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Fiore G, Scapaticci S, Neri CR, Azaryah H, Escudero-Marín M, Pascuzzi MC, La Mendola A, Mameli C, Chiarelli F, Campoy C, Zuccotti G, Verduci E. Chrononutrition and metabolic health in children and adolescents: a systematic review and meta-analysis. Nutr Rev 2023:nuad122. [PMID: 37944081 DOI: 10.1093/nutrit/nuad122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023] Open
Abstract
CONTEXT Obesity has emerged as a global health issue for the pediatric population, increasing the need to investigate physiopathological aspects to prevent the appearance of its cardiometabolic complications. Chrononutrition is a field of research in nutritional sciences that investigates the health impact of 3 different dimensions of feeding behavior: regularity of meals, frequency, and timing of food intake. OBJECTIVE We carried out a systematic review and meta-analysis to investigate the association between chrononutrition in children and adolescents and the risk of overweight/obesity or a cluster of metabolic abnormalities related to glucose and lipid metabolism, blood pressure, and cardiovascular disease risk. DATA EXTRACTION A literature search was performed using PubMed, EMBASE, and The Cochrane Library for relevant articles published before August 2022. DATA ANALYSIS A total of 64 articles were included in the narrative synthesis (47 cross-sectional and 17 cohort studies), while 16 studies were included in the meta-analysis. Meta-analysis showed that non-daily breakfast consumers (≤6 d/wk) had a higher risk of overweight/obesity (odds ratio [OR], 1.45; 95% confidence interval [CI], 1.08-1.82] compared with daily breakfast eaters (7 d/wk). Similarly, irregular breakfast consumption (only 0-to-3 times/wk) increased the risk of abdominal obesity (waist-to-height ratio ≥ 0.5) compared with regular consumption (5-to-7 times/wk) (OR, 1.38; 95% CI, 1.26-1.49). There was evidence to suggest that a regular frequency of meal consumption (≥4 times/d) is preventive against overweight/obesity development compared with fewer meals (≤3 times/d) (OR, 0.83; 95% CI, 0.70-0.97). In the narrative synthesis, snacking habits showed controversial results, while food timing was the most understudied dimension. CONCLUSION Overall, our data indicate a potential implication of chrononutrition in affecting pediatric metabolic health; however, the evidence of this association is limited and heterogeneous. Further prospective and intervention studies with a consistent approach to categorize the exposure are needed to elucidate the importance of chrononutrition for pediatric metabolic health.
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Affiliation(s)
- Giulia Fiore
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Serena Scapaticci
- Department of Pediatrics, University of Chieti "G. D'Annunzio", Chieti, Italy
| | - Costanza R Neri
- Department of Pediatrics, University of Chieti "G. D'Annunzio", Chieti, Italy
| | - Hatim Azaryah
- Department of Pediatrics, School of Medicine, University of Granada, Granada, Spain
- EURISTIKOS Excellence Centre for Pediatric Research, Biomedical Research Centre (CIBM), University of Granada, Granada, Spain
| | - Mireia Escudero-Marín
- Department of Pediatrics, School of Medicine, University of Granada, Granada, Spain
- EURISTIKOS Excellence Centre for Pediatric Research, Biomedical Research Centre (CIBM), University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (Ibs-GRANADA), San Cecilio University Hospital, Granada, Spain
- Neurosciences Institute Dr. Federico Oloriz, University of Granada, Granada, Spain
| | - Martina C Pascuzzi
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Alice La Mendola
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Chiara Mameli
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Francesco Chiarelli
- Department of Pediatrics, University of Chieti "G. D'Annunzio", Chieti, Italy
| | - Cristina Campoy
- Department of Pediatrics, School of Medicine, University of Granada, Granada, Spain
- EURISTIKOS Excellence Centre for Pediatric Research, Biomedical Research Centre (CIBM), University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (Ibs-GRANADA), San Cecilio University Hospital, Granada, Spain
- Neurosciences Institute Dr. Federico Oloriz, University of Granada, Granada, Spain
- Spanish Network of Biomedical Research in Epidemiology and Public Health (CIBERESP), Granada's Node, Institute of Health Carlos III, Madrid, Spain
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Elvira Verduci
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
- Department of Health Sciences, University of Milan, Milan, Italy
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Wang K, Niu Y, Lu Z, Duo B, Effah CY, Guan L. The effect of breakfast on childhood obesity: a systematic review and meta-analysis. Front Nutr 2023; 10:1222536. [PMID: 37736138 PMCID: PMC10510410 DOI: 10.3389/fnut.2023.1222536] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/22/2023] [Indexed: 09/23/2023] Open
Abstract
Objective Previous cohort trials have shown that skipping breakfast increases the risk of obesity or overweight in children. However, this finding remains controversial. Through a meta-analysis, this study systematically evaluated the effect of skipping breakfast on the prevalence of obesity or overweight in children. Methods We performed a literature search for studies published until March 19, 2023. using the Cochrane, PubMed, and Embase databases. Based on the inclusion and exclusion criteria, observational studies on the relationship between skipping breakfast and overweight/obesity in children and adolescents were analyzed. Three investigators independently screened the relevant literature, extracted the data, and assessed the risk of bias. The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). A random-effects model was used. The odds ratio (OR) with its 95% confidence interval (CI) was used to indicate the effect size. Results A total of 40 retrospective studies with 323,244 children ranging in age from 2 to 20 years were included in this study. The results of this meta-analysis showed that children and adolescents who skipped breakfast had a significantly higher prevalence of obesity or overweight than those who ate breakfast (OR, 1.59; 95% CI, 1.33-1.90; P < 0.001). Skipping breakfast was positively associated with overweight in children and adolescents (OR, 1.37; 95% CI, 1.23-1.54; P < 0.001). Similarly, skipping breakfast was positively associated with obesity in children and adolescents (OR, 1.51; 95% CI, 1.30-1.76; P < 0.001). The effect was also different by sex, with girls being the most affected (OR, 1.47; 95% CI, 1.23-1.76; P < 0.001). There was also a correlation between skipping breakfast and abdominal obesity in children (OR, 0.65; 95% CI, 0.55-0.77; P < 0.001). Conclusion This meta-analysis suggested that skipping breakfast is associated with an increased risk of overweight/obesity in children and adolescents. The findings provide support for a possible protective role of breakfast against excessive weight gain in children and adolescents. However, more rigorous study designs with validated and standardized measures of relevant variables are needed.
