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de Mello GT, Minatto G, Costa RM, Leech RM, Cao Y, Lee RE, Silva KS. Clusters of 24-hour movement behavior and diet and their relationship with health indicators among youth: a systematic review. BMC Public Health 2024; 24:1080. [PMID: 38637757 PMCID: PMC11027390 DOI: 10.1186/s12889-024-18364-6] [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: 09/28/2023] [Accepted: 03/15/2024] [Indexed: 04/20/2024] Open
Abstract
Movement-related behaviors (physical activity [PA], sedentary behavior [SB], and sleep) and diet interact with each other and play important roles in health indicators in youth. This systematic review aimed to investigate how PA, SB, sleep, and diet cluster in youth by biological sex; and to examine which cluster are associated with health indicators. This study was registered in PROSPERO (number: CRD42018094826). Five electronic databases were assessed. Eligibility criteria allowed studies that included youth (aged 19 years and younger), and only the four behaviors {PA, SB, sleep, and diet (ultra-processed foods [UPF]; fruits and vegetables [FV])} analyzed by applying data-based cluster procedures. From 12,719 articles screened; 23 were included. Of these, four investigated children, and ten identified clusters by biological sex. Sixty-six mixed cluster were identified including, 34 in mixed-sex samples, 10 in boys and 11 in girls. The most frequent clusters in mixed-sex samples were "High SB UPF Low Sleep", "Low PA High SB Satisfactory Sleep", and "High PA". The main difference in profiles according to sex was that girls' clusters were characterized by high sleep duration, whereas boys' clusters by high PA. There were a few associations found between cluster types and health indicators, highlighting that youth assigned to cluster types with low PA exhibited higher adiposity. In conclusion, the youth presented a range of clusters of behaviors, typically exhibiting at least one unhealthy behavior. Similar patterns were observed in both sexes with the biggest difference in time of sleep for girls and PA for boys. These findings underscore the importance of intervention strategies targeting multiple behaviors simultaneously to enhance health risk profiles and indicators in children and adolescents.
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Affiliation(s)
- Gabrielli T de Mello
- Research Center for Physical Activity and Health, Federal University of Santa Catarina, Florianópolis, Brazil.
| | - Giseli Minatto
- Research Center for Physical Activity and Health, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Rafael M Costa
- Research Center for Physical Activity and Health, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Rebecca M Leech
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Melbourne, Australia
| | - Yingting Cao
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Rebecca E Lee
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, USA
| | - Kelly S Silva
- Research Center for Physical Activity and Health, Federal University of Santa Catarina, Florianópolis, Brazil
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Loo BKG, Sirisena D, Müller-Riemenschneider F, Chia MYH, Tan B, Tan NC, Teoh OH, Lim EJK, Zainuddin MA, Gao JS, Chan PC, Tan TSZ, Visruthan NK, Rajadurai VS, Chia MS, Ahmad Hatib NAB, Cai S, Ong JL, Lo JCY, Chong MFF, Lee LY, Chew ECS, Siriamornsarp R, Lee M, Sim A, Wong CM, Sherwood SA, Toh SH, Quah PL, Ng KC, Tan KH, Lee YS. Consensus statement on Singapore integrated 24-hour activity guide for early childhood. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2023; 52:310-320. [PMID: 38904512 DOI: 10.47102/annals-acadmedsg.2022315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
Introduction Early childhood is a critical period for growth and development. Adopting healthy lifestyle behaviours during this period forms the foundation for future well-being and offers the best protection against non-communicable diseases. Singapore studies have shown that many young children are not achieving the recommendations on physical activity, sedentary behaviour and sleep. A workgroup was set up to develop recommendations for caregivers of infants, toddlers and preschoolers (aged <7 years) on how to integrate beneficial activities within a daily 24-hour period for optimal development and metabolic health. Method The Grading of Recommendations Assessment, Development and Evaluation (GRADE)- ADOLOPMENT approach was employed for adoption, adaption or de novo development of recommendations. International and national guidelines were used as references, and an update of the literature reviews up to September 2021 was conducted through an electronic search of PubMed, Embase and Cochrane Central Register of Controlled Trials (CENTRAL) databases. Results Four consensus statements were developed for each age group: infants, toddlers and preschoolers. The statements focus on achieving good metabolic health through regular physical activity, limiting sedentary behaviour, achieving adequate sleep and positive eating habits. The 13th consensus statement recognises that integration of these activities within a 24-hour period can help obtain the best results. Conclusion This set of recommendations guides and encourages caregivers of Singapore infants, toddlers and preschoolers to adopt beneficial lifestyle activities within each 24-hour period.
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Affiliation(s)
- Benny Kai Guo Loo
- Sport & Exercise Medicine Service, KK Women's and Children's Hospital, Singapore
| | - Dinesh Sirisena
- Department of Sports Medicine, Khoo Teck Puat Hospital, Singapore
| | | | - Michael Yong Hwa Chia
- Academic Group of Physical Education & Sports Science, National Institute of Education, Nanyang Technological University, Singapore
| | - Benedict Tan
- Department of Sport & Exercise Medicine, Changi General Hospital, Singapore
| | | | - Oon Hoe Teoh
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore
| | - Ethel Jie Kai Lim
- Department of Nutrition & Dietetics, KK Women's and Children's Hospital, Singapore
| | | | - Joanne Shumin Gao
- Sport & Exercise Medicine Service, KK Women's and Children's Hospital, Singapore
| | - Poh Chong Chan
- Department of Paediatrics, Khoo Teck Puat - National University Children's Medical Institute, National University Hospital, Singapore
| | - Teresa Shu Zhen Tan
- Department of Paediatrics, Khoo Teck Puat - National University Children's Medical Institute, National University Hospital, Singapore
| | | | | | - Moira Suyin Chia
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore
| | | | - Shirong Cai
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Ju Lynn Ong
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - June Chi Yan Lo
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Mary Foong-Fong Chong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Le Ye Lee
- Department of Neonatology, Khoo Teck Puat - National University Children's Medical Institute, National University Hospital, Singapore
| | | | | | - Miriam Lee
- Division of Children & Youth Programme Development, Sport Singapore, Singapore
| | - Aaron Sim
- Division of Physical Activity & Weight Management, Health Promotion Board, Singapore
| | - Chui Mae Wong
- Department of Child Development, KK Women's and Children's Hospital, Singapore
| | | | - Siao Hui Toh
- Physiotherapy Department, KK Women's and Children's Hospital, Singapore
| | - Phaik Ling Quah
- Division of Obstetrics & Gynaecology, KK Women's and Children's Hospital, Singapore
| | - Kee Chong Ng
- Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore
| | - Yung Seng Lee
- Department of Paediatrics, Khoo Teck Puat - National University Children's Medical Institute, National University Hospital, Singapore
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Krijger A, Steenbergen E, Schiphof-Godart L, van Rossum C, Verkaik-Kloosterman J, Elstgeest L, Ter Borg S, Raat H, Joosten K. Clusters of lifestyle behaviours and their associations with socio-demographic characteristics in Dutch toddlers. Eur J Nutr 2023; 62:1143-1151. [PMID: 36434406 PMCID: PMC10030397 DOI: 10.1007/s00394-022-03056-x] [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: 06/08/2022] [Accepted: 11/10/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE This study aimed to identify clusters of lifestyle behaviours in toddlers and assess associations with socio-demographic characteristics. METHODS We used data from the Dutch National Food Consumption Survey 2012-2016 and included 646 children aged 1-3 years. Based on 24-h dietary recalls and a questionnaire, a two-step cluster analysis was conducted to identify clusters in the intake of fruit, vegetables, sugar-sweetened beverages and unhealthy snacks, physical activity and screen time. Logistic regression models assessed associations between socio-demographic characteristics and cluster allocation. RESULTS Three clusters emerged from the data. The 'relatively healthy cluster' demonstrated a high intake of fruit and vegetables, low sugar-sweetened beverage and unhealthy snack intake and low screen time. The 'active snacking cluster' was characterised by high unhealthy snack intake and high physical activity, and the 'sedentary sweet beverage cluster' by high intake of sugar-sweetened beverages and high screen time. Children aged 1 year were most likely to be allocated to the 'relatively healthy cluster'. Compared to children of parents with a high education level, children of parents with a low or middle education level were less likely to be in the 'relatively healthy cluster', but more likely to be in the 'sedentary sweet beverage cluster'. CONCLUSION Clusters of lifestyle behaviours can be distinguished already in children aged 1-3 years. To promote healthy lifestyle behaviour, efforts may focus on maintaining healthy behaviour in 1-year-olds and more on switching towards healthy behaviour in 2- and 3-year-olds.
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Affiliation(s)
- Anne Krijger
- Department of Pediatrics and Pediatric Surgery, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands.
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
| | - Elly Steenbergen
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Lieke Schiphof-Godart
- Department of Medical Informatics, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Caroline van Rossum
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | - Liset Elstgeest
- Department of Pediatrics and Pediatric Surgery, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands
- Reinier Academy, Reinier de Graaf Hospital, Delft, The Netherlands
| | - Sovianne Ter Borg
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Koen Joosten
- Department of Pediatrics and Pediatric Surgery, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands
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Anselma M, Altenburg TM, Twisk JWR, Wang X, Chinapaw MJM. How to Evaluate the Effectiveness of Health Promotion Actions Developed Through Youth-Centered Participatory Action Research. HEALTH EDUCATION & BEHAVIOR 2023; 50:199-210. [PMID: 34628967 PMCID: PMC10021122 DOI: 10.1177/10901981211046533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Most actions targeting children's health behaviors have limited involvement of children in the development, potentially contributing to disappointing effectiveness. Therefore, in the 3-year "Kids in Action" study, 9- to 12-year-old children from a lower-socioeconomic neighborhood were involved as coresearchers in the development, implementation, and evaluation of actions targeting health behaviors. The current study describes the controlled trial that evaluated the effects on children's energy balance-related behaviors, physical fitness, and self-rated health, as well as experienced challenges and recommendations for future evaluations. Primary school children from the three highest grades of four intervention and four control schools were eligible for participation. Outcome measures assessed at baseline, and at 1- and 2-year follow-up were as follows: motor fitness by the MOPER test (N = 656, N = 485, N = 608, respectively), physical activity and sedentary behavior by accelerometry (N = 223, N = 149, N = 164, respectively), and consumption of sugar sweetened beverages and snacks and self-rated health by a questionnaire (N = 322, N = 281, N = 275, respectively). Mixed-model analyses were performed adjusted for clustering within schools and relevant confounders. Significant beneficial intervention effects were found on self-reported consumption of energy/sports drinks at T2 versus T0, and on total time and ≥5-minute bouts of moderate-to-vigorous physical activity at T1 versus T0. Significant adverse effects were found on "speed and agility" and "coordination and upper-limb speed." No other significant effects were found. The inconsistent intervention effects may be explained by the dynamic cohort and suboptimal outcome measures. We advise future studies with a similar approach to apply alternative evaluation designs, such as the delayed baseline design.
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Affiliation(s)
- Manou Anselma
- Amsterdam UMC, Vrije Universiteit
Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health
research institute, Amsterdam, The Netherlands
- Manou Anselma, Department of Public and
Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam
Public Health research institute, Van der Boechorststraat 7, Amsterdam NL-1081
BT, Netherlands.
| | - Teatske M. Altenburg
- Amsterdam UMC, Vrije Universiteit
Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health
research institute, Amsterdam, The Netherlands
| | - Jos W. R. Twisk
- Amsterdam UMC, Vrije Universiteit
Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health
research institute, Amsterdam, The Netherlands
| | - Xinhui Wang
- College of Computer Science, Qinghai
Normal University, Xining, Qinghai, China
| | - Mai J. M. Chinapaw
- Amsterdam UMC, Vrije Universiteit
Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health
research institute, Amsterdam, The Netherlands
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Fernandes RC, Höfelmann DA. Patterns of energy balance-related behaviors and food insecurity in pregnant women. CIENCIA & SAUDE COLETIVA 2023; 28:909-920. [PMID: 36888873 DOI: 10.1590/1413-81232023283.13342022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/02/2022] [Indexed: 03/08/2023] Open
Abstract
The behaviors related to caloric balance during pregnancy can lead to short- and long-term repercussion over the life course. This study aimed to identify patterns of energy balance-related behavior (EBRB) and its association with food insecurity (FI) in pregnant women. Cross-sectional, with pregnant women undergoing prenatal care in public health units in Colombo, Brazil, in 2018/2019. EBRB patterns were identified by factor analysis, and the scores were compared according to FI levels (mild and moderate/severe (M/S) through quantile regression. Four EBRB patterns were identified among 535 pregnant women: Factor 1- household/caregiving activities, exercise/sport, and physical inactivity; Factor 2 - fruits and vegetables; Factor 3 - paid work and commuting; Factor 4 - soda and sweetened beverage, sweets, and goodies. After adjusted analyses, women with mild FI presented higher scores for Factor 1 and lower scores for Factor 3. Higher scores for Factor 4 (p25) were observed among women with mild FI in simultaneous quantile regression. M/S FI was associated with lower scores for Factor 3 (p75). Mixed patterns with factors negatively and positively associated with energy balance were identified among pregnant women with FI.
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Affiliation(s)
- Renata Cordeiro Fernandes
- Programa de Pós-Graduação em Alimentação e Nutrição, Universidade Federal do Paraná. Av. Lothário Meissner 632, Jardim Botânico. 80210-170 Curitiba PR
| | - Doroteia Aparecida Höfelmann
- Programa de Pós-Graduação em Alimentação e Nutrição, Universidade Federal do Paraná. Av. Lothário Meissner 632, Jardim Botânico. 80210-170 Curitiba PR
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Zhang S, Gao H, Cui Y, Wang X, Cao W, Ding Q, Chang B. Relationship between energy balance-related behaviors and personal and family factors in overweight/obese primary school students aged 10-12 years in China: a cross-sectional study. BMC Public Health 2022; 22:1968. [PMID: 36303130 PMCID: PMC9608935 DOI: 10.1186/s12889-022-14238-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 09/19/2022] [Indexed: 11/24/2022] Open
Abstract
Background Increasing rates of childhood obesity worldwide are a serious threat to the health of school-aged children. Unhealthy behavioral habits are modifiable factors in the control of childhood obesity, and personal and family factors are key influencing factors of behavioral habits in school-aged children. This study assessed the relationship between overweight/obesity, energy balance-related behaviors (EBRB), and their influencing factors in school-aged children. Methods This cross-sectional survey included 4412 primary school-aged (10–12 years) students who underwent body tests and were selected through stratified sampling in the Northeast, North, Northwest, and Southwest regions of China from March to July 2021. Independent sample t test was used to compare differences between behaviors and influencing factors of energy balance among overweight/obesity and normal weight students. Logistic regression analysis was used to assess the influence of EBRB on body shape. Multiple linear regression was used to assess the influence of personal and family factors on EBRB effects. Results Compared with normal-weight students, number of breakfasts consumed per week by overweight/obese students was significantly lower (p < 0.01), and weekly screen-viewing time was significantly longer (p < 0.01). Overweight/obese students’ health beliefs, parental subjective norms, parental modelling, parental practices, and home availability scores increased significantly in terms of beverage consumption behavior (p < 0.01 or p < 0.05). Attitude, health beliefs, self-efficacy, parental subjective norms, and parental support scores decreased significantly in terms of breakfast consumption (p < 0.01 or p < 0.05). Health belief scores on physical activity increased significantly (p < 0.01), while preference and autonomy scores decreased significantly (p < 0.01). Health beliefs, parental subjective norms, and parental practices scores of screen-viewing activities increased significantly (p < 0.01 or p < 0.05). Breakfast consumption (odds ratio [OR]: 0.911; 95% confidence interval [CI]: 0.870–0.954) and screen-viewing activities (OR:1.055; 95% CI: 1.030–1.080) correlated negatively and positively with overweight/obesity, respectively. The main influencing factors of breakfast behavior in overweight/obese students were self-efficacy (0.14), preference (0.11), attitude (0.07), home availability (0.18), and parent modelling (0.09); those for screen-viewing behavior were preference (0.19), self-efficacy (− 0.15), parental practices (0.13), and parental subjective norm (0.12). Conclusions Irregular breakfast consumption and excessive screen-viewing time are key EBRB associated with overweight/obesity among these Chinese participants. Their unhealthy breakfast consumption and screen-viewing activities result from a combination of personal and family factors. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14238-x.
