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D’Hooghe S, Inaç Y, De Clercq E, Deforche B, Dury S, Vandevijvere S, Van de Weghe N, Van Dyck D, De Ridder K. The CIVISANO protocol: a mixed-method study about the role of objective and perceived environmental factors on physical activity and eating behavior among socioeconomically disadvantaged adults. Arch Public Health 2022; 80:219. [PMID: 36199109 PMCID: PMC9533259 DOI: 10.1186/s13690-022-00956-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 08/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Overweight and obesity have a strong socioeconomic profile. Unhealthy behaviors like insufficient physical activity and an unbalanced diet, which are causal factors of overweight and obesity, tend to be more pronounced in socioeconomically disadvantaged groups in high income countries. The CIVISANO project aims to identify objective and perceived environmental factors among different socioeconomic population groups that impede or facilitate physical activity and healthy eating behavior in the local context of two peri-urban Flemish municipalities in Belgium. We also aim to identify and discuss possible local interventions and evaluate the participatory processes of the project. METHODS This study (2020-2023) will use community-based participatory tools, involving collaborative partnerships with civic and stakeholder members of the community and regular exchanges among all partners to bridge knowledge development and health promotion for socioeconomically disadvantaged citizens. Furthermore, a mixed-methods approach will be used. A population survey and geographic analysis will explore potential associations between the physical activity and eating behaviors of socioeconomically disadvantaged adults (25-65 years old) and both their perceived and objective physical, food and social environments. Profound perceptive context information will be gathered from socioeconomically disadvantaged adults by using participatory methods like photovoice, walk-along, individual map creation and group model building. An evaluation of the participatory process will be conducted simultaneously. DISCUSSION The CIVISANO project will identify factors in the local environment that might provoke inequities in adopting a healthy lifestyle. The combination of perceived and objective measures using validated strategies will provide a robust assessment of the municipality environment. Through this analysis, the project will investigate to what extent community engagement can be a useful strategy to reduce health inequities. The strong knowledge exchange and capacity-building in a local setting is expected to contribute to our understanding of how to maximize research impact in this field and generate evidence about potential linkages between a health enhancing lifestyle among socioeconomically disadvantaged groups and their physical, food and social environments.
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Affiliation(s)
- Suzannah D’Hooghe
- grid.508031.fSciensano, Department of Epidemiology and Public Health, Brussels, Belgium ,grid.5342.00000 0001 2069 7798Ghent University, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent, Belgium ,grid.8767.e0000 0001 2290 8069Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Brussels, Belgium
| | - Yasemin Inaç
- grid.508031.fSciensano, Department of Epidemiology and Public Health, Brussels, Belgium ,grid.8767.e0000 0001 2290 8069Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Brussels, Belgium ,grid.5342.00000 0001 2069 7798Ghent University, Faculty of Sciences, Department of Geography, Ghent, Belgium
| | - Eva De Clercq
- grid.508031.fSciensano, Department of Chemical and Physical Health Risks, Brussels, Belgium
| | - Benedicte Deforche
- grid.5342.00000 0001 2069 7798Ghent University, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent, Belgium ,grid.8767.e0000 0001 2290 8069Vrije Universiteit Brussel (VUB), Faculty of Physical Education and Physiotherapy, Department of Movement and Sport Sciences, Brussels, Belgium
| | - Sarah Dury
- grid.8767.e0000 0001 2290 8069Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Brussels, Belgium
| | - Stefanie Vandevijvere
- grid.508031.fSciensano, Department of Epidemiology and Public Health, Brussels, Belgium
| | - Nico Van de Weghe
- grid.5342.00000 0001 2069 7798Ghent University, Faculty of Sciences, Department of Geography, Ghent, Belgium
| | - Delfien Van Dyck
- grid.5342.00000 0001 2069 7798Ghent University, Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Brussels, Belgium
| | - Karin De Ridder
- grid.508031.fSciensano, Department of Epidemiology and Public Health, Brussels, Belgium
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Hidese S, Ota M, Matsuo J, Ishida I, Yokota Y, Hattori K, Yomogida Y, Kunugi H. Association of body mass index and its classifications with gray matter volume in individuals with a wide range of body mass index group: A whole-brain magnetic resonance imaging study. Front Hum Neurosci 2022; 16:926804. [PMID: 36158620 PMCID: PMC9493114 DOI: 10.3389/fnhum.2022.926804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 08/17/2022] [Indexed: 11/17/2022] Open
Abstract
Aim To examine the association of body mass index (BMI) [kg/m2] and its classifications (underweight [BMI < 18.5], normal [18.5 ≤ BMI < 25], overweight [25 ≤ BMI < 30], and obese [BMI ≥ 30]) with brain structure in individuals with a wide range of BMI group. Materials and methods The participants included 382 right-handed individuals (mean age: 46.9 ± 14.3 years, 142 men and 240 women). The intelligence quotient was assessed using the Japanese Adult Reading Test. Voxel-based morphometry (VBM) and diffusion tensor imaging (DTI) were performed to analyze the association of BMI and its classifications with gray and white matter structures, respectively. Results According to VBM, BMI was significantly and negatively correlated with the bilateral cerebellum exterior volumes. In group comparisons, the right cerebellum exterior volume was significantly lower in the overweight or obese group than in the underweight or normal group, while the bilateral cuneus and calcarine cortex, left cuneus, and left precuneus volume was significantly lower in the underweight group than in the non-underweight group. Sex-related stratification analyses for VBM revealed that BMI was significantly and negatively correlated with the bilateral cerebellum exterior volumes only in women. In group comparisons, the left cerebellum exterior volume was significantly lower in obese women than in non-obese women. The left thalamus proper and the right cerebellum exterior volumes were significantly lower in overweight or obese group than in underweight or normal group in men and women, respectively. The bilateral cuneus and calcarine cortex, left cuneus and carcarine cortex, and bilateral cuneus volume was significantly lower in underweight men than in non-underweight men. In contrast, there were no notable findings on DTI. Conclusion Our results suggest association of continuous BMI, being overweight or obese, and being underweight with decreased gray matter volume in individuals with a wide range of BMI group. Furthermore, sex-related differences are seen in the association of BMI and its classifications with regional gray matter volume reductions. Abnormally high or low BMIs may have a negative influence on regional gray matter volumes.
