The associations of parenting factors with adolescent body mass index in an underserved population

Body mass index and potential correlates among elementary school children in Jordan

PURPOSE

Childhood obesity and overweight are on the rise worldwide, and Jordanian children are no exception to this rule. Childhood Obesity has major implications on the physical and mental health of individuals, and it can often develop into adult obesity. Obesity/overweight correlates have not been researched extensively in the Middle East region, where Jordan is central. This region is undergoing tremendous changes because of wars, globalization, and the influx of refugees. The cultural and eating habits of the people are changing along with demographical changes. Thus, timely research is required to assess the current health state of this dynamic society. The main goal of this study is to understand the environmental and cultural factors that are associated with Body Mass Index (BMI) z score in elementary school children in Jordan.

METHODS

A total of 1260 children enrolled in this descriptive, cross-sectional study. The study used a parental self-reporting questionnaire that contains possible factors associated with BMI, zBMI, demographics, and other pertinent information.

RESULTS

Several factors have been associated with higher zBMI among elementary school children: if a child owns a smartphone (p = 0.0037), uses electronics to play ([Formula: see text]), uses electronics for longer hours ([Formula: see text]), eats food while using electronics or watching TV ([Formula: see text] and [Formula: see text], respectively), sleeps less hours in weekends ([Formula: see text]), was breastfed for lower number of months ([Formula: see text]), lives in rural areas ([Formula: see text]), goes to a private school ([Formula: see text]) and is a male ([Formula: see text]).

CONCLUSION

Investigating characteristics and environmental determinants of childhood obesity play an essential role in establishing effective intervention program and reduce future risks of morbidity.

LEVEL OF EVIDENCE

Level V, descriptive (cross-sectional) study.

Family Legacy of Diabetes-Related Behaviors: An Exploration of the Experiences of African American Parents and Adult Children

African Americans are at higher risk of developing type 2 diabetes mellitus (T2DM), and this risk may be influenced by familial experiences and cultural norms throughout the life course. This led us to conduct this study of 20 African American families with strong histories of T2DM to explore familial complexities that prevent or help manage diabetic symptoms. Experiences were analyzed inductively through individual family profiles created using content-analytic summaries. When profiles were further analyzed for emerging and theoretically informed data patterns, two themes emerged: (a) family interactions characterized by T2DM-related actions and communication patterns, and (b) intergenerational patterns of openness characterized by variations in approach within generational cohort and parental gender. Through inquiries related to intergenerational experiences with T2DM, nursing and health care professionals may be better able to tailor and promote success for prevention and management of behaviors among high-risk African Americans.

Home Environment Factors and Health Behaviors of Low-income, Overweight, and Obese Youth

Objectives: Home environment may influence children's health behaviors associated with obesity. In this study, we examined home environment factors associated with diet and physical activity behaviors of overweight or obese youth. Methods: We analyzed baseline data from child and parent/caregiver dyads enrolled in an urban family weight management program. Multivariable logistic regression examined how home environment (parenting practices, family meal habits, and home availability of fruits/vegetables, sugar-sweetened beverages (SSBs), screen media, and physical activity resources) are related to children's intake of fruit, vegetables, and SSBs, and moderate-vigorous physical activity and sedentary time (ST) after adjusting for potential confounders. Results: Children were more likely to consume fruit if their families frequently ate meals together and infrequently watched TV during meals, and more likely to consume vegetables with high fruit/vegetable availability and low SSB availability. Children were more likely to engage in ST if parents practiced monitoring and frequently watched TV during meals. Conclusions: Overweight or obese children appear to have healthier habits if their families eat meals together without watching TV and if healthy food choices are available in the home. Encouraging parents to focus these practices may promote healthier body weight in children.

A descriptive study of biological and psychosocial factors associated with body mass index for age, in adolescents attending an outpatient department at Weskoppies Psychiatric Hospital

Objective

To describe biological and psychosocial factors associated with body mass index (BMI) for age in adolescents attending an outpatient department at Weskoppies Psychiatric Hospital.

