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De Moraes ACF, Medeiros-Oliveira VC, Burford K, Schaan BD, Bloch K, de Carvalho KMB, Cureau FV, Nascimento-Ferreira MV. Association Between Sleep Time and Pro- and Anti-Inflammatory Biomarkers Is Mediated by Abdominal Obesity Among Adolescents. J Phys Act Health 2023; 20:926-933. [PMID: 37295784 DOI: 10.1123/jpah.2022-0468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 04/03/2023] [Accepted: 04/27/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Movement behaviors and abdominal obesity are associated with higher inflammatory biomarkers. However, the role of waist circumference as a mediating factor is still unknown. Thus, our aims were to (1) test the associations between 24-hour movement behavior variables (physical activity, sedentary behavior, and sleep), abdominal obesity, and pro- and anti-inflammatory biomarkers; and (2) investigate whether abdominal obesity had a mediating effect between the investigated associations. METHODS This multicenter cross-sectional study included 3591 adolescents (aged 12-17 y) from 4 Brazilian cities. Waist circumference (in centimeters; at half the distance between the iliac crest and at the lower costal margin), 24-hour movement behaviors (validated questionnaire), high-sensitive C-reactive protein, and adiponectin (serum plasma) were evaluated. We used multiple mediation regression models (95% confidence interval) to determine if waist circumference mediated the association between 24-hour movement behaviors and pro- and anti-inflammatory biomarkers. RESULTS The results revealed that screen time and moderate to vigorous physical activity were not associated with pro- or anti-inflammatory biomarkers. However, sleep duration (in hours per day) was negatively associated with pro- (C-reactive protein, β = -0.08; 95% confidence interval, -0.38 to -0.02) and anti- (adiponectin, β = -0.31; 95% confidence interval, -2.13 to -0.12) inflammatory biomarkers. Our results also showed that waist circumference mediated the association between sleep duration and high-sensitive C-reactive protein (2.7%), and adiponectin (2.8%). CONCLUSION Sleep duration was inversely associated with pro- and anti-inflammatory biomarkers, and these relations were mediated by abdominal obesity. Therefore, adolescents having healthy sleep can have implications for reducing waist circumference and inflammatory indicators.
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Affiliation(s)
- Augusto César Ferreira De Moraes
- The University of Texas Health Science Center at Houston School of Public Health Austin Campus, Department of Epidemiology, Human Genetics, and Environmental Science, Michael & Susan Dell Center for Healthy Living, Austin, TX,USA
- Department of Epidemiology, Graduate Program in Public Health and Graduate Program in Epidemiology, School of Public Health, University of Sao Paulo, Sao Paulo, SP,Brazil
- YCARE (Youth/Child and cArdiovascular Risk and Environmental) Research Group, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP,Brazil
| | - Vanessa Cassia Medeiros-Oliveira
- Department of Epidemiology, Graduate Program in Public Health and Graduate Program in Epidemiology, School of Public Health, University of Sao Paulo, Sao Paulo, SP,Brazil
- YCARE (Youth/Child and cArdiovascular Risk and Environmental) Research Group, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP,Brazil
| | - Katie Burford
- The University of Texas Health Science Center at Houston School of Public Health Austin Campus, Department of Epidemiology, Human Genetics, and Environmental Science, Michael & Susan Dell Center for Healthy Living, Austin, TX,USA
| | - Beatriz D Schaan
- Faculty of Medicine, Graduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS,Brazil
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS,Brazil
- Faculty of Medicine, Graduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS,Brazil
| | - Katia Bloch
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ,Brazil
| | | | - Felipe Vogt Cureau
- Graduate Program in Cardiology and Cardiovascular Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS,Brazil
| | - Marcus Vinicius Nascimento-Ferreira
- YCARE (Youth/Child and cArdiovascular Risk and Environmental) Research Group, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP,Brazil
- HEALth, pHYsical activity and Behavior ReseArch (HEALTHY-BRA) group, Federal University of Tocantins, Campus Miracema, Miracema, TO,Brazil
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Karssen LT, Larsen JK, Burk WJ, Kremers SPJ, Hermans RCJ, Ruiter ELM, Vink JM, de Weerth C. Process and effect evaluation of the app-based parenting program Samen Happie! on infant zBMI: A randomized controlled trial. Front Public Health 2022; 10:1012431. [PMID: 36620259 PMCID: PMC9822729 DOI: 10.3389/fpubh.2022.1012431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
Background Although energy balance-related parenting practices are regarded critical components in the prevention of childhood obesity, most programs targeting parenting practices with respect to a wide range of energy balance-related behaviors were not aimed at high-risk families with a lower socioeconomic position (SEP). Objective The Samen Happie! app-based program aimed to stimulate healthy child weight development especially among families with a lower SEP, by encouraging healthy energy balance-related parenting practices. Methods A two-armed randomized controlled trial examined the process and effectiveness of the Samen Happie! program on child zBMI outcomes at 6- and 12-months follow-up. In total, 357 Dutch parents with infants aged 5-15 months old at baseline participated. Parents in the app condition (n = 179) received access to the Samen Happie! app and were compared to a waitlist-control condition (n = 178). Changes in zBMI were examined through linear mixed-effects models based on intention-to-treat and exploratory per-protocol principles. Results Process data showed low levels of sustained app use and moderate app acceptability. A general increase in child zBMI was observed in both conditions after 6 and 12 months. Intention-to-treat analyses using multiple imputations showed several statistically significant differences between conditions and high-risk subgroups. Specifically, at 6-months follow-up, zBMI increase was least pronounced in the app condition among children of parents with lower educational level. These findings were supported by exploratory per-protocol analyses including only frequent app users. In addition, per-protocol analyses showed benefits of app use at 6-months follow-up for children of parents with higher BMI. However, these effects were reversed at 12-months follow-up in both intention-to-treat and per-protocol analyses, where children of parents in the app condition in general increased the most in zBMI. Conclusions This study suggests that the Samen Happie! program might prevent zBMI increases after 6 months among children of parents with lower educational level, and children of parents with higher BMI who more frequently use the app. However, the app did not prevent increases in zBMI after 12 months. Future research should investigate strategies to increase sustained app use and engagement in mHealth parenting programs for childhood obesity as well as options to combine app-based programs with additional support strategies aimed at high-risk families. Trial registration Netherlands trial register (ID: NTR6938), https://trialsearch.who.int/Trial2.aspx?TrialID=NTR6938.
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Affiliation(s)
- Levie T. Karssen
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands,*Correspondence: Levie T. Karssen ✉
| | - Junilla K. Larsen
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - William J. Burk
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Stef P. J. Kremers
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, Netherlands
| | - Roel C. J. Hermans
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, Netherlands
| | - Emilie L. M. Ruiter
- Academic Collaborative Centre AMPHI, Primary and Community Care, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Jacqueline M. Vink
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Carolina de Weerth
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
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Baran R, Baran J, Leszczak J, Bejer A, Wyszyńska J. Sociodemographic and Socioeconomic Factors Influencing the Body Mass Composition of School-Age Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811261. [PMID: 36141532 PMCID: PMC9517388 DOI: 10.3390/ijerph191811261] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/26/2022] [Accepted: 09/06/2022] [Indexed: 05/31/2023]
Abstract
The purpose of the study was to evaluate the components of overweight, obesity, and body mass components among children aged 7 to 13 years against important sociodemographic factors. The analyses considered 315 school-age children from 7 to 13 years of age (164 boys and 151 girls). Each subject was assessed for body weight and height, body weight category, and main sociodemographic factors. Body mass components of body mass (body-fat percentage (BFP), muscle tissue, fat-free mass (FFM), and total body water (TBW) levels) were evaluated using the electrical bioimpedance method (BIA) and the TANITA 780 MC analyzer. A statistical analysis showed significant differences between the body composition of children living in cities in relation to children living in small towns and villages, and no significant differences were found between the results of children living in small towns and children living in villages. The presence of statistically significant differences between the values of the parameters of body composition of the studied children was demonstrated depending on the level of education of their fathers. The presence of statistically significant relationships between BMI of mothers and BFP of their children (p = 0.003), FFM (p = 0.003), muscle tissue (p = 0.001), and TBW (p = 0.001) has been demonstrated. The higher content of adipose tissue in children is strongly dependent on the higher BMI and body mass category of the mother, as well as the lower level of education of the father. The place of residence also significantly affects both the body fat content and the total body water content of body hydration. Living in the city is associated with better body composition.