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Affiliation(s)
- Kun Wang
- Department of Anesthesiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yifan Niu
- Henan Medical School of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhenzhen Lu
- Henan Medical School of Zhengzhou University, Zhengzhou, Henan, China
| | - Boyang Duo
- Henan Medical School of Zhengzhou University, Zhengzhou, Henan, China
| | - Clement Yaw Effah
- General ICU, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lina Guan
- Department of Anesthesiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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3
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Yang HM, Choo J. Effects of a parent-led childhood obesity management program for socioeconomically vulnerable families: A randomised controlled trial. Collegian 2023. [DOI: 10.1016/j.colegn.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
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4
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Vidmar AP, Cáceres NA, Schneider-Worthington CR, Shirazipour C, Buman MP, de la Haye K, Salvy SJ. Integration of Time-Based Recommendations with Current Pediatric Health Behavior Guidelines: Implications for Obesity Prevention and Treatment in Youth. Curr Obes Rep 2022; 11:236-253. [PMID: 36348216 PMCID: PMC9742346 DOI: 10.1007/s13679-022-00491-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/11/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE OF REVIEW Youth-onset obesity is associated with negative health outcomes across the lifespan including cardiovascular diseases, type 2 diabetes, obstructive sleep apnea, dyslipidemias, asthma, and several cancers. Pediatric health guidelines have traditionally focused on the quality and quantity of dietary intake, physical activity, and sleep. RECENT FINDINGS Emerging evidence suggests that the timing (time of day when behavior occurs) and composition (proportion of time spent allocated to behavior) of food intake, movement (i.e., physical activity, sedentary time), and sleep may independently predict health trajectories and disease risks. Several theoretically driven interventions and conceptual frameworks feature behavior timing and composition (e.g., 24 h movement continuum, circadian science and chronobiology, intermittent fasting regimens, structured day hypothesis). These literatures are, however, disparate, with little crosstalk across disciplines. In this review, we examine dietary, sleep, and movement guidelines and recommendations for youths ages 0-18 in the context of theoretical models and empirical findings in support of time-based approaches. The review aims to inform a unifying framework of health behaviors and guide future research on the integration of time-based recommendations into current quantity and quality-based health guidelines for children and adolescents.
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Affiliation(s)
- Alaina P Vidmar
- Department of Pediatrics, Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles and Keck School of Medicine of USC, 4650 Sunset Boulevard, Mailstop #61, Los Angeles, CA, 90027, USA.
| | - Nenette A Cáceres
- Cancer Research Center On Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, USA
| | | | - Celina Shirazipour
- Cancer Research Center On Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, USA
| | - Matthew P Buman
- College of Health Solutions, Arizona State University, Tempe, USA
| | - Kayla de la Haye
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Sarah-Jeanne Salvy
- Cancer Research Center On Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, USA
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
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5
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Kim B, Thomsen MR, Nayga RM, Goudie A. The effect of gender-specific labor market conditions on children's weight. HEALTH ECONOMICS REVIEW 2021; 11:44. [PMID: 34855042 PMCID: PMC8641227 DOI: 10.1186/s13561-021-00345-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 11/24/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Macroeconomic conditions are widely known to influence health outcomes through direct behavioral change or indirect mental effects of individuals. However, they have not received much attention in relation to childhood obesity. METHODS Using gender-specific predicted employment growth rates as an index for labor market conditions, we analyze how economic shocks affect children's weight status in Arkansas. To understand the underlying mechanisms behind these results, we use data on individual time use to examine how economic shocks are related to activities related to children's weight. RESULTS Improvement in the female labor market is associated with an increase in body mass index (BMI) and the probability that a child is overweight or obese, while an improvement in the male labor market has no significant effects on children's weight. This impact is particularly evident among female children, older children, and African-American children. We also find a negative effect of improvements in the female labor market on time spent on preparation for foods at home. CONCLUSIONS These results suggest that a decrease in time spent preparing home-cooked foods might be a plausible explanation for the pro-cyclical relationship between children's weight and improvement in the labor market conditions. Thus, the policy implications of our paper should be aimed at mitigating the adverse effects of women's labor participation.
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Affiliation(s)
- Bongkyun Kim
- Department of Eonomics, Kangwon National University, 1 Gangwondaehakgil, Chuncheon-si, Gangwondo Republic of Korea 25913
| | - Michael R. Thomsen
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 W. Markham, Slot 820, Little Rock, AR 72205 USA
| | - Rodolfo M. Nayga
- Department of Agricultural Economics, Texas A&M University, 600 John Kimbrough Blvd, Suite 309, College Station, TX 77843 USA
| | - Anthony Goudie
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Director of Research and Evaluation Arkansas Center for Health Improvement, 1401 West Capitol Suite 300, Little Rock, AR 72201 USA
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6
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Sobek C, Ober P, Abel S, Spielau U, Kiess W, Meigen C, Poulain T, Igel U, Vogel M, Lipek T. Purchasing Behavior, Setting, Pricing, Family: Determinants of School Lunch Participation. Nutrients 2021; 13:4209. [PMID: 34959761 PMCID: PMC8706800 DOI: 10.3390/nu13124209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/16/2021] [Accepted: 11/22/2021] [Indexed: 11/16/2022] Open
Abstract
Despite growing school lunch availability in Germany, its utilization is still low, and students resort to unhealthy alternatives. We investigated predictors of school lunch participation and reasons for nonparticipation in 1215 schoolchildren. Children reported meal habits, parents provided family-related information (like socioeconomic status), and anthropometry was conducted on-site in schools. Associations between school lunch participation and family-related predictors were estimated using logistic regression controlling for age and gender if necessary. School was added as a random effect. School lunch participation was primarily associated with family factors. While having breakfast on schooldays was positively associated with school lunch participation (ORadj = 2.20, p = 0.002), lower secondary schools (ORadj = 0.52, p < 0.001) and low SES (ORadj = 0.25, p < 0.001) were negatively associated. The main reasons for nonparticipation were school- and lunch-related factors (taste, time constraints, pricing). Parents reported pricing as crucial a reason as an unpleasant taste for nonparticipation. Nonparticipants bought sandwiches and energy drinks significantly more often on school days, whereas participants were less often affected by overweight (OR = 0.66, p = 0.043). Our data stress school- and lunch-related factors as an important opportunity to foster school lunch utilization.
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Affiliation(s)
- Carolin Sobek
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (M.V.); (T.L.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, 04103 Leipzig, Germany;
| | - Peggy Ober
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (M.V.); (T.L.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, 04103 Leipzig, Germany;
- Integrated Research and Treatment Center Adiposity Diseases, Medical Faculty, Leipzig University, 04103 Leipzig, Germany
| | - Sarah Abel
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (M.V.); (T.L.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, 04103 Leipzig, Germany;
- Integrated Research and Treatment Center Adiposity Diseases, Medical Faculty, Leipzig University, 04103 Leipzig, Germany
| | - Ulrike Spielau
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, 04103 Leipzig, Germany;
- Integrated Research and Treatment Center Adiposity Diseases, Medical Faculty, Leipzig University, 04103 Leipzig, Germany
| | - Wieland Kiess
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (M.V.); (T.L.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, 04103 Leipzig, Germany;
| | - Christof Meigen
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (M.V.); (T.L.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, 04103 Leipzig, Germany;
| | - Tanja Poulain
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (M.V.); (T.L.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, 04103 Leipzig, Germany;
| | - Ulrike Igel
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (M.V.); (T.L.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, 04103 Leipzig, Germany;
- Department of Social Work, University of Applied Science, 99085 Erfurt, Germany
| | - Mandy Vogel
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (M.V.); (T.L.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, 04103 Leipzig, Germany;
| | - Tobias Lipek
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (M.V.); (T.L.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, 04103 Leipzig, Germany;
- Integrated Research and Treatment Center Adiposity Diseases, Medical Faculty, Leipzig University, 04103 Leipzig, Germany
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Genitsaridi SM, Giannios C, Karampatsou S, Papageorgiou I, Papadopoulos G, Farakla I, Koui E, Georgiou A, Romas S, Terzioglou E, Papathanasiou C, Kassari P, Manios Y, Charmandari E. A Comprehensive Multidisciplinary Management Plan Is Effective in Reducing the Prevalence of Overweight and Obesity in Childhood and Adolescence. Horm Res Paediatr 2021; 93:94-107. [PMID: 32580197 DOI: 10.1159/000507760] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 04/06/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Obesity in childhood and adolescence represents a major health problem of our century. In Greece, 30-35% of children and adolescents are overweight or obese. Objective and Hypotheses: To investigate the effectiveness of a comprehensive multidisciplinary personalized management plan at reducing the prevalence of overweight and obesity in childhood and adolescence. PATIENTS AND METHODS One thousand (n = 1,000) children and adolescents aged 2-18 years (mean age ± SD: 10.09 ± 2.86 years; 520 females, 480 males) were studied prospectively. Subjects were classified as obese (n = 579, 57.9%), overweight (n = 295, 29.5%) or having a normal body mass index (BMI) (n = 126, 12.6%) according to the International Obesity Task Force cutoff points. All subjects were evaluated by a multidisciplinary team at frequent intervals, received personalized advice on diet and exercise and were studied prospectively for 1 year. Detailed clinical evaluation and laboratory investigations were performed at the beginning and at the end of the study. RESULTS At initial evaluation, 57.9% of subjects were obese, 29.5% overweight and 12.6% of normal BMI. Indices of cardiometabolic disease were higher in obese than in overweight and normal-BMI subjects. Following 1 year of multidisciplinary management interventions, the prevalence of obesity decreased by 16.8%, the prevalence of normal BMI increased by 8.2%, and all cardiometabolic indices improved significantly. CONCLUSIONS A personalized multidisciplinary management plan is effective at reducing the prevalence of obesity in childhood and adolescence.
