Differences in lifestyle behaviors, dietary habits, and familial factors among normal-weight, overweight, and obese Chinese children and adolescents

The relationship between the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet and metabolic health status in adolescents with overweight and obesity: results from a cross-sectional study in Iran

Few studies investigated the association between Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet and metabolic health status, particularly among adolescents. The present study was designed to investigate the association of MIND diet with metabolic health status in Iranian adolescents with overweight/obesity. This cross-sectional study was done among 203 adolescents with overweight/obesity (12-18 years) in Isfahan, Iran. A validated FFQ was applied to collect dietary intakes. Anthropometric indices and blood pressure were also measured by standard procedures. Fasting blood samples were obtained to determine serum insulin, glucose and lipid profile. To categorise participants as being with metabolically healthy overweight/obesity (MHO) or metabolically unhealthy overweight/obesity (MUO), two methods including International Diabetes Federation (IDF) criteria and IDF plus Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) were applied. Participants had a mean age of 13·98 years and 50·2 % of them were girls. In fully adjusted models, participants with highest MIND diet adherence had lower odds of MUO status based on IDF (OR = 0·20; 95 % CI 0·08, 0·51) and IDF/HOMA-IR (OR = 0·22; 95 % CI 0·08, 0·59) criteria. Stratified analyses revealed that this association was stronger among girls and was only significant among individuals with overweight. An inverse association was also found between MIND diet score and odds of hyperglycaemia and insulin resistance (IR). Higher MIND diet adherence was associated with lower odds MUO in adolescents with overweight/obesity. Inverse associations were also found between MIND diet and odds of hyperglycaemia and IR. Future longitudinal prospective studies are necessary to confirm our results.

Maternal folic acid supplementation during pregnancy in association with childhood overweight or obesity

OBJECTIVE

This study aimed to examine associations of maternal folic acid supplementation (FAS) during pregnancy with childhood overweight or obesity (OWO) or adiposity.

METHODS

In a population-based cohort of 1479 children, maternal FAS during pregnancy was assessed retrospectively by questionnaires. BMI and body fat percentages were measured at a mean age of 6.4 years. Pertinent factors were accounted for in data analyses.

RESULTS

Maternal FAS during pregnancy was negatively associated with OWO (adjusted odds ratio: 0.70; 95% CI: 0.50 to 0.99). There were inverse associations of maternal FAS during pregnancy with BMI z score (β: -0.22; 95% CI: -0.39 to -0.05), whole body fat percentage (β: -1.28; 95% CI: -2.27 to -0.30), trunk fat percentage (β: -1.41; 95% CI: -2.78 to -0.04), and limb fat percentage (β: -1.31; 95% CI: -2.32 to -0.30). Stratified analyses found inverse associations of FAS during pregnancy with OWO, BMI z score, and body fat percentages predominantly among children without breastfeeding and whose parents had a below-tertiary educational level.

CONCLUSIONS

This study provides novel evidence that maternal FAS during pregnancy was significantly associated with a decreased risk of childhood OWO and adiposity, particularly among children with no breastfeeding and lower parental educational level.

Association between dietary Intake, eating behavior, and childhood obesity among children and adolescents in Ethiopia

Introduction

The upsurge of overweight/obesity (OW/OB) among children and adolescents is as a result of complex interactions between lifestyle behaviours and socioeconomic factors. The objective of this study was to determine socioeconomic and sociodemographic factors, dietary intake and eating behaviours of children and adolescents in Ethiopia and their association with OW/OB.

Methods

A cross-sectional study was conducted among 632 children and adolescents-parent dyads. To identify overweight/obese among children and adolescents, body mass index-for-age Z-scores by sex and age relative to WHO 2007 reference was calculated using WHO AnthroPlus software. A multivariable logistic regression model fitted to determine the adjusted associations between the outcome and the predictors selected from the bivariate analyses. Data analysis was carried out using STATA V.15.0.

Results

The proportion of participants with low, medium and high dietary diversity scores was 7.28%, 22.5%, and 70.2%, respectively. Participants aged 13-18 years were less likely to be overweight or obese [adjusted OR (aOR) = 0.40; 95%CI: 0.26, 0.64] to those aged 5-12 years. Children in a family with the richest or highest socioeconomic status (SES) were more likely to be overweight or obese than those in families with the poorest or lowest status. Children and adolescents who consumed soft drinks (sugar-sweetened beverages) four or more times per week [aOR = 3.24; 95%CI: 1.13, 7.95] were more likely to be overweight or obese to those who did not consume soft drinks.

Conclusions

The study identified factors such as younger age (<12 years), high SES and consumption of soft drinks as key contributors to overweight and obesity among children and adolescents. Therefore, interventions targeting behavioural prevention and reduction of overweight and obesity among children and adolescents should be cognizant of the above factors during implementation in order to achieve desired outcomes, further guided by exploratory qualitative studies to identify public perceptions and attitudes affecting dietary practices.

Prevalence of overweight/obesity and related factors in Keerqin District, Tongliao City: A cross-sectional study

OBJECTIVE

This study aimed to analyze the prevalence of overweight/obesity and the factors influencing these conditions among 9- to 18-year-old adolescents in Keerqin District of Tongliao City. We explored whether overweight/obesity is accompanied by differences in eating habits, lifestyle, and mental health.

