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Barbour Z, Mojica C, Alvarez HO, Foster BA. Socio-Ecologic Influences on Weight Trajectories Among Children with Obesity Living in Rural and Urban Settings. Child Obes 2024. [PMID: 38973696 DOI: 10.1089/chi.2023.0193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Abstract
Background: Childhood obesity is a risk factor for poor cardiovascular, metabolic, and respiratory health. The studies examining influences of socio-ecologic factors on weight trajectories using longitudinal data are limited, often examine single measures (e.g., proximity to parks), and have not examined the specific trajectories of children with obesity. Methods: We examined influences on weight among 1518 children, 6-12 years of age, who had obesity using body mass index (BMI) criteria. BMI slope trajectories were categorized as decreasing, flat, or increasing, with a median of 2.1 years of follow-up. We examined socio-ecologic exposures, stratified by rural and urban settings, using census tracts to map indices, including food access, proximity to parks, normalized difference vegetation index, and area deprivation index (ADI). We used ordinal logistic regression to examine the associations between the socio-ecologic factors and BMI trajectories. Results: Among the 1518 children, 360 (24%) had a decreasing BMI trajectory with the remainder having flat (23%) or increasing (53%) trajectories. Children in rural areas were more likely to live in high disadvantage areas, 85%, compared with urban children, 46%. In the multivariable ordinal model, living in a lower ADI census tract had a 0.78 (95% CI 0.61-0.99) lower odds of being in an increasing BMI slope group, and no other socio-ecologic factor was associated. Conclusions: The area deprivation index captures a range of resources and social context compared with the built environment indicators, which had no association with BMI trajectory. Further work examining how to develop effective interventions in high deprivation areas is warranted.
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Affiliation(s)
- Zoe Barbour
- Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA
| | - Cynthia Mojica
- College of Public Health Sciences, Oregon State University, Portland, OR, USA
| | | | - Byron Alexander Foster
- Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA
- School of Public Health, Oregon Health & Science University and Portland State University, Portland, OR, USA
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Wood AC, Pratt K. School-based health: an area of opportunity to address challenges in management of pediatric obesity and type 2 diabetes. Curr Opin Pediatr 2024; 36:33-41. [PMID: 37975428 PMCID: PMC10763718 DOI: 10.1097/mop.0000000000001307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
PURPOSE OF REVIEW Obesity and type 2 diabetes (T2D) are increasingly common, chronic, and complex and disproportionally affect systemically under-resourced communities negatively impacted by social determinants of health. The primary goals of management for both conditions are improvement of medical and psychosocial well being and prevention of secondary complications. The advent of pediatric specific multidisciplinary weight management programs, bariatric surgery, and recent FDA approved medications have provided clinicians with tools to improve patient outcomes. However, implementation remains a challenge. RECENT FINDINGS The Chronic Care Model proposes utilization of community-based interventions to support children and families in managing chronic disease The CDC's Whole School, Whole Community, Whole Child Model provides a framework for schools to engage in this role. School-Based Health Centers (SBHCs) utilize a child-focused, multidisciplinary approach to support the medical home and overcome barriers to routine primary care, medical screenings and successful care plans for management of chronic disease. SBHCs and school-based programs have proven sustainable and effective in addressing obesity and T2D in youth, however recent studies are limited and more research evaluating impact are needed. SUMMARY School-based health offers an evidence-based solution to ensuring equitable and comprehensive care for obesity and T2D, particularly among at-risk communities.