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Affiliation(s)
- Shinsuke Hidese
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Japan
- Department of Psychiatry, Teikyo University School of Medicine, Itabashi-ku, Japan
- *Correspondence: Shinsuke Hidese,
| | - Miho Ota
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Japan
- Department of Neuropsychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Junko Matsuo
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Japan
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Ikki Ishida
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Japan
- Department of Psychiatry, Teikyo University School of Medicine, Itabashi-ku, Japan
| | - Yuuki Yokota
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Japan
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Kotaro Hattori
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Japan
- Medical Genome Center, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Yukihito Yomogida
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Japan
- Araya Inc., Minato-ku, Japan
| | - Hiroshi Kunugi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Japan
- Department of Psychiatry, Teikyo University School of Medicine, Itabashi-ku, Japan
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Nutritional Strategies for Childhood Obesity Prevention. Life (Basel) 2021; 11:life11060532. [PMID: 34201017 PMCID: PMC8227398 DOI: 10.3390/life11060532] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/31/2021] [Accepted: 05/31/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Reducing the spread of obesity represents a challenge for clinicians in which obesity prevention plays a key role in achieving this purpose. The aim of this review is to analyze the nutritional interventions that can be implemented to prevent childhood obesity. METHODS Searching PubMed and Cochrane Library between 2019 and 2021. Further searching with no date range for articles selected for their specific relevance in the pediatric area or for their scientific relevance. A total of 871 articles were identified and 90 were included. RESULTS We organized the results of the selected articles into age groups, and according to the subjects targeted for interventions or to the site of interventions, reserving an in-depth analysis on specific nutritional aspects. Promotion of breastfeeding, reduction of protein content of formulated milks, and diet of the first 12-24 months, involving family and schools in interventions that promote physical activity and healthy diet, are promising strategies for reduction of the risk of obesity. To increase the efficacy of interventions, a multidimensional approach is crucial. CONCLUSIONS A multidimensional approach, which takes into consideration different areas of intervention, is pivotal for childhood obesity prevention. Integrated programs involving several components (nutrition and physical activity at first) at different levels (individual, family, school, and institutional) are crucial.
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Sowden S, Nezafat-Maldonado B, Wildman J, Cookson R, Thomson R, Lambert M, Beyer F, Bambra C. Interventions to reduce inequalities in avoidable hospital admissions: explanatory framework and systematic review protocol. BMJ Open 2020; 10:e035429. [PMID: 32709641 PMCID: PMC7380849 DOI: 10.1136/bmjopen-2019-035429] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Internationally there is pressure to contain costs due to rising numbers of hospital admissions. Alongside age, socioeconomic disadvantage is the strongest risk factor for avoidable hospital admission. This equity-focussed systematic review is required for policymakers to understand what has been shown to work to reduce inequalities in hospital admissions, what does not work and where the current gaps in the evidence-base are. METHODS AND ANALYSIS An initial framework shows how interventions are hypothesised to reduce socioeconomic inequalities in avoidable hospital admissions. Studies will be included if the intervention focusses exclusively on socioeconomically disadvantaged populations or if the study reports differential effects by socioeconomic status (education, income, occupation, social class, deprivation, poverty or an area-based proxy for deprivation derived from place of residence) with respect to hospital admission or readmission (overall or condition-specific for those classified as ambulatory care sensitive). Studies involving individuals of any age, undertaken in OECD (Organisation for Economic Co-operation and Development) countries, published from 2000 to 29th February 2020 in any language will be included. Electronic searches will include MEDLINE, Embase, CINAHL, Cochrane CENTRAL and the Web of Knowledge platform. Electronic searches will be supplemented with full citation searches of included studies, website searches and retrieval of relevant unpublished information. Study inclusion, data extraction and quality appraisal will be conducted by two reviewers. Narrative synthesis will be conducted and also meta-analysis where possible. The main analysis will examine the effectiveness of interventions at reducing socioeconomic inequalities in hospital admissions. Interventions will be characterised by their domain of action and approach to addressing inequalities. For included studies, contextual information on where, for whom and how these interventions are organised, implemented and delivered will be examined where possible. ETHICS AND DISSEMINATION Ethical approval was not required for this protocol. The research will be disseminated via peer-reviewed publication, conferences and an open-access policy-orientated paper. PROSPERO REGISTRATION NUMBER CRD42019153666.
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Affiliation(s)
- Sarah Sowden
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | - Josephine Wildman
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Richard Cookson
- Centre for Health Economics, University of York, York, North Yorkshire, UK
| | - Richard Thomson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Mark Lambert
- North East Centre, Public Health England, Newcastle upon Tyne, UK
| | - Fiona Beyer
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Clare Bambra
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Hu YL, Junge K, Nguyen A, Hiegel K, Somerville E, Keglovits M, Stark S. Evidence to Improve Physical Activity among Medically Underserved Older adults: A Scoping Review. THE GERONTOLOGIST 2020; 59:e279-e293. [PMID: 29668895 DOI: 10.1093/geront/gny030] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Participation in leisure physical activity (PA) and engagement in PA interventions among older adults is influenced by socioeconomic status (SES), race/ethnicity, and environment. However, studies of PA for medically underserved older adults have not yet been systematically evaluated. The objective of this study is to map the nature and extent of research conducted on PA participation, interventions, and components of effective leisure PA programs for medically underserved older adults. RESEARCH DESIGN AND METHODS The five-stage approach was used to conduct this scoping review. We searched PubMed, CINAHL, and Cochrane Library for peer-reviewed studies published between 2006 and 2016. Data extracted from selected studies included study population, study type, purpose of intent, evidence level, barriers to PA participation, and components of PA intervention. RESULTS Three hundred and ninety-two articles were identified, and 60 studies were included in the final data charting. Existing literature showed that most studies remained descriptive in nature, and few intervention studies have achieved a high level of evidence. Among 21 intervention studies, only 4 were explicitly conducted for older adults. Culturally adapted materials, race/ethnicity-specific barriers and facilitators, and form of intervention were important components for intervention programs. DISCUSSION AND IMPLICATIONS Findings indicate that more studies are needed to reduce health disparities related to PA participation for medically underserved older adults. Intervention components such as race/ethnicity-relevant barriers and facilitators and culturally sensitive materials are also needed for PA interventions targeting underserved older adults in order to provide evidence for best practices.