METHODS

A cross-sectional survey was administered to 1,736 adolescents in November 2020. A physical examination was performed for each participant, and an online questionnaire was adopted to collect information. The association of several risk factors with overweight/obesity was explored using a logistic regression model.

RESULTS

The prevalence of overweight/obesity in the study population was 43.32%. The risk of overweight/obesity was higher among nonresident students (odds ratio [OR] = 1.564, 95% CI = 1.182-2.069) who had an average of 3-4 (OR = 2.164, 95% CI = 1.087-4.308) or 5 or more (OR = 2.114, 95% CI = 1.376-3.248) PE classes per week. The risk of overweight/obesity was lower among girls (OR = 0.485, 95% CI = 0.396-0.593), students aged 15-16 years (OR = 0.288, 95% CI = 0.135-0.617) and those aged 17-18 years (OR = 0.282, 95% CI = 0.124-0.639), students who ate sweets more than once a week (OR = 0.570, 95% CI = 0.366-0.887), students who spent less than 1 hour per day on the computer each week (OR = 0.776, 95% CI = 0.620-0.971), students with depressive symptoms (Center for Epidemiologic Studies Depression Scale [CES-D] score ≥ 16) (Model 2: OR = 0.618, 95% CI = 0.385-0.990; Model 3: OR = 0.623, 95% CI = 0.388-1.000), and students with depressed affect (Model 2: OR = 0.921, 95% CI = 0.877-0.967; Model 3: OR = 0.929, 95% CI = 0.885-0.976).

CONCLUSION

Overweight/obesity was influenced by eating habits and lifestyle factors. In addition, overweight/obesity adolescents had a lower risk of depressed than those with normal weight.

Motivational Interviewing in Pediatric Obesity: A Meta-analysis of the Effects on Behavioral Outcomes

BACKGROUND

Currently, the effects of motivational interviewing (MI) on children's behavioral changes remain obscure.

PURPOSE

This systematic review and meta-analysis examined the effects of MI on children's lifestyle behavioral changes (fruits and vegetables [F/V], dairy, sugary beverages, calories, snacks, fat intake, moderate vigorous physical activity [MVPA], and screen time).

METHODS

Six databases (CINAHL, Cochrane, Embase, PsycINFO, PubMed, and Web of Sciences) from 2005 to 2022 were searched. Thirty-one intervention studies with a comparison group met the criteria. Random-effects models were performed to estimate the pooled effects; exploratory moderation analyses with mixed-effects models were used to explore potential intervention moderators.

RESULTS

The pooled effect size was 0.10 (p = .334) on ↑F/V, 0.02 (p = .724) on ↑dairy, -0.29 (p < .001) on ↓calories, -0.16 (p = .054) on ↓sugary beverages, -0.22 (p = .002) on ↓snacks, -0.20 (p = .044) on ↓fat, 0.22 (p = .001) on ↑MVPA, and -0.06 (p = .176) on ↓screen time. The effects of MIs were moderated by ↑MI sessions regarding ↓snacks (B = -0.04, p = .010). Multicomponent and clinical programs had greater effects on dairy intake than their counterparts (0.09 vs. -0.21, p = .034; 0.12 vs. -0.14, p = .027, respectively). Similarly, interventions with a fidelity check resulted in greater dairy intake than those without a check (0.29 vs. -0.15, p = .014). A few long-term follow-up assessments revealed effects on ↓F/V (-0.18; p = .143, k = 2), ↓dairy (-0.13, p = .399, k = 4), ↓MVPA (-0.04; p = .611, k = 6), and ↑screen time (0.12; p = .242, k = 4).

CONCLUSIONS

Our findings support the short-term effects of MI on improving children's lifestyle behaviors. Additional investigations are needed to better sustain children's long-term behavioral changes.

Factors associated with overweight and obesity among Bangladeshi university students: a case-control study

Objectives: Overweight and obesity has an adverse effect on public health, and emerging adulthood (18-25 years) is recognized as a potential period for the onset of obesity, thus, this study aimed to explore risk factors associated with overweight and obesity in Bangladeshi university students. Participants: Bangladeshi university students (n = 280). Methods: A case-control study of 140 students with overweight and obesity and 140 students with normal weight. Results: Multiple logistic regression revealed having at least one overweight or obese parent (AOR = 4.2; 95% CI: 2.2-8.4) and participating in no physical activity (AOR = 3.2; 95% CI: 1.0-9.9) were potential risk factors. Reported consumption ≥4 meals in a day, junk food/fast food, and soft drinks for ≥3 days a week were potential determinants of overweight and obesity in this population. Conclusion: Increased awareness on the importance of regular physical activity and a healthy diet may reduce the risk of overweight and obesity among Bangladeshi university students.

Sleep, nutritional status and eating behavior in children: a review study

OBJECTIVE

To review the current literature on the relationship between sleep, nutritional status and eating behavior, as well as mechanisms associated with these elements in children.