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Affiliation(s)
- Sofia-Maria Genitsaridi
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece,
| | - Christos Giannios
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece
| | - Sofia Karampatsou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece
| | - Ifigeneia Papageorgiou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece
| | - Georgios Papadopoulos
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece
| | - Ioanna Farakla
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece
| | - Eleni Koui
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece
| | - Alexandra Georgiou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece.,Department of Nutrition, Harokopio University of Athens, Athens, Greece
| | - Stamatis Romas
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece
| | - Eleni Terzioglou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece
| | - Chryssanthi Papathanasiou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece
| | - Penio Kassari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece
| | - Yannis Manios
- Department of Nutrition, Harokopio University of Athens, Athens, Greece
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece.,Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
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8
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Ober P, Sobek C, Stein N, Spielau U, Abel S, Kiess W, Meigen C, Poulain T, Igel U, Lipek T, Vogel M. And yet Again: Having Breakfast Is Positively Associated with Lower BMI and Healthier General Eating Behavior in Schoolchildren. Nutrients 2021; 13:1351. [PMID: 33919560 PMCID: PMC8072724 DOI: 10.3390/nu13041351] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/13/2021] [Accepted: 04/16/2021] [Indexed: 12/18/2022] Open
Abstract
Given the high prevalence of childhood overweight, school-based programs aiming at nutritional behavior may be a good starting point for community-based interventions. Therefore, we investigated associations between school-related meal patterns and weight status in 1215 schoolchildren. Anthropometry was performed on-site in schools. Children reported their meal habits, and parents provided family-related information via questionnaires. Associations between nutritional behavior and weight status were estimated using hierarchical linear and logistic regression. Analyses were adjusted for age, socio-economic status, school type, migration background, and parental weight status. Having breakfast was associated with a lower BMI-SDS (βadj = -0.51, p = 0.004) and a lower risk of being overweight (ORadj = 0.30, p = 0.009), while having two breakfasts resulting in stronger associations (BMI-SDS: βadj = -0.66, p < 0.001; risk of overweight: ORadj = 0.22, p = 0.001). Likewise, children who regularly skipped breakfast on school days showed stronger associations (BMI-SDS: β = 0.49, p < 0.001; risk of overweight: OR = 3.29, p < 0.001) than children who skipped breakfast only occasionally (BMI-SDS: β = 0.43, p < 0.001; risk of overweight: OR = 2.72, p = 0.032). The associations persisted after controlling for parental SES and weight status. Therefore, our data confirm the school setting as a suitable starting point for community-based interventions and may underline the necessity of national programs providing free breakfast and lunch to children.
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Affiliation(s)
- Peggy Ober
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Ph-Rosenthal-Str. 27, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (T.L.); (M.V.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Liebigstr. 20a, 04103 Leipzig, Germany;
- Integrated Research and Treatment Center Adiposity Diseases, Medical Faculty, Leipzig University, Ph.-Rosenthal-Str. 27, 04103 Leipzig, Germany;
| | - Carolin Sobek
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Ph-Rosenthal-Str. 27, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (T.L.); (M.V.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Liebigstr. 20a, 04103 Leipzig, Germany;
| | - Nancy Stein
- Integrated Research and Treatment Center Adiposity Diseases, Medical Faculty, Leipzig University, Ph.-Rosenthal-Str. 27, 04103 Leipzig, Germany;
| | - Ulrike Spielau
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Liebigstr. 20a, 04103 Leipzig, Germany;
- Integrated Research and Treatment Center Adiposity Diseases, Medical Faculty, Leipzig University, Ph.-Rosenthal-Str. 27, 04103 Leipzig, Germany;
| | - Sarah Abel
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Ph-Rosenthal-Str. 27, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (T.L.); (M.V.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Liebigstr. 20a, 04103 Leipzig, Germany;
- Integrated Research and Treatment Center Adiposity Diseases, Medical Faculty, Leipzig University, Ph.-Rosenthal-Str. 27, 04103 Leipzig, Germany;
| | - Wieland Kiess
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Ph-Rosenthal-Str. 27, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (T.L.); (M.V.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Liebigstr. 20a, 04103 Leipzig, Germany;
| | - Christof Meigen
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Ph-Rosenthal-Str. 27, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (T.L.); (M.V.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Liebigstr. 20a, 04103 Leipzig, Germany;
| | - Tanja Poulain
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Ph-Rosenthal-Str. 27, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (T.L.); (M.V.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Liebigstr. 20a, 04103 Leipzig, Germany;
| | - Ulrike Igel
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Ph-Rosenthal-Str. 27, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (T.L.); (M.V.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Liebigstr. 20a, 04103 Leipzig, Germany;
- Department of Social Work, University of Applied Science, Altonaer Str. 25, 99085 Erfurt, Germany
| | - Tobias Lipek
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Ph-Rosenthal-Str. 27, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (T.L.); (M.V.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Liebigstr. 20a, 04103 Leipzig, Germany;
- Integrated Research and Treatment Center Adiposity Diseases, Medical Faculty, Leipzig University, Ph.-Rosenthal-Str. 27, 04103 Leipzig, Germany;
| | - Mandy Vogel
- LIFE Child, Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Ph-Rosenthal-Str. 27, 04103 Leipzig, Germany; (P.O.); (S.A.); (W.K.); (C.M.); (T.P.); (U.I.); (T.L.); (M.V.)
