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Fischer JAJ, Thomas J, van Zutphen‐Küffer KG, Ierodiakonou D, Kraemer K, Garcia‐Larsen V. PROTOCOL: Breakfast consumption, anthropometry, and nutrition-related outcomes in adolescents from low- and middle-income countries: Protocol for a systematic review and meta-analysis. CAMPBELL SYSTEMATIC REVIEWS 2024; 20:e1415. [PMID: 38808167 PMCID: PMC11131355 DOI: 10.1002/cl2.1415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 05/01/2024] [Accepted: 05/07/2024] [Indexed: 05/30/2024]
Abstract
Objectives This is the protocol for a Campbell systematic review. The objectives are as follows: The aim of this systematic review is to examine the scientific evidence available from low- and middle-income countries on the association of breakfast consumption habits and anthropometry/adiposity- and nutrition-related outcomes in adolescents aged 10-19 years old.
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Affiliation(s)
| | - Jonathan Thomas
- Sight and LifeBaselSwitzerland
- School of Medicine, Texas A&MBryanTexasUSA
| | | | - Despo Ierodiakonou
- Department of Primary Care and Population HealthUniversity of Nicosia Medical SchoolNicosiaCyprus
| | - Klaus Kraemer
- Sight and LifeBaselSwitzerland
- Program in Human Nutrition, Department of International HealthJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Vanessa Garcia‐Larsen
- Program in Human Nutrition, Department of International HealthJohns Hopkins UniversityBaltimoreMarylandUSA
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Sharma N, Sanjeevi RR, Balasubramanian K, Chahal A, Sharma A, Sidiq M. A Systematic Review on Prevalence of Overweight and Obesity among School Children and Adolescents in Indian Population. Indian J Endocrinol Metab 2024; 28:104-116. [PMID: 38911116 PMCID: PMC11189280 DOI: 10.4103/ijem.ijem_365_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 12/07/2023] [Accepted: 01/20/2024] [Indexed: 06/25/2024] Open
Abstract
Obesity has erupted as an epidemic around the world. It has set itself as a fast wave among other prevailing specific clusters of non-communicable diseases. The current study reviews and presents an updated meaningful review of the vast research work performed at schools located in different cities of India. A systematic search was conducted in PubMed, Scopus, Google Scholar and PEDro. Studies representing data on obesity and overweight among children in Indian cities were included in the review. A total of 21 articles with 71,466 participants were included in the review for analysis. Obesity developed in childhood and adolescence is greatly associated with heart disease, stroke and cancer (breast and ovarian in women and prostate in men) in the late stage of life. In India, despite being a country with a faster rate of population becoming overweight and obese in urban areas, in contrast, rural areas are still struggling with malnutrition.
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Affiliation(s)
- Nidhi Sharma
- Uttaranchal College of Health Sciences, Uttaranchal University, Prem Nagar, Dehradun, India
| | - Ramya Ramasamy Sanjeevi
- Physical Therapy Department, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Karthick Balasubramanian
- Physical Therapy Department, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Aksh Chahal
- Department of Physiotherapy, School of Medical and Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Abhishek Sharma
- Department of Physiotherapy, Arogyam Institute of Paramedical and Allied Sciences (Affiliated to H.N.B. Uttarakhand Medical Education University) Roorkee, Uttarakhand, India
| | - Mohammad Sidiq
- Department of Physiotherapy, School of Medical and Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
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Rawal T, Muris JWM, Mishra VK, Arora M, Tandon N, van Schayck OCP. Effect of an educational intervention on diet and physical activity among school-aged adolescents in Delhi -The i-PROMISe (PROMoting health literacy in Schools) Plus Study. DIALOGUES IN HEALTH 2023; 2:100123. [PMID: 36919028 PMCID: PMC9991929 DOI: 10.1016/j.dialog.2023.100123] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 01/21/2023] [Accepted: 03/05/2023] [Indexed: 03/11/2023]
Abstract
Purpose Emerging lifestyle changes due to rapid urbanization have led to an epidemiological transition and the rising prevalence of obesity is responsible for major non-communicable diseases (NCDs) which have further aggravated due to the COVID-19 pandemic. This study aims to assess the effectiveness of a comprehensive school-based intervention on diet and physical activity-related behavior of adolescents. Methods In 2019, a cluster-randomized controlled trial was conducted in randomly selected (n = 8) private schools. A 2-year intervention program was implemented over consecutive academic years (2019-2020 and 2020-2021) with students who were in the 6th and 7th grades when the study began. Four schools were randomly assigned to the intervention (n = 794) and four schools to the control group (n = 774). Results The difference in changes in diet and physical-activity-related behaviors of the students between the intervention and control schools were not significant in the intention to treat analysis probably due to the large drop-out due to COVID-19 measures: 304 students were available for follow-up in the intervention group and 122 in the control group (391 cases were excluded to make data comparable with baseline survey). The intake of vegetables (once a day) [β = 0.35, OR = 1.42, 95% CI (1.03, 1.95)] in the per-protocol analysis has increased among adolescents in the intervention group as compared to the control group. Conclusion The findings of this study indicated a positive effect of the intervention on diet and physical-activity-related changes in the expected direction and highlights the importance of addressing such behavior to prevent obesity among adolescents and thus NCDs in the later stage of life.
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Affiliation(s)
- Tina Rawal
- Health Promotion Division, Public Health Foundation of India, Gurgaon, India.,Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Jean W M Muris
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Vijay Kumar Mishra
- Health Promotion Division, Public Health Foundation of India, Gurgaon, India
| | - Monika Arora
- Health Promotion Division, Public Health Foundation of India, Gurgaon, India
| | - Nikhil Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Onno C P van Schayck
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
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Lu YS, Wu YR, Cheng YR, Chang CH, Jan CF. Ten years' trend analysis for Taiwanese youth high school students' health behaviors. J Formos Med Assoc 2023; 122:1077-1086. [PMID: 37095019 DOI: 10.1016/j.jfma.2023.04.010] [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: 08/19/2022] [Revised: 03/27/2023] [Accepted: 04/11/2023] [Indexed: 04/26/2023] Open
Abstract
PURPOSE To delineate the 10 years' trend regarding Taiwanese adolescents' health perspectives and compare the differences of six adolescent health aspects between Taiwan and the U.S. METHODS The anonymous structured questionnaire was done every other year with representative sampling methods as Youth Risk Behavior Surveillance System in the United States. Twenty-one questions from six health aspects were extracted for further analysis. Multivariate regression analysis was performed to delineate the relationship among protective factors and risk-taking behaviors, respectively. RESULTS Overall, 22,419 adolescents were recruited. There were decreasing trend in terms of risk-taking behaviors, such as early contact to pornography (< age 16) (70.6%-60.9%), early cigarette use (< age 13) (20.7%-14.0%), and seriously considering suicide (36.0%-17.8%). There was an increasing trend in behaviors harmful to health: current alcohol drinkers (18.9%-23.4%), and staying up late every day (15.2%-18.5%). Multivariate regression analysis after adjusting gender and grade; it disclosed an increasing trend in protective assets, such as having multiple intimate friends (75.8%-79.3%), satisfaction to body weight and body shape (31.5%-36.1% and 34.5%-40.7%), as well as always wearing a helmet while riding a bike (1.8%-3.0%). CONCLUSION We should continuously monitor the health status trend of the adolescents to provide them with a healthier environment and well-being.
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Affiliation(s)
- Yu-Sheng Lu
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Rui Wu
- Department of Family Medicine, Taitung Christian Hospital, Taitung, Taiwan
| | - Yih-Ru Cheng
- Clinical Psychology Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Chin-Hao Chang
- Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan
| | - Chyi-Feng Jan
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan; College of Medicine, National Taiwan University, Taipei, Taiwan.
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Kokkou S, Notara V, Kanellopoulou A, Antonogeorgos G, Rojas-Gil AP, Kornilaki EN, Lagiou A, Panagiotakos D. The Association between Breakfast Macronutrient Composition and Body Weight, in Preadolescence: An Epidemiological Study among Schoolchildren. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121960. [PMID: 36553403 PMCID: PMC9777345 DOI: 10.3390/children9121960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/08/2022] [Accepted: 12/10/2022] [Indexed: 12/15/2022]
Abstract
Over the last few decades, childhood overweight and obesity tend to reach epidemic proportions. The present study aimed to examine whether the composition of breakfast, through the prism of its macronutrient content, could play a part in the development of excess body weight in children. A sample of 1728 Greek students from 47 primary schools was enrolled for the purposes of this study. Their weight and height were measured and their Body Mass Index was calculated and classified according to the International Obesity Task Force criteria. Their dietary habits, breakfast foods of choice, and physical activity were assessed through the use of a self-completed questionnaire. Further assessment of breakfast composition was carried out in order to evaluate its macronutrient content. Initial analysis, which was only energy-adjusted, showed a negative association between body weight and breakfast protein content and a positive association for lipid content. After further adjustment for age, sex, level of adherence to the Mediterranean diet, and physical activity, there was a significant negative association between breakfast protein and excess body weight in children (p = 0.029), as well as a significant positive association of breakfast lipid content (p = 0.028). Breakfast macronutrient content seems to have an effect on body composition in children, independently of overall adherence to the Mediterranean diet and physical activity, however further research is needed in order to elucidate potential pathways.
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Affiliation(s)
- Stamatia Kokkou
- Department of Public and Community Health, Laboratory of Hygiene and Epidemiology, School of Public Health, University of West Attica, Alexandras Avenue 196, 115 21 Athens, Greece
| | - Venetia Notara
- Department of Public and Community Health, Laboratory of Hygiene and Epidemiology, School of Public Health, University of West Attica, Alexandras Avenue 196, 115 21 Athens, Greece
| | - Aikaterini Kanellopoulou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Thiseos 70, 176 76 Athens, Greece
| | - George Antonogeorgos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Thiseos 70, 176 76 Athens, Greece
| | - Andrea Paola Rojas-Gil
- Department of Nursing, Faculty of Health Sciences, University of Peloponnese, Karaiskaki 70, 221 00 Tripoli, Greece
| | - Ekaterina N. Kornilaki
- Department of Preschool Education, School of Education, University of Crete, 741 00 Gallos, Greece
| | - Areti Lagiou
- Department of Public and Community Health, Laboratory of Hygiene and Epidemiology, School of Public Health, University of West Attica, Alexandras Avenue 196, 115 21 Athens, Greece
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Thiseos 70, 176 76 Athens, Greece
- Correspondence: ; Tel.: +30-2109549332
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Xu Y, Bi X, Gao T, Yang T, Xu P, Gan Q, Xu J, Cao W, Wang H, Pan H, Ren Z, Yin C, Zhang Q. Effect of School-Based Nutrition and Health Education for Rural Chinese Children. Nutrients 2022; 14:nu14193997. [PMID: 36235650 PMCID: PMC9573275 DOI: 10.3390/nu14193997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/20/2022] [Accepted: 09/22/2022] [Indexed: 11/23/2022] Open
Abstract
The nutritional status of rural Chinese children has improved in recent years, but their nutritional knowledge is still relatively lacking. School-based nutrition and health education was conducted for children in three counties of China from 2018 to 2020. The students in the intervention schools were given two-year nutrition and health education courses, while the control schools did not receive any intervention. Students’ nutrition knowledge, dietary intake, and dietary behaviors were collected using a questionnaire, and height and weight were measured uniformly. The nutrition knowledge score in the intervention group was increased by 1.01 and 0.64 points in the first and second years. A multilevel model was used to evaluate the intervention effects. Statistically significant interactions between groups and time were observed in nutrition knowledge, the frequency of eating breakfast, and dietary intake, including meat, eggs, milk, and vegetables (p < 0.05), but not in nutritional status. Therefore, the supplementation of school-based nutrition and health education had a positive impact on the nutrition knowledge and dietary intake of rural Chinese children.