DATA SOURCE

The literature research was conducted in the PubMed, LILACS and Scopus databases, using the following terms: "Child"; "Nutritional status"; "Sleep"; "Physical activity OR Physical activities OR Exercise". The articles included were those that met the research objective. Review articles, letters to authors, or guidelines were excluded.

DATA SYNTHESIS

402 articles were initially found in the literature search. After careful analyses of the title and abstract, and application of inclusion criteria, only 24 studies were included in the present review. Most studies (n=13) suggest that short sleep duration (<9-10 hours/night) is associated with overweight/obesity in children. Only three studies did not show associations between overweight/obesity and sleep variables. Short sleep duration is also associated with poor food quality, higher intake of soft drinks and stimulant beverages before bedtime, as well as micronutrient deficiency.

CONCLUSIONS

Sleep duration is related to overweight and obesity development in infants. Changes in dietary pattern are also related to sleep debt, being one of the mechanisms that contribute to excessive weight gain. It is necessary that health professionals understand the importance of sleep quality in the nutritional status maintenance in children.

Sono, estado nutricional e hábitos alimentares em crianças: um estudo de revisão

RESUMO Objetivo: Fazer uma revisão da literatura sobre a relação entre sono, estado nutricional e padrão alimentar, bem como mecanismos associados, na população infantil. Fontes de dados: Foram realizadas buscas bibliográficas nas bases PubMed, LILACS e Scopus, usando os seguintes descritores: “Child”; “Nutritional status”; “Sleep”; “Physical activity OR Physical activities OR Exercise”. Os artigos que atenderam ao objetivo da pesquisa foram incluídos. Excluíram-se estudos de revisão, cartas para autores ou diretrizes. Síntese dos dados: Inicialmente, 402 artigos foram encontrados na pesquisa. Após análise dos títulos e abstracts e a aplicação dos critérios de exclusão, 24 estudos foram selecionados para a revisão. A maioria dos estudos (n=13) sugere que sono de curta duração (<9-10 horas/noite) está associado com sobrepeso/obesidade na população infantil. Apenas três artigos não reportaram associações entre variáveis do sono e estado nutricional. Curta duração do sono também foi associada a hábitos alimentares ruins, maior consumo de refrigerantes e bebidas estimulantes antes de deitar, bem como deficiência de micronutrientes. Conclusões: A duração do sono tem relação com sobrepeso e obesidade na população infantil. Alterações no padrão alimentar também têm relação com débito de sono, sendo um dos mecanismos que contribuem para o ganho de peso excessivo. É necessário que os profissionais de saúde tomem conhecimento da importância da qualidade do sono para a manutenção do estado nutricional em crianças.

[Sleep duration, overweight and consumption of ultra-processed foods among adolescents]

The scope of this article is to analyze the relationship between insufficient sleep duration, overweight/obesity and the consumption of ultra-processed foods among adolescents aged 10 to 14 years. This is a cross-sectional study, with an evaluation of 1,384 adolescents from public schools in João Pessoa-PB, participating in the Longitudinal Study on Sedentary Behavior, Physical Activity, Diet and Adolescent Health (LONCAAFS). Sociodemographic variables, sleep duration, class shift, anthropometric nutritional status, sedentary behavior and food consumption were measured. Linear and logistic regression of the following were performed using Stata 13.0 Software: the prevalence of short sleep duration of 29.5% (<9h/night); a significant association between short sleep duration and excess weight only for adolescents <12 years old. With respect to the relationship between sleep duration and the consumption of ultra-processed foods, the longer the sleep duration, the lower the consumption of snacks by adolescents under 12 years old, with a positive association for ≥12 years old only with adjustment by the physical activity variable. There was no association with the "sugary drinks" and "cookies" groups for any of the age groups analyzed.

Overweight and obesity in Eastern Morocco: Prevalence and associated risk factors among high school students

BACKGROUND

Overweight and obesity in children and adolescents have become a major public health problem affecting most countries worldwide. The purpose of the study was to assess the prevalence and risk factors of overweight and obesity among public high school students in Eastern Morocco.

METHODS

A cross-sectional survey was conducted between February and May 2014 among a sample of 2271 students (1086 girls and 1185 boys). References from the International Obesity Task Force (IOTF) were used to determine the prevalence of overweight and obesity.

RESULTS

The prevalence of overweight and obesity reached 12.2% (14.2% in girls vs 10.4% in boys, P<0.01) and 3.0% (3.1% in girls vs 2.8% in boys), respectively. Risk factors associated with overweight and obesity were urban residence (OR=1.76; [1.18-2.63]; P<0.01), father's income≥5000MAD (OR=1.32; [1.02-1.70]; P<0.05), father's overweight (including obesity) (OR=1.87; [1.38-2.54]; P<0.001) and female sex (OR=1.31; [1.02-1.68]; P<0.05).

CONCLUSION

The prevalence of overweight/obesity has reached an alarming rate among high school students in the Eastern region of Morocco. The findings of the present study suggest an urgent need to set up a strategy to prevent and combat this epidemic.

