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Zelber-Sagi S, Carrieri P, Pericàs JM, Ivancovsky-Wajcman D, Younossi ZM, Lazarus JV. Food inequity and insecurity and MASLD: burden, challenges, and interventions. Nat Rev Gastroenterol Hepatol 2024:10.1038/s41575-024-00959-4. [PMID: 39075288 DOI: 10.1038/s41575-024-00959-4] [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] [Accepted: 06/20/2024] [Indexed: 07/31/2024]
Abstract
Liver disease prevalence, severity, outcomes and hepatic risk factors (for example, unhealthy diet) are heavily affected by socioeconomic status and food insecurity. Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent liver disease globally and is likely to co-occur with other liver diseases associated with food insecurity. Though weight reduction and adopting a healthy diet can reverse the course of MASLD, gaps between recommendations and practice transcend individual responsibility and preference. Broader sociocultural determinants of food choices (social nutrition) include food insecurity, community and social norms and the local environment, including commercial pressures that target people experiencing poverty, ethnic minorities and children. Food insecurity is a barrier to a healthy diet, as a low-quality diet is often less expensive than a healthy one. Consequently, food insecurity is an 'upstream' risk factor for MASLD, advanced fibrosis and greater all-cause mortality among patients with liver disease. Intervening on food insecurity at four major levels (environment, policy, community and health care) can reduce the burden of liver disease, thereby reducing social and health inequities. In this Review, we report on the current research in the field, the need for implementing proven interventions, and the role liver specialists can have.
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Affiliation(s)
- Shira Zelber-Sagi
- School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
- The Global NASH Council, Washington, DC, USA.
| | - Patrizia Carrieri
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Juan M Pericàs
- Liver Unit, Vall d'Hebron University Hospital, Vall d'Hebron Institute for Research, Universitat Autònoma de Barcelona, CIBERehd, Barcelona, Spain
- Johns Hopkins University-Pompeu Fabra University Public Policy Center, Barcelona, Spain
| | - Dana Ivancovsky-Wajcman
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Zobair M Younossi
- The Global NASH Council, Washington, DC, USA
- Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, VA, USA
| | - Jeffrey V Lazarus
- The Global NASH Council, Washington, DC, USA
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
- CUNY Graduate School of Public Health and Health Policy (CUNY SPH), New York, NY, USA
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2
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Concincion S, van Houtum L, Verhoeff A, Dedding C. Bored, afraid, alone: What can we learn from children with paediatric obesity about the impact of the COVID-19 pandemic for future pandemics, care practices and policies? J Pediatr Nurs 2024; 77:162-171. [PMID: 38522210 DOI: 10.1016/j.pedn.2024.03.025] [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] [Received: 10/09/2023] [Revised: 02/16/2024] [Accepted: 03/16/2024] [Indexed: 03/26/2024]
Abstract
PURPOSE The aim of this study was to gain insight into the perspectives of children with paediatric obesity themselves, during the pandemic and afterwards, regarding their wellbeing and health, and to solicit their advice on tailoring obesity care to match their daily realities. DESIGN AND METHODS We used a 'draw, write and tell' interview technique, conducted walk-alongs, participant observations and a group session with children with paediatric obesity from seldom-heard communities in Amsterdam, the Netherlands. Data was analysed using reflexive thematic analysis. RESULTS Children reported that during lockdowns they were confined to the house, causing them to feel bored and alone. This triggered them to fall into previous unhealthy patterns, such as an increase in sitting on the couch or lying in bed, gaming or watching TV, feeling hungry a lot and eating more. Some children experienced major events, such as mourning the death of a loved one or taking care of other family members, and thus felt they had to grow up fast. CONCLUSION Our study adds to our understanding of the mechanisms of the impact of the COVID-19 pandemic from the perspectives of children with paediatric obesity from seldom-heard communities and emphasizes the importance of considering how the pandemic (and related measures) affected the daily - as well as future - lives of children in vulnerable circumstances. PRACTICAL IMPLICATIONS The recommendations children gave could be explored as pathways for more child-centred, successful and tailored obesity care practices and policies in order to support their (mental) wellbeing and health.
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Affiliation(s)
- Siegnella Concincion
- Faculty of Social and Behavioural Sciences, University of Amsterdam, Youth Health Care Department (JGZ) of the Public Health Service Amsterdam (GGD), Nieuwe Achtergracht 100, 1018 WT Amsterdam, Postbus 2200, 1000 CE Amsterdam, the Netherlands.
| | - Lieke van Houtum
- Public Health Service Amsterdam (GGD), Nieuwe Achtergracht 100, 1018 WT Amsterdam, Postbus 2200, 1000 CE Amsterdam, the Netherlands.
| | - Arnoud Verhoeff
- Faculty of Social and Behavioural Sciences, University of Amsterdam, Sarphati Amsterdam, Public Health Service Amsterdam (GGD), Nieuwe Achtergracht 100, 1018 WT Amsterdam, Postbus 2200, 1000 CE Amsterdam, the Netherlands.
| | - Christine Dedding
- Department of Ethics, Law and Humanities (ERH), Amsterdam University Medical Centers, location VUmc, De Boelelaan 1089a, 1081 HV Amsterdam, the Netherlands.
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Lim H, Lee H. Eating Habits and Lifestyle Factors Related to Childhood Obesity Among Children Aged 5-6 Years: Cluster Analysis of Panel Survey Data in Korea. JMIR Public Health Surveill 2024; 10:e51581. [PMID: 38578687 PMCID: PMC11031700 DOI: 10.2196/51581] [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: 08/04/2023] [Revised: 11/19/2023] [Accepted: 01/23/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Childhood obesity has emerged as a major health issue due to the rapid growth in the prevalence of obesity among young children worldwide. Establishing healthy eating habits and lifestyles in early childhood may help children gain appropriate weight and further improve their health outcomes later in life. OBJECTIVE This study aims to classify clusters of young children according to their eating habits and identify the features of each cluster as they relate to childhood obesity. METHODS A total of 1280 children were selected from the Panel Study on Korean Children. Data on their eating habits (eating speed, mealtime regularity, consistency of food amount, and balanced eating), sleep hours per day, outdoor activity hours per day, and BMI were obtained. We performed a cluster analysis on the children's eating habits using k-means methods. We conducted ANOVA and chi-square analyses to identify differences in the children's BMI, sleep hours, physical activity, and the characteristics of their parents and family by cluster. RESULTS At both ages (ages 5 and 6 years), we identified 4 clusters based on the children's eating habits. Cluster 1 was characterized by a fast eating speed (fast eaters); cluster 2 by a slow eating speed (slow eaters); cluster 3 by irregular eating habits (poor eaters); and cluster 4 by a balanced diet, regular mealtimes, and consistent food amounts (healthy eaters). Slow eaters tended to have the lowest BMI (P<.001), and a low proportion had overweight and obesity at the age of 5 years (P=.03) and 1 year later (P=.005). There was a significant difference in sleep time (P=.01) and mother's education level (P=.03) at the age of 5 years. Moreover, there was a significant difference in sleep time (P=.03) and the father's education level (P=.02) at the age of 6 years. CONCLUSIONS Efforts to establish healthy eating habits in early childhood may contribute to the prevention of obesity in children. Specifically, providing dietary guidance on a child's eating speed can help prevent childhood obesity. This research suggests that lifestyle modification could be a viable target to decrease the risk of childhood obesity and promote the development of healthy children. Additionally, we propose that future studies examine long-term changes in obesity resulting from lifestyle modifications in children from families with low educational levels.