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Affiliation(s)
- Ying Xu
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Xiaoyi Bi
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
- Beijing Tongzhou District Center for Disease Control and Prevention, Beijing 101199, China
| | - Tingting Gao
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
- Beijing Shunyi District Center for Disease Control and Prevention, Beijing 101300, China
| | - Titi Yang
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Peipei Xu
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Qian Gan
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Juan Xu
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Wei Cao
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Hongliang Wang
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Hui Pan
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Zhibin Ren
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Chunjie Yin
- School of Public Health, Xinjiang Medical University, Urumqi 830017, China
| | - Qian Zhang
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
- Correspondence: ; Tel.: +86-10-6623-7133
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Socio-economic, demographic, and familial correlates of physical activity and dietary practices among adolescent boys in Bihar, India. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-022-01756-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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Gupta MK, Mingwal M, Mantri N, Goel AD, Bhardwaj P, Singh K. Why The Knowledge of Indian School-Going Adolescents Regarding NCDs is Not Transforming into Lifestyle Changes? Niger Med J 2022; 63:326-335. [PMID: 38863467 PMCID: PMC11163254 DOI: 10.60787/nmj-63-4-129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024] Open
Abstract
Background There is a paucity of research to demonstrate the quantification of adolescents' risk behavior toward Non-Communicable Diseases (NCD) in India. This study aims to explain the knowledge of school-aged adolescents about NCD and whether their knowledge is truly translating into lifestyle changes and if not, what are the potential underlying factors responsible for that. Methodology A school-based cross-sectional study was conducted on adolescents in Jodhpur district, India, in grades 6 to 12. The data was gathered via a semi-structured questionnaire. The participant's weight and height were assessed using a digital weighing machine and a stadiometer, respectively. SPSS v.23 was used to analyze the data. Univariate (chi-square) and multivariate (logistic regression) analysis were used to quantify knowledge and risk factors, and inferences were derived. Results A total of 1010 students participated in the study. The mean scores of knowledge and risk behavior were 32.82±6.43 (out of 40) and 9.23+2.63 (out of 30), respectively. Adolescent risk behavior and knowledge were not found to be significantly related. Physical activity, spending fewer hours sitting, not skipping breakfast, and habit of fruit and vegetable consumption were significant factors for a healthy lifestyle among them. Conclusion Due to differences in underlying predictors, adolescents' understanding of NCDs did not translate into healthy lifestyle modifications. These findings highlight the importance of developing tailored interventions for adolescents that target identified risk domains.
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Affiliation(s)
- Manoj Kumar Gupta
- Department of Community Medicine & Family Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
- School of Public Health, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
| | - Mrinalini Mingwal
- School of Public Health, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
| | - Neha Mantri
- School of Public Health, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
| | - Akhil Dhanesh Goel
- Department of Community Medicine & Family Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
| | - Pankaj Bhardwaj
- Department of Community Medicine & Family Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
- School of Public Health, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
| | - Kuldeep Singh
- Department of Paediatrics, All India Institute of Medical Sciences (AIIMS) Jodhpur, India
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S.V M, Nitin K, Sambit D, Nishant R, Sanjay K. ESI Clinical Practice Guidelines for the Evaluation and Management of Obesity In India. Indian J Endocrinol Metab 2022; 26:295-318. [PMID: 36185955 PMCID: PMC9519829 DOI: 10.4103/2230-8210.356236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Madhu S.V
- Department of Endocrinology, Centre for Diabetes, Endocrinology and Metabolism, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India
| | - Kapoor Nitin
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India
| | - Das Sambit
- Department of Endocrinology, Hi Tech Medical College and Hospital, Bhubaneshwar, Odisha, India
| | - Raizada Nishant
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India
| | - Kalra Sanjay
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India
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Patterns and Associations of Physical Activity, Screen Time, Sleep, and Dietary Habits among Saudi Females Participating in Fitness Centers. Healthcare (Basel) 2022; 10:healthcare10060958. [PMID: 35742017 PMCID: PMC9222570 DOI: 10.3390/healthcare10060958] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/15/2022] [Accepted: 05/16/2022] [Indexed: 12/30/2022] Open
Abstract
This study was designed to investigate the level and associations of physical activity, sedentary behavior, sleep, and dietary habits among Saudi women attending fitness centers in Riyadh. A descriptive cross-sectional study was carried out from 12 fitness centers in Riyadh, Saudi Arabia. A total of 460 participants answered a two-part survey self-administered questionnaire, which included information about the demographic characteristics and lifestyle. The analysis found significant differences between the two groups in terms of age, weight, BMI, and combined prevalence of being overweight and obese. Compared with less active females, high active females showed significantly more favorable dietary habits (p < 0.05). Significantly higher values were observed for the total physical activity energy expenditure in METs-min/week (p = 0.028). Moreover, females with high screen time (>3 h per day) were younger, less active, slept longer, and had higher intakes of fast foods and chocolates/candy intake (p = 0.001). Overall, the participants were highly active, exceeding the recommended physical activity needed to enhance health. The analysis also showed sufficient sleep duration (>7 h/night) was significantly associated with the diet and nutrition of the participants. Health education programs are needed to reduce the risks of sedentary behavior, sleep problems, and dietary habits.
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Trends in Obesity and Obesity-Related Risk Factors among Adolescents in Korea from 2009 to 2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095672. [PMID: 35565066 PMCID: PMC9103843 DOI: 10.3390/ijerph19095672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/28/2022] [Accepted: 05/05/2022] [Indexed: 02/04/2023]
Abstract
This study was conducted to identify the trends in obesity prevalence among adolescents and changes in the risk factors related to obesity. The study analyzed secondary data obtained from Korean Youth Risk Behavior Web-based Surveys conducted from 2009 to 2019. The Korean Youth Risk Behavior Web-based Survey is an annual survey of a nationwide representative sample of enrolled students aged 13–18 years in middle and high schools in Korea. Linear and trend analyses showed that the prevalence of obesity increased by 0.47% on average annually; this increase was statistically significant. Healthy food intake decreased significantly, but the prevalence of unhealthy food intake and the prevalence of skipping breakfast increased significantly. Vigorous-intensity physical activity, physical activity for over 60 min a day, and muscle-strengthening exercise for more than 3 days a week increased significantly, but so did the adolescents’ sedentary time. Therefore, health care providers and public policymakers need to actively manage adolescent obesity, which has been continuously increasing since 2009. In addition, long-term trends in obesity-related risk factors such as physical activity and dietary behaviors need to be considered in the development of obesity management strategies.
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Rawal T, van Schayck OC, Willeboordse M, Arora M, Bhaumik S, Bhagra A, Bhagra S, Muris JW, Tandon N. How to promote a healthy lifestyle among schoolchildren: Development of an intervention module (i-PROMISe). PUBLIC HEALTH IN PRACTICE 2022; 3:100262. [PMID: 36101760 PMCID: PMC9461553 DOI: 10.1016/j.puhip.2022.100262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 04/02/2022] [Accepted: 04/22/2022] [Indexed: 11/30/2022] Open
Abstract
Objective Lifestyle preferences are inculcated in childhood and once established, persist into adulthood. The Project PROMoting Health LIteracy in School (i-PROMISe) aims to promote a healthy lifestyle among students for the universal prevention of non-communicable diseases (NCDs) like diabetes. Study design Qualitative study using focus-group-discussions (FGDs) and In-Depth Interviews (IDI). Method Project was undertaken in two-phases in two private schools in New Delhi, India. In phase-one, FGDs with students (grades IV to VIII) and IDIs with teachers were conducted to ascertain their perceptions of diabetes prevention and management according to the Health Belief Model. The data was analyzed using a thematic framework method. In phase-two, the resources were pre-tested and participants’ feedback was requested on the duration, quality, and understanding of the resources. Results In total, 89 students and 17 teachers participated in phase-one (n = 54 [in FGDs] and n = 5 [in IDIs]) and phase-two (n = 35 students and n = 12 teachers in FGDs). In phase-one, themes that emerged included: diabetes was considered a disease of the elderly; misconceptions about susceptibility to these diseases were common; children were largely aware of measures to prevent these diseases, but barriers to adopting a healthy lifestyle existed. Based on the findings, a comprehensive module was developed, which consisted of a teacher's manual with interactive activities and short films. The resources (teacher's manual and short films) were well received and contributed to a better understanding of diabetes and other NCDs; myths/misconceptions were clarified. Conclusion Development of resources using participatory approach can be effective in promoting and reinforcing healthy behaviours among school going children to prevent and control NCDs in schools.
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Affiliation(s)
- Tina Rawal
- Health Promotion Division, Public Health Foundation of India, Gurgaon, India
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
- Corresponding author. Health Promotion Division, Public Health Foundation of India (PHFI), Plot No. 47, Sector 44, Gurgaon (Haryana) 122002, India.
| | - Onno C.P. van Schayck
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Maartje Willeboordse
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Monika Arora
- Health Promotion Division, Public Health Foundation of India, Gurgaon, India
| | - Soumyadeep Bhaumik
- Health Promotion Division, Public Health Foundation of India, Gurgaon, India
| | - Anjali Bhagra
- Mayo Clinic, Mayo Clinic, World India Diabetes Foundation, Rochester, United States
| | - Sumit Bhagra
- Mayo Clinic, Mayo Clinic, World India Diabetes Foundation, Rochester, United States
| | - Jean W.M. Muris
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Nikhil Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
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Apperley LJ, Blackburn J, Erlandson-Parry K, Gait L, Laing P, Senniappan S. Childhood obesity: A review of current and future management options. Clin Endocrinol (Oxf) 2022; 96:288-301. [PMID: 34750858 DOI: 10.1111/cen.14625] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 02/02/2023]
Abstract
Obesity is becoming increasingly prevalent in paediatric populations worldwide. In addition to increasing prevalence, the severity of obesity is also continuing to rise. Taken together, these findings demonstrate a worrying trend and highlight one of the most significant challenges to public health. Childhood obesity affects multiple organs in the body and is associated with both significant morbidity and ultimately premature mortality. The prevalence of complications associated with obesity, including dyslipidaemia, hypertension, fatty liver disease and psychosocial complications are becoming increasingly prevalent within the paediatric populations. Treatment guidelines currently focus on intervention with lifestyle and behavioural modifications, with pharmacotherapy and surgery reserved for patients who are refractory to such treatment. Research into adult obesity has established pharmacological novel therapies, which have been approved and established in clinical practice; however, the research and implementation of such therapies in paediatric populations have been lagging behind. Despite the relative lack of widespread research in comparison to the adult population, newer therapies are being trialled, which should allow a greater availability of treatment options for childhood obesity in the future. This review summarizes the current evidence for the management of obesity in terms of medical and surgical options. Both future therapeutic agents and those which cause weight loss but have an alternative indication are also included and discussed as part of the review. The review summarizes the most recent research for each intervention and demonstrates the potential efficacy and limitations of each treatment option.
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Affiliation(s)
- Louise J Apperley
- Department of Paediatric Endocrinology, Alder Hey Children's Hospital, Liverpool, UK
| | - James Blackburn
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University of London, London, UK
| | | | - Lucy Gait
- Department of Paediatric Clinical Psychology, Alder Hey Children's Hospital, Liverpool, UK
| | - Peter Laing
- Department of Paediatric Endocrinology, Alder Hey Children's Hospital, Liverpool, UK
| | - Senthil Senniappan
- Department of Paediatric Endocrinology, Alder Hey Children's Hospital, Liverpool, UK
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Liu BP, Fang HJ, Jia CX. The Serial Mediation of the Association between Breakfast Skipping and Suicidality by Weight Status and Depressive Symptoms: Findings from the National Youth Risk Behavior Surveys of the United States. Nutrients 2022; 14:nu14050956. [PMID: 35267931 PMCID: PMC8912887 DOI: 10.3390/nu14050956] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 02/13/2022] [Accepted: 02/22/2022] [Indexed: 02/05/2023] Open
Abstract
Background: The evidence is limited for the dose–response association between breakfast skipping and suicidality. The underlying pathway from breakfast skipping to suicidality has also rarely been explored in previous studies. Methods: The data of Youth Risk Behavior Surveys (YRBSs) of the United States from 2011 to 2019 were used with a sample size of 74,074. The male: female ratio was nearly 1:1. Binary logistic regression models with complex sampling design were adopted to show the effect of breakfast skipping on weight status, depressive symptoms, and suicidality. Serial mediation was used to explore the association between breakfast skipping and suicidality by overweight/obesity and depressive symptoms. Findings: The weighted prevalence rates (95% confidence interval) of suicidal ideation, suicide plan, suicide attempt, and medically serious suicide attempt for skipping breakfast totally (0 times/week) were 25.6% (24.4–26.8%), 21.7% (20.5–22.9%), 14.2% (13.0–15.3%), and 5.3% (4.6–5.9%). Breakfast skipping was significantly associated with increased risk of suicidal ideation, suicide plan, suicide attempt, and medically serious suicide attempt. There was statistical significance for the linear dose–response association between breakfast skipping and overweight/obesity, depressive symptoms, and suicidality regardless of sex and age. A serial mediation with effect sizes between 39.68% and 51.30% for the association between breakfast skipping and suicidality by overweight/obesity and depressive symptoms was found in this study. Conclusions: This study emphasizes the hazards of breakfast skipping, which could increase the risk of suicidality among adolescents. Overweight/obesity and depressive symptoms as the mediating factors for the association between breakfast skipping and suicidality should also be with more attention.