Obesity Prevention and Treatment in Primary Care

Despite extensive public health and clinical interventions, obesity rates remain high, and evidence-based preventive strategies are elusive. Many consensus guidelines suggest that providers should screen all children after age 2 years for obesity by measuring height and weight, calculating body mass index (BMI), and sensitively communicating weight status in the context of health to the family at each visit. However, preventive counseling should begin in infancy and focus on healthy feeding, activity, and family lifestyle behaviors. For children with overweight or obesity, the American Academy of Pediatrics outlines 4 stages of treatment: 1) Primary care providers should offer "prevention plus," the use of motivational interviewing to achieve healthy lifestyle modifications in family behaviors or environments; 2) children requiring the next level of obesity treatment, structured weight management, need additional support beyond the primary care provider (such as a dietitian, physical therapist, or mental health counselor) and more structured goal setting with the team, including providers adept at weight management counseling; 3) children with severe obesity and motivated families may benefit from referral to a comprehensive multidisciplinary intervention, such as an obesity treatment clinic; and 4) tertiary care interventions are provided in a multidisciplinary pediatric obesity treatment clinic with standard clinical protocols for evaluation of interventions, including medications and surgery. Although it is certainly a challenge for providers to fit in all the desired prevention and treatment counseling during preventive health visits, by beginning to provide anticipatory guidance at birth, providers can respond to parents' questions, add to parents' knowledge base, and partner with parents and children and adolescents to help them grow up healthy. This is especially important in an increasingly toxic food environment with numerous incentives and messages to eat unhealthfully, barriers to appropriate physical activity, and concomitant stigma about obesity. Focusing on key nutrition and physical activity habits and establishing these healthy behaviors at an early age will allow children to develop a healthy growth trajectory. However, much more work is needed to determine the best evidence-based practices for providers to counsel families on improving target behaviors, environmental modifications, and parenting skills and to decrease abundant disparities in obesity prevalence and treatment.

The Role of Maternal and Child Characteristics in Chinese Children's Dietary Intake Across Three Groups

Objective

To examine whether mothers' early-life food insecurity (ELFI), pressuring to eat feeding practices (PEP), and child effortful control (EC) are associated with child dietary intake within and across three Chinese ethnic groups.

Method

Participants included 119 Chinese international immigrants in the United States, 230 urban nonmigrant, and 468 rural-to-urban migrant mothers and preschoolers in China. Mothers reported on their ELFI, PEP, and their children's EC and dietary intake.

Results

Controlling for maternal and child body mass index, age, and gender, multiple group path analyses revealed that maternal ELFI was positively associated with PEP in all groups, which in turn was positively associated with child unhealthy diet in all groups, but negatively associated with child fruits and vegetables (F&V) consumption in the urban nonmigrant group only. Also, EC was positively associated with child F&V diet for all groups. Moreover, the indirect effect of ELFI on children's unhealthy diet through PEP was significant only for immigrant children with lower levels of EC, but not those with higher levels of EC.

Conclusions

Our findings highlighted the long-lasting effect of mothers' ELFI on their feeding and child eating. Mothers' pressuring to eat played a central role in the association between their past experiences and children's diet. Also, children's poor EC abilities might exacerbate the adverse effect of mothers' ELFI through PEP, resulting in more unhealthy eating. These findings can contribute to the design of contextually based intervention/prevention programs that promote young children's healthy eating through maternal feeding practices and children's EC abilities.

Dietary Behaviors and Caregiver Perceptions of Overweight and Obesity among Chinese Preschool Children

Introduction: Early childhood obesity in China has become a pressing public health concern. A substantial barrier to healthy weight management is poor parental recognition of child overweight. This study examined the relationship between caregiver perceptions of child weight and dietary practices. Methods: A total of 364 children between 2 and 6 years old from six urban preschools in Changsha (China) were included in a cross-sectional study. Information on household demographics, health behaviors, and caregiver attitudes was collected through a self-administered caregiver questionnaire. Chi-squared tests, t-tests, and multivariable logistic regression analysis were used to determine the relationship between caregiver perceptions, dietary behaviors, and child weight status. Results: Over 60% of caregivers with overweight/obese children underestimated their children's weight status. These caregivers were less likely to worry about weight and restrict their children's dietary intakes. Children of caregivers who incorrectly classified their weights were also more likely to have a poor appetite. Caregivers of male children and those from families with incomes between 7000 and 11,000 Ren Min Bi (RMB) were more likely to underestimate weight compared to caregivers with daughters and those from higher income households. Conclusions: Although accurate weight perception may be important for motivating healthy behavioral changes, it may also lead to greater restriction of children's diets, which has been linked to long-term weight gain. Interventions to improve awareness of child overweight should be coupled with efforts that teach caregivers about healthy weight management strategies.

Links between the organization of the family home environment and child obesity: a systematic review

Due to increasingly high rates of child overweight and obesity, it is important to identify risk and protective factors that may inform more effective prevention and intervention. The degree of organization in the family home environment is a studied, but not well-specified, factor that may impact child weight. Prior research on household organization has examined an array of constructs, including family routines, limit setting, household chaos, crowding and the broad home environment. This study systematically reviews literature on organization within the family home environment and weight among children ages 2-12. Six hundred thirty-seven studies were reviewed by four coders for eligibility, and 32 studies were included in the final synthesis. Overall, 84% of studies provided evidence for relations between at least one indicator of organization within the family home environment and child weight. Studies provided compelling evidence across several constructs, suggesting that the relevance of household organization to child weight extends beyond a single indicator. Directions for future work include (i) examining the mediating role of health behaviours, (ii) examining the moderating role of socioeconomic factors, (iii) broadening this evidence base across cultures and nationalities and (iv) integrating constructs to develop a comprehensive model of organization within the home environment.

