental health in primary care patients with demonstrated access to primary care. METHODS We obtained cross-sectional survey responses from a multicenter randomized controlled trial on 2726 adult primary care patients with multiple chronic medical or behavioral conditions from 42 primary care practices in 13 states. Study outcomes include measures of mental health including: The Patient-Reported Outcomes Measurement Information System (PROMIS-29®), General Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9), as well as physical health including: the PROMIS-29® and the Duke Activity Status Index (DASI). Urban-rural residence was indicated by census-tract Rural Urban Commuting Areas of the participant's home address. Differences in mental and physical health outcomes attributable to rurality were assessed using multilevel models with a random intercept for census-tract. RESULTS After adjustment for demographic and neighborhood characteristics, urban residents had significantly worse generalized anxiety disorder (GAD-7) (ß = 0.7; 95% CI = 0.1, 1.3; p = 0.027), depression (PHQ-9) (ß = 0.7; 95% CI = 0.1, 1.4; p = 0.024), and functional capacity (DASI) (ß = -0.4; 95% CI = -0.5, -0.2; p < 0.001) compared to rural residents. Urban residents also had significantly worse anxiety and depression as measured by the PROMIS-29® compared to their rural counterparts. There were no urban-rural differences in the other PROMIS-29® subdomains. CONCLUSIONS Among adults with demonstrated access to care and multiple diagnosed chronic conditions, rural residents had better mental health and functional capacity than their urban counterparts. This finding is not consistent with prior research documenting rural health disparities and should be confirmed.
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Affiliation(s)
- Levi N. Bonnell
- Department of Medicine, University of Vermont, Burlington, VT 05405, USA
| | - Jessica Clifton
- Department of Medicine, University of Vermont, Burlington, VT 05405, USA
| | - Gail L. Rose
- Department of Psychiatry, University of Vermont, Burlington, VT 05405, USA
| | - Elizabeth N. Waddell
- Division of General Internal Medicine and Geriatrics, Oregon Health and Science University, Portland, OR 97201, USA
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11
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Gülü M, Yapici H, Mainer-Pardos E, Alves AR, Nobari H. Investigation of obesity, eating behaviors and physical activity levels living in rural and urban areas during the covid-19 pandemic era: a study of Turkish adolescent. BMC Pediatr 2022; 22:405. [PMID: 35820871 PMCID: PMC9274641 DOI: 10.1186/s12887-022-03473-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 07/05/2022] [Indexed: 11/27/2022] Open
Abstract
Background The purpose of this study was to determine the eating behaviors, obesity and physical activity status of children of similar ages living in rural and urban areas and to examine these relationships during the coronavirus disease (COVID-19) pandemic process. Method The research was conducted using the scanning model. The research group consists of children living in rural and urban areas in Turkey. The sample of the study consists of a total of 733 adolescent participants, 351 females (47.9%) and 382 males (52.1%). After anthropometric measurements were made, the Physical Activity Questionnaire for older children and the Yale Food Addiction Scale for children 2.0 were used to determine the food addiction and physical activity status of children during the COVID19 pandemic process. Since the groups were homogeneously distributed, independent samples t-test and Pearson correlation test were used. Result In terms of food addiction and physical activity levels, children living in the urban have higher scores than children living in rural areas. In addition, children living in the urban were taller and have higher body mass values than those in rural areas. In terms of physical activity level and food addiction levels, while girls living in the urban had higher activity levels than those living in rural areas, no statistically significant difference was found between the physical activity levels of boys. When evaluated in terms of general and gender, it was determined that children living in rural areas were overweight and obese at a higher rate. Obese children had higher levels of food addiction and lower physical activity levels than non-obese children. Conclusion In order to prevent childhood obesity, the level of food addiction should be reduced as well as increasing the level of physical activity. This study is limited in terms of cross-sectional evaluation. Future research can experimentally reveal how much obesity is reduced by methods such as exercise and diet interventions.
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Affiliation(s)
- Mehmet Gülü
- Department of Coaching Education, Faculty of Sport Sciences, Kirikkale University, Kirikkale, 71450, Turkey
| | - Hakan Yapici
- Department of Coaching Education, Faculty of Sport Sciences, Kirikkale University, Kirikkale, 71450, Turkey
| | - Elena Mainer-Pardos
- Health Sciences Faculty, Universidad San Jorge, Autovia A23 km 299, 50830, Saragossa, Villanueva de Gállego, Spain
| | - Ana Ruivo Alves
- Department of Sport Sciences, University of Beira Interior, Covilha, Portugal.,Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, 5001-801, Vila Real, Portugal
| | - Hadi Nobari
- Department of Motor Performance, Faculty of Physical Education and Mountain Sports, Transilvania University of Braşov, 500068, Braşov, Romania. .,Department of Exercise Physiology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, 56199-11367, Iran. .,Faculty of Sport Sciences, University of Extremadura, 10003, Cáceres, Spain.
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12
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A Comparison of Meeting Physical Activity and Screen Time Recommendations between Canadian Youth Living in Rural and Urban Communities: A Nationally Representative Cross-Sectional Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074394. [PMID: 35410073 PMCID: PMC8998429 DOI: 10.3390/ijerph19074394] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/01/2022] [Accepted: 04/03/2022] [Indexed: 02/07/2023]
Abstract
Meeting the physical activity (PA) and recreational screen time recommendations for children and young people is associated with several health benefits. The purpose of this study was to compare the odds of meeting PA and recreational screen time recommendations between the Canadian youth living in urban versus rural communities. We analyzed nationally representative cross-sectional data collected as part of the 2017–2018 cycles of the Canadian Community Health Survey among young people aged 12–17 years. PA and screen time were self-reported. Sex-specific multivariable logistic regression models were used to estimate the odds of meeting individual and combined PA and recreational screen time recommendations by rural and urban status after adjusting for individual, socioeconomic, and seasonal covariates. The odds of meeting the PA recommendation were not statistically significantly different among males (OR = 1.01, 95% CI: 0.86–1.18) or females (OR 1.05, 95% CI: 0.99–1.11) living in urban versus rural communities. The odds of meeting the recreational screen time recommendations were statistically significantly lower among male (OR = 0.71, 95% CI: 0.65–0.77) and female (OR = 0.71, 95% CI: 0.59–0.86) youth living in urban compared to those in rural communities. The odds of meeting the combined PA and screen time recommendations were statistically significantly lower among urban males (OR = 0.75, 95% CI: 0.71–0.81) but not females (OR = 0.82, 95% CI: 0.58–1.15) than those from rural communities. These findings suggest that residential context (i.e., urban versus rural) may have a differential impact on meeting the combined PA and screen time recommendations among the male and female Canadian youth. Future research should investigate these differences using device-based measures.
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13
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Lo AX, Wedel LK, Liu SW, Wongtangman T, Thatphet P, Santangelo I, Chary AN, Biddinger PD, Grudzen CR, Kennedy M. COVID-19 hospital and emergency department visitor policies in the United States: Impact on persons with cognitive or physical impairment or receiving end-of-life care. J Am Coll Emerg Physicians Open 2022; 3:e12622. [PMID: 35079730 PMCID: PMC8776041 DOI: 10.1002/emp2.12622] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/15/2021] [Accepted: 11/23/2021] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To characterize the national distribution of COVID-19 hospital and emergency department visitor restriction policies across the United States, focusing on patients with cognitive or physical impairment or receiving end-of-life care. METHODS Cross-sectional study of visitor policies and exceptions, using a nationally representative random sample of EDs and hospitals during the first wave of the COVID-19 pandemic, by trained study investigators using standardized instrument. RESULTS Of the 352 hospitals studied, 326 (93%) had a COVID-19 hospital-wide visitor restriction policy and 164 (47%) also had an ED-specific policy. Hospital-wide policies were more prevalent at academic than non-academic (96% vs 90%; P < 0.05) and at urban than rural sites (95% vs 84%; P < 0.001); however, the prevalence of ED-specific policies did not significantly differ across these site characteristics. Geographic region was not associated with the prevalence of any visitor policies. Among all study sites, only 58% of hospitals reported exceptions for patients receiving end-of-life care, 39% for persons with cognitive impairment, and 33% for persons with physical impairment, and only 12% provided policies in non-English languages. Sites with ED-specific policies reported even fewer exceptions for patients with cognitive impairment (29%), with physical impairments (24%), or receiving end-of-life care (26%). CONCLUSION Although the benefits of visitor policies towards curbing COVID-19 transmission had not been firmly established, such policies were widespread among US hospitals. Exceptions that permitted family or other caregivers for patients with cognitive or physical impairments or receiving end-of-life care were predominantly lacking, as were policies in non-English languages.
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Affiliation(s)
- Alexander X. Lo
- Department of Emergency MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Center for Health Services & Outcomes ResearchNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Logan K. Wedel
- Department of Emergency MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Shan W. Liu
- Department of Emergency MedicineMassachusetts General HospitalBostonMassachusettsUSA
- Department of Emergency MedicineHarvard Medical SchoolBostonMassachusettsUSA
| | - Thiti Wongtangman
- Department of Emergency MedicineMassachusetts General HospitalBostonMassachusettsUSA
- Department of Emergency MedicineLerdsin General HospitalBangkokThailand
| | - Phraewa Thatphet
- Department of Emergency MedicineMassachusetts General HospitalBostonMassachusettsUSA
- Department of Emergency MedicineFaculty of MedicineKhon Kaen UniversityKhon KaenThailand
| | - Ilianna Santangelo
- Department of Emergency MedicineMassachusetts General HospitalBostonMassachusettsUSA
| | - Anita N. Chary
- Departments of Medicine and Emergency MedicineBaylor College of Medicine
| | - Paul D. Biddinger
- Department of Emergency MedicineMassachusetts General HospitalBostonMassachusettsUSA
- Department of Emergency MedicineHarvard Medical SchoolBostonMassachusettsUSA
- Mass General BrighamBostonMassachusettsUSA
| | - Corita R. Grudzen
- Ronald O. Perelman Department of Emergency Medicine and Department of Population HealthNYU Grossman School of MedicineNew YorkNew YorkUSA
| | - Maura Kennedy
- Department of Emergency MedicineMassachusetts General HospitalBostonMassachusettsUSA
- Department of Emergency MedicineHarvard Medical SchoolBostonMassachusettsUSA
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14
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Grace SM, Barr-Anderson DJ, Fulkerson JA. Exploring Associations of Household Chaos and Child Health Behaviors in Rural Families. Am J Health Behav 2022; 46:49-59. [PMID: 35227369 PMCID: PMC9704546 DOI: 10.5993/ajhb.46.1.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Objectives: Regular physical activity (PA) and limited sedentary behavior (SB) and screen-time are essential for children's health, and rural children are more likely to have overweight and obesity. Household chaos (HHchaos), defined as disorganization characterized by noise and crowding, is associated with negative behavioral outcomes in children. In this study, we examined associations between HHchaos and PA, SB, and screen-time among rural children. Methods: Parent/child dyads (N=105) were enrolled in NU-HOME, a family-based, obesity prevention randomized-controlled trial. We used hierarchical regression analyses of baseline data to examine unadjusted and adjusted (child age, sex, BMI z-scores and economic assistance) associations between HHchaos and outcomes. Results: Children were 8.96 ± 1.06 years old; 58% were female; and 53% were categorized as normal weight. Total daily PA, SB, and weekday screen-time were 259.1 ± 58.22 minutes, 499.9 ± 77.46 minutes, and 1.79 ± 1.48 hours, respectively. Unadjusted HHchaos scores (mean = 5.04 ± 3.6; range = 0-15 with higher score indicating more chaos) were not associated with child PA or SB. HHchaos was positively associated with child screen-time in all models (p<.05), except the fully adjusted model for weekday screen-time. Conclusions: Our findings suggest that decreasing household chaos may be useful in reducing child screen-time. Our findings align with current literature in viewing household chaos as a risk factor for children's health.