- Center for Pediatric Research (CPL), Hospital for Children and Adolescents, Medical Faculty, Leipzig University, Liebigstr. 20a, 04103 Leipzig, Germany;
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9
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Borisenkov MF, Popov SV, Tserne TA, Bakutova LA, Pecherkina AA, Dorogina OI, Martinson EA, Vetosheva VI, Gubin DG, Solovieva SV, Turovinina EF, Symanyuk EE. Food addiction and symptoms of depression among inhabitants of the European North of Russia: Associations with sleep characteristics and photoperiod. EUROPEAN EATING DISORDERS REVIEW 2020; 28:332-342. [DOI: 10.1002/erv.2728] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 12/23/2019] [Accepted: 02/16/2020] [Indexed: 01/20/2023]
Affiliation(s)
- Mikhail F. Borisenkov
- Department of Molecular Immunology and BiotechnologyInstitute of Physiology of Komi Science Centre of the Ural Branch of the Russian Academy of Sciences Syktyvkar Russia
- Ural Institute of HumanitiesUral Federal University Yekaterinburg Russia
| | - Sergey V. Popov
- Department of Molecular Immunology and BiotechnologyInstitute of Physiology of Komi Science Centre of the Ural Branch of the Russian Academy of Sciences Syktyvkar Russia
- Ural Institute of HumanitiesUral Federal University Yekaterinburg Russia
| | - Tatyana A. Tserne
- Department of Molecular Immunology and BiotechnologyInstitute of Physiology of Komi Science Centre of the Ural Branch of the Russian Academy of Sciences Syktyvkar Russia
| | - Larisa A. Bakutova
- Department of Molecular Immunology and BiotechnologyInstitute of Physiology of Komi Science Centre of the Ural Branch of the Russian Academy of Sciences Syktyvkar Russia
| | - Anna A. Pecherkina
- Ural Institute of HumanitiesUral Federal University Yekaterinburg Russia
| | - Olga I. Dorogina
- Ural Institute of HumanitiesUral Federal University Yekaterinburg Russia
| | | | - Valentina I. Vetosheva
- Institute of Pedagogy and PsychologyPitirim Sorokin Syktyvkar State University Syktyvkar Russia
| | - Denis G. Gubin
- Department of BiologyTyumen Medical University Tyumen Russia
- Tyumen Cardiology Research Centre, Tomsk National Research Medical CenterRussian Academy of Science Tyumen Russia
| | | | | | - Elvira E. Symanyuk
- Ural Institute of HumanitiesUral Federal University Yekaterinburg Russia
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10
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Polonsky HM, Bauer KW, Fisher JO, Davey A, Sherman S, Abel ML, Hanlon A, Ruth KJ, Dale LC, Foster GD. Effect of a Breakfast in the Classroom Initiative on Obesity in Urban School-aged Children: A Cluster Randomized Clinical Trial. JAMA Pediatr 2019; 173:326-333. [PMID: 30801612 PMCID: PMC6450266 DOI: 10.1001/jamapediatrics.2018.5531] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Serving breakfast in the classroom is promoted to increase participation in the federal School Breakfast Program. However, little is known about the effect of breakfast in the classroom on children's weight status. OBJECTIVE To evaluate the effect of a breakfast in the classroom initiative, which combined breakfast in the classroom with breakfast-specific nutrition education, on overweight and obesity among urban children in low-income communities. DESIGN, SETTING, AND PARTICIPANTS A cluster-randomized clinical trial among 1362 fourth- through sixth-grade students from low-income urban communities across 2.5 years. Sixteen kindergarten through eighth grade Philadelphia public schools with universal breakfast participated. Participants were recruited in September 2013, and the intervention began in January 2014. Data analysis took place from April 1, 2018, to August 30, 2018. INTERVENTIONS Intervention schools received a program that included breakfast in the classroom and breakfast-specific nutrition education. Control schools continued breakfast before school in the cafeteria and standard nutrition education. MAIN OUTCOMES AND MEASURES The primary outcome was the combined incidence of overweight and obesity. Secondary outcomes included the combined prevalence of overweight and obesity, incidence and prevalence of obesity, changes in body mass index (BMI) z score, and School Breakfast Program participation. RESULTS Among the 1362 students, mean (SD) age was 10.8 (0.96) years and 700 (51.4%) were female; 907 (66.6%) were black, 233 (17.1%) were Hispanic, 100 (7.3%) were white, 83 (6.1%) were Asian, and 39 were of multiple or other race/ethnicity. After 2.5 years, students in intervention schools had participated in the School Breakfast Program 53.8% of days, compared with 24.9% of days among students in control schools (β = 0.33; 95% CI, 0.22-0.42). There was no difference between intervention and control schools in the combined incidence of overweight and obesity after 2.5 years (11.7% vs 9.3%; odds ratio [OR] 1.31; 95% CI, 0.85-2.02; P = .22). However, the incidence (11.6% vs 4.4%; OR, 2.43; 95% CI, 1.47-4.00) and prevalence (28.0% vs 21.2%; OR, 1.46; 95% CI, 1.11-1.92) of obesity were higher in intervention schools than in control schools after 2.5 years. CONCLUSIONS AND RELEVANCE A breakfast in the classroom initiative increased participation in the School Breakfast Program and did not affect the combined incidence of overweight and obesity. However, the initiative had an unintended consequence of increasing incident and prevalent obesity. Further research is needed to identify approaches to increase participation in the School Breakfast Program that do not increase obesity among students. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01924130.
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Affiliation(s)
- Heather M. Polonsky
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, Pennsylvania
| | - Katherine W. Bauer
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor
| | - Jennifer O. Fisher
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, Pennsylvania,Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, Pennsylvania,Department of Social & Behavioral Sciences, College of Public Health, Temple University, Philadelphia, Pennsylvania
| | - Adam Davey
- College of Health Sciences and Department of Behavioral Health and Nutrition, University of Delaware, Newark
| | | | | | - Alexandra Hanlon
- Department of Statistics, Virginia Polytechnic Institute and State University, Roanoake
| | - Karen J. Ruth
- Fox Chase Cancer Center, Temple Health, Philadelphia, Pennsylvania
| | | | - Gary D. Foster
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, Pennsylvania,WW (formerly Weight Watchers), New York, New York,Center for Weight and Eating Disorders, University of Pennsylvania, Philadelphia
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11
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Amini M, Dadkhah Piraghaj M, Khosravi M, Lotfollahi N. Dietary Patterns and Obesity Associated Factors in Primary School Children. NUTRITION AND FOOD SCIENCES RESEARCH 2018. [DOI: 10.29252/nfsr.5.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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12
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Rehm CD, Drewnowski A. Replacing American Breakfast Foods with Ready-To-Eat (RTE) Cereals Increases Consumption of Key Food Groups and Nutrients among US Children and Adults: Results of an NHANES Modeling Study. Nutrients 2017; 9:nu9091010. [PMID: 28902145 PMCID: PMC5622770 DOI: 10.3390/nu9091010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 09/01/2017] [Accepted: 09/11/2017] [Indexed: 11/16/2022] Open
Abstract
Replacing the typical American breakfast with ready-to-eat cereals (RTECs) may improve diet quality. Our goal was to assess the impact of RTECs on diet quality measures for different age groups, using substitution modeling. Dietary intakes came from the 2007-2010 National Health and Examination Surveys (NHANES; n = 18,112). All breakfast foods, excluding beverages, were replaced on a per calorie basis, with frequency-weighted and age/race specific RTECs. Model 1 replaced foods with RTECs alone; Model 2 replaced foods with RTECs and milk. Diet quality measures were based on desirable food groups and nutrients, Healthy Eating Index (HEI)-2010 scores, and estimated diet costs. Model 1 diets were significantly higher in whole grains (+84.6%), fiber (+14.3%), vitamin D (+14.0%), iron (+54.5%) and folic acid (+104.6%), as compared to observed diets. Model 2 diets were additionally higher in dairy (+15.8%), calcium (+11.3%) and potassium (+3.95%). In Model 1, added sugar increased (+5.0%), but solid fats declined (-10.9%). Energy from solid fats and added sugars declined (-3.2%) in both models. Model 2 offered higher diet quality (57.1 vs. 54.6, p-value < 0.01) at a lower cost ($6.70 vs. $6.92; p < 0.01), compared to observed diets. Substitution modeling of NHANES data can assess the nutritional and economic impact of dietary guidance.