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Affiliation(s)
- Bao-Peng Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China;
- Center for Suicide Prevention and Research, Shandong University, Jinan 250012, China
| | - Hui-Juan Fang
- Department of Pediatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China;
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China;
- Center for Suicide Prevention and Research, Shandong University, Jinan 250012, China
- Correspondence:
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Olatona FA, Oloruntola OO, Adeniyi OF, Amu EO. Association Between Breakfast Consumption and Anthropometrically Determined Nutritional Status of Secondary-School Adolescents in Lagos, Southwest Nigeria. Int J MCH AIDS 2022; 11:e503. [PMID: 35601681 PMCID: PMC9083379 DOI: 10.21106/ijma.503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Breakfast skipping has been associated with obesity among adolescents in some studies but little is known about the relationship between breakfast consumption and obesity among secondary-school adolescents in Nigeria. This study contributes to the empirical literature by analyzing the relationship between breakfast consumption and anthropometrically determined nutritional status of secondary-school adolescents in Lagos, Nigeria. METHODS This was a descriptive cross-sectional study in which multi-stage sampling was used to select 397 secondary-school adolescents (10 to 19 years, mean = 13.8 ± 1.7 years). They were classified into student groups from public or private schools in Lagos. Data were collected using a semi-structured self-administered questionnaire and analyzed using Epi-info version 7. The independent variables were the proportion of adolescents who had a high level of knowledge about breakfast consumption, while the outcome variable was the proportion of adolescents who were overweight or obese. World Health Organization (WHO) AnthroPlus software was used to determine the nutritional status of adolescents. Mean and standard deviations were computed for continuous variables, and frequency tables were generated for categorical variables. Significant associations between variables were obtained using Chi-square with the level of significance set at p < 0.05. RESULTS Only 17% of the adolescents had good knowledge of breakfast consumption. More than half (57.4%) of the participants ate a daily breakfast. The percentage of adolescents who skipped breakfast was higher among older 16-19 years (52.2%) and middle 13-15 years (43%) than the younger adolescents (34.7%). Girls skipped breakfast more than boys. Most respondents were in the normal Body Mass Index (BMI) ranges for their genders. Prevalence of overweight and obesity were 7.1% and 3.3% among males and 7.1% and 2.8% among females respectively. The mean BMI of those who skipped breakfast (19.33 ± 3.27kg/m2) was significantly higher than the BMI of those who ate breakfast (18.56 ± 3.05 kg/m2) (p=0.019). Most of the adolescents who ate a daily breakfast had mothers who had completed only primary school education although the relationship was not statistically significant (χ2 =5, p=0.172). CONCLUSION AND GLOBAL HEALTH IMPLICATIONS Breakfast knowledge was low, while breakfast consumption was average. Adolescents who skipped breakfast had a significantly higher BMI (19.33 ± 3.27kg/m2) than those who ate breakfast (18.56 ± 3.05 kg/m2) (p=0.019). Nutrition education that emphasizes the importance of breakfast consumption with the purpose of behavioral change should be intensified among adolescents.
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Affiliation(s)
- Foluke A Olatona
- Department of Community Health and Primary Care, College of Medicine of the University of Lagos, Lagos, Nigeria
| | - Oyetola O Oloruntola
- Department of Community Health and Primary Care, College of Medicine of the University of Lagos, Lagos, Nigeria
| | - Oluwafunmilayo F Adeniyi
- Department of Pediatrics, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - Eyitope O Amu
- Department of Community Medicine. Ekiti State University. Ado-Ekiti, Nigeria
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Maravalhas RDA, Santana DD, Salles-Costa R, Veiga GVD. Mudanças na frequência do consumo de refeições em adolescentes residentes em área de vulnerabilidade social da região metropolitana do Rio de Janeiro, Brasil. CIENCIA & SAUDE COLETIVA 2022; 27:387-398. [DOI: 10.1590/1413-81232022271.28092020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 11/20/2020] [Indexed: 11/22/2022] Open
Abstract
Resumo O objetivo deste estudo foi descrever as mudanças na frequência do consumo de refeições de adolescentes residentes na região metropolitana do Rio de Janeiro, em período de 5 anos. Utilizaram-se dados de dois estudos transversais, de base populacional, que foram realizados por meio de visitas domiciliares. Em 2005, a amostra final foi de 1089 domicílios com 511 adolescentes (de 12 a 18 anos), e em 2010 de 1121 domicílios com 314 adolescentes. A frequência do consumo de refeições foi obtida por meio de questionário autopreenchido e a avaliação da adequação de peso dos adolescentes foi realizada com base nos pontos de corte do IMC por sexo e faixa etária. Houve aumento da substituição diária do almoço tradicional por lanche (3,7% para 13,7%) e no consumo do jantar tradicional (62,9% para 72,0%). Os adolescentes com sobrepeso consumiram o desjejum com menor frequência do que aqueles sem sobrepeso (2005: 68,3% vs 79,3% p=0,02, 2010: 59,5% vs 77,4% p=0,03). Conclui-se que houve aumento da substituição diária do almoço tradicional por lanche e no consumo do jantar tradicional no período de 5 anos. Ademais, a prática do desjejum diário se associou com a classificação de IMC nos dois momentos do estudo, de modo que aqueles com sobrepeso consomem o desjejum com menor frequência.
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Sagbo H, Kpodji P, Bakai TA, Khanafer N. OUP accepted manuscript. Int Health 2022; 15:265-273. [PMID: 35488369 PMCID: PMC10153559 DOI: 10.1093/inthealth/ihac018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/04/2022] [Accepted: 04/19/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND There is little information regarding fruit and vegetable (FV) intake and physical activity (PA) among schoolchildren in Benin. In this study we evaluated the differences in breakfast eating, FV consumption and PA according to socio-economic (SE) determinants in primary schoolchildren. METHODS A cross-sectional study using a probabilistic sample of 612 students (8-17 y of age) from 26 primary schools was done between December 2018 and January 2019. The association was estimated by logistic regression analyses. RESULTS Of all students, 53% were physically inactive, 60% took breakfast <5 d/week, 84% irregularly ate fruits and 68% irregularly ate vegetables. Younger students (8-10 y) take breakfast regularly and older ones (>15 y) were physically more active. The probability of regular breakfast and fruit consumption were significantly higher in children of educated parents (p<0.01 and p<0.001, respectively) compared with children of non-educated parents. Medium SE status was associated with regular breakfast intake, whereas high SE status was associated with higher fruit intake and lower physical activity compared with low SE status (p<0.001). There was no association between breakfast eating, FV intake, PA and the body mass index. CONCLUSIONS Findings emphasize the need for interventions to promote healthy eating behaviours in primary schoolchildren and their family environments.
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Affiliation(s)
- Herbert Sagbo
- Faculty of Medicine, Federal University of Minas Gerais, Av. Prof. Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte - MG 30130100, Brazil
| | | | - Tchaa Abalo Bakai
- Centre Africain Recherche en Épidémiologie et en Santé Publique, 89 rue des Sarrasins, B.P. 4089, Lomé, Togo
| | - Nagham Khanafer
- Department of Hygiene, Epidemiology, and Prevention, Edouard Herriot Hospital, Hospices Civils de Lyon, Place d'Arsonval, 69437 Lyon, France
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Kang E, Kim S, Yun YH. Comparison of eating habits and inappropriate weight control efforts of secondary school students enrolled in a weight control program. Nutr Res Pract 2021; 15:628-638. [PMID: 34603610 PMCID: PMC8446692 DOI: 10.4162/nrp.2021.15.5.628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/22/2020] [Accepted: 12/18/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND/OBJECTIVES Numerous school-based weight control programs have been initiated for weight loss among adolescents. However, the relationship between these programs and inappropriate weight control efforts, dietary habits and behavior of students, have not been investigated sufficiently. This study was undertaken to investigate the association between body mass index (BMI) of adolescents, and their health status and inappropriate weight-control efforts. We further examined the relationship between attendance to school-based weight-control programs and attempting inappropriate weight-control efforts, dietary habits, and behavior. SUBJECTS/METHODS A survey of 1,742 students was conducted in Korea. Logistic regression was used to assess differences in the health status (grouped by BMI and improper weight control) and dietary habits, based on attendance to the weight-control programs. RESULTS Obese students were significantly more dissatisfied with physical, mental and spiritual health. Students who attended weight-control programs were likely to be underweight (P < 0.001), whereas those who did not attend weight-control programs were likely to attempt weight control improperly (P < 0.001). Students who participated in the program also had relatively healthy dietary habits (P < 0.001-0.027), and students who did not attend had comparatively unhealthy dietary habits (P < 0.001-0.008). Students who attended weight-control programs were likely to be underweight (P < 0.001) with relatively healthy dietary habits (P < 0.001-0.027), whereas students who did not attend the programs were likely to attempt weight control improperly (P < 0.001) and had comparatively unhealthy dietary habits (P < 0.001-0.008). CONCLUSIONS Attending school-based weight-control programs was significantly associated with not attempting inappropriate weight-control efforts, as well as following healthy dietary habits. Our data indicates that offering school-based weight-control programs is valuable to student health, and is anticipated to reducing the public health burden.
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Affiliation(s)
- EunKyo Kang
- Public Healthcare Center, Seoul National University Hospital, Seoul 03080, Korea
- Department of Family Medicine, Seoul National University Hospital, Seoul 03080, Korea
| | - Soojeong Kim
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Young Ho Yun
- Department of Family Medicine, Seoul National University Hospital, Seoul 03080, Korea
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul 03080, Korea
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Prevalence of Excessive Weight and Underweight and Its Associated Knowledge and Lifestyle Behaviors among Urban Private School-Going Adolescents in New Delhi. Nutrients 2021; 13:nu13093296. [PMID: 34579174 PMCID: PMC8472350 DOI: 10.3390/nu13093296] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/03/2021] [Accepted: 09/14/2021] [Indexed: 11/25/2022] Open
Abstract
With rapid urbanization and the Indian nutrition transition, Indian adolescents face a high risk of developing an energy imbalance. This study aims to assess the prevalence of excessive weight, underweight, and associated knowledge and lifestyle behaviors among private school-going adolescents in Delhi. A cross-sectional study was conducted in students (6th–7th grades) of eight randomly selected private schools in Delhi, India in 2019. A self-administered survey was used to assess students’ dietary-and-physical-activity-related knowledge and behavior. Anthropometric measurements (height, weight, and waist circumference) were also conducted. Out of 1567 participants, 7.2% were underweight, 61.3% normal, and 31.5% excess in weight. Underweight was associated with significantly more eating whilst studying for exams (relative risk ratio (RRR) 1.7 (1.0–2.9)). Excessive weight was associated with less incorrect knowledge on behaviors causing overweight (RRR 0.7 (0.5–0.9)), more often reading nutritional labels of packed food items (RRR 0.6 (0.4–0.9)), and less frequent vegetable-intake (RRR 0.7 (0.4–0.9)). Underweight students showed more suboptimal knowledge and unhealthy behaviors, whilst students with excessive weight showed more correct knowledge and healthy behaviors. This study highlights the immediate need for effective health-promoting interventions focused on the importance of healthy lifestyle at least in underweight adolescents.
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Dietary Behavior of Adolescents in the Qassim Region, Saudi Arabia: A Comparison between Cities with and without the Healthy Cities Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189508. [PMID: 34574431 PMCID: PMC8465802 DOI: 10.3390/ijerph18189508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/02/2021] [Accepted: 09/05/2021] [Indexed: 11/17/2022]
Abstract
This study reports dietary behaviors of adolescents in the Qassim region, Saudi Arabia, and comparison of these behaviors between cities with and without the Healthy Cities Program (HCP). We surveyed 1133 school-attending adolescents aged 15–19, using a multi-staged cluster sampling with probability proportionate to size. Prevalence of daily breakfast consumption was 27.7% among the adolescents. Prevalence of daily vegetables, fruits and milk or milk products consumption was 35.9%, 28.6% and 51.1%, respectively. Meanwhile, the prevalence of daily consumption of fast-food and carbonated drinks was 7.5% and 37.1%, respectively. There was no significant association between living in the healthy cities and daily intake of breakfast (OR: 1.15, 95% CI: 0.87–1.53), fruits (OR: 1.02; 95% CI: 0.77–1.36), vegetables (OR: 1.27; 95% CI: 0.98–1.67), or milk/milk products (OR: 1.0; 95% CI: 0.77–1.29); and the daily intake of fast-food (OR: 0.81; 95% CI: 0.49–1.35) or carbonated drinks (OR: 0.80; 95% CI: 0.60–1.05). These findings warrant further in-depth evaluation of the HCP in the Qassim region of Saudi Arabia.