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Affiliation(s)
- Shicheng Zhang
- grid.440818.10000 0000 8664 1765Liaoning Normal University, Dalian, 116029 Liaoning China
| | - Haining Gao
- grid.443556.50000 0001 1822 1192Shenyang Sport University, Shenyang, 110115 Liaoning China
| | - Ying Cui
- grid.443556.50000 0001 1822 1192Shenyang Sport University, Shenyang, 110115 Liaoning China
| | - Xin Wang
- grid.443556.50000 0001 1822 1192Shenyang Sport University, Shenyang, 110115 Liaoning China
| | - Wenshuo Cao
- grid.443556.50000 0001 1822 1192Shenyang Sport University, Shenyang, 110115 Liaoning China
| | - Qian Ding
- grid.443556.50000 0001 1822 1192Shenyang Sport University, Shenyang, 110115 Liaoning China
| | - Bo Chang
- grid.443556.50000 0001 1822 1192Shenyang Sport University, Shenyang, 110115 Liaoning China
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Parental Perspectives of the Impact of COVID-19 Lockdown on Food-Related Behaviors: Systematic Review. Foods 2022; 11:foods11182851. [PMID: 36140979 PMCID: PMC9498514 DOI: 10.3390/foods11182851] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/06/2022] [Accepted: 09/10/2022] [Indexed: 12/15/2022] Open
Abstract
Home confinement during the COVID-19 pandemic has been accompanied by dramatic changes in household food dynamics that can significantly influence health. This systematic literature review presents parental perspectives of the impact of COVID-19 lockdown (up to 30 June 2022) on food preparation and meal routines, as well as other food-related behaviors, capturing both favorable and unfavorable changes in the household food environment. Themes and trends are identified and associations with other lifestyle factors are assessed. Overall, families enjoyed more time together around food, including planning meals, cooking, and eating together. Eating more diverse foods and balanced home-cooked meals (e.g., fresh fruit and vegetables) was combined with overeating and increased snacking (e.g., high-calorie snacks, desserts, and sweets), as parents became more permissive towards food; however, food insecurity increased among families with the lowest income. Adoption of meal planning skills and online shopping behavior emerged alongside behaviors aimed at self-sufficiency, such as bulk purchasing and stockpiling of non-perishable processed foods. These results are an important first step in recognizing how this pandemic may be affecting the family food environment, including low-income families. Future obesity prevention and treatment initiatives, but also ongoing efforts to address food management, parental feeding practices, and food insecurity, can account for these changes moving forward.
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Nigg C, Niessner C, Burchartz A, Woll A, Schipperijn J. The geospatial and conceptual configuration of the natural environment impacts the association with health outcomes and behavior in children and adolescents. Int J Health Geogr 2022; 21:9. [PMID: 35953832 PMCID: PMC9366780 DOI: 10.1186/s12942-022-00309-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background Studies investigating associations between natural environments and health outcomes or health behaviors in children and adolescents yielded heterogenous results to date. This may be the result of different geospatial configurations of the natural environment and confounding characteristics of the study population. Thus, we investigated how the relationship between the natural environment and mental health, muscular fitness, and physical activity varies depending on the geospatial configuration of nature and children’s and adolescents’ characteristics. Methods Data were derived from the German Motorik-Modul (MoMo) cohort study (2018–2020) that investigates physical activity, muscular fitness, and health parameters in a national sample of children and adolescents (N = 2843) between four and 17 years (Mage = 10.46 ± 3.49 years; 48.3% girls). Mental health was assessed via questionnaire, muscular fitness via standing long jump, and physical activity with 7-day accelerometer measurement. Using geographic information systems, land cover, and land use data, three different nature definitions were applied. Both circular buffers (100–1000 m) and street-network buffers (1000–5000 m) were created for each of the nature definitions. Associations were explored with linear regression models, and interaction analysis was used to investigate how those relationships vary by gender, age, and socio-economic status. Results The relationship between the three outcomes and the natural environment varied considerably depending on the nature definition, buffer size, and buffer type, as well as socio-demographic characteristics. Specifically, when comparing youth with a high socio-economic status to those with a medium socio-economic status, smaller circular buffer distances were related to less physical activity, but larger street-network buffer distances were related to greater mental health problems. Distinct relationships also occurred for youth with low socio-economic status in those relationships, with the pattern being less clear. Conclusions For future health research studies that investigate the role of the natural environment, we argue for the development of an a-priori model that integrates both geospatial considerations (nature definition, buffer type, and buffer size) and conceptual considerations (health outcome/behavior, sample characteristics) based on potentially underlying mechanisms that link the natural environment and the health outcome or behavior under investigation to theoretically underpin the geospatial configuration of the natural environment. Supplementary Information The online version contains supplementary material available at 10.1186/s12942-022-00309-0.
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Affiliation(s)
- Carina Nigg
- Institute of Sport Science, University of Bern, Bremgartenstrasse 145, 3012, Bern, Switzerland. .,Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany.
| | - Claudia Niessner
- Institute of Sport Science, University of Bern, Bremgartenstrasse 145, 3012, Bern, Switzerland
| | - Alexander Burchartz
- Institute of Sport Science, University of Bern, Bremgartenstrasse 145, 3012, Bern, Switzerland
| | - Alexander Woll
- Institute of Sport Science, University of Bern, Bremgartenstrasse 145, 3012, Bern, Switzerland
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark
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9
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D'Souza NJ, Zheng M, Abbott G, Lioret S, Hesketh KD. Differing associations with childhood outcomes using behavioural patterns derived from three data reduction techniques. Int J Epidemiol 2022; 52:577-588. [PMID: 35830330 PMCID: PMC10114100 DOI: 10.1093/ije/dyac142] [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: 10/13/2021] [Accepted: 06/20/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Behavioural patterns help to understand the influence of multiple health behaviours on childhood outcomes. Behavioural patterns derived using different data reduction techniques can be non-identical and may differentially associate with childhood outcomes. This study aimed to compare associations of behavioural patterns derived from three methods with three childhood outcomes. METHODS Data were from the Healthy Active Preschool and Primary Years study when children were 6-8 years old (n = 432). Cluster analysis (CA), latent profile analysis (LPA) and principal component analysis (PCA) were used to derive behavioural patterns from children's diet, physical activity, sedentary behaviour and sleep data. Behavioural data were obtained through parent report and accelerometry. Children's height, weight and waist circumference were measured by trained study staff. Health-related quality of life data were obtained using the Pediatric Quality of Life Inventory and academic performance scores were from a national test. Associations between derived patterns from each method and each of the outcomes were tested using linear regression (adjusted for child age and sex and parent education). RESULTS Three patterns were each derived using CA and LPA, and four patterns were derived using PCA. Each method identified a healthy, an unhealthy and a mixed (comprising healthy and unhealthy behaviours together) pattern. Differences in associations were observed between pattern groups from CA and LPA and pattern scores from PCA with the three outcomes. CONCLUSIONS Discrepancies in associations across pattern derivation methods suggests that the choice of method can influence subsequent associations with outcomes. This has implications for comparison across studies that have employed different methods.
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Affiliation(s)
- Ninoshka J D'Souza
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia
| | - Gavin Abbott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia
| | - Sandrine Lioret
- Research Center in Epidemiology and Biostatistics, Université de Paris, INSERM, INRA, Paris, France
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia
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Guedes DP, Recalcatti R, Missaka MS. Obesogenic clusters: excess body weight-related lifestyle behaviors in schoolchildren. REVISTA BRASILEIRA DE CINEANTROPOMETRIA E DESEMPENHO HUMANO 2022. [DOI: 10.1590/1980-0037.2022v24e82910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
abstract The objective of the study was to identify the existence of clusters in multiple lifestyle behaviors, including fruits/vegetables intake, sweetened products/soft drinks intake, sleep duration, physical activity and sedentary behavior. In sequence, the association between identified clusters and excess body weight in schoolchildren was examined. This was a cross-sectional school-based epidemiological study with approximately 17 thousand schoolchildren aged 4-20 years who participated in the Parana Health Project. Questionnaire was applied with structured questions to collect lifestyle behaviors. Excess body weight was identified through body mass index. Cluster analysis was performed to identify sex-specific clusters of multiple lifestyle behaviors. Analysis of covariance and logistic regression were used to analyze associations between clusters and excess body weight. Five clusters were identified in both sexes. Schoolchildren in the cluster characterized by lower fruits/vegetables intake and greater time spent in sedentary behavior showed close to twice the chance of having excess body weight compared to their peers in the reference cluster (girls: OR=1.98 [1.41-2.93]; boys: OR=1.94 [1.39-3.01]). In the case of schoolchildren in the cluster characterized by high sweetened products/soft drinks intake and shorter sleep duration, the chances of having excess body weight were 69% in girls (OR=1.69 [1.23-2.67]) and 73% in boys (OR=1.73 [1.25-2.91]). In conclusion, high fruits/vegetables intake, low sweetened products/soft drinks intake, longer sleep duration and less sedentary behavior was considered the most effective combination for maintaining a healthy body weight in the sample of schoolchildren.
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Prospective Association of Maternal Educational Level with Child's Physical Activity, Screen Time, and Diet Quality. Nutrients 2021; 14:nu14010160. [PMID: 35011035 PMCID: PMC8747409 DOI: 10.3390/nu14010160] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 11/25/2022] Open
Abstract
Evidence has identified unhealthy lifestyle behaviors as the main contributors to obesity in children, so it is essential to identify factors that could influence children’s lifestyles. The objective of the present study was to analyze the association of baseline maternal educational level with child’s physical activity, screen time, and dietary habits at follow-up. This community-based cohort study was carried out between 2012 and 2014 and included 1405 children aged 8 to 10 years old. Maternal educational level was used as an indicator of child’s socioeconomic status. Physical activity, screen time, and dietary habits were assessed by validated questionnaires. The odds of having commercially baked goods for breakfast [OR 1.47 (95% CI 1.03 to 2.10)], going more than once a week to a fast-food restaurant [OR 1.64 (95% CI 1.20 to 2.26)], and taking sweets and candys several times a day [OR 3.23 (95% CI 2.14 to 4.87) were significantly higher among children whose mothers had a lower educational level compared to their peers whose mothers had a higher level. These associations held for taking sweets and candy several times a day after additional adjustment for the corresponding dietary behavior at baseline. Maternal educational level was inversely associated (p < 0.001) with child’s screen time at follow up and being in the lowest maternal educational category was associated with an increased odds of surpassing the maximum recommended time of screen time of 120 min per day (OR (95% CI) 1.43 (1.07 to 1.90), p = 0.016). Maternal education is a predictor for unhealthy dietary habits and high screen time in children.
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D’Souza NJ, Zheng M, Abbott G, Lioret S, Hesketh KD. Associations between Child and Family Level Correlates and Behavioural Patterns in School-Aged Children. CHILDREN 2021; 8:children8111023. [PMID: 34828735 PMCID: PMC8620248 DOI: 10.3390/children8111023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/02/2021] [Accepted: 11/04/2021] [Indexed: 11/21/2022]
Abstract
Identifying correlates of behavioural patterns are important to target population sub-groups at increased health risk. The aim was to investigate correlates of behavioural patterns comprising four behavioural domains in children. Data were from the HAPPY study when children were 6–8 years (n = 335) and 9–11 years (n = 339). Parents reported correlate and behavioural data (dietary intake, physical activity, sedentary behaviour, and sleep). Behavioural data were additionally captured using accelerometers. Latent profile analysis was used to derive patterns. Patterns were identified as healthy, unhealthy, and mixed at both time points. Multinomial logistic regression tested for associations. Girls were more likely to display healthy patterns at 6–8 years and display unhealthy and mixed patterns at 9–11 years than boys, compared to other patterns at the corresponding ages. Increased risk of displaying the unhealthy pattern with higher age was observed at both timepoints. At 9–11 years, higher parental working hours were associated with lower risk of displaying mixed patterns compared to the healthy pattern. Associations observed revealed girls and older children to be at risk for unhealthy patterns, warranting customisation of health efforts to these groups. The number of behaviours included when deriving patterns and the individual behaviours that dominate each pattern appear to be drivers of the associations for child level, but not for family level, correlates.
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Affiliation(s)
- Ninoshka J. D’Souza
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC 3125, Australia; (M.Z.); (G.A.); (K.D.H.)
- Correspondence:
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC 3125, Australia; (M.Z.); (G.A.); (K.D.H.)
| | - Gavin Abbott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC 3125, Australia; (M.Z.); (G.A.); (K.D.H.)
| | - Sandrine Lioret
- Research Center in Epidemiology and Biostatistics (CRESS), Université de Paris, INSERM, INRAE, 75004 Paris, France;
| | - Kylie D. Hesketh
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC 3125, Australia; (M.Z.); (G.A.); (K.D.H.)
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de Mello GT, Lopes MVV, Minatto G, da Costa RM, Matias TS, Guerra PH, Filho VCB, Silva KS. Clustering of Physical Activity, Diet and Sedentary Behavior among Youth from Low-, Middle-, and High-Income Countries: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010924. [PMID: 34682670 PMCID: PMC8535526 DOI: 10.3390/ijerph182010924] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 09/24/2021] [Accepted: 09/30/2021] [Indexed: 12/16/2022]
Abstract
Background: The interaction between physical activity (PA), diet, and sedentary behavior (SB) plays an important role on health-related outcomes. This scoping review (Prospero CRD42018094826) aims to identify and appraise clusters of PA, diet, and SB among youth (0–19 years) according to country income. Methods: Five databases were searched. Fifty-seven articles met the inclusion criteria. Results: Fifty-five cluster types were identified, with greater variety in high-income than lower income countries. The most prevalent profiles were “High SB and consumption of sugar, salt, and beverages (SSB)” (n = 17) and “High PA” (n = 13–5), both of which presented in all income countries. The healthiest profile, “High PA and fruit and vegetables (F&V); Low SB and SSB” (n = 12), was present in upper-middle and high-income countries, while the unhealthiest “Low PA and F&V; High SB and SSB” (n = 6) was present only in high-income countries. Conclusions: High SB and unhealthy diet (SSB) were more prevalent in clusters, mainly in high-income countries. The results support the need for multi-component actions targeting more than one behavior at the same time.
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Affiliation(s)
- Gabrielli Thais de Mello
- Research Center for Physical Activity and Health, Department of Physical Education, School of Sports, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil; (M.V.V.L.); (G.M.); (R.M.d.C.); (T.S.M.); (K.S.S.)
- Correspondence: ; Tel.: +55-49-9107-8363
| | - Marcus Vinicius Veber Lopes
- Research Center for Physical Activity and Health, Department of Physical Education, School of Sports, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil; (M.V.V.L.); (G.M.); (R.M.d.C.); (T.S.M.); (K.S.S.)
| | - Giseli Minatto
- Research Center for Physical Activity and Health, Department of Physical Education, School of Sports, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil; (M.V.V.L.); (G.M.); (R.M.d.C.); (T.S.M.); (K.S.S.)
| | - Rafael Martins da Costa
- Research Center for Physical Activity and Health, Department of Physical Education, School of Sports, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil; (M.V.V.L.); (G.M.); (R.M.d.C.); (T.S.M.); (K.S.S.)
| | - Thiago Sousa Matias
- Research Center for Physical Activity and Health, Department of Physical Education, School of Sports, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil; (M.V.V.L.); (G.M.); (R.M.d.C.); (T.S.M.); (K.S.S.)
| | - Paulo Henrique Guerra
- Department of Medicine, Federal University of Fronteira Sul, Chapecó 89815-899, Brazil;
| | | | - Kelly Samara Silva
- Research Center for Physical Activity and Health, Department of Physical Education, School of Sports, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil; (M.V.V.L.); (G.M.); (R.M.d.C.); (T.S.M.); (K.S.S.)