Methods

A total of 50 adolescents participated in a convenience sampling research study. BMIs were calculated using their weights and heights to distinguish different weight categories based on the 2007 World Health Organization (WHO) growth charts. Based on their BMIs, participants were categorised as underweight, normal body weight, overweight and obese. The association between the BMIs of the biological parents and their adolescent children was investigated using the Fisher's exact test. The data collection included adolescents' demographic information, psychiatric diagnosis, psychiatric medication, nutritional intake, eating habits and the intensity of physical activity such as sports, leisure and sedentary behaviour.

Setting

The study was conducted at Weskoppies Psychiatric Hospital's adolescents outpatient department.

Results

Of the participants, 72% were males. Forty-eight per cent of all the adolescents had a normal BMI, mostly of black African descent. When comparing the adolescents' BMI with that of their biological mothers, 50% of those who were obese also had mothers who were mostly obese (53.8%). The Fisher's exact test indicated a statistically significant association between the BMI categories of mothers and those of their adolescent children (Fisher's exact test, p = 0.032). Despite the above association, no significant association could be found regarding their nutritional intake and eating habits. Also, no significant association was found between the adolescents' BMIs and the use of psychotropic medication, as compared with other previous studies. Furthermore, no association could be found between adolescents' BMI categories and the level of intensity of physical activity such as sports and leisure activities or sedentary behaviours.

Conclusion

This study supports previous findings that a significant association exists between maternal and childhood obesity. The association between BMI and psychotropic medication, nutritional intake and eating habits, and level of physical activity could not be confirmed in our study. The study results were limited by the small sample size and the convenience sampling method. Although this was only a descriptive study, it highlighted the complexity of biological and psychosocial factors involved in weight gain. Further studies are needed to explore the interplay of physical and environmental risk factors for childhood obesity, as well as to ensure early identification and education of patients and their families to prevent development of obesity.

Salient Features of a Proposed Adolescent Health Policy Draft for India

India is one of the most populous countries in the world. The adolescent population in India constitutes about one fifth of the total Indian population. Adolescent phase is a transitional phase in life and the adolescents are neither child nor adult at this stage and are full of energy, have significant drive and new ideas. The relatively lower death rate and relatively good health status of the adolescents has always been a misleading measure to adolescent health and thus given lesser priorities. In order to respond effectively to the needs of adolescent health and development, it is important to place adolescence in a life-span perspective within dynamic sociological, cultural and economic realities. For this, government of India has started a national programme known as "Rashtriya Kishor Swathya Karyakram" in 2014. However, India as a country does not have an adolescent health policy till date and hence the country requires a national adolescent health policy. The key priorities should include sexual and reproductive health, nutritional problems (both under and over nutrition), substance abuse, mental health, road traffic accidents, intentional violence and non-communicable diseases. In addition to key priorities, the policy draft should include pertinent components such as a preamble, guiding principles, coordinating agencies, monitoring and evaluation, research and documentation components.

Maternal Eating and Physical Activity Strategies and their Relation with Children's Nutritional Status

Objectives

to describe the maternal eating and physical activity strategies (monitoring, discipline, control, limits and reinforcement) [MEES]; to determine the relation between MEES and the child's nutritional status [body mass index (BMI) and body fat percentage (BFP)]; to verify whether the MEES differ according to the child's nutritional status.

Method

participants were 558 mothers and children (3 to 11 years of age) who studied at public schools. The Parental Strategies for Eating and Activity Scale (PEAS) was applied and the child's weight, height and BFP were measured. For analysis purposes, descriptive statistics were obtained, using multiple linear regression and the Kruskal-Wallis test.

Results

the highest mean score was found for reinforcement (62.72) and the lowest for control (50.07). Discipline, control and limits explained 12% of the BMI, while discipline and control explained 6% of the BFP. Greater control is found for obese children (χ²=38.36, p=0.001) and greater reinforcement for underweight children (χ²=7.19, p<0.05).

Conclusions

the mothers exert greater control (pressure to eat) over obese children and greater recognition (congratulating due to healthy eating) in underweight children. Modifications in parental strategies are recommended with a view to strengthening healthy eating and physical activity habits.