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Affiliation(s)
| | | | - Jayne A Fulkerson
- University of Minnesota, Twin Cities, United States; grace130@umn. edu
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15
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Christiana RW, Bouldin ED, Battista RA. Active living environments mediate rural and non-rural differences in physical activity, active transportation, and screen time among adolescents. Prev Med Rep 2021; 23:101422. [PMID: 34159049 PMCID: PMC8193609 DOI: 10.1016/j.pmedr.2021.101422] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 05/25/2021] [Indexed: 01/10/2023] Open
Abstract
Disparities in physical activity-related behaviors among rural and non-rural adolescents are important to consider given the relatively recent concerns surrounding the health of rural populations. Differences in rural and non-rural environments may facilitate or hinder physical activity opportunities. The purpose of this study is to examine differences between non-rural and rural adolescents' moderate-to-vigorous physical activity (MVPA), screen time, and active transportation, including the mediating role of neighborhood resources. Data came from 1,128 adolescents (207 rural, 18%) aged 12-17 years old and their parents living in the United States in the 2014 Family Life, Activity, Sun, Health, and Eating (FLASHE) study. Counterfactual mediation models were used to compare MVPA and screen time (linear regression) and active transit (log-binomial regression) among rural and non-rural adolescents, adjusting for demographics and health and measuring the mediating influence of neighborhood resources for PA. In adjusted models, rural adolescents engaged in less MVPA at school compared to non-rural adolescents (B = -1.14 min/day, p = 0.031) while no difference was found in MVPA at home or on weekends. Rural adolescents had less screen time (B = -2.1 min/day, p = 0.036) than their non-rural peers and were less likely to report active transit trips than non-rural adolescents (OR = 0.66, p = 0.016). Much of the differences in MVPA (70%) and active transit (54%) were mediated by differences in neighborhood resources. Improving the neighborhood resources in rural areas may encourage adolescents to be more active. This includes providing physical activity resources in rural areas such as sidewalks, bike lanes, greenways, playgrounds, fitness facilities, and parks/green space.
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Affiliation(s)
- Richard W. Christiana
- Department of Health & Exercise Science, Beaver College of Health Sciences, Appalachian State University, 1179 State Farm Road, Boone, NC 28608, USA
| | - Erin D. Bouldin
- Department of Health & Exercise Science, Beaver College of Health Sciences, Appalachian State University, 1179 State Farm Road, Boone, NC 28608, USA
| | - Rebecca A. Battista
- Department of Health & Exercise Science, Beaver College of Health Sciences, Appalachian State University, 1179 State Farm Road, Boone, NC 28608, USA
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16
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Collado ZC, Rescober AAS, Hipolito IG, Ulat APA, Tayfour A. Examining community-managed drug outlets' failure in geographically isolated and disadvantaged areas: insights from the consumers' end. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2021. [DOI: 10.1093/jphsr/rmaa008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Objectives
The article aimed to examine the impact of poor purchasing power, perceptions on the physical structure, and medicine demand to community-managed drug outlets or Botika ng Barangay (BnB) in the Philippines. The study investigated what contributes to program resiliency or failure in so far as the consumers in geographically isolated and disadvantaged area (GIDA) are concerned.
Methods
Findings were drawn from five sets of focus-group discussion (FGD) among residents, four in-depth interviews (IDIs) with former operators of BnB and three IDI with former members of the village council specifically assigned in health sector.
Key findings
The study found out that all our study variables namely; poor purchasing power, perceptions on BnBs' physical image, and limited medicines that do not match the consumers' medicine demand did not contribute to the failure of the program in their communities. However, the study found out that informal arrangements in the community which allowed people to just loan medicines without actually paying in return was intimately connected to BnBs' closure in the communities.
Conclusion
The study suggests that, in the context of GIDAs, the failure of community-managed drug outlets rests as well on financially unsustainable practices in the community. This, we believe, can be negated through provisions for medicine subsidy.
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Affiliation(s)
- Zaldy C Collado
- Department of Sociology, Faculty of Arts and Letters, University of Santo Tomas, Manila, Philippines
| | | | - Imee G Hipolito
- College of Pharmacy, Adamson University, Manila, Philippines
| | | | - Abubakr Tayfour
- College of Pharmacy, Adamson University, Manila, Philippines
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17
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Greder K, Zaman A, Routh B, Hammons A, Villegas E. Rural Midwestern Mexican Fathers' Perspectives on Family Food, Mealtimes, and Physical Activity. Ecol Food Nutr 2020; 60:409-434. [PMID: 33334199 DOI: 10.1080/03670244.2020.1858408] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Two focus group interviews with eight low-income Mexican fathers in two communities in a rural Midwestern state explored fathers' perceptions, behaviors, and roles related to child and family food consumption, mealtimes, and physical activity. On average, fathers were 34 years of age, had 10 years of formal education, and annual household incomes ranged from $36,250 to $46,249. Findings include the identification of fifteen themes through the process of thematic analysis that are organized by five thematic areas of interest (family food patterns, strategies for healthy eating, family roles in food shopping and preparation, family mealtimes, physical activity among families). Findings revealed ways fathers contributed to their children's and families' health and well-being, and challenges they faced. Health promotion efforts aimed at rural, low-income Mexican immigrant families can benefit from embracing fathers' perspectives and how they influence the health and well-being of their children and families.
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Affiliation(s)
- Kimberly Greder
- Department of Human Development and Family Studies, Iowa State University, Ames, Iowa, USA
| | - Andrew Zaman
- Department of Kinesiology and Department of Psychology, Iowa State University, Ames, Iowa, USA
| | - Brianna Routh
- Department of Health and Human Development, Montana State University, Bozeman, Montana, USA
| | - Amber Hammons
- Department of Child and Family Science, California State University, Fresno, California, USA
| | - Elizabeth Villegas
- Department of Education and Child Development, University of Chicago, Chicago, Illinois, USA
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18
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Kaczynski AT, Eberth JM, Stowe EW, Wende ME, Liese AD, McLain AC, Breneman CB, Josey MJ. Development of a national childhood obesogenic environment index in the United States: differences by region and rurality. Int J Behav Nutr Phys Act 2020; 17:83. [PMID: 32615998 PMCID: PMC7330993 DOI: 10.1186/s12966-020-00984-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 06/10/2020] [Indexed: 11/24/2022] Open
Abstract
Background Diverse environmental factors are associated with physical activity (PA) and healthy eating (HE) among youth. However, no study has created a comprehensive obesogenic environment index for children that can be applied at a large geographic scale. The purpose of this study was to describe the development of a childhood obesogenic environment index (COEI) at the county level across the United States. Methods A comprehensive search of review articles (n = 20) and input from experts (n = 12) were used to identify community-level variables associated with youth PA, HE, or overweight/obesity for potential inclusion in the index. Based on strength of associations in the literature, expert ratings, expertise of team members, and data source availability, 10 key variables were identified – six related to HE (# per 1000 residents for grocery/superstores, farmers markets, fast food restaurants, full-service restaurants, and convenience stores; as well as percentage of births at baby (breastfeeding)-friendly facilities) and four related to PA (percentage of population living close to exercise opportunities, percentage of population < 1 mile from a school, a composite walkability index, and number of violent crimes per 1000 residents). Data for each variable for all counties in the U.S. (n = 3142) were collected from publicly available sources. For each variable, all counties were ranked and assigned percentiles ranging from 0 to 100. Positive environmental variables (e.g., grocery stores, exercise opportunities) were reverse scored such that higher values for all variables indicated a more obesogenic environment. Finally, for each county, a total obesogenic environment index score was generated by calculating the average percentile for all 10 variables. Results The average COEI percentile ranged from 24.5–81.0 (M = 50.02,s.d. = 9.01) across US counties and was depicted spatially on a choropleth map. Obesogenic counties were more prevalent (F = 130.43,p < .0001) in the South region of the U.S. (M = 53.0,s.d. = 8.3) compared to the Northeast (M = 43.2,s.d. = 6.9), Midwest (M = 48.1,s.d. = 8.5), and West (M = 48.4,s.d. = 9.8). When examined by rurality, there were also significant differences (F = 175.86,p < .0001) between metropolitan (M = 46.5,s.d. = 8.4), micropolitan (M = 50.3,s.d. = 8.1), and rural counties (M = 52.9,s.d. = 8.8) across the U.S. Conclusion The COEI can be applied to benchmark obesogenic environments and identify geographic disparities and intervention targets. Future research can examine associations with obesity and other health outcomes.
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Affiliation(s)
- Andrew T Kaczynski
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA. .,Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
| | - Jan M Eberth
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.,Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Ellen W Stowe
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Marilyn E Wende
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Angela D Liese
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Alexander C McLain
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Charity B Breneman
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Michele J Josey
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.,Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
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19
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Pannicke B, Reichenberger J, Schultchen D, Pollatos O, Blechert J. Affect Improvements and Measurement Concordance Between a Subjective and an Accelerometric Estimate of Physical Activity. EUROPEAN JOURNAL OF HEALTH PSYCHOLOGY 2020. [DOI: 10.1027/2512-8442/a000050] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Objectives: Physical activity (PA) positively influences several aspects of mental well-being including affect improvements. Yet, the fact that subjective and objective measures of PA often diverge challenges research on the relationship of PA and affect. Methods: Subjective (ecological momentary assessment, EMA) and objective (combined heart rate and accelerometric activity tracker) measures of PA alongside repeated ratings of positive and negative affects were obtained from 37 participants over 7 consecutive days. Results: Subjective and objective PA were significantly positively correlated. Affect improvements, that is, negative affect decrease as well as positive affect increase, were predicted by both subjective (EMA) and objective (activity tracker) data. Conclusions: Measurement concordance supports the validity of both assessment strategies. Affect improvements result from both subjective representations of one’s own activity as well as from physiological mechanisms of PA that one is not aware of, suggesting two independent routes to affect improvements.