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Affiliation(s)
- Aurelia C.H. Wood
- Department of Pediatrics, Nationwide Children's Hospital
- The Ohio State University College of Medicine
| | - Keeley Pratt
- Department of Pediatrics, Nationwide Children's Hospital
- The Ohio State University College of Medicine
- Department of Human Sciences, Human Development & Family Science Program, The Ohio State University College of Education & Human Ecology
- Department of Surgery, The Ohio State University, Columbus, Ohio, USA
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Kontochristopoulou AM, Karatzi K, Karaglani E, Cardon G, Kivelä J, Iotova V, Tankova T, Rurik I, Radone AS, Liatis S, Makrilakis K, Moreno LA, Manios Y. Parental practices and children's lifestyle correlates of childhood overweight/obesity in Europe: The Feel4Diabetes study. J Hum Nutr Diet 2024; 37:31-46. [PMID: 37828766 DOI: 10.1111/jhn.13229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/09/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Parental influences on children's eating and physical activity (PA) and consequently on their weight are fundamental. The present study aimed to identify the predominant correlates of childhood overweight/obesity among a variety of parental practices and children's lifestyle indices in a large sample of children in Europe. METHODS Families from low socio-economic status regions were recruited through schools, located in six European countries (Belgium, Finland, Greece, Spain, Bulgaria and Hungary). Seven thousand three hundred ninety-seven children 4-12 years old and their parents were selected using the FINDRISC-questionnaire. Parental practices assessed included parental role modelling, permissiveness and reward. Children's dietary intake and lifestyle behaviours were assessed through parent-reported questionnaires. RESULTS Regarding parental practices, it was revealed that being sometimes (odds ratio [OR] = 1.26; 95% confidence interval [CI] = 1.10-1.43) or rarely (OR = 1.43; 95% CI = 1.21-1.69) physically active with the child was associated with greater overweight/obesity risk, whereas rare permission of computer/mobile/tablet (OR = 0.81; 95% CI = 0.67-0.98) and sometimes (OR = 0.77; 95% CI = 0.68-0.88) or rare (OR = 0.77; 95% CI = 0.66-0.91) reward with PA were associated with lower risk. Regarding children's lifestyle factors, consuming > 3 cups/week fresh fruit juices (OR = 1.28; 95% CI = 1.13-1.45), skipping breakfast (OR = 1.37; 95% CI = 1.17-1.61), absence of 1 h of daily PA (OR = 1.40; 95% CI = 1.24-1.58) and increased daily screen time (ST) (OR = 1.23; 95% CI = 1.09-1.39) were associated with greater overweight/obesity risk. All the variables were adjusted for maternal education, child's sex and age. CONCLUSIONS These findings emphasize the necessity of family-centered approaches in health promotion and obesity prevention programs for children. Such programs should focus on parents as the primary role models in exerting positive influence and encouraging healthy eating habits, PA, and ST behaviors in their children, which in turn, may have a substantial impact on children's overall weight status.
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Affiliation(s)
| | - Kalliopi Karatzi
- Laboratory of Dietetics and Quality of Life, Department of Food Science & Human Nutrition, Agricultural University of Athens, Athens, Greece
| | - Eva Karaglani
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Greet Cardon
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Jemina Kivelä
- Finnish Institute for Health and Welfare, Population Health Unit, Helsinki, Finland
| | - Violeta Iotova
- Department of Pediatrics, Medical University Varna, Varna, Bulgaria
| | | | - Imre Rurik
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Anett S Radone
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Stavros Liatis
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, Athens, Greece
| | - Konstantinos Makrilakis
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, Athens, Greece
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development Research Group, Zaragoza, Spain
- School of Health Science (EUCS), Zaragoza, Spain
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
- Institute of Agri-food and Life Sciences, Heraklion, Greece
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Adamou H, Robitaille É, Paquette MC, Lebel A. Food environment trajectories: a sequence analysis from the CARTaGENE cohort. Public Health Nutr 2024; 27:e90. [PMID: 38250947 DOI: 10.1017/s1368980024000119] [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] [Indexed: 01/23/2024]
Abstract
OBJECTIVE The purpose of this study was to create a typology of longitudinal exposure to food environment based on socio-economic context. DESIGN Food environment trajectories were modelled using a sequence analysis method, followed by a logistic regression to describe those trajectories. SETTING The study took place in Quebec, Canada, using food environment data from 2009, 2011 and 2018 merged with participants' demographic and socio-economic characteristics. PARTICIPANT At recruitment, 38 627 participants between the ages of 40 and 69 years from six urban areas in Quebec were included in the CARTaGENE cohort study. The cohort was representative of the Quebec urban population within this age range. RESULTS Our study revealed five trajectories of food access over time: (1) limited access to food stores throughout the study period, (2) limited access improving, (3) good access diminishing, (4) good access throughout the period and (5) low access throughout the period. Logistic regression analysis showed that participants who were unable to work (OR = 1·42, CI = 1·08-1·86), lived in households with five or more persons (OR = 1·69, CI = 1·17-2·42) and those living in low-income households (OR = 1·32, CI = 1·03-1·71) had higher odds of experiencing a disadvantaged food environment trajectory. Additionally, the level of education and age of participants were associated with the odds of experiencing a disadvantaged food environment trajectory. CONCLUSIONS The study demonstrates that people facing socio-economic disadvantage are more likely to experience a disadvantaged food environment trajectory over time.