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Affiliation(s)
- Rafał Baran
- Institute of Health Sciences, Medical College, University of Rzeszów, 35-959 Rzeszów, Poland
- SOLUTION-Statistical Analysis, 35-120 Rzeszów, Poland
| | - Joanna Baran
- Institute of Health Sciences, Medical College, University of Rzeszów, 35-959 Rzeszów, Poland
- Natural and Medical Center for Innovative Research, 35-310 Rzeszów, Poland
| | - Justyna Leszczak
- Institute of Health Sciences, Medical College, University of Rzeszów, 35-959 Rzeszów, Poland
- Natural and Medical Center for Innovative Research, 35-310 Rzeszów, Poland
| | - Agnieszka Bejer
- Institute of Health Sciences, Medical College, University of Rzeszów, 35-959 Rzeszów, Poland
- Natural and Medical Center for Innovative Research, 35-310 Rzeszów, Poland
| | - Justyna Wyszyńska
- Institute of Health Sciences, Medical College, University of Rzeszów, 35-959 Rzeszów, Poland
- Natural and Medical Center for Innovative Research, 35-310 Rzeszów, Poland
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Family socioeconomic status and childhood adiposity in Europe - A scoping review. Prev Med 2022; 160:107095. [PMID: 35594926 DOI: 10.1016/j.ypmed.2022.107095] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/28/2022] [Accepted: 05/13/2022] [Indexed: 11/23/2022]
Abstract
Childhood obesity is a considerable public health problem worldwide. In Europe, lower parental socioeconomic status (SES) relates to higher childhood adiposity. This scoping review strives to discover, which SES indicators are the most commonly used and meaningful determinants of childhood adiposity (greater level of continuous adiposity indicator, e.g. body mass index z-score, or overweight or obesity categorized by established definitions). The review focused on studies about European general populations from the 21st century (January 2000-April 2021) considering children and adolescents aged 0-17 years. PubMed and reference lists of articles were searched in February-April 2021. Total of 53 studies with 121 association analyses between different SES indicators and adiposity indicators, were identified and reviewed. Different SES indicators were grouped to 25 indicators and further to six indicator groups. The most used indicator was mother's education (n of association analyses = 24) and the most used indicator group was parental education (n of association analyses = 51). Of all association analyses, 55% were inverse, 36% were non-significant, and 8% were positive. Composite SES (80%), parental education (69%) and parental occupation (64%) indicators showed most frequently inverse associations with obesity measures (i.e. lower parental SES associating with higher adiposity), while parental income (50% inverse; 50% non-significant) and property and affluence (42% inverse; 50% nonsignificant) indicators showed approximately even number of inverse and non-significant associations. Instead, majority of parental employment (60%) indicators, showed non-significant associations and 33% showed positive associations (i.e. higher parental SES associating with higher adiposity). Despite some variation in percentages, majority of the associations were inverse in each age group and with different outcome categorizations. In girls and in boys, non-significant associations predominated. It seems that children with parents of higher SES have lower likelihood of adiposity in Europe. Parents' employment appears to differ from other SES indicators, so that having an employed parent(s) does not associate with lower likelihood of adiposity. Positive associations seem to occur more frequently in poorer countries. Criteria for uniform childhood SES and adiposity measures should be established and used in studies in order to be able to produce comparable results across countries.
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Seum T, Meyrose AK, Rabel M, Schienkiewitz A, Ravens-Sieberer U. Pathways of Parental Education on Children's and Adolescent's Body Mass Index: The Mediating Roles of Behavioral and Psychological Factors. Front Public Health 2022; 10:763789. [PMID: 35321198 PMCID: PMC8936576 DOI: 10.3389/fpubh.2022.763789] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 01/31/2022] [Indexed: 12/20/2022] Open
Abstract
Aim The increasing body mass index (BMI) often followed by overweight and obesity is a global health problem of the 21st century. Children and adolescents with lower socioeconomic status are more affected than their counterparts. The mechanisms behind these differences must be well understood to develop effective prevention strategies. This analysis aims at examining the association of parental education as an indicator of the socioeconomic status on children's and adolescent's body mass index and the role of behavioral and psychological risk factors for a higher BMI longitudinally. Methods The analysis was based on a nationwide sample of N = 460 children and adolescents, aged 11 to 17 at baseline (2009-2012), who took part in the representative BELLA study, the mental health module of the German National Health Interview and Examination Survey among Children and Adolescents (KiGGS). A follow-up was conducted 5 years later. Using mediation analyses, the mediating effects of breakfast consumption, consumption of sugar-sweetened beverages, screen time, physical activity, mental health problems (Strengths and Difficulties Questionnaire), and health-related quality of life (KIDSCREEN-10) on the association of parent's years of education on their children's BMI were investigated. Results A lower level of parental education was significantly associated with a higher BMI in children and adolescents 5 years later. The association was partially mediated by breakfast consumption and total screen time, with breakfast consumption mediating 16.7% and total screen time 27.8% of the association. After controlling for age, gender, and migration status, only breakfast consumption remained a partial mediator (8.5%). Other included variables had no mediating effects. Conclusions Preventive measures should be mainly targeted at children and adolescents of parents with lower educational levels. Tailored strategies to prevent the development of overweight and obesity in this population among children and adolescents should promote daily breakfast consumption at home and reducing screen time.
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Affiliation(s)
- Teresa Seum
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ann-Katrin Meyrose
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Clinical Psychology, Helmut-Schmidt-University/University of the Federal Armed Forces, Hamburg, Germany
| | - Matthias Rabel
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Anja Schienkiewitz
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Ding S, Chen J, Dong B, Hu J. Association between parental socioeconomic status and offspring overweight/obesity from the China Family Panel Studies: a longitudinal survey. BMJ Open 2021; 11:e045433. [PMID: 33827842 PMCID: PMC8031690 DOI: 10.1136/bmjopen-2020-045433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To examine the association between parental socioeconomic status (SES) and the risk of offspring overweight/obesity and the changes of the association that occur as children grow older. DESIGN We used data from the nationally representative longitudinal survey of the China Family Panel Studies of 2010 and its three follow-up waves in 2012, 2014 and 2016. PARTICIPANTS A total of 6724 children aged 0-15 years old were included. PRIMARY AND SECONDARY OUTCOME MEASURES Average household income and paternal and maternal education levels were used as SES indicators. Logistic regression model for panel data was used to examine the associations between SES indicators and child overweight/obesity. A restricted cubic spline linear regression model was used to estimate body mass index (BMI) trajectories with child growth across parental SES levels. RESULTS Compared with the lowest education level (primary school or less), the ORs for fathers who had completed junior high school, senior high school and junior college or higher were 0.85 (95% CI 0.75 to 0.97), 0.77 (95% CI 0.64 to 0.92) and 0.72 (95% CI 0.55 to 0.93), respectively. The corresponding ORs for mothers were 0.76 (95% CI 0.67 to 0.86), 0.59 (95% CI 0.47 to 0.72) and 0.45 (95% CI 0.34 to 0.60), respectively. A negative association between parental education and offspring overweight/obesity was observed in the first 10 years but not in children 11-15 years old. BMI differences across parental education levels emerged from birth and widened before 6-7 years old, but decreased before adolescence. High average household income was related to a low risk of offspring overweight/obesity but not when parental education level was adjusted for. CONCLUSION High parental education levels were associated with a low risk of offspring overweight/obesity, especially before adolescence. Effective approaches need to be adopted in early childhood to reduce socioeconomic differences in overweight/obesity.