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D’Souza NJ, Downing K, Abbott G, Orellana L, Lioret S, Campbell KJ, Hesketh KD. A comparison of children's diet and movement behaviour patterns derived from three unsupervised multivariate methods. PLoS One 2021; 16:e0255203. [PMID: 34314443 PMCID: PMC8315509 DOI: 10.1371/journal.pone.0255203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 07/13/2021] [Indexed: 11/29/2022] Open
Abstract
Background Behavioural patterns are typically derived using unsupervised multivariate methods such as principal component analysis (PCA), latent profile analysis (LPA) and cluster analysis (CA). Comparability and congruence between the patterns derived from these methods has not been previously investigated, thus it’s unclear whether patterns from studies using different methods are directly comparable. This study aimed to compare behavioural patterns derived across diet, physical activity, sedentary behaviour and sleep domains, using PCA, LPA and CA in a single dataset. Methods Parent-report and accelerometry data from the second wave (2011/12; child age 6-8y, n = 432) of the HAPPY cohort study (Melbourne, Australia) were used to derive behavioural patterns using PCA, LPA and CA. Standardized variables assessing diet (intake of fruit, vegetable, sweet, and savoury discretionary items), physical activity (moderate- to vigorous-intensity physical activity [MVPA] from accelerometry, organised sport duration and outdoor playtime from parent report), sedentary behaviour (sedentary time from accelerometry, screen time, videogames and quiet playtime from parent report) and sleep (daily sleep duration) were included in the analyses. For each method, commonly used criteria for pattern retention were applied. Results PCA produced four patterns whereas LPA and CA each generated three patterns. Despite the number and characterisation of the behavioural patterns derived being non-identical, each method identified a healthy, unhealthy and a mixed pattern. Three common underlying themes emerged across the methods for each type of pattern: (i) High fruit and vegetable intake and high outdoor play (“healthy”); (ii) poor diet (either low fruit and vegetable intake or high discretionary food intake) and high sedentary behaviour (“unhealthy”); and (iii) high MVPA, poor diet (as defined above) and low sedentary time (“mixed”). Conclusion Within this sample, despite differences in the number of patterns derived by each method, a good degree of concordance across pattern characteristics was seen between the methods. Differences between patterns could be attributable to the underpinning statistical technique of each method. Therefore, acknowledging the differences between the methods and ensuring thorough documentation of the pattern derivation analyses is essential to inform comparison of patterns derived through a range of approaches across studies.
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Affiliation(s)
- Ninoshka J. D’Souza
- Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
- * E-mail:
| | - Katherine Downing
- Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Gavin Abbott
- Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Liliana Orellana
- Biostatistics Unit, Deakin University, Geelong, Victoria, Australia
| | - Sandrine Lioret
- Research Center in Epidemiology and Biostatistics (CRESS), INSERM, INRAE, Université de Paris, Paris, France
| | - Karen J. Campbell
- Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Kylie D. Hesketh
- Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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Hernandez-Martin A, Garcia-Unanue J, Martínez-Rodríguez A, Manzano-Carrasco S, Felipe JL, Carvalho MJ, Gallardo L, Sanchez-Sanchez J. The Effects of Football Practice on Nutritional Status and Body Composition in Children: A Systematic Review and Meta-Analysis. Nutrients 2021; 13:2562. [PMID: 34444722 PMCID: PMC8401613 DOI: 10.3390/nu13082562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/19/2021] [Accepted: 07/23/2021] [Indexed: 12/13/2022] Open
Abstract
Dietary patterns, exercise, sport, and physical activity have been shown to improve body composition in children. This systematic review with meta-analysis analyzed the effects of practicing football on body composition (fat mass, lean body mass, and bone mineral content) in children. An initial search in PubMed, Web of Science, and SPORTDiscus was carried out in April 2021 to identify relevant articles. Inclusion criteria required children up to 12 years of age with a minimum football intervention duration of 10 weeks. Methodological quality of the articles was evaluated using the PEDro scale. Between the 1803 articles originally founded, only 14 articles were included in the meta-analysis. A total of 1643 subjects between the 14 studies were identified. The review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and used Review Manager and Full Meta-Analysis software. The results between the control and experimental groups showed significantly better lean body mass and fat mass values in the experimental group (p < 0.05). Football practice was positively associated with increases in lean body mass (mean difference of 1.55; 95% CI, 0.96, 2.15), decreases in fat mass (mean difference of -0.81; 95% CI, -1.49, -0.13), and increases in whole body bone mineral content (mean difference of 117.68; 95% CI, 83.69, 151.67). In conclusion, the results of this systematic review with meta-analysis suggest that football positively affects body composition in children. However, further research is needed to confirm the results for bone mineral content.
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Affiliation(s)
- Antonio Hernandez-Martin
- IGOID Research Group, Physical Activity and Sport Sciences Department, University of Castilla-La Mancha, 45004 Toledo, Spain; (A.H.-M.); (S.M.-C.); (L.G.)
| | - Jorge Garcia-Unanue
- IGOID Research Group, Physical Activity and Sport Sciences Department, University of Castilla-La Mancha, 45004 Toledo, Spain; (A.H.-M.); (S.M.-C.); (L.G.)
| | | | - Samuel Manzano-Carrasco
- IGOID Research Group, Physical Activity and Sport Sciences Department, University of Castilla-La Mancha, 45004 Toledo, Spain; (A.H.-M.); (S.M.-C.); (L.G.)
| | - Jose Luis Felipe
- School of Sport Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain; (J.L.F.); (J.S.-S.)
| | - Maria Jose Carvalho
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, 4099-002 Porto, Portugal;
| | - Leonor Gallardo
- IGOID Research Group, Physical Activity and Sport Sciences Department, University of Castilla-La Mancha, 45004 Toledo, Spain; (A.H.-M.); (S.M.-C.); (L.G.)
| | - Javier Sanchez-Sanchez
- School of Sport Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain; (J.L.F.); (J.S.-S.)
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Nigg C, Oriwol D, Wunsch K, Burchartz A, Kolb S, Worth A, Woll A, Niessner C. Population density predicts youth's physical activity changes during Covid-19 - Results from the MoMo study. Health Place 2021; 70:102619. [PMID: 34233210 PMCID: PMC9190022 DOI: 10.1016/j.healthplace.2021.102619] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/29/2021] [Accepted: 06/29/2021] [Indexed: 12/24/2022]
Abstract
Children in Germany showed positive physical activity changes during the first Covid-19 lockdown in April 2020, but it is unclear how the changes relate to population density, which we investigated in a longitudinal sample of 1711 youth (4–17 years). For each ten citizens more per km2, less positive physical activity changes were observed. For example, a child living in an area with 100 citizens/km2 increased daily life physical activity by 44.50 min/day, whereas a child living in an area with 3000 citizens/km2 only engaged in an additional 9.70 min/day. Policymakers should ensure that youth in densely populated areas have access to physical activity opportunities during the pandemic.
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Affiliation(s)
- Carina Nigg
- Institute of Sport Science, University of Bern, Bremgartenstrasse 145, 3012, Bern, Switzerland; Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany.
| | - Doris Oriwol
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany; Institute of Movement and Sport, University of Education Karlsruhe, Bismarckstraße 10, 76133, Karlsruhe, Germany.
| | - Kathrin Wunsch
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany.
| | - Alexander Burchartz
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany.
| | - Simon Kolb
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany.
| | - Annette Worth
- Institute of Movement and Sport, University of Education Karlsruhe, Bismarckstraße 10, 76133, Karlsruhe, Germany.
| | - Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany.
| | - Claudia Niessner
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany.
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17
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Dietary Patterns and Their Association with Body Composition and Cardiometabolic Markers in Children and Adolescents: Genobox Cohort. Nutrients 2020; 12:nu12113424. [PMID: 33171599 PMCID: PMC7695147 DOI: 10.3390/nu12113424] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/03/2020] [Accepted: 11/06/2020] [Indexed: 12/20/2022] Open
Abstract
Diet is a key factor for obesity development; however, limited data are available on dietary cluster analysis in children with obesity. We aimed to assess the associations between dietary patterns and obesity and several cardiometabolic markers. Anthropometry, bioelectrical impedance, blood pressure and plasma biomarkers of oxidative stress, inflammation and endothelial damage were determined in 674 Caucasian children, aged 5-16, with normal or excess weight. Using a food frequency questionnaire and cluster analysis, two consistent dietary patterns were shown, labeled as health conscious (HC) and sweet and processed (SP). The HC pattern included a greater proportion of participants with overweight/obesity than the SP cluster (80.1% vs. 63.8%). However, children with obesity within the HC cluster, showed less abdominal fat, through waist to hip (0.93 vs. 0.94) and waist to height (0.61 vs. 0.63) indexes (p < 0.01). Univariate general models showed several additional differences in cardiometabolic risk biomarkers in the global and stratified analyses, with a healthier profile being observed mainly in the HC cluster. However, multivariate models questioned these findings and pointed out the need for further studies in this field. Anyhow, our findings support the benefits of a healthy diet and highlight the importance of dietary patterns in the cardiometabolic risk assessment of children with overweight/obesity, beyond weight control.
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Ayala-Marín AM, Iguacel I, Miguel-Etayo PD, Moreno LA. Consideration of Social Disadvantages for Understanding and Preventing Obesity in Children. Front Public Health 2020; 8:423. [PMID: 32984237 PMCID: PMC7485391 DOI: 10.3389/fpubh.2020.00423] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 07/13/2020] [Indexed: 01/22/2023] Open
Abstract
Addressing social disadvantages that lead to obesity should be a public health priority. Obesity prevalence among children and adolescents has reached a plateau in countries with high income but it continues rising in low-income and middle-income countries. In high-income countries, an elevated prevalence of obesity is found among racial and ethnic minority groups and individuals from disadvantaged socioeconomic backgrounds. In addition to classic socioeconomic status (SES) factors, like income, parental education, and occupation, recent publications have linked parental social disadvantages, such as minimal social network, non-traditional family structure, migrant status and unemployment, with obesogenic behaviors and obesity among children. Socio-ecological models of obesity in children can explain the influence of classic SES factors, social disadvantages, culture, and genes on behaviors that could lead to obesity, contributing to the elevated prevalence of obesity. Obesity is a multifactorial disease in which multilevel interventions seem to be the most effective approach to prevent obesity in children, but previous meta-analyses have found that multilevel interventions had poor or inconsistent results. Despite these results, some multilevel interventions addressing specific disadvantaged social groups have shown beneficial effects on children's weight and energy balance-related behaviors, while other interventions have benefited children from both disadvantaged and non-disadvantaged backgrounds. Considering obesity as a worldwide problem, the World Health Organization, the European Commission, and the National Institutes of Health recommend the implementation of obesity prevention programs, but the implementation of such programs without taking into consideration social disadvantages may be an unsuccessful approach. Therefore, the present publication consists of a review of the pertinent literature related to social disadvantage and its consequences for behaviors that could lead to childhood obesity. In addition, we will discuss the relationship between social disadvantages and the socio-ecological model of obesity in children. Finally, we will summarize the relevant aspects of multilevel intervention programs aiming to prevent obesity in children and provide recommendations for future research and intervention approaches to improve weight status in children with social disadvantages.
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Affiliation(s)
- Alelí M Ayala-Marín
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, España.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Universidad de Zaragoza, Zaragoza, España.,Instituto Agroalimentario de Aragón, Universidad de Zaragoza, Zaragoza, España.,Departamento de Fisiatría y Enfermería, Universidad de Zaragoza, Zaragoza, España
| | - Isabel Iguacel
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, España.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, España
| | - Pilar De Miguel-Etayo
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, España.,Instituto Agroalimentario de Aragón, Universidad de Zaragoza, Zaragoza, España.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, España
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, España.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Universidad de Zaragoza, Zaragoza, España.,Instituto Agroalimentario de Aragón, Universidad de Zaragoza, Zaragoza, España.,Departamento de Fisiatría y Enfermería, Universidad de Zaragoza, Zaragoza, España.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, España
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19
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D'Souza NJ, Kuswara K, Zheng M, Leech R, Downing KL, Lioret S, Campbell KJ, Hesketh KD. A systematic review of lifestyle patterns and their association with adiposity in children aged 5-12 years. Obes Rev 2020; 21:e13029. [PMID: 32297464 DOI: 10.1111/obr.13029] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/16/2020] [Accepted: 03/17/2020] [Indexed: 12/11/2022]
Abstract
Diet, physical activity, sedentary behaviour and sleep are typically examined independently with childhood adiposity; however, their combined influence remains uncertain. This review aims to systematically summarize evidence on the clustering of these behaviours through lifestyle patterns and evaluate associations with adiposity in children aged 5-12 years. Search strategies were run in six databases. Twenty-eight papers met the inclusion criteria, six of which included all four behaviours. A range of lifestyle patterns were identified (healthy, unhealthy and mixed). Mixed patterns were most frequently reported. Unhealthy patterns comprising low physical activity and high sedentary behaviour were also frequently observed. Mixed patterns comprising healthy diets, low physical activity and high sedentary behaviour were more commonly seen in girls, whereas boys were more physically active, similarly sedentary and had unhealthier diets. Children from lower socio-economic backgrounds tended to more frequently display unhealthy patterns. Unhealthy lifestyle patterns were more often associated with adiposity risk than healthy and mixed patterns. With few studies including all four behaviours, it is difficult to establish a clear picture of their interplay and associations with adiposity. Nonetheless, reliance on lifestyle patterns is likely more beneficial than individual behaviours in targeting adiposity and improving understanding of how these behaviours influence health.
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Affiliation(s)
- Ninoshka J D'Souza
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Konsita Kuswara
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Rebecca Leech
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Katherine L Downing
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Sandrine Lioret
- Research Center in Epidemiology and Biostatistics (CRESS), Universite de Paris, INSERM, INRA, 75004, Paris, France
| | - Karen J Campbell
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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Yang-Huang J, van Grieken A, Wang L, Jansen W, Raat H. Clustering of Sedentary Behaviours, Physical Activity, and Energy-Dense Food Intake in Six-Year-Old Children: Associations with Family Socioeconomic Status. Nutrients 2020; 12:nu12061722. [PMID: 32526862 PMCID: PMC7352876 DOI: 10.3390/nu12061722] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 12/16/2022] Open
Abstract
This study examined the clustering of lifestyle behaviours in children aged six years from a prospective cohort study in the Netherlands. Additionally, we analysed the associations between socioeconomic status and the lifestyle behaviour clusters that we identified. Data of 4059 children from the Generation R Study were analysed. Socioeconomic status was measured by maternal educational level and net household income. Lifestyle behaviours including screen time, physical activity, calorie-rich snack consumption and sugar-sweetened beverages consumption were measured via a parental questionnaire. Hierarchical and non-hierarchical cluster analyses were applied. The associations between socioeconomic status and lifestyle behaviour clusters were assessed using logistic regression models. Three lifestyle clusters were identified: “relatively healthy lifestyle” cluster (n = 1444), “high screen time and physically inactive” cluster (n = 1217), and “physically active, high snacks and sugary drinks” cluster (n = 1398). Children from high educated mothers or high-income households were more likely to be allocated to the “relatively healthy lifestyle” cluster, while children from low educated mothers or from low-income households were more likely to be allocated in the “high screen time and physically inactive” cluster. Intervention development and prevention strategies may use this information to further target programs promoting healthy behaviours of children and their families.
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Affiliation(s)
- Junwen Yang-Huang
- The Generation R Study Group, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands;
- Department of Public Health, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands; (A.v.G.); (L.W.); (W.J.)
| | - Amy van Grieken
- Department of Public Health, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands; (A.v.G.); (L.W.); (W.J.)
| | - Lu Wang
- Department of Public Health, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands; (A.v.G.); (L.W.); (W.J.)
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Wilma Jansen
- Department of Public Health, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands; (A.v.G.); (L.W.); (W.J.)
- Municipality of Rotterdam, 3011 AD Rotterdam, The Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands; (A.v.G.); (L.W.); (W.J.)