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Affiliation(s)
- Habila Adamou
- Center for Research in Regional Planning and Development (CRAD), Laval University, Quebec, Canada
- Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute Research Center, Quebec, Canada
| | - Éric Robitaille
- Institut national de santé publique du Québec, 190, boulevard Crémazie Est, Montréal, Québec, Canada
- ESPUM, Université de Montréal, Montréal, Canada
| | - Marie-Claude Paquette
- Institut national de santé publique du Québec, 190, boulevard Crémazie Est, Montréal, Québec, Canada
- Département de nutrition, Université de Montréal, Montréal, Canada
| | - Alexandre Lebel
- Center for Research in Regional Planning and Development (CRAD), Laval University, Quebec, Canada
- Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute Research Center, Quebec, Canada
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de França FCO, Zandonadi RP, da Silva Santana ÍA, da Silva ICR, Akutsu RDCCDA. Food and Consumers' Environment Inside and around Federal Public Schools in Bahia, Brazil. Nutrients 2024; 16:201. [PMID: 38257094 PMCID: PMC10821399 DOI: 10.3390/nu16020201] [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: 11/13/2023] [Revised: 12/18/2023] [Accepted: 12/22/2023] [Indexed: 01/24/2024] Open
Abstract
The food environment plays a crucial role in shaping people's eating habits and, in and around schools, this influence becomes even more critical due to the time students spend daily in these spaces. This study aimed to analyze the food and consumer environments inside and around federal institutes in Bahia, Brazil. Ecological study and audit methodologies were combined, with all the 35 federal institutes in Bahia as the sample universe. To delimit the food environment around the school, the establishments were mapped in a 1000 m buffer, with the school as the centroid. The geographic coordinates of schools and food outlets were initially obtained using Google Maps and later confirmed on-site. The data were collected in WGS 84 and converted to UTM zone 23S SIRGAS 2000. To map the consumer environment, establishments found in a 250 m buffer and also canteens within schools were audited, using the ESAO-r instrument that considers the availability and prices of healthy and unhealthy foods; availability of nutritional information near the point of purchase or on the menu; and presence of internal marketing of healthy and unhealthy foods. The healthy meal-restaurant index (HMRI) was also measured. This index ranges from 0 to 8 points and positively scores items related to healthy consumption and fails to score those related to unhealthy consumption and behavior. The establishments were grouped into four categories (healthy, unhealthy, mixed, and supermarkets). The surrounding area with four or more unhealthy establishments within the 250 m buffer was considered a food swamp. Descriptive analyses were carried out with frequency measurements, measures of central tendency (mean and median), and dispersion (standard deviation). Around the analyzed schools, 732 food establishments were identified, 73.8% (n = 540) formal and 26.2% (n = 192) informal. Considering the characteristics of existing commerce, there was a predominance of snack bars (45%), grocery stores (23%), and bars (7.8%), with a smaller number of supermarkets identified (4.1%). School canteens were found in 20 schools analyzed and only 15% had a variety of healthy foods. When evaluating the availability of healthy foods, a median HMRI of 3 (1-7) was observed. When analyzing this index according to the type of establishment, it was found that fruit and vegetables presented higher values (HMRI = 7; P25-P75: 4-8) compared to large chain supermarkets (HMRI = 5; P25-P75: 2-6; p < 0.001) and local markets (HMRI = 4; P25-P75: 2-5; p < 0.001). From the analysis of the food and consumer environments, it was possible to make inferences about the quality of the food offered to students in these locations, as well as the potential health outcomes arising from this exposure and the need to carry out food education activities and nutritional activities.
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Affiliation(s)
- Fabiana Chagas Oliveira de França
- Nutrition School, Federal University of Bahia-Augusto Viana, s/n-Palácio da Reitoria, Canela, Salvador 40110-907, Brazil; (F.C.O.d.F.); (Í.A.d.S.S.)
| | | | - Ívenes Ariele da Silva Santana
- Nutrition School, Federal University of Bahia-Augusto Viana, s/n-Palácio da Reitoria, Canela, Salvador 40110-907, Brazil; (F.C.O.d.F.); (Í.A.d.S.S.)
| | | | - Rita de Cassia Coelho de Almeida Akutsu
- Nutrition School, Federal University of Bahia-Augusto Viana, s/n-Palácio da Reitoria, Canela, Salvador 40110-907, Brazil; (F.C.O.d.F.); (Í.A.d.S.S.)