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Affiliation(s)
- Yi-Ling Hu
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
| | - Kristin Junge
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
| | - An Nguyen
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
| | - Kelsey Hiegel
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
| | - Emily Somerville
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
| | - Marian Keglovits
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
| | - Susan Stark
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
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Valerio G, Maffeis C, Saggese G, Ambruzzi MA, Balsamo A, Bellone S, Bergamini M, Bernasconi S, Bona G, Calcaterra V, Canali T, Caroli M, Chiarelli F, Corciulo N, Crinò A, Di Bonito P, Di Pietrantonio V, Di Pietro M, Di Sessa A, Diamanti A, Doria M, Fintini D, Franceschi R, Franzese A, Giussani M, Grugni G, Iafusco D, Iughetti L, Lamborghini A, Licenziati MR, Limauro R, Maltoni G, Manco M, Reggiani LM, Marcovecchio L, Marsciani A, del Giudice EM, Morandi A, Morino G, Moro B, Nobili V, Perrone L, Picca M, Pietrobelli A, Privitera F, Purromuto S, Ragusa L, Ricotti R, Santamaria F, Sartori C, Stilli S, Street ME, Tanas R, Trifiró G, Umano GR, Vania A, Verduci E, Zito E. Diagnosis, treatment and prevention of pediatric obesity: consensus position statement of the Italian Society for Pediatric Endocrinology and Diabetology and the Italian Society of Pediatrics. Ital J Pediatr 2018; 44:88. [PMID: 30064525 PMCID: PMC6069785 DOI: 10.1186/s13052-018-0525-6] [Citation(s) in RCA: 125] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 06/07/2018] [Indexed: 01/06/2023] Open
Abstract
The Italian Consensus Position Statement on Diagnosis, Treatment and Prevention of Obesity in Children and Adolescents integrates and updates the previous guidelines to deliver an evidence based approach to the disease. The following areas were reviewed: (1) obesity definition and causes of secondary obesity; (2) physical and psychosocial comorbidities; (3) treatment and care settings; (4) prevention.The main novelties deriving from the Italian experience lie in the definition, screening of the cardiometabolic and hepatic risk factors and the endorsement of a staged approach to treatment. The evidence based efficacy of behavioral intervention versus pharmacological or surgical treatments is reported. Lastly, the prevention by promoting healthful diet, physical activity, sleep pattern, and environment is strongly recommended since the intrauterine phase.
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Affiliation(s)
- Giuliana Valerio
- Department of Movement Sciences and Wellbeing, University of Naples Parthenope, via Medina 40, 80133 Naples, Italy
| | - Claudio Maffeis
- Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, Verona, Italy
| | - Giuseppe Saggese
- Department of Pediatrics, University Hospital of Pisa, Pisa, Italy
| | | | - Antonio Balsamo
- Department of Medical and Surgical Sciences, University Hospital S.Orsola-Malpighi, Bologna, Italy
| | - Simonetta Bellone
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | | | - Sergio Bernasconi
- Italian Society for Pediatric Endocrinology and Diabetology (SIEDP), Parma, Italy
| | - Gianni Bona
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Valeria Calcaterra
- Pediatrics Unit, University of Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Margherita Caroli
- Italian Society for Obesity (SIO), Francavilla Fontana (Brindisi), Italy
| | | | - Nicola Corciulo
- Pediatric Unit, Hospital of Gallipoli, Gallipoli (Lecce), Italy
| | - Antonino Crinò
- Autoimmune Endocrine Diseases Unit, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Procolo Di Bonito
- Department of Internal Medicine, “S. Maria delle Grazie”, Pozzuoli Hospital, Naples, Italy
| | | | - Mario Di Pietro
- Pediatric and Neonatal Unit, “G. Mazzini”Hospital, Teramo, Italy
| | - Anna Di Sessa
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Antonella Diamanti
- Artificial Nutrition Unit Bambino Gesù, Children’s Hospital, IRCCS, Rome, Italy
| | - Mattia Doria
- Italian Federation of Pediatricians (FIMP), Venice, Italy
| | - Danilo Fintini
- Endocrinology and Diabetology Unit Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | | | - Adriana Franzese
- Department of Translational Medical Science, Regional Center for Pediatric Diabetes, University Federico II of Naples, Naples, Italy
| | | | - Graziano Grugni
- Division of Auxology, Istituto Auxologico Italiano, IRCCS, Verbania, Italy
| | - Dario Iafusco
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Lorenzo Iughetti
- Pediatric Unit, University of Modena and Reggio Emilia, Modena, Italy
| | | | | | | | - Giulio Maltoni
- Department of Medical and Surgical Sciences, University Hospital S.Orsola-Malpighi, Bologna, Italy
| | - Melania Manco
- Research Area for Multifactorial Diseases, Children’s Hospital Bambino Gesù, Rome, Italy
| | | | | | | | - Emanuele Miraglia del Giudice
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Anita Morandi
- Pediatric Diabetes and Metabolic Disorders Unit, University Hospital of Verona, Verona, Italy
| | - Giuseppe Morino
- Nutrition Unit, Bambino Gesù Children’s Hospital IRCCS, Rome, Italy
| | | | - Valerio Nobili
- Department of Pediatrics and Infantile Neuropsychiatry, Sapienza University of Rome, Rome, Italy
- Hepatometabolic Unit, Bambino Gesù Children’s Hospital, IRCSS, Rome, Italy
| | - Laura Perrone
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | | | | | | | | | | | - Roberta Ricotti
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Francesca Santamaria
- Department of Translational Medical Science, Regional Center for Pediatric Diabetes, University Federico II of Naples, Naples, Italy
| | - Chiara Sartori
- Department of Obstetrics, Gynaecology and Paediatrics, Arcispedale S.Maria Nuova-IRCCS, Reggio Emilia, Italy
| | | | - Maria Elisabeth Street