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Affiliation(s)
- Suqin Ding
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- Department of Chronic Disease Control and Prevention, Suzhou Industrial Park Center for Disease Control and Prevention, Suzhou, China
| | - Jingqi Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Bin Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Jie Hu
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
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Gätjens I, Hasler M, di Giuseppe R, Bosy-Westphal A, Plachta-Danielzik S. Family and Lifestyle Factors Mediate the Relationship between Socioeconomic Status and Fat Mass in Children and Adolescents. Obes Facts 2020; 13:596-607. [PMID: 33321513 PMCID: PMC7802469 DOI: 10.1159/000511927] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 09/24/2020] [Indexed: 12/19/2022] Open
Abstract
Socioeconomic status (SES) is strongly associated with childhood overweight. The underlying mechanism and the role of family and lifestyle factors as potential mediators of this relationship remain, however, unclear. Cross-sectional data of 4,772 girls and boys aged 5-16 years from the Kiel Obesity Prevention Study were considered in mediation analyses. Fat mass (FM) was assessed by bioelectrical impedance analysis and converted into a percent FM SD score (FM%-SDS). SES was defined by the parental educational level, classified as low, middle, or high. Characteristics of family and lifestyle factors were obtained via validated questionnaires and considered as mediators. In 3 different age groups, the product-of-coefficients method was used to examine age-specific mediator effects on the relationship between SES and FM%-SDS (c = total effects) and their ratio to total effects, adjusted for age, sex, puberty, and nationality. The prevalence of overweight was 6.9%. In all age groups, SES was inversely associated with FM%-SDS as follows: 5-7 years, c1 = -0.11 (95% CI -0.19 to -0.03); 9-11 years, c2 = -0.21 (95% CI -0.27 to -0.14); and 13-16 years, c3 = -0.23 (95% CI -0.28 to -0.17). The relationship between SES and FM%-SDS was fully (5-7 and 9-11 years) and partly (13-16 years) mediated by similar and age-specific mediators, including parental BMI, parental smoking habits, media consumption, physical activity, and shared meals. Overall, these variables resulted in a total mediating effect of 77.8% (5-7 years), 82.4% (9-11 years), and 70.6% (13-16 years). Consistent for both sexes, the relationship between SES and FM%-SDS was therefore mediated by parental weight status, risk-related behavior within families, and children's and adolescents' lifestyle factors. Strategies for obesity prevention, which are predominantly targeted at socially disadvantaged groups, should therefore address the family environment and lifestyle factors.
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Affiliation(s)
- Isabel Gätjens
- Human Nutrition, Institute of Human Nutrition and Food Science, Christian-Albrechts University, Kiel, Germany
| | - Mario Hasler
- Applied Statistic, Agricultural and Food Economics Faculty, Christian-Albrechts University, Kiel, Germany
| | | | - Anja Bosy-Westphal
- Human Nutrition, Institute of Human Nutrition and Food Science, Christian-Albrechts University, Kiel, Germany
| | - Sandra Plachta-Danielzik
- Human Nutrition, Institute of Human Nutrition and Food Science, Christian-Albrechts University, Kiel, Germany,
- Kompetenznetz Darmerkrankungen e.V., Kiel, Germany,
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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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9
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Proportion of Japanese primary school children meeting recommendations for 24-h movement guidelines and associations with weight status. Obes Res Clin Pract 2020; 14:234-240. [PMID: 32487356 DOI: 10.1016/j.orcp.2020.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 05/11/2020] [Accepted: 05/15/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND 24-h movement guidelines were recently developed to improve both the present and future health of children. The purpose of the present study was to evaluate adherence to the three recommendations strongly associated with health in 24-h movement guidelines and their relationship with weight status (overweight/obesity or underweight) in Japanese primary school children. METHODS This cross-sectional study was based on 902 children. Weight status according to measured body mass index (BMI) was classified by the WHO growth reference. Meeting the 24-h movement guidelines was defined as: 9-11 h/night of sleep, ≤2 h/day of screen time, and at least 60 min/day of moderate-to-vigorous physical activity (MVPA). RESULTS The prevalence of children meeting the all three recommendations was 10.5% and 13.2% met none of the three recommendations. Children meeting all three behaviors recommendation, screen time and MVPA or sleep recommendations, or only screen time recommendation had lower odds ratios adjusted for age, gender and socioeconomic status of each school for overweight/obesity compared to children meeting none of the 3 recommendations. CONCLUSIONS The screen time recommendation or combinations including screen time recommendation were associated with overweight/obesity. On the other hand, none of the recommendations was associated with underweight.
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10
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Eck KM, Delaney CL, Shelnutt KP, Olfert MD, Byrd-Bredbenner C. Parenting Advice School-Age Kids Offer to Parents to Promote Healthier Child Weight-Related Behaviors. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:290-298. [PMID: 31607432 DOI: 10.1016/j.jneb.2019.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 09/09/2019] [Accepted: 09/10/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To explore parenting advice children would provide to help parents encourage positive health-related behaviors by children. DESIGN Focus group discussions were conducted, and children shared the advice they would provide parents to help them encourage healthy weight-related behaviors (ie, diet, physical activity, and sleep) for children. SETTING Focus groups (n = 65) were conducted in 3 states (Florida, New Jersey, and West Virginia). PARTICIPANTS School-age children (n = 194) between the ages of 6 and 11 years old. PHENOMENON OF INTEREST What parenting practices are recommended by children, and are they in line with best-practice guidelines? ANALYSIS Focus group data were analyzed to identify themes and trends. RESULTS Children's recommendations were congruent with authoritative parenting styles (ie, high levels of warmth and control). Most of the advice shared by children aligned with recommended parent practices (ie, responsive feeding, facilitation, environmental restructuring, parent modeling, and encouragement). However, not all of the children's advice aligned with best practices guidelines (ie, use of food rewards and deception). CONCLUSIONS AND IMPLICATIONS Future nutrition education programs may be strengthened by helping parents adopt best practices for promoting healthy child behaviors. Furthermore, teaching children about recommended child feeding parenting practices may help protect future generations by preparing children to care for younger siblings or raise their children using best parenting practices.
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Affiliation(s)
- Kaitlyn M Eck
- Nutritional Sciences Department, Rutgers University, New Brunswick, NJ.
| | - Colleen L Delaney
- Nutritional Sciences Department, Rutgers University, New Brunswick, NJ
| | - Karla P Shelnutt
- Department of Family, Youth, and Community Sciences, University of Florida, Gainesville, FL
| | - Melissa D Olfert
- Division of Animal and Nutritional Sciences, West Virginia University, Morgantown, WV
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11
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Distribution of body mass index in children with different parental risk: Findings of a family-based cohort study in a West-Asian population. Sci Rep 2019; 9:9375. [PMID: 31253815 PMCID: PMC6599208 DOI: 10.1038/s41598-019-45543-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 06/07/2019] [Indexed: 11/09/2022] Open
Abstract
Using quantile regression analysis, the current study, conducted within the framework of the Tehran Lipid and Glucose Study (TLGS) aimed to assess the effects of parental risk clusters on different percentiles of Body Mass Index (BMI) distribution in children. Participants included 2296 school-aged children who had participated in the baseline assessment of the TLGS and were followed for an approximate duration of fifteen years. Parental socio-demographic, behavioral and clinical characteristics were considered to determine risk clusters. Comparing of the high- to the low-risk parental clusters showed that after adjusting for age in boys, BMI was significantly higher at the 75th (1.82, p = 03), 85th (1.78, p = 0.007) and 95th (1.66, p = 0.03) percentiles; and in girls it was significantly higher at the 25th (1.45, p = 0.003), 50th (1.05, p = 0.015), 95th (2.31, p = 0.018) and 97th (2.44, p = 0.006) percentiles in the high risk cluster. Our data indicate that during a long-term follow up, children with a high-risk family are more likely to have higher BMI, compared to their counterparts in low-risk families, a difference observed mainly at the upper percentiles of BMI distribution for both genders and at all ages, findings that should be considered for strategies aimed at preventing childhood obesity and its consequences.