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Affiliation(s)
- Björn Pannicke
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Austria
| | - Julia Reichenberger
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Austria
| | - Dana Schultchen
- Department of Clinical & Health Psychology, Ulm University, Ulm, Germany
| | - Olga Pollatos
- Department of Clinical & Health Psychology, Ulm University, Ulm, Germany
| | - Jens Blechert
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Austria
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20
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McCrorie P, Mitchell R, Macdonald L, Jones A, Coombes E, Schipperijn J, Ellaway A. The relationship between living in urban and rural areas of Scotland and children's physical activity and sedentary levels: a country-wide cross-sectional analysis. BMC Public Health 2020; 20:304. [PMID: 32156285 PMCID: PMC7065337 DOI: 10.1186/s12889-020-8311-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 01/31/2020] [Indexed: 12/02/2022] Open
Abstract
Background Living in urban or rural environments may influence children’s levels of physical activity and sedentary behaviours. We know little about variations in device-measured physical activity and sedentary levels of urban and rural children using nationally representative samples, or if these differences are moderated by socioeconomic factors or seasonal variation. Moreover, little is known about the influence of ‘walkability’ in the UK context. A greater understanding of these can better inform intervention strategies or policy initiatives at the population level. Methods Country-wide cross-sectional study in Scotland in which 774 children (427 girls, 357 boys), aged 10/11 years, wore an accelerometer on one occasion for at least four weekdays and one weekend day. Mean total physical activity, time spent in sedentary, light, and moderate-to-vigorous physical activity (MVPA), per day were extracted for weekdays, weekend days, and all days combined. Regression analyses explored associations between physical activity outcomes, urban/rural residence, and a modified walkability index (dwelling density and intersection density); with interactions fitted for household equivalised income and season of data collection. Sensitivity analyses assessed variation in findings by socioeconomic factors and urbanicity. Results Rural children spent an average of 14 min less sedentary (95% CI of difference: 2.23, 26.32) and 13 min more in light intensity activity (95% CI of difference, 2.81, 24.09) per day than those from urban settlements. No urban-rural differences were found for time spent in MVPA or in total levels of activity. Our walkability index was not associated with any outcome measure. We found no interactions with household equivalised income, but there were urban/rural differences in seasonal variation; urban children engaged in higher levels of MVPA in the spring months (difference: 10 mins, p = 0.06, n.s) and significantly lower levels in winter (difference: 8.7 mins, p = 0.036). Conclusions Extrapolated across one-year, rural children would accumulate approximately 79 h (or just over 3 days) less sedentary time than urban children, replacing this for light intensity activity. With both outcomes having known implications for health, this finding is particularly important. Future work should prioritise exploring the patterns and context in which these differences occur to allow for more targeted intervention/policy strategies.
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Affiliation(s)
- Paul McCrorie
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland.
| | - Rich Mitchell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland
| | - Laura Macdonald
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland
| | - Andrew Jones
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Emma Coombes
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Anne Ellaway
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland
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21
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Physical Fitness in Upper Austrian Children Living in Urban and Rural Areas: A Cross-Sectional Analysis with More Than 18,000 Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17031045. [PMID: 32045983 PMCID: PMC7037332 DOI: 10.3390/ijerph17031045] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 02/04/2020] [Accepted: 02/05/2020] [Indexed: 12/02/2022]
Abstract
Physical fitness is an important component in the development and health of children and adolescents. Given the equivocal results of previous research regarding the influence of the living environment on physical fitness, this study examined differences in physical fitness in urban and rural elementary school children in Upper Austria. A total of 18,168 (51% male) children between 6 and 11 years of age participated in anthropometric assessments and completed eight fitness tests that assessed cardiorespiratory endurance, muscular power, speed, agility, flexibility, and ball handling skills during a single test session in the school’s gymnasium. Urban living environment was associated with higher body weight (p = 0.01) and lower physical fitness (p < 0.01), except for flexibility, which was better in urban children (p < 0.01) and upper body strength (no difference), even after accounting for differences in body weight. Furthermore, it was shown that urban–rural differences in physical fitness are more pronounced in normal weight children and that these differences increase with age. These results highlight the potential of the living environment for the promotion of an active lifestyle that enhances physical fitness. The availability of safe spaces that facilitate unstructured and structured physical activity, as well as active transportation provide viable options for the promotion of physical fitness in children.
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Dinkel D, Dev D, Guo Y, Sedani A, Hulse E, Rida Z, Abel K. Comparison of Urban and Rural Physical Activity and Outdoor Play Environments of Childcare Centers and Family Childcare Homes. FAMILY & COMMUNITY HEALTH 2020; 43:264-275. [PMID: 32658027 DOI: 10.1097/fch.0000000000000267] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The purpose of this study was to examine the physical activity environment in childcare programs across type (childcare centers [CCCs] and family childcare homes [FCCHs]) and geographic location (urban and rural) as assessed by physical activity best practices according to the Go Nutrition and Physical Activity Self-assessment in Child Care. Results showed CCCs compared with FCCHs reported higher achievement of best practices. Further, urban childcare programs (CCCs and FCCHs) reported higher achievement of best practices in comparison to rural childcare programs. There is a need to deliver targeted interventions that promote children's physical activity in FCCHs and CCCs in rural areas.
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Affiliation(s)
- Danae Dinkel
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha (Dr Dinkel); Department of Child, Youth, and Family Studies, University of Nebraska, Lincoln (Dr Dev and Ms Guo); Nebraska Department of Health & Human Services, Lincoln (Mss Sedani and Abel); University of Oklahoma Health Sciences Center, Oklahoma City (Ms Sedani); Children's Hospital and Medical Center, Center for the Child & Community, Lincoln, Nebraska (Ms Hulse); Nebraska Department of Education, Lincoln (Dr Rida); and Family Service WIC, Lincoln, Nebraska (Ms Abel)
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23
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Euler R, Jimenez EY, Sanders S, Kuhlemeier A, Van Horn ML, Cohen D, Gonzales-Pacheco D, Kong AS. Rural-Urban Differences in Baseline Dietary Intake and Physical Activity Levels of Adolescents. Prev Chronic Dis 2019; 16:E01. [PMID: 30605423 PMCID: PMC6341819 DOI: 10.5888/pcd16.180200] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Differences in dietary intake and physical activity may explain the higher prevalence of obesity among adolescents living in rural versus urban settings. The objective of this cross-sectional secondary analysis was to compare baseline dietary intake and physical activity of adolescents by rurality. METHODS We analyzed data on 940 adolescents who participated in ACTION PAC (Adolescents Committed to Improvement of Nutrition and Physical Activity), an obesity prevention and management intervention trial conducted from 2014 through 2017 in 8 public high schools in the southwestern United States. Dietary intake was assessed with the Block Food Screener, and participants completed an exercise log and wore an accelerometer to provide data on physical activity. We compared data by rural-urban commuting area (RUCA) codes and log population density by using multilevel models, with students nested within zip code and repeated measures for accelerometer analysis. RESULTS After adjusting for socioeconomic status and ethnicity, accelerometer data indicated that moderate-to-vigorous physical activity was 8.17 min/d (P = .02) higher and sedentary time was 20.42 min/d (P = .02) lower in moderately urban areas than in the urban reference area. Each 1-unit increase in log population density was associated with higher reported intake of whole grains (0.02 ounce equivalents, P = .03), potatoes (0.01 cup equivalents, P = .02), and added sugar (0.37 tsp, P = .02) after adjusting for socioeconomic status and ethnicity. CONCLUSION Differences in reported dietary intake and physical activity level by measures of rurality were small and inconsistent in direction to explain the disparities observed in rural versus urban areas.
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Affiliation(s)
- Renee Euler
- Nutrition Program, Department of Individual, Family and Community Education, MSC05 3040, 1 University of New Mexico, Albuquerque, NM 87131. E-mail:
| | - Elizabeth Yakes Jimenez
- Division of Adolescent Medicine, Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, New Mexico,Division of Epidemiology, Biostatistics and Preventive Medicine, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Sarah Sanders
- Division of Adolescent Medicine, Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Alena Kuhlemeier
- Department of Sociology, University of New Mexico, Albuquerque, New Mexico
| | - M. Lee Van Horn
- Department of Individual, Family and Community Education, University of New Mexico, Albuquerque, New Mexico
| | - Deborah Cohen
- Department of Individual, Family and Community Education, University of New Mexico, Albuquerque, New Mexico
| | - Diana Gonzales-Pacheco
- Department of Individual, Family and Community Education, University of New Mexico, Albuquerque, New Mexico
| | - Alberta S. Kong
- Division of Adolescent Medicine, Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
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24
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Daly CM, Foote SJ, Wadsworth DD. Physical Activity, Sedentary Behavior, Fruit and Vegetable Consumption and Access: What Influences Obesity in Rural Children? J Community Health 2018; 42:968-973. [PMID: 28382455 DOI: 10.1007/s10900-017-0343-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The purpose of this project was to determine the effect of diet, physical activity, and access to fruits, vegetables on weight status of children who reside in a low-income rural area. 153 3rd-6th graders were assessed for physical activity, sedentary behavior, fruit and vegetable consumption and access to physical activity, fruits and vegetables. Physical activity and sedentary behavior was objectively assessed via accelerometery. Fruit and vegetable consumption was assessed by direct observation and a recall questionnaire. Access was assessed by a questionnaire. Regression analysis was used to determine relationships with weight status as measured by BMI. On average children met physical activity requirements (71 min of MVPA) per day which significantly related to children's weight status (p = .016). Sedentary behavior was also related to weight status (p = < 0.001). Participants' access to physical activity opportunities near the home was not significantly related to their physical activity levels or weight status. Fruit and vegetable consumption was not related to BMI or access to fruits and vegetables. The results of this study suggested that children's physical activity and sedentary behavior impacts weight status of children residing in a rural environment.
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Affiliation(s)
- Colleen M Daly
- School of Kinesiology, Auburn University, 301 Wire Road, Auburn, AL, 36849, USA
| | - Shelby J Foote
- School of Kinesiology, Auburn University, 301 Wire Road, Auburn, AL, 36849, USA
| | - Danielle D Wadsworth
- School of Kinesiology, Auburn University, 301 Wire Road, Auburn, AL, 36849, USA.