- Department of Nutrition, University of Brasilia, Brasilia 70910-900, Brazil;
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Longitudinal association between density of retail food stores and body mass index in Mexican school children and adolescents. Int J Obes (Lond) 2023; 47:365-374. [PMID: 36792910 PMCID: PMC10147568 DOI: 10.1038/s41366-023-01273-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND Obesity is rapidly increasing in Mexican children and adolescents, while food environments are rapidly changing. We evaluated the association between changes in retail food stores and change in body mass index (BMI) in Mexican children and adolescents. METHODS Data on 7507 participants aged 5-19 years old came from the Mexican Family Life Survey 2002-2012. Density of food stores at the municipal-level (number of food stores/area in km2) came from the Economic Censuses of 1999, 2004 and 2009. We categorized food stores as small food retail (small neighborhood stores, tiendas de abarrotes in Mexico), specialty foods, fruit/vegetables, convenience foods, and supermarkets. Associations between change in food stores and change in BMI were estimated using five longitudinal linear fixed-effects regression models (one per type of food store) adjusted for age, parental education, municipal-level socioeconomic deprivation and population density. Density of each food store type was operationalized as quartiles. Analyses were stratified by urbanization. RESULTS There was an inverse dose-response association between increases in fruit/vegetable store density and BMI (β = -0.455 kg/m2, β = -0.733 kg/m2, and β = -0.838 kg/m2 in the second, third, and fourth quartile). In non-urban areas, children living in municipalities with the highest density of small food retail stores experienced a reduction in BMI (β = -0.840 kg/m2). In urban areas, there was an inverse association between specialty food stores with BMI (β = -0.789 kg/m2 in third quartile, and β = -1.204 kg/m2 in fourth quartile). We observed dynamic associations with age; results suggested stronger associations in adolescents. CONCLUSIONS The availability of fruit/vegetable stores may influence a reduction in children and adolescents BMI. These results indicate that policy approaches could be tailored by type of food store - with some consideration for level of urbanization and children's age.
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Hampl SE, Hassink SG, Skinner AC, Armstrong SC, Barlow SE, Bolling CF, Avila Edwards KC, Eneli I, Hamre R, Joseph MM, Lunsford D, Mendonca E, Michalsky MP, Mirza N, Ochoa ER, Sharifi M, Staiano AE, Weedn AE, Flinn SK, Lindros J, Okechukwu K. Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity. Pediatrics 2023; 151:e2022060640. [PMID: 36622115 DOI: 10.1542/peds.2022-060640] [Citation(s) in RCA: 271] [Impact Index Per Article: 271.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 01/10/2023] Open
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8
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Longitudinal effects of school policies on children's eating behaviors and weight status: findings from the childhood obesity study in China megacities. Int J Obes (Lond) 2023; 47:17-23. [PMID: 36253402 DOI: 10.1038/s41366-022-01206-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 02/06/2022] [Accepted: 08/03/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVES To examine longitudinal effects of school policies on children's weight status and eating behaviors, and study how these effects may vary by children's age, sex, and baseline weight status in China. METHODS Data were collected in 2015, 2016, and 2017 in an open cohort of 3298 children aged 6-17, their parents, and schools in five large cities across China (Beijing, Shanghai, Xi'an, Nanjing, and Chengdu). Children's weight, height, and waist circumference were measured, and their eating behaviors were self-reported. The 1691 children with such repeated measures in ≥ two waves were included in longitudinal data analysis with mixed effects models, testing the associations. RESULTS Having school vicinity food stall policy was associated with less frequent consumption of fast food (β = -0.14, p < 0.01) and snack (β = -0.84, p < 0.01). More significant associations were found between school policies and unhealthy eating behaviors for girls and children aged 6-11 than their counterparts. Among children without overweight or central obesity at baseline, having school cafeteria food policy was associated with lower risks for overweight and obesity (OR = 0.33, 95% CI: 0.17-0.63) and central obesity (OR = 0.47, 95% CI: 0.26-0.85). This existed for girls, but not for boys. School vicinity food stall policy was associated with lower BMI (β = -0.20, 95% CI: -0.37, -0.03) among all children and in girls (β = -0.28, 95% CI: -0.50, -0.05) without overweight at baseline. CONCLUSIONS School policies could reduce children's unhealthy eating behaviors and obesity risk in megacities in China. Children's age, sex, and baseline weight status modify the effects. School policies are important to fight the growing childhood obesity epidemic.