- Department of Obstetrics, Gynaecology and Paediatrics, Arcispedale S.Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Rita Tanas
- Italian Society for Pediatric Endocrinology and Diabetology (SIEDP), Ferrara, Italy
| | | | - Giuseppina Rosaria Umano
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Andrea Vania
- Department of Pediatrics and Infantile Neuropsychiatry, Sapienza University of Rome, Rome, Italy
| | - Elvira Verduci
- Deparment of Pediatrics, San Paolo Hospital, University of Milan, Milan, Italy
| | - Eugenio Zito
- Department of Social Sciences, University of Naples Federico II, Naples, Italy
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Vinturache AE, Winn A, Tough SC. Recall of Prenatal Counselling Among Obese and Overweight Women from a Canadian Population: A Population Based Study. Matern Child Health J 2018; 21:2092-2101. [PMID: 28721648 DOI: 10.1007/s10995-017-2324-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Objective The objective of this study was to evaluate the recall of prenatal counselling received among overweight and obese women in primary care settings. Methods A sample of 1996 women with singleton, term deliveries and pre-pregnancy BMI >18.5 kg/m2 were identified from the All Our Babies pregnancy cohort. Information on socio-demographic characteristics and women's experiences with prenatal counselling on nutrition, vitamin and mineral supplements, exercise, weight gain, employment, alcohol and drug use, and smoking during pregnancy were collected through questionnaires administered at <25 weeks and 34-36 weeks gestation. Multivariable logistic regression analyses explored the associations between pre-pregnancy BMI and the domains of prenatal counselling, controlling for confounders. Results Women reported high levels of comfort asking questions and satisfaction with their health care provider. Women reported getting information about nutrition (69.3%), weight gain (67.8%), exercise (64.4%), vitamins and minerals supplementation (86.1%). Obese women (211, 10.6%) were more likely than normal weight women (1313, 65.8%) to be Caucasian (p = 0.004), less educated (p = 0.001), and to have been born or lived in Canada for at least 5 years (p = 0.01). There was no difference in the prenatal advice received on nutrition, weight gain and exercise in pregnancy between obese, overweight, and normal weight women. Conclusions for Practice Pre-pregnancy BMI did not appear to influence the recall of prenatal counselling women receive in community health care centers. Given the importance of nutrition and weight gain during pregnancy, and guidelines for weight gain based on pre-pregnancy BMI, there are missed opportunities in knowledge exchange between women and providers in the prenatal period.
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Affiliation(s)
- Angela E Vinturache
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada.
| | - Anika Winn
- Faculty of Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Suzanne C Tough
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada.,Department of Community of Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Crutze C, Pétré B, Dardenne N, Donneau AF, Streel S, Albert A, Scheen A, Husson E, Guillaume M. [Exploratory population study of overweight and obese subjects' perceptions: Searching for improved management practices]. Rev Epidemiol Sante Publique 2017; 65:209-219. [PMID: 28330702 DOI: 10.1016/j.respe.2017.01.117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 12/22/2016] [Accepted: 01/10/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Overweight and obesity are major public health problems of growing concern. Few studies have investigated the representations and perceptions of subjects with overweight and obesity, especially in the general population, as compared to people in a medical weight loss process. The objective of this study was to fill this gap by enabling participants to express their feelings and experience about their overweight, and to assess the extent of the body mass index (BMI) as a determinant of these perceptions. METHODS A total of 4155 persons participated in an exploratory study conducted in Wallonia (Belgium). Data were collected by means of a web-based questionnaire. This study investigated the following parameters: sociodemographic and anthropometric factors, perceived health, quality of life, diet perception, enrolment in a weight loss process and weight loss target. The influence of BMI was considered, on one hand, looking at how the above variables evolve according to BMI category, secondly, as a mediation factor in the relationship between socioeconomic level and these same variables. RESULTS A large majority (87.5%) of subjects were overweight (32.2%) or obese (obese class I 29.9%, class II 14.8%, class III 10.6%). Perceived health was found to deteriorate with the BMI (P<0.0001); obese class III had a 5.9-fold risk to present bad perceived health compared to subjects with normal weight. The physical and psychological quality of life reported by the subjects decreased significantly with the BMI (P<0.0001) particularly for the physical quality of life. The percentage of poor diet perception (frustration, weight gain, aggressiveness, inefficacy and impossibility) as well as the weight loss targeted by the subjects increased with the BMI. Between overweight subjects and obese class III subjects, weight loss target increased from 13% to 34% of the initial weight. The majority of subjects judged that diet represents "aggressiveness", "weight gain" and "impossibility". A partial mediation role of BMI was identified in the relationship between social status and the variables of interest. CONCLUSIONS This study focused on a sample of people from the general population. It confirmed previous results of others studies. All results gave a feeling of resignation and powerlessness which can seize obese individuals (especially when BMI increases). As a consequence, there is a need for more adapted weight management to achieve a genuine therapeutic alliance.