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25
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Hughey SM, Kaczynski AT, Porter DE, Hibbert J, Turner-McGrievy G, Liu J. Spatial clustering patterns of child weight status in a southeastern US county. APPLIED GEOGRAPHY (SEVENOAKS, ENGLAND) 2018; 99:12-21. [PMID: 34924644 PMCID: PMC8682833 DOI: 10.1016/j.apgeog.2018.07.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Youth obesity is a major public health concern due to associated physical, social, and psychological health consequences. While rates and disparities of youth obesity levels are known, less research has explored spatial clustering patterns, associated correlates of spatial clustering, comparing patterns in urban and rural areas. Therefore, this study 1) examined spatial clustering of youth weight status, 2) investigated sociodemographic correlates of spatial clustering patterns, and 3) explored spatial patterns by level of urbanization. This study occurred in a southeastern US county (pop:474,266) in 2013. Trained physical education teachers collected height and weight for all 3rd-5th grade youth (n = 13,469) and schools provided youth demographic attributes. BMI z-scores were calculated using standard procedures. Global Moran's Index and Anselin's Local Moran's I (LISA) were used detect global and local spatial clustering, respectively. To examine correlates of spatial clustering, BMI z-score residuals from a series of four linear regression models were spatially analyzed, mapped, and compared. SAS 9.4 and GeoDA were used for analyses; ArcGIS was used for mapping. Significant, positive global clustering (Index = 0.04,p < 0.001) was detected. LISA results showed that about 4.7% (n = 635) and 7.9% (n = 1058) of the sample were identified as high and low obesity localized spatial clusters (p < 0.01), respectively. Individual and neighborhood sociodemographic characteristics accounted for the majority of spatial clustering and differential patterns were observed by level of urbanization. Identifying geographic areas that contain significant spatial clusters is a powerful tool for understanding the location of and exploring contributing factors to youth obesity.
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Affiliation(s)
- S. Morgan Hughey
- Department of Health and Human Performance, College of Charleston, USA
- Corresponding author. Department of Health and Human Performance, College of Charleston, Silcox Center, Room 336, 30 George Street, Charleston, SC, 29401, USA. (S.M. Hughey)
| | - Andrew T. Kaczynski
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, USA
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, USA
| | - Dwayne E. Porter
- Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, USA
| | | | - Gabrielle Turner-McGrievy
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, USA
| | - Jihong Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, USA
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26
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Brown B, Harris KJ, Heil D, Tryon M, Cooksley A, Semmens E, Davis J, Gandhi K. Feasibility and outcomes of an out-of-school and home-based obesity prevention pilot study for rural children on an American Indian reservation. Pilot Feasibility Stud 2018; 4:129. [PMID: 30065847 PMCID: PMC6062940 DOI: 10.1186/s40814-018-0322-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 07/18/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Children living in rural areas are at higher risk for obesity compared to urban children, and Native American (NA) children have the highest prevalence of overweight/obesity for all races combined. Out-of-school programs (OOSPs) are a promising setting to improve children's health. Parents are important in supporting their child's obesity-related behaviors, yet it remains unclear what combination and dose of parent engagement strategies is feasible and optimal. This study's primary objective was to assess the feasibility of an OOSP and home-based obesity prevention intervention for rural NA and non-NA children. METHODS This was an 11-week, two group, randomized feasibility study. Participants were children and their parents at one OOSP on a rural American Indian reservation. Children, ages 6-9, were randomized to receive the Generations Health (GH) intervention or comparison condition. The GH group received daily activities focused on physical activity (PA), nutrition, sleep, and reducing TV/screen time, and frequently engaged parents. The comparison group received usual OOSP activities. To assess intervention feasibility, we measured recruitment and participation rates and program satisfaction. We assessed pre- to posttest changes in body composition, PA and sleep patterns, dietary intake and Healthy Eating Index-2010 (HEI-2010) scores, TV/screen time, and nutrition knowledge. We report recruitment and participation rates as percentages and participants' program satisfaction as means. Two-tailed paired t tests and 95% confidence intervals were used to detect changes in behavioral and health outcome variables. RESULTS Forty-six children met age eligibility criteria; following screening, 52% (24/46) met the inclusion criteria and 96% (23/24) were randomized to the study. Overall, 91% of the children participated in the intervention and 100% participated in at least some of the posttest assessments. Parents reported high program satisfaction (mean rating of 4, on a 1-5 scale). Our outcome measure for child adiposity, zBMI, was reduced by 0.15 in the GH group, but increased by 0.13 in the comparison condition. Meaningful changes were evident for total kilocalories, HEI-2010 scores, PA, TV/screen time, and nutrition knowledge. CONCLUSIONS High recruitment, participation and program satisfaction and positive health and behavioral outcomes at 11 weeks provide encouraging indications of the feasibility and potential effectiveness of the intervention. TRIAL REGISTRATION ISRCTN24274245.
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Affiliation(s)
- Blakely Brown
- Department of Health and Human Performance, The University of Montana, McGill Hall 206, 32 Campus Drive Missoula, Missoula, MT 59812 USA
| | - Kari Jo Harris
- School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT 59812 USA
| | - Daniel Heil
- Department Health and Human Development, Montana State University, 210 Romney Gym, Bozeman, MT 59715 USA
| | - Michael Tryon
- Polson Medical Fitness Center, Summit Medical Fitness Center, 205 Sunnyview Lane, Kalispell, MT 59901 USA
| | - Aric Cooksley
- Boys and Girls Club of the Flathead Reseration and Lake County, 63055 US-93, Ronan, MT 59864 USA
| | - Erin Semmens
- Department of Health and Human Performance, The University of Montana, McGill Hall 206, 32 Campus Drive Missoula, Missoula, MT 59812 USA
| | - James Davis
- Department of Complementary and Integrative Medicine, University of Hawaii John A. Burns School of Medicine, Biosciences Building Suite 211, 651 Ilalo Street, Honolulu, HI 96813 USA
| | - Krupa Gandhi
- Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics, Thomas Jefferson University, 1015 Chestnut Street, Suite 520, Philadelphia, PA 19107 USA
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27
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Erdei G, Bakacs M, Illés É, Nagy B, Kaposvári C, Mák E, Nagy ES, Cserháti Z, Kovács VA. Substantial variation across geographic regions in the obesity prevalence among 6-8 years old Hungarian children (COSI Hungary 2016). BMC Public Health 2018; 18:611. [PMID: 29743055 PMCID: PMC5944005 DOI: 10.1186/s12889-018-5530-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 05/01/2018] [Indexed: 11/10/2022] Open
Abstract
Background There have been previous representative nutritional status surveys conducted in Hungary, but this is the first one that examines overweight and obesity prevalence according to the level of urbanization and in different geographic regions among 6–8-year-old children. We also assessed whether these variations were different by sex. Methods This survey was part of the fourth data collection round of World Health Organization (WHO) Childhood Obesity Surveillance Initiative which took place during the academic year 2016/2017. The representative sample was determined by two-stage cluster sampling. A total of 5332 children (48.4% boys; age 7.54 ± 0.64 years) were measured from all seven geographic regions including urban (at least 500 inhabitants per square kilometer; n = 1598), semi-urban (100 to 500 inhabitants per square kilometer; n = 1932) and rural (less than 100 inhabitants per square kilometer; n = 1802) areas. Results Using the WHO reference, prevalence of overweight and obesity within the whole sample were 14.2, and 12.7%, respectively. According to the International Obesity Task Force (IOTF) reference, rates were 12.6 and 8.6%. Northern Hungary and Southern Transdanubia were the regions with the highest obesity prevalence of 11.0 and 12.0%, while Central Hungary was the one with the lowest obesity rate (6.1%). The prevalence of overweight and obesity tended to be higher in rural areas (13.0 and 9.8%) than in urban areas (11.9 and 7.0%). Concerning differences in sex, girls had higher obesity risk in rural areas (OR = 2.0) but boys did not. Odds ratios were 2.0–3.4 in different regions for obesity compared to Central Hungary, but only among boys. Conclusions Overweight and obesity are emerging problems in Hungary. Remarkable differences were observed in the prevalence of obesity by geographic regions. These variations can only be partly explained by geographic characteristics. Trial registration Study protocol was approved by the Scientific and Research Ethics Committee of the Medical Research Council (61158–2/2016/EKU).
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Affiliation(s)
- Gergő Erdei
- School of PhD Studies, Doctoral School of Pathological Sciences, Health Science Research, Semmelweis University, 26 Üllői Street, Budapest, 1085, Hungary. .,Division of Nutrition, National Institute of Pharmacy and Nutrition, 3 Zrínyi Street, Budapest, 1051, Hungary. .,Department of Dietetics and Nutrition Sciences, Faculty of Health Sciences, Semmelweis University, 17 Vas Street, Budapest, 1088, Hungary.
| | - Márta Bakacs
- Division of Nutrition, National Institute of Pharmacy and Nutrition, 3 Zrínyi Street, Budapest, 1051, Hungary
| | - Éva Illés
- Division of Nutrition, National Institute of Pharmacy and Nutrition, 3 Zrínyi Street, Budapest, 1051, Hungary
| | - Barbara Nagy
- Division of Nutrition, National Institute of Pharmacy and Nutrition, 3 Zrínyi Street, Budapest, 1051, Hungary
| | - Csilla Kaposvári
- Division of Nutrition, National Institute of Pharmacy and Nutrition, 3 Zrínyi Street, Budapest, 1051, Hungary
| | - Erzsébet Mák
- Department of Dietetics and Nutrition Sciences, Faculty of Health Sciences, Semmelweis University, 17 Vas Street, Budapest, 1088, Hungary
| | - Eszter Sarkadi Nagy
- Division of Nutrition, National Institute of Pharmacy and Nutrition, 3 Zrínyi Street, Budapest, 1051, Hungary
| | - Zoltán Cserháti
- Division of Nutrition, National Institute of Pharmacy and Nutrition, 3 Zrínyi Street, Budapest, 1051, Hungary
| | - Viktória Anna Kovács
- Division of Nutrition, National Institute of Pharmacy and Nutrition, 3 Zrínyi Street, Budapest, 1051, Hungary
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28
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Grant LP, Gennings C, Wickham EP, Chapman D, Sun S, Wheeler DC. Modeling Pediatric Body Mass Index and Neighborhood Environment at Different Spatial Scales. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018. [PMID: 29518029 PMCID: PMC5877018 DOI: 10.3390/ijerph15030473] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In public health research, it has been well established that geographic location plays an important role in influencing health outcomes. In recent years, there has been an increased emphasis on the impact of neighborhood or contextual factors as potential risk factors for childhood obesity. Some neighborhood factors relevant to childhood obesity include access to food sources, access to recreational facilities, neighborhood safety, and socioeconomic status (SES) variables. It is common for neighborhood or area-level variables to be available at multiple spatial scales (SS) or geographic units, such as the census block group and census tract, and selection of the spatial scale for area-level variables can be considered as a model selection problem. In this paper, we model the variation in body mass index (BMI) in a study of pediatric patients of the Virginia Commonwealth University (VCU) Medical Center, while considering the selection of spatial scale for a set of neighborhood-level variables available at multiple spatial scales using four recently proposed spatial scale selection algorithms: SS forward stepwise regression, SS incremental forward stagewise regression, SS least angle regression (LARS), and SS lasso. For pediatric BMI, we found evidence of significant positive associations with visit age and black race at the individual level, percent Hispanic white at the census block group level, percent Hispanic black at the census tract level, and percent vacant housing at the census tract level. We also found significant negative associations with population density at the census tract level, median household income at the census tract level, percent renter at the census tract level, and exercise equipment expenditures at the census block group level. The SS algorithms selected covariates at different spatial scales, producing better goodness-of-fit in comparison to traditional models, where all area-level covariates were modeled at the same scale. These findings underscore the importance of considering spatial scale when performing model selection.