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Masento NA, Dulay KM, Harvey K, Bulgarelli D, Caputi M, Cerrato G, Molina P, Wojtkowska K, Pruszczak D, Barlińska J, Messer D, Houston-Price C. Parent, child, and environmental predictors of vegetable consumption in Italian, Polish, and British preschoolers. Front Nutr 2022; 9:958245. [PMID: 36337641 PMCID: PMC9633668 DOI: 10.3389/fnut.2022.958245] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/01/2022] [Indexed: 11/13/2022] Open
Abstract
This study compared the vegetable intake of preschool children from three European countries [Italy, Poland, and the United Kingdom (UK)] and explored the parent, child, and environmental factors that predicted intake in each country. A total of 408 parents of preschoolers (Italy: N = 61, Poland: N = 124, and UK: N = 225; child mean age = 32.2 months, SD = 9.47) completed an online survey comprising a set of standardised questionnaires. For all three countries, the questionnaires included measures of children's vegetable intake (VegFFQ), child eating behaviour (CEBQ-FF), parents' mealtime goals (FMGs), and sociodemographic questions about family background and environment. In the UK and Italy, additional questionnaires were used to assess child temperament (EAS-T) and parents' feeding practices (CFPQ). The results showed that the number of child-sized portions of vegetables consumed per day varied significantly across countries; Polish children consumed the most (∼3 portions) and Italian children the least (∼1.5 portions). Between-country differences were seen in parents' goals for family mealtimes; compared to Italian parents, Polish and UK parents were more motivated to minimise mealtime stress, increase family involvement in meal preparation, and share the same foods with family members. British and Italian parents also adopted different feeding practices; parents in the UK reported more use of healthy modelling behaviours and more use of foods to support their child's emotion regulation. In terms of child factors, Italian children were reported to be more emotional and more sociable than British children. Analyses of the relationships between the parent, child, and environmental factors and children's vegetable intake revealed both similarities and differences between countries. Negative predictors of vegetable intake included child food fussiness in the UK and Poland, child temperament (especially, shyness) in Italy, and the use of food as a reward and child emotionality in the UK. Positive predictors included the parental mealtime goal of 'family involvement' in the UK. These results highlight differences in the extent to which European preschoolers achieve recommended levels of vegetable intake, and in the factors that influence whether they do. The results suggest a need to develop healthy eating interventions that are adopted to meet the specific needs of the countries in which they are implemented.
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Affiliation(s)
- Natalie A. Masento
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Katrina May Dulay
- Department of Psychology, City, University of London, London, United Kingdom
| | - Kate Harvey
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | | | - Marcella Caputi
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | | | - Paola Molina
- Department of Regional & Urban Studies and Planning, University of Turin, Turin, Italy
| | | | | | | | - David Messer
- Faculty of Wellbeing, Education & Language Studies, Open University, Milton Keynes, United Kingdom
| | - Carmel Houston-Price
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, United Kingdom
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The association of dimensions of fruit and vegetable access in the retail food environment with consumption; a systematic review. GLOBAL FOOD SECURITY-AGRICULTURE POLICY ECONOMICS AND ENVIRONMENT 2021; 29:100528. [PMID: 34164256 PMCID: PMC8202327 DOI: 10.1016/j.gfs.2021.100528] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 01/29/2021] [Accepted: 03/04/2021] [Indexed: 12/04/2022]
Abstract
The consumption of fruit and vegetables (F&V) is important for human health to protect against non-communicable disease and micronutrient deficiency. Increasing consumption of F&V may also benefit planetary health if these foods are substituted for foods with higher environmental footprints such as red meat or dairy. The retail food environment (RFE) is an influential junction between the food system and individual diets as it drives access to F&V through external (physical access) and personal (availability, affordability, acceptability) domains. We performed a systematic search of six literature databases (January 2021) for studies assessing access to F&V in the RFE and its association with F&V consumption in adults in high- and upper-middle income countries. 36 studies were identified and categorised by dimensions of food access – accessibility, affordability, acceptability, availability and accommodation. More than half of the studies (n = 20) were based in the USA. F&V accessibility was the most commonly reported dimension (n = 29); no study reported on accommodation. 6 studies were rated to be high quality. A positive association of increased availability of F&V options in the RFE with intake was identified in 9 of 15 studies. Associations in both acceptability and accessibility dimensions were inconsistent. No association was observed between F&V affordability and consumption although available data were limited. Many challenges exist to building a robust evidence base within food environment research including conceptual, definitional and methodological heterogeneity and measurement standardisation. Future food policies should consider multi-dimensional interventions to promote access to F&V in the RFE across all domains. First systematic review of dimensions of access in the retail food environment (RFE) and fruit and vegetable (F&V) intake. This review suggests potential importance of having access to available healthy options in the RFE for F&V intake. The absence of an association of F&V affordability with consumption is likely due to limited and mixed data availability. F&V accessibility and acceptability require development as dimensions of access for clearer links to be made. The retail food environment is complex but likely predictor of F&V consumption.
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11
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Wu T, Yang S, Liu M, Qiu G, Li H, Luo M, Jia P. Urban sprawl and childhood obesity. Obes Rev 2021; 22 Suppl 1:e13091. [PMID: 32808474 PMCID: PMC7988579 DOI: 10.1111/obr.13091] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 12/14/2022]
Abstract
Urban sprawl is thought to be a risk factor for childhood obesity primarily because the physical environment it creates discourages children's physical activity while encouraging their sedentary behavior. However, there has not been any review on the association between urban sprawl and childhood obesity. This study filled this research gap by comprehensively reviewing literature focusing on associations between urban sprawl and weight-related behaviors and outcomes among children and adolescents. Only two longitudinal and three cross-sectional studies conducted in two countries were identified. Sample sizes ranged from 2324 to 129 781. Four studies used weight status, and only one study used both behaviors and weight status as outcome variables. All positive, negative, and non-significant associations were reported. This review could not identify a clear association between urban sprawl and childhood obesity. More longitudinal studies are needed for in-depth analyses on this important topic in more regions, which would be important not only for public health guidelines but also for research, practice, and policies in urban planning.