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12
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Rendo-Urteaga T, Ferreira de Moraes AC, Torres-Leal FL, Manios Y, Gottand F, Sjöström M, Kafatos A, Widhalm K, De Henauw S, Molnár D, Marcos A, González-Gross M, Ferrari M, Carvalho HB, Moreno LA. Leptin and adiposity as mediators on the association between early puberty and several biomarkers in European adolescents: the HELENA Study. J Pediatr Endocrinol Metab 2018; 31:1221-1229. [PMID: 30325733 DOI: 10.1515/jpem-2018-0120] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 09/11/2018] [Indexed: 12/15/2022]
Abstract
Background Adolescents having early puberty (EP) are more likely to have obesity and increased cardiometabolic and inflammatory markers and atherosclerosis risk. We aimed to assess the indirect and mediated effects of leptin and adiposity on the relation between EP and cardiometabolic and inflammatory markers in European adolescents. Methods A sample of 511 adolescents with EP (12.5-17.5 years) from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) cross-sectional study was studied. To assess whether leptin levels and adiposity mediate the relation between EP and several biomarkers, linear regression models for mediation analyses were performed. Results EP was positively associated with the atherogenic index (Ath-I) (β=0.174; 95%CI 0.029-0.265) and negatively associated with the C-reactive protein (CRP) (β=-0.284; 95%CI -0.542 to -0.028) in girls. These associations were fully mediated by leptin levels (9.5%) and adiposity (44%), respectively. Moreover, EP has indirect effects on the apolipoprotein A-1 (ApoA-1) levels through adiposity in girls (for body mass index [BMI], β=0.014; 95%CI 0.005-0.028, and for waist circumference [WC], β=0.011; 95%CI 0.003-0.024), and on ApoA-1 (β=0.012; 95%CI 0.004-0.025), apolipoprotein B (ApoB) (β=-0.004; 95%CI -0.011 to -0.0004) and CRP (β=-0.265; 95%CI -0.819 to -0.047) through abdominal fat in boys. Conclusions Leptin levels and adiposity seem to play an important indirect and mediation role in the association between EP and cardiometabolic and inflammatory markers in adolescents. Weight control should be recommended in order to control the impaired cardiometabolic and inflammatory status arising in early pubertal adolescents.
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Affiliation(s)
- Tara Rendo-Urteaga
- Youth/Child and cArdiovascular Risk and Environmental (YCARE) Research Group, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.,Growth, Exercise, NUtrition and Development (GENUD) Research Group, Faculty of Health Science (EUCS), Instituto Agroalimentario de Aragón (IA2), University of Zaragoza-CITA, Zaragoza, Spain
| | - Augusto César Ferreira de Moraes
- Youth/Child and cArdiovascular Risk and Environmental (YCARE) Research Group, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.,Johns Hopkins University, Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD, USA
| | | | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Frederic Gottand
- CHU Lille, Univ Lille 2, Inserm U995, LIRIC, Hôpital J de Flandre, Lille, France
| | - Michael Sjöström
- Unit for Preventive Nutrition, Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Anthony Kafatos
- Department of Social Medicine, School of Medicine, Preventive Medicine and Nutrition Clinic, University of Crete, Crete, Greece
| | - Kurt Widhalm
- Department of Pediatrics, Private Medical University, Salzburg, Austria.,Department of Pediatrics, Medical University of Vienna, Salzburg, Austria
| | - Stefaan De Henauw
- Department of Public Health, Ghent University, Ghent, Belgium.,University College Ghent Vesalius, Ghent, Belgium
| | - Dénes Molnár
- Department of Pediatrics, Medical Faculty, University of Pécs, Pécs, Hungary
| | - Ascensión Marcos
- Inmunonutrition Research Group, Department of Metabolism and Nutrition, Instituto del Frío, Institute of Food Science and Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
| | - Marcela González-Gross
- ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport-INEF, Universidad Politécnica de Madrid, Madrid, Spain.,Institut für Ernährungs- und Lebensmittelwissenschaften - Ernährungphysiologie, Rheinische Friedrich Wilhelms Universität, Bonn, Germany
| | - Marika Ferrari
- CRA-NUT, Food and Nutrition Research Center, Agricultural Research Council Roma, Rome, Italy
| | - Heráclito B Carvalho
- Youth/Child and cArdiovascular Risk and Environmental (YCARE) Research Group, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Luis A Moreno
- Growth, Exercise, NUtrition and Development (GENUD) Research Group, Faculty of Health Science (EUCS), Instituto Agroalimentario de Aragón (IA2), University of Zaragoza-CITA, Zaragoza, Spain.,Department of Preventive Medici, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
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13
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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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14
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Tan Z, Min J, Xue H, Wang W, Wang Y. Parenting practices and overweight status of junior high school students in China: A nationally representative study of 19,487 students from 112 schools. Prev Med 2018; 107:1-7. [PMID: 28919202 PMCID: PMC6752200 DOI: 10.1016/j.ypmed.2017.09.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 09/07/2017] [Accepted: 09/09/2017] [Indexed: 01/09/2023]
Abstract
The study aimed to examine the level of parental responsiveness and demandingness for junior high students in China and its association with child weight status; assess if it differs by student socio-demographic characteristics; and to test the association between parenting and child physical activity. Nationally representative survey data collected from 19,487 students in 112 middle schools across China in 2013-2014 academic year were analyzed in 2016. Children's anthropometrics and perceptions of parenting practices were accessed by self-administered questionnaire. Multilevel logistic regression models were fit to test the association controlling for child age, sex, school region, and parental education. The majority of adolescents reported their parents were highly responsive in terms of emotional support and involvement (high: 64.1% vs. low: 9.2%), although more parents were not perceived as highly demanding (high: 21.4% vs. low: 35.5%). Children were more likely to be overweight or obese if their parents were highly responsive (OR=1.4 [95%CI: 1.2,1.6]) and demanding (OR=1.1 [95%CI: 1.0,1.3]) compared to those with medium parenting scores. Older children, boys, children with highly educated parents, or in urban schools had greater odds of being overweight or obese by receiving highly responsive parenting compared to their counterparts. Children with highly demanding or responsive parenting had longer physical activity duration and higher physical activity participation rates than their counterparts. High responsiveness and demandingness among Chinese parents were associated with the risk of child overweight and obesity. Further research is needed to examine the causal relationship between parenting practices and childhood obesity in China.
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Affiliation(s)
- Zhengqi Tan
- Systems-oriented Global Childhood Obesity Intervention Program, Department of Epidemiology and Environmental Health, The State University of New York at Buffalo, USA
| | - Jungwon Min
- Systems-oriented Global Childhood Obesity Intervention Program, Department of Epidemiology and Environmental Health, The State University of New York at Buffalo, USA; Systems-Oriented Global Childhood Obesity Intervention Program, Fisher Institute of Health and Well-being, College of Health, Ball State University, USA
| | - Hong Xue
- Systems-oriented Global Childhood Obesity Intervention Program, Department of Epidemiology and Environmental Health, The State University of New York at Buffalo, USA; Systems-Oriented Global Childhood Obesity Intervention Program, Fisher Institute of Health and Well-being, College of Health, Ball State University, USA
| | - Weidong Wang
- Department of Sociology, Renmin University of China, China.
| | - Youfa Wang
- Systems-oriented Global Childhood Obesity Intervention Program, Department of Epidemiology and Environmental Health, The State University of New York at Buffalo, USA; Systems-Oriented Global Childhood Obesity Intervention Program, Fisher Institute of Health and Well-being, College of Health, Ball State University, USA; Department of Nutrition and Health Sciences, College of Health, Ball State University, USA.