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Affiliation(s)
- Heemoon Lim
- College of Nursing, Yonsei University, Seoul, Republic of Korea
| | - Hyejung Lee
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Republic of Korea
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Royo-Bordonada MÁ, Cavero-Esponera C, Romero-Fernández MM, González-Díaz C, Ordaz Castillo E. Differences in children's exposure to television advertising of unhealthy foods and beverages in Spain by socio-economic level. BMC Public Health 2024; 24:739. [PMID: 38454414 PMCID: PMC10921598 DOI: 10.1186/s12889-023-17410-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] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/05/2023] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND The influence of food advertising on food preferences and consumption could also contribute to the socio-economic inequalities among Spanish children in terms of eating habits and childhood obesity. Although the main food advertising channel targeted at children in Spain is television, available studies estimate exposure indirectly by combining content data with audience data. The aim of this study was therefore to describe the frequency of exposure to television advertising of unhealthy foods and drinks, measured directly, among Spanish children and adolescents, and analyse its socio-economic inequalities. METHODS Observational study of television advertising impacts in a sample of 1590 children aged 4 to 16 years drawn from a consumer panel representative of the Spanish population in this age group, over the course of a full week of broadcasting in February 2022. The sample was obtained through stratified random sampling by Autonomous Region, with quotas being set by reference to socio-demographic variables. Exposure was measured with an audiometer, and the nutrient content of the food and drink advertised was analysed using the nutrient profile of the WHO Regional Office for Europe. We used the Chi-squared test to analyse possible differences in advertising coverage by socio-economic level. RESULTS The participants saw a weekly mean of 82.4 food and drink commercials, 67.4 of which were for unhealthy products (81.8%), mostly outside the child-protection time slot. On average, low-social class participants received 94.4% more impacts from unhealthy food and drink advertising than did high-class participants (99.9 vs. 51.4 respectively). The mean advertising coverage of unhealthy foods and drinks was 71.6% higher in low-class than in high-class participants (10.9% vs. 18.7%; p = 0.01). CONCLUSION Spanish children and adolescents received an average of 10 impacts per day from television spots for unhealthy foods and drinks. The exposure of low-class children is double that of high-class children, a finding compatible with the high prevalence of childhood obesity in Spain and the related socio-economic inequalities. To protect Spanish minors from the harmful effects of food advertising and reduce the related social health inequalities would require the implementation of a 24:00 watershed for unhealthy food advertising on television.
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Affiliation(s)
- Miguel Ángel Royo-Bordonada
- National School of Public Health, Institute of Health Carlos III, Ministry of Science and Innovation, Madrid, 28029, Spain
| | - Cristina Cavero-Esponera
- Department of Preventive Medicine and Public Health, Hospital Central de la Cruz Roja San José y Santa Adela, Madrid, 28003, Spain.
- Doctoral Program in Biomedical Sciences and Public Health, International Doctorate Program, National University of Distance Education (UNED), Madrid, 28015, Spain.
| | - María Mar Romero-Fernández
- Puertollano Integrated Care Management. Health Service of Castilla-La Mancha, Unit of Teaching and Research, Santa Bárbara Hospital, Castilla-La Mancha, Spain
| | | | - Elena Ordaz Castillo
- National School of Public Health, Institute of Health Carlos III, Ministry of Science and Innovation, Madrid, 28029, Spain
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Skaffari E, Vepsäläinen H, Nissinen K, Lehto E, Lehto R, Roos E, Erkkola M, Korkalo L. Food consumption and nutrient intake of Finnish preschool children according to parental educational level. Br J Nutr 2024; 131:113-122. [PMID: 37424281 DOI: 10.1017/s0007114523001460] [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: 07/11/2023]
Abstract
We examined the association between parental educational level (PEL) and children's food consumption and nutrient intake in a sample of Finnish 3- to 6-year-old preschoolers (n 811). The data were obtained from the cross-sectional DAGIS project, conducted in eight municipalities in Finland during 2015-2016. The food consumption and nutrient intake were assessed using food records. The highest educational level of the family was used as the indicator of socio-economic status. Differences in diet by PEL were analysed using a hierarchical linear model adjusted for energy intake. Compared with high PEL, low PEL was associated with a child's lower consumption of fresh vegetables and salads, vegetarian dishes, berries, white bread, blended spread, skimmed milk and ice cream but higher consumption of milk with 1-1·5 % fat content, dairy-based desserts and sugar-sweetened soft drinks. Food consumption was also examined after disaggregating dishes into their ingredients. Low PEL was associated with lower consumption of vegetables, nuts and seeds, berries and fish but higher consumption of red meat. Children in the low PEL, compared with the high PEL group, had a lower intake of protein, fibre, EPA, DHA, vitamin D, riboflavin, vitamin B6, folate, vitamin B12, vitamin C, potassium, phosphorous, Ca, Mg, Zn and iodine but a higher intake of fat and saturated, trans and MUFA. The observed diet-related disparities highlight the need for policy actions and interventions supporting healthy eating patterns such as high consumption of vegetables, nuts and berries in childhood, paying special attention to those with low PEL.
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Affiliation(s)
- Essi Skaffari
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Kaija Nissinen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
- School of Food and Agriculture, Seinäjoki University of Applied Sciences, Seinäjoki, Finland
| | - Elviira Lehto
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
- Department of Sociology, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | | | - Eva Roos
- Folkhälsan Research Center, Helsinki, Finland
- Department of Food Studies, Nutrition and Dietetics, Uppsala Universitet, Uppsala, Sweden
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Liisa Korkalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
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Gutiérrez-González E, García-Solano M, Pastor-Barriuso R, Fernández de Larrea-Baz N, Rollán-Gordo A, Peñalver-Argüeso B, Peña-Rey I, Pollán M, Pérez-Gómez B. A nation-wide analysis of socioeconomic and geographical disparities in the prevalence of obesity and excess weight in children and adolescents in Spain: Results from the ENE-COVID study. Pediatr Obes 2024; 19:e13085. [PMID: 37963589 DOI: 10.1111/ijpo.13085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 09/22/2023] [Accepted: 10/22/2023] [Indexed: 11/16/2023]
Abstract
OBJECTIVE To estimate national and provincial prevalence of obesity and excess weight in the child and adolescent population in Spain by sex and sociodemographic characteristics, and to explore sources of inequalities in their distribution, and their geographical patterns. METHODS ENE-COVID is a nationwide representative seroepidemiological survey (68 287 participants) stratified by province and municipality size (April-June 2020). Participants answered a questionnaire which collected self-reported weight and height, that allowed estimating crude and model-based standardized prevalences of obesity and excess weight in the 10 543 child and adolescent participants aged 2-17 years. RESULTS Crude prevalences (WHO growth reference) were higher in boys than in girls (obesity: 13.4% vs. 7.9%; excess weight: 33.7% vs. 26.0%; severe obesity: 2.9% vs. 1.2%). These prevalences varied with age, increased with the presence of any adult with excess weight in the household, while they decreased with higher adult educational and census tract average income levels. Obesity by province ranged 1.8%-30.5% in boys and 0%-17.6% in girls; excess weight ranged 15.2%-49.9% in boys and 10.8%-40.8% in girls. The lowest prevalences of obesity and excess weight were found in provinces in the northern half of Spain. Sociodemographic characteristics only partially explained the observed geographical variability (33.6% obesity; 44.2% excess weight). CONCLUSIONS Childhood and adolescent obesity and excess weight are highly prevalent in Spain, with relevant sex, sociodemographic and geographical differences. The geographic variability explained by sociodemographic variables indicates that there are other potentially modifiable factors on which to focus interventions at different geographic levels to fight this problem.
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Affiliation(s)
| | | | - Roberto Pastor-Barriuso
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Nerea Fernández de Larrea-Baz
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Belén Peñalver-Argüeso
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Marina Pollán
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Beatriz Pérez-Gómez
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Vandevijvere S, De Pauw R, Djojosoeparto S, Gorasso V, Guariguata L, Løvhaug AL, Mialon M, Van Dam I, von Philipsborn P. Upstream Determinants of Overweight and Obesity in Europe. Curr Obes Rep 2023; 12:417-428. [PMID: 37594616 DOI: 10.1007/s13679-023-00524-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/20/2023] [Indexed: 08/19/2023]
Abstract
PURPOSE OF REVIEW To review the upstream determinants of overweight and obesity in Europe, including food and built environments, and political, commercial, and socioeconomic determinants. RECENT FINDINGS Overweight and obesity affect 60% of European adults, and one in three children, and are more common in individuals with low compared to high socioeconomic position (SEP). Individuals in low SEP groups are more exposed to unhealthy built and food environments, including higher exposure to unhealthy food marketing. Industries influencing the food system have much economic power, resulting in ignoring or silencing the role of ultra-processed foods and commercial practices in weight gain. Overall, effective policies to address overweight and obesity have been insufficiently implemented by governments. To accelerate implementation, strengthened political commitment is essential. Policies must also focus on the upstream, structural, and systemic drivers of overweight and obesity; be comprehensive; and target socioeconomic inequalities in diets and physical activity.