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Affiliation(s)
- C Crutze
- Département des sciences de la santé publique, université de Liège, 13, avenue Hippocrate, bâtiment 23, 4000 Liège, Belgique.
| | - B Pétré
- Département des sciences de la santé publique, université de Liège, 13, avenue Hippocrate, bâtiment 23, 4000 Liège, Belgique.
| | - N Dardenne
- Département des sciences de la santé publique, université de Liège, 13, avenue Hippocrate, bâtiment 23, 4000 Liège, Belgique
| | - A-F Donneau
- Département des sciences de la santé publique, université de Liège, 13, avenue Hippocrate, bâtiment 23, 4000 Liège, Belgique
| | - S Streel
- Département des sciences de la santé publique, université de Liège, 13, avenue Hippocrate, bâtiment 23, 4000 Liège, Belgique
| | - A Albert
- Département des sciences de la santé publique, université de Liège, 13, avenue Hippocrate, bâtiment 23, 4000 Liège, Belgique
| | - A Scheen
- Centre hospitalier universitaire de Liège, Liège, Belgique
| | - E Husson
- Département des sciences de la santé publique, université de Liège, 13, avenue Hippocrate, bâtiment 23, 4000 Liège, Belgique
| | - M Guillaume
- Département des sciences de la santé publique, université de Liège, 13, avenue Hippocrate, bâtiment 23, 4000 Liège, Belgique
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Frankish CJ, Kwan B, Gray DE, Simpson A, Jetha N. Status report -- Identifying equity-focussed interventions to promote healthy weights. Health Promot Chronic Dis Prev Can 2017; 37:94-101. [PMID: 28273037 PMCID: PMC5602164 DOI: 10.24095/hpcdp.37.3.05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION We developed screening criteria to identify population health interventions with an equity focus for inclusion on the Public Health Agency of Canada's Canadian Best Practices Portal. We applied them to the area of "healthy weights," specifically, obesity prevention. METHODS We conducted a review of the literature and obtained input from expert external reviewers on changes to midstream environments. Interventions had to identify outcomes for groups with an underlying social disadvantage. We included papers with a focus on equity and vulnerable populations, intervention and/or evaluation studies, social determinants of health and healthy weights or obesity prevention. We then appraised the shortlisted studies for quality of evidence to determine eligibility for inclusion as promising practices on the Canadian Best Practices Portal. RESULTS Few of the references reviewed passed the equity screening criteria (26 out of 2823 published papers reviewed, or 0.9%). Six (of the 26) interventions qualified as promising practices. CONCLUSION The ability of the equity screening criteria to distinguish midstream-level interventions for obesity prevention suggests that the criteria have potential to be applied to other public health topics. What is most important about our work is that the Portal, which is no longer being updated but is still accessible, was broadened to include interventions with a focus on equity.
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Affiliation(s)
- C James Frankish
- Centre for Health Promotion Research, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Providence Health Care, Vancouver, British Columbia, Canada
| | - Brenda Kwan
- Centre for Health Promotion Research, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Diane E Gray
- Centre for Health Promotion Research, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrea Simpson
- Public Health Agency of Canada, Halifax, Nova Scotia, Canada
| | - Nina Jetha
- Public Health Agency of Canada, Ottawa, Ontario, Canada
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Mantziki K, Renders CM, Vassilopoulos A, Radulian G, Borys JM, du Plessis H, Gregório MJ, Graça P, de Henauw S, Handjiev S, Visscher TLS, Seidell JC. Inequalities in energy-balance related behaviours and family environmental determinants in European children: changes and sustainability within the EPHE evaluation study. Int J Equity Health 2016; 15:160. [PMID: 27680964 PMCID: PMC5041563 DOI: 10.1186/s12939-016-0438-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 09/07/2016] [Indexed: 11/17/2022] Open
Abstract
Background Increasing social inequalities in health across Europe are widening the gap between low and high socio-economic groups, notably in the prevalence of obesity. Public health interventions may result in differential effects across population groups. Therefore, the EPHE (EPODE for the Promotion of Health Equity) project analysed the added value of community-based programmes, based on the EPODE (Ensemble Prévenons l’Obésité Des Enfants-Together Let’s Prevent Obesity) model, to reduce socio-economic inequalities in energy balance-related behaviours of children and their family-environmental related determinants in seven European communities. This study presents the changes between baseline and follow-up after the one-year interventions and their sustainability one year after. Methods This is a prospective study with a one school-year intervention, followed by one year of follow-up. In all, 1266 children (age 6-8 years) and their families from different socio-economic backgrounds were recruited at baseline. For 1062 children, information was available after one year (T1) and for 921 children after two years (T2). A self-reported questionnaire was completed by the parents to examine the children’s energy balance-related behaviours and family- environmental determinants. Socio-economic status was defined by the educational level of the mother. The Wilcoxon signed-rank test for paired data was used to test the differences between baseline and intermediate, and between intermediate and final, measurements for each of the socio-economic status groups. Results Post-intervention effects in energy-balance related behaviours showed the following improvements among the low socio-economic status groups: increased fruit consumption (Netherlands), decreased fruit juices amount consumed (Romania) and decreased TV time on weekdays (Belgium). Whereas in only the latter case the behavioural change was accompanied with an improvement in a family-environmental determinant (monitoring the time the child watches TV), other improvements in parental rules and practices related to soft drinks/fruit juices and TV exposure were observed. A few of those effects were sustainable, notably in the case of Belgium. Conclusions Inequalities in obesity-related behaviours could be potentially reduced when implementing community-based interventions, tailored to inequality gaps and using the EPODE methodology. Within-group changes varied widely, whereas monitoring of interventions and process evaluation are crucial to understand the observed results. Electronic supplementary material The online version of this article (doi:10.1186/s12939-016-0438-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Krystallia Mantziki
- Department of Health Sciences, VU University Amsterdam, De Boelelaan 1085, 1081HV, Amsterdam, The Netherlands.