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Affiliation(s)
- Lauren P Grant
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA 23298, USA.
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Mount Sinai, New York, NY 10029, USA.
| | - Edmond P Wickham
- Children's Hospital of Richmond, Virginia Commonwealth University, Richmond, VA 23298, USA.
| | - Derek Chapman
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA 23298, USA.
| | - Shumei Sun
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA 23298, USA.
| | - David C Wheeler
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA 23298, USA.
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29
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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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Khashayar P, Kasaeian A, Heshmat R, Motlagh ME, Mahdavi Gorabi A, Noroozi M, Qorbani M, Kelishadi R. Childhood Overweight and Obesity and Associated Factors in Iranian Children and Adolescents: A Multilevel Analysis; the CASPIAN-IV Study. Front Pediatr 2018; 6:393. [PMID: 30622935 PMCID: PMC6308200 DOI: 10.3389/fped.2018.00393] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Accepted: 11/28/2018] [Indexed: 11/16/2022] Open
Abstract
Objective: The purpose of this paper is to explore multidimensional factors related to childhood obesity and overweight based on the data gathered on different aspects of the general health status were assessed among a large number of Iranian children and adolescents in the fourth phase of the "Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable disease" survey. It also aims to determine the degree to which each ecological context contributes to childhood overweight/obesity. Method: A total of 14,880 students and their parents were recruited. They filled out a questionnaire on their relationship with peers, body image, and psychosocial environment of school, dietary habits, life-style habits, physical activity pattern and socioeconomic status (SES). Their height, weight, was measured and body mass index (BMI) was calculated. Obesity and overweight was defined based on the WHO growth chart. Multilevel modeling using three-level random intercept logistic regression models were used to assess predictors of overweight and obesity. In our hierarchical models, children (first level) were conceptualized as being nested within provinces (second level) and provinces within quad regions (third level). Result: From among the 13,486 recruited students, 9.7% were overweight and 11.9% were obese. In multivariate model (adjusted model), being boy (OR:1.58), living in urban area (OR:1.58), having positive family history of obesity (OR = 2.04), breakfast skipping (OR: 1.46), socioeconomic status (OR moderateSES/lowSES = 1.44 and OR highSES/lowSES = 1.89), and birth weight (BW) (OR normalBW/lowBW = 1.33 and OR highBW/lowBW = 1.8) were associated with childhood obesity. Increasing age was the only factor in the obesity model that had a significant preventive effect on the odds of becoming obese (OR = 0.96, P < 0.001). In multivariate model, living in urban area, increasing age, high and moderate SES, high BW and family history of obesity were the significant predictors of overweight. Conclusion: Our findings show that high BW, sociodemographic characteristics, breakfast skipping, and family history of obesity are associated with childhood obesity and overweight. Therefore, developing strategies that consider the effects of diverse sociodemographic and environmental factors on childhood overweight and obesity would be the most effective way to prevent and manage this multifactorial health concern.
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Affiliation(s)
- Patricia Khashayar
- Chronic Disease Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Center for Microsystems Technology, Imec and Ghent University, Ghent, Belgium
| | - Amir Kasaeian
- Hematology-Oncology and Stem Cell Transplantation Research Center, Research Institute for Oncology, Hematology and Cell Therapy, Tehran University of Medical Sciences, Tehran, Iran.,Hematologic Malignancies Research Center, Research Institute for Oncology, Hematology and Cell Therapy, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Heshmat
- Chronic Disease Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Armita Mahdavi Gorabi
- Department of Basic and Clinical Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Noroozi
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Diseases, Isfahan University of Medical Sciences, Isfahan, Iran
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Abstract
PURPOSE To collect 30-second walk test (30sWT) normative data on a large, diverse sample of school children developing typically, ages 5 to 13 years, and describe the influences of gender, body mass index, and path shape on distance walked. METHODS Five physical therapists administered the 30sWT on 1223 children developing typically (boys = 517, girls = 706) from 20 urban schools. RESULTS Average distances (standard deviation) ranged from 139.1 (20.3) to 163.0 (18.6) ft; children aged 10 years walked the farthest and those aged 5 years the shortest. Distance steadily increased from ages 5 to 10 years, steadily decreased from ages 11 to 13 years; children aged 8, 9, and 10 years had statistical but not functionally meaningful gender differences. Body mass index and path shape had no meaningful effects. Distance and velocities are similar to prior studies. CONCLUSION This study updated 30sWT normative values with a large, ethnically diverse, urban sample developing typically. Norms may be useful as part of a comprehensive examination.
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32
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Attachment Style and Obesity: Disordered Eating Behaviors as a Mediator in a Community Sample of Canadian Youth. J Dev Behav Pediatr 2017; 37:762-770. [PMID: 27801724 DOI: 10.1097/dbp.0000000000000361] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Obesity and overweight are associated with many negative health outcomes. Attachment style has been implicated in the development of obesity in youth. The present study examined if disordered eating behaviors mediate the relationship between attachment style and body mass index (BMI) in a large community sample of Canadian youth. METHOD A total of 3,043 participants (1,254 males and 1,789 females, Mage = 14.20 years) completed self-report questionnaires including the Relationship Questionnaire and the Dutch Eating Behavior Questionnaire, and BMI was objectively measured. Disordered eating behaviors (restrained, emotional, and external) were examined as possible mediating mechanisms in the relationship between attachment style and BMI z-score, using a multiple mediation model using bootstrapping while controlling for socio-demographic covariates. RESULTS Insecure attachment was significantly associated with higher BMI, and disordered eating mediated this relationship. Restrained eating was the strongest mediator of this pathway. CONCLUSION Results suggest that it may be important to take attachment history and restrained eating into account when designing treatment and prevention strategies for obesity in youth.
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Vogeltanz-Holm N, Holm J. Changes in Body Mass Index During a 3-Year Elementary School-Based Obesity Prevention Program for American Indian and White Rural Students. HEALTH EDUCATION & BEHAVIOR 2017; 45:277-285. [PMID: 28693339 DOI: 10.1177/1090198117714825] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Childhood obesity is a significant but largely modifiable health risk, disproportionately affecting socioeconomically disadvantaged, racial/ethnic minority, and rural children. Elementary school-aged children typically experience the greatest increases in excess weight gain and therefore are important targets for reducing adolescent and adult obesity while improving children's health. Our study evaluated outcomes of a 3-year elementary school-based program for reducing obesity in American Indian and White students attending eight rural schools in the U.S. upper Midwest. METHOD Researchers measured body mass indexes (BMI) and other health indicators and behaviors of 308 beginning third-grade students and then again at the end of students' third, fourth, and fifth grades. The primary focus of this study is a mixed multilevel longitudinal model testing changes in age- and gender-adjusted BMI z scores ( zBMI). RESULTS There was a significant decrease in zBMI across the 3-year study period. Ethnicity analyses showed that White students had overall decreases in zBMI whereas American Indian students' zBMIs remained stable across the program. Comparisons with children from an age- and cohort-matched national sample provided support for the effectiveness of the school program in reducing BMI and obesity during the study period. CONCLUSION An elementary school-based health program that addresses a range of students' obesity-related health behaviors, the school health environment, and that involves educators and parents is an effective intervention for reducing or stabilizing BMI in rural White and American Indian students. School health programs for students living in rural communities may be especially effective due to greater school and community cohesiveness, and valuing of the school's primary role in improving community health.
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Affiliation(s)
| | - Jeffrey Holm
- 1 University of North Dakota, Grand Forks, ND, USA
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Howard G, Kleindorfer DO, Cushman M, Long DL, Jasne A, Judd SE, Higginbotham JC, Howard VJ. Contributors to the Excess Stroke Mortality in Rural Areas in the United States. Stroke 2017; 48:1773-1778. [PMID: 28626048 PMCID: PMC5502731 DOI: 10.1161/strokeaha.117.017089] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 04/11/2017] [Accepted: 04/27/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Stroke mortality is 30% higher in the rural United States. This could be because of either higher incidence or higher case fatality from stroke in rural areas. METHODS The urban-rural status of 23 280 stroke-free participants recruited between 2003 and 2007 in the REGARDS study (Reasons for Geographic and Racial Differences in Stroke) was classified using the Rural-Urban Commuting Area scheme as residing in urban, large rural town/city, or small rural town or isolated areas. The risk of incident stroke was assessed using proportional hazards analysis, and case fatality (death within 30 days of stroke) was assessed using logistic regression. Models were adjusted for demographics, traditional stroke risk factors, and measures of socioeconomic status. RESULTS After adjustment for demographic factors and relative to urban areas, stroke incidence was 1.23-times higher (95% confidence intervals, 1.01-1.51) in large rural town/cities and 1.30-times higher (95% confidence intervals, 1.03-1.62) in small rural towns or isolated areas. Adjustment for risk factors and socioeconomic status only modestly attenuated this association, and the association became marginally nonsignificant (P=0.071). There was no association of rural-urban status with case fatality (P>0.47). CONCLUSIONS The higher stroke mortality in rural regions seemed to be attributable to higher stroke incidence rather than case fatality. A higher prevalence of risk factors and lower socioeconomic status only modestly contributed to the increased risk of incident stroke risk in rural areas. There was no evidence of higher case fatality in rural areas.