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Affiliation(s)
- Stefanie Vandevijvere
- Department of Epidemiology and Public Health, Sciensano, J. Wytsmanstraat 14, 1050, Brussels, Belgium.
| | - Robby De Pauw
- Department of Epidemiology and Public Health, Sciensano, J. Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Sanne Djojosoeparto
- Consumption and Healthy Lifestyles Chair Group, Wageningen University and Research, Wageningen, The Netherlands
| | - Vanessa Gorasso
- Department of Epidemiology and Public Health, Sciensano, J. Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Leonor Guariguata
- Department of Epidemiology and Public Health, Sciensano, J. Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Anne Lene Løvhaug
- Department of Nursing and Health Promotion, OsloMet-Oslo Metropolitan University, Oslo, Norway
| | | | - Iris Van Dam
- Department of Epidemiology and Public Health, Sciensano, J. Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Peter von Philipsborn
- Pettenkofer School of Public Health, Ludwig-Maximilians-Universität München, Munich, Germany
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Younossi ZM, Zelber-Sagi S, Henry L, Gerber LH. Lifestyle interventions in nonalcoholic fatty liver disease. Nat Rev Gastroenterol Hepatol 2023; 20:708-722. [PMID: 37402873 DOI: 10.1038/s41575-023-00800-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/26/2023] [Indexed: 07/06/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is a dynamic chronic liver disease that develops in close association with metabolic irregularities. Between 2016 and 2019, the global prevalence among adults was reported as 38% and among children and adolescents it was about 10%. NAFLD can be progressive and is associated with increased mortality from cardiovascular disease, extrahepatic cancers and liver complications. Despite these numerous adverse outcomes, no pharmacological treatments currently exist to treat nonalcoholic steatohepatitis, the progressive form of NAFLD. Therefore, the main treatment is the pursuit of a healthy lifestyle for both children and adults, which includes a diet rich in fruits, nuts, seeds, whole grains, fish and chicken and avoiding overconsumption of ultra-processed food, red meat, sugar-sweetened beverages and foods cooked at high heat. Physical activity at a level where one can talk but not sing is also recommended, including leisure-time activities and structured exercise. Avoidance of smoking and alcohol is also recommended. Policy-makers, community and school leaders need to work together to make their environments healthy by developing walkable and safe spaces with food stores stocked with culturally appropriate and healthy food items at affordable prices as well as providing age-appropriate and safe play areas in both schools and neighbourhoods.
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Affiliation(s)
- Zobair M Younossi
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, USA.
- Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, VA, USA.
- Inova Medicine, Inova Health System, Falls Church, VA, USA.
| | | | - Linda Henry
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, USA
- Inova Medicine, Inova Health System, Falls Church, VA, USA
| | - Lynn H Gerber
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, USA
- Inova Medicine, Inova Health System, Falls Church, VA, USA
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Reppas K, Papamichael MM, Moschonis G, Cardon G, Iotova V, Bazdarska Y, Chakarova N, Rurik I, Antal E, Valve P, Liatis S, Makrilakis K, Moreno L, Manios Y. Role of parenting practices and digital media on beverage intake in European schoolchildren of different weight status. Feel4Diabetes-study. Nutrition 2023; 115:112142. [PMID: 37541142 DOI: 10.1016/j.nut.2023.112142] [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: 02/23/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVES Halting the rise in childhood obesity is an ongoing challenge in Europe. Sugar-sweetened beverage (SSB) and artificially sweetened beverage (ASB) consumption has become common practice at home and during family meals. The objective of this study was to investigate associations of parenting practices and home digital media availability with beverage intake in European schoolchildren of different weight groups. METHODS Cross-sectional data were derived from six countries taking part in the multicentered Feel4Diabetes-study. Anthropometric data were measured for 12 030 schoolchildren (n = 6097 girls; median age = 8.1 y). Details on sociodemographic characteristics, beverage intake, food parenting practices, and home availability of digital media were collated from questionnaires. The outcomes, daily SSB and ASB intakes, were included as dependent variables in multivariable regression models that provided odds ratios reflecting their association with parenting practices and digital media (exposures), after stratifying for children's weight status (underweight or normal versus overweight or obese). RESULTS After controlling for children's sex, region, maternal body mass index, and education, the multivariate model found that in both body mass index groups, permissive parenting practices, such as rewarding and allowing consumption of unhealthy foods "very often or often," as compared with "rarely or never," were associated with a high daily intake of SSBs and ASBs in children, while parents "watching television together with their child," rewarding with screen time, and availability of television in children's rooms increased the likelihood of both beverages in the underweight or normal-weight group. CONCLUSIONS Modification of permissive parenting practices and removal of television from children's rooms could effectively reduce SSB intake and curb the ongoing threat of child obesity in Europe.
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Affiliation(s)
- Kyriakos Reppas
- Department of Nutrition & Dietetics, School of Health Science & Education, Harokopio University of Athens, Kallithea, Greece
| | - Maria Michelle Papamichael
- Department of Nutrition & Dietetics, School of Health Science & Education, Harokopio University of Athens, Kallithea, Greece; Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - George Moschonis
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Violeta Iotova
- Department of Pediatrics, Medical University of Varna, Varna, Bulgaria
| | - Yuliya Bazdarska
- Department of Pediatrics, Medical University of Varna, Varna, Bulgaria
| | - Nevena Chakarova
- Department of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Imre Rurik
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary; Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Emese Antal
- Hungarian Society of Nutrition, Budapest, Hungary
| | - Päivi Valve
- Public Health and Welfare Department, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Stavros Liatis
- First Department of Propaedeutic Medicine, Laiko General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Konstantinos Makrilakis
- First Department of Propaedeutic Medicine, Laiko General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Luis Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
| | - Yannis Manios
- Department of Nutrition & Dietetics, School of Health Science & Education, Harokopio University of Athens, Kallithea, Greece; Agri-Food and Life Sciences Institute, Hellenic Mediterranean University Research Center, Heraklion, Greece.
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10
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Hanssen H, Moholdt T, Bahls M, Biffi A, Siegrist M, Lewandowski AJ, Biondi-Zoccai G, Cavarretta E, Kokkvoll A, Løchen ML, Maestrini V, Pinto RS, Palermi S, Thivel D, Wojcik M, Hansen D, Van Craenenbroeck EM, Weghuber D, Kraenkel N, Tiberi M. Lifestyle interventions to change trajectories of obesity-related cardiovascular risk from childhood onset to manifestation in adulthood: a joint scientific statement of the task force for childhood health of the European Association of Preventive Cardiology and the European Childhood Obesity Group. Eur J Prev Cardiol 2023; 30:1462-1472. [PMID: 37491406 DOI: 10.1093/eurjpc/zwad152] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/20/2023] [Accepted: 05/06/2023] [Indexed: 07/27/2023]
Abstract
There is an immediate need to optimize cardiovascular (CV) risk management and primary prevention of childhood obesity to timely and more effectively combat the health hazard and socioeconomic burden of CV disease from childhood development to adulthood manifestation. Optimizing screening programs and risk management strategies for obesity-related CV risk in childhood has high potential to change disease trajectories into adulthood. Building on a holistic view on the aetiology of childhood obesity, this document reviews current concepts in primary prevention and risk management strategies by lifestyle interventions. As an additional objective, this scientific statement addresses the high potential for reversibility of CV risk in childhood and comments on the use of modern surrogate markers beyond monitoring weight and body composition. This scientific statement also highlights the clinical importance of quantifying CV risk trajectories and discusses the remaining research gaps and challenges to better promote childhood health in a population-based approach. Finally, this document provides an overview on the lessons to be learned from the presented evidence and identifies key barriers to be targeted by researchers, clinicians, and policymakers to put into practice more effective primary prevention strategies for childhood obesity early in life to combat the burden of CV disease later in life.