| | - Carry M Renders
- Department of Health Sciences, VU University Amsterdam, De Boelelaan 1085, 1081HV, 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 L S Visscher
- Department of Health Sciences, VU University Amsterdam, De Boelelaan 1085, 1081HV, Amsterdam, The Netherlands.,Research Centre for the Prevention of Overweight, Windesheim University of Applied Sciences Zwolle, Zwolle, The Netherlands.,Research Centre for the Prevention of Overweight, VU University, Zwolle, The Netherlands
| | - Jacob C Seidell
- Department of Health Sciences, VU University Amsterdam, De Boelelaan 1085, 1081HV, Amsterdam, The Netherlands
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11
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Thomson K, Bambra C, McNamara C, Huijts T, Todd A. The effects of public health policies on population health and health inequalities in European welfare states: protocol for an umbrella review. Syst Rev 2016; 5:57. [PMID: 27059307 PMCID: PMC4826536 DOI: 10.1186/s13643-016-0235-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 04/04/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The welfare state is potentially an important macro-level determinant of health that also moderates the extent, and impact, of socio-economic inequalities in exposure to the social determinants of health. The welfare state has three main policy domains: health care, social policy (e.g. social transfers and education) and public health policy. This is the protocol for an umbrella review to examine the latter; its aim is to assess how European welfare states influence the social determinants of health inequalities institutionally through public health policies. METHODS/DESIGN A systematic review methodology will be used to identify systematic reviews from high-income countries (including additional EU-28 members) that describe the health and health equity effects of upstream public health interventions. Interventions will focus on primary and secondary prevention policies including fiscal measures, regulation, education, preventative treatment and screening across ten public health domains (tobacco; alcohol; food and nutrition; reproductive health services; the control of infectious diseases; screening; mental health; road traffic injuries; air, land and water pollution; and workplace regulations). Twenty databases will be searched using a pre-determined search strategy to evaluate population-level public health interventions. DISCUSSION Understanding the impact of specific public health policy interventions will help to establish causality in terms of the effects of welfare states on population health and health inequalities. The review will document contextual information on how population-level public health interventions are organised, implemented and delivered. This information can be used to identify effective interventions that could be implemented to reduce health inequalities between and within European countries. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016025283.
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Affiliation(s)
- Katie Thomson
- Centre for Health and Inequalities Research, Department of Geography, Durham University, Lower Mountjoy, South Road, Durham, DH1 3LE, UK.
| | - Clare Bambra
- Centre for Health and Inequalities Research, Department of Geography, Durham University, Lower Mountjoy, South Road, Durham, DH1 3LE, UK
| | - Courtney McNamara
- Department of Sociology and Political Science, Norwegian University of Science and Technology, Dragvoll, Building 9, Level 5, 7491, Trondheim, Norway
| | - Tim Huijts
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Yvonne Carter Building, 58 Turner Street, Whitechapel, London, E1 2AB, UK
| | - Adam Todd
- Centre for Health and Inequalities Research, Department of Geography, Durham University, Lower Mountjoy, South Road, Durham, DH1 3LE, UK.,Division of Pharmacy, School of Medicine, Pharmacy and Health, Durham University, Stockton-on-Tees, TS17 6BH, UK
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12
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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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13
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Moore TG, McDonald M, Carlon L, O'Rourke K. Early childhood development and the social determinants of health inequities. Health Promot Int 2015; 30 Suppl 2:ii102-15. [DOI: 10.1093/heapro/dav031] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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14
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Bambra CL, Hillier FC, Cairns JM, Kasim A, Moore HJ, Summerbell CD. How effective are interventions at reducing socioeconomic inequalities in obesity among children and adults? Two systematic reviews. PUBLIC HEALTH RESEARCH 2015. [DOI: 10.3310/phr03010] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BackgroundTackling obesity is one of the major contemporary public health policy challenges and is vital in terms of addressing health inequalities.ObjectivesTo systematically review the effectiveness of interventions (individual, community and societal) in reducing socioeconomic inequalities in obesity among (1) children aged 0–18 years (including prenatal) and (2) adults aged ≥18 years, in any setting, in any country, and (3) to establish how such interventions are organised, implemented and delivered.Data sourcesNine electronic databases including MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO and NHS Economic Evaluation Database were searched from database start date to 10 October 2011 (child review) and to 11 October 2012 (adult review). We did not exclude papers on the basis of language, country or publication date. We supplemented these searches with website and grey literature searches.Review methodsPreferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Experimental studies and observational studies with a duration of at least 12 weeks were included. The reviews considered strategies that might reduce existing inequalities in the prevalence of obesity [i.e. effective targeted interventions or universal interventions that work more effectively in low socioeconomic status (SES) groups] as well as those interventions that might prevent the development of inequalities in obesity (i.e. universal interventions that work equally along the SES gradient). Interventions that involved drugs or surgery and laboratory-based studies were excluded from the reviews. The initial screening of titles and abstracts was conducted by one reviewer with a random 10% of the sample checked by a second reviewer. Data extraction was conducted by one reviewer and independently checked by a second reviewer. The methodological quality of the included studies was appraised independently by two reviewers. Meta-analysis and narrative synthesis were conducted focusing on the ‘best-available’ evidence for each intervention type (defined in terms of study design and quality).ResultsOf 56,967 papers of inequalities in obesity in children, 76 studies (85 papers) were included, and of 70,730 papers of inequalities in obesity in adults, 103 studies (103 papers) were included. These studies suggested that interventions that aim to prevent, reduce or manage obesity do not increase inequalities. For children, there was most evidence of effectiveness for targeted school-delivered, environmental and empowerment interventions. For adults, there was most evidence of effectiveness for primary care-delivered tailored weight loss and community-based weight loss interventions, at least in the short term among low-income women. There were few studies of appropriate design that could be included on societal-level interventions, a clear limitation of the evidence base found.LimitationsThe reviews located few evaluations of societal-level interventions and this was probably because they included only experimental study designs. The quality assessment tool, although described as a tool for public health interventions, seemed to favour those that followed a more clinical model. The implementation tool was practical but enabled only a brief summary of implementation factors to be made. Most of the studies synthesised in the reviews were from outside the UK and related to women.ConclusionsThe reviews have found some evidence of interventions with the potential to reduce SES inequalities in obesity and that obesity management interventions do not increase health inequalities. More experimental studies of the effectiveness and cost-effectiveness of interventions (particularly at the societal level) to reduce inequalities in obesity, particularly among adolescents and adult men in the UK, are needed.Study registrationThe studies are registered as PROSPERO CRD42011001740 and CRD42013003612.FundingThe National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- Clare L Bambra