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15
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Gebremariam MK, Lien N, Nianogo RA, Arah OA. Mediators of socioeconomic differences in adiposity among youth: a systematic review. Obes Rev 2017; 18:880-898. [PMID: 28434193 DOI: 10.1111/obr.12547] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 03/06/2017] [Accepted: 03/07/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND Youth with a low socioeconomic position in developed countries are at a disproportionately higher risk of being overweight or obese than their counterparts. Tackling these inequalities requires that the mechanisms behind them are well understood. OBJECTIVES The aim of this review was to summarize existing evidence regarding the factors that mediate or contribute to the explanation of the relationship between socioeconomic position and adiposity among youth. METHODS AND RESULTS A systematic literature search, conducted using the databases Medline, Embase, Web of Science and PsycINFO, yielded 28 eligible studies. These studies were of low to moderate methodological quality. The most consistent mediators of the association between socioeconomic position and adiposity identified in this review were as follows: consumption of sugar-sweetened beverages, television viewing, computer use, parental body mass index, breastfeeding duration, breakfast consumption, maternal smoking during pregnancy and infant feeding practices. The mediating role of physical activity as well as fruit and vegetable consumption was found to be indeterminate. Other potential mediators were explored in too few studies to make conclusions about their mediating role. CONCLUSION The review found several modifiable factors that could be targeted as feasible in interventions aimed at reducing socioeconomic differences in overweight and obesity among youth.
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Affiliation(s)
- M K Gebremariam
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California, USA.,Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - N Lien
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - R A Nianogo
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California, USA
| | - O A Arah
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California, USA.,UCLA Center for Health Policy Research, Los Angeles, California, USA.,California Center for Population Research, UCLA, Los Angeles, California, USA
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16
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Altenburg TM, Singh AS, Te Velde S, De Bourdeaudhuij I, Lien N, Bere E, Molnár D, Jan N, Fernández-Alvira JM, Manios Y, Bringolf-Isler B, Brug J, Chinapaw MJ. Actual and perceived weight status and its association with slimming and energy-balance related behaviours in 10- to 12-year-old European children: the ENERGY-project. Pediatr Obes 2017; 12:137-145. [PMID: 26916601 DOI: 10.1111/ijpo.12120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 12/17/2015] [Accepted: 01/17/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Both parents' and children's perception of children's weight status may be important predictors of slimming and energy-balance related behaviours, independent of children's actual weight status. OBJECTIVES We examined the cross-sectional association of children's self-reported slimming and energy-balance related behaviours with children's (i) actual, (ii) self-perceived and (iii) parent-perceived weight status. METHODS Data of 10- to 12-year-old European children and their parents were used. Multilevel logistic and linear regression analyses were performed, adjusting for age, gender, parental weight controlling behaviours, education, marital status and ethnicity. RESULTS Independent of their actual weight status, a higher proportion of children reported slimming when they or their parents perceived them as too fat. Children's self-perceived weight status was more strongly associated with slimming than their parents' perception or their actual weight status. Moreover, children who perceive themselves as overweight reported less physical activity and more screen time. Children whose parents perceive them as overweight reported less physical activity. CONCLUSIONS Children's own perception of their weight status appears to be more important for their self-reported slimming than their actual or their parent's perceptions of their weight status. Additionally, children's self-perceived weight status seems important in engaging more physical activity and reduces screen time.
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Affiliation(s)
- T M Altenburg
- EMGO Institute for Health and Care Research, Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands
| | - A S Singh
- EMGO Institute for Health and Care Research, Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands
| | - S Te Velde
- EMGO Institut1e for Health and Care Research, Department of Epidemiology & Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - I De Bourdeaudhuij
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - N Lien
- Department of Nutrition, University of Oslo, Oslo, Norway
| | - E Bere
- Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway
| | - D Molnár
- Department of Paediatrics, University of Pécs, Pécs, Hungary
| | - N Jan
- Slovenian Heart Foundation, Ljubljana, Slovenia
| | - J M Fernández-Alvira
- Faculty of Health Sciences, Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
| | - Y Manios
- School of Health Science and Education, Department of Nutrition-Dietetics, Harokopio University Athens, Athens, Greece
| | - B Bringolf-Isler
- Department of Epidemiology and Public Health, Swiss TPH, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - J Brug
- EMGO Institut1e for Health and Care Research, Department of Epidemiology & Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - M J Chinapaw
- EMGO Institute for Health and Care Research, Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands
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17
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Roman-Viñas B, Chaput JP, Katzmarzyk PT, Fogelholm M, Lambert EV, Maher C, Maia J, Olds T, Onywera V, Sarmiento OL, Standage M, Tudor-Locke C, Tremblay MS. Proportion of children meeting recommendations for 24-hour movement guidelines and associations with adiposity in a 12-country study. Int J Behav Nutr Phys Act 2016; 13:123. [PMID: 27887654 PMCID: PMC5123420 DOI: 10.1186/s12966-016-0449-8] [Citation(s) in RCA: 213] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 11/17/2016] [Indexed: 01/16/2023] Open
Abstract
Background The Canadian 24-h movement guidelines were developed with the hope of improving health and future health outcomes in children and youth. The purpose of this study was to evaluate adherence to the 3 recommendations most strongly associated with health outcomes in new 24-h movement guidelines and their relationship with adiposity (obesity and body mass index z-score) across countries participating in the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE). Methods Cross-sectional results were based on 6128 children aged 9–11 years from the 12 countries of ISCOLE. Sleep duration and moderate-to-vigorous physical activity (MVPA) were assessed using accelerometry. Screen time was measured through self-report. Body weight and height were measured. Body mass index (BMI, kg · m−2) was calculated, and BMI z-scores were computed using age- and sex-specific reference data from the World Health Organization. Obesity was defined as a BMI z-score > +2 SD. Meeting the overall 24-h movement guidelines was defined as: 9 to 11 h/night of sleep, ≤2 h/day of screen time, and at least 60 min/day of MVPA. Age, sex, highest parental education and unhealthy diet pattern score were included as covariates in statistical models. Associations between meeting vs. not meeting each single recommendation (and combinations) with obesity were assessed with odds ratios calculated using generalized linear mixed models. A linear mixed model was used to examine the differences in BMI z-scores between children meeting vs. not meeting the different combinations of recommendations. Results The global prevalence of children meeting the overall recommendations (all three behaviors) was 7%, with children from Australia and Canada showing the highest adherence (15%). Children meeting the three recommendations had lower odds ratios for obesity compared to those meeting none of the recommendations (OR = 0.28, 95% CI 0.18–0.45). Compared to not meeting the 24-h movement recommendations either independently or combined, meeting them was significantly associated with a lower BMI z-score. Whenever the MVPA recommendation was included in the analysis the odds ratios for obesity were lower. Conclusions For ISCOLE participants meeting these 3 healthy movement recommendations the odds ratios of being obese or having high BMI z-scores were lower. However, only a small percentage of children met all recommendations. Future efforts should aim to find promising ways to increase daily physical activity, reduce screen time, and ensure an adequate night’s sleep in children. Trial registration The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) was registered at ClinicalTrials.gov (Identifier NCT01722500) (October 29, 2012).