Childhood overweight, obesity and associated factors among primary school children in dire dawa, eastern Ethiopia; a cross-sectional study

Background

Obesity in children is increasing worldwide. Malnutrition has become a double burden challenge of public health concern in developing countries. Childhood obesity increases the risk of chronic disease in childhood as well as adulthood. However, information is very scarce about childhood obesity in developing countries specifically in Ethiopia. Therefore, we aimed to assess childhood overweight, obesity and associated factors among primary school children at Dire Dawa, Eastern Ethiopia.

Methods

A school based cross-sectional study was conducted in Dire Dawa from 1^st to 30^th March, 2016. Study participants were selected using multistage sampling method. Pre-tested self-administered questionnaire, face to face interview technique and anthropometric measurements were used to collect data by eight well trained data collectors. Data were coded, cleaned and entered into EpiData software version 3.5.1, and exported into SPSS (version 21.0) statistical software, for data analysis. Bivariate and multivariate logistic regression were carried out to identify associated factors with childhood overweight and obesity. Statistical significance was declared using Adjusted Odds Ratio (AOR) at 95% CI and p-value less than 0.05.

Results

The prevalence of overweight and obesity were 14.7% (95% CI: 11.7, 18.0) and 5.8% (95% CI: 3.6, 8.0), respectively. Children who were from private school (AOR = 3.4, 95% CI: 1.4, 8.5), from families belonged to high socioeconomic class (AOR = 16.9, 95% CI: 6.5, 23.9), preferred sweetened foods (AOR = 2.3, 95% CI: 1.1, 5.1), had not engaged in regular physical exercise (AOR = 3.8, 95% CI: 1.5, 9.8), had experienced sedentary life style like spent their free time watching TV (AOR = 3.6, 95% CI: 1.6, 7.9), play computer game (AOR = 4.6, 95% CI:1.4,15.4), and were not having close friends (AOR = 2.9, 95% CI: 1.4, 6.2) were significantly associated with overweight/obesity risk.

Conclusion

Overweight/obesity in children is on alarming stage in the study area. Therefore, more attention should be given to creating awareness about healthy diet and improving life style through school and public media in collaboration with concerned bodies.

Multipathway Integrated Adjustment Mechanism of Glycyrrhiza Triterpenes Curing Gastric Ulcer in Rats

Background:

Gastric ulcer is a common chronic disease in human digestive system, which is difficult to cure, easy to relapse, and endangers human health seriously. Compared with western medicine, traditional Chinese medicine has a unique advantage in improving the general situation, stablizing medical condition, and with little side effects. Glycyrrhiza known as “king of all the medicine”, has a range of pharmacological activities and is commonly used in a variety of proprietary Chinese medicines and formulations.

Objective:

On the basis of explicit antiulcer effect of Glycyrrhiza triterpenes, the molecular mechanisms of its therapeutic effect on acetic acid induced gastric ulcer in rats were explored.

Materials and Methods:

Acetic acid induced gastric ulcer model in rats was established to evaluate the curing effect of G. triterpenes and all of the rats were randomised into six groups: Control group, model group, omeprazole group (0.8 mg/mL), triterpenes high dose group (378.0 mg/mL), triterpenes middle dose group (126.0 mg/mL), and triterpenes low dose group (42.0 mg/mL). All rats in groups were orally administered the active group solution 1.5 mL once daily (model and control groups with saline) for 7 days. HPLC-TOF-MS analysis method was performed to obtain the plasma metabolites spectrums of control group, model group, triterpenes high, middle and low dose groups.

Results:

A total of 11 differential endogenous metabolites related to the therapeutic effect of G. triterpenes were identified, including tryptophan, phingosine-1-phosphate, pantothenic acid, and so on, among which tryptophan and phingosine-1-phosphate are related with the calcium signaling pathway and arachidonic acid (AA) metabolism. At the same time, in order to verify the above results, quantitative real time polymerase chain reaction were performed to evaluate the expression of H⁺-K⁺-ATPase alpha mRNA and phospholipase a 2 mRNA in relational signaling pathways. Combined with statistical analysis of plasma metabolic spectrum and gene expression in tissue, it is suggested that G. triterpenes has antiulcer effect on gastric ulcer in rats.

Conclusion:

G. triterpenes has a certain regulating effect on the metabolism of tryptophan, AA, sphingosine, and other endogenous metabolites, and we speculated that the antiulcer potential of G. triterpenes can be primarily attributed to its inhibiting gastric acid secretion, reducing the release of inflammatory mediators, and protecting gastric mucosa effects to prevent the further development of gastric ulcer.

SUMMARY

G. triterpenes can obviously relieve the symptoms of gastric ulcer, especially the low dose group.

G. triterpenes can effectively regulate the amount of small molecule metablism in gastric ulcer rats in vivo, including tryptophan, phingosine-1-phosphate, etc.