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Affiliation(s)
- Henner Hanssen
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Grosse Allee 6, 4052 Basel, Switzerland
| | - Trine Moholdt
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Women's Clinic, St. Olavs Hospital, Trondheim, Norway
| | - Martin Bahls
- Department of Internal Medicine B University Medicine Greifswald, University of Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Alessandro Biffi
- Med-Ex Medicine & Exercise, Medical Partner Scuderia Ferrari, Rome, Italy
| | - Monika Siegrist
- Department of Prevention and Sports Medicine, School of Medicine, University Hospital 'rechts der Isar', Technical University of Munich, Munich, Germany
| | - Adam J Lewandowski
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Giuseppe Biondi-Zoccai
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
- Mediterranea Cardiocentro, Napoli, Italy
| | - Elena Cavarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
- Mediterranea Cardiocentro, Napoli, Italy
| | - Ane Kokkvoll
- Department of Paediatrics, Finnmark Hospital Trust, Hammerfest, Norway
| | - Maja-Lisa Løchen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Viviana Maestrini
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, 'Sapienza' University of Rome, Policlinico Umberto I, Rome, Italy
| | | | - Stefano Palermi
- Med-Ex Medicine & Exercise, Medical Partner Scuderia Ferrari, Rome, Italy
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Malgorzata Wojcik
- Department of Pediatric and Adolescent Endocrinology, Jagiellonian University Medical College, Krakow, Poland
| | - Dominique Hansen
- Department of Cardiology, Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
- UHasselt, Faculty of Rehabilitation Sciences, BIOMED-REVAL-Rehabilitation Research Centre, Hasselt University, Hasselt, Belgium
| | - Emeline M Van Craenenbroeck
- Research Group Cardiovascular Diseases, GENCOR Department, University of Antwerp, Campus Drie Eiken, Antwerp, Belgium
- Department of Cardiology, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Daniel Weghuber
- Obesity Research Unit, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - Nicolle Kraenkel
- Deutsches Herzzentrum der Charité (DHZC), Department of Cardiology, Angiology and Intensive Care, Campus Benjamin-Franklin (CBF), Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), Partner site Berlin, Germany
- Friede Springer- Cardiovascular Prevention Center @ Charité, Charite- Universitätsmedizin Berlin, Berlin, Germany
| | - Monica Tiberi
- Department of Public Health, Azienda Sanitaria Unica Regionale Marche AV 1, Pesaro, Italy
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11
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Manios Y, Papamichael MM, Mourouti N, Argyropoulou M, Iotova V, Usheva N, Dimova R, Cardon G, Valve P, Rurik I, Antal E, Liatis S, Makrilakis K, Moreno L, Moschonis G. Parental BMI and country classification by Gross National Income are stronger determinants of prospective BMI deterioration compared to perinatal risk factors at pre-adolescence: Feel4Diabetes Study. Nutrition 2023; 114:112128. [PMID: 37481919 DOI: 10.1016/j.nut.2023.112128] [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: 02/09/2023] [Accepted: 06/05/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVES This study aimed to evaluate all known risk factors, from perinatal to adolescence and identify those predominantly related with prospective BMI deterioration. METHODS Prospective data analysis from the European Feel4Diabetes-study involving 12,211 children from six countries. Details on perinatal and sociodemographic characteristics were collected by parental self-reported questionnaires. Children's anthropometric data were measured by research personnel. Associations between risk factors and children's BMI deterioration (i.e increase) from baseline (mean age 8.2 ± 0.98 years) to the 2-year follow-up (10.3 ± 1.0 years) were explored by applying logistic regression analyses. RESULTS Univariate analysis revealed that all known risk factors for early overweight/obesity development, remained dominant in prospective BMI deterioration. When multivariate analysis was applied including additional variables such as parents' current BMI status, family socio-demographic characteristics and country economic classification based on Gross National Income, most perinatal risk factors were no longer significant. Multivariate analysis revealed that pre-pregnancy maternal overweight/obesity (OR, 95%CI: 2.71, 1.67-4.38), early introduction of solid foods (2.54, 1.21-5.31), parental current BMI status (3.53, 2.17-5.72) and country economic classification (low income: 4.67, 2.20-9.93; under austerity measures: 6.78, 3.18-14.48) were the only parameters associated with higher odds for children's BMI deterioration from the study baseline to 2-year follow-up after adjusting for children's gender. CONCLUSIONS The most predominant risk factors influencing children's prospective BMI deterioration were parental BMI and country economic classification as compared to perinatal. These findings should guide public health initiatives aiming to tackle the childhood obesity epidemic and social inequalities on a European level.
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Affiliation(s)
- Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece.
| | - Maria Michelle Papamichael
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Niki Mourouti
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; Department of Nutrition and Dietetics, Hellenic Mediterranean University, Sitia, Greece
| | - Matzourana Argyropoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Violeta Iotova
- Department of Paediatrics, Medical University of Varna, Bulgaria
| | - Natalya Usheva
- Department of Social Medicine and Health Care Organization, Medical University of Varna, Varna, Bulgaria
| | - Roumyana Dimova
- Department of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Päivi Valve
- Department of Public Health and Welfare, Finnish Institute of Health and Welfare, Helsinki, Finland
| | - Imre Rurik
- Semmelweis University, Department of Family Medicine, Budapest, Hungary; Hungarian Society of Nutrition, Budapest, Hungary
| | - Emese Antal
- Hungarian Society of Nutrition, Budapest, Hungary
| | - Stavros Liatis
- National and Kapodistrian University of Athens Medical School, First Department of Propaedeutic Medicine, Laiko General Hospital, Athens, Greece
| | - Konstantinos Makrilakis
- National and Kapodistrian University of Athens Medical School, First Department of Propaedeutic Medicine, Laiko General Hospital, Athens, Greece
| | - Luis Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Spain
| | - George Moschonis
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
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12
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Spinelli A, Censi L, Mandolini D, Ciardullo S, Salvatore MA, Mazzarella G, Nardone P. Inequalities in Childhood Nutrition, Physical Activity, Sedentary Behaviour and Obesity in Italy. Nutrients 2023; 15:3893. [PMID: 37764677 PMCID: PMC10534384 DOI: 10.3390/nu15183893] [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: 08/07/2023] [Revised: 09/01/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
Unhealthy diets, physical inactivity and high body mass index (BMI) are preventable risk factors for non-communicable diseases throughout a person's lifespan. The higher prevalence of these risk factors in children from lower socio-economic groups has been generally observed. The aim of this study is to explore the effect of parents' socio-economic conditions on children's consumption of fruit, vegetables and sugar-sweetened drinks, and inactivity, sedentary behaviour, overweight and obesity. This study used data from the sixth cross-sectional survey of the surveillance "OKkio alla Salute" (Italian COSI), involving 2467 schools and 53,275 children in 2019. All the information was collected through four questionnaires addressed to parents, children, teachers and head teachers. The weights and heights of the children were measured with standard techniques and equipment to classify overweight/obesity according to the WOF-IOTF cut-offs. The results showed a high percentage of children who do not adhere to health recommendations and a high prevalence of overweight and obesity. In particular, "less healthy" behaviours and higher BMI were more frequent in children from families with a lower socio-economic status and those residing in Southern Italy. These findings highlight the need for effective interventions that address the differences in these health-related behaviours.
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Affiliation(s)
- Angela Spinelli
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Viale Regina Elena 299, 00161 Rome, Italy; (D.M.); (S.C.); (M.A.S.); (P.N.)
| | - Laura Censi
- Council for Agricultural Research and Economics-Research Centre for Food and Nutrition, Via Ardeatina 546, 00178 Rome, Italy;
| | - Donatella Mandolini
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Viale Regina Elena 299, 00161 Rome, Italy; (D.M.); (S.C.); (M.A.S.); (P.N.)
| | - Silvia Ciardullo
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Viale Regina Elena 299, 00161 Rome, Italy; (D.M.); (S.C.); (M.A.S.); (P.N.)
| | - Michele Antonio Salvatore
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Viale Regina Elena 299, 00161 Rome, Italy; (D.M.); (S.C.); (M.A.S.); (P.N.)
| | | | - Paola Nardone
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Viale Regina Elena 299, 00161 Rome, Italy; (D.M.); (S.C.); (M.A.S.); (P.N.)
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13
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Abdoli M, Scotto Rosato M, Cipriano A, Napolano R, Cotrufo P, Barberis N, Cella S. Affect, Body, and Eating Habits in Children: A Systematic Review. Nutrients 2023; 15:3343. [PMID: 37571280 PMCID: PMC10420931 DOI: 10.3390/nu15153343] [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: 07/01/2023] [Revised: 07/22/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
The present review investigates the complex associations between children's affective states, body perceptions, and eating habits, thus providing crucial insights for potential health interventions. Following PRISMA guidelines, three databases were searched for peer-reviewed studies exploring the relationship between eating habits, emotional states, and body image perceptions in a population of children (5 to 11 years old). A total of seven articles were included. Our findings revealed a pattern of associations between negative emotional states, like anxiety and depressive feelings, and maladaptive eating behaviors. Additionally, explicit influences from parental feeding practices, peer pressure, socioeconomic factors, and children's body perceptions were observed to shape eating habits, with a pronounced tendency among older girls towards dieting and food preoccupation. Our results underline the intertwining nature of age, gender, and emotional states. Furthermore, our findings accentuate the urgency for comprehensive interventions that acknowledge and address the complex interplay of emotional, familial, and socioeconomic factors alongside children's body image perceptions. The criticality of continued research, particularly ones employing longitudinal designs and diverse demographic samples, is highlighted as we strive to understand and navigate such multifaceted relationships to enhance children's health and well-being.