- Correspondence: ; Tel.: +31-615127884
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Hodder RK, O'Brien KM, Tzelepis F, Wyse RJ, Wolfenden L. Interventions for increasing fruit and vegetable consumption in children aged five years and under. Cochrane Database Syst Rev 2020; 5:CD008552. [PMID: 32449203 PMCID: PMC7273132 DOI: 10.1002/14651858.cd008552.pub7] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Insufficient consumption of fruits and vegetables in childhood increases the risk of future non-communicable diseases, including cardiovascular disease. Testing the effects of interventions to increase consumption of fruit and vegetables, including those focused on specific child-feeding strategies or broader multicomponent interventions targeting the home or childcare environment is required to assess the potential to reduce this disease burden. OBJECTIVES To assess the effectiveness, cost effectiveness and associated adverse events of interventions designed to increase the consumption of fruit, vegetables or both amongst children aged five years and under. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase and two clinical trials registries to identify eligible trials on 25 January 2020. We searched Proquest Dissertations and Theses in November 2019. We reviewed reference lists of included trials and handsearched three international nutrition journals. We contacted authors of included trials to identify further potentially relevant trials. SELECTION CRITERIA We included randomised controlled trials, including cluster-randomised controlled trials and cross-over trials, of any intervention primarily targeting consumption of fruit, vegetables or both among children aged five years and under, and incorporating a dietary or biochemical assessment of fruit or vegetable consumption. Two review authors independently screened titles and abstracts of identified papers; a third review author resolved disagreements. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed the risks of bias of included trials; a third review author resolved disagreements. Due to unexplained heterogeneity, we used random-effects models in meta-analyses for the primary review outcomes where we identified sufficient trials. We calculated standardised mean differences (SMDs) to account for the heterogeneity of fruit and vegetable consumption measures. We conducted assessments of risks of bias and evaluated the quality of evidence (GRADE approach) using Cochrane procedures. MAIN RESULTS We included 80 trials with 218 trial arms and 12,965 participants. Fifty trials examined the impact of child-feeding practices (e.g. repeated food exposure) in increasing child vegetable intake. Fifteen trials examined the impact of parent nutrition education only in increasing child fruit and vegetable intake. Fourteen trials examined the impact of multicomponent interventions (e.g. parent nutrition education and preschool policy changes) in increasing child fruit and vegetable intake. Two trials examined the effect of a nutrition education intervention delivered to children in increasing child fruit and vegetable intake. One trial examined the impact of a child-focused mindfulness intervention in increasing vegetable intake. We judged 23 of the 80 included trials as free from high risks of bias across all domains. Performance, detection and attrition bias were the most common domains judged at high risk of bias for the remaining trials. There is low-quality evidence that child-feeding practices versus no intervention may have a small positive effect on child vegetable consumption, equivalent to an increase of 5.30 grams as-desired consumption of vegetables (SMD 0.50, 95% CI 0.29 to 0.71; 19 trials, 2140 participants; mean post-intervention follow-up = 8.3 weeks). Multicomponent interventions versus no intervention has a small effect on child consumption of fruit and vegetables (SMD 0.32, 95% CI 0.09 to 0.55; 9 trials, 2961 participants; moderate-quality evidence; mean post-intervention follow-up = 5.4 weeks), equivalent to an increase of 0.34 cups of fruit and vegetables a day. It is uncertain whether there are any short-term differences in child consumption of fruit and vegetables in meta-analyses of trials examining parent nutrition education versus no intervention (SMD 0.13, 95% CI -0.02 to 0.28; 11 trials, 3050 participants; very low-quality evidence; mean post-intervention follow-up = 13.2 weeks). We were unable to pool child nutrition education interventions in meta-analysis; both trials reported a positive intervention effect on child consumption of fruit and vegetables (low-quality evidence). Very few trials reported long-term effectiveness (6 trials), cost effectiveness (1 trial) or unintended adverse consequences of interventions (2 trials), limiting our ability to assess these outcomes. Trials reported receiving governmental or charitable funds, except for four trials reporting industry funding. AUTHORS' CONCLUSIONS Despite identifying 80 eligible trials of various intervention approaches, the evidence for how to increase children's fruit and vegetable consumption remains limited in terms of quality of evidence and magnitude of effect. Of the types of interventions identified, there was moderate-quality evidence that multicomponent interventions probably lead to, and low-quality evidence that child-feeding practice may lead to, only small increases in fruit and vegetable consumption in children aged five years and under. It is uncertain whether parent nutrition education or child nutrition education interventions alone are effective in increasing fruit and vegetable consumption in children aged five years and under. Our confidence in effect estimates for all intervention approaches, with the exception of multicomponent interventions, is limited on the basis of the very low to low-quality evidence. Long-term follow-up of at least 12 months is required and future research should adopt more rigorous methods to advance the field. This is a living systematic review. Living systematic reviews offer a new approach to review updating, in which the review is continually updated, incorporating relevant new evidence as it becomes available. Please refer to the Cochrane Database of Systematic Reviews for the current status of this review.
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Affiliation(s)
- Rebecca K Hodder
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
- Priority Research Centre in Health and Behaviour, University of Newcastle, Callaghan, Australia
| | - Kate M O'Brien
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
- Priority Research Centre in Health and Behaviour, University of Newcastle, Callaghan, Australia
| | - Flora Tzelepis
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
- Priority Research Centre in Health and Behaviour, University of Newcastle, Callaghan, Australia
| | - Rebecca J Wyse
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
- Priority Research Centre in Health and Behaviour, University of Newcastle, Callaghan, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
- Priority Research Centre in Health and Behaviour, University of Newcastle, Callaghan, Australia
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22
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Hodder RK, O'Brien KM, Stacey FG, Tzelepis F, Wyse RJ, Bartlem KM, Sutherland R, James EL, Barnes C, Wolfenden L. Interventions for increasing fruit and vegetable consumption in children aged five years and under. Cochrane Database Syst Rev 2019; 2019:CD008552. [PMID: 31697869 PMCID: PMC6837849 DOI: 10.1002/14651858.cd008552.pub6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Insufficient consumption of fruits and vegetables in childhood increases the risk of future non-communicable diseases, including cardiovascular disease. Interventions to increase consumption of fruit and vegetables, such as those focused on specific child-feeding strategies and parent nutrition education interventions in early childhood may therefore be an effective strategy in reducing this disease burden. OBJECTIVES To assess the effectiveness, cost effectiveness and associated adverse events of interventions designed to increase the consumption of fruit, vegetables or both amongst children aged five years and under. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase and two clinical trials registries to identify eligible trials on 25 August 2019. We searched Proquest Dissertations and Theses in May 2019. We reviewed reference lists of included trials and handsearched three international nutrition journals. We contacted authors of included trials to identify further potentially relevant trials. SELECTION CRITERIA We included randomised controlled trials, including cluster-randomised controlled trials and cross-over trials, of any intervention primarily targeting consumption of fruit, vegetables or both among children aged five years and under, and incorporating a dietary or biochemical assessment of fruit or vegetable consumption. Two review authors independently screened titles and abstracts of identified papers; a third review author resolved disagreements. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed the risks of bias of included trials; a third review author resolved disagreements. Due to unexplained heterogeneity, we used random-effects models in meta-analyses for the primary review outcomes where we identified sufficient trials. We calculated standardised mean differences (SMDs) to account for the heterogeneity of fruit and vegetable consumption measures. We conducted assessments of risks of bias and evaluated the quality of evidence (GRADE approach) using Cochrane procedures. MAIN RESULTS We included 78 trials with 214 trial arms and 13,746 participants. Forty-eight trials examined the impact of child-feeding practices (e.g. repeated food exposure) in increasing child vegetable intake. Fifteen trials examined the impact of parent nutrition education in increasing child fruit and vegetable intake. Fourteen trials examined the impact of multicomponent interventions (e.g. parent nutrition education and preschool policy changes) in increasing child fruit and vegetable intake. Two trials examined the effect of a nutrition education intervention delivered to children in increasing child fruit and vegetable intake. One trial examined the impact of a child-focused mindfulness intervention in increasing vegetable intake. We judged 20 of the 78 included trials as free from high risks of bias across all domains. Performance, detection and attrition bias were the most common domains judged at high risk of bias for the remaining trials. There is very low-quality evidence that child-feeding practices versus no intervention may have a small positive effect on child vegetable consumption equivalent to an increase of 4.45 g as-desired consumption of vegetables (SMD 0.42, 95% CI 0.23 to 0.60; 18 trials, 2004 participants; mean post-intervention follow-up = 8.2 weeks). Multicomponent interventions versus no intervention has a small effect on child consumption of fruit and vegetables (SMD 0.34, 95% CI 0.10 to 0.57; 9 trials, 3022 participants; moderate-quality evidence; mean post-intervention follow-up = 5.4 weeks), equivalent to an increase of 0.36 cups of fruit and vegetables per day. It is uncertain whether there are any short-term differences in child consumption of fruit and vegetables in meta-analyses of trials examining parent nutrition education versus no intervention (SMD 0.12, 95% CI -0.03 to 0.28; 11 trials, 3078 participants; very low-quality evidence; mean post-intervention follow-up = 13.2 weeks). We were unable to pool child nutrition education interventions in meta-analysis; both trials reported a positive intervention effect on child consumption of fruit and vegetables (low-quality evidence). Very few trials reported long-term effectiveness (6 trials), cost effectiveness (1 trial) and unintended adverse consequences of interventions (2 trials), limiting their assessment. Trials reported receiving governmental or charitable funds, except for four trials reporting industry funding. AUTHORS' CONCLUSIONS Despite identifying 78 eligible trials of various intervention approaches, the evidence for how to increase children's fruit and vegetable consumption remains limited. There was very low-quality evidence that child-feeding practice may lead to, and moderate-quality evidence that multicomponent interventions probably lead to small increases in fruit and vegetable consumption in children aged five years and younger. It is uncertain whether parent nutrition education interventions are effective in increasing fruit and vegetable consumption in children aged five years and younger. Given that the quality of the evidence is very low or low, future research will likely change estimates and conclusions. Long-term follow-up of at least 12 months is required and future research should adopt more rigorous methods to advance the field. This is a living systematic review. Living systematic reviews offer a new approach to review updating, in which the review is continually updated, incorporating relevant new evidence as it becomes available. Please refer to the Cochrane Database of Systematic Reviews for the current status of this review.
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Affiliation(s)
- Rebecca K Hodder
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia
- Hunter Medical Research InstituteNew LambtonAustralia
- University of NewcastlePriority Research Centre in Health and BehaviourCallaghanAustralia
| | - Kate M O'Brien
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia
- Hunter Medical Research InstituteNew LambtonAustralia
- University of NewcastlePriority Research Centre in Health and BehaviourCallaghanAustralia
| | - Fiona G Stacey
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia
- Hunter Medical Research InstituteNew LambtonAustralia
- University of NewcastlePriority Research Centre in Health and BehaviourCallaghanAustralia
- University of NewcastlePriority Research Centre in Physical Activity and NutritionCallaghanAustralia
| | - Flora Tzelepis
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia
- Hunter Medical Research InstituteNew LambtonAustralia
- University of NewcastlePriority Research Centre in Health and BehaviourCallaghanAustralia
| | - Rebecca J Wyse
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia
- Hunter Medical Research InstituteNew LambtonAustralia
- University of NewcastlePriority Research Centre in Health and BehaviourCallaghanAustralia
| | - Kate M Bartlem
- University of NewcastleSchool of PsychologyUniversity DriveCallaghanNew South WalesAustralia2308
| | - Rachel Sutherland
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia
- Hunter Medical Research InstituteNew LambtonAustralia
- University of NewcastlePriority Research Centre in Health and BehaviourCallaghanAustralia
| | - Erica L James
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia
- Hunter Medical Research InstituteNew LambtonAustralia
| | - Courtney Barnes
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia
- Hunter Medical Research InstituteNew LambtonAustralia
- University of NewcastlePriority Research Centre in Health and BehaviourCallaghanAustralia
| | - Luke Wolfenden
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia
- Hunter Medical Research InstituteNew LambtonAustralia
- University of NewcastlePriority Research Centre in Health and BehaviourCallaghanAustralia
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Vinciguerra F, Tumminia A, Roppolo F, Romeo LC, La Spina N, Baratta R, Parrino C, Sciacca L, Vigneri R, Frittitta L. Impact of unhealthy childhood and unfavorable parents' characteristics on adiposity in schoolchildren. Diabetes Metab Res Rev 2019; 35:e3199. [PMID: 31257680 DOI: 10.1002/dmrr.3199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 06/06/2019] [Accepted: 06/20/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND Childhood obesity is encouraged by low physical activity (PA), time spent using screens (screen time, ST), and by sugar-sweetened beverage consumption (SSBc). It is also influenced by unfavorable parents' characteristics, such as a high body mass index (BMI) and low education level (EL). Our aim was to evaluate the overall and specific influence of these factors on childhood adiposity. MATERIAL AND METHODS Anthropometric parameters including BMI z-score, waist circumference (WC), waist to height ratio (WtHR), and fat mass were measured in a cohort of 1702 schoolchildren (6.0-14.5 years, mean 10.7 ± 1.8) and questionnaires concerning children's PA, ST, and SSBc, and parent's BMI and EL were administered to parents. RESULTS Overweight/obesity prevalence was higher (P < .0001) in males (57%) than in females (43%). Less physically active children (28.9%) had a higher prevalence of overweight/obesity and higher BMI z-score, WC, WtHR, and fat mass relative to more physically active children (P < .05). PA was negatively associated with the BMI z-score (r = 0.18, P < .0001) and fat mass percentage (r = 0.18, P < .0001). Children with more ST had higher WC and WtHR than non-ST viewers (P < .05) but not BMI. Moreover, SSBc did not influence the anthropometric parameters. At multivariate analysis, male gender, less PA, and parental risk factors (parent's overweight/obesity and low/medium EL) were independently associated with overweight and obesity among childhood with a progressively increasing odds ratio (1.65, 1.40, and 1.80, respectively). CONCLUSIONS Male gender, behavioral risk factors (particularly low PA), and parent's characteristics are important correlates of obesity in children.
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Affiliation(s)
- Federica Vinciguerra
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Andrea Tumminia
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Francesca Roppolo
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Luana Catena Romeo
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Nadia La Spina
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | | | - Cristina Parrino
- Endocrinology and Diabetology Unit, I.R.C.C.S, Policlinico San Donato University Hospital, Milan, Italy
| | - Laura Sciacca
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Unit of Endocrinology, Garibaldi Hospital, Catania, Italy
| | | | - Lucia Frittitta
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Unit of Endocrinology, Garibaldi Hospital, Catania, Italy
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24
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Immigration and adolescent health: the case of a multicultural population. Public Health 2019; 175:120-128. [PMID: 31473368 DOI: 10.1016/j.puhe.2019.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 05/29/2019] [Accepted: 07/02/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Previous research indicates that the impact of immigration on health tends to be specific as it is influenced by many factors such as life stage and host country. The aim of this study was to examine the relationship between immigration and adolescent health within the multicultural context of the Brussels-Capital Region in Belgium. STUDY DESIGN The study was based on the 2014 Health Behaviour in School-aged Children survey. The sample consisted of 2962 adolescents from the fifth grade of primary to the last grade of secondary schools in Brussels. METHODS Associations between health indicators and immigration status were analysed using multivariable logistic regression models adjusted for sociodemographic characteristics. RESULTS Natives, first-generation immigrants, second-generation immigrants with both parents born abroad and second-generation immigrants with one parent born abroad represented 19%, 23%, 36% and 22% of the respondents, respectively. Sociodemographic characteristics and health behaviours varied according to immigrant status. Young immigrants were more likely to present overweight (odds ratio [OR] first-generation immigrants vs. natives = 1.76 [95% confidence interval {CI} = 1.16-2.65]; OR second-generation immigrants with both parents born abroad vs. natives = 2.06 [95% CI = 1.41-3.02]; OR second-generation immigrants with one parent born abroad vs. natives = 1.69 [95% CI = 1.12-2.56]). This effect turned out to be partially explained by sociodemographic status and health-related behaviours. No association was detected between immigration and self-rated health and multiple recurrent symptoms. CONCLUSIONS Discrepancies in health behaviours and weight status were identified between adolescents of different immigration background, whereas this was not the case for well-being. Socio-economic status, cultural characteristics and specific behaviours partly explained these findings. Future research is needed to better understand immigration-related risk and protective factors, at individual and school levels.
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Socio-economic and cultural disparities in diet among adolescents and young adults: a systematic review. Public Health Nutr 2019; 23:843-860. [PMID: 31466544 DOI: 10.1017/s1368980019002362] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To explore dietary differences according to socio-economic and sociocultural characteristics of adolescents and young adults. DESIGN A systematic review was conducted. SETTING The main search source was MEDLINE, consulted between January 2012 and March 2017. Quality of selected studies was assessed based on dietary measurement method, sample selection, socio-economic indicator choice and statistical modelling. PARTICIPANTS Cross-sectional and longitudinal studies, assessing relationships between socio-economic status and dietary intake (patterns, scores and food groups) in the 10- to 40-year-old general population of high-income countries, were selected. RESULTS Among the 7250 reports identified, forty were selected, seventeen of which were of high quality; their conclusions, related only to adolescents, were combined and presented. The most favourable dietary patterns, higher dietary scores, greater consumption of fruits, vegetables and dairy products, and lower consumption of sugary sweetened beverages and energy-dense foods, were associated with better parental socio-economic status, particularly in terms of higher education. Migrant status was associated with plant-based patterns, greater consumption of fruits and vegetables and of sugary sweetened beverages and energy-dense foods. For the other food groups, and for young adults, very few high-quality studies were found. CONCLUSIONS The socio-economic gradient in adolescent diets requires confirmation by higher-grade studies of a wider set of food groups and must be extended to young adult populations. Future nutritional interventions should involve the most vulnerable adolescent populations, taking account of socio-economic status and migration.