- Department of Geography, Durham University, Durham, UK
- Wolfson Research Institute for Health and Wellbeing, Durham University Queen’s Campus, Stockton-on-Tees, UK
| | - Frances C Hillier
- School of Medicine, Pharmacy and Health, Wolfson Research Institute for Health and Wellbeing, Durham University Queen’s Campus, Stockton-on-Tees, UK
| | - Joanne-Marie Cairns
- Department of Geography, Durham University, Durham, UK
- Wolfson Research Institute for Health and Wellbeing, Durham University Queen’s Campus, Stockton-on-Tees, UK
| | - Adetayo Kasim
- Wolfson Research Institute for Health and Wellbeing, Durham University Queen’s Campus, Stockton-on-Tees, UK
| | - Helen J Moore
- School of Medicine, Pharmacy and Health, Wolfson Research Institute for Health and Wellbeing, Durham University Queen’s Campus, Stockton-on-Tees, UK
| | - Carolyn D Summerbell
- School of Medicine, Pharmacy and Health, Wolfson Research Institute for Health and Wellbeing, Durham University Queen’s Campus, Stockton-on-Tees, UK
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15
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Brownie S, Hills AP, Rossiter R. Public health service options for affordable and accessible noncommunicable disease and related chronic disease prevention and management. J Multidiscip Healthc 2014; 7:543-9. [PMID: 25473294 PMCID: PMC4247142 DOI: 10.2147/jmdh.s72636] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Globally, nations are confronted with the challenge of providing affordable health services to populations with increasing levels of noncommunicable and chronic disease. Paradoxically, many nations can both celebrate increases in life expectancy and bemoan parallel increases in chronic disease prevalence. Simply put, despite living longer, not all of that time is spent in good health. Combined with factors such as rising levels of obesity and related noncommunicable disease, the demand for health services is requiring nations to consider new models of affordable health care. Given the level of disease burden, all staff, not just doctors, need to be part of the solution and encouraged to innovate and deliver better and more affordable health care, particularly preventative primary health care services. This paper draws attention to a range of exemplars to encourage and stimulate readers to think beyond traditional models of primary health service delivery. Examples include nurse-led, allied health-led, and student-led clinics; student-assisted services; and community empowerment models. These are reported for the interest of policy makers and health service managers involved in preventative and primary health service redesign initiatives.
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Affiliation(s)
- Sharon Brownie
- Workforce and Health Services, Griffith Health, Griffith University, Gold Coast, QLD, Australia
- Oxford PRAXIS Forum, Green Templeton College, Oxford University, Oxford, United Kingdom
| | - Andrew P Hills
- Allied Health Research, Mater Research Institute – The University of Queensland and Mater Mothers’ Hospital, South Brisbane, QLD, Australia
- Griffith Health Institute, Griffith Health, Griffith University, Gold Coast, QLD, Australia
| | - Rachel Rossiter
- MMHN and Nurse Practitioner Programs, School of Nursing and Midwifery, University of Newcastle, Callaghan, NSW, Australia
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Cairns JM, Bambra C, Hillier-Brown FC, Moore HJ, Summerbell CD. Weighing up the evidence: a systematic review of the effectiveness of workplace interventions to tackle socio-economic inequalities in obesity. J Public Health (Oxf) 2014; 37:659-70. [PMID: 25316262 DOI: 10.1093/pubmed/fdu077] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Addressing socio-economic inequalities in obesity is a public health priority and the workplace is seen as a potential health promotion site. However, there is a lack of evidence on what works. This article systematically reviews studies of the effects of workplace interventions on socio-economic inequalities in obesity. METHODS Following PRISMA guidelines, we searched for published or unpublished experimental and observational evaluation studies. Nine electronic databases were searched as well as websites and bibliographies. Included studies were data extracted, quality assessed and narratively synthesized. RESULTS Eighteen studies were included of which 14 examined behavioural interventions and 4 mixed or environmental ones. While most studies (n = 12) found no effects on inequalities in obesity--and a minority found increases (n = 3), there was also some evidence of potentially effective workplace interventions (n = 3) especially in terms of physical activity interventions targeted at lower occupational groups. CONCLUSION There is experimental evidence that workplace delivered physical activity interventions have the potential to reduce inequalities in obesity by targeting lower occupational groups. However, overall, the evidence base is small, largely from the USA, and of a low quality. More high-quality, experimental study designs are required.
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Affiliation(s)
- Joanne-Marie Cairns
- Department of Geography, Durham University Durham, Durham DH1 3LE, UK Wolfson Research Institute for Health and Wellbeing, Durham University Queen's Campus, Stockton-on-Tees TS17 6BH, UK
| | - Clare Bambra
- Department of Geography, Durham University Durham, Durham DH1 3LE, UK Wolfson Research Institute for Health and Wellbeing, Durham University Queen's Campus, Stockton-on-Tees TS17 6BH, UK
| | - Frances C Hillier-Brown
- School of Medicine, Pharmacy and Health, Wolfson Research Institute for Health and Wellbeing, Durham University Queen's Campus, Stockton-on-Tees TS17 6BH, UK
| | - Helen J Moore
- School of Medicine, Pharmacy and Health, Wolfson Research Institute for Health and Wellbeing, Durham University Queen's Campus, Stockton-on-Tees TS17 6BH, UK
| | - Carolyn D Summerbell
- School of Medicine, Pharmacy and Health, Wolfson Research Institute for Health and Wellbeing, Durham University Queen's Campus, Stockton-on-Tees TS17 6BH, UK
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Beauchamp A, Backholer K, Magliano D, Peeters A. The effect of obesity prevention interventions according to socioeconomic position: a systematic review. Obes Rev 2014; 15:541-54. [PMID: 24629126 DOI: 10.1111/obr.12161] [Citation(s) in RCA: 144] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 01/01/2014] [Accepted: 01/02/2014] [Indexed: 01/19/2023]
Abstract
Obesity prevention is a major public health priority. It is important that all groups benefit from measures to prevent obesity, but we know little about the differential effectiveness of such interventions within particular population subgroups. This review aimed to identify interventions for obesity prevention that evaluated a change in adiposity according to socioeconomic position (SEP) and to determine the effectiveness of these interventions across different socioeconomic groups. A systematic search of published and grey literature was conducted. Studies that described an obesity prevention intervention and reported anthropometric outcomes according to a measure of SEP were included. Evidence was synthesized using narrative analysis. A total of 14 studies were analysed, representing a range of study designs and settings. All studies were from developed countries, with eight conducted among children. Three studies were shown to have no effect on anthropometric outcomes and were not further analysed. Interventions shown to be ineffective in lower SEP participants were primarily based on information provision directed at individual behaviour change. Studies that were shown to be effective in lower SEP participants primarily included community-based strategies or policies aimed at structural changes to the environment. Interventions targeting individual-level behaviour change may be less successful in lower SEP populations. It is essential that our efforts to prevent obesity do not leave behind the most disadvantaged members of society.