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Affiliation(s)
- Tong Wu
- Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, China.,International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China
| | - Shujuan Yang
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China.,West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Meijing Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Ge Qiu
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China
| | - Hanqi Li
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China.,School of Resources and Environmental Science, Wuhan University, Wuhan, China
| | - Miyang Luo
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China.,Xiangya School of Public Health, Central South University, Changsha, China.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Peng Jia
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China.,Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China.,Faculty of Geo-information Science and Earth Observation, University of Twente, Enschede, The Netherlands
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12
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Yang S, Zhang X, Feng P, Wu T, Tian R, Zhang D, Zhao L, Xiao C, Zhou Z, He F, Cheng G, Jia P. Access to fruit and vegetable markets and childhood obesity: A systematic review. Obes Rev 2021; 22 Suppl 1:e12980. [PMID: 31943666 PMCID: PMC7988651 DOI: 10.1111/obr.12980] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 10/30/2019] [Indexed: 01/16/2023]
Abstract
The lack of access to fruit/vegetable markets (FVMs) is thought to be a risk factor for childhood obesity by discouraging healthy dietary behaviours while encouraging access to venues that offer more unhealthy food (and thus the compensatory intake of those options). However, findings remain mixed, and there has not been a review of the association between FVM access and childhood obesity. A comprehensive and systematic understanding of this epidemiologic relationship is important to the design and implementation of relevant public health policies. In this study, a literature search was conducted in the Cochrane Library, PubMed, and Web of Science for articles published before 1 January 2019 that focused on the association between neighbourhood FVM access and weight-related behaviours and outcomes among children and adolescents. Eight cross-sectional studies, two longitudinal studies, and one ecological study conducted in five countries were identified. The median sample size was 2142 ± 1371. Weight-related behaviours and outcomes were used as the outcome variable in two and eight studies, respectively, with one study using both weight-related behaviours and outcomes as outcome variables. We still found a negative association between access to FVMs in children's residential and school neighbourhoods and weight-related behaviours and an inconclusive association between FVM access and overweight or obesity. This conclusion should be regarded as provisional because of a limited amount of relevant evidence and may not be a strong guide for policymaking. Nonetheless, it points to an important research gap that needs to be filled if successful public health interventions are to be undertaken.
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Affiliation(s)
- Shujuan Yang
- Healthy Food Evaluation Research Center, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.,Department of Health-Related Social and Behavioral Sciences, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.,International Institute of Spatial Lifecourse Epidemiology (ISLE), The Netherlands
| | - Xiao Zhang
- Healthy Food Evaluation Research Center, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Ping Feng
- Healthy Food Evaluation Research Center, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Tong Wu
- International Institute of Spatial Lifecourse Epidemiology (ISLE), The Netherlands.,Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, China
| | - Ruochen Tian
- Healthy Food Evaluation Research Center, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Donglan Zhang
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia, USA
| | - Li Zhao
- Healthy Food Evaluation Research Center, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.,International Institute of Spatial Lifecourse Epidemiology (ISLE), The Netherlands.,Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chenghan Xiao
- Department of Health-Related Social and Behavioral Sciences, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Zonglei Zhou
- Healthy Food Evaluation Research Center, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Fang He
- Healthy Food Evaluation Research Center, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Guo Cheng
- Healthy Food Evaluation Research Center, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.,International Institute of Spatial Lifecourse Epidemiology (ISLE), The Netherlands.,State Key Laboratory of Biotherapy and Cancer Center, Sichuan University, Chengdu, China
| | - Peng Jia
- International Institute of Spatial Lifecourse Epidemiology (ISLE), The Netherlands.,Faculty of Geo-information Science and Earth Observation, University of Twente, Enschede, The Netherlands
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13
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Jia P, Yang H, Cao X, Yuan C, Xiao Q, Yang S, Wang Y. Association between access to full-service restaurants and childhood obesity. Obes Rev 2021; 22 Suppl 1:e13076. [PMID: 32618058 PMCID: PMC7988535 DOI: 10.1111/obr.13076] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 05/18/2020] [Indexed: 12/19/2022]
Abstract
The lack of access to full-service restaurants (FSRs) is generally thought to be a risk factor for childhood obesity, as it could discourage healthful eating-out behaviours while increasing the exposure to unhealthful food venues as "compensatory" options. However, the association between FSR access and childhood obesity has not been comprehensively reviewed previously. A literature search was conducted on PubMed and Web of Science for articles published before 1 January 2019 that examined the association between FSR access and weight-related behaviours and outcomes among children and adolescents. Eighteen studies conducted in three countries were identified, published from 2006 to 2018 with a median sample size of 2352 (ranging from 323 to 529 367). Findings were mixed among these 18 studies that reported on the association between access to FSRs and weight-related outcomes. Our meta-analyses showed that there were no significant associations of FSR access with the level of body mass index (BMI) and the BMI z-score among children. Also, there was no apparent evidence on the association between FSR access and the risk of overweight/obesity. Our results need to be interpreted with caution, considering the menu quality of FSRs and heterogeneity of eligible studies in this meta-analysis. Well-designed epidemiologic studies are warranted to further elaborate on the potential association between FSR access and children's weight status.