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Healthy or Unhealthy? The Cocktail of Health-Related Behavior Profiles in Spanish Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173151. [PMID: 31470547 PMCID: PMC6747495 DOI: 10.3390/ijerph16173151] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/20/2019] [Accepted: 08/23/2019] [Indexed: 11/16/2022]
Abstract
The aim of this study was to identify the prevalence and clustering of health-related behaviors in Spanish adolescents and to examine their association with sex, body mass index (BMI), different types of sedentary screen time, and adherence to 24-hour movement guidelines. A final sample of 173 students (M = 12.99 ± 0.51) participated in this study. Cluster analysis was conducted based on five health-related behaviors: PA and sedentary time derived from accelerometers, as well as healthy diet, sedentary screen time, and sleep duration derived from self-reported scales. Recommendations for 24-hour movement guidelines (i.e., physical activity (PA), screen time, and sleep duration) were analyzed both independently and combined. A total of 8.9% of the sample did not meet any of the guidelines, whereas 72.3%, 17.3%, and 1.7% of the sample met 1, 2, or all 3 guidelines, respectively. Six distinct profiles were identified, most of them showing the co-occurrence of healthy- and unhealthy-related behaviors. Given that most of the adolescents failed to meet the combination of PA, screen time, and sleep duration guidelines, these findings suggest the necessity to implement school-based interventions that target multiple health behaviors, especially because (un)healthy behaviors do not always cluster in the same direction.
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27
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Bel-Serrat S, Ojeda-Rodríguez A, Heinen MM, Buoncristiano M, Abdrakhmanova S, Duleva V, Sant'Angelo VF, Fijałkowska A, Hejgaard T, Huidumac C, Hyska J, Kujundzic E, Milanović SM, Ovezmyradova G, Pérez-Farinós N, Petrauskiene A, Rito AI, Shengelia L, Braunerová RT, Rutter H, Murrin CM, Kelleher CC, Breda J. Clustering of Multiple Energy Balance-Related Behaviors in School Children and its Association with Overweight and Obesity-WHO European Childhood Obesity Surveillance Initiative (COSI 2015⁻2017). Nutrients 2019; 11:E511. [PMID: 30818859 PMCID: PMC6471416 DOI: 10.3390/nu11030511] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 02/19/2019] [Accepted: 02/21/2019] [Indexed: 01/22/2023] Open
Abstract
It is unclear how dietary, physical activity and sedentary behaviors co-occur in school-aged children. We investigated the clustering of energy balance-related behaviors and whether the identified clusters were associated with weight status. Participants were 6- to 9-year-old children (n = 63,215, 49.9% girls) from 19 countries participating in the fourth round (2015/2017) of the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative. Energy balance-related behaviors were parentally reported. Weight and height were objectively measured. We performed cluster analysis separately per group of countries (North Europe, East Europe, South Europe/Mediterranean countries and West-Central Asia). Seven clusters were identified in each group. Healthier clusters were common across groups. The pattern of distribution of healthy and unhealthy behaviors within each cluster was group specific. Associations between the clustering of energy balance-related behaviors and weight status varied per group. In South Europe/Mediterranean countries and East Europe, all or most of the cluster solutions were associated with higher risk of overweight/obesity when compared with the cluster 'Physically active and healthy diet'. Few or no associations were observed in North Europe and West-Central Asia, respectively. These findings support the hypothesis that unfavorable weight status is associated with a particular combination of energy balance-related behavior patterns, but only in some groups of countries.
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Affiliation(s)
- Silvia Bel-Serrat
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin,D4 Dublin, Ireland.
| | - Ana Ojeda-Rodríguez
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin,D4 Dublin, Ireland.
- Department of Nutrition, Food Science and Physiology, University of Navarra, 31008 Pamplona, Spain.
| | - Mirjam M Heinen
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin,D4 Dublin, Ireland.
| | - Marta Buoncristiano
- Division of Noncommunicable Diseases and Promoting Health through the Life-course, WHO European Office for Prevention and Control of Noncommunicable Diseases, 125009 Moscow, Russia.
| | - Shynar Abdrakhmanova
- National Center of Public Health, Ministry of Health of the Republic of Kazakhstan, 50010 Almaty, Kazakhstan.
| | - Vesselka Duleva
- National Center of Public Health and Analyses, 1431 Sofia, Bulgaria.
| | | | - Anna Fijałkowska
- Department of Cardiology, Institute of Mother and Child, 01-211 Warsaw, Poland.
| | | | | | | | - Enisa Kujundzic
- Institute of Public Health of Montenegro, 8100 Podgorica, Montenegro.
| | - Sanja Musić Milanović
- Croatian Institute of Public Health, 10000 Zagreb, Croatia.
- School of Medicine, School of Public Health Andrija Štampar, University of Zagreb, 10000 Zagreb, Croatia.
| | | | | | - Ausra Petrauskiene
- Department of Preventive Medicine, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania.
| | - Ana Isabel Rito
- National Institute of Health Doutor Ricardo Jorge, I.P.,1649-016 Lisbon, Portugal.
| | - Lela Shengelia
- National Center for Disease Control and Public Health of Georgia, 0186 Tbilisi, Georgia.
| | | | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Claverton Down, BA2 7AYBath, UK.
| | - Celine M Murrin
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin,D4 Dublin, Ireland.
| | - Cecily C Kelleher
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin,D4 Dublin, Ireland.
| | - João Breda
- Division of Noncommunicable Diseases and Promoting Health through the Life-course, WHO European Office for Prevention and Control of Noncommunicable Diseases, 125009 Moscow, Russia.
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Emotional Eating, Health Behaviours, and Obesity in Children: A 12-Country Cross-Sectional Study. Nutrients 2019; 11:nu11020351. [PMID: 30736444 PMCID: PMC6412589 DOI: 10.3390/nu11020351] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/05/2019] [Accepted: 02/05/2019] [Indexed: 11/16/2022] Open
Abstract
Eating in response to negative emotions (emotional eating, EE) may predispose an individual to obesity. Yet, it is not well known how EE in children is associated with body mass index (BMI) and health behaviours (i.e., diet, physical activity, sleep, and TV-viewing). In the present study, we examined these associations in a cross-sectional sample of 5426 (54% girls) 9–11-year-old children from 12 countries and five continents. EE, food consumption, and TV-viewing were measured using self-administered questionnaires, and physical activity and nocturnal sleep duration were measured with accelerometers. BMI was calculated using measured weights and heights. EE factor scores were computed using confirmatory factor analysis, and dietary patterns were identified using principal components analysis. The associations of EE with health behaviours and BMI z-scores were analyzed using multilevel models including age, gender, and household income as covariates. EE was positively and consistently (across 12 study sites) associated with an unhealthy dietary pattern (β = 0.29, SE = 0.02, p < 0.0001), suggesting that the association is not restricted to Western countries. Positive associations between EE and physical activity and TV viewing were not consistent across sites. Results tended to be similar in boys and girls. EE was unrelated to BMI in this sample, but prospective studies are needed to determine whether higher EE in children predicts the development of undesirable dietary patterns and obesity over time.
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Abstract
PURPOSE To identify "activity phenotypes" from accelerometer-derived activity characteristics among young adults. METHODS Participants were young adults (n = 628, mean age, 22.1, SD 0.6) in the Raine Study in Western Australia. Sex-specific latent class analyses identified sub-groups using eight indicators derived from 7-day hip-worn Actigraph GT3X+ accelerometers: daily steps, total daily moderate-to-vigorous physical activity (MVPA), MVPA variation, MVPA intensity, MVPA bout duration, sedentary-to-light ratio, sedentary-to-light ratio variation, and sedentary bout duration. RESULTS Five activity phenotypes were identified for women (n = 324) and men (n = 304). Activity phenotype 1 for both women (35%) and men (30%) represented average activity characteristics. Phenotype 2 for women (17%) and men (16%) was characterized by below average total activity and MVPA (10.6 and 16.7 min of MVPA/day, women and men respectively). Phenotype 3 for women (15%) and men (23%) was characterized by below average total physical activity, average MVPA (32.6 and 36.5 min/day), high sedentary-light ratio and long sedentary bouts. Phenotype 4 differed between women (29%) and men (18%) but both had low sedentary-to-light ratios and shorter sedentary bouts. Finally, phenotype 5 in both women (4%) and men (12%) was characterized by extreme MVPA metrics (81.3 and 96.1 min/day). CONCLUSIONS Five activity phenotypes were identified for each gender in this population of young adults which can help design targeted interventions to enhance or modulate activity phenotypes.
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Profile Resemblance in Health-Related Markers: The Portuguese Sibling Study on Growth, Fitness, Lifestyle, and Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122799. [PMID: 30544663 PMCID: PMC6313717 DOI: 10.3390/ijerph15122799] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 12/06/2018] [Accepted: 12/07/2018] [Indexed: 11/17/2022]
Abstract
The co-occurrence of health-related markers and their associations with individual, family, and environmental characteristics have not yet been widely explored in siblings. We aimed to identify multivariate profiles of health-related markers, analyze their associations with biological, sociodemographic, and built environment characteristics, and estimate sibling resemblance in these profiles. The sample includes 736 biological siblings aged 9–20 years. Body fat was measured with a portable bioelectrical impedance scale; biological maturation was assessed with the maturity offset; handgrip strength, standing long jump, one-mile run, and shuttle run were used to mark physical fitness. Health behaviors, sociodemographic, and built environmental characteristics were recorded by questionnaire. Latent profile analysis and multilevel logistic regression models were used; sibling resemblance was estimated with the intraclass correlation (ρ). Two multivariate profiles emerged: “P1 = fit, lower fat and poorer diet” (86.7%) and “P2 = higher fat and lower fit, but better diet” (13.3%). Siblings whose fathers were less qualified in their occupation were more likely to belong to P2 (OR = 1.24, p = 0.04); those whose fathers with Grade 12 and university level education were more likely to fit in P2 compared to peers living with fathers having an educational level below Grade 12 (OR = 3.18, p = 0.03, and OR = 6.40, p = 0.02, Grade 12 and university level, respectively). A moderate sibling profile resemblance was found (0.46 ≤ ρ ≤ 0.55). In conclusion, youth health-related markers present substantial differences linked with their body composition, physical fitness and unhealthy diet. Furthermore, only father socio-demographic characteristics were associated with profile membership. Sibling´s profile resemblance mirrors the effects of genetics and shared characteristics.
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How do energy balance-related behaviors cluster in adolescents? Int J Public Health 2018; 64:195-208. [PMID: 30511170 DOI: 10.1007/s00038-018-1178-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 10/31/2018] [Accepted: 11/22/2018] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES To delineate the clustering of energy balance-related behaviors in adolescents and investigate whether these behaviors are associated with the household socioeconomic status and parental education level. METHODS Two cross-sectional studies assessed information on sedentary behavior, physical activity, sugar-sweetened beverages and fruit and vegetable consumption, and sleep duration by self-reported questionnaires in adolescents (12.5-17.5 years old) from Maringá/Brazil (BRACAH Study; n = 682) and ten European cities (HELENA Study; n = 1252) from nine different countries. Gender-specific cluster analyses were performed separately for each study, applying a combination of hierarchical and non-hierarchical methods. RESULTS Girls showed equivalent behaviors: Sedentary; Active; Unhealthy Eating; Healthy Eating; while boys differed (Brazilian: Sedentary; Active; Healthy Eating; European: Sedentary; Healthy; Unhealthy Eating). In Brazil, we found no association between socioeconomic status and parental education. In European girls, the high socioeconomic status and both parents' university degree were associated with Healthy Eating. In European boys, the high socioeconomic status was associated with Unhealthy Eating, and the mothers' university degree was associated with the Healthy cluster. CONCLUSIONS Adolescents show Sedentary behavior, regardless of their sex, country of origin, or socioeconomic condition.
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Cabanas-Sánchez V, Martínez-Gómez D, Izquierdo-Gómez R, Segura-Jiménez V, Castro-Piñero J, Veiga OL. Association between Clustering of Lifestyle Behaviors and Health-Related Physical Fitness in Youth: The UP&DOWN Study. J Pediatr 2018; 199:41-48.e1. [PMID: 29803300 DOI: 10.1016/j.jpeds.2018.03.075] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 03/08/2018] [Accepted: 03/30/2018] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To examine clustering of lifestyle behaviors in Spanish children and adolescents based on screen time, nonscreen sedentary time, moderate-to-vigorous physical activity, Mediterranean diet quality, and sleep time, and to analyze its association with health-related physical fitness. STUDY DESIGN The sample consisted of 1197 children and adolescents (597 boys), aged 8-18 years, included in the baseline cohort of the UP&DOWN study. Moderate-to-vigorous physical activity was assessed by accelerometry. Screen time, nonscreen sedentary time, Mediterranean diet quality, and sleep time were self-reported by participants. Health-related physical fitness was measured following the Assessing Levels of Physical Activity battery for youth. A 2-stage cluster analysis was performed based on the 5 lifestyle behaviors. Associations of clusters with fatness and physical fitness were analyzed by 1-way ANCOVA. RESULTS Five lifestyle clusters were identified: (1) active (n = 171), (2) sedentary nonscreen sedentary time-high diet quality (n = 250), (3) inactive-high sleep time (n = 249 [20.8%]), (4) sedentary nonscreen sedentary time-low diet quality (n = 273), and (5) sedentary screen time-low sleep time (n = 254). Cluster 1 was the healthiest profile in relation to health-related physical fitness in both boys and girls. In boys, cluster 3 had the worst fatness and fitness levels, whereas in girls the worst scores were found in clusters 4 and 5. CONCLUSIONS Clustering of different lifestyle behaviors was identified and differences in health-related physical fitness were found among clusters, which suggests that special attention should be given to sedentary behaviors in girls and physical activity in boys when developing childhood health prevention strategies focusing on lifestyles patterns.
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Affiliation(s)
- Verónica Cabanas-Sánchez
- Department of Physical Education, Sport and Human Movement, Faculty of Teacher Training and Education, Autonomous University of Madrid, Madrid, Spain.
| | - David Martínez-Gómez
- Department of Physical Education, Sport and Human Movement, Faculty of Teacher Training and Education, Autonomous University of Madrid, Madrid, Spain; IMDEA Food Institute, CEI UAM + CSIC, Madrid, Spain
| | - Rocío Izquierdo-Gómez
- Research Center, Faculty of Education, Universidad Central de Chile, Santiago, Chile; Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain
| | - Víctor Segura-Jiménez
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain
| | - José Castro-Piñero
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain
| | - Oscar L Veiga
- Department of Physical Education, Sport and Human Movement, Faculty of Teacher Training and Education, Autonomous University of Madrid, Madrid, Spain
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Jilani HS, Pohlabeln H, Buchecker K, Gwozdz W, De Henauw S, Eiben G, Molnar D, Moreno LA, Pala V, Reisch L, Russo P, Veidebaum T, Ahrens W, Hebestreit A. Association between parental consumer attitudes with their children's sensory taste preferences as well as their food choice. PLoS One 2018; 13:e0200413. [PMID: 30067786 PMCID: PMC6070197 DOI: 10.1371/journal.pone.0200413] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Accepted: 06/26/2018] [Indexed: 11/30/2022] Open
Abstract
Background We investigated the association between the consumer attitudes of European parents and their children’s taste preferences and food choice. Furthermore, we studied whether the parental consumer attitudes were related to education level. Methods This analysis included 1,407 IDEFICS study children aged 6.0 to 11.8 years and from 7 European countries, who participated in the sensory taste perception module between 2007 and 2010. Parental consumer attitude was operationalized as ‘trusting in foods known from advertisements’ (trusting advertisements) and as ‘not avoiding additives in food’ (not avoiding additives). Parents reported their educational attainment and completed a food frequency questionnaire for their children. Consumption frequencies of sweet, fatty and processed foods as well as a healthy diet adherence score were calculated. Children performed fat, sweet and umami taste preference tests. Multivariable logistic models were used to analyse the association between parental consumer attitudes and their children’s taste preference frequencies as well as parental education. Linear regression models were used to analyse the association between parental consumer attitudes and their children’s food consumption. Results Parental consumer attitudes were not associated with children’s fat, sweet and umami taste preferences. Children of parents trusting advertisements consumed more frequently processed foods (β = 1.21, 95% CI: 0.49; 1.93). Children of parents not avoiding additives consumed more often sweet, fatty and processed foods and had a lower healthy diet adherence score (β = 2.37, 95% CI: 1.03; 3.70; β = 2.27, 95% CI: 1.12; 3.43; β = 0.91, 95% CI: 0.22; 1.59; β = -2.87, 95% CI: -3.89; -1.85, respectively). Unfavourable parental consumer attitudes were associated with a lower parental education level across Europe (Compared to high education: Odds Ratio (OR) of trusting advertisements with medium education: 1.04, 95% CI: 0.77; 1.40; OR with low education: 2.01, 95% CI: 1.15; 3.54; OR of not avoiding additives with medium education: 1.91, 95% CI: 1.44; 2.54; OR with low education: 1.76, 95% CI: 0.96; 3.24). Conclusions Across Europe, unfavourable parental consumer attitudes are associated with a lower diet quality of their children. Parental consumer attitudes in turn were associated with their own level of education. This has implications for policy makers, interventions and health promotion programmes that aim to promote healthy eating.