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Affiliation(s)
- Colin D Rehm
- Center for Public Health Nutrition, University of Washington, Seattle, WA 98195-3410, USA.
| | - Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, WA 98195-3410, USA.
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13
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Breakfast consumption and nutrient intakes in 4-18-year-olds: UK National Diet and Nutrition Survey Rolling Programme (2008-2012). Br J Nutr 2017; 118:280-290. [PMID: 28814349 DOI: 10.1017/s0007114517001714] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Although breakfast consumption is widely considered to be an important component of a healthy lifestyle, few UK studies have examined differences in nutrient intakes between breakfast consumers and breakfast skippers among children and adolescents. We investigated associations between breakfast skipping in 4-18-year-olds and their nutrient intakes using data from the UK's National Diet and Nutrition Survey Rolling Programme. Dietary data were derived from 4-d estimated food diaries of 802 children aged 4-10 years and 884 children aged 11-18 years (1686 in total). Daily nutrient intakes of children with different breakfast habits were compared by one-way ANCOVA adjusting for relevant covariates (sex, age, ethnicity, equivalised household income and BMI). Within-person analysis was carried out on children with an irregular breakfast habit (n 879) comparing nutrient intakes on breakfast days with those on non-breakfast days using repeated measures ANCOVA. We observed that the overall nutritional profile of the children in terms of fibre and micronutrient intake was superior in frequent breakfast consumers (micronutrients: folate, Ca, Fe and I (P<0·01)) and, for the 4-10 years age group, on breakfast days (micronutrients: folate, vitamin C, Ca and I (P<0·01)). Also, significantly higher proportions of breakfast-consuming children met their reference nutrient intakes of folate, vitamin C, Ca, Fe and I compared with breakfast skippers (χ 2 analysis, P<0·001). Our study adds to the body of data linking breakfast consumption with higher quality dietary intake in school-age children, supporting the promotion of breakfast as an important element of a healthy dietary pattern in children.
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14
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Mehrabbeik A, Mahmoodabad SSM, Khosravi HM, Fallahzadeh H. Breakfast consumption determinants among female high school students of Yazd Province based on Pender's Health Promotion Model. Electron Physician 2017; 9:5061-5067. [PMID: 28979742 PMCID: PMC5614292 DOI: 10.19082/5061] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 05/30/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND AND AIM Despite the importance of breakfast, especially for students, unfortunately, this meal is usually ignored in daily routine. The aim of this study was to identify determinants among female high school students of Yazd province based on the Pender Health Promotion Model. METHODS This was a cross-sectional study conducted to examine 200 female high school students of Yazd, selected by cluster sampling method in 2016. A researcher-made questionnaire, based on Pender's Health Promotion Model, was used as a data collection tool. A panel of experts and Cronbach's alpha coefficient were used to confirm the questionnaire validity and reliability. In order to analyze descriptive data, SPSS version 22 was used. AMOS software (v.23) was employed for path analysis. RESULTS Direct impact of activity -related affect (0.300), interpersonal influences (0.276), and perceived barriers to eating breakfast (-0.223) were approved at significance level p<0.000. By influencing perceived barriers, perceived self-efficacy and previous related behavior indirectly affected breakfast consumption. These components determined 33% of breakfast consumption. CONCLUSION By planning to create a positive feeling in students to have breakfast, to involve family and friends to encourage students to eat breakfast, to reduce barriers to have breakfast by increasing students' self-efficacy, the behavior of having breakfast among students can be improved.
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Affiliation(s)
- Akram Mehrabbeik
- M.Sc. in Health Education, Department of Health Education & Promotion, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyed Saeed Mazloomy Mahmoodabad
- Ph.D. in Health Education, Professor, Department of Health Education & Promotion, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hassan Mozaffari Khosravi
- Ph.D. in Nutritional Sciences, Professor, Department of Nutrition, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hossein Fallahzadeh
- Ph.D. in Biostatistics, Professor, Department of Biostatistics, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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15
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Wang S, Schwartz MB, Shebl FM, Read M, Henderson KE, Ickovics JR. School breakfast and body mass index: a longitudinal observational study of middle school students. Pediatr Obes 2017; 12:213-220. [PMID: 26989876 PMCID: PMC7075461 DOI: 10.1111/ijpo.12127] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 02/02/2016] [Accepted: 02/10/2016] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The objectives are to identify breakfast location patterns (frequency and place of breakfast consumption) and explore the association between breakfast patterns and weight status over time among preadolescents. METHODS Surveys and physical measurements were completed among students from 12 randomly selected schools in a medium-sized urban school district. All students were followed from fifth (Fall, 2011) to seventh grade (Fall, 2013). Latent transition analysis and longitudinal analyses were used in the study. RESULTS Six distinct breakfast location patterns emerged at baseline (1) frequent skippers; (2) inconsistent school eaters; (3) inconsistent home eaters; (4) regular home eaters; (5) regular school eaters and (6) double breakfast eaters. Results from the longitudinal analyses revealed that there was an increased odds of overweight/obesity among frequent skippers compared with double breakfast eaters after adjusting for school, year and students' race/ethnicity (AOR: 2.66, 95% CI: 1.67, 4.24). Weight changes from year to year were similar between double breakfast eaters and other students. CONCLUSIONS Concerns that a second breakfast at school increases risk of excessive weight gain are unsupported. Students who regularly consumed breakfasts at school, including double breakfast eaters, were more likely to exhibit a healthy weight trajectory. Additional research is needed to understand the impact of universal school breakfast on students' overall diets.
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Affiliation(s)
- S. Wang
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - M. B. Schwartz
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA
| | - F. M. Shebl
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - M. Read
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA
| | | | - J. R. Ickovics
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA,Community Alliance for Research and Engagement, Yale School of Public Health, New Haven, CT, USA
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16
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Abstract
OBJECTIVE Eating less frequently is associated with increased obesity risk in older children but data are potentially confounded by reverse causation, where bigger children eat less often in an effort to control their weight. Longitudinal data, particularly in younger children, are scarce. We aimed to determine whether eating frequency (meals and snacks) at 2 years of age is associated with past, current or subsequent BMI. DESIGN Cohort analysis of a randomised controlled trial. Eating frequency at 2 years of age was estimated using 48 h diaries that recorded when each child ate meals and snacks (parent-defined) in five-minute blocks. Body length/height and weight were measured at 1, 2 and 3·5 years of age. Linear regression assessed associations between the number of eating occasions and BMI Z-score, before and after adjustment for potential confounding variables. SETTING Prevention of Overweight in Infancy (POI) study, Dunedin, New Zealand. SUBJECTS Children (n 371) aged 1-3·5 years. RESULTS On average, children ate 5·5 (sd 1·2) times/d at 2 years of age, with most children (88-89 %) eating 4-7 times/d. Eating frequency at 2 years was not associated with current (difference in BMI Z-score per additional eating occasion; 95 % CI: -0·02; -0·10, 0·05) or subsequent change (0·02; -0·03, 0·06) in BMI. Similarly, BMI at age 1 year did not predict eating frequency at 2 years of age (difference in eating frequency per additional BMI Z-score unit; 95 % CI: -0·03; -0·19, 0·13). CONCLUSIONS Number of eating occasions per day was not associated with BMI in young children in the present study.