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Affiliation(s)
- Blanca Roman-Viñas
- Department of Physical Activity and Sport Sciences, Psychology, Education and Sport Sciences, FPCEE Blanquerna, Universitat Ramon Llull, 34 Cister, 08022, Barcelona, Spain.,Nutrition Research Foundation, 242 Rocafort, 08029, Barcelona, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Jean-Philippe Chaput
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Peter T Katzmarzyk
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
| | - Mikael Fogelholm
- Department of Food and Environmental Sciences, University of Helsinki, 00014, Helsinki, Finland
| | - Estelle V Lambert
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, PO Box 115, Newlands, Cape Town, South Africa
| | - Carol Maher
- Alliance for Research in Exercise Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, City East Campus, North Terrace, Adelaide, 5000, Australia
| | - Jose Maia
- CIFI2D, Faculdade de Desporto, University of Porto, Porto, Portugal
| | - Timothy Olds
- Alliance for Research in Exercise Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, City East Campus, North Terrace, Adelaide, 5000, Australia
| | - Vincent Onywera
- Department of Recreation Management and Exercise Science, Kenyatta University, Nairobi, Kenya
| | - Olga L Sarmiento
- School of Medicine Universidad de los Andes, Carrera 1ª N° 18A 12, Bogotá, Colombia
| | - Martyn Standage
- Department for Health, University of Bath, Claverton Down, Bath, BA2 7AY, UK
| | - Catrine Tudor-Locke
- Department of Kinesiology, University of Massachusetts, 111 Totman, 30 Eastman Lane, Amherst, MA, 01002, USA
| | - Mark S Tremblay
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.
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Keykhaei F, Shahraki M, Sargolhosseinzadeh E, Shahraki T, Dashipour A. Correlation of Body Mass Index and Physical Activity Among 7- to 11-Year Children at Zahedan, Iran. Food Nutr Bull 2016; 37:364-374. [DOI: 10.1177/0379572116657225] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background: Childhood obesity is currently one of the major concerns in pediatric field. In recent literature, correlation of obesity with some behavioral factors such as physical activity (PA) received attention. Objective: The purpose of this study was to determine the relationship between body mass index (BMI) and PA. Materials and Methods: This cross-sectional study was carried out in 2012 on 548 randomly selected 7- to 11-year schoolchildren from Zahedan, Iran. The underweight, normal weight, overweight, and obesity status were all based on BMI percentiles for age and sex. Moderate to vigorous PA during the previous 7 days was assessed by a modified version of the Physical Activity Questionnaire for Children. Results: The prevalence of underweight, normal weight, overweight, and obesity among the participants was 18.3%, 47.9%, 11.8%, and 22.1%, respectively. Overweight and obesity were significantly higher among girls than boys. Mean PA score in participants was 2.4 ± 0.5. The results showed the PA score was significantly higher among boys than girls. The PA score had a significant association with BMI ( P = .018), and it was greater in normal participants than in obese participants. Conclusion: On the basis of observed data and due to the impact of PA on BMI as an indicator of nutritional status and health, teaching children to have better nutrition and lifestyle changes is very important. Therefore, more studies should focus on childhood obesity prevention programs to prevent nonoverweight children from becoming overweight or obese in the future.
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Affiliation(s)
- Fatemeh Keykhaei
- Department of Nutrition, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran
| | - Mansour Shahraki
- Department of Nutrition, Zahedan University of Medical Sciences, Zahedan, Islamic Republic of Iran
- Children and Adolescent Health Research Center, Zahedan University of Medical Sciences, Zahedan, Islamic Republic of Iran
| | - Elham Sargolhosseinzadeh
- Department of Nutrition, Zahedan University of Medical Sciences, Zahedan, Islamic Republic of Iran
| | - Touran Shahraki
- Children and Adolescent Health Research Center, Zahedan University of Medical Sciences, Zahedan, Islamic Republic of Iran
- Department of Pediatrics, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Islamic Republic of Iran
| | - Alireza Dashipour
- Department of Nutrition, Zahedan University of Medical Sciences, Zahedan, Islamic Republic of Iran
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Carson V, Hunter S, Kuzik N, Gray CE, Poitras VJ, Chaput JP, Saunders TJ, Katzmarzyk PT, Okely AD, Connor Gorber S, Kho ME, Sampson M, Lee H, Tremblay MS. Systematic review of sedentary behaviour and health indicators in school-aged children and youth: an update. Appl Physiol Nutr Metab 2016; 41:S240-65. [DOI: 10.1139/apnm-2015-0630] [Citation(s) in RCA: 656] [Impact Index Per Article: 82.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This systematic review is an update examining the relationships between objectively and subjectively measured sedentary behaviour and health indicators in children and youth aged 5–17 years. EMBASE, PsycINFO, and Medline were searched in December 2014, and date limits were imposed (≥February 2010). Included studies were peer-reviewed and met the a priori-determined population (apparently healthy children and youth, mean age: 5–17 years), intervention (durations, patterns, and types of sedentary behaviours), comparator (various durations, patterns, and types of sedentary behaviours), and outcome (critical: body composition, metabolic syndrome/cardiovascular disease risk factors, behavioural conduct/pro-social behaviour, academic achievement; important: fitness, self-esteem) study criteria. Quality of evidence by outcome was assessed using the Grading of Recommendations Assessment, Development, and Evaluation framework. Due to heterogeneity, a narrative analysis was conducted. A total of 235 studies (194 unique samples) were included representing 1 657 064 unique participants from 71 different countries. Higher durations/frequencies of screen time and television (TV) viewing were associated with unfavourable body composition. Higher duration/frequency of TV viewing was also associated with higher clustered cardiometabolic risk scores. Higher durations of TV viewing and video game use were associated with unfavourable behavioural conduct/pro-social behaviour. Higher durations of reading and doing homework were associated with higher academic achievement. Higher duration of screen time was associated with lower fitness. Higher durations of screen time and computer use were associated with lower self-esteem. Evidence ranged from “very low” to “moderate” quality. Higher quality studies using reliable and valid sedentary behaviour measures should confirm this largely observational evidence.
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Affiliation(s)
- Valerie Carson
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB T6G 2H9, Canada
| | - Stephen Hunter
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB T6G 2H9, Canada
| | - Nicholas Kuzik
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB T6G 2H9, Canada
| | - Casey E. Gray
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Veronica J. Poitras
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Travis J. Saunders
- Applied Human Sciences, Faculty of Science, University of Prince Edward Island, Charlottetown, PE C1A 4P3, Canada
| | | | - Anthony D. Okely
- Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, 2522, Australia
| | - Sarah Connor Gorber
- Office of the Task Force on Preventive Health Care, Public Health Agency of Canada, Ottawa, ON K1A 0K9, Canada
| | - Michelle E. Kho
- School of Rehabilitation Science, McMaster University, Hamilton, ON L8S 1C7, Canada
| | - Margaret Sampson
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Helena Lee
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB T6G 2H9, Canada
| | - Mark S. Tremblay
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
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Hui LL, Leung GM, Schooling CM. Social Patterning in Adiposity in Adolescence: Prospective Observations from the Chinese Birth Cohort ''Children of 1997''. PLoS One 2016; 11:e0146198. [PMID: 26735134 PMCID: PMC4703380 DOI: 10.1371/journal.pone.0146198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 12/13/2015] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Low early life socio-economic position is more strongly associated with adiposity among women than men. We examined whether the sex difference of social patterning in general and central adiposity exists before adulthood. METHODS In Hong Kong's "Children of 1997" birth cohort, we used multivariable regression to examine the association of parental education, a marker of early life socio-economic position, with body mass index (BMI) (n = 7252, 88% follow-up) and waist-height ratio (n = 5636, 68% follow-up), at 14 years. RESULTS Parental education of Grade 9 or below, compared to Grade 12 or above, was associated with higher waist-height ratio z-score particularly in girls (0.30, 95% confidence interval (CI) 0.19, 0.41) compared to boys (0.12, 95% CI 0.02, 0.22) (p for sex interaction = 0.02). Lower parental education was associated with greater BMI z-score in adolescents of locally born mothers, but not adolescents of migrant mothers, with no difference by sex. CONCLUSIONS Different social patterning in different markers of adiposity may imply different sociological and biological mediating pathways. A stronger association between low early life socio-economic position and waist-height ratio in adolescent girls may indicate sex-specific influences of SEP related early life exposures on central adiposity.