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Affiliation(s)
- George Howard
- From the Department of Biostatistics (G.H., D.L.L., S.E.J.) and Department of Epidemiology (V.J.H.), School of Public Health, University of Alabama at Birmingham; Department of Neurology, University of Cincinnati, OH (D.O.K., A.J.); Department of Medicine, University of Vermont, Burlington (M.C.); and College of Community Health Sciences, University of Alabama, Tuscaloosa (J.C.H.).
| | - Dawn O Kleindorfer
- From the Department of Biostatistics (G.H., D.L.L., S.E.J.) and Department of Epidemiology (V.J.H.), School of Public Health, University of Alabama at Birmingham; Department of Neurology, University of Cincinnati, OH (D.O.K., A.J.); Department of Medicine, University of Vermont, Burlington (M.C.); and College of Community Health Sciences, University of Alabama, Tuscaloosa (J.C.H.)
| | - Mary Cushman
- From the Department of Biostatistics (G.H., D.L.L., S.E.J.) and Department of Epidemiology (V.J.H.), School of Public Health, University of Alabama at Birmingham; Department of Neurology, University of Cincinnati, OH (D.O.K., A.J.); Department of Medicine, University of Vermont, Burlington (M.C.); and College of Community Health Sciences, University of Alabama, Tuscaloosa (J.C.H.)
| | - D Leann Long
- From the Department of Biostatistics (G.H., D.L.L., S.E.J.) and Department of Epidemiology (V.J.H.), School of Public Health, University of Alabama at Birmingham; Department of Neurology, University of Cincinnati, OH (D.O.K., A.J.); Department of Medicine, University of Vermont, Burlington (M.C.); and College of Community Health Sciences, University of Alabama, Tuscaloosa (J.C.H.)
| | - Adam Jasne
- From the Department of Biostatistics (G.H., D.L.L., S.E.J.) and Department of Epidemiology (V.J.H.), School of Public Health, University of Alabama at Birmingham; Department of Neurology, University of Cincinnati, OH (D.O.K., A.J.); Department of Medicine, University of Vermont, Burlington (M.C.); and College of Community Health Sciences, University of Alabama, Tuscaloosa (J.C.H.)
| | - Suzanne E Judd
- From the Department of Biostatistics (G.H., D.L.L., S.E.J.) and Department of Epidemiology (V.J.H.), School of Public Health, University of Alabama at Birmingham; Department of Neurology, University of Cincinnati, OH (D.O.K., A.J.); Department of Medicine, University of Vermont, Burlington (M.C.); and College of Community Health Sciences, University of Alabama, Tuscaloosa (J.C.H.)
| | - John C Higginbotham
- From the Department of Biostatistics (G.H., D.L.L., S.E.J.) and Department of Epidemiology (V.J.H.), School of Public Health, University of Alabama at Birmingham; Department of Neurology, University of Cincinnati, OH (D.O.K., A.J.); Department of Medicine, University of Vermont, Burlington (M.C.); and College of Community Health Sciences, University of Alabama, Tuscaloosa (J.C.H.)
| | - Virginia J Howard
- From the Department of Biostatistics (G.H., D.L.L., S.E.J.) and Department of Epidemiology (V.J.H.), School of Public Health, University of Alabama at Birmingham; Department of Neurology, University of Cincinnati, OH (D.O.K., A.J.); Department of Medicine, University of Vermont, Burlington (M.C.); and College of Community Health Sciences, University of Alabama, Tuscaloosa (J.C.H.)
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Hassapidou M, Tzotzas T, Makri E, Pagkalos I, Kaklamanos I, Kapantais E, Abrahamian A, Polymeris A, Tziomalos K. Prevalence and geographic variation of abdominal obesity in 7- and 9-year-old children in Greece; World Health Organization Childhood Obesity Surveillance Initiative 2010. BMC Public Health 2017; 17:126. [PMID: 28129758 PMCID: PMC5273825 DOI: 10.1186/s12889-017-4061-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 01/24/2017] [Indexed: 01/03/2023] Open
Abstract
Background In children, abdominal obesity is a better predictor of the presence of cardiovascular risk factors than body mass index (BMI)-defined obesity. We aimed to evaluate the prevalence of abdominal obesity in the Greek pediatric population and to assess the impact of residence on the prevalence of both BMI-defined and abdominal obesity. Methods In the context of the Childhood Obesity Surveillance Initiative of the World Health Organization (WHO) Regional Office for Europe, a national representative sample of 7.0–7.9 and 9.0–9.9-year-old children was evaluated (n = 2,531 and 2,700, respectively). Overweight and obesity according to BMI were estimated using both the WHO and International Obesity Task Force cut-off points. Abdominal obesity was defined as waist circumference/height ratio >0.5. Results The prevalence of abdominal obesity did not differ between 7-year-old boys and girls (25.2 and 25.3%, respectively; p = NS). Among 9-year-old children, abdominal obesity was more prevalent in boys than in girls (33.2 and 28.2%, respectively; p = 0.005). Among normal weight and overweight children, the prevalence of abdominal obesity was 1.6–6.8 and 21.8–49.1%, respectively. The prevalence of abdominal and BMI-defined obesity did not differ between children living in the mainland, in Crete and in other islands except in 7-year-old girls, where the prevalence of BMI-defined obesity was highest in those living in Crete, intermediate in those living in other islands and lowest in those living in the mainland. In 9-year-old boys and in 7- and 9-year-old girls, the prevalence of abdominal obesity was highest in children living in Athens and lowest in children living in Thessaloniki, whereas children living in other cities and in villages showed intermediate rates. The prevalence of abdominal obesity in 7-year-old boys and the prevalence of BMI-defined obesity did not differ between children living in cities and villages. Conclusions The prevalence of pediatric abdominal obesity in Greece is among the highest worldwide. Boys and children living in the capital are at higher risk for becoming obese. Given that abdominal obesity is more prevalent than BMI-defined obesity and appears to be more sensitive in identifying cardiovascular risk, measurement of waist circumference might have to be incorporated in the screening for childhood obesity. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4061-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maria Hassapidou
- Department of Nutrition and Dietetics, Alexander Technological Educational Institute of Thessaloniki, Thessaloniki, Greece
| | - Themistoklis Tzotzas
- Department of Nutrition and Dietetics, Alexander Technological Educational Institute of Thessaloniki, Thessaloniki, Greece
| | - Evangelia Makri
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 1 Stilponos Kyriakidi street, Thessaloniki, 54636, Greece
| | - Ioannis Pagkalos
- Department of Nutrition and Dietetics, Alexander Technological Educational Institute of Thessaloniki, Thessaloniki, Greece
| | | | | | | | | | - Konstantinos Tziomalos
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 1 Stilponos Kyriakidi street, Thessaloniki, 54636, Greece.
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Montoya C, Boursaw B, Tigges B, Lobo ML. Mirror, Mirror on the Wall: Children's Preferences and Self-Perceptions of Weight in a Rural Hispanic Community. J Pediatr Health Care 2016; 30:528-534. [PMID: 26810855 DOI: 10.1016/j.pedhc.2015.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 11/23/2015] [Accepted: 11/30/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Although studies have documented parents' misperceptions regarding their children's weight, studies examining preadolescent children's self-perceptions of weight-in particular, Hispanic children's self-perceptions of weight-are limited. METHOD A convenience sample of 424 children from a rural community, aged 8 to 11 years and in grades 3 through 5, participated in this cross-sectional, descriptive, nonexperimental study. Using the Children's Body Image Scale, the children were asked to select a figure representing their actual body perception and a figure representing their ideal body perception. The children were weighed and measured, body mass index (BMI) was calculated, and each child was assigned to one of the Centers for Disease Control and Prevention weight categories: underweight, normal or healthy weight, overweight, or obese. RESULTS Only BMI category was found to be significantly associated with accurate perception, χ2(3) = 201.4, p < .001, with only 9% of overweight or obese children selecting figures representing their actual BMI category. Actual BMI category, χ2(3) = 8.8, p = .032, and grade level, χ2(2) = 6.7, p = .036, had a significant association with selection of an underweight ideal. Overall, 32% of children selected an underweight figure as ideal. DISCUSSION Prepubertal children who are either overweight or obese do not accurately perceive their weight status. Rather than focusing solely on weight reduction programs, emphasis should be placed on promoting healthy lifestyles and choices.
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Abdul Majid H, Ramli L, Ying SP, Su TT, Jalaludin MY, Abdul Mohsein NAS. Dietary Intake among Adolescents in a Middle-Income Country: An Outcome from the Malaysian Health and Adolescents Longitudinal Research Team Study (the MyHeARTs Study). PLoS One 2016; 11:e0155447. [PMID: 27187889 PMCID: PMC4871353 DOI: 10.1371/journal.pone.0155447] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 04/28/2016] [Indexed: 11/18/2022] Open
Abstract
Optimal nutrition is essential for healthy growth during adolescence. This study aims to investigate the baseline nutritional intake of Malaysian adolescents by gender, body mass index, and places of residence, both urban and rural. A cohort study was conducted consisting of 794 adolescents (aged 13-years) attending 15 public secondary schools from the Central (Kuala Lumpur and Selangor) and Northern (Perak) Regions of Peninsular Malaysia. Qualified dietitians conducted a 7-day historical assessment of habitual food intakes. Facilitated by flipcharts and household measurement tools, detailed information on portion sizes and meal contents were recorded. Nutritionist Pro™ Diet Analysis software was also used to analyze the dietary records.The mean age of the adolescents was 12.86 ± 0.33 y; the mean energy intake was 1659.0 ± 329.6 kcal/d. Males had significantly (P < .001) higher energy intake than females (1774.0 ± 369.8 vs 1595.2 ± 320.6 kcal/d); adolescents in rural schools consumed more energy and cholesterol (P < .001) compared to adolescents in urban schools (1706.1 ± 377.7 kcal/d and 244.1 ± 100.2 mg/d, respectively). Obese adolescents in rural schools consumed more energy and sugar (1987.6 ± 374.0 kcal/d and 48.9 ± 23.0 g/d) (p-value <0.001).The dietary intake of normal weight versus obese adolescents differs by the location of their school. Thus, the implementation of a structured and tailored intervention is recommended to help minimize this nutritional inequality.
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Affiliation(s)
- Hazreen Abdul Majid
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Centre for Population Health, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Liyana Ramli
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sim Pei Ying
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Tin Tin Su
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Centre for Population Health, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Nabilla Al-Sadat Abdul Mohsein
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Centre for Population Health, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Eating breakfast together as a family: mealtime experiences and associations with dietary intake among adolescents in rural Minnesota, USA. Public Health Nutr 2016; 19:1565-74. [PMID: 26973150 DOI: 10.1017/s1368980016000379] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Although existing evidence links breakfast frequency to better dietary quality, little is known specifically in regard to the benefits associated with eating breakfast together with one's family. The present study describes the prevalence and experience of having family meals at breakfast among rural families and examines associations between meal frequency and adolescent diet quality. DESIGN Data were drawn from Project BreakFAST, a group-randomized trial aimed at increasing school breakfast participation in rural Minnesota high schools, USA. Linear mixed models were used to examine associations between student reports of family breakfast frequency and Healthy Eating Index 2010 (HEI-2010) scores while accounting for clustering within schools, demographics and household food security. SETTING Adolescent students from sixteen schools completed online surveys, height and weight measurements, and dietary recalls at baseline in 2012-2014. SUBJECTS The sample included 827 adolescents (55·1 % girls) in grades 9-10 who reported eating breakfast on at most three days per school week. RESULTS On average, adolescents reported eating breakfast with their family 1·3 (sd 1·9) times in the past week. Family breakfast meals occurred most frequently in the homes of adolescents who reported a race other than white (P=0·002) or Hispanic ethnicity (P=0·02). Family breakfast frequency was directly associated with adolescent involvement in preparing breakfast meals (P<0·001) and positive attitudes (P≤0·01) about mealtime importance, interactions and structure. Family breakfast frequency was unrelated to most diet quality markers. CONCLUSIONS Family meals may be one important context of opportunity for promoting healthy food patterns at breakfast. Additional research is needed to better inform and evaluate strategies.