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Affiliation(s)
- Hannah S. Jilani
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- Institute for Public Health and Nursing Research, University of Bremen and Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | | | - Wencke Gwozdz
- Department of Management, Society and Communication, Copenhagen Business School, Frederiksberg, Denmark
| | - Stefaan De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Gabriele Eiben
- Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, Skövde, Sweden
| | - Dénes Molnar
- Department of Pediatrics, University of Pécs, Medical School, Pécs, Hungary
| | - Luis A. Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - Valeria Pala
- Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Lucia Reisch
- Department of Management, Society and Communication, Copenhagen Business School, Frederiksberg, Denmark
| | - Paola Russo
- Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- * E-mail:
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Hodder RK, O'Brien KM, Stacey FG, Wyse RJ, Clinton‐McHarg T, Tzelepis F, James EL, Bartlem KM, Nathan NK, Sutherland R, Robson E, Yoong SL, Wolfenden L. Interventions for increasing fruit and vegetable consumption in children aged five years and under. Cochrane Database Syst Rev 2018; 5:CD008552. [PMID: 29770960 PMCID: PMC6373580 DOI: 10.1002/14651858.cd008552.pub5] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Insufficient consumption of fruits and vegetables in childhood increases the risk of future non-communicable diseases, including cardiovascular disease. Interventions to increase consumption of fruit and vegetables, such as those focused on specific child-feeding strategies and parent nutrition education interventions in early childhood may therefore be an effective strategy in reducing this disease burden. OBJECTIVES To assess the effectiveness, cost effectiveness and associated adverse events of interventions designed to increase the consumption of fruit, vegetables or both amongst children aged five years and under. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase and two clinical trials registries to identify eligible trials on 25 January 2018. We searched Proquest Dissertations and Theses in November 2017. We reviewed reference lists of included trials and handsearched three international nutrition journals. We contacted authors of included studies to identify further potentially relevant trials. SELECTION CRITERIA We included randomised controlled trials, including cluster-randomised controlled trials and cross-over trials, of any intervention primarily targeting consumption of fruit, vegetables or both among children aged five years and under, and incorporating a dietary or biochemical assessment of fruit or vegetable consumption. Two review authors independently screened titles and abstracts of identified papers; a third review author resolved disagreements. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed the risks of bias of included studies; a third review author resolved disagreements. Due to unexplained heterogeneity, we used random-effects models in meta-analyses for the primary review outcomes where we identified sufficient trials. We calculated standardised mean differences (SMDs) to account for the heterogeneity of fruit and vegetable consumption measures. We conducted assessments of risks of bias and evaluated the quality of evidence (GRADE approach) using Cochrane procedures. MAIN RESULTS We included 63 trials with 178 trial arms and 11,698 participants. Thirty-nine trials examined the impact of child-feeding practices (e.g. repeated food exposure) in increasing child vegetable intake. Fourteen trials examined the impact of parent nutrition education in increasing child fruit and vegetable intake. Nine studies examined the impact of multicomponent interventions (e.g. parent nutrition education and preschool policy changes) in increasing child fruit and vegetable intake. One study examined the effect of a nutrition education intervention delivered to children in increasing child fruit and vegetable intake.We judged 14 of the 63 included trials as free from high risks of bias across all domains; performance, detection and attrition bias were the most common domains judged at high risk of bias for the remaining studies.There is very low quality evidence that child-feeding practices versus no intervention may have a small positive effect on child vegetable consumption equivalent to an increase of 3.50 g as-desired consumption of vegetables (SMD 0.33, 95% CI 0.13 to 0.54; participants = 1741; studies = 13). Multicomponent interventions versus no intervention may have a very small effect on child consumption of fruit and vegetables (SMD 0.35, 95% CI 0.04 to 0.66; participants = 2009; studies = 5; low-quality evidence), equivalent to an increase of 0.37 cups of fruit and vegetables per day. It is uncertain whether there are any short-term differences in child consumption of fruit and vegetables in meta-analyses of trials examining parent nutrition education versus no intervention (SMD 0.12, 95% CI -0.03 to 0.28; participants = 3078; studies = 11; very low-quality evidence).Insufficient data were available to assess long-term effectiveness, cost effectiveness and unintended adverse consequences of interventions. Studies reported receiving governmental or charitable funds, except for four studies reporting industry funding. AUTHORS' CONCLUSIONS Despite identifying 63 eligible trials of various intervention approaches, the evidence for how to increase children's fruit and vegetable consumption remains limited. There was very low- and low-quality evidence respectively that child-feeding practice and multicomponent interventions may lead to very small increases in fruit and vegetable consumption in children aged five years and younger. It is uncertain whether parent nutrition education interventions are effective in increasing fruit and vegetable consumption in children aged five years and younger. Given that the quality of the evidence is very low or low, future research will likely change estimates and conclusions. Long-term follow-up is required and future research should adopt more rigorous methods to advance the field.This is a living systematic review. Living systematic reviews offer a new approach to review updating, in which the review is continually updated, incorporating relevant new evidence as it becomes available. Please refer to the Cochrane Database of Systematic Reviews for the current status of this review.
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Affiliation(s)
- Rebecca K Hodder
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Kate M O'Brien
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Fiona G Stacey
- University of Newcastle, Hunter Medical Research Institute, Priority
Research Centre in Health Behaviour, and Priority Research Centre in
Physical Activity and NutritionSchool of Medicine and Public HealthCallaghanAustralia2287
| | - Rebecca J Wyse
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia2308
| | - Tara Clinton‐McHarg
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia2308
| | - Flora Tzelepis
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia2308
| | - Erica L James
- University of Newcastle, Hunter Medical Research InstituteSchool of Medicine and Public HealthUniversity DriveCallaghanAustralia2308
| | - Kate M Bartlem
- University of NewcastleSchool of PsychologyUniversity DriveCallaghanAustralia2308
| | - Nicole K Nathan
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Rachel Sutherland
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Emma Robson
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Sze Lin Yoong
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Luke Wolfenden
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia2308
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Hodder RK, Stacey FG, O'Brien KM, Wyse RJ, Clinton‐McHarg T, Tzelepis F, James EL, Bartlem KM, Nathan NK, Sutherland R, Robson E, Yoong SL, Wolfenden L. Interventions for increasing fruit and vegetable consumption in children aged five years and under. Cochrane Database Syst Rev 2018; 1:CD008552. [PMID: 29365346 PMCID: PMC6491117 DOI: 10.1002/14651858.cd008552.pub4] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Insufficient consumption of fruits and vegetables in childhood increases the risk of future chronic diseases, including cardiovascular disease. OBJECTIVES To assess the effectiveness, cost effectiveness and associated adverse events of interventions designed to increase the consumption of fruit, vegetables or both amongst children aged five years and under. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE and Embase to identify eligible trials on 25 September 2017. We searched Proquest Dissertations and Theses and two clinical trial registers in November 2017. We reviewed reference lists of included trials and handsearched three international nutrition journals. We contacted authors of included studies to identify further potentially relevant trials. SELECTION CRITERIA We included randomised controlled trials, including cluster-randomised controlled trials and cross-over trials, of any intervention primarily targeting consumption of fruit, vegetables or both among children aged five years and under, and incorporating a dietary or biochemical assessment of fruit or vegetable consumption. Two review authors independently screened titles and abstracts of identified papers; a third review author resolved disagreements. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed the risks of bias of included studies; a third review author resolved disagreements. Due to unexplained heterogeneity, we used random-effects models in meta-analyses for the primary review outcomes where we identified sufficient trials. We calculated standardised mean differences (SMDs) to account for the heterogeneity of fruit and vegetable consumption measures. We conducted assessments of risks of bias and evaluated the quality of evidence (GRADE approach) using Cochrane procedures. MAIN RESULTS We included 55 trials with 154 trial arms and 11,108 participants. Thirty-three trials examined the impact of child-feeding practices (e.g. repeated food exposure) in increasing child vegetable intake. Thirteen trials examined the impact of parent nutrition education in increasing child fruit and vegetable intake. Eight studies examined the impact of multicomponent interventions (e.g. parent nutrition education and preschool policy changes) in increasing child fruit and vegetable intake. One study examined the effect of a nutrition intervention delivered to children in increasing child fruit and vegetable intake.We judged 14 of the 55 included trials as free from high risks of bias across all domains; performance, detection and attrition bias were the most common domains judged at high risk of bias for the remaining studies.Meta-analysis of trials examining child-feeding practices versus no intervention revealed a positive effect on child vegetable consumption (SMD 0.38, 95% confidence interval (CI) 0.15 to 0.61; n = 1509; 11 studies; very low-quality evidence), equivalent to a mean difference of 4.03 g of vegetables. There were no short-term differences in child consumption of fruit and vegetables in meta-analyses of trials examining parent nutrition education versus no intervention (SMD 0.11, 95% CI -0.05 to 0.28; n = 3023; 10 studies; very low-quality evidence) or multicomponent interventions versus no intervention (SMD 0.28, 95% CI -0.06 to 0.63; n = 1861; 4 studies; very low-quality evidence).Insufficient data were available to assess long-term effectiveness, cost effectiveness and unintended adverse consequences of interventions. Studies reported receiving governmental or charitable funds, except for three studies reporting industry funding. AUTHORS' CONCLUSIONS Despite identifying 55 eligible trials of various intervention approaches, the evidence for how to increase children's fruit and vegetable consumption remains sparse. There was very low-quality evidence that child-feeding practice interventions are effective in increasing vegetable consumption in children aged five years and younger, however the effect size was very small and long-term follow-up is required. There was very low-quality evidence that parent nutrition education and multicomponent interventions are not effective in increasing fruit and vegetable consumption in children aged five years and younger. All findings should be considered with caution, given most included trials could not be combined in meta-analyses. Given the very low-quality evidence, future research will very likely change estimates and conclusions. Such research should adopt more rigorous methods to advance the field.This is a living systematic review. Living systematic reviews offer a new approach to review updating, in which the review is continually updated, incorporating relevant new evidence as it becomes available. Please refer to the Cochrane Database of Systematic Reviews for the current status of this review.
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Affiliation(s)
- Rebecca K Hodder
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Fiona G Stacey
- University of Newcastle, Hunter Medical Research Institute, Priority Research Centre in Health Behaviour, and Priority Research Centre in Physical Activity and NutritionSchool of Medicine and Public HealthCallaghanAustralia2287
| | - Kate M O'Brien
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Rebecca J Wyse
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia2308
| | - Tara Clinton‐McHarg
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia2308
| | - Flora Tzelepis
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia2308
| | - Erica L James
- University of Newcastle, Hunter Medical Research InstituteSchool of Medicine and Public HealthUniversity DriveCallaghanAustralia2308
| | - Kate M Bartlem
- University of NewcastleSchool of PsychologyUniversity DriveCallaghanAustralia2308
| | - Nicole K Nathan
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Rachel Sutherland
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Emma Robson
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Sze Lin Yoong
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Luke Wolfenden
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia2308
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Clustering of energy balance-related behaviours and parental education in European preschool children: the ToyBox study. Br J Nutr 2017; 118:1089-1096. [DOI: 10.1017/s0007114517003129] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractEnergy balance-related behaviours (EBRB) are established in childhood and seem to persist through to adulthood. A lower parental educational level was associated with unhealthy behavioural patterns. The aim of the study is to identify clusters of EBRB and examine their association with preschool children’s BMI and maternal, paternal and parental education. A subsample of the ToyBox study (n 5387) conducted in six European countries was used. Six behavioural clusters (‘healthy diet and low activity’, ‘active’, ‘healthy lifestyle’, ‘high water and screen time; low fruits and vegetables (F&V) and physical activity (PA)’, ‘unhealthy lifestyle’ and ‘high F&V consumers’) emerged. The healthiest group characterised by high water and F&V consumption and high PA z scores (‘healthy lifestyle’) was more prevalent among preschool children with at least one medium- or higher-educated parent and showed markedly healthier trends for all the included EBRB. In the opposite, the ‘unhealthy lifestyle’ cluster (characterised by high soft drinks and screen time z scores, and low water, F&V and PA z scores) was more prevalent among children with lower parental, paternal and maternal education levels. OR identified that children with lower maternal, paternal and parental education levels were less likely to be allocated in the ‘healthy lifestyle’ cluster and more likely to be allocated in the ‘unhealthy lifestyle’ cluster. The ‘unhealthy lifestyle’ cluster was more prevalent among children with parents in lower parental educational levels and children who were obese. Therefore, parental educational level is one of the key factors that should be considered when developing childhood obesity prevention interventions.
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Moreira NF, da Veiga GV, Santaliestra-Pasías AM, Androutsos O, Cuenca-García M, de Oliveira ASD, Pereira RA, de Moraes ABDV, Van den Bussche K, Censi L, González-Gross M, Cañada D, Gottrand F, Kafatos A, Marcos A, Widhalm K, Mólnar D, Moreno LA. Clustering of multiple energy balance related behaviors is associated with body fat composition indicators in adolescents: Results from the HELENA and ELANA studies. Appetite 2017; 120:505-513. [PMID: 29017906 DOI: 10.1016/j.appet.2017.10.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 10/05/2017] [Accepted: 10/06/2017] [Indexed: 01/05/2023]
Abstract
The objective of this study was to identify clustering patterns of four energy balance-related behaviors (EBRB): television (TV) watching, moderate and vigorous physical activity (MVPA), consumption of fruits and vegetables (F&V), and consumption of sugar-sweetened beverages (SSB), among European and Brazilian adolescents. EBRB associations with different body fat composition indicators were then evaluated. Participants included adolescents from eight European countries in the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescents) study (n = 2,057, 53.8% female; age: 12.5-17.5 years) and from the metropolitan region of Rio de Janeiro/Brazil in the ELANA study (the Adolescent Nutritional Assessment Longitudinal Study) (n = 968, 53.2% female; age: 13.5-19 years). EBRB data allowed for sex- and study-specific clusters. Associations were estimated by ANOVA and odds ratios. Five clustering patterns were identified. Four similar clusters were identified for each sex and study. Among boys, different cluster identified was characterized by high F&V consumption in the HELENA study and high TV watching and high MVPA time in the ELANA study. Among girls, the different clusters identified was characterized by high F&V consumption in both studies and, additionally, high SSB consumption in the ELANA study. Regression analysis showed that clusters characterized by high SSB consumption in European boys; high TV watching, and high TV watching plus high MVPA in Brazilian boys; and high MVPA, and high SSB and F&V consumption in Brazilian girls, were positively associated with different body fat composition indicators. Common clusters were observed in adolescents from Europe and Brazil, however, no cluster was identified as being completely healthy or unhealthy. Each cluster seems to impact on body composition indicators, depending on the group. Public health actions should aim to promote adequate practices of EBRB.