The Role of Parenting Practices in the Home Environment among Underserved Youth

BACKGROUND

The home environment, which includes parenting practices, is an important setting in which children develop their health behaviors. We examined the role of parenting practices in the home environment among underserved youth.

METHODS

We examined baseline data of a family-focused pediatric obesity intervention. Parenting practices (monitoring, discipline, limit setting of soda/snacks [SS] and screen media [SM], pressure to eat, and reinforcement) and availability of fruits/vegetables (FV) and sugar-sweetened beverages (SSBs), family meals, television (TV) watching during meals, TVs in the home, owning active video games/sports equipment, and household food security were assessed in 301 parent/caregivers of overweight/obese children (ages 7-12 years; BMI≥85th percentile). Associations were evaluated using Spearman's rank correlation coefficients and logistic regression models adjusted for potential confounders.

RESULTS

Parents/caregivers (ages 22-67 years) were largely Hispanic/Latino (74.1%), female (92.4%), and reported high levels of limit setting SS and low levels of pressure to eat. Parent age, gender, country of birth, and years living in the United States accounted for differences among several parenting practices. Adjusted logistic regression models identified several statistically significant associations, including: Monitoring was positively associated with availability FV (odds ratio [OR]=2.19; 95% confidence interval [CI], 1.25, 3.82); limit setting SS was inversely associated with availability of SSBs (OR=0.40; 95% CI, 0.21, 0.75); and limit setting SM was inversely associated with TV viewing during family meals (OR=0.51; 95% CI, 0.31, 0.85). Nearly 40% of our population was food insecure, and food insecurity was positively associated with pressure to eat (OR=1.77; 95% CI, 1.01, 3.15).

CONCLUSIONS

Parenting practices play an important role in the home environment, and longitudinal studies are needed to examine these associations in the context of family-focused pediatric obesity interventions.

Associations of social and environmental supports with sedentary behavior, light and moderate-to-vigorous physical activity in obese underserved adolescents

Background

Evidence to support differential health impacts of sedentary behavior (SB), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) is building. However, few studies have examined individual, social, and environmental supports across the full range of sedentary and physical activities, including key influences such as self-efficacy, parenting factors, and home and neighborhood resources. This may be particularly important in underserved (low-income, minority), overweight/obese adolescents due to the social and environmental challenges (lack of resources, etc.) associated with increasing MVPA. This study evaluated a range of bioecological factors including individual (self-efficacy), parental (parental support, monitoring, limit-setting, and nurturance), and environmental (perceived home resources for PA and neighborhood support for PA) predictors of SB, LPA and MVPA in overweight/obese adolescents.

Methods

Overweight/obese and predominantly minority adolescents and caregivers (n = 181) completed measures in 2010 in the US including surveys assessing self-efficacy for PA, parenting variables related to PA and home and neighborhood supports for PA. Outcomes included 7-day accelerometer estimates of SB, LPA, and MVPA.

Results

Regression analyses showed parental social support and neighborhood support were significantly associated with LPA. No significant associations were found for SB or MVPA.

Conclusions

Results emphasized the importance of examining a range of sedentary and PA intensities and highlighted the role of parental and neighborhood social supports for LPA. These results have important implications that suggest that health promotion efforts should target social and environmental supports for increasing LPA in youth who are overweight/obese.

Childhood obesity in America

PURPOSE OF REVIEW

To provide an overview of the current advances in childhood obesity physiology, intervention, and prevention.

RECENT FINDINGS

Structural and functional brain impairments are present in obese adolescents with metabolic syndrome (MetS). Aerobic training for 20 or 40 min per day produced similar affects on metabolic risk factors. Vitamin D supplementation has been shown to improve the metabolic risk factors in obese children; however, obese children require greater doses to treat vitamin D deficiency. A 10-week community-based exergaming weight management program significantly decreased the BMI in obese children.

SUMMARY

There is surmounting research on MetS and its associated risk factors in obese children. Gaining a comprehensive overview of the factors associated with obesity in children is crucial in developing the most effective intervention strategies. Community-based and family-centered interventions have generated positive results in reducing children's BMI and improving MetS risk factors. In addition to obesity intervention efforts, ongoing prevention initiatives are imperative to reduce the prevalence of childhood obesity.