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17
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Schröder H, Bawaked RA, Ribas-Barba L, Izquierdo-Pulido M, Roman-Viñas B, Fíto M, Serra-Majem L. Cumulative Effect of Obesogenic Behaviours on Adiposity in Spanish Children and Adolescents. Obes Facts 2017; 10:584-596. [PMID: 29207394 PMCID: PMC5836229 DOI: 10.1159/000480403] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 08/17/2017] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE Little is known about the cumulative effect of obesogenic behaviours on childhood obesity risk. We determined the cumulative effect on BMI z-score, waist-to-height ratio (WHtR), overweight and abdominal obesity of four lifestyle behaviours that have been linked to obesity. METHODS In this cross-sectional analysis, data were obtained from the EnKid sudy, a representative sample of Spanish youth. The study included 1,614 boys and girls aged 5-18 years. Weight, height and waist circumference were measured. Physical activity (PA), screen time, breakfast consumption and meal frequency were self-reported on structured questionnaires. Obesogenic behaviours were defined as <1 h PA/day, ≥2 h/day screen time, skipping breakfast and <3 meals/day. BMI z-score was computed using age- and sex-specific reference values from the World Health Organization (WHO). Overweight including obesity was defined as a BMI > 1 SD from the mean of the WHO reference population. Abdominal obesity was defined as a WHtR ≥ 0.5. RESULTS High screen time was the most prominent obesogenic behaviour (49.7%), followed by low physical activity (22.4%), low meal frequency (14.4%), and skipping breakfast (12.5%). Although 33% of participants were free of all 4 obesogenic behaviours, 1, 2, and 3 or 4 behaviours were reported by 44.5%, 19.3%, and 5.0%, respectively. BMI z-score and WHtR were positively associated (p < 0.001) with increasing numbers of concurrent obesogenic behaviours. The odds of presenting with obesogenic behaviours were significantly higher in children who were overweight (OR 2.68; 95% CI 1.50; 4.80) or had abdominal obesity (OR 2.12; 95% CI 1.28; 3.52); they reported more than 2 obesogenic behaviours. High maternal and parental education was inversely associated (p = 0.004 and p < 0.001, respectively) with increasing presence of obesogenic behaviours. Surrogate markers of adiposity increased with numbers of concurrent presence of obesogenic behaviours. The opposite was true for high maternal and paternal education.
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Affiliation(s)
- Helmut Schröder
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- *Dr. Helmut Schröder, Cardiovascular Risk and Nutrition Research Group (CARIN), Program of Research in Epidemiology and Public Health, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Parc de Recerca Biomèdica de Barcelona Doctor Aiguader, 88, 08003 Barcelona, Spain,
| | - Rowaedh Ahmed Bawaked
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Biomedicine PhD program, Pompeu Fabra University, Barcelona, Spain
| | - Lourdes Ribas-Barba
- Fundación para la Investigación Nutricional (Nutrition Research Foundation), Barcelona, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Maria Izquierdo-Pulido
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Nutrition, Food Sciences and Gastronomy, University of Barcelona, Barcelona, Spain
| | - Blanca Roman-Viñas
- Fundación para la Investigación Nutricional (Nutrition Research Foundation), Barcelona, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Montserrat Fíto
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Lluis Serra-Majem
- Fundación para la Investigación Nutricional (Nutrition Research Foundation), Barcelona, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain
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18
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Blondin SA, Anzman-Frasca S, Djang HC, Economos CD. Breakfast consumption and adiposity among children and adolescents: an updated review of the literature. Pediatr Obes 2016; 11:333-48. [PMID: 26842913 DOI: 10.1111/ijpo.12082] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 10/07/2015] [Accepted: 10/14/2015] [Indexed: 12/01/2022]
Abstract
BACKGROUND Breakfast consumption has been associated with reduced risk of overweight and obesity among children, but previous evidence reviews fail to confirm a causal relationship. OBJECTIVES To review recent literature on breakfast consumption and adiposity among children and discuss potential underlying mechanisms. METHODS A comprehensive literature search of studies published since the 2010 US National Evidence Library review (January 2010-January 2015) was conducted. RESULTS Twelve studies met inclusion criteria. All were conducted in industrialized countries: six in Europe, four in the USA, one in China and one in Australia. Ten of the studies used observational longitudinal designs, with follow-up periods ranging from 1 to 27 years (median: 3, mean: 7.4); of these, eight reported inverse associations between breakfast consumption and excess adiposity, while two found no association. The other studies (1 case-control, 1 experimental) each reported a protective effect of breakfast consumption on overweight and obesity among children. CONCLUSIONS Findings corroborate results from previous reviews, adding support for a possible, protective role for breakfast consumption in preventing excess adiposity during childhood and adolescence. However, drawing a causal conclusion from the collective evidence is curtailed by methodological limitations and inconsistencies, including study design, follow-up duration and frequency, exposure and outcome assessment, as well as limited consideration of confounding, mediating and effect-modifying variables. More rigorous study designs employing valid and standardized measurement of relevant variables are needed.
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Affiliation(s)
- S A Blondin
- Friedman School of Nutrition Science and Policy, ChildObesity180, Tufts University, Boston, USA.
| | | | - H C Djang
- Friedman School of Nutrition Science and Policy, ChildObesity180, Tufts University, Boston, USA
| | - C D Economos
- Friedman School of Nutrition Science and Policy, ChildObesity180, Tufts University, Boston, USA
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19
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Associations between meal and snack frequency and overweight and abdominal obesity in US children and adolescents from National Health and Nutrition Examination Survey (NHANES) 2003–2012. Br J Nutr 2016; 115:1819-29. [DOI: 10.1017/s0007114516000854] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
AbstractThe association between eating frequency (EF) and adiposity in young populations is inconsistent. This cross-sectional study examined associations of EF, meal frequency (MF) and snack frequency (SF) with adiposity measures in US children aged 6–11 years (n 4346) and adolescents aged 12–19 years (n 6338) participating in the National Health and Nutrition Examination Survey 2003–2012. Using data from two 24-h dietary recalls, all eating occasions providing ≥210 kJ of energy were divided into meals or snacks based on contribution to energy intake (≥15 or <15 %), self-report and time (06.00–09.00, 12.00–14.00 and 17.00–20.00 hours or others). When analysed without adjustment for the ratio of reported energy intake:estimated energy requirement (EI:EER), all measures of EF, MF and SF showed inverse or null associations with overweight (BMI≥85th percentile of BMI-for-age) and abdominal obesity (waist circumference≥90th percentile) in both children and adolescents. After adjustment for EI:EER, however, EF and SF, but not MF, showed positive associations in children, irrespective of the definition of meals and snacks. In adolescents, after adjustment for EI:EER, positive associations were observed for EF (abdominal obesity only), SF based on energy contribution and MF based on self-report, whereas there was an inverse association between MF based on energy contribution and overweight. In conclusion, higher SF and EF, but not MF, were associated with higher risks of overweight and abdominal obesity in children, whereas associations varied in adolescents, depending on the definition of meals and snacks. Prospective studies are needed to establish the associations observed here.