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Bassi S, Bahl D, Harrell MB, Jain N, Kandasamy A, Salunke SR, Shah VG, Raghunathan P, Markandan S, Murthy P, Arora M. Knowledge, attitude, and behaviours on diet, physical activity, and tobacco use among school students: A cross-sectional study in two Indian states. F1000Res 2021; 10:544. [PMID: 34745560 PMCID: PMC8543165 DOI: 10.12688/f1000research.51136.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/23/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Non-communicable diseases (NCDs) are escalating in India and can be attributed to behavioural risk factors such as unhealthy diet, physical inactivity and tobacco use that began in early years. Understanding adolescents' knowledge, attitudes and behaviours (KAB) related to NCD risk factors would inform the development of school-based health programmes to prevent NCDs. Methods: Sixth-grade students (n=1026) in 20 schools (10 private, 10 public) from two Indian cities (n=667 from Pune; n=359 from Bengaluru) participated in a KAB survey in 2019. Differences in KAB by gender, school type within cities were investigated. Results: Knowledge about the harms of tobacco use was higher than knowledge about a healthy diet and importance of physical activity. Only a small proportion of students did not eat breakfast (8.7%) or fruits (11.3%) daily. Only 33.4% of students read nutrition labels before choosing their food. Moderate-to-vigorous physical activity of less than an hour per day was reported by 42.5% of students. Approximately one-third of students had ever tried smoking tobacco (30.1%), smokeless tobacco (30.5%), and e-cigarettes (32.4%). Differences in these behaviours by gender and school type showed that both boys, girls and students of private and public schools are vulnerable. Conclusions: The study findings highlight that knowledge is low for thematic areas like diet and physical activity. While knowledge of tobacco related harms is better but the prevalence of ever tobacco use was found to be high. Socio-demographic factors such as school type and gender had a varying effect on various KAB indicators. There is a need to strengthen health education activities by developing context-specific health intervention materials by engaging school children, their parents, teachers, and communities to promote healthy behaviours among adolescents. Need to augment school health programmes in India with a differential approach based on the issues, specific to school type and city.
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Affiliation(s)
- Shalini Bassi
- Health Promotion Division, Public Health Foundation of India (PHFI), Gurgaon, Haryana, 122002, India
| | - Deepika Bahl
- Health Promotion Division, Public Health Foundation of India (PHFI), Gurgaon, Haryana, 122002, India
| | - Melissa Blythe Harrell
- School of Public Health, Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston, Austin, Texas, 78701, USA
| | - Neha Jain
- Health Promotion Division, Public Health Foundation of India (PHFI), Gurgaon, Haryana, 122002, India
| | - Arun Kandasamy
- Department of Psychiatry, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bengaluru, Karnataka, 560029, India
| | | | | | - Prema Raghunathan
- Department of Paediatrics, Rajarajeswari Medical, College & Hospital, Bengaluru, Karnataka, 560074, India
| | - Selvarajan Markandan
- Department of Health and Family Welfare, Government of Karnataka, Bengaluru, Karnataka, 560008, India
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bengaluru, Karnataka, 560029, India
| | - Monika Arora
- Health Promotion Division, Public Health Foundation of India (PHFI), Gurgaon, Haryana, 122002, India
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Bassi S, Bahl D, Harrell MB, Jain N, Kandasamy A, Salunke SR, Shah VG, Raghunathan P, Markandan S, Murthy P, Arora M. Knowledge, attitude, and behaviours on diet, physical activity, and tobacco use among school students: A cross-sectional study in two Indian states. F1000Res 2021; 10:544. [PMID: 34745560 PMCID: PMC8543165 DOI: 10.12688/f1000research.51136.1] [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] [Accepted: 06/22/2021] [Indexed: 04/04/2024] Open
Abstract
Background: Non-communicable diseases (NCDs) are escalating in India and can be attributed to behavioural risk factors such as unhealthy diet, physical inactivity and tobacco use that began in early years. Understanding adolescents' knowledge, attitudes and behaviours (KAB) related to NCD risk factors would inform the development of school-based health programmes to prevent NCDs. Methods: Sixth-grade students (n=1026) in 20 schools (10 private, 10 public) from two Indian cities (n=667 from Pune; n=359 from Bengaluru) participated in a KAB survey in 2019. Differences in KAB by gender, school type within cities were investigated. Results: Knowledge about the harms of tobacco use was higher than knowledge about a healthy diet and the importance of physical activity. Only a small proportion of students did not eat breakfast (8.7%) or fruits (11.3%) daily. Only 33.4% of students read nutrition labels before choosing their food. Moderate-to-vigorous physical activity of less than an hour per day was reported by 42.5% of students. Approximately one-third of students had ever tried smoking tobacco (30.1%), smokeless tobacco (30.5%), and e-cigarettes (32.4%). Differences in these behaviours by gender and school type showed that both boys, girls and students of private and public schools are vulnerable. Conclusions: The findings highlight that knowledge is low for thematic areas like diet and physical activity. Low knowledge can be attributed to unfavourable behaviours like lack of reading nutrition labels and indulgence in sedentary activities. To protect India's young population (adolescents), there is a need to amplify health education activities and context-specific health intervention materials for them by engaging parents and communities. Thus, these programmes should be incorporated into the curriculum as part of the regular teaching, as they may induce positive changes in their knowledge and behaviours. In India, school health programmes should dedicate significant time to health promotion and NCD risk prevention.
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Affiliation(s)
- Shalini Bassi
- Health Promotion Division, Public Health Foundation of India (PHFI), Gurgaon, Haryana, 122002, India
| | - Deepika Bahl
- Health Promotion Division, Public Health Foundation of India (PHFI), Gurgaon, Haryana, 122002, India
| | - Melissa Blythe Harrell
- School of Public Health, Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston, Austin, Texas, 78701, USA
| | - Neha Jain
- Health Promotion Division, Public Health Foundation of India (PHFI), Gurgaon, Haryana, 122002, India
| | - Arun Kandasamy
- Department of Psychiatry, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bengaluru, Karnataka, 560029, India
| | | | | | - Prema Raghunathan
- Department of Paediatrics, Rajarajeswari Medical, College & Hospital, Bengaluru, Karnataka, 560074, India
| | - Selvarajan Markandan
- Department of Health and Family Welfare, Government of Karnataka, Bengaluru, Karnataka, 560008, India
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bengaluru, Karnataka, 560029, India
| | - Monika Arora
- Health Promotion Division, Public Health Foundation of India (PHFI), Gurgaon, Haryana, 122002, India
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Breakfast Eating Habits and Lifestyle Behaviors among Saudi Primary School Children Attending Public Versus Private Schools. CHILDREN-BASEL 2021; 8:children8020134. [PMID: 33670284 PMCID: PMC7917862 DOI: 10.3390/children8020134] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/26/2021] [Accepted: 02/08/2021] [Indexed: 12/18/2022]
Abstract
We investigated breakfast eating habits and lifestyle behaviors among Saudi school children attending public versus private schools. A random sample of 1149 children (girls: 54.4%) from public and private schools was selected from elementary schools using the multistage stratified cluster method. Measurements included body weight, height, body mass index (BMI), and self-reported questionnaires filled by the child’s parents. There was no significant (p = 0.44) difference in the prevalence of breakfast intake between children attending public (20.6%) versus private (19.4%) schools. However, there was a gender by school type interactions in breakfast intake frequency, as boys in private but not in public schools had significantly (p = 0.006) higher (26.3%) daily breakfast intake than girls (13.3%). Over 56% of the children ate and drank from the school canteen, and impacting factors on children’s choices were children’s desire, food taste, and parental influence. More parents of children in private (12.1%) than in public (6.9%) schools were satisfied with the food in the school canteen. Younger age (aOR = 0.889, 95% CI = 0.815–0.970, p = 0.008), higher father education (aOR = 1.380, 95% CI = 1.130–1.686, p = 0.002), family income (aOR = 1.227, 95% CI = 1.005–1.498, p = 0.044), and insufficient sleep duration (aOR = 0.740, 95% CI = 0.553–0.990, p = 0.042) were significantly associated with being in a private school. Furthermore, no significant differences, when adjusted for socio-demographic factors, appeared in breakfast intake or overweight/obesity relative to school type. Interventions to improve daily breakfast consumption and lifestyle behaviors of Saudi children are warranted.
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Jain D, Grover K, Choudhary M. Study on Breakfast Consumption Pattern and Its Outcomes in Relation to Hematological and Body Composition Indices among Adolescent Girls. Ecol Food Nutr 2020; 59:675-691. [PMID: 32568560 DOI: 10.1080/03670244.2020.1778474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Breakfast consumption is of utmost importance for adolescents to attain nutritional adequacy. The association of breakfast skipping with overall nutritional status has been supported with little causal evidences. Therefore, the present investigation was undertaken to examine this conjecture. A total of 500 adolescent girls from rural and urban government schools of Ludhiana District in the Punjab State of India in the age group of 16-18 years were randomly interviewed to assess their breakfast consumption pattern. Based on their breakfast consumption pattern, 90 subjects out of 500 interviewed girls were selected and categorized in three groups of regular, occasional, and never breakfast consumers. They were further assessed for body composition and hematological profile including hemoglobin level, red blood cell count, packed cell volume to evaluate the association with breakfast consumption. Consequently, a higher percentage of regular breakfast (83%) consumers were found in the normal category of BMI as compared to occasional (30%) and never (27%) consumers. There was a significant (p ≤ 0.05) association of body mass index and muscle mass with breakfast consumption. Similarly, a higher percentage of regular breakfast consumers (60%) were found non-anemic in comparison to occasional (13%) and never (3%) and showed a significant association with breakfast consumption.
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Affiliation(s)
- Divya Jain
- Department of Food and Nutrition, Punjab Agricultural University , Ludhiana, India
| | - Kiran Grover
- Department of Food and Nutrition, Punjab Agricultural University , Ludhiana, India
| | - Monika Choudhary
- Krishi Vigyan Kendra, Sangrur, Punjab Agricultural University , Ludhiana, India
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25
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Leidy HJ, Gwin JA. Growing up strong: The importance of physical, mental, and emotional strength during childhood and adolescence with focus on dietary factors. Appl Physiol Nutr Metab 2020; 45:1071-1080. [PMID: 32650648 DOI: 10.1139/apnm-2020-0058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Childhood and adolescence are critical time periods for growth and development. Given the current physical and psychological health concerns affecting United States youth, an emerging area of interest exists supporting the importance of physical and psychological aspects of strength for health, resilience, and well-being through these life stages. This synopsis highlights the key concepts that were presented within the 2018 Strength Summit conference, entitled The Role of Strength in Optimal Health and Well-being. During the conference, strength was broadly defined as the ability to successfully respond to a challenge. Although much of the current research focuses on strength from a muscle function and performance perspective, mental and emotional strength are also important components of overall health and well-being, especially in children and adolescents. This paper provides a brief overview of the clinical and/or research-based strength outcomes, summarizes the relationship between strength and health, and discusses evidence-based dietary factors that promote strength in children and adolescents. Novelty Building physical, mental, and emotional strength during childhood and adolescence lays the foundation for health and well-being. Emerging evidence indicate positive associations between diet quality and strength in children and adolescents. Promising areas include the promotion of family-based meals, with focus on breakfast, for improved strength in United States youth.
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Affiliation(s)
- Heather J Leidy
- Department of Nutritional Sciences & Dept. of Pediatrics, University of Texas at Austin, Austin, TX 78723, USA
| | - Jess A Gwin
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA 01760, USA.,Oak Ridge Institute for Science and Education, Belcamp, MD, USA
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26
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Ben Cheikh A, Maatoug J, Ghammam R, Chouikha F, Mallat A, Ghannem H. Effect of a school-based intervention in eating habits among school children: quasi experimental study, Tunisia. Int J Adolesc Med Health 2020; 33:157-164. [PMID: 32549142 DOI: 10.1515/ijamh-2018-0206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 10/04/2018] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The present study aimed to assess whether six months intervention program with parents' implication in primary schools is able to decrease morning snack consumption among children aged 6-12 years. METHODS We carried out a quasi-experimental study with two groups of schoolchildren in the region of Sousse (Tunisia) from 2015 to 2016. One primary school in each group was selected. In each school, we randomly selected a sample size of schoolchildren and their parents. The intervention was based on healthy eating habits promotion. RESULTS The consumption of morning snacks the day before data collection, reported by children, decreased significantly in post-intervention in both intervention and control groups. The decrease of consumption of morning snacks was significantly higher in intervention group (p=0.009). According to parents, the proportion of children who had the habit of eating morning snack decreased significantly from pre to post-intervention in intervention group (p<0.001). CONCLUSION A healthy environment should be created through effective school policies to prevent obesity.