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Raistenskis J, Sidlauskiene A, Cerkauskiene R, Burokiene S, Strukcinskiene B, Buckus R. Physical Activity and Sedentary Screen Time in Obese and Overweight Children Living in Different Environments. Cent Eur J Public Health 2016; 23 Suppl:S37-43. [PMID: 26849542 DOI: 10.21101/cejph.a4184] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 03/15/2015] [Indexed: 11/15/2022]
Abstract
AIM To assess the relationship of children's physical activity and sedentary screen time with overweight and obesity in children living in different environments (town and city) in Lithuania. METHODS An analysis of anthropometric data from 532 children living in town and city areas was performed. A youth physical activity questionnaire (YPAQ) was conducted to evaluate physical activity and sedentary screen time. RESULTS The prevalence of overweight and obesity among the children was 25.5% in the town and 18.6% in the city. Children living in the town on average engaged 9.3 min/day less in moderate to vigorous physical activity (p=0.050) and had 33.2 MET-min/day lower energy expenditure than children living in the city. Sedentary screen time was extremely high on weekends in both town and city children. CONCLUSIONS A higher prevalence of overweight and obesity and a lower amount of moderate-to-vigorous physical activity was found in children living in the town compared to children living in the city.
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Affiliation(s)
- Juozas Raistenskis
- Department of Rehabilitation, Physical and Sports Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Aurelija Sidlauskiene
- Department of Rehabilitation, Physical and Sports Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Rimante Cerkauskiene
- Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuani
| | - Sigita Burokiene
- Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuani
| | | | - Raimondas Buckus
- Public Health Institute, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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De Marco MM, Smith TW, Kearney W, Ammerman A. Harvest of Hope: The impact of a church garden project on African American youth and adults in the rural American South. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2016; 11:317-327. [PMID: 28496559 DOI: 10.1080/19320248.2016.1146193] [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: 10/21/2022]
Abstract
A pilot study was conducted of the feasibility of a church garden program to impact health outcomes in rural African American youth and adults. Thirty-six workdays were held at a Black church. Pre and post-intervention attitudes, diet, weight and blood pressure were measured. T-tests were used to test for significant within group differences. Spearman's rank correlation coefficients were used to test for significant bivariate associations. Youth showed improved attitudes about farming and gardening. No statistically significant changes were observed in adults. Church garden interventions can improve farming and gardening attitudes for rural, African American youth.
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Affiliation(s)
- Molly Michelle De Marco
- University of North Carolina at Chapel Hill, Center for Health Promotion & Disease Prevention, 1700 Martin Luther King Jr. Bl, CB #7426, 1700 Martin Luther King Jr. Blvd., Chapel Hill, 27599-7426 United States
| | - Tosha Woods Smith
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 Martin Luther King Jr. Boulevard, Chapel Hill, 27599-7426 United States. Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Nutrition, 135 Dauer Drive, 2200 McGavran-Greenberg Hall, Chapel Hill, 27599-7461 United States
| | - William Kearney
- Coley Springs Missionary Baptist Church, Warrenton, United States
| | - Alice Ammerman
- UNC-CH Gillings School of Global Public Health, Department of Nutrition, Chapel Hill, United States
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Machado-Rodrigues AM, Coelho E Silva MJ, Ribeiro LP, Fernandes R, Mota J, Malina RM. Waist Circumference and Objectively Measured Sedentary Behavior in Rural School Adolescents. THE JOURNAL OF SCHOOL HEALTH 2016; 86:54-60. [PMID: 26645421 DOI: 10.1111/josh.12350] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 05/07/2015] [Accepted: 05/10/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Research on relationships between lifestyle behaviors and adiposity in school youth is potentially important for identifying subgroups at risk. This study evaluates the associations between waist circumference (WC) and objective measures of sedentary behavior (SB) in a sample of rural school adolescents. METHODS The sample included 254 students (114 boys, 140 girls), 13-16 years of age, from rural regions of the Portuguese midlands. Height, weight, and WC were measured. Cardiorespiratory fitness (CRF) was assessed with the 20-m shuttle-run test. An uniaxial GT1M accelerometer was used to obtain 5 consecutive days of physically activity (PA) and SB. Multiple linear regression was used to test associations between WC and SB, adjusted for several potential confounders (age, sex, PA, CRF, parental education). RESULTS SB was not significantly associated with the WC, neither in the unadjusted model nor after adjustment for all potential confounders. In the final model, the unique significant predictor of the WC was cardiorespiratory fitness (β = -0.82; 95% confidence interval [CI], -1.02 to -0.62). CONCLUSION WC was not independently associated with SB time in rural school adolescents. Future research is claimed among rural adolescents in different geographic contexts to try to clarify recent findings of less studied communities.
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Affiliation(s)
- Aristides M Machado-Rodrigues
- Research Centre for Sport and Physical Activity, Universidade de Coimbra, Escola Superior de Educação de Viseu, Rua Dr. Maximiano Aragão, 3504-501, Viseu, Portugal.
| | - Manuel J Coelho E Silva
- Faculdade de Ciências do Desporto e Educação Física, Universidade de Coimbra, Estádio Universitário Coimbra Pavilhão-III, 3040-156 Coimbra, Portugal.
| | - Luís P Ribeiro
- Departamento de Educação Física/Department of Physical Education, Faculdade de Ciências e Tecnologia/Center of Science and Technology, Universidade Estadual Paulista - UNESP, Presidente Prudente, São Paulo, Brazil.
| | - Romulo Fernandes
- Faculdade de Ciências do Desporto e Educação Física, Universidade de Coimbra, Estádio Universitário Coimbra Pavilhão-III, 3040-156 Coimbra, Portugal.
| | - Jorge Mota
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport Sciences, University of Porto, R. Dr. Plácido Costa, 91, 4200-450 Porto, Portugal.
| | - Robert M Malina
- Department of Kinesiology and Health Education, University of Texas, Austin, TX.
- Department of Kinesiology, Tarleton State University, Stephenville, 10735 FM 2668, Bay City, TX 77414.
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Abstract
PURPOSE To collect normative data for the Timed Up and Go (TUG) on a large, diverse sample of urban school children who are typically developing, accounting for age, sex, and body mass index. METHODS Physical therapists administered the TUG with natural walking speeds on 1481 children (M = 635, F = 846), ages 5 to 13 years representing 29.60% whites, 24.2% Asian/Pacific Islanders, 19.7% Latino/Hispanics, 16.3% African Americans, 1.40% Native American/Alaskans, and 8.80% other. RESULTS Average TUG speeds ranged from 6.20 to 7.12 seconds across all ages, with speeds decreasing from 5 to 9 years and increasing from 9 to 13 years. Differences between 8-, 9-, and 11-year-old males and females and across age groups did not exceed a clinically important threshold. Body mass index was not consistently correlated with TUG speed. CONCLUSION This study provides reference data on the TUG. These data should complement clinical observations and additional tests and measures to determine whether a student is functioning slower than age-matched peers.
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Jackson JA, Smit E, Manore MM, John D, Gunter K. The Family-Home Nutrition Environment and Dietary Intake in Rural Children. Nutrients 2015; 7:9707-20. [PMID: 26610566 PMCID: PMC4690047 DOI: 10.3390/nu7125495] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 11/09/2015] [Accepted: 11/16/2015] [Indexed: 01/16/2023] Open
Abstract
Obesity and food insecurity rates are higher among rural compared to non-rural populations. Little is known, however, about how family-home environments influence childhood obesity-related behaviors, particularly in rural settings. This study examined associations between the family-home nutrition (FN) environment, food insecurity, and dietary intake (fruits, vegetables, whole grains, dairy, protein foods, and added sugars) in rural elementary school-age children (grades K-5/6; n = 102). Parents/caregivers completed surveys on FN, food insecurity, and the Block Kids Food Screener (BKFS). Body mass index (BMI, kg/m2) was calculated from measured height and weight. Approximately 33% of children were classified as overweight/obese and 28% of families were at-risk for food insecurity. Multivariable linear regression analyses examined associations between dietary intakes with FN and food insecurity. More favorable FN scores were associated with lower added sugar intake (B = -1.38, p = 0.04) and higher vegetable (B = 0.15, p < 0.001), fruit (B = 0.71, p = 0.01), and dairy (B = 0.31, p < 0.001) intakes. No significant associations were found between food insecurity and dietary intake. Given the association between higher FN scores and more favorable dietary intake, promoting healthy FN environments among rural children is warranted.
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Affiliation(s)
- Jennifer A Jackson
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR 97331, USA.
| | - Ellen Smit
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR 97331, USA.
| | - Melinda M Manore
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR 97331, USA.
| | - Deborah John
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR 97331, USA.
| | - Katherine Gunter
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR 97331, USA.
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Barriuso L, Miqueleiz E, Albaladejo R, Villanueva R, Santos JM, Regidor E. Socioeconomic position and childhood-adolescent weight status in rich countries: a systematic review, 1990-2013. BMC Pediatr 2015; 15:129. [PMID: 26391227 PMCID: PMC4578240 DOI: 10.1186/s12887-015-0443-3] [Citation(s) in RCA: 122] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 09/04/2015] [Indexed: 01/09/2023] Open
Abstract
Background Childhood obesity is a major problem in rich countries due to its high prevalence and its harmful health consequences. An exploratory analysis conducted in the PubMed database highlighted that the number of papers published on the relationship between socioeconomic position (SEP) and childhood-adolescent weight status had risen substantially with respect to an earlier review which had covered the period 1990–2005. Methods To describe the findings on the relationship between SEP and childhood-adolescent weight status in papers published in rich countries from 1990 through 2013, studies were identified in the following databases: PubMed; Web of Knowledge (WOK); PsycINFO; Global Health; and Embase. We included observational studies from the 27 richest OECD countries, which covered study populations aged 0 to 21 years, and used parental education, income and/or occupation as family SEP indicators. A total of 158 papers met the inclusion criteria and reported 134 bivariable and 90 multivariable analyses. Results Examination of the results yielded by the bivariable analyses showed that 60.4 % of studies found an inverse relationship, 18.7 % of studies did not found relationship, and 20.9 % of studies found a relationship that varied depending on another variable, such as age, sex or ethnic group; the corresponding percentages in the multivariable analyses were 51.1, 20.0 and 27.8 %, respectively. Furthermore, 1.1 % found a positive relationship. Conclusion The relationship between SEP and childhood-adolescent weight status in rich countries is predominantly inverse and the positive relationship almost has disappeared. The SEP indicator that yields the highest proportion of inverse relationships is parents’ education. The proportion of inverse relationships is higher when the weight status is reported by parents instead using objective measurements. Electronic supplementary material The online version of this article (doi:10.1186/s12887-015-0443-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Laura Barriuso
- Instituto de Salud Pública y Laboral de Navarra, Pamplona, Spain.