G. triterpenes resisting gastric ulcer is probably by regulating arachidonic acid metabolism, sphingosine metabolism, etc.

Down-regulation of H+-K+-ATPase alpha subunit mRNA and up-regulation of PLA₂ mRNA in gastric tissue of dose group validated the possible mechanisms of G. triterpenes for the treatment of gastric ulcer

Abbreviations used: HP: Helicobacter pylori, ECL: enterochromaffinlike, TCM: Traditional Chinese medicine; HPLC: High Performance Liquid Chromatography, HPLC/MS: High Performance Liquid chromatography Mass Spectrometry, HPLC-TOF-MS: High Performance Liquid Chromatography and Tof Mass Spectrometry, SD: Sprague Dawley, PCDL: Personal Compound Database and Library, MPP: Mass Profiler Professiona; PCA: principal component analysis, RT-PCR: real time polymerase chain reaction, PGE 2: Prostaglandin E2, COX1: cyclooxygenase 1 S1P: Sphingosine-1-phosphate, AA: Arachidonic acid, 5-HT: 5- hydroxytryptamine.

Effects of a Randomised Controlled School-Based Health Promotion Intervention on Obesity Related Behavioural Outcomes of Children with Migration Background

Children with migration background (MB) appear to be at higher risk of developing obesity, therefore, prevention is necessary to avoid possible health inequalities. This study investigated a 1-year intervention with focus on increasing physical activity (PA) and fruit and vegetable intake (FVI), decreasing screen media use (SMU) and soft drink consumption (SDC) in children with MB. 525 children (7.1 ± 0.7 years) with MB who participated in the cluster-randomised study were assessed at baseline and after 1 year. Daily SMU, PA behaviours, SDC and FVI were assessed using a parental questionnaire. After one year, significant effects were found in the intervention group for FVI (p ≤ 0.035). Partially strong tendencies but no significant differences were found for PA and SDC. Although the effects are small, the intervention seems to reach children with MB. An intervention lasting longer than one year might result in more changes.

Systematic review of the relationships between sleep duration and health indicators in school-aged children and youth

The objective of this systematic review was to examine the relationships between objectively and subjectively measured sleep duration and various health indicators in children and youth aged 5-17 years. Online databases were searched in January 2015 with no date or study design limits. Included studies were peer-reviewed and met the a priori-determined population (apparently healthy children and youth aged 5-17 years), intervention/exposure/comparator (various sleep durations), and outcome (adiposity, emotional regulation, cognition/academic achievement, quality of life/well-being, harms/injuries, and cardiometabolic biomarkers) criteria. Because of high levels of heterogeneity across studies, narrative syntheses were employed. A total of 141 articles (110 unique samples), including 592 215 unique participants from 40 different countries, met inclusion criteria. Overall, longer sleep duration was associated with lower adiposity indicators, better emotional regulation, better academic achievement, and better quality of life/well-being. The evidence was mixed and/or limited for the association between sleep duration and cognition, harms/injuries, and cardiometabolic biomarkers. The quality of evidence ranged from very low to high across study designs and health indicators. In conclusion, we confirmed previous investigations showing that shorter sleep duration is associated with adverse physical and mental health outcomes. However, the available evidence relies heavily on cross-sectional studies using self-reported sleep. To better inform contemporary sleep recommendations, there is a need for sleep restriction/extension interventions that examine the changes in different outcome measures against various amounts of objectively measured sleep to have a better sense of dose-response relationships.

Snacking Is Longitudinally Associated with Declines in Body Mass Index z Scores for Overweight Children, but Increases for Underweight Children

BACKGROUND

Few studies, to our knowledge, have examined the longitudinal association of snacking with child body mass index (BMI), especially in China, where the incidence of overweight and obesity has increased rapidly.

OBJECTIVES

Our objective was to examine the longitudinal association between snacking and BMI z score and to test whether this association differs by baseline weight status.

METHODS

Using data from the China Health and Nutrition Survey (2006, 2009, and 2011), we characterized snack intake for 9 provinces and 3 megacities. We used linear mixed-effects models to examine longitudinally the association between snacking (none, low, medium, and high tertiles according to energy) and BMI z score in children aged 2-13 y at baseline, controlling for sex, urbanicity, parental education, physical activity, and foods consumed at meals (n = 2277 observations). We tested whether this association differed by baseline underweight, normal weight, or overweight/obese.

RESULTS

Snacking is prevalent in Chinese children, with fruit being the most common snack. Snacking was not associated with meaningful BMI z score changes in normal-weight children. However, in children who were underweight at baseline, snacking in the top tertiles was associated with increases in BMI z scores from 2006 to 2011 (+1.2 and +1.1 BMI z score units for ages 2-6 and 7-13 y, respectively) (P < 0.05). In overweight/obese 2- to 6-y-old children at baseline, being in the lowest snacking tertile was associated with declines in BMI z score (-3.3), whereas in overweight 7- to 13-y-old children, being in the top tertile of snacking was associated with the greatest decline in BMI z score (-2.1) (P < 0.05). The direction and magnitude of associations did not vary regardless of adjustment for total energy intake.