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Affiliation(s)
- Marzieh Abdoli
- Observatory on Eating Disorders, Department of Psychology, University of Campania “Luigi Vanvitelli”, Viale Ellittico, 31, 81100 Caserta, Italy; (M.A.); (M.S.R.); (A.C.); (R.N.); (P.C.)
| | - Marco Scotto Rosato
- Observatory on Eating Disorders, Department of Psychology, University of Campania “Luigi Vanvitelli”, Viale Ellittico, 31, 81100 Caserta, Italy; (M.A.); (M.S.R.); (A.C.); (R.N.); (P.C.)
| | - Annarosa Cipriano
- Observatory on Eating Disorders, Department of Psychology, University of Campania “Luigi Vanvitelli”, Viale Ellittico, 31, 81100 Caserta, Italy; (M.A.); (M.S.R.); (A.C.); (R.N.); (P.C.)
| | - Rosanna Napolano
- Observatory on Eating Disorders, Department of Psychology, University of Campania “Luigi Vanvitelli”, Viale Ellittico, 31, 81100 Caserta, Italy; (M.A.); (M.S.R.); (A.C.); (R.N.); (P.C.)
| | - Paolo Cotrufo
- Observatory on Eating Disorders, Department of Psychology, University of Campania “Luigi Vanvitelli”, Viale Ellittico, 31, 81100 Caserta, Italy; (M.A.); (M.S.R.); (A.C.); (R.N.); (P.C.)
| | - Nadia Barberis
- Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy;
| | - Stefania Cella
- Observatory on Eating Disorders, Department of Psychology, University of Campania “Luigi Vanvitelli”, Viale Ellittico, 31, 81100 Caserta, Italy; (M.A.); (M.S.R.); (A.C.); (R.N.); (P.C.)
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14
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Olsson C, Hörnell A, Waling M. High availability of vegetables and fruit through government-funded school lunch is not reflected in 4th grade pupils' intake. Food Nutr Res 2023; 67:9405. [PMID: 37533447 PMCID: PMC10392862 DOI: 10.29219/fnr.v67.9405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/26/2023] [Accepted: 05/01/2023] [Indexed: 08/04/2023] Open
Abstract
Background An increased intake of vegetable and fruit (VF) through school meals can contribute to the prevention of non-communicable diseases. Objective The purpose of this study was to investigate what types of VF 4th grade pupils (10-11 years old) choose, how much they eat when they are given the opportunity to serve themselves from the daily vegetable buffet available at lunch, and whether this varies with socioeconomic background and gender. Design A cross-sectional study design was used where pupils' VF intake was measured during 5 days with a photographic method. In total, 196 pupils from nine public schools participated. Results The results show that pupils on average ate less than one type of VF per day from the vegetable buffet. Girls, pupils with a higher socio-economic status (SES) and those with a more frequent VF intake at home, ate more types of VF per day from the vegetable buffet than their counterparts. The median intake of VF from the vegetable buffet was generally low, 20.4 g/day. The intake was two thirds higher for pupils with higher SES in comparison with pupils with lower SES; 25 g/day versus14 g/day (P = 0.001). No gender differences in grams per day of VF were identified (P = 0.123). Discussion This study indicates that a well-stocked vegetable buffet as part of government-funded school lunch does not automatically contribute substantially to the recommended daily intake of VF among a sample of 4th grade pupils in a high-income country like Sweden. Conclusions The results of the study can be interpreted as a missed opportunity to increase the intentional consumption of VF among pupils in a way that would have implications for public health as well as attenuating differences between socioeconomic groups.
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Affiliation(s)
| | | | - Maria Waling
- Maria Waling Department of Food, Nutrition and Culinary Science, SE-901 87 Umeå, Sweden.
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15
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Şat S, Aydınkoç-Tuzcu K, Berger F, Barakat A, Danquah I, Schindler K, Fasching P. Diabetes and Migration. Exp Clin Endocrinol Diabetes 2023; 131:319-337. [PMID: 37315566 DOI: 10.1055/a-1946-3878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Sebahat Şat
- MVZ DaVita Rhine-Ruhr, Düsseldorf, Germany
- German Diabetes Association (DDG) Working Group on Diabetes and Migrants
| | - Kadriye Aydınkoç-Tuzcu
- German Diabetes Association (DDG) Working Group on Diabetes and Migrants
- Wilhelminenspital of the City of Vienna, 5th Medical Department of Endocrinology, Rheumatology and Acute Geriatrics, Vienna, Austria
- Austrian Diabetes Association (ÖGD) Working Group on Migration and Diabetes
| | - Faize Berger
- German Diabetes Association (DDG) Working Group on Diabetes and Migrants
| | - Alain Barakat
- German Diabetes Association (DDG) Working Group on Diabetes and Migrants
- Diabetes Center Duisburg-Mitte (DZDM), Duisburg, Germany
| | - Ina Danquah
- German Diabetes Association (DDG) Working Group on Diabetes and Migrants
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital Heidelberg, Heidelberg University, Heidelberg, Germany
| | - Karin Schindler
- Austrian Diabetes Association (ÖGD) Working Group on Migration and Diabetes
- Medical University of Vienna, Department of Internal Medicine III, Clinical Department of Endocrinology and Metabolism, Vienna, Austria
| | - Peter Fasching
- Wilhelminenspital of the City of Vienna, 5th Medical Department of Endocrinology, Rheumatology and Acute Geriatrics, Vienna, Austria
- Austrian Diabetes Association (ÖGD) Working Group on Migration and Diabetes
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16
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Park J, Baek S, Hwang G, Park C, Hwang S. Diet-Related Disparities and Childcare Food Environments for Vulnerable Children in South Korea: A Mixed-Methods Study. Nutrients 2023; 15:nu15081940. [PMID: 37111159 PMCID: PMC10147062 DOI: 10.3390/nu15081940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/20/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
Diet-related disparities that have often been observed in vulnerable families may play a negative role in children's health and health-related quality of life. In South Korea, an afterschool care policy, called Community Childcare Center (CCC), was established in the 1960s to protect and educate vulnerable children; this role has expanded to provide meal services in recent times. Therefore, the CCCs' food environment has become a pivotal platform for observing children's nutrition and health-related disparities. Using a mixed-methods approach including a survey with self-reported questionnaires, field observation, and participant interviews, the food environment of CCC was explored alongside children's eating behaviors. Eating behaviors were not as healthy as expected. Although service providers and cooks reported in the survey responses that the centers' food environment was healthy, participant observations and interviews revealed a significant gap. Establishing a standardized food environment and improving the nutrition literacy of workers as a significant human resource at a CCC can promote healthy eating for vulnerable children. The findings suggest that in the absence of steps to improve the food environment of CCC, diet-related disparities may affect children's health in the future.
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Affiliation(s)
- Jiyoung Park
- College of Nursing, Institute for Health Science Research, Inje University, Busan 47392, Republic of Korea
| | - Seolhyang Baek
- Department of Nursing, College of Nursing, WISE Campus, Dongguk University, Dongdaero 123, Gyeongju-si 38066, Republic of Korea
| | - Gahui Hwang
- College of Nursing, Yonsei University, Seoul 03722, Republic of Korea
| | - Chongwon Park
- Department of English Language and Literatures, Pukyong National University, Busan 46241, Republic of Korea
| | - Sein Hwang
- Department of Social Welfare, College of Social Science, Inje University, Gimhae-si 50834, Republic of Korea
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17
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Mascarenhas P, Furtado JM, Almeida SM, Ferraz ME, Ferraz FP, Oliveira P. Pediatric Overweight, Fatness and Risk for Dyslipidemia Are Related to Diet: A Cross-Sectional Study in 9-year-old Children. Nutrients 2023; 15:329. [PMID: 36678200 PMCID: PMC9865454 DOI: 10.3390/nu15020329] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/03/2023] [Accepted: 01/06/2023] [Indexed: 01/12/2023] Open
Abstract
Pediatric overweight, dyslipidemia and insulin resistance can result from unhealthy lifestyle habits and increase morbidity and mortality in adulthood. Herein, we evaluated the relationship between diet and physical activity patterns with the metabolic health of 9-year-old school children. Measurements included anthropometry, adiposity, lipid, and glycemic profiles. Questionnaires evaluated diet and physical activity. Exploratory factor analysis (EFA) screened for diet patterns, and multilevel models evaluated diet and physical activity patterns against overweight, dyslipidemia, and insulin resistance markers across schools and children. EFA highlighted two diet patterns, Western and Traditional. Food rich in fat, salt, and sugar and fewer vegetables and fruits defined the Western pattern. The Traditional pattern, linked to healthier eating habits, had analogies to the Mediterranean diet. Overall, 39% of the children were overweight (including the obese), while 62% presented cardiovascular risk factors on their lipid profiles. Normal-weight children presented 60% high cholesterol incidence. Global insulin resistance incidence was 4.1%, but almost doubled among the overweight/obese. The Westernized diet consistently linked to worse cardiovascular risk markers, even independently of physical practice. Intensive or competitive physical activity was associated with decreased triglycerides (p = 0.003), regardless of diet. Future prospective studies are warranted to validate these results externally.