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Affiliation(s)
- Asma Ben Cheikh
- Faculty of medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Jihène Maatoug
- Faculty of medicine of Sousse, University of Sousse, Sousse, Tunisia.,Department of Epidemiology - Sousse, University Hospital Center Farhat Hached, Sousse, Tunisia
| | - Rim Ghammam
- Faculty of medicine of Sousse, University of Sousse, Sousse, Tunisia.,Department of Epidemiology - Sousse, University Hospital Center Farhat Hached, Sousse, Tunisia
| | - Firas Chouikha
- Department of Epidemiology - Sousse, University Hospital Center Farhat Hached, Sousse, Tunisia
| | - Amal Mallat
- Department of Epidemiology - Sousse, University Hospital Center Farhat Hached, Sousse, Tunisia
| | - Hassen Ghannem
- Faculty of medicine of Sousse, University of Sousse, Sousse, Tunisia.,Department of Epidemiology - Sousse, University Hospital Center Farhat Hached, Sousse, Tunisia
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Hirschler V, Lapertosa S, Raquel Scaiola E, Garcia C, Maldonado N, Guntsche Z, Miorin C, Obeziuk A, Molinari C, Gonzalez CD. Adiposity, lifestyle behaviors, and cardiometabolic markers in Argentinean schoolchildren. Clin Chim Acta 2020; 507:280-285. [PMID: 32387636 DOI: 10.1016/j.cca.2020.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/02/2020] [Accepted: 05/04/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND We determined the association between schoolchildren's OW/OB with age, sex, lifestyle behaviors, and cardiometabolic markers. METHODS Age, sex, anthropometric measures, and BP (blood pressure) were recorded in 1249 (554 M) schoolchildren. OW/OB was defined as BMI > 85%ile and BMI > 95%ile respectively. A validated questionnaire for lifestyle behaviors was performed. We offered free laboratory testing to a subgroup of 168 children. RESULTS Schoolchildren aged 8.8 ± 2.1 y from 9 elementary schools in 4 areas of Argentina were examined between April and September 2019. 265 (21.2%) of the children were OW, 265 (21.2%) were OB, and 425 (35%) had central OB. OW/OB was associated with low milk intake (OR = 1.92; 95% CI, 1.1-3.3), skipping breakfast (OR = 2.00; 95% CI, 1.2-3.4), a family history of hypertension (OR = 1.74; 95% CI, 1.1-2.9), and systolic BP (OR = 1.03; 95% CI, 1.01-1.05); adjusted for confounding variables. The subgroup analysis showed that OW/OB children had lower iron (83 vs. 94 ug/dl, respectively) and HDL-C (43 vs. 47 mg/dl) levels, but higher non-HDL-C (107 vs. 99 mg/dl) levels than normal-weight children. Multiple logistic regression analysis showed that OW/OB was inversely associated with iron (OR = 0.99; 95% CI, 0.98-0.998) and HDL-C (OR = 0.94; 95% CI, 0.91-0.97) levels; adjusted for confounding variables. CONCLUSION Adiposity in schoolchildren was associated with unhealthy lifestyle behaviors, higher atherogenic risk, and lower iron concentrations, suggesting that OW/OB children are at increased risk for anemia and cardiometabolic disease.
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Affiliation(s)
| | | | | | | | | | | | - Cecilia Miorin
- Universidad of Cuyo, Argentina; University of La Plata, Argentina
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28
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Abstract
Large population-based surveys by the Government of India and several other regional studies have reconfirmed the coexisting burden of over- and undernutrition. While time trends from the 2nd, 3rd and 4th rounds of the National Family Health Survey show declining trends in the prevalence of the underweight, it also highlights increasing rates in the overweight/obesity. Dose-response relationships with different micro- and macronutrient consumption with overweight/obesity prevalence have been established. In this context, it was attempted to identify the specific diet pattern and socio-behavioural determinants of overnutrition along with its combat strategies. This review highlights that while the proportion of chronic energy deficiency is decreasing in India, the intake of micronutrients and food groups continues to be below the recommended dietary allowance set by the Indian Council of Medical Research. Distal factors that determine the nutritional imbalance among Indians are presented under (i) household contextual factors, (ii) peer and socio-cultural influencers, and (iii) business and neighbourhood environment. Accumulation of such factors increases the density of obesogenic environment around individuals. Further, the review offers action points at individual, society and policy levels, presented in a 'logframe matrix' for bringing convergence actions across sectors in consultation with programme managers from different ministries/departments.
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Affiliation(s)
- Prashant Mathur
- National Centre for Disease Informatics & Research, Indian Council of Medical Research, Bengaluru, India
| | - Rakesh Pillai
- INCLEN Institute of Global Health, The INCLEN Trust International, New Delhi, India
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29
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Ganle JK, Boakye PP, Baatiema L. Childhood obesity in urban Ghana: evidence from a cross-sectional survey of in-school children aged 5-16 years. BMC Public Health 2019; 19:1561. [PMID: 31771549 PMCID: PMC6880588 DOI: 10.1186/s12889-019-7898-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 11/05/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Childhood obesity is a growing public health concern in many low-income urban settings; but its determinants are not clear. The purpose of this study is to assess the prevalence of childhood obesity and associated factors among in-school children aged 5-16 years in a Metropolitan district of Ghana. METHODS A cross-sectional quantitative survey was conducted among a sample of 285 in-school children aged 5-16 years. Pre-tested questionnaires and anthropometric data collection methods were used to collect data. Descriptive, bivariate, binary and multivariate logistic regression statistical techniques were used to analyse data. RESULTS Some 46.9% (42.2% for males and 51.7% for females) of the children were overweight. Of this, 21.2% were obese (BMI falls above 95th percentile). Childhood obesity was higher in private school (26.8%) than public school (21.4%), and among girls (27.2%) than boys (19%). Factors that increased obesity risks included being aged 11-16 as against 5-10 years (aOR = 6.07; 95%CI = 1.17-31.45; p = 0.025), having a father whose highest education is 'secondary' (aOR =2.97; 95% CI = 1.09-8.08; p = 0.032), or 'tertiary' (aOR = 3.46; 95% CI = 1.27-9.42; p = 0.015), and consumption of fizzy drinks most days of the week (aOR = 2.84; 95% CI = 1.24-6.52; p = 0.014). Factors that lowered obesity risks included engaging in sport at least 3times per week (aOR = 0.56; 95% CI = 0.33-0.96; p = 0.034), and sleeping for more than 8 h per day (aOR = 0.38; 95% CI = 0.19-0.79; p = 0.009). CONCLUSION Higher parental (father) educational attainment and frequent consumption of fizzy drinks per week may increase obesity risks among in-school children aged 5-16 years in the Metropolitan district of Ghana. However, regular exercise (playing sport at least 3 times per week) and having 8 or more hours of sleep per day could lower obesity risks in the same population. Age and sex-appropriate community and school-based interventions are needed to promote healthy diet selection and consumption, physical activity and healthy life styles among in-school children.
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Affiliation(s)
- John Kuumuori Ganle
- Department of Population,Family and Reproductive Health, School of Public Health, University of Ghana, P.O. Box LG 13, Legon, Accra, Ghana. .,Stellenbosch Institute for Advanced Study (STIAS), Wallenberg Research Centre at Stellenbosch University, Stellenbosch, 7600, South Africa.
| | - Priscilla Pokuaa Boakye
- Department of Population,Family and Reproductive Health, School of Public Health, University of Ghana, P.O. Box LG 13, Legon, Accra, Ghana
| | - Leonard Baatiema
- Regional Institute for Population Studies, University of Ghana, Accra, Ghana
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30
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Leandro CG, Fonseca EVDSD, de Lim CR, Tchamo ME, Ferreira-E-Silva WT. Barriers and Enablers That Influence Overweight/Obesity/Obesogenic Behavior in Adolescents From Lower-Middle Income Countries: A Systematic Review. Food Nutr Bull 2019; 40:562-571. [PMID: 31272220 DOI: 10.1177/0379572119853926] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Overweight/obesity during adolescence in lower-middle income countries has become a public health problem with consequences in adulthood. Inadequate dietary habits, poor diet quality, sedentary behavior, and parental obesity have been reported. OBJECTIVE To describe management of obesity-like food habits and behavior of adolescents from lower-middle income countries with respect to what keeps them using this diet (barriers) and what helps them avoid it (enablers). METHODS Systematic review of the literature related to obesity and food intake of adolescents conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). RESULTS We classified 11 eligible studies describing the barriers to and enablers of the management of obesity-like food intake and obesity lifestyle. The dual burdens of malnutrition and increased urbanization have been observed. There is preference for processed food, dietary habits, and obesity-like food intake and sedentary behavior. Barriers to managing body weight gain included mostly consumption of fast-food and snack food, less vegetable and fruit intake, skipping meals, and sedentary behavior. Enablers of managing body weight gain included changes in nutritional habits, perception of the consumption of healthy food, physical activity, and engagement in programs to change lifestyle. CONCLUSION The globalization of the fast food industry has provided an obesogenic environmental stimulus for adolescents in lower-middle income countries.
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Affiliation(s)
- Carol Góis Leandro
- Department of Nutrition, Federal University of Pernambuco, CAV-UFPE, Recife, Brazil.,Department of Physical Education and Sports Science, Federal University of Pernambuco, CAV-UFPE, Recife, Brazil
| | | | - Cybelle Rolim de Lim
- Department of Nutrition, Federal University of Pernambuco, CAV-UFPE, Recife, Brazil
| | - Mario Eugénio Tchamo
- Faculty of Physical Education and Sports, Pedagogic University, Maputo, Mozambique
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31
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Association between breakfast frequency and physical activity and sedentary time: a cross-sectional study in children from 12 countries. BMC Public Health 2019; 19:222. [PMID: 30791951 PMCID: PMC6385453 DOI: 10.1186/s12889-019-6542-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 02/13/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Existing research has documented inconsistent findings for the associations among breakfast frequency, physical activity (PA), and sedentary time in children. The primary aim of this study was to examine the associations among breakfast frequency and objectively-measured PA and sedentary time in a sample of children from 12 countries representing a wide range of human development, economic development and inequality. The secondary aim was to examine interactions of these associations between study sites. METHODS This multinational, cross-sectional study included 6228 children aged 9-11 years from the 12 International Study of Childhood Obesity, Lifestyle and the Environment sites. Multilevel statistical models were used to examine associations between self-reported habitual breakfast frequency defined using three categories (breakfast consumed 0 to 2 days/week [rare], 3 to 5 days/week [occasional] or 6 to 7 days/week [frequent]) or two categories (breakfast consumed less than daily or daily) and accelerometry-derived PA and sedentary time during the morning (wake time to 1200 h) and afternoon (1200 h to bed time) with study site included as an interaction term. Model covariates included age, sex, highest parental education, body mass index z-score, and accelerometer waking wear time. RESULTS Participants averaged 60 (s.d. 25) min/day in moderate-to-vigorous PA (MVPA), 315 (s.d. 53) min/day in light PA and 513 (s.d. 69) min/day sedentary. Controlling for covariates, breakfast frequency was not significantly associated with total daily or afternoon PA and sedentary time. For the morning, frequent breakfast consumption was associated with a higher proportion of time in MVPA (0.3%), higher proportion of time in light PA (1.0%) and lower min/day and proportion of time sedentary (3.4 min/day and 1.3%) than rare breakfast consumption (all p ≤ 0.05). No significant associations were found when comparing occasional with rare or frequent breakfast consumption, or daily with less than daily breakfast consumption. Very few significant interactions with study site were found. CONCLUSIONS In this multinational sample of children, frequent breakfast consumption was associated with higher MVPA and light PA time and lower sedentary time in the morning when compared with rare breakfast consumption, although the small magnitude of the associations may lack clinical relevance. TRIAL REGISTRATION The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) is registered at (Identifier NCT01722500 ).
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32
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Yi DY, Kim SC, Lee JH, Lee EH, Kim JY, Kim YJ, Kang KS, Hong J, Shim JO, Lee Y, Kang B, Lee YJ, Kim MJ, Moon JS, Koh H, You J, Kwak YS, Lim H, Yang HR. Clinical Practice Guideline for the Diagnosis and Treatment of Pediatric Obesity: Recommendations from the Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology Hepatology and Nutrition. Pediatr Gastroenterol Hepatol Nutr 2019; 22:1-27. [PMID: 30671370 PMCID: PMC6333581 DOI: 10.5223/pghn.2019.22.1.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 12/11/2018] [Accepted: 12/12/2018] [Indexed: 12/12/2022] Open
Abstract
The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in South Korea and worldwide, and new guidelines were established in each area with the strength of recommendations based on the levels of evidence: 1) definition and diagnosis of overweight and obesity in children and adolescents; 2) principles of treatment of pediatric obesity; 3) behavioral interventions for children and adolescents with obesity, including diet, exercise, lifestyle, and mental health; 4) pharmacotherapy; and 5) bariatric surgery.