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20
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Evans EW, Jacques PF, Dallal GE, Sacheck J, Must A. The role of eating frequency on relative weight in urban school-age children. Pediatr Obes 2015; 10:442-7. [PMID: 25565335 PMCID: PMC4495000 DOI: 10.1111/ijpo.12004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 10/28/2014] [Accepted: 11/19/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND The role of eating frequency on relative weight in childhood is not well understood. OBJECTIVE To clarify this relationship by assessing the cross-sectional and prospective relationships of weekday eating frequency with BMI z-score (BMIz) and change in BMIz in a sample of schoolchildren. METHODS Eating frequency, the average number of reported daily eating occasions, was assessed using two weekday 24-h diet recalls. BMIz was measured at baseline, 6 months and 1 year in 155 urban schoolchildren, ages 9-15 years. Multiple linear regression models were used. RESULTS Cross-sectional analyses at baseline suggest that BMIz was 0.23 units lower for each additional reported eating occasion (regression coefficient = -0.23; 95% confidence interval [CI]: -0.44, -0.07). From baseline to 6 months, BMIz increased by 0.03 units for each additional reported eating occasion (regression coefficient = 0.03; 95% CI: 0.01, 0.05). This relationship was no longer statistically significant at 1 year (regression coefficient = 0.01; 95% CI: -0.01, 0.03). CONCLUSIONS The findings suggest that the relationship of eating frequency with BMIz differs from that of change in BMIz. This difference may be due to methodological deficiencies of cross-sectional studies, challenges of dietary assessment or differences in eating patterns among normal and overweight youth. Controlled trials are needed to further clarify this relationship.
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Affiliation(s)
- E. Whitney Evans
- Brown University Medical School, Weight Control and Diabetes Research Center, 196 Richmond St, Providence, RI 02903
| | - Paul F. Jacques
- Tufts University, Jean Mayer USDA Human Nutrition Research Center on Aging, 711 Washington St, Boston, MA 02111,Tufts University, Friedman School of Nutrition Science and Policy, 150 Harrison Ave, Boston, MA 02111
| | - Gerard E. Dallal
- Tufts University, Jean Mayer USDA Human Nutrition Research Center on Aging, 711 Washington St, Boston, MA 02111,Tufts University, Friedman School of Nutrition Science and Policy, 150 Harrison Ave, Boston, MA 02111
| | - Jennifer Sacheck
- Tufts University, Friedman School of Nutrition Science and Policy, 150 Harrison Ave, Boston, MA 02111
| | - Aviva Must
- Tufts University, Friedman School of Nutrition Science and Policy, 150 Harrison Ave, Boston, MA 02111,Tufts University, School of Medicine, 136 Harrison Ave, Boston, MA 02111
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Decreasing the number of small eating occasions (<15 % of total energy intake) regardless of the time of day may be important to improve diet quality but not adiposity: a cross-sectional study in British children and adolescents. Br J Nutr 2015; 115:332-41. [PMID: 26568443 DOI: 10.1017/s0007114515004420] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Evidence of associations between meal frequency (MF) and snack frequency (SF) and diet and obesity in young populations is limited. This cross-sectional study examined MF and SF in relation to dietary intake and adiposity measures in British children aged 4-10 years (n 818) and adolescents aged 11-18 years (n 818). Based on data from a 7-d weighed dietary record, all eating occasions were divided into meals or snacks on the basis of contribution to energy intake (≥15 or <15 %) or time (06.00-10.00, 12.00-15.00 and 18.00-21.00 hours or others). All measures of MF and SF showed positive associations with energy intake, except for MF based on energy contribution in children. Irrespective of the definition of snacks, SF was associated with higher intakes of soft drinks, confectionery and total sugar, lower intakes of cereals, fish, meat, protein, PUFA, starch and dietary fibre, and a lower diet quality (assessed by the Mediterranean diet score, except for SF based on energy contribution in adolescents). MF based on time, but not based on energy contribution, was associated with higher intakes of confectionery and total sugar, lower intakes of fish, protein, PUFA and starch, and, only in children, a lower diet quality. All measures of MF and SF showed no association with adiposity measures. In conclusion, this cross-sectional study in British children and adolescents suggests that decreasing the number of small eating occasions (<15 % of total energy intake) regardless of the time of day may be important to improve diet quality but not adiposity.
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22
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Skipping breakfast in early childhood and its associations with maternal and child BMI: a study of 2-5-year-old Australian children. Eur J Clin Nutr 2015; 70:450-5. [PMID: 26508462 DOI: 10.1038/ejcn.2015.184] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 08/24/2015] [Accepted: 09/21/2015] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES Evidence supporting the association between skipping breakfast and children's body mass index (BMI) has been widely reported, and some consideration has been given to children aged 2-5 years. However, no evidence has considered an association between children skipping breakfast and mother's BMI. This study therefore investigated associations between skipping breakfast, child's BMI and mother's BMI in a large cohort of Australian children. SUBJECTS/METHODS Data were drawn from wave 2 (2-3 years, n=4601) and wave 3 (4-5 years, n=4381) of the Longitudinal Study of Australian Children. The primary outcome was skipping breakfast. Child's and mother's BMI was assessed by trained professionals. RESULTS Girls at 4-5 years were significantly more likely to skip breakfast compared with boys (56.9% versus 43.1%; P=0.031). In cross-sectional data analysis, obese boys at 2-3 years (odds ratio (OR) 2.38; P=0.039) and at 4-5 years (OR 2.32; P=0.046), and also obese girls at 4-5 years (OR 2.26; P=0.018), were more likely to skip breakfast. Skipping breakfast was positively associated with boys at 2-3 years (OR 2.04; P=0.042) whose mothers were overweight and with girls at 4-5 years (OR 2.60; P=0.001) whose mothers were obese. In longitudinal cross-lagged analysis, boys at 2-3 years whose mothers were obese were more likely to skip breakfast 2 years later at age 4-5 years (OR 2.36; P=0.045). CONCLUSIONS Skipping breakfast was associated with higher BMI in children and mothers. Future interventions should target obese mothers to promote breakfast intake among children. The interventions may involve changes to dietary and lifestyle habits and provision of education on the benefits of breakfast intake.
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Azadbakht L, Izadi V, Esmaillzadeh A. The Importance of the First Mealtime in Prevalence of Overweightness and Obesity Among Female Adolescents in Isfahan. INTERNATIONAL JOURNAL OF SCHOOL HEALTH 2014. [DOI: 10.17795/intjsh-24547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Associations of eating frequency with adiposity measures, blood lipid profiles and blood pressure in British children and adolescents. Br J Nutr 2014; 111:2176-83. [PMID: 24655480 DOI: 10.1017/s0007114514000452] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Several epidemiological studies in adults have suggested a favourable effect of frequent eating on blood lipid profiles, but evidence in younger populations is lacking. In the present cross-sectional study, we examined the associations of eating frequency (EF) with metabolic risk factors in British children aged 4-10 years (n 818) and adolescents aged 11-18 years (n 818). Dietary intake was assessed using a 7 d weighed dietary record. EF was calculated based on all eating occasions, except for those providing < 210 kJ of energy. Metabolic risk factors examined were total, HDL-cholesterol and LDL-cholesterol concentrations, TAG concentration, BMI z-score, waist:height ratio (WHtR; only adolescents), and systolic and diastolic blood pressures. Adjustment was made for age, sex, social class, physical activity levels, intakes of protein, fat, total sugar and dietary fibre, ratio of reported energy intake to estimated energy requirement (EI:EER) and BMI z-score (except for BMI z-score and WHtR). In children, EF was inversely associated with total cholesterol and LDL-cholesterol concentrations (n 324, P= 0·01 and 0·04, respectively). Conversely, EF was positively associated with BMI z-score in adolescents (P= 0·004). There were no associations between EF and other metabolic risk factors. In analyses in which only plausible energy reporters (EI:EER: 0·72-1·28) were included, similar results were obtained, except for an inverse association between EF and diastolic blood pressure in children. In conclusion, a higher EF is associated with lower total cholesterol and LDL-cholesterol concentrations in children but with a higher BMI z-score in adolescents.