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Affiliation(s)
- Paulo Mascarenhas
- Centro de Genética Médica e Nutrição Pediátrica Egas Moniz, Instituto Universitário Egas Moniz, 2829-511 Monte de Caparica, Portugal
| | - José M. Furtado
- Centro de Genética Médica e Nutrição Pediátrica Egas Moniz, Instituto Universitário Egas Moniz, 2829-511 Monte de Caparica, Portugal
| | - Sílvia M. Almeida
- Centro de Genética Médica e Nutrição Pediátrica Egas Moniz, Instituto Universitário Egas Moniz, 2829-511 Monte de Caparica, Portugal
| | - Maria E. Ferraz
- Centro de Genética Médica e Nutrição Pediátrica Egas Moniz, Instituto Universitário Egas Moniz, 2829-511 Monte de Caparica, Portugal
| | - Fernando P. Ferraz
- Centro de Genética Médica e Nutrição Pediátrica Egas Moniz, Instituto Universitário Egas Moniz, 2829-511 Monte de Caparica, Portugal
| | - Pedro Oliveira
- Department of Population Studies, ICBAS—Instituto de Ciências Biomédicas Abel Salazar, University of Porto, 4050-313 Porto, Portugal
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18
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de la Rie S, Washbrook E, Perinetti Casoni V, Waldfogel J, Kwon SJ, Dräger J, Schneider T, Olczyk M, Boinet C, Keizer R. The role of energy balance related behaviors in socioeconomic inequalities in childhood body mass index: A comparative analysis of Germany, the Netherlands, the United Kingdom, and the United States. Soc Sci Med 2023; 317:115575. [PMID: 36470056 DOI: 10.1016/j.socscimed.2022.115575] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 11/09/2022] [Accepted: 11/24/2022] [Indexed: 11/27/2022]
Abstract
Socioeconomic inequalities in childhood Body Mass Index (BMI) are becoming increasingly more pronounced across the world. Although countries differ in the direction and strength of these inequalities, cross-national comparative research on this topic is rare. This paper draws on harmonized longitudinal cohort data from four wealthy countries-Germany, the Netherlands, the United Kingdom (UK), and the United States (US)-to 1) map cross-country differences in the magnitude of socioeconomic inequalities in childhood BMI, and 2) to examine cross-country differences in the role of three energy-balance-related behaviors-physical activity, screen time, and breakfast consumption-in explaining these inequalities. Children were aged 5-7 at our first timepoint and were followed up at age 8-11. We used data from the German National Educational Panel Study, the Dutch Generation R study, the UK Millennium Cohort Study and the US Early Childhood Longitudinal-Kindergarten Study. All countries revealed significant inequalities in childhood BMI. The US stood out in having the largest inequalities. Overall, inequalities between children with low versus medium educated parents were smaller than those between children with high versus medium educated parents. The role of energy-balance-related behaviors in explaining inequalities in BMI was surprisingly consistent. Across countries, physical activity did not, while screen time and breakfast consumption did play a role. The only exception was that breakfast consumption did not play a role in the US. Cross-country differences emerged in the relative contribution of each behavior in explaining inequalities in BMI: Breakfast consumption was most important in the UK, screen time explained most in Germany and the US, and breakfast consumption and screen time were equally important in the Netherlands. Our findings suggest that what constitutes the most effective policy intervention differs across countries and that these should target both children from medium as well as low educated families.
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Affiliation(s)
- Sanneke de la Rie
- Department of Public Administration & Sociology, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3000 DR, Rotterdam, Netherlands.
| | - Elizabeth Washbrook
- School of Education, University of Bristol, 35 Berkeley Square, Bristol, BS8 1JA, United Kingdom
| | | | - Jane Waldfogel
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA
| | - Sarah Jiyoon Kwon
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA
| | - Jascha Dräger
- School of Education, University of Strathclyde, 141 St James Road, Glasgow, G4 0LT, United Kingdom
| | | | - Melanie Olczyk
- Martin-Luther-Universität Halle-Wittenberg, Paracelsusstr. 22, 06114, Halle (Saale), Germany
| | - Césarine Boinet
- Department of Economics, University of Strathclyde, 199 Cathedral Street, Glasgow, G4 0QU, United Kingdom; French Institute for Demographic Studies (INED), 9 Cours des Humanités CS 50004, 93322, Aubervilliers Cedex, Aubervilliers, France
| | - Renske Keizer
- Department of Public Administration & Sociology, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3000 DR, Rotterdam, Netherlands
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19
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Woodside JV, Sun Q, de Roos B, Rimm EB, Hu FB, Heinen MM, McEvoy CT, Piernas C, Scheelbeek PFD, Rushton J, Ensaff H, Brennan SF, Brennan L. Meeting report: plant-rich dietary patterns and health. Proc Nutr Soc 2022; 81:288-305. [PMID: 35996940 PMCID: PMC9839575 DOI: 10.1017/s002966512200266x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Dietary patterns (DP) rich in plant foods are associated with improved health and reduced non-communicable disease risk. In October 2021, the Nutrition Society hosted a member-led conference, held online over 2 half days, exploring the latest research findings examining plant-rich DP and health. The aim of the present paper is to summarise the content of the conference and synopses of the individual speaker presentations are included. Topics included epidemiological analysis of plant-rich DP and health outcomes, the effects of dietary interventions which have increased fruit and vegetable (FV) intake on a range of health outcomes, how adherence to plant-rich DP is assessed, the use of biomarkers to assess FV intake and a consideration of how modifying behaviour towards increased FV intake could impact environmental outcomes, planetary health and food systems. In conclusion, although there are still considerable uncertainties which require further research, which were considered as part of the conference and are summarised in this review, adopting a plant-rich DP at a population level could have a considerable impact on diet and health outcomes, as well as planetary health.
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Affiliation(s)
- Jayne V. Woodside
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- Corresponding author: Jayne V. Woodside,
| | - Qi Sun
- Harvard TH Chan School of Public Health, Boston, USA
| | - Baukje de Roos
- The Rowett Institute, University of Aberdeen, Aberdeen, UK
| | - Eric B. Rimm
- Harvard TH Chan School of Public Health, Boston, USA
| | - Frank B. Hu
- Harvard TH Chan School of Public Health, Boston, USA
| | - Mirjam M. Heinen
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Department of Country Health Programmes, WHO Regional Office for Europe, Geneva, Switzerland
| | - Claire T. McEvoy
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
| | - Carmen Piernas
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Pauline F. D. Scheelbeek
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Jonathan Rushton
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Hannah Ensaff
- School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Sarah F. Brennan
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
| | - Lorraine Brennan
- School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
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20
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Increasing Fruit and Vegetable Intake of Primary School Children in a Quasi-Randomized Trial: Evaluation of the Three-Year School-Based Multicomponent Intervention. Nutrients 2022; 14:nu14194197. [PMID: 36235849 PMCID: PMC9571246 DOI: 10.3390/nu14194197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 11/07/2022] Open
Abstract
Insufficient consumption of fruit and vegetables was found in primary school children. To address this problem, a three-year school-based multicomponent intervention was conducted in 14 primary schools in the City of Zagreb. The aim of the study was therefore to evaluate one of the primary goals of the intervention—the increase in fruit and vegetable intake among primary school children. A total of 681 children were allocated to the intervention (n = 300 in the control group and n = 381 in the intervention group). The intervention included 23 interactive classroom workshops, 10 cross-curricular activities, 13 homework challenges, visual exposure with educational posters in classrooms, parent education via the website, and the implementation of new dishes into the school food system. Fruit and vegetable intake was assessed using a semi-quantitative food frequency questionnaire at baseline and after the intervention. Data were analyzed by per-protocol analysis. The study involved 259 children (50.2% girls; age 7.7 ± 0.4 years; n = 116 in the control group and n = 143 in the intervention group) who completed a food intake frequency questionnaire at both time points. Children in the intervention group showed a significant increase (p < 0.001) in total daily fruit and vegetable intake (before: 332.1 ± 164.9 g; after: 430.1 ± 186.7 g) compared to the control group (before: 350.2 ± 187.5; after: 382.6 ± 196.8) after the intervention. The increase in fruit and vegetable intake was achieved in 89% of children, while 25% more children reached the daily recommendation of 400 g. The use of the multicomponent intervention showed potential to increase fruit and vegetable intake in primary school children.