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Affiliation(s)
- Dae Yong Yi
- Department of Pediatrics, Chung-Ang University Hospital, Chung-Ang University, College of Medicine, Seoul, Korea
| | - Soon Chul Kim
- Department of Pediatrics, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea
| | - Ji Hyuk Lee
- Department of Pediatrics, Chungbuk National University College of Medicine, Chungju, Korea
| | - Eun Hye Lee
- Department of Pediatrics, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Jae Young Kim
- Department of Pediatrics, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Yong Joo Kim
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Ki Soo Kang
- Department of Pediatrics, Jeju National University Hospital, Jeju, Korea
| | - Jeana Hong
- Department of Pediatrics, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Jung Ok Shim
- Department of Pediatrics, Korea University Guro Hospital, Seoul, Korea.,Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Yoon Lee
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Ben Kang
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Yeoun Joo Lee
- Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Mi Jin Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin Soo Moon
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hong Koh
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - JeongAe You
- Department of Physical Education, College of Education, Chung-Ang University, Seoul, Korea
| | - Young-Sook Kwak
- Department of Psychiatry, Jeju National University Hospital, Jeju, Korea
| | - Hyunjung Lim
- Department of Medical Nutrition, Kyung Hee University, Seoul, Korea
| | - Hye Ran Yang
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
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33
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Song S, Song H. Dietary and Lifestyle Factors Associated with Weight Status among Korean Adolescents from Multicultural Families: Using Data from the 2017–2018 Korea Youth Risk Behavior Surveys. ACTA ACUST UNITED AC 2019. [DOI: 10.5720/kjcn.2019.24.6.465] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- SuJin Song
- Department of Food and Nutrition, Hannam University, Daejeon, Korea, Assistant Professor
| | - Hyojune Song
- Department of Multicultural Education, Hanyang University, Seoul, Korea, Graduate student
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34
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Yi DY, Kim SC, Lee JH, Lee EH, Kim JY, Kim YJ, Kang KS, Hong J, Shim JO, Lee Y, Kang B, Lee YJ, Kim MJ, Moon JS, Koh H, You J, Kwak YS, Lim H, Yang HR. Clinical practice guideline for the diagnosis and treatment of pediatric obesity: recommendations from the Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology Hepatology and Nutrition. KOREAN JOURNAL OF PEDIATRICS 2018; 62:3-21. [PMID: 30589999 PMCID: PMC6351800 DOI: 10.3345/kjp.2018.07360] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 12/27/2018] [Indexed: 12/17/2022]
Abstract
The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in South Korea and worldwide, and new guidelines were established in each area with the strength of recommendations based on the levels of evidence: (1) definition and diagnosis of overweight and obesity in children and adolescents; (2) principles of treatment of pediatric obesity; (3) behavioral interventions for children and adolescents with obesity, including diet, exercise, lifestyle, and mental health; (4) pharmacotherapy; and (5) bariatric surgery.
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Affiliation(s)
- Dae Yong Yi
- Department of Pediatrics, Chung-Ang University College of Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Soon Chul Kim
- Department of Pediatrics, Chonbuk National University Medical School and Hospital, Jeonju, Korea
| | - Ji Hyuk Lee
- Department of Pediatrics, Chungbuk National University College of Medicine, Chungju, Korea
| | - Eun Hye Lee
- Department of Pediatrics, Eulji University School of Medicine, Nowon Eulji Medical Hospital, Seoul, Korea
| | - Jae Young Kim
- Department of Pediatrics, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Yong Joo Kim
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Ki Soo Kang
- Department of Pediatrics, Jeju National University Hospital, Jeju, Korea
| | - Jeana Hong
- Department of Pediatrics, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Jung Ok Shim
- Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Yoon Lee
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Ben Kang
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Yeoun Joo Lee
- Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Mi Jin Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin Soo Moon
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hong Koh
- Department of Pediatrics, Yonsei University College of Medicine, Severance Children's Hospital, Seoul, Korea
| | - JeongAe You
- Department of Physical Education, College of Education, Chung-Ang University, Seoul, Korea
| | - Young-Sook Kwak
- Department of Psychiatry, Jeju National University Hospital, Jeju, Korea
| | - Hyunjung Lim
- Department of Medical Nutrition, Kyung Hee University, Seoul, Korea
| | - Hye Ran Yang
- Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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35
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Arora M, Mathur C, Rawal T, Bassi S, Lakshmy R, Nazar G, Gupta V, Park M, Kinra S. Socioeconomic differences in prevalence of biochemical, physiological, and metabolic risk factors for non-communicable diseases among urban youth in Delhi, India. Prev Med Rep 2018; 12:33-39. [PMID: 30155404 PMCID: PMC6111063 DOI: 10.1016/j.pmedr.2018.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 07/15/2018] [Accepted: 08/07/2018] [Indexed: 11/19/2022] Open
Abstract
This study examined whether the distribution of biochemical, physiological, and metabolic risk factors for non-communicable diseases (NCDs) among children and youth in urban India vary by socioeconomic status (SES). Data were derived from a cross-sectional survey of students enrolled in the 2nd and 11th grades in 19 randomly selected schools in Delhi (N = 1329) in 2014-15. Mixed-effect regression models were used to determine the prevalence of risk factors for NCDs among private (higher SES) and government (lower SES) school students. After adjusting for age, gender, and grade we found the percentage of overweight (13.16% vs. 3.1%, p value < 0.01) and obese (8.7% vs. 0.3%, p value < 0.01) students was significantly higher among private relative to government school students. Similarly, significantly higher percentage of private school students had higher waist circumference values (7.72% vs. 0.58%, p value < 0.01) than government school students. Furthermore, similar trend was observed across schools in the distribution of other NCD risk factors: raised blood pressure, raised total cholesterol, and low-density lipoprotein. Surprisingly, despite a higher prevalence of all risk factors, significantly higher percentage of private school students had adequate/ideal levels of high-density lipoprotein. Overall, the risk profile of private school students suggests they are more vulnerable to future NCDs.
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Affiliation(s)
- M. Arora
- Health Promotion Division, Public Health Foundation of India, Plot no. 47, Sector 44, Institutional Area Gurgaon, Haryana 122002, India
| | - C. Mathur
- Indian Institute of Health Management and Research University, Jaipur, Rajasthan 302029, India
| | - T. Rawal
- Health Promotion Division, Public Health Foundation of India, Plot no. 47, Sector 44, Institutional Area Gurgaon, Haryana 122002, India
| | - S. Bassi
- Health Promotion Division, Public Health Foundation of India, Plot no. 47, Sector 44, Institutional Area Gurgaon, Haryana 122002, India
| | - R. Lakshmy
- Department of Bio-chemistry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - G.P. Nazar
- Health Promotion Division, Public Health Foundation of India, Plot no. 47, Sector 44, Institutional Area Gurgaon, Haryana 122002, India
| | - V.K. Gupta
- Health Promotion Division, Public Health Foundation of India, Plot no. 47, Sector 44, Institutional Area Gurgaon, Haryana 122002, India
| | - M.H. Park
- Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, UK
| | - S. Kinra
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
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36
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Sharma K, Shah K, Brahmbhatt P, Kandre Y. Skipping breakfast and the risk of coronary artery disease. QJM 2018; 111:715-719. [PMID: 30016512 DOI: 10.1093/qjmed/hcy162] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND/INTRODUCTION Nutritional studies have indicated a critical role of dietary habits in development of cardiovascular diseases (CVD). AIM We aimed to compare the risk of coronary artery disease (CAD) in habitual 'breakfast skippers' with those of 'habitual breakfast eaters' in Western part of India. We also planned to compare the cardiometabolic profiles of both the groups. DESIGN In this prospective, case-control study of 1607 individuals; 980 were patients of CAD (cases) undergoing various cardiac interventions for revascularisation and other 627 were healthy individuals (controls) who were free from CAD. METHODS Details of demographics and classical risk factors were collected for all the participants. Subjects were categorized as 'breakfast eater' or 'breakfast skippers' according to their response to the questionnaire. Logistic regression and correlation analysis were performed to assess the independent risk of all the factors and their inter-variable association. RESULTS Significantly (P < 0.05) high prevalence of classical risk factors and breakfast skipping habit was found in cases when compared with controls. Diabetes showed the highest odds ratio (7.296; 95% confidence interval (CI) 4.825-11.030; P < 0.0001) for CAD, followed by hypertension (3.756; 95% CI 2.891-4.881; P < 0.0001) and habits of smoking/tobacco/alcohol consumption (1.914; 95% CI 1.528-2.398; P < 0.0001) and breakfast skipping 1.348 (95% CI 1.076-1.689; P < 0.0001). Breakfast skipping emerged as stronger risk factor than obesity and sedentary life style in Indians and showed close association with presence of hypertension. DISCUSSION/CONCLUSION Habitual breakfast skippers are at increased risk for development of CAD and hypertension in Western India.
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Affiliation(s)
- K Sharma
- Department of Cardiology, U.N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Asarwa, Ahmedabad, India
| | - K Shah
- Department of Research, U.N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Asarwa, Ahmedabad, India
| | - P Brahmbhatt
- Department of Diet, U.N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Asarwa, Ahmedabad, India
| | - Y Kandre
- Department of Research, U.N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Asarwa, Ahmedabad, India
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Saluja K, Rawal T, Bassi S, Bhaumik S, Singh A, Park MH, Kinra S, Arora M. School environment assessment tools to address behavioural risk factors of non-communicable diseases: A scoping review. Prev Med Rep 2018; 10:1-8. [PMID: 29868351 PMCID: PMC5984208 DOI: 10.1016/j.pmedr.2018.01.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 01/09/2018] [Accepted: 01/20/2018] [Indexed: 11/19/2022] Open
Abstract
We aimed to identify, describe and analyse school environment assessment (SEA) tools that address behavioural risk factors (unhealthy diet, physical inactivity, tobacco and alcohol consumption) for non-communicable diseases (NCD). We searched in MEDLINE and Web of Science, hand-searched reference lists and contacted experts. Basic characteristics, measures assessed and measurement properties (validity, reliability, usability) of identified tools were extracted. We narratively synthesized the data and used content analysis to develop a list of measures used in the SEA tools. Twenty-four SEA tools were identified, mostly from developed countries. Out of these, 15 were questionnaire based, 8 were checklists or observation based tools and one tool used a combined checklist/observation based and telephonic questionnaire approach. Only 1 SEA tool had components related to all the four NCD risk factors, 2 SEA tools has assessed three NCD risk factors (diet/nutrition, physical activity, tobacco), 10 SEA tools has assessed two NCD risk factors (diet/nutrition and physical activity) and 11 SEA tools has assessed only one of the NCD risk factor. Several measures were used in the tools to assess the four NCD risk factors, but tobacco and alcohol was sparingly included. Measurement properties were reported for 14 tools. The review provides a comprehensive list of measures used in SEA tools which could be a valuable resource to guide future development of such tools. A valid and reliable SEA tool which could simultaneously evaluate all NCD risk factors, that has been tested in different settings with varying resource availability is needed.
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Affiliation(s)
- Kiran Saluja
- Health Promotion Division, Public Health Foundation of India, India
| | - Tina Rawal
- Health Promotion Division, Public Health Foundation of India, India
| | - Shalini Bassi
- Health Promotion Division, Public Health Foundation of India, India
| | | | - Ankur Singh
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Australia
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Min Hae Park
- Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Sanjay Kinra
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Monika Arora
- Health Promotion Division, Public Health Foundation of India, India
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Sekulic MR, Stajic D, Djonovic N. The Analysis of Nutritional Predictors of Anemia Combined with Obesity in Primary School-Age Children. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2018. [DOI: 10.1515/sjecr-2016-0089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
The consumption and amounts of a variety of food products used in a diet affect the incidence of anemia and different levels of nutritional status among school-age children. The prevalence of food intake comprised of fats, carbohydrates and sodium (salt) is a significant contributing factor to the incidence of excessive weight. Apart from nutrition, a leisure-time physical activity and the time spent in front of the TV or computer may contribute to an increase in anemia and obesity rates. The objective of this paper was to examine nutritional status, dietary habits and anemia among school-age children in the central Serbia region (the city of Kragujevac). It was established that 47.3% of the surveyed children fell into the normal weight group, 24.5% of the children are considered to be at risk of being overweight, 21.4 % of the children are considered as obese, whereas 6.8% of the children fell into the under-weight group. The incidence of anemia was noted in 10.8% of the cases, whereas anemia in obese children was observed in 21.6% of the cases (n=114; during the school year of 2014-2015). The obtained results show a statistically significant correlation between an increase in the consumption of fast food and anemia in children, whereas the amount of time children spend in front of the TV is also associated with the higher percentage of anemia and obesity.