| | - Estrella Miqueleiz
- Department of Sociology, Universidad Pública de Navarra, Campus de Arrosadía, s/n, 31006, Pamplona, Spain.
| | - Romana Albaladejo
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
| | - Rosa Villanueva
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
| | - Juana M Santos
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain. .,Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
| | - Enrique Regidor
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain. .,Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain. .,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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45
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Jenkin GL, Pearson AL, Bentham G, Day P, Kingham S. Neighbourhood Influences on Children's Weight-related Behaviours and Body Mass Index. AIMS Public Health 2015; 2:501-515. [PMID: 29546122 PMCID: PMC5690247 DOI: 10.3934/publichealth.2015.3.501] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 08/13/2015] [Indexed: 11/18/2022] Open
Abstract
Introduction Neighbourhood contextual factors such as accessibility of food shops and green spaces are associated with adult bodyweight but not necessarily weight-related behaviours. Whether these associations are replicated amongst children is unknown. Aim To understand which aspects of childrens' neighbourhoods are associated with unhealthy weight and weight-related behaviours. Methods Individual-level data for children from the 2006/7 New Zealand Health Survey (of Body Mass Index (BMI), dietary indicators and socioeconomic variables) were linked with geographic level data on neighbourhood deprivation, rural/urban status, percentage of community engaged in active travel, access to green space, food shops and sports/leisure facilities. Logistic regression models were fitted for measures of BMI and weight-related behaviours; sugar sweetened beverage (SSB) consumption; fast-food consumption; and television viewing. Results Increased community engagement in active transport was, counterintuitively, the only neighbourhood contextual factor associated with unhealthy weight amongst children. After adjustment for socioeconomic and environmental variables, greater access to green space appeared to have a protective effect on SSB consumption and neighbourhood deprivation was associated with all three unhealthy weight-related behaviours (SSB and fast-food consumption and television viewing). Conclusions Although further research is needed, evidence from the current study suggests that a repertoire of health promotion interventions and policies to change unhealthy weight-related behaviours in high deprivation neighbourhoods may be required to address childhood obesity.
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Affiliation(s)
- Gabrielle L Jenkin
- Department of Public Health, University of Otago, 23A Mein Street, Newtown, PO Box 7343, Wellington 6242, New Zealand
| | - Amber L Pearson
- Department of Public Health, University of Otago, 23A Mein Street, Newtown, PO Box 7343, Wellington 6242, New Zealand.,Department of Geography, Michigan State University, 673 Auditorium Road, East Lansing, MI, 48823, USA
| | - Graham Bentham
- School of Environmental Sciences, University of East Anglia, Norwich NR4 7TJ, United Kingdom
| | - Peter Day
- Department of Geography, GeoHealth Laboratory,University of Canterbury, Private Box 1400, Christchurch 8140, New Zealand
| | - Simon Kingham
- Department of Geography, GeoHealth Laboratory,University of Canterbury, Private Box 1400, Christchurch 8140, New Zealand
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Heshmat R, Shafiee G, Kelishadi R, Babaki AES, Motlagh ME, Arefirad T, Ardalan G, Ataie-Jafari A, Asayesh H, Mohammadi R, Qorbani M. Is the association of continuous metabolic syndrome risk score with body mass index independent of physical activity? The CASPIAN-III study. Nutr Res Pract 2015; 9:404-10. [PMID: 26244080 PMCID: PMC4523485 DOI: 10.4162/nrp.2015.9.4.404] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Revised: 03/16/2015] [Accepted: 04/19/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND/OBJECTIVES Although the association of body mass index (BMI) with metabolic syndrome (MetS) is well documented, there is little knowledge on the independent and joint associations of BMI and physical activity with MetS risk based on a continuous scoring system. This study was designed to explore the effect of physical activity on interactions between excess body weight and continuous metabolic syndrome (cMetS) in a nationwide survey of Iranian children and adolescents. SUBJECTS/METHODS Data on 5,625 school students between 10 and 18 years of age were analyzed. BMI percentiles, screen time activity (STA), leisure time physical activity (LTPA) levels, and components of cMetS risk score were extracted. Standardized residuals (z-scores) were calculated for MetS components. Linear regression models were used to study the interactions between different combinations of cMetS, LTPA, and BMI percentiles. RESULTS Overall, 984 (17.5%) subjects were underweight, whereas 501 (8.9%) and 451 (8%) participants were overweight and obese, respectively. All standardized values for cMetS components, except fasting blood glucose level, were directly correlated with BMI percentiles in all models (P-trend < 0.001); these associations were independent of STA and LTPA levels. Linear associations were also observed among LTPA and standardized residuals for blood pressure, high-density lipoprotein, and waist circumference (P-trend < 0.01). CONCLUSIONS Our findings suggest that BMI percentiles are associated with cMetS risk score independent of LTPA and STA levels.
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Affiliation(s)
- Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | | | - Tahereh Arefirad
- Department of Exercise Physiology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Gelayol Ardalan
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Asal Ataie-Jafari
- Department of Nutrition, Faculty of Medicine, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Rasool Mohammadi
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Department of Community Medicine, School of Public Health, Alborz University of Medical Sciences, Baghestan Boulevard, 31485/56, Karaj, Iran. ; Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Duan J, Hu H, Wang G, Arao T. Study on Current Levels of Physical Activity and Sedentary Behavior among Middle School Students in Beijing, China. PLoS One 2015; 10:e0133544. [PMID: 26181052 PMCID: PMC4504466 DOI: 10.1371/journal.pone.0133544] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 06/29/2015] [Indexed: 01/28/2023] Open
Abstract
Introduction This study aimed to determine current levels of physical activity and sedentary behavior in middle school students on the basis of grade, sex, student attitudes toward physical education, and residence location. Methods In 2013, a cross-sectional study of 1793 students aged 12 to 15 years was conducted across eight middle schools in Beijing, China. Four schools were selected from an urban district and another four schools were from a suburban district. Physical activity and sedentary behavior data were collected using the commonly used school-based Chinese version of the China Health and Nutrition Survey. Results The mean age of sampled students was 13.3±1.0 years; 51.5% were boys. Approximately 76.6% of students reported having three 45-minute physical education classes every week. A total of 35.6% students spent ≥1 h/day performing moderate to vigorous physical activity (MVPA) during school, and 34.9% spent ≥1 h/day in MVPA outside school time. Approximately half (49.7%) of the students engaged in reading, writing, or drawing for ≥2 h/day, and 42.9% reported screen time for ≥2 h/day. Although boys spent more time engaged in physical activity than girls did, they also spent more time exhibiting sedentary behavior. Each 10-unit increase in attitudes toward physical education was associated with an increased odds of 1.15 (95%CI: 1.09–1.20) for spending more than 1 h/day on MVPA. Students in suburban schools reported engaging in physical activity less when compared with those in urban schools. Conclusion The majority of our students did not meet the current physical activity recommendations, and about half of the students spent excessive time engaging in sedentary behaviors. Findings from this study highlight a positive association between student attitudes toward physical education and physical activity. Studies are needed to further explore the role of student attitudes toward physical education in promoting physical activity among Chinese students.
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Affiliation(s)
- Jiali Duan
- Institute of School Health, Beijing Center for Diseases Control and Prevention, Beijing, China
| | - Huanhuan Hu
- Lab of Exercise Epidemiology, School of Sport Sciences, Waseda University, Saitama, Japan
- * E-mail:
| | - Guan Wang
- Institute of School Health, Beijing Center for Diseases Control and Prevention, Beijing, China
| | - Takashi Arao
- Lab of Exercise Epidemiology, Faculty of Sport Sciences, Waseda University, Saitama, Japan
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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: 219] [Impact Index Per Article: 24.3] [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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Geremia R, Cimadon HMS, de Souza WB, Pellanda LC. Childhood overweight and obesity in a region of Italian immigration in Southern Brazil: a cross-sectional study. Ital J Pediatr 2015; 41:28. [PMID: 25883083 PMCID: PMC4427939 DOI: 10.1186/s13052-015-0126-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 03/11/2015] [Indexed: 12/02/2022] Open
Abstract
Background The main modifiable risk factors for obesity are related to lifestyle and significantly influenced by the family, environment and culture. We aimed to estimate the prevalence of overweight/obesity and associated lifestyle factors in children from Bento Gonçalves, a southern Brazil city with strong Italian immigration influence. Italian traditional foods were locally adapted since the immigrants’ arrival in the XIX century, to include more fat and fewer vegetables, and physical activity levels have decreased. Methods Cross-sectional study of a population-based cluster sample with students aged 9–18 years. We assessed time spent in sedentary behaviors, hours of physical activity, food frequency and family history. All children underwent physical examination with anthropometric and blood pressure measurements. Overweight and obesity were classified according to WHO percentile curves. Results A total of 590 students were evaluated. Mean age was 12.45 ± 1.49 years. The prevalence of overweight and obesity was 16.3% and 8.3%, respectively. Boys were more frequently overweight and obese than girls (16.3% and 12.2% versus 16.2% and 5.5%, respectively). Vegetables and fruits were consumed less than 4 times per week in 49% and 36.8%, while soft drinks, fast food and sweets were consumed more than 4 times a week by 71%, 70.3% and 42.7%, respectively. The habit of omitting breakfast was associated with overweight (p = 0.007). The average screen time was 5.38 ± 2.88 hours/day. Overweight/obesity was present in 12.2% (n = 5), 24.8% (n = 122) and 36.8% (n = 14) children with low birth weight, normal birth weight and high birth weight respectively (p = 0.04). The prevalence of high blood pressure was higher in obese (30.6%) and overweight (21.2%) children, comparing to eutrophic children (6.8%; p < 0.001). Excess weight was more frequent among fathers (62.8%) than in mothers (46.3%), but excess weight in mothers was positively associated with excess weight in children (p 0.048). Conclusion The city showed high prevalence of overweight and obesity. These findings reinforce the importance of implementing prevention strategies aimed at children and their families, considering that health habits are shared and transmitted along generations.
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Affiliation(s)
- Renata Geremia
- Programa de Pós-Graduação em Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, Brazil.
| | - Hosana Maria Speranza Cimadon
- Programa de Pós-Graduação em Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, Brazil. .,Centro Universitário Feevale, Novo Hamburgo, Brazil. .,CNEC, Bento Gonçalves, Brazil.
| | - William Brasil de Souza
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), IC/FUC, Avenida Princesa Isabel, 370, Porto Alegre, RS, 90620-001, Brazil.
| | - Lucia Campos Pellanda
- Programa de Pós-Graduação em Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, Brazil. .,Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), IC/FUC, Avenida Princesa Isabel, 370, Porto Alegre, RS, 90620-001, Brazil.
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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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