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Affiliation(s)
- L. L. Hui
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Gabriel M. Leung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - C. Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- CUNY School of Public Health and Hunter College, New York City, New York, United States of America
- * E-mail:
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Mantziki K, Vassilopoulos A, Radulian G, Borys JM, Du Plessis H, Gregório MJ, Graça P, De Henauw S, Handjiev S, Visscher TL, Seidell JC. Inequities in energy-balance related behaviours and family environmental determinants in European children: baseline results of the prospective EPHE evaluation study. BMC Public Health 2015; 15:1203. [PMID: 26630926 PMCID: PMC4668694 DOI: 10.1186/s12889-015-2540-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 11/23/2015] [Indexed: 11/24/2022] Open
Abstract
Background Tackling inequalities in overweight, obesity and related determinants has become a top priority for the European research and policy agendas. Although it has been established that such inequalities accumulate from early childhood onward, they have not been studied extensively in children. The current article discusses the results of an explorative analysis for the identification of inequalities in behaviours and their determinants between groups with high and low socio-economic status. Methods This study is part of the Epode for the Promotion of Health Equity (EPHE) evaluation study, the overall aim of which is to assess the impact and sustainability of EPODE methodology to diminish inequalities in childhood obesity and overweight. Seven community-based programmes from different European countries (Belgium, Bulgaria, France, Greece, Portugal, Romania, The Netherlands) participate in the EPHE study. In each of the communities, children aged 6–8 years participated, resulting in a total sample of 1266 children and their families. A parental self-administrated questionnaire was disseminated in order to assess the socio-economic status of the household, selected energy balance-related behaviours (1. fruit and vegetable consumption; 2. soft drink/ fruit juices and water consumption; 3. screen time and 4. sleep duration) of the children and associated family environmental determinants. The Mann–Whitney U test and Pearson’s chi-square test were used to test differences between the low and high education groups. The country-specific median was chosen as the cut-off point to determine the educational level, given the different average educational level in every country. Results Children with mothers of relatively high educational level consumed fruits and vegetables more frequently than their peers of low socio-economic status. The latter group of children had a higher intake of fruit juices and/or soft drinks and had higher screen time. Parental rules and home availability were consistently different between the two socio-economic groups in our study in all countries. However we did not find a common pattern for all behaviours and the variability across the countries was large. Conclusions Our findings are indicative of socio-economic inequalities in our samples, although the variability across the countries was large. The effectiveness of interventions aimed at chancing parental rules and behaviour on health inequalities should be studied. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2540-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Krystallia Mantziki
- Department of Health Sciences, VU University Amsterdam, Amsterdam, The Netherlands.
| | - Achilleas Vassilopoulos
- Department of Agricultural Economics and Rural Development, Agricultural University of Athens, Athens, Greece
| | | | | | | | - Maria João Gregório
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Pedro Graça
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal.,Directorate General of Health, Lisbon, Portugal
| | | | - Svetoslav Handjiev
- Bulgarian Association for the study of Obesity and related diseases, Sofia, Bulgaria
| | - Tommy Ls Visscher
- Department of Health Sciences, VU University Amsterdam, Amsterdam, The Netherlands.,Research Centre for the Prevention of Overweight, Windesheim University of Applied Sciences Zwolle & VU University, Zwolle, The Netherlands
| | - Jacob C Seidell
- Department of Health Sciences, VU University Amsterdam, Amsterdam, The Netherlands
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Barriuso L, Miqueleiz E, Albaladejo R, Villanueva R, Santos JM, Regidor E. Socioeconomic position and childhood-adolescent weight status in rich countries: a systematic review, 1990-2013. BMC Pediatr 2015; 15:129. [PMID: 26391227 PMCID: PMC4578240 DOI: 10.1186/s12887-015-0443-3] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 09/04/2015] [Indexed: 01/09/2023] Open
Abstract
Background Childhood obesity is a major problem in rich countries due to its high prevalence and its harmful health consequences. An exploratory analysis conducted in the PubMed database highlighted that the number of papers published on the relationship between socioeconomic position (SEP) and childhood-adolescent weight status had risen substantially with respect to an earlier review which had covered the period 1990–2005. Methods To describe the findings on the relationship between SEP and childhood-adolescent weight status in papers published in rich countries from 1990 through 2013, studies were identified in the following databases: PubMed; Web of Knowledge (WOK); PsycINFO; Global Health; and Embase. We included observational studies from the 27 richest OECD countries, which covered study populations aged 0 to 21 years, and used parental education, income and/or occupation as family SEP indicators. A total of 158 papers met the inclusion criteria and reported 134 bivariable and 90 multivariable analyses. Results Examination of the results yielded by the bivariable analyses showed that 60.4 % of studies found an inverse relationship, 18.7 % of studies did not found relationship, and 20.9 % of studies found a relationship that varied depending on another variable, such as age, sex or ethnic group; the corresponding percentages in the multivariable analyses were 51.1, 20.0 and 27.8 %, respectively. Furthermore, 1.1 % found a positive relationship. Conclusion The relationship between SEP and childhood-adolescent weight status in rich countries is predominantly inverse and the positive relationship almost has disappeared. The SEP indicator that yields the highest proportion of inverse relationships is parents’ education. The proportion of inverse relationships is higher when the weight status is reported by parents instead using objective measurements. Electronic supplementary material The online version of this article (doi:10.1186/s12887-015-0443-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Laura Barriuso
- Instituto de Salud Pública y Laboral de Navarra, Pamplona, Spain.
| | - Estrella Miqueleiz
- Department of Sociology, Universidad Pública de Navarra, Campus de Arrosadía, s/n, 31006, Pamplona, Spain.
| | - Romana Albaladejo
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
| | - Rosa Villanueva
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
| | - Juana M Santos
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain. .,Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
| | - Enrique Regidor
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain. .,Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain. .,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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Parikka S, Mäki P, Levälahti E, Lehtinen-Jacks S, Martelin T, Laatikainen T. Associations between parental BMI, socioeconomic factors, family structure and overweight in Finnish children: a path model approach. BMC Public Health 2015; 15:271. [PMID: 25885334 PMCID: PMC4371876 DOI: 10.1186/s12889-015-1548-1] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 02/16/2015] [Indexed: 12/24/2022] Open
Abstract
Background The aim of this study was to assess the less studied interrelationships and pathways between parental BMI, socioeconomic factors, family structure and childhood overweight. Methods The cross-sectional LATE-study was carried out in Finland in 2007–2009. The data for the analyses was classified into four categories: younger boys and girls (ca 3–8 years) (n = 2573) and older boys and girls (ca 11–16 years) (n = 1836). Associations between parental BMI, education, labor market status, self-perceived income sufficiency, family structure and childhood overweight were first examined by logistic regression analyses. As parental BMI and education had the most consistent associations with childhood overweight, the direct and indirect (mediated by parental BMI) associations of maternal and paternal education with childhood overweight were further assessed using a path model. Results Parental BMI and education were the strongest determinants of childhood overweight. Children of overweight parents had an increased risk of being overweight. In younger boys, maternal and paternal education had both direct (b-coefficient paternal −0.21, 95% CI −0.34 to −0.09; maternal −0.17, 95% CI −0.28 to −0.07) and indirect (b-coefficient paternal −0.04, 95% CI −0.07 to −0.02; maternal −0.04, 95% CI −0.06 to −0.02) inverse associations with overweight. Among the older boys, paternal education had both direct (b-coefficient −0.12, 95% CI −0.24 to −0.01) and indirect (b-coefficient −0.03, 95% CI −0.06 to −0.01) inverse associations with overweight, but maternal education had only an indirect association (b-coefficient −0.04, 95% CI −0.07 to −0.02). Among older girls, only an indirect association of maternal education with childhood overweight was found (b-coefficient −0.03, 95% CI −0.06 to −0.01). In younger girls, parental education was not associated with childhood overweight. Conclusion The observed pathways between parental BMI and education and childhood overweight emphasize a need for evidence-based health promotion interventions tailored for families identified with parental overweight and low level of education.