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Affiliation(s)
- Marija R. Sekulic
- University of Kragujevac , Serbia , Faculty of Medical Sciences, Department of Hygiene and ecology
| | - Dalibor Stajic
- University of Kragujevac , Serbia , Faculty of Medical Sciences, Department of Hygiene and ecology
| | - Nela Djonovic
- University of Kragujevac , Serbia , Faculty of Medical Sciences, Department of Hygiene and ecology
- Institute of Public Health , Kragujevac , Serbia
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Zakrzewski-Fruer JK, Wells EK, Crawford NSG, Afeef SMO, Tolfrey K. Physical Activity Duration but Not Energy Expenditure Differs between Daily and Intermittent Breakfast Consumption in Adolescent Girls: A Randomized Crossover Trial. J Nutr 2018; 148:236-244. [PMID: 29490105 DOI: 10.1093/jn/nxx055] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 11/27/2017] [Indexed: 11/14/2022] Open
Abstract
Background It is not known whether breakfast frequency affects physical activity (PA) in children or adolescents. Objective This study examined the effect of daily compared with intermittent breakfast consumption on estimated PA energy expenditure (PAEE) in adolescent girls. Methods Under a randomized crossover design, 27 girls [mean ± SD age: 12.4 ± 0.5 y, body mass index (in kg/m2): 19.3 ± 3.0] completed two 7-d conditions. A standardized breakfast (∼1674 kJ) was consumed every day before 0900 in the daily breakfast consumption (DBC) condition. The standardized breakfast was consumed on only 3 d before 0900 in the intermittent breakfast consumption (IBC) condition, alternating with breakfast omission on the remaining 4 d (i.e., only water consumed before 1030). Combined heart rate accelerometry was used to estimate PAEE throughout each condition. Statistical analyses were completed by using condition × time of day repeated-measures ANOVA. The primary outcome was PAEE and the secondary outcome was time spent in PA. Results Daily estimated PAEE from sedentary or light-, moderate-, or vigorous-intensity PA and total PAEE were not significantly different between the conditions. The condition × time of day interaction for sedentary time (P = 0.05) indicated that the girls spent an additional 11.5 min/d being sedentary in the IBC condition compared with the DBC condition from 1530 to bedtime (P = 0.04). Light PA was 19.8 min/d longer in the DBC condition than in the IBC condition (P = 0.05), which was accumulated from waking to 1030 (P = 0.04) and from 1530 to bedtime (P = 0.03). There were no significant differences in time spent in moderate PA or vigorous PA between the conditions. Conclusions Adolescent girls spent more time in light PA before 1030 and after school and spent less time sedentary after school when a standardized breakfast was consumed daily than when consumed intermittently across 7 d. However, breakfast manipulation did not affect estimated daily PAEE. This trial was registered at www.isrctn.com as ISRCTN74579070.
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Affiliation(s)
- Julia K Zakrzewski-Fruer
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Bedford, United Kingdom
| | - Emma K Wells
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Bedford, United Kingdom
| | - Natasha S G Crawford
- Pediatric Exercise Physiology Research Group, School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Sahar M O Afeef
- Pediatric Exercise Physiology Research Group, School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Keith Tolfrey
- Pediatric Exercise Physiology Research Group, School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, United Kingdom
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FIUZA RFDP, MURARO AP, RODRIGUES PRM, SENA EDMS, FERREIRA MG. Skipping breakfast and associated factors among Brazilian adolescents. REV NUTR 2017. [DOI: 10.1590/1678-98652017000500007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective To analyze the prevalence and factors associated with breakfast skipping among adolescents. Methods Cross-sectional study, with adolescents aged 10-17 years, evaluated between 2009 and 2011, belonging to a cohort study in the Central-West region of Brazil. Breakfast skipping was considered as not having breakfast every day. Demographic, socioeconomic, and lifestyle factors were evaluated through a questionnaire. Anthropometric assessment included measurement of weight and height, which were used to classify weight status using body mass index. Poisson regression was used to assess the association of breakfast skipping with demographic and socioeconomic variables, lifestyle factors, and weight status. Results Among 1,716 Brazilian adolescents evaluated, 36.2% reported not consuming breakfast every day, with the highest prevalence among girls (p=0.03). After adjusting for age and economic class, breakfast skipping was associated with not consuming breakfast with parents and morning shift at school, in both genders, and with obesity only in boys. Lifestyle factors such as alcohol consumption, physical activity, diet quality, and smoking were not associated with skipping breakfast. Conclusion The omission of breakfast was observed in more than a third of adolescents, being associated with demographic and lifestyle factors. In the public health perspective, the importance of encouraging the consumption of this meal is highlighted, with actions involving the school environment and the family.
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Effect of breakfast omission and consumption on energy intake and physical activity in adolescent girls: a randomised controlled trial. Br J Nutr 2017; 118:392-400. [PMID: 28901889 DOI: 10.1017/s0007114517002148] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
It is not known if breakfast consumption is an effective intervention for altering daily energy balance in adolescents when compared with breakfast omission. This study examined the acute effect of breakfast consumption and omission on free-living energy intake (EI) and physical activity (PA) in adolescent girls. Using an acute randomised cross-over design, forty girls (age 13·3 (sd 0·8) years, BMI 21·5 (sd 5·0) kg/m2) completed two, 3-d conditions in a randomised, counter-balanced order: no breakfast (NB) and standardised (approximately 1962 kJ) breakfast (SB). Dietary intakes were assessed using food diaries combined with digital photographic records and PA was measured via accelerometry throughout each condition. Statistical analyses were completed using repeated-measures ANOVA. Post-breakfast EI was 483 (sd 1309) kJ/d higher in NB v. SB (P=0·025), but total daily EI was 1479 (sd 11311) kJ/d higher in SB v. NB (P<0·0005). Daily carbohydrate, fibre and protein intakes were higher in SB v. NB (P<0·0005), whereas daily fat intake was not different (P=0·405). Effect sizes met the minimum important difference of ≥0·20 for all significant effects. Breakfast manipulation did not affect post-breakfast macronutrient intakes (P≥0·451) or time spent sedentary or in PA (P≥0·657). In this sample of adolescent girls, breakfast omission increased post-breakfast free-living EI, but total daily EI was greater when a SB was consumed. We found no evidence that breakfast consumption induces compensatory changes in PA. Further experimental research is required to determine the effects of extended periods of breakfast manipulation in young people.
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Jeyakumar A, Ghugre P. Is lack of breakfast contributing to nutrient deficits and poor nutritional indicators among adolescent girls? Nutr Health 2017; 23:177-184. [PMID: 28838293 DOI: 10.1177/0260106017721074] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Breakfast is considered the first and most important meal of the day. Missing the first meal may result in significant nutritional deficits, if not compensated in subsequent meals. AIM To describe the nutrient intake through breakfast and to study its association with nutritional indicators among adolescent girls. METHODS A cross-sectional study among adolescent girls ( n = 565) 16-18 years was carried out in urban slums of Pune, Maharashtra, India. Haemoglobin was assessed by cyanmethemoglobin method. Nutritional status was assessed through anthropometry and three 24-hours diet recall. Z scores, independent sample test, and linear logistic regression were used to assess undernutrition, to compare means of nutrient intake and to associate nutrient intake with nutritional status, respectively. RESULTS Almost 50% did not consume solid food for breakfast and 99% of the participants consumed inadequate breakfast (<610 kcal). Two types of breakfast emerged: I (bakery products + beverage) and II (traditional breakfast + beverage). Although the mean energy intake of type II breakfast (235±100.55 kcal) and the mean micronutrient intake was significantly higher than type I (micronutrients: vitamin C and folate ( p = 0.001), iron ( p = 0.01)) it did not meet the adequacy norms for breakfast. Among nutritional indicators breakfast intake was not directly associated with body mass index. However, mean intake of nutrients such as energy, protein and iron through the day were significantly lesser ( p = 0.001, p = 0.01 and p = 0.01 respectively) among anaemic adolescents. Linear regression showed significant association between energy, fat intake and BAZ scores. CONCLUSIONS Compensating dietary deficits that arise in the first meal would directly address the day's nutrient deficit. The results highlight the need for a food-based approach to address undernutrition among adolescent girls in resource-poor settings.
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Affiliation(s)
- Angeline Jeyakumar
- 1 Interdisciplinary School of Health Sciences, Savitribai Phule University of Pune, India
| | - Padmini Ghugre
- 2 Department of Foods and Nutrition, S.N.D.T Women's University, Mumbai, India
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Rodrigues PRM, Luiz RR, Monteiro LS, Ferreira MG, Gonçalves-Silva RMV, Pereira RA. Adolescents' unhealthy eating habits are associated with meal skipping. Nutrition 2017; 42:114-120.e1. [PMID: 28596058 DOI: 10.1016/j.nut.2017.03.011] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 03/23/2017] [Accepted: 03/27/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Meal consumption and diet quality are important for healthy development during adolescence. The aim of this study was to determine the association between meal habits and diet quality in Brazilian adolescents. METHODS A school-based, cross-sectional study was conducted in 2008 with a probabilistic sample of adolescents ages 14 to 19 y (N = 1139) from high schools in central-western Brazil. Consumption of breakfast, morning snack, lunch, afternoon snack, and dinner was assessed to evaluate adolescents' meal profile. The Brazilian Healthy Eating Index-Revised (BHEI-R) was calculated to evaluate diet quality. The association between meal profile and BHEI-R (global estimates and components) was assessed using multivariate linear regression models. RESULTS Diet was characterized by unhealthy eating: a low consumption of fruits, vegetables, and milk/dairy, and a high consumption of fats and sodium. An unsatisfactory meal profile was observed in 14% of adolescents, whereas daily consumption of breakfast, lunch, and dinner was reported by 47%, 78%, and 52% of adolescents, respectively. Meal profile was positively associated with diet quality. Daily consumption of breakfast was associated with higher BHEI-R scores, lower sodium intake, and greater consumption of fruits and milk/dairy. Daily consumption of lunch was associated with greater consumption of vegetables and "meats, eggs, and legumes," whereas consumption of dinner was associated with an increased consumption of "whole fruits." CONCLUSION This study showed a parallelism between daily consumption of meals with healthier eating and greater adherence to traditional Brazilian food habits. Skipping meals was associated with a low-quality diet, especially concerning to the low consumption of fruits and vegetables and a high intake of sodium and calories from solid fats, added sugars, and alcoholic beverages. Therefore, the adoption of regular meal habits may help adolescents improve their diet quality.
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Affiliation(s)
| | - Ronir Raggio Luiz
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luana Silva Monteiro
- Faculdade de Nutrição - Universidade Federal do Rio de Janeiro/Campus Macaé Prof. Aloísio Teixeira, Rio de Janeiro, Brazil
| | | | | | - Rosangela Alves Pereira
- Departamento de Nutrição Social e Aplicada, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
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Styne DM, Arslanian SA, Connor EL, Farooqi IS, Murad MH, Silverstein JH, Yanovski JA. Pediatric Obesity-Assessment, Treatment, and Prevention: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2017; 102:709-757. [PMID: 28359099 PMCID: PMC6283429 DOI: 10.1210/jc.2016-2573] [Citation(s) in RCA: 630] [Impact Index Per Article: 90.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 11/10/2016] [Indexed: 02/06/2023]
Abstract
COSPONSORING ASSOCIATIONS The European Society of Endocrinology and the Pediatric Endocrine Society. This guideline was funded by the Endocrine Society. OBJECTIVE To formulate clinical practice guidelines for the assessment, treatment, and prevention of pediatric obesity. PARTICIPANTS The participants include an Endocrine Society-appointed Task Force of 6 experts, a methodologist, and a medical writer. EVIDENCE This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation approach to describe the strength of recommendations and the quality of evidence. The Task Force commissioned 2 systematic reviews and used the best available evidence from other published systematic reviews and individual studies. CONSENSUS PROCESS One group meeting, several conference calls, and e-mail communications enabled consensus. Endocrine Society committees and members and co-sponsoring organizations reviewed and commented on preliminary drafts of this guideline. CONCLUSION Pediatric obesity remains an ongoing serious international health concern affecting ∼17% of US children and adolescents, threatening their adult health and longevity. Pediatric obesity has its basis in genetic susceptibilities influenced by a permissive environment starting in utero and extending through childhood and adolescence. Endocrine etiologies for obesity are rare and usually are accompanied by attenuated growth patterns. Pediatric comorbidities are common and long-term health complications often result; screening for comorbidities of obesity should be applied in a hierarchal, logical manner for early identification before more serious complications result. Genetic screening for rare syndromes is indicated only in the presence of specific historical or physical features. The psychological toll of pediatric obesity on the individual and family necessitates screening for mental health issues and counseling as indicated. The prevention of pediatric obesity by promoting healthful diet, activity, and environment should be a primary goal, as achieving effective, long-lasting results with lifestyle modification once obesity occurs is difficult. Although some behavioral and pharmacotherapy studies report modest success, additional research into accessible and effective methods for preventing and treating pediatric obesity is needed. The use of weight loss medications during childhood and adolescence should be restricted to clinical trials. Increasing evidence demonstrates the effectiveness of bariatric surgery in the most seriously affected mature teenagers who have failed lifestyle modification, but the use of surgery requires experienced teams with resources for long-term follow-up. Adolescents undergoing lifestyle therapy, medication regimens, or bariatric surgery for obesity will need cohesive planning to help them effectively transition to adult care, with continued necessary monitoring, support, and intervention. Transition programs for obesity are an uncharted area requiring further research for efficacy. Despite a significant increase in research on pediatric obesity since the initial publication of these guidelines 8 years ago, further study is needed of the genetic and biological factors that increase the risk of weight gain and influence the response to therapeutic interventions. Also needed are more studies to better understand the genetic and biological factors that cause an obese individual to manifest one comorbidity vs another or to be free of comorbidities. Furthermore, continued investigation into the most effective methods of preventing and treating obesity and into methods for changing environmental and economic factors that will lead to worldwide cultural changes in diet and activity should be priorities. Particular attention to determining ways to effect systemic changes in food environments and total daily mobility, as well as methods for sustaining healthy body mass index changes, is of importance.