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Affiliation(s)
- Naiara Ferraz Moreira
- Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, Brazil.
| | - Gloria Valeria da Veiga
- Department of Social and Applied Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alba María Santaliestra-Pasías
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Spain
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece
| | - Magdalena Cuenca-García
- Department of Physiology, School of Medicine, University of Granada, Granada, Spain; Department of Physical Education, School of Education, University of Cadiz, Puerto Real, Spain
| | | | - Rosangela Alves Pereira
- Department of Social and Applied Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Laura Censi
- Council for Agricultural Research and Economics (CREA) - Research Center for Food and Nutrition, Rome, Italy
| | - Marcela González-Gross
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Spain; ImFINE Research Group, Department of Health and Human Performance, Facultad de Ciencias de la Actividad Física y del Deporte (INEF), Universidad Politécnica de Madrid, Madrid, Spain
| | - David Cañada
- ImFINE Research Group, Department of Health and Human Performance, Facultad de Ciencias de la Actividad Física y del Deporte (INEF), Universidad Politécnica de Madrid, Madrid, Spain
| | | | - Anthony Kafatos
- Preventive Medicine and Nutrition Clinic, University of Crete, Heraklion, Greece
| | - Ascensión Marcos
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
| | - Kurt Widhalm
- Department of Pediatrics, Private Medical University, Salzburg, Austria
| | - Dénes Mólnar
- Department of Pediatrics, Medical Faculty, University of Pécs, Pecs, Hungary
| | - Luis Alberto Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Spain
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Hodder RK, Stacey FG, Wyse RJ, O'Brien KM, Clinton‐McHarg T, Tzelepis F, Nathan NK, James EL, Bartlem KM, Sutherland R, Robson E, Yoong SL, Wolfenden L. Interventions for increasing fruit and vegetable consumption in children aged five years and under. Cochrane Database Syst Rev 2017; 9:CD008552. [PMID: 28945919 PMCID: PMC6483688 DOI: 10.1002/14651858.cd008552.pub3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Insufficient consumption of fruits and vegetables in childhood increases the risk of future chronic diseases, including cardiovascular disease. OBJECTIVES To assess the effectiveness, cost effectiveness and associated adverse events of interventions designed to increase the consumption of fruit, vegetables or both amongst children aged five years and under. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE, Embase Classic and Embase to identify eligible trials on 30 September 2016. We searched CINAHL and PsycINFO in July 2016, Proquest Dissertations and Theses in November 2016 and three clinical trial registers in November 2016 and June 2017. We reviewed reference lists of included trials and handsearched three international nutrition journals. We contacted authors of included studies to identify further potentially relevant trials. SELECTION CRITERIA We included randomised controlled trials, including cluster-randomised controlled trials and cross-over trials, of any intervention primarily targeting consumption of fruit, vegetables or both among children aged five years and under, and incorporating a dietary or biochemical assessment of fruit or vegetable consumption. Two review authors independently screened titles and abstracts of identified papers; a third review author resolved disagreements. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed the risks of bias of included studies; a third review author resolved disagreements. Due to unexplained heterogeneity, we used random-effects models in meta-analyses for the primary review outcomes where we identified sufficient trials. We calculated standardised mean differences (SMDs) to account for the heterogeneity of fruit and vegetable consumption measures.We conducted assessments of risks of bias and evaluated the quality of evidence (GRADE approach) using Cochrane procedures. MAIN RESULTS We included 50 trials with 137 trial arms and 10,267 participants. Thirty trials examined the impact of child-feeding practices (e.g. repeated food exposure) in increasing child vegetable intake. Eleven trials examined the impact of parent nutrition education in increasing child fruit and vegetable intake. Eight studies examined the impact of multicomponent interventions (e.g. parent nutrition education and preschool policy changes) in increasing child fruit and vegetable intake. One study examined the effect of a nutrition intervention delivered to children in increasing child fruit and vegetable intake.Thirteen of the 50 included trials were judged as free from high risks of bias across all domains; performance, detection and attrition bias were the most common domains judged at high risk of bias of remaining studies.Meta-analysis of trials examining child-feeding practices versus no intervention revealed a positive effect on child vegetable consumption (SMD 0.38, 95% CI 0.15 to 0.61; n = 1509; 11 studies; very low-quality evidence), equivalent to a mean difference of 4.03 grams of vegetables. There were no short-term differences in child consumption of fruit and vegetables in meta-analyses of trials examining parent nutrition education versus no intervention (SMD 0.11, 95% CI -0.05 to 0.28; n = 3023; 10 studies; very low-quality evidence) or multicomponent interventions versus no intervention (SMD 0.28, 95% CI -0.06 to 0.63; n = 1861; 4 studies; very low-quality evidence).Insufficient data were available to assess long-term effectiveness, cost effectiveness and unintended adverse consequences of interventions.Studies reported receiving governmental or charitable funds, except for two studies reporting industry funding. AUTHORS' CONCLUSIONS Despite identifying 50 eligible trials of various intervention approaches, the evidence for how to increase fruit and vegetable consumption of children remains sparse. There was very low-quality evidence child-feeding practice interventions are effective in increasing vegetable consumption of children aged five years and younger, however the effect size was very small and long-term follow-up is required. There was very low-quality evidence that parent nutrition education and multicomponent interventions are not effective in increasing fruit and vegetable consumption of children aged five years and younger. All findings should be considered with caution, given most included trials could not be combined in meta-analyses. Given the very low-quality evidence, future research will very likely change estimates and conclusions. Such research should adopt more rigorous methods to advance the field.This is a living systematic review. Living systematic reviews offer a new approach to review updating, in which the review is continually updated, incorporating relevant new evidence as it becomes available. Please refer to the Cochrane Database of Systematic Reviews for the current status of this review.
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Affiliation(s)
- Rebecca K Hodder
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Fiona G Stacey
- University of Newcastle, Hunter Medical Research Institute, Priority Research Centre in Health Behaviour, and Priority Research Centre in Physical Activity and NutritionSchool of Medicine and Public HealthCallaghanAustralia2287
| | - Rebecca J Wyse
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia2308
| | | | - Tara Clinton‐McHarg
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia2308
| | - Flora Tzelepis
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia2308
| | - Nicole K Nathan
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Erica L James
- University of Newcastle, Hunter Medical Research InstituteSchool of Medicine and Public HealthUniversity DriveCallaghanAustralia2308
| | - Kate M Bartlem
- University of NewcastleSchool of PsychologyUniversity DriveCallaghanAustralia2308
| | - Rachel Sutherland
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Emma Robson
- Hunter New England Local Health DistrictHunter Population HealthLocked Bag 10WallsendAustralia
| | - Sze Lin Yoong
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Luke Wolfenden
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia2308
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Clustering of energy balance-related behaviours, sleep, and overweight among Finnish adolescents. Int J Public Health 2017; 62:929-938. [PMID: 28593331 DOI: 10.1007/s00038-017-0991-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 05/26/2017] [Accepted: 06/01/2017] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES To examine how clusters of energy balance-related behaviours (EBRBs), including sleep related factors, were associated with overweight among adolescents. METHODS In Finland, 4262 adolescents, aged 13-15, participated in the cross-national Health Behaviour in School-aged Children study. The adolescents completed questionnaires assessing EBRBs [sleep duration, discrepancy and quality, physical activity (PA), screen time, junk food, fruit, and vegetable intake] and height and weight. Clusters were identified with κ-means cluster analysis and their associations with overweight with logistic regression analyses. RESULTS Common clusters for boys and girls were labelled "Healthy lifestyle" and "High screen time, unhealthy lifestyle". In addition, the cluster "Low/moderate screen time, unhealthy lifestyle" was identified among boys, and the cluster "Poor sleep, unhealthy lifestyle" among girls. Only girls in the cluster "High screen time, unhealthy lifestyle" were at increased risk for overweight. CONCLUSIONS Girls, whose EBRB was characterized by high screen time and low PA, but not with poor sleep, were at increased risk for overweight. Future studies should examine ways to promote PA among adolescent girls with high interest in screen-based activities.
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Dumuid D, Olds T, Martín-Fernández JA, Lewis LK, Cassidy L, Maher C. Academic Performance and Lifestyle Behaviors in Australian School Children: A Cluster Analysis. HEALTH EDUCATION & BEHAVIOR 2017; 44:918-927. [DOI: 10.1177/1090198117699508] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Dorothea Dumuid
- University of South Australia, Adelaide, South Australia, Australia
| | - Timothy Olds
- University of South Australia, Adelaide, South Australia, Australia
| | | | - Lucy K. Lewis
- University of South Australia, Adelaide, South Australia, Australia
- Flinders University, Bedford Park, South Australia, Australia
| | - Leah Cassidy
- Department for Education and Child Development, Adelaide, South Australia, Australia
| | - Carol Maher
- University of South Australia, Adelaide, South Australia, Australia
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Watanabe E, Lee JS, Mori K, Kawakubo K. Clustering patterns of obesity-related multiple lifestyle behaviours and their associations with overweight and family environments: a cross-sectional study in Japanese preschool children. BMJ Open 2016; 6:e012773. [PMID: 27815299 PMCID: PMC5128936 DOI: 10.1136/bmjopen-2016-012773] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES The purpose of this study is (1) to identify obesity-related lifestyle behaviour patterns of diet, physical activity, sedentary and sleep behaviours in preschool children, (2) to examine the association between identified behaviour clusters and overweight/obesity and (3) to investigate differences in children's family environments according to clusters. DESIGN SETTING AND PARTICIPANTS A cross-sectional study on 2114 preschool children aged 3-6 years who attended childcare facilities (24 nursery schools and 10 kindergartens) in Tsuruoka city, Japan in April 2003 was conducted. MAIN OUTCOME MEASURES Children's principal caregivers completed a questionnaire on children's lifestyle behaviours (dinner timing, outside playtime, screen time and night-time sleep duration), family environment (family members, maternal employment, mealtime regularity and parents' habitual exercise and screen time) and measurements of weight and height. Cluster analysis was performed using children's 4 lifestyle behaviours based on those non-missing values (n=1545). The χ2 tests and analysis of variance (ANOVA) estimated cluster differences in overweight/obesity and family environments. RESULTS 6 clusters were identified. Children's overweight/obesity varied across clusters (p=0.007). The cluster with the most screen time, shorter night-time sleep duration, average dinner timing and outside playtime had the highest overweight/obesity prevalence (15.1%), while the cluster with the least screen time, the longest sleep duration, the earliest dinner timing and average outside playtime had the lowest prevalence (4.0%). Family environments regarding mealtime regularity and both parents' screen time also significantly varied across clusters. The cluster having the highest overweight/obesity prevalence had the highest proportion of irregular mealtimes and the most screen time for both parents. CONCLUSIONS This study suggests that public health approaches to prevent children's overweight/obesity should focus on decreasing screen time and increasing night-time sleep duration. To shape those behaviours, regular mealtimes and decreasing parents' screen time within family environments need to be targeted among family members.
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Affiliation(s)
- Etsuko Watanabe
- Department of Health Promotion Science, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Jung Su Lee
- Department of Health Promotion Science, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Katsumi Mori
- Department of Health Promotion Science, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kiyoshi Kawakubo
- Department of Food Science and Nutrition, Kyoritsu Women's University, Tokyo, Japan
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Rodrigues D, Muc M, Rodrigues PRM, Pinto AM, Padez C. Dietary Patterns and Their Socioeconomic and Behavioral Determinants in 6- to 8-Year-Old Portuguese Children. Ecol Food Nutr 2016; 55:428-41. [DOI: 10.1080/03670244.2016.1200038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Van Hecke L, Loyen A, Verloigne M, van der Ploeg HP, Lakerveld J, Brug J, De Bourdeaudhuij I, Ekelund U, Donnelly A, Hendriksen I, Deforche B. Variation in population levels of physical activity in European children and adolescents according to cross-European studies: a systematic literature review within DEDIPAC. Int J Behav Nutr Phys Act 2016; 13:70. [PMID: 27350134 PMCID: PMC5399406 DOI: 10.1186/s12966-016-0396-4] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 06/11/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Regular physical activity is associated with physical, social and mental health benefits, whilst insufficient physical activity is associated with several negative health outcomes (e.g. metabolic problems). Population monitoring of physical activity is important to gain insight into prevalence of compliance to physical activity recommendations, groups at risk and changes in physical activity patterns. This review aims to provide an overview of all existing studies that measure physical activity in youth, in cross-European studies, to describe the variation in population levels of physical activity and to describe and define challenges regarding assessment methods that are used. METHODS A systematic search was performed on six databases (PubMed, EMBASE, CINAHL, PsycINFO, SportDiscus and OpenGrey), supplemental forward- and backward tracking was done and authors' and experts' literature databases were searched to identify relevant articles. Journal articles or reports that reported levels of physical activity in the general population of youth from cross-European studies were included. Data were reviewed, extracted and assessed by two researchers, with disagreements being resolved by a third researcher. The review protocol of this review is published under registration number CRD42014010684 in the PROSPERO database. RESULTS The search resulted in 9756 identified records of which 30 articles were included in the current review. This review revealed large differences between countries in prevalence of compliance to physical activity recommendations (i.e. 60 min of daily moderate- to vigorous-intensity physical activity (MVPA)) measured subjectively (5-47%) and accelerometer measured minutes of MVPA (23-200 min). Overall boys and children were more active than girls and adolescents. Different measurement methods (subjective n = 12, objective n = 18) and reported outcome variables (n = 17) were used in the included articles. Different accelerometer intensity thresholds used to define MVPA resulted in substantial differences in MVPA between studies conducted in the same countries when assessed objectively. CONCLUSIONS Reported levels of physical activity and prevalence of compliance to physical activity recommendations in youth showed large variation across European countries. This may reflect true variation in physical activity as well as variation in assessment methods and reported outcome variables. Standardization across Europe, of methods to assess physical activity in youth and reported outcome variables is warranted, preferably moving towards a pan-European surveillance system combining objective and self-report methods.
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Affiliation(s)
- Linde Van Hecke
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium
- Physical activity, nutrition and health research unit, Department of Movement and sport Sciences, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium
| | - Anne Loyen
- Department of Epidemiology and Biostatistics, VU University Medical Center, EMGO+ Institute for Health and Care Research, De Boelelaan 1089a, 1081 HV Amsterdam, The Netherlands
| | - Maïté Verloigne
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium
| | - Hidde P. van der Ploeg
- Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
- Sydney School of Public Health, The Charles Perkins Centre (D17), University of Sydney, 2006 Sydney, NSW Australia
| | - Jeroen Lakerveld
- Department of Epidemiology and Biostatistics, VU University Medical Center, EMGO+ Institute for Health and Care Research, De Boelelaan 1089a, 1081 HV Amsterdam, The Netherlands
| | - Johannes Brug
- Department of Epidemiology and Biostatistics, VU University Medical Center, EMGO+ Institute for Health and Care Research, De Boelelaan 1089a, 1081 HV Amsterdam, The Netherlands
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sport Sciences, PO Box 4014, 0806 Ullevål Stadion, Oslo Norway
| | - Alan Donnelly
- Centre for Physical Activity and Health Research, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Ingrid Hendriksen
- TNO Expertise Centre Lifestyle, Schipholweg 77-89, 2316 ZL Leiden, The Netherlands
- Body@Work, EMGO+ Institute for Health and Care Research, VU University Medical Center, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Benedicte Deforche
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium
- Physical activity, nutrition and health research unit, Department of Movement and sport Sciences, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium
| | - on behalf of the DEDIPAC consortium
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium
- Physical activity, nutrition and health research unit, Department of Movement and sport Sciences, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium
- Department of Epidemiology and Biostatistics, VU University Medical Center, EMGO+ Institute for Health and Care Research, De Boelelaan 1089a, 1081 HV Amsterdam, The Netherlands
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium
- Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
- Sydney School of Public Health, The Charles Perkins Centre (D17), University of Sydney, 2006 Sydney, NSW Australia
- Department of Sports Medicine, Norwegian School of Sport Sciences, PO Box 4014, 0806 Ullevål Stadion, Oslo Norway
- Centre for Physical Activity and Health Research, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- TNO Expertise Centre Lifestyle, Schipholweg 77-89, 2316 ZL Leiden, The Netherlands
- Body@Work, EMGO+ Institute for Health and Care Research, VU University Medical Center, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
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Verloigne M, Loyen A, Van Hecke L, Lakerveld J, Hendriksen I, De Bourdheaudhuij I, Deforche B, Donnelly A, Ekelund U, Brug J, van der Ploeg HP. Variation in population levels of sedentary time in European children and adolescents according to cross-European studies: a systematic literature review within DEDIPAC. Int J Behav Nutr Phys Act 2016; 13:69. [PMID: 27350043 PMCID: PMC4924322 DOI: 10.1186/s12966-016-0395-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 06/11/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A high amount of sedentary time has been proposed as a risk factor for various health outcomes in adults. While the evidence is less clear in children and adolescents, monitoring sedentary time is important to understand the prevalence rates and how this behaviour varies over time and by place. This systematic literature review aims to provide an overview of existing cross-European studies on sedentary time in children (0-12y) and adolescents (13-18y), to describe the variation in population levels of sedentary time, and to discuss the impact of assessment methods. METHODS Six literature databases were searched (PubMed, EMBASE, CINAHL, PsycINFO, SportDiscus and OpenGrey), followed by backward- and forward tracking and searching authors' and experts' literature databases. Included articles were observational studies reporting on levels of sedentary time in the general population of children and/or adolescents in at least two European countries. Population levels were reported separately for children and adolescents. Data were reviewed, extracted and assessed by two researchers, with disagreements being resolved by a third researcher. The review protocol is published under registration number CRD42014013379 in the PROSPERO database. RESULTS Forty-two eligible articles were identified, most were cross-sectional (n = 38). The number of included European countries per article ranged from 2 to 36. Levels of sedentary time were observed to be higher in East-European countries compared to the rest of Europe. There was a large variation in assessment methods and reported outcome variables. The majority of articles used a child-specific questionnaire (60%). Other methods included accelerometers, parental questionnaires or interviews and ecological momentary assessment tools. Television time was reported as outcome variable in 57% of included articles (ranging from a mean value of 1 h to 2.7 h in children and 1.3 h to 4.4 h in adolescents), total sedentary time in 24 % (ranging from a mean value of 192 min to 552 min in children and from 268 min to 506 min in adolescents). CONCLUSION A substantial number of published studies report on levels of sedentary time in children and adolescents across European countries, but there was a large variation in assessment methods. Questionnaires (child specific) were used most often, but they mostly measured specific screen-based activities and did not assess total sedentary time. There is a need for harmonisation and standardisation of objective and subjective methods to assess sedentary time in children and adolescents to enable comparison across countries.