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Affiliation(s)
- Suvi Parikka
- National Institute for Health and Welfare, Department of Welfare, P.O. Box 30, 00271, Helsinki, Finland.
| | - Päivi Mäki
- National Institute for Health and Welfare, Department of Health, Helsinki, Finland.
| | - Esko Levälahti
- National Institute for Health and Welfare, Department of Health, Helsinki, Finland.
| | - Susanna Lehtinen-Jacks
- National Institute for Health and Welfare, Department of Health, Helsinki, Finland. .,University of Tampere, School of Health Sciences, Tampere, Finland.
| | - Tuija Martelin
- National Institute for Health and Welfare, Department of Welfare, P.O. Box 30, 00271, Helsinki, Finland.
| | - Tiina Laatikainen
- National Institute for Health and Welfare, Department of Health, Helsinki, Finland. .,University of Eastern Finland, Institute of Public Health and Clinical Nutrition, Kuopio, Finland. .,Hospital District of North Karelia, Joensuu, Finland.
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Energy balance related behaviour: personal, home- and friend-related factors among schoolchildren in Europe studied in the ENERGY-project. PLoS One 2014; 9:e111775. [PMID: 25372490 PMCID: PMC4221133 DOI: 10.1371/journal.pone.0111775] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 10/07/2014] [Indexed: 11/19/2022] Open
Abstract
Objective To design interventions that target energy balance-related behaviours, knowledge of primary schoolchildren's perceptions regarding soft drink intake, fruit juice intake, breakfast consumption, TV viewing and physical activity (PA) is essential. The current study describes personal beliefs and attitudes, home- and friend-related variables regarding these behaviours across Europe. Design Cross-sectional study in which personal, family and friend -related variables were assessed by validated questionnaires, and dichotomized as favourable versus unfavourable answers. Logistic regression analyses were conducted to estimate proportions of children giving unfavourable answers and test between-country differences. Setting A survey in eight European countries. Subjects A total of 7903 10–12 year old primary schoolchildren. Results A majority of the children reported unfavourable attitudes, preferences and subjective norms regarding soft drink, fruit juice intake and TV viewing accompanied with high availability and accessibility at home. Few children reported unfavourable attitudes and preferences regarding breakfast consumption and PA. Many children reported unfavourable health beliefs regarding breakfast consumption and TV viewing. Substantial differences between countries were observed, especially for variables regarding soft drink intake, breakfast consumption and TV viewing. Conclusion The surveyed children demonstrated favourable attitudes to some healthy behaviours (PA, breakfast intake) as well as to some unhealthy behaviours (soft drink consumption, TV viewing). Additionally, many children across Europe have personal beliefs and are exposed to social environments that are not supportive to engagement in healthy behaviours. Moreover, the large differences in personal, family and friend-related variables across Europe argue for implementing different strategies in the different European countries.
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Rebholz CE, Chinapaw MJM, van Stralen MM, Bere E, Bringolf B, De Bourdeaudhuij I, Jan N, Kovacs E, Maes L, Manios Y, Moreno L, Singh AS, Brug J, te Velde SJ. Agreement between parent and child report on parental practices regarding dietary, physical activity and sedentary behaviours: the ENERGY cross-sectional survey. BMC Public Health 2014; 14:918. [PMID: 25190541 PMCID: PMC4169834 DOI: 10.1186/1471-2458-14-918] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 07/29/2014] [Indexed: 12/14/2022] Open
Abstract
Background Parents and their parenting practices play an important role in shaping their children’s environment and energy-balance related behaviours (EBRBs). Measurement of parenting practices can be parent- or child-informed, however not much is known about agreement between parent and child perspectives. This study aimed to assess agreement between parent and child reports on parental practices regarding EBRBs across different countries in Europe and to identify correlates of agreement. Methods Within the ENERGY-project, a cross-sectional survey was conducted among 10–12 year old children and their parents in eight European countries. Both children and parents filled in a questionnaire on 14 parental practices regarding five different EBRBs (i.e. soft drink, fruit juice and breakfast consumption, sports activity and watching TV) and socio-demographic characteristics. Children’s anthropometric measurements were taken at school. We calculated percentages of agreement between children and their parents and weighted kappa statistics (for ordinal variables) per practice and country and assessed factors associated with agreement using multilevel linear regression. Results Reports of 6425 children and their parents were available for analysis. Overall mean agreement between parent and child reports was 43% and varied little among countries. The lowest agreement was found for questions assessing joint parent–child activities, such as sports (27%; Kappa (κ) = 0.14) or watching TV (30%;κ = 0.17), and for parental allowance of the child to have soft drinks (32%;κ = 0.24) or fruit juices (32%;κ = 0.19), or to watch TV (27%;κ = 0.17). Having breakfast products available at home or having a TV in the child’s bedroom were the only practices with moderate to good agreement (>60%;κ = 0.06 and 0.77, respectively). In general, agreement was lower for boys, younger children, younger parents, parents with less than 14 years of education, single parents, parents with a higher self-reported body mass index and parents who perceived their child to be underweight. Conclusions Parents and children perceive parental practices regarding dietary, physical activity and sedentary behaviours differently in all parts of Europe, with considerable variation across specific practices and countries. Therefore, future studies should assess both, parents and children’s view on parental practices. Electronic supplementary material The online version of this article (doi:10.1186/1471-2458-14-918) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Saskia J te Velde
- EMGO Institute for Health and Care Research and the Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.
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Mantziki K, Vassilopoulos A, Radulian G, Borys JM, du Plessis H, Gregório MJ, Graça P, de Henauw S, Handjiev S, Visscher TLS, Seidell JC. Promoting health equity in European children: design and methodology of the prospective EPHE (Epode for the Promotion of Health Equity) evaluation study. BMC Public Health 2014; 14:303. [PMID: 24690078 PMCID: PMC3997816 DOI: 10.1186/1471-2458-14-303] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 03/26/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Reducing health inequalities is a top priority of the public health agendas in Europe. The EPHE project aims to analyse the added value of a community-based interventional programme based on EPODE methodology, adapted for the reduction of socio-economic inequalities in childhood obesity. The interventions that will be implemented by this project focus on four energy balance-related behaviours (fruit and vegetable consumption, tap water intake, physical inactivity, sleep duration) and their determinants. This article presents the design of the effect evaluation of the EPHE project. METHODS/DESIGN This is a prospective two-year follow-up evaluation study, which will collect data on the energy balance-related behaviours and potential environmental determinants of 6-8 year olds, depending on the socio-economic status of the parents. For this purpose a parental self-reported questionnaire is constructed. This assesses the socio-economic status of the parents (5 items) and the dietary (12 items), sedentary (2 items) and sleeping (4 items) behaviour of the child. Alongside potential family-environmental determinants are assessed. The EPHE parental questionnaire will be disseminated in schools of a selected medium-sized city in seven European countries (Belgium, Bulgaria, France, Greece, Portugal, Romania, The Netherlands). DISCUSSION This study will evaluate the effects of the EPHE community-based interventional programmes. Furthermore, it will provide evidence for children's specific energy balance-related behaviours and family environmental determinants related to socio-economic inequalities, in seven European countries.
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Affiliation(s)
- Krystallia Mantziki
- Department of Health Sciences, VU University Amsterdam, De Boelelaan 1085, Amsterdam 1081HV, The Netherlands.
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