CONCLUSIONS

Snacking in China, dominated by fruit consumption, is associated with decreased BMI in overweight/obese children and increased BMI in underweight children. More work will be needed to monitor this relation as Chinese diets continue to westernize.

Short Sleep Duration in the First Years of Life and Obesity/Overweight at Age 4 Years: A Birth Cohort Study

OBJECTIVE

To investigate whether short sleep duration from the first year of life influenced weight at an early age.

STUDY DESIGN

During 2004, children born in Pelotas, Brazil, were enrolled in a cohort study. Sleeping habits during the previous 2 weeks were assessed, and the children were weighed and measured at 1-, 2-, and 4-year follow-ups. Overweight and obesity at 4 years were defined according to World Health Organization z-scores for body mass index for age. Short sleep duration was defined as fewer than 10 hours of sleep per night at any follow-up.

RESULTS

Out of the 4263 live births, 4231 were recruited. The prevalence of short sleep duration at any follow-up from 1-4 years of age was 10.1%. At 4 years of age, 201 children were obese (5.3%), and 302 (8%) were overweight. Among short sleepers, the prevalence ratio for overweight/obesity after adjusting for maternal and children's characteristics was 1.32 (1.03; 1.70).

CONCLUSIONS

Children who slept for fewer than 10 hours per night at any follow-up from 1-4 years of age were more likely to be overweight or obese at 4 years of age, despite their sociodemographic and sleep characteristics.

Differences in Overweight and Obesity among Children from Migrant and Native Origin: The Role of Physical Activity, Dietary Intake, and Sleep Duration

A cross-sectional survey was performed to examine to what degree differences in overweight and obesity between native Dutch and migrant primary school children could be explained by differences in physical activity, dietary intake, and sleep duration among these children. Subjects (n=1943) were primary school children around the age of 8-9 years old and their primary caregivers: native Dutch children (n=1546), Turkish children (n=93), Moroccan children (n=66), other non-western children (n=105), and other western children (n=133). Multivariate regressions and logistic regressions were used to examine the relationship between migrant status, child's behavior, and BMI or prevalence of overweight, including obesity (logistic). Main explanatory variables were physical activity, dietary intake, and sleep duration. We controlled for age, sex, parental educational level, and parental BMI. Although sleep duration, dietary intake of fruit, and dietary intake of energy-dense snacks were associated with BMI, ethnic differences in sleep duration and dietary intake did not have a large impact on ethnic differences in overweight and obesity among children from migrant and native origin. It is suggested that future preventive strategies to reduce overweight and obesity, in general, consider the role of sleep duration. Also, cross-cultural variation in preparation of food among specific migrant groups, focusing on fat, sugar, and salt, deserves more attention. In order to examine which other variables may clarify ethnic differences in overweight and obesity, future research is needed.

Prevalence of overweight and underweight and its associated factors among male and female university students in Thailand

Lifestyle habits of Thai society lead young people to conditions of potential cardiovascular risk. The purpose of this study was to assess the prevalence of overweight/obese and underweight along with associated factors in a sample of Thai university students. Using a cross-sectional survey, we assessed anthropometric measurements and a self-administered questionnaire among university students selected by stratified random sampling. The sample included 860 undergraduate university students from Mae Fah Luang University in Thailand (27.3% males), with age ranging from 18 to 25 years (M=20.1, SD=1.3 years). Results indicated that the median BMI was 20.2, which was higher in men than in women. Overall, 21.5% were underweight (<18 BMI) and 20.8% were overweight (7.8% overweight [≥23 BMI] and 13% obese [≥25 BMI]). More men than women were overweight and obese, whereas more women than men were underweight. Multinomial logistic regression analyses revealed that among men, older age, trying to eat fibre, and trying to lose weight were associated with overweight or obesity and among women trying to lose weight, depression symptoms and normal sleep duration were associated with overweight or obesity. The risk of underweight was greater among men living off campus, having a high income background, and short sleep duration and among women with low physical activity and who were not trying to lose weight. Considering the large percentage of overweight and underweight found in this study and the associated possible negative health consequences, it is suggested to include information on the assessment of adequate weight in health promotion programmes.

A cultural understanding of Chinese immigrant mothers' feeding practices. A qualitative study

Differences in parental feeding practices revealed across and within different ethnic/cultural groups indicate that cultural examinations of feeding practices in understudied non-European-American populations require urgent attention. China ranks as the second largest source country for children in foreign-born U.S. households. Contrary to the stereotype of slender Asians, Chinese-American young children are at high risk for obesity but have not received sufficient attention from researchers and practitioners dealing with parental feeding practices and childhood obesity. The present study aimed to understand food-related parenting practices among Chinese immigrants in the U.S. using qualitative focus groups. Twenty-two mothers with preschool aged children participated in a discussion regarding parent-child food-related interactions and feeding practices. A thematic approach was adopted to analyze the focus group data following five stages of framework analysis. Thirteen key themes of feeding practices were identified, including 9 that are in existing feeding measures (pre-exiting practices) and 4 practices that have not been documented or emphasized in previous feeding measures (culturally-emphasized practices), including regulating healthy routines and food energy, spoon-feeding, using social comparison to pressure the child to eat, and making an effort to prepare/cook specific foods. Through the use of an emic approach and meaning-centered evidence, the complexities of parent-child interactions and unique nuances of parental feeding in this understudied population were revealed. Our findings can guide future development of culturally-appropriate measurement and inform intervention programs to promote the healthy development of Chinese-American children.