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Affiliation(s)
- Maïté Verloigne
- />Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium
| | - Anne Loyen
- />Department of Epidemiology and Biostatistics, VU University Medical Center, EMGO+ Institute for Health and Care Research, De Boelelaan 1089a, 1081 HV Amsterdam, The Netherlands
| | - Linde Van Hecke
- />Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium
- />Physical activity, Nutrition and Health Research Unit, Department of Movement and Sport Sciences, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium
| | - Jeroen Lakerveld
- />Department of Epidemiology and Biostatistics, VU University Medical Center, EMGO+ Institute for Health and Care Research, De Boelelaan 1089a, 1081 HV Amsterdam, The Netherlands
| | - Ingrid Hendriksen
- />TNO Expertise Centre Lifestyle, Schipholweg 77-89, 2316 ZL Leiden, The Netherlands
- />Body@Work, EMGO+ Institute for Health and Care Research, VU University Medical Center, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Ilse De Bourdheaudhuij
- />Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium
| | - Benedicte Deforche
- />Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium
| | - Alan Donnelly
- />Centre for Physical Activity and Health Research, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Ulf Ekelund
- />Department of Sports Medicine, Norwegian School of Sport Sciences, PO Box 4014, 0806 Ullevål Stadion, Oslo Norway
| | - Johannes Brug
- />Department of Epidemiology and Biostatistics, VU University Medical Center, EMGO+ Institute for Health and Care Research, De Boelelaan 1089a, 1081 HV Amsterdam, The Netherlands
| | - Hidde P. van der Ploeg
- />Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
- />Sydney School of Public Health, The Charles Perkins Centre (D17), University of Sydney, NSW 2006 Sydney, Australia
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de Moraes ACF, Fernández-Alvira JM, Rendo-Urteaga T, Julián-Almárcegui C, Beghin L, Kafatos A, Molnar D, De Henauw S, Manios Y, Widhalm K, Pedrero-Chamizo R, Galfo M, Gottrand F, Carvalho HB, Moreno LA. Effects of clustering of multiple lifestyle-related behaviors on blood pressure in adolescents from two observational studies. Prev Med 2016; 82:111-7. [PMID: 26592688 DOI: 10.1016/j.ypmed.2015.11.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 11/12/2015] [Accepted: 11/15/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUD Several lifestyle-related behaviors are associated with cardiovascular health outcomes in adolescents. To examine the associations between clustered lifestyle-related behaviors and blood pressure (BP) levels in adolescents. METHODS Participants were recruited by multistage random cluster in two cross-sectional studies; one conducted in 2006 and 2007 in ten cities from nine European countries: Athens and Heraklion in Greece, Dortmund in Germany, Ghent in Belgium, Lille in France, Pécs in Hungary, Rome in Italy, Stockholm in Sweden, Vienna in Austria, and Zaragoza in Spain; and another conducted in 2007 one city in Brazil (Maringá/PR). Systolic BP (SBP) and diastolic BP (DBP) (outcomes) and clustered behaviors (weekly consumption of fruits and vegetables, weekly consumption of sugar-sweetened beverages, sleep duration, screen time and physical activity) were analyzed. RESULTS The Healthy Eating cluster was negatively associated with DBP in European girls, β=-2.46 (-4.62; -0.30), and with SBP in Brazilian boys, β=-2.79 (-3.10; -0.15). Furthermore, the Unhealthy Eating cluster was associated with increased SBP in European girls, β=4.54 (1.29; 7.79), and in Brazilian boys, β=4.10 (0.80; 7.40). CONCLUSION The Healthy Eating cluster was associated with lower blood pressure, whereas the Unhealthy Eating cluster was associated with increased SBP in adolescents.
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Affiliation(s)
- Augusto César Ferreira de Moraes
- School of Medicine of the University of São Paulo, YCARE (Youth/Child and cArdiovascular Risk and Environmental) Research Group, São Paulo, SP, Brazil; Facultad de Ciencias de la Salud de la Universidad de Zaragoza, GENUD (Growth, Exercise, NUtrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.
| | - Juan Miguel Fernández-Alvira
- Facultad de Ciencias de la Salud de la Universidad de Zaragoza, GENUD (Growth, Exercise, NUtrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain; Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
| | - Tara Rendo-Urteaga
- School of Medicine of the University of São Paulo, YCARE (Youth/Child and cArdiovascular Risk and Environmental) Research Group, São Paulo, SP, Brazil; Facultad de Ciencias de la Salud de la Universidad de Zaragoza, GENUD (Growth, Exercise, NUtrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
| | - Cristina Julián-Almárcegui
- Facultad de Ciencias de la Salud de la Universidad de Zaragoza, GENUD (Growth, Exercise, NUtrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
| | - Laurent Beghin
- Univ. Lille, Inserm, CHU Lille, U995 LIRIC - Lille Inflammation Research International Center, F-59000 Lille, France; Centre d'Investigation Clinique, CIC-1403-Inserm-CH&U, Lille, F-59037 France
| | - Anthony Kafatos
- Preventive Medicine & Nutrition Unit, University of Crete School of Medicine, Heraklion, Crete, Greece
| | - Dénes Molnar
- Department of Paediatrics, Medical Faculty, University of Pécs, Pécs, Hungary
| | | | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Kurt Widhalm
- Department of Pediatrics, Private Medical University Salzburg, Salzburg, Austria
| | | | - Myriam Galfo
- Agricultural Research Council, Food and Nutrition Research Centre (CRA-NUT), Rome, Italy
| | - Frederic Gottrand
- Univ. Lille, Inserm, CHU Lille, U995 LIRIC - Lille Inflammation Research International Center, F-59000 Lille, France; Centre d'Investigation Clinique, CIC-1403-Inserm-CH&U, Lille, F-59037 France
| | - Heráclito Barbosa Carvalho
- School of Medicine of the University of São Paulo, YCARE (Youth/Child and cArdiovascular Risk and Environmental) Research Group, São Paulo, SP, Brazil
| | - Luis A Moreno
- Facultad de Ciencias de la Salud de la Universidad de Zaragoza, GENUD (Growth, Exercise, NUtrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain; School of Medicine of the University of São Paulo, Department of Preventive Medicine, São Paulo, SP, Brazil
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Clustering of Dietary Patterns, Lifestyles, and Overweight among Spanish Children and Adolescents in the ANIBES Study. Nutrients 2015; 8:nu8010011. [PMID: 26729155 PMCID: PMC4728625 DOI: 10.3390/nu8010011] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 12/09/2015] [Accepted: 12/11/2015] [Indexed: 01/05/2023] Open
Abstract
Weight gain has been associated with behaviors related to diet, sedentary lifestyle, and physical activity. We investigated dietary patterns and possible meaningful clustering of physical activity, sedentary behavior, and sleep time in Spanish children and adolescents and whether the identified clusters could be associated with overweight. Analysis was based on a subsample (n = 415) of the cross-sectional ANIBES study in Spain. We performed exploratory factor analysis and subsequent cluster analysis of dietary patterns, physical activity, sedentary behaviors, and sleep time. Logistic regression analysis was used to explore the association between the cluster solutions and overweight. Factor analysis identified four dietary patterns, one reflecting a profile closer to the traditional Mediterranean diet. Dietary patterns, physical activity behaviors, sedentary behaviors and sleep time on weekdays in Spanish children and adolescents clustered into two different groups. A low physical activity-poorer diet lifestyle pattern, which included a higher proportion of girls, and a high physical activity, low sedentary behavior, longer sleep duration, healthier diet lifestyle pattern. Although increased risk of being overweight was not significant, the Prevalence Ratios (PRs) for the low physical activity-poorer diet lifestyle pattern were >1 in children and in adolescents. The healthier lifestyle pattern included lower proportions of children and adolescents from low socioeconomic status backgrounds.
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WHO European Childhood Obesity Surveillance Initiative: health-risk behaviours on nutrition and physical activity in 6-9-year-old schoolchildren. Public Health Nutr 2015; 18:3108-24. [PMID: 26132808 PMCID: PMC4642225 DOI: 10.1017/s1368980015001937] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Objective To assess to what extent eight behavioural health risks related to breakfast and food
consumption and five behavioural health risks related to physical activity, screen time
and sleep duration are present among schoolchildren, and to examine whether health-risk
behaviours are associated with obesity. Design Cross-sectional design as part of the WHO European Childhood Obesity Surveillance
Initiative (school year 2007/2008). Children’s behavioural data were reported by their
parents and children’s weight and height measured by trained fieldworkers. Descriptive
statistics and logistic regression analyses were performed. Setting Primary schools in Bulgaria, Lithuania, Portugal and Sweden; paediatric clinics in the
Czech Republic. Subjects Nationally representative samples of 6–9-year-olds (n 15 643). Results All thirteen risk behaviours differed statistically significantly across countries.
Highest prevalence estimates of risk behaviours were observed in Bulgaria and lowest in
Sweden. Not having breakfast daily and spending screen time ≥2 h/d were clearly
positively associated with obesity. The same was true for eating ‘foods like pizza,
French fries, hamburgers, sausages or meat pies’ >3 d/week and playing outside
<1 h/d. Surprisingly, other individual unhealthy eating or less favourable
physical activity behaviours showed either no or significant negative associations with
obesity. A combination of multiple less favourable physical activity behaviours showed
positive associations with obesity, whereas multiple unhealthy eating behaviours
combined did not lead to higher odds of obesity. Conclusions Despite a categorization based on international health recommendations, individual
associations of the thirteen health-risk behaviours with obesity were not consistent,
whereas presence of multiple physical activity-related risk behaviours was clearly
associated with higher odds of obesity.
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Profiling physical activity, diet, screen and sleep habits in Portuguese children. Nutrients 2015; 7:4345-62. [PMID: 26043034 PMCID: PMC4488788 DOI: 10.3390/nu7064345] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 05/08/2015] [Accepted: 05/20/2015] [Indexed: 11/18/2022] Open
Abstract
Obesity in children is partly due to unhealthy lifestyle behaviours, e.g., sedentary activity and poor dietary choices. This trend has been seen globally. To determine the extent of these behaviours in a Portuguese population of children, 686 children 9.5 to 10.5 years of age were studied. Our aims were to: (1) describe profiles of children’s lifestyle behaviours; (2) identify behaviour pattern classes; and (3) estimate combined effects of individual/socio-demographic characteristics in predicting class membership. Physical activity and sleep time were estimated by 24-h accelerometry. Nutritional habits, screen time and socio-demographics were obtained. Latent Class Analysis was used to determine unhealthy lifestyle behaviours. Logistic regression analysis predicted class membership. About 78% of children had three or more unhealthy lifestyle behaviours, while 0.2% presented no risk. Two classes were identified: Class 1-Sedentary, poorer diet quality; and Class 2-Insufficiently active, better diet quality, 35% and 65% of the population, respectively. More mature children (Odds Ratio (OR) = 6.75; 95%CI = 4.74–10.41), and boys (OR = 3.06; 95% CI = 1.98–4.72) were more likely to be overweight/obese. However, those belonging to Class 2 were less likely to be overweight/obese (OR = 0.60; 95% CI = 0.43–0.84). Maternal education level and household income did not significantly predict weight status (p ≥ 0.05).
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de Moraes ACF, Carvalho HB, Gomez-Martinez S, Androutsos O, Jiménez-Pavón D, Sjöström M, Kafatos A, Widhalm K, Cañada D, Martin-Matillas M, Beghin L, Gottrand F, Moreno LA. Family socioeconomic factors are negatively associated with blood pressure in European boys, but not girls, and Brazilian adolescents: Results from two observational studies. Blood Press 2015; 24:250-7. [PMID: 25880603 DOI: 10.3109/08037051.2015.1033171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE We aimed to estimate the attributable fraction of systolic (SBP) and diastolic blood pressure (DBP) that can be explained by family socioeconomic factors (FSFs) in adolescents using two observational studies. METHODS Participants were recruited by multistage random cluster in two cross-sectional studies performed in Europe [Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study, n = 3308] and Brazil [Brazilian Cardiovascular Adolescent Health (BRACAH) study, n = 991]. SBP and DBP were measured, and FSFs (socioeconomic status and parental education) were self-reported in both studies. The correlations of SBP and DBP with FSFs were examined by multilevel linear regression through two different models (hierarchical and fully adjusted). The generalized attributable fractions of the FSFs were estimated by comparing the models. RESULTS Our results showed a significant inverse relationship between parental education (father and mother) and SBP in European boys. The higher generalized attributable fraction to SBP was observed in boys (13.2-22.4%). In girls, we found lower generalized attributable fractions to DBP (10.8-12.1% in Brazilian girls and 3.1-3.8% in European girls). CONCLUSIONS Our findings revealed a significant inverse relationship between parental education and SBP in European boys. FSF also significantly influenced blood pressure in adolescents, mainly in Brazilian adolescents.
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Affiliation(s)
- Augusto César Ferreira de Moraes
- YCARE (Youth/Child and cARdiovascular Risk and Environmental) Research Group, Department of Preventive Medicine, School of Medicine of the University of São Paulo , São Paulo, SP , Brazil
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Ferrar K, Golley R. Adolescent diet and time use clusters and associations with overweight and obesity and socioeconomic position. HEALTH EDUCATION & BEHAVIOR 2015; 42:361-9. [PMID: 25576499 DOI: 10.1177/1090198114560017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Risk factors for adolescent overweight and obesity include low levels of physical activity, high levels of sedentary behavior, low fruit and vegetable intake, and low socioeconomic position (SEP). To date, the vast majority of research investigating associations between lifestyle behaviors and weight status analyze dietary and time use factors separately. Our research aimed to describe Australian youth time use and diet clusters and explore relationships with weight status and SEP (parental education and income). Cluster analysis of the National Children's Nutrition and Physical Activity Survey data from Australians aged 9 to 16 years (random sample n = 1,853) was conducted. Time use data (17 age-adjusted time use variables) and dietary data (7 age-adjusted diet variables) were collected via 24-hour recalls. Two clusters were associated with a reduced frequency of overweight and obesity (the boys' Active Sitter and girls' Healthy Academic clusters) and one with an increased frequency of overweight and obesity (the boys' Unhealthy cluster). Of these three clusters, two demonstrated associations with parental income and/or parental education level. The boys' Unhealthy cluster was associated with low SEP status (parental income and education), and the girls' Healthy Academic cluster was associated with high parental income. Not all unhealthy adolescent clusters were associated with overweight and obesity. The findings suggest sex-specific diet and activity clusters can be used to identify at-risk subgroups and inform multifaceted interventions to address overweight and obesity.
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Affiliation(s)
- Katia Ferrar
- Alliance for Research in Exercise, Nutrition and Activity, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Rebecca Golley
- Alliance for Research in Exercise, Nutrition and Activity, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
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