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21
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Grigsby-Duffy L, Brooks R, Boelsen-Robinson T, Blake MR, Backholer K, Palermo C, Peeters A. The impact of primary school nutrition policy on the school food environment: a systematic review. Health Promot Int 2022; 37:6722685. [PMID: 36166267 PMCID: PMC9514228 DOI: 10.1093/heapro/daac084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
School nutrition policies that aim to address unhealthy diets have been introduced in many countries. This systematic review aimed to synthesize the international literature to determine the impact (overall and by socioeconomic position [SEP]) of primary school nutrition policies on the availability of foods and beverages in schools. Seven databases were searched using keywords and medical subject headings related to nutrition policies and schools. Studies that reported on the impact of implemented school nutrition policies on food and beverage availability within primary schools were included. Eighteen studies (reported across 20 papers) were included. Fifteen of the included studies reported some positive impacts of policies, including increased availability of healthier foods and decreased availability of less healthy foods. Five studies focused specifically on schools in low-income communities and a further three specifically compared schools by SEP, with mixed findings. Two studies reported on factors influencing policy implementation, reporting a lack of financial resources as a barrier to schools offering a wider selection of healthy foods and additional school resources as increasing the likelihood of offering healthy foods. School nutrition policies appear to be effective at improving the healthiness of foods and beverages available at schools. Furthermore, the results suggest that well-implemented school nutrition policies that improve the healthiness of foods available are unlikely to exacerbate the socioeconomic gradient of poor nutrition. However, the number of studies that reported results by SEP limits drawing strong conclusions regarding equity impacts and we strongly recommend further studies analyze their findings according to SEP.
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Affiliation(s)
- Lily Grigsby-Duffy
- School of Health and Social Development, Deakin University, Geelong, Australia Global Obesity Centre (GLOBE), Institute for Health Transformation, Melbourne, VIC 3220, Australia
| | - Ruby Brooks
- School of Health and Social Development, Deakin University, Geelong, Australia Global Obesity Centre (GLOBE), Institute for Health Transformation, Melbourne, VIC 3220, Australia
| | - Tara Boelsen-Robinson
- School of Health and Social Development, Deakin University, Geelong, Australia Global Obesity Centre (GLOBE), Institute for Health Transformation, Melbourne, VIC 3220, Australia
| | - Miranda R Blake
- School of Health and Social Development, Deakin University, Geelong, Australia Global Obesity Centre (GLOBE), Institute for Health Transformation, Melbourne, VIC 3220, Australia.,School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Commercial Road, Melbourne, VIC 3004, Australia
| | - Kathryn Backholer
- School of Health and Social Development, Deakin University, Geelong, Australia Global Obesity Centre (GLOBE), Institute for Health Transformation, Melbourne, VIC 3220, Australia
| | - Claire Palermo
- Department of Nutrition, Dietetics and Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC 3168, Australia
| | - Anna Peeters
- School of Health and Social Development, Deakin University, Geelong, Australia Global Obesity Centre (GLOBE), Institute for Health Transformation, Melbourne, VIC 3220, Australia.,School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Commercial Road, Melbourne, VIC 3004, Australia
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22
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Tan SB. Changes in neighborhood environments and the increasing socioeconomic gap in child obesity risks: Evidence from Singapore. Health Place 2022; 76:102860. [PMID: 35863272 DOI: 10.1016/j.healthplace.2022.102860] [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: 03/31/2022] [Revised: 06/12/2022] [Accepted: 06/27/2022] [Indexed: 11/26/2022]
Abstract
Most empirical research studying the link between neighborhood environments and child obesity risks are conducted in contexts such as the U.S., with pronounced patterns of residential segregation, making it difficult to extrapolate how far built environment characteristics contribute to socioeconomic disparities in obesity risks in less segregated contexts. Using a large national dataset of almost 625,000 students' height and weight data collected at ages 7, 11 and 14, between 2004 and 2015, this paper explores whether differences in eight neighborhood characteristics measuring access to different type of food outlets, parks and other active spaces, and public transport infrastructure might be responsible for socioeconomic differences in child obesity risks in Singapore, a city-state with relatively low levels of residential segregation. Through descriptive analyses we find that socioeconomic disparities in child BMIz in Singapore widened from 2004 onwards. However, while longitudinal regression models with individual and time fixed effects suggest that family socioeconomic status modified the relationship between environmental exposures and BMIz, there does not seem to be a clear, unequivocal relationship between built environment changes and the observed widening of the socioeconomic obesity gap.
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Affiliation(s)
- Shin Bin Tan
- Lee Kuan Yew School of Public Policy, National University of Singapore, 469C Bukit Timah Rd, National University of Singapore, 259772, Singapore; Department of Urban Studies and Planning, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA, 02139, USA.
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23
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Buoncristiano M, Williams J, Simmonds P, Nurk E, Ahrens W, Nardone P, Rito AI, Rutter H, Bergh IH, Starc G, Jonsson KR, Spinelli A, Vandevijvere S, Mäki P, Milanović SM, Salanave B, Yardim MS, Hejgaard T, Fijałkowska A, Abdrakhmanova S, Abdurrahmonova Z, Duleva V, Farrugia Sant'Angelo V, García-Solano M, Gualtieri A, Gutiérrez-González E, Huidumac-Petrescu C, Hyska J, Kelleher CC, Kujundžić E, Peterkova V, Petrauskiene A, Pudule I, Sacchini E, Shengelia L, Tanrygulyyeva M, Taxová Braunerová R, Usupova Z, Maruszczak K, Ostojic SM, Spiroski I, Stojisavljević D, Wickramasinghe K, Breda J. Socioeconomic inequalities in overweight and obesity among 6- to 9-year-old children in 24 countries from the World Health Organization European region. Obes Rev 2021; 22 Suppl 6:e13213. [PMID: 34184399 DOI: 10.1111/obr.13213] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 01/17/2023]
Abstract
Childhood overweight and obesity have significant short- and long-term negative impacts on children's health and well-being. These challenges are unequally distributed according to socioeconomic status (SES); however, previous studies have often lacked standardized and objectively measured data across national contexts to assess these differences. This study provides a cross-sectional picture of the association between SES and childhood overweight and obesity, based on data from 123,487 children aged 6-9 years in 24 countries in the World Health Organization (WHO) European region. Overall, associations were found between overweight/obesity and the three SES indicators used (parental education, parental employment status, and family-perceived wealth). Our results showed an inverse relationship between the prevalence of childhood overweight/obesity and parental education in high-income countries, whereas the opposite relationship was observed in most of the middle-income countries. The same applied to family-perceived wealth, although parental employment status appeared to be less associated with overweight and obesity or not associated at all. This paper highlights the need for close attention to context when designing interventions, as the association between SES and childhood overweight and obesity varies by country economic development. Population-based interventions have an important role to play, but policies that target specific SES groups are also needed to address inequalities.