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Hajna S, Leblanc PJ, Faught BE, Merchant AT, Cairney J, Hay J, Liu J. Associations between family eating behaviours and body composition measures in peri-adolescents: results from a community-based study of school-aged children. Canadian Journal of Public Health 2014; 105:e15-21. [PMID: 24735691 DOI: 10.17269/cjph.105.4150] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 01/14/2014] [Accepted: 12/17/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To identify key eating behaviours in children and their parents and to determine the associations between these behaviours and measures of body composition in children. METHODS Data were collected on a sample of 431 peri-adolescent children (12.4±0.3 years) and their parents from the Niagara Region. Body composition was assessed by trained research assistants. Eating behaviours were assessed using a revised version of the Family Eating and Activity Habits Questionnaire. Principal component analyses were used to identify key eating behaviours among children, mothers and fathers. Linear regression models were used to assess their associations with body mass index (BMI), waist-to-height ratio, waist-to-hip ratio, waist girth, and hip girth measures in children. RESULTS Emotional/uncontrolled eating and eating by the television in children and their mothers were positively associated with measures of body composition in children. Other eating behaviours that were associated with larger measures of body composition in children included low frequency of eating meals with parents, frequent sweet beverage consumption and snacking and eating "on-the-go" in children, eating "on-the-go" in mothers, and emotional eating and eating by the television/late at night in fathers. CONCLUSIONS The eating behaviours of children and mothers, and to a lesser degree fathers, are important predictors of children's body composition. Public health interventions designed to help mothers and children reduce the frequency of emotional/uncontrolled eating and eating by the television may be effective means of facilitating positive weight outcomes in children.
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Affiliation(s)
| | | | | | | | | | | | - Jian Liu
- Department of Community Health Sciences, Brock University, 500 Glenridge Avenue, St. Catharines, Ontario, Canada..
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26
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Jääskeläinen A, Schwab U, Kolehmainen M, Pirkola J, Järvelin MR, Laitinen J. Associations of meal frequency and breakfast with obesity and metabolic syndrome traits in adolescents of Northern Finland Birth Cohort 1986. Nutr Metab Cardiovasc Dis 2013; 23:1002-1009. [PMID: 22901841 DOI: 10.1016/j.numecd.2012.07.006] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Revised: 07/19/2012] [Accepted: 07/20/2012] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Breakfast consumption and meal frequencies have been linked to the risk of obesity in youth but their associations with metabolic syndrome (MetS) in young populations are yet to be studied. We examined associations of three meal patterns on weekdays--five meals including breakfast, ≤four meals including breakfast and ≤four meals without breakfast--with overweight/obesity and MetS components in Finnish adolescents. METHODS AND RESULTS A population-based sample of 16-year-old boys and girls (n = 6247) from the Northern Finland Birth Cohort 1986 was used. Adolescents were clinically examined and dietary data were collected using self-administered questionnaires. Overweight/obesity and MetS features were defined according to the International Obesity Task Force cut-offs and the International Diabetes Federation MetS paediatric criteria and their associations with meal patterns assessed using logistic regression, adjusted separately for early life factors (birth size, maternal health) and later childhood factors (health behaviours, weight status, parental education). After adjustment for early life factors, the adolescents who ate five meals/day were at lower risk for overweight/obesity (OR [95% CI] for boys: 0.47 [0.34, 0.65]; girls: 0.57 [0.41, 0.79]), abdominal obesity (OR [95% CI] for boys: 0.32 [0.22, 0.48]; girls: 0.54 [0.39, 0.75]) and hypertriglyceridaemia (boys only). Adjusting for later childhood factors, the five-meal-a-day pattern was associated with decreased odds of overweight/obesity (OR [95% CI] for boys: 0.41 [0.29, 0.58]; girls: 0.63 [0.45, 0.89]) and abdominal obesity in boys (OR 0.32, 95% CI 0.16, 0.63). CONCLUSION Among 16-year-olds, the five-meal-a-day pattern was robustly associated with reduced risks of overweight/obesity in both genders and abdominal obesity in boys.
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Affiliation(s)
- A Jääskeläinen
- Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, P.O. Box 1627, FI-70211 Kuopio, Finland.
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Chang Y, Gable S. Predicting weight status stability and change from fifth grade to eighth grade: the significant role of adolescents' social-emotional well-being. J Adolesc Health 2013; 52:448-55. [PMID: 23298991 DOI: 10.1016/j.jadohealth.2012.09.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Revised: 09/15/2012] [Accepted: 09/18/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE The primary objective of this study was to predict weight status stability and change across the transition to adolescence using parent reports of child and household routines and teacher and child self-reports of social-emotional development. METHODS Data were from the Early Childhood Longitudinal Study-Kindergarten Cohort (ECLS-K), a nationally representative sample of children who entered kindergarten during 1998-1999 and were followed through eighth grade. At fifth grade, parents reported on child and household routines and the study child and his/her primary classroom teacher reported on the child's social-emotional functioning. At fifth and eighth grade, children were directly weighed and measured at school. Nine mutually-exclusive weight trajectory groups were created to capture stability or change in weight status from fifth to eighth grade: (1) stable obese (ObeSta); (2) obese to overweight (ObePos1); (3) obese to healthy (ObePos2); (4) stable overweight (OverSta); (5) overweight to healthy (OverPos); (6) overweight to obese (OverNeg); (7) stable healthy (HelSta); (8) healthy to overweight (HelNeg1); and (9) healthy to obese (HelNeg2). RESULTS Except for breakfast consumption at home, school-provided lunches, nighttime sleep duration, household and child routines did not predict stability or change in weight status. Instead, weight status trajectory across the transition to adolescence was significantly predicted by measures of social-emotional functioning at fifth grade. CONCLUSIONS Assessing children's social-emotional well-being in addition to their lifestyle routines during the transition to adolescence is a noteworthy direction for adolescent obesity prevention and intervention.
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Affiliation(s)
- Yiting Chang
- University of Vermont, Burlington, VT 05405, USA.
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The mediating effect of parents' educational status on the association between adherence to the Mediterranean diet and childhood obesity: the PANACEA study. Int J Public Health 2012; 58:401-8. [PMID: 23128782 DOI: 10.1007/s00038-012-0424-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2012] [Revised: 08/31/2012] [Accepted: 10/17/2012] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To investigate the potential mediating effect of parental education on the association between adherence to the Mediterranean diet and obesity, in 10-12 years old children. METHODS A cross-sectional survey was performed among 1,125 (529 male) children in Greece. Children and their parents completed standardized questionnaires, which evaluated parents' educational level and dietary habits. Body mass index was calculated and children were classified as normal, overweight or obese (IOTF classification). Adherence to the Mediterranean diet was assessed using the KIDMED score. RESULTS 27.7% of the children were overweight and 6.3% were obese; 12.3% of children reported high adherence to the Mediterranean diet. Multi-adjusted analysis, stratified by parental education, revealed that adherence to the Mediterranean diet was inversely associated with children's obesity status only in families in which at least one parent was of higher educational level (stratum-specific adjusted odds ratio: 0.41; 95% CI 0.17-0.98), but not those in which both parents were of low educational level. CONCLUSIONS Parental education status seems to play a mediating role in the beneficial effect of Mediterranean diet on children's obesity status.
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