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Affiliation(s)
- Peng Jia
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China.,Faculty of Geo-Information Science and Earth Observation, University of Twente, Enschede, The Netherlands.,International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China
| | - Hongxi Yang
- Department of Health Service Management, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xinxi Cao
- Department of Health Service Management, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Changzheng Yuan
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China.,The Children's Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Qian Xiao
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China.,Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Shujuan Yang
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China.,West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yaogang Wang
- Department of Health Service Management, School of Public Health, Tianjin Medical University, Tianjin, China
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14
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Jia P, Dai S, Rohli KE, Rohli RV, Ma Y, Yu C, Pan X, Zhou W. Natural environment and childhood obesity: A systematic review. Obes Rev 2021; 22 Suppl 1:e13097. [PMID: 32869468 PMCID: PMC7988590 DOI: 10.1111/obr.13097] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 01/17/2023]
Abstract
The associations between built and food environments and childhood obesity have been studied extensively. However, the association between the natural environment and childhood obesity has received too little scholarly attention. This study reviewed the literature published before 1 January 2019, which described associations between a full range of natural environmental factors (e.g., rainfall, temperature, sunlight, natural disasters, flood and drought) and weight-related behaviours and childhood obesity. Five cross-sectional studies and one longitudinal study were identified. Measures of natural environmental factors varied across six included studies, falling into five broad categories: weather conditions, altitude, natural disaster risk, air quality and day length. It was found that temperature was a significant weather indicator in most included studies and was associated with a reduction of daily physical activity. Children living in high-altitude areas were more likely to be shorter and heavier than their counterparts in low-altitude areas. Findings of this study will contribute to helping multiple stakeholders, including policy makers and urban planners, and formulate health policies and interventions to mitigate the detrimental impact of the natural environment on childhood obesity. More longitudinal studies should be designed to confirm these effects and explore the potential health effects of more natural environmental factors.
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Affiliation(s)
- Peng Jia
- Department of Land Surveying and Geo‐InformaticsThe Hong Kong Polytechnic UniversityHong KongChina
- Faculty of Geo‐information Science and Earth ObservationUniversity of TwenteEnschedeThe Netherlands
- International Institute of Spatial Lifecourse Epidemiology (ISLE)Hong KongChina
| | - Shaoqing Dai
- Faculty of Geo‐information Science and Earth ObservationUniversity of TwenteEnschedeThe Netherlands
- International Institute of Spatial Lifecourse Epidemiology (ISLE)Hong KongChina
| | | | - Robert V. Rohli
- Department of Oceanography and Coastal Sciences, College of the Coast and EnvironmentLouisiana State UniversityBaton RougeLouisianaUSA
| | - Yanan Ma
- School of Public HealthChina Medical UniversityShenyangChina
- Institute of Health SciencesChina Medical UniversityShenyangChina
| | - Chao Yu
- International Institute of Spatial Lifecourse Epidemiology (ISLE)Hong KongChina
- State Key Laboratory of Remote Sensing Science, Aerospace Information Research InstituteChinese Academy of SciencesBeijingChina
| | - Xiongfeng Pan
- International Institute of Spatial Lifecourse Epidemiology (ISLE)Hong KongChina
- Xiangya School of Public HealthCentral South UniversityChangshaChina
| | - Weiqi Zhou
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco‐Environmental SciencesChinese Academy of SciencesBeijingChina
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15
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雨洋 张, 宁睿 刘, 瀛 龙, Yuyang Z, Ningrui L, Ying L. [Research on Healthy Neighborhood Evaluation System Based on the Combined Perspectives of Urban Planning and Public Health]. FENG JING YUAN LIN = LANDSCAPE ARCHITECTURE 2020; 27:96-103. [PMID: 38420146 PMCID: PMC7615674 DOI: 10.14085/j.fjyl.2020.11.0096.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Neighborhoods are places where people spend the most time in their lives. Neighborhoods have a decisive impact on the residents' health. With several important tasks, including the transformation of old neighborhoods, the maintenance of existing neighborhoods, and the construction of new neighborhoods in the future, a scientific and reasonable evaluation standard is urgently needed to guide the development of healthy neighborhoods. To build the evaluation system, this paper first clarifies the principles for selecting evaluation indicators, which include: 1) the indicators are selected from a humanistic perspective; 2) the pathways between neighborhoods environment and health outcomes are deeply considered; 3) the indicators are selected from multiple scales. Secondly, based on the combined perspectives of urban planning and public health, it identifies the indicators that affect the residents' health in neighborhoods and searches the literature through the quality assessment to provide evidence to support the accuracy and effectiveness of the indicators. Finally, it proposes prospect to the evaluation, including 1) it is urgent to improve and utilize the healthy neighborhoods based on the Chinese condition; 2) advanced technologies need to be widely applied in neighborhoods in the future; 3) the transitions in cities should be considered in the future development of neighborhoods. It hopes that relevant researchers and government leaders to realize the importance and urgency of healthy neighborhoods to build more healthy neighborhoods in China.