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Affiliation(s)
- Marta Buoncristiano
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Julianne Williams
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Philippa Simmonds
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Eha Nurk
- Department of Nutrition Research, National Institute for Health Development, Tallinn, Estonia
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany.,Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Paola Nardone
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Ana Isabel Rito
- WHO/Europe Collaborating Center for Nutrition and Childhood Obesity - Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Ingunn Holden Bergh
- Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Gregor Starc
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Kenisha Russell Jonsson
- Department of Living Conditions and Lifestyle, Public Health Agency of Sweden, Solna, Sweden
| | - Angela Spinelli
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | | | - Päivi Mäki
- Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Sanja Musić Milanović
- Croatian Institute of Public Health, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Benoît Salanave
- Departement of Non-Communicable Diseases and Traumatisms, Santé publique France, the French Public Health Agency, Saint Maurice, France.,Nutritional Surveillance and Epidemiology Team (ESEN), University Sorbonne Paris Nord, Bobigny, France
| | | | - Tatjana Hejgaard
- Health Promotion and Inequality, Danish Health Authority, Copenhagen, Denmark
| | - Anna Fijałkowska
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
| | - Shynar Abdrakhmanova
- Department of Science and Professional Development, National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Almaty, Kazakhstan.,Kazakhstan School of Public Health, Kazakhstan's Medical University, Almaty, Kazakhstan
| | - Zulfiya Abdurrahmonova
- Republican Centre for Nutrition, Ministry of Health and Social Protection of Population, Dushanbe, Tajikistan
| | - Vesselka Duleva
- Department Food and Nutrition, National Centre of Public Health and Analyses, Sofia, Bulgaria
| | | | - Marta García-Solano
- Spanish Agency for Food Safety and Nutrition, Ministry of Consumer Affairs, Madrid, Spain
| | | | | | - Constanta Huidumac-Petrescu
- National Center for Health Assessment and Promotion, National Institute of Public Health, Bucharest, Romania
| | - Jolanda Hyska
- Nutrition and Food Safety Sector, Institute of Public Health, Tirana, Albania
| | - Cecily C Kelleher
- College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland
| | - Enisa Kujundžić
- Center for Health Ecology, Institute of Public Health, Podgorica, Montenegro
| | - Valentina Peterkova
- Institute of Paediatric Endocrinology, National Medical Research Centre for Endocrinology of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Ausra Petrauskiene
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Iveta Pudule
- Department of Research and Health Statistics, Centre for Disease and Prevention Control, Riga, Latvia
| | - Elena Sacchini
- Health Authority, Ministry of Health, San Marino, San Marino
| | - Lela Shengelia
- Maternal, Child and Reproductive Health, National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - Maya Tanrygulyyeva
- Scientific Research Institute of Maternal and Child Health, Ashgabat, Turkmenistan
| | | | - Zhamilya Usupova
- Republican Center for Health Promotion and Mass Communication, Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan
| | | | - Sergej M Ostojic
- Biomedical Sciences Department, Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Igor Spiroski
- Institute of Public Health, Skopje, North Macedonia.,Faculty of Medicine, SS. Cyril and Methodius University, Skopje, North Macedonia
| | - Dragana Stojisavljević
- Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina.,Public Health Institute of Republic of Srpska, Banja Luka, Bosnia and Herzegovina
| | - Kremlin Wickramasinghe
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - João Breda
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
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24
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Musić Milanović S, Buoncristiano M, Križan H, Rathmes G, Williams J, Hyska J, Duleva V, Zamrazilová H, Hejgaard T, Jørgensen MB, Salanave B, Shengelia L, Kelleher CC, Spinelli A, Nardone P, Abdrakhmanova S, Usupova Z, Pudule I, Petrauskiene A, Farrugia Sant'Angelo V, Kujundžić E, Fijałkowska A, Rito AI, Cucu A, Brinduse LA, Peterkova V, Gualtieri A, García-Solano M, Gutiérrez-González E, Boymatova K, Yardim MS, Tanrygulyyeva M, Melkumova M, Weghuber D, Nurk E, Mäki P, Bergh IH, Ostojic SM, Russell Jonsson K, Spiroski I, Rutter H, Ahrens W, Rakovac I, Whiting S, Breda J. Socioeconomic disparities in physical activity, sedentary behavior and sleep patterns among 6- to 9-year-old children from 24 countries in the WHO European region. Obes Rev 2021; 22 Suppl 6:e13209. [PMID: 34235843 DOI: 10.1111/obr.13209] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 12/30/2020] [Indexed: 12/22/2022]
Abstract
Physical activity, sedentary behavior, and sleep are important predictors of children's health. This paper aimed to investigate socioeconomic disparities in physical activity, sedentary behavior, and sleep across the WHO European region. This cross-sectional study used data on 124,700 children aged 6 to 9 years from 24 countries participating in the WHO European Childhood Obesity Surveillance Initiative between 2015 and 2017. Socioeconomic status (SES) was measured through parental education, parental employment status, and family perceived wealth. Overall, results showed different patterns in socioeconomic disparities in children's movement behaviors across countries. In general, high SES children were more likely to use motorized transportation. Low SES children were less likely to participate in sports clubs and more likely to have more than 2 h/day of screen time. Children with low parental education had a 2.24 [95% CI 1.94-2.58] times higher risk of practising sports for less than 2 h/week. In the pooled analysis, SES was not significantly related to active play. The relationship between SES and sleep varied by the SES indicator used. Importantly, results showed that low SES is not always associated with a higher prevalence of "less healthy" behaviors. There is a great diversity in SES patterns across countries which supports the need for country-specific, targeted public health interventions.
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Affiliation(s)
- Sanja Musić Milanović
- Croatian Institute of Public Health, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Marta Buoncristiano
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Helena Križan
- Croatian Institute of Public Health, Zagreb, Croatia
| | - Giulia Rathmes
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Julianne Williams
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Jolanda Hyska
- Nutrition and Food Safety Sector, Institute of Public Health, Tirana, Albania
| | - Vesselka Duleva
- Department Food and Nutrition, National Centre of Public Health and Analyses, Sofia, Bulgaria
| | - Hana Zamrazilová
- Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic
| | - Tatjana Hejgaard
- Health Promotion and Inequality, Danish Health Authority, Copenhagen, Denmark
| | | | - Benoît Salanave
- Department of Non-Communicable Diseases and Traumatisms, Santé publique France, the French Public Health Agency, Saint-Maurice, France.,Nutritional Surveillance and Epidemiology Team (ESEN), University Sorbonne Paris Nord, Bobigny, France
| | - Lela Shengelia
- Maternal, Child and Reproductive Health, National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Cecily C Kelleher
- College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland
| | - Angela Spinelli
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Paola Nardone
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Shynar Abdrakhmanova
- Department of Science and Professional Development, National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Almaty, Kazakhstan.,Kazakhstan School of Public Health, Kazakhstan's Medical University, Almaty, Kazakhstan
| | - Zhamilya Usupova
- Republican Center for Health Promotion and Mass Communication, Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan
| | - Iveta Pudule
- Department of Research and Health Statistics, Centre for Disease and Prevention Control, Riga, Latvia
| | - Ausra Petrauskiene
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Enisa Kujundžić
- Center for Health Ecology, Institute of Public Health, Podgorica, Montenegro
| | - Anna Fijałkowska
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
| | - Ana Isabel Rito
- WHO/Europe Collaborating Center for Nutrition and Childhood Obesity - Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Alexandra Cucu
- Faculty of Midwifery and Nursing, Discipline of Public Health and Health Management, University of Medicine and Pharmacy Carol Davila Bucharest, Bucharest, Romania.,National Centre of Health Promotion and Health Evaluation, National Institute of Public Health, Bucharest, Romania
| | - Lacramioara Aurelia Brinduse
- National Centre of Health Promotion and Health Evaluation, National Institute of Public Health, Bucharest, Romania.,Faculty of Medicine, Department of Public Health and Management, University of Medicine and Pharmacy Carol Davila Bucharest, Bucharest, Romania
| | - Valentina Peterkova
- Institute of Paediatric Endocrinology, National Medical Research Centre for Endocrinology of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | | | - Marta García-Solano
- Spanish Agency for Food Safety and Nutrition, Ministry of Consumer Affairs, Madrid, Spain
| | | | - Khadichamo Boymatova
- Division of Noncommunicable Diseases and Promoting Health through the Life-Course, WHO Country Office for Tajikistan, Dushanbe, Tajikistan
| | | | - Maya Tanrygulyyeva
- Scientific Research Institute of Maternal and Child Health, Ashgabat, Turkmenistan
| | - Marina Melkumova
- Institute of Child and Adolescent Health, Arabkir Medical Centre-Institute of Child and Adolescent Health, Yerevan, Armenia
| | - Daniel Weghuber
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - Eha Nurk
- Department of Nutrition Research, National Institute for Health Development, Tallinn, Estonia
| | - Päivi Mäki
- Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Ingunn Holden Bergh
- Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Sergej M Ostojic
- Biomedical Sciences Department, Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Kenisha Russell Jonsson
- Department of Living Conditions and Lifestyle, Public Health Agency of Sweden, Solna, Sweden
| | - Igor Spiroski
- Institute of Public Health, Skopje, North Macedonia.,Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, North Macedonia
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany.,Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Ivo Rakovac
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Stephen Whiting
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - João Breda
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
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