Overweight and obesity in Portuguese children: prevalence and correlates

There are widespread differences in overweight/obesity prevalence in children, and understanding the reasons for this is very important. The present study aims: (I) to conduct a meta-analysis on overweight/obesity prevalence in Portuguese children; (II) to identify differences in biological and behavioural characteristics between normal-weight and overweight/obese children; and (III) to investigate the importance of individual- and school-level correlates of variation in children's BMI using multilevel modelling. A search was done for all published papers including Portuguese children during the last decade; further, 686 Portuguese children (9-11 years old) were sampled and their BMI, family income, maturity offset, nutritional habits, physical activity, sedentariness, sleep time, and school environment information were collected. Results showed a stabilization of overweight/obesity during the last decade, 30.6% (95%CI: 0.287-0.34) for boys, 28.4% (95%CI: 0.23-0.35) for girls, and 30.3% (95%CI: 0.27-0.34) for boys and girls together. Differences between weight groups were only found in individual-level biological traits. The multilevel analysis did not identify significant contributions of school-level variables to children's BMI variation. In conclusion, no increase was found in the prevalence of overweight/obesity among Portuguese children since 2000. Normal-weight and overweight/obese children only differ in individual-level characteristics, and school context variables were not related to variation in BMI.

Recreational screen-time among Chinese adolescents: a cross-sectional study

Background

Rapid urbanization in China has led to a proliferation of electronic entertainment media among youth. Prolonged screen time (ST; includes watching television and playing on computers, video game consoles, or mobile phones) is linked to poor health profiles. The aim of this study was to report recreational ST behaviors and ST correlates among Chinese adolescents living in two regions with different degrees of urbanization.

Methods

A cross-sectional, school-based survey (n = 3461 adolescents; aged 12–14 years old) living in inner-city Shanghai and a peri-urban region of Hangzhou. Students completed a questionnaire including family characteristics, daily ST, and information on family environment related to screen use. Recreational ST was categorized into two groups according to recommendations by the American Academy of Pediatrics (< or ≥2 h/day). Parents reported their own ST and also reported educational attainment as a proxy for socioeconomic status.

Results

ST was higher among boys than girls and on weekends than weekdays. Peri-urban girls were more likely to exceed 2 h/day ST compared to inner-city girls on weekends. Having a father with no university degree, mother’s TV viewing ≥2 h/day, no ST rules at home, and eating meals in front of the TV were associated with higher ST on both weekdays and weekends, and regional differences were found for weekend ST.

Conclusions

TV viewing and playing on the computer were the most prevalent ST behaviors among Chinese adolescents. Mobile phone playing was less prevalent but persistent throughout the week. More population-level surveillance and research is needed to monitor the trends in ST behaviors and to better understand the characteristics of those who are at risk.

Prevalence of overweight/obesity and central obesity and its associated factors among a sample of university students in India

BACKGROUND

Obesity and the lifestyle characteristic of Indian society lead young people to conditions of potential cardiovascular risk. The purpose of this study was to assess the prevalence of overweight/obesity and central obesity and its associated factors in a sample of Indian university students.

METHODS

In a cross-sectional survey assessed anthropometric measurements and a self-administered questionnaire among a sample of randomly selected university students. The sample included 800 university students from non health (mainly sciences) courses Gitam University in India. The students were 541 (67.6%) males and 259 (32.4%) females in the age range of 17-20 years (M age 18.2 years, SD=1.0).

RESULTS

37.5% were overweight or obese, 26.8% overweight (≥23-27.4 BMI) and 10.7% obese (≥27.5 kg/m(2)), 11.7% underweight (<18.5 kg/m(2)) and 16.4% central obesity (WC ≥90 cm for men and ≥80 cm for women). In multivariate analysis among men lack of non-organised religious activity (odds ratio=OR 0.85, confidence interval=CI 0.77-0.95), lower dietary risk knowledge (OR=0.64, CI=0.41-0.99), tobacco use (OR=2.23, CI=1.14-4.38), and suffering from depression (OR=1.59, CI=1.00-2.47) were associated with overweight/obesity, and younger age (OR=0.32, CI=0.12-0.90), lives away from parents or guardians (OR=1.79, CI=1.04-3.07), healthy dietary practices (OR=1.95, CI=1.02-3.72) and 9 or more hours sleep duration (OR=0.28, CI=0.09-0.96) were associated with central obesity. In bivariate analysis among women, lack of social support, lower dietary risk knowledge, tobacco use, and 9 or more hours sleep duration were associated with overweight/obesity and lives away from parents or guardians and abstinence from alcohol associated with central obesity.

CONCLUSIONS

The study found a high prevalence of overweight/obesity and central obesity. Several gender specific health risk practices were identified including lack of dietary risk knowledge, shorter sleep duration, living away from parents or guardians, tobacco use and lack of social support and religiousness that can be utilised in health promotion programmes.