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Affiliation(s)
- 张 雨洋
- / / /
- ZHANG Yuyang is a postdoctoral researcher in the School of Architecture, Tsinghua University. His research focuses on healthy city and healthy neighborhood
- / / / 、
- LIU Ningrui is a Ph.D. candidate in the Department of Building Science, School of Architecture, Tsinghua University. His research focuses on indoor air quality, healthy building and healthy city
- / / / / (Corresponding author Email):
- LONG Ying, Ph.D., is a research fellow in the School of Architecture, Tsinghua University. His research focuses on urban and rural planning technical science
| | - 刘 宁睿
- / / /
- ZHANG Yuyang is a postdoctoral researcher in the School of Architecture, Tsinghua University. His research focuses on healthy city and healthy neighborhood
- / / / 、
- LIU Ningrui is a Ph.D. candidate in the Department of Building Science, School of Architecture, Tsinghua University. His research focuses on indoor air quality, healthy building and healthy city
- / / / / (Corresponding author Email):
- LONG Ying, Ph.D., is a research fellow in the School of Architecture, Tsinghua University. His research focuses on urban and rural planning technical science
| | - 龙 瀛
- / / /
- ZHANG Yuyang is a postdoctoral researcher in the School of Architecture, Tsinghua University. His research focuses on healthy city and healthy neighborhood
- / / / 、
- LIU Ningrui is a Ph.D. candidate in the Department of Building Science, School of Architecture, Tsinghua University. His research focuses on indoor air quality, healthy building and healthy city
- / / / / (Corresponding author Email):
- LONG Ying, Ph.D., is a research fellow in the School of Architecture, Tsinghua University. His research focuses on urban and rural planning technical science
| | - Zhang Yuyang
- / / /
- ZHANG Yuyang is a postdoctoral researcher in the School of Architecture, Tsinghua University. His research focuses on healthy city and healthy neighborhood
- / / / 、
- LIU Ningrui is a Ph.D. candidate in the Department of Building Science, School of Architecture, Tsinghua University. His research focuses on indoor air quality, healthy building and healthy city
- / / / / (Corresponding author Email):
- LONG Ying, Ph.D., is a research fellow in the School of Architecture, Tsinghua University. His research focuses on urban and rural planning technical science
| | - Liu Ningrui
- / / /
- ZHANG Yuyang is a postdoctoral researcher in the School of Architecture, Tsinghua University. His research focuses on healthy city and healthy neighborhood
- / / / 、
- LIU Ningrui is a Ph.D. candidate in the Department of Building Science, School of Architecture, Tsinghua University. His research focuses on indoor air quality, healthy building and healthy city
- / / / / (Corresponding author Email):
- LONG Ying, Ph.D., is a research fellow in the School of Architecture, Tsinghua University. His research focuses on urban and rural planning technical science
| | - Long Ying
- / / /
- ZHANG Yuyang is a postdoctoral researcher in the School of Architecture, Tsinghua University. His research focuses on healthy city and healthy neighborhood
- / / / 、
- LIU Ningrui is a Ph.D. candidate in the Department of Building Science, School of Architecture, Tsinghua University. His research focuses on indoor air quality, healthy building and healthy city
- / / / / (Corresponding author Email):
- LONG Ying, Ph.D., is a research fellow in the School of Architecture, Tsinghua University. His research focuses on urban and rural planning technical science
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