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Affiliation(s)
- Dennis M Styne
- University of California Davis, Sacramento, California 95817
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Greene-Cramer B, Harrell MB, Hoelscher DM, Sharma S, Ranjit N, Gupta V, Nazar G, Arora M. Association between parent and child weight status among private school children in Delhi, India. Glob Health Promot 2016; 25:67-74. [PMID: 27468751 DOI: 10.1177/1757975916658002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Over the past three decades there has been a surge in the prevalence of overweight and obesity worldwide in both adults and children. To date few studies have examined obesity in India and most have only looked at prevalence estimates. While studies in Western countries have identified parent weight status as a predictor of child weight status, there have been no studies examining this association in India. This study examined the relationship between parent weight status and child weight status using an internationally representative growth reference for children and Asian-specific action points for adults. Overall, this study found 29.6% of children and 77.7% of parents in a sample of private schools in Delhi, India were overweight/obese. Parent weight status was found to be associated with child weight status after controlling for child grade and sex. However, while maternal weight status was associated with child weight status (odds ratio=1.51, 95% confidence interval: 1.04-2.20), paternal weight status was not (odds ratio=1.10, 95% confidence interval: 0.81-1.48). The association was greatest between mothers and sons (odds ratio=2.13, 95% confidence interval: 1.39-3.27). These results provide initial evidence that parent weight status is associated with child weight status in Delhi, India. Future research should continue to explore the relationship between parent, particularly maternal, and child weight status to better understand the nature of the relationship and the differences between male and female children. Interventions to address child overweight and obesity in India should include parents as direct targets.
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Affiliation(s)
| | | | | | - Shreela Sharma
- 2. School of Public Health, University of Texas, Houston, USA
| | - Nalini Ranjit
- 1. School of Public Health, University of Texas, Austin, USA
| | - Vinay Gupta
- 3. Public Health Foundation of India, Delhi, India
| | | | - Monika Arora
- 3. Public Health Foundation of India, Delhi, India
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Wang M, Zhong JM, Wang H, Zhao M, Gong WW, Pan J, Fei FR, Wu HB, Yu M. Breakfast Consumption and Its Associations with Health-Related Behaviors among School-Aged Adolescents: A Cross-Sectional Study in Zhejiang Province, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13080761. [PMID: 27472357 PMCID: PMC4997447 DOI: 10.3390/ijerph13080761] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 07/15/2016] [Accepted: 07/20/2016] [Indexed: 11/16/2022]
Abstract
Evidence indicates that breakfast consumption is associated with a cluster of health-related behaviors, yet studies in mainland China are scarce. This study is conducted to describe the frequency of breakfast consumption among Chinese adolescents and examine its associations with other dietary, physical activity, sedentary, sleep, cigarette-smoking, and alcohol-drinking behaviors. Breakfast consumption and other health-related behaviors data was collected via a self-administered questionnaire in a cross-sectional study in Zhejiang Province, China. A total of 19,542 school-aged adolescents were recruited in this survey. The associations between breakfast consumption and other health-related behaviors were examined using logistic regression models. A significantly higher prevalence of daily breakfast consumption was found among students who were younger (p for trend <0.001), from urban schools (p < 0.001), and academic high schools (p < 0.001). More frequent vegetable and milk consumption, greater physical activity, and longer sleep duration were positively associated with daily breakfast consumption, while soft drinks and fast food consumption, computer use, cigarette-smoking and alcohol-drinking behaviors were inversely associated. The prevalence of irregular breakfast consumption was relatively high among Chinese adolescents in Zhejiang Province. Daily breakfast consumption was associated with a constellation of health-related behaviors.
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Affiliation(s)
- Meng Wang
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou 310051, China.
| | - Jie-Ming Zhong
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou 310051, China.
| | - Hao Wang
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou 310051, China.
| | - Ming Zhao
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou 310051, China.
| | - Wei-Wei Gong
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou 310051, China.
| | - Jin Pan
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou 310051, China.
| | - Fang-Rong Fei
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou 310051, China.
| | - Hai-Bin Wu
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou 310051, China.
| | - Min Yu
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou 310051, China.
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Baygi F, Kelishadi R, Qorbani M, Mohammadi F, Motlagh ME, Ardalan G, Mansourian M, Arzaghi SM, Asayesh H, Heshmat R. Association of some psychosocial factors with anthropometric measures in nationally representative sample of Iranian adolescents: the CASPIAN-III study. J Diabetes Metab Disord 2016; 15:15. [PMID: 27252934 PMCID: PMC4888475 DOI: 10.1186/s40200-016-0237-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 05/25/2016] [Indexed: 01/09/2023]
Abstract
Background During the last two decades, adolescent obesity has increased in western countries. In Iran-as a developing country- the prevalence of obesity is raised among youngsters as well. This study conducted to identify an association of adolescents’ loneliness, self-confidence and relationship with others in home and school environment with their weight status. Methods In this cross-sectional national survey, 5682 students aged 10–18 years from urban and rural districts of 27 provinces of Iran were selected via stratified multi-stage sampling method. Data on psychological problems of students was gathered through a questionnaire. Height, weight, and waist circumferences were measured according to standard protocols. Body mass index (BMI) and waist- to-height ratio was calculated. Results Boys which did not have best friends, spend time with their friends after school or get acceptance from them, had higher BMI than others. Only girls who did not spend time with their friends had higher BMI (19.48 ± 4.28) vs. (19.09 ± 3.92) and WC (71.04 ± 21.29) vs. (69.15 ± 17.43) than others, P < 0.05. In both sexes, adolescents who had sense of pressure about doing homework or had difficulties in relationship with their parents had higher BMI and WC values. Girls who reported being victim of violent behaviors (being bullied), had lower BMI compared to others. Risk of being overweight and obese, but not abdominal obese was statistically higher in adolescents not having close friends (OR = 1.81, CI: 1.11–2.95). Lack of self-confidence increased only the risk of obesity in teens (OR = 1033, CI: 1.09–1.64). Conclusions Our findings suggest that strategies for prevention of overweight and obesity in adolescent should be taking into account a deeper knowledge of psychosocial issues due to be able to design more effective programs for treating overweight teens.
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Affiliation(s)
- Fereshteh Baygi
- Occupation Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Diseases, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mostafa Qorbani
- Dietary Supplements and Probiotics Research Center, Alborz University of Medical Sciences, Karaj, Iran ; Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Mohammadi
- Department of Food and Nutrition Policy and Planning Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Gelayol Ardalan
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Diseases, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Morteza Mansourian
- Department of Health Education and Promotion, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Masoud Arzaghi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Palomo Atance E, Bahíllo Curieses P, Bueno Lozano G, Feliu Rovira A, Gil-Campos M, Lechuga-Sancho A, Ruiz Cano R, Vela Desojo A. Recomendaciones del Grupo de Trabajo de Obesidad de la Sociedad Española de Endocrinología Pediátrica sobre hábitos de alimentación para la prevención de la obesidad y los factores de riesgo cardiovascular en la infancia. An Pediatr (Barc) 2016. [DOI: 10.1016/j.anpedi.2015.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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49
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Recommendations of the Spanish Paediatric Endocrinology Society Working Group on Obesity on eating habits for the prevention of obesity and cardiovascular risk factors in childhood. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.anpede.2015.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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50
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Zakrzewski JK, Gillison FB, Cumming S, Church TS, Katzmarzyk PT, Broyles ST, Champagne CM, Chaput JP, Denstel KD, Fogelholm M, Hu G, Kuriyan R, Kurpad A, Lambert EV, Maher C, Maia J, Matsudo V, Mire EF, Olds T, Onywera V, Sarmiento OL, Tremblay MS, Tudor-Locke C, Zhao P, Standage M. Associations between breakfast frequency and adiposity indicators in children from 12 countries. INTERNATIONAL JOURNAL OF OBESITY SUPPLEMENTS 2015; 5:S80-8. [PMID: 27152190 DOI: 10.1038/ijosup.2015.24] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Reports of inverse associations between breakfast frequency and indices of obesity are predominantly based on samples of children from high-income countries with limited socioeconomic diversity. Using data from the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE), the present study examined associations between breakfast frequency and adiposity in a sample of 9-11-year-old children from 12 countries representing a wide range of geographic and socio-cultural variability. METHODS Multilevel statistical models were used to examine associations between breakfast frequency (independent variable) and adiposity indicators (dependent variables: body mass index (BMI) z-score and body fat percentage (BF%)), adjusting for age, sex, and parental education in 6941 children from 12 ISCOLE study sites. Associations were also adjusted for moderate-to-vigorous physical activity, healthy and unhealthy dietary patterns and sleep time in a sub-sample (n=5710). Where interactions with site were significant, results were stratified by site. RESULTS Adjusted mean BMI z-score and BF% for frequent breakfast consumers were 0.45 and 20.5%, respectively. Frequent breakfast consumption was associated with lower BMI z-scores compared with occasional (P<0.0001, 95% confidence intervals (CI): 0.10-0.29) and rare (P<0.0001, 95% CI: 0.18-0.46) consumption, as well as lower BF% compared with occasional (P<0.0001, 95% CI: 0.86-1.99) and rare (P<0.0001, 95% CI: 1.07-2.76). Associations with BMI z-score varied by site (breakfast by site interaction; P=0.033): associations were non-significant in three sites (Australia, Finland and Kenya), and occasional (not rare) consumption was associated with higher BMI z-scores compared with frequent consumption in three sites (Canada, Portugal and South Africa). Sub-sample analyses adjusting for additional covariates showed similar associations between breakfast and adiposity indicators, but lacked site interactions. CONCLUSIONS In a multinational sample of children, more frequent breakfast consumption was associated with lower BMI z-scores and BF% compared with occasional and rare consumption. Associations were not consistent across all 12 countries. Further research is required to understand global differences in the observed associations.
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Affiliation(s)
- J K Zakrzewski
- Department of Sport Science and Physical Activity, University of Bedfordshire , Bedford, UK
| | - F B Gillison
- Department for Health, University of Bath , Bath, UK
| | - S Cumming
- Department for Health, University of Bath , Bath, UK
| | - T S Church
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
| | - P T Katzmarzyk
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
| | - S T Broyles
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
| | - C M Champagne
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
| | - J-P Chaput
- Children's Hospital of Eastern Ontario Research Institute , Ottawa, Ontario, Canada
| | - K D Denstel
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
| | - M Fogelholm
- Department of Food and Environmental Sciences, University of Helsinki , Helsinki, Finland
| | - G Hu
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
| | - R Kuriyan
- St Johns Research Institute , Bangalore, India
| | - A Kurpad
- St Johns Research Institute , Bangalore, India
| | - E V Lambert
- Department of Human Biology, Faculty of Health Sciences, Division of Exercise Science and Sports Medicine, University of Cape Town , Cape Town, South Africa
| | - C Maher
- Alliance for Research In Exercise Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia , Adelaide, South Australia, Australia
| | - J Maia
- CIFI2D, Faculdade de Desporto, University of Porto , Porto, Portugal
| | - V Matsudo
- Centro de Estudos do Laboratório de Aptidão Física de São Caetano do Sul (CELAFISCS) , Sao Paulo, Brazil
| | - E F Mire
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
| | - T Olds
- Alliance for Research In Exercise Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia , Adelaide, South Australia, Australia
| | - V Onywera
- Department of Recreation Management and Exercise Science, Kenyatta University , Nairobi, Kenya
| | - O L Sarmiento
- School of Medicine Universidad de los Andes , Bogota, Colombia
| | - M S Tremblay
- Children's Hospital of Eastern Ontario Research Institute , Ottawa, Ontario, Canada
| | - C Tudor-Locke
- Pennington Biomedical Research Center, Baton Rouge, LA, USA; Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA
| | - P Zhao
- Tianjin Women's and Children's Health Center , Tianjin, China
| | - M Standage
- Department for Health, University of Bath , Bath, UK
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