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Affiliation(s)
- A Beauchamp
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Population Health Strategic Research Centre, Deakin University, Melbourne, Victoria, Australia
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Hillier-Brown FC, Bambra CL, Cairns JM, Kasim A, Moore HJ, Summerbell CD. A systematic review of the effectiveness of individual, community and societal-level interventions at reducing socio-economic inequalities in obesity among adults. Int J Obes (Lond) 2014; 38:1483-90. [PMID: 24813369 PMCID: PMC4262962 DOI: 10.1038/ijo.2014.75] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 03/13/2014] [Accepted: 03/22/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND Socioeconomic inequalities in obesity are well established in high-income countries. There is a lack of evidence of the types of intervention that are effective in reducing these inequalities among adults. OBJECTIVES To systematically review studies of the effectiveness of individual, community and societal interventions in reducing socio-economic inequalities in obesity among adults. METHODS Nine electronic databases were searched from start date to October 2012 along with website and grey literature searches. The review examined the best available international evidence (both experimental and observational) of interventions at an individual, community and societal level that might reduce inequalities in obesity among adults (aged 18 years or over) in any setting and country. Studies were included if they reported a body fatness-related outcome and if they included a measure of socio-economic status. Data extraction and quality appraisal were conducted using established mechanisms and narrative synthesis was conducted. RESULTS The 'best available' international evidence was provided by 20 studies. At the individual level, there was evidence of the effectiveness of primary care delivered tailored weight loss programmes among deprived groups. Community based behavioural weight loss interventions and community diet clubs (including workplace ones) also had some evidence of effectiveness-at least in the short term. Societal level evaluations were few, low quality and inconclusive. Further, there was little evidence of long term effectiveness, and few studies of men or outside the USA. However, there was no evidence to suggest that interventions increase inequalities. CONCLUSIONS The best available international evidence suggests that some individual and community-based interventions may be effective in reducing socio-economic inequalities in obesity among adults in the short term. Further research is required particularly of more complex, multi-faceted and societal-level interventions.
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Affiliation(s)
- F C Hillier-Brown
- 1] Department of Geography, Wolfson Research Institute, Durham University Queen's Campus, Stockton-on-Tees, UK [2] School of Medicine, Pharmacy and Health, Wolfson Research Institute, Durham University Queen's Campus, Stockton-on-Tees, UK [3] Wolfson Research Institute for Health and Wellbeing, Durham University Queen's Campus, Stockton-on-Tees, UK
| | - C L Bambra
- 1] Department of Geography, Wolfson Research Institute, Durham University Queen's Campus, Stockton-on-Tees, UK [2] Wolfson Research Institute for Health and Wellbeing, Durham University Queen's Campus, Stockton-on-Tees, UK
| | - J-M Cairns
- 1] Department of Geography, Wolfson Research Institute, Durham University Queen's Campus, Stockton-on-Tees, UK [2] Wolfson Research Institute for Health and Wellbeing, Durham University Queen's Campus, Stockton-on-Tees, UK
| | - A Kasim
- Wolfson Research Institute for Health and Wellbeing, Durham University Queen's Campus, Stockton-on-Tees, UK
| | - H J Moore
- 1] School of Medicine, Pharmacy and Health, Wolfson Research Institute, Durham University Queen's Campus, Stockton-on-Tees, UK [2] Wolfson Research Institute for Health and Wellbeing, Durham University Queen's Campus, Stockton-on-Tees, UK
| | - C D Summerbell
- 1] School of Medicine, Pharmacy and Health, Wolfson Research Institute, Durham University Queen's Campus, Stockton-on-Tees, UK [2] Wolfson Research Institute for Health and Wellbeing, Durham University Queen's Campus, Stockton-on-Tees, UK
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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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O'Neil CE, Nicklas TA, Liu Y, Berenson GS. Candy consumption in childhood is not predictive of weight, adiposity measures or cardiovascular risk factors in young adults: the Bogalusa Heart Study. J Hum Nutr Diet 2014; 28 Suppl 2:59-69. [PMID: 24382141 DOI: 10.1111/jhn.12200] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND There are limited data available on the longitudinal relationship between candy consumption by children on weight and other cardiovascular risk factors (CVRF) in young adults. The present study investigated whether candy consumption in children was predictive of weight and CVRF in young adults. METHODS A longitudinal sample of children 10 years (n = 355; 61% females; 71% European-Americans, 29% African-Americans) who participated in cross-sectional surveys from 1973 to 1984 (baseline) and in one of two surveys (follow-ups) as young adults [19-38 years; mean (SD) = 23.6 (2.6) years] in Bogalusa, LA, were studied. Dietary data were collected using 24-h dietary recalls at baseline and at one follow-up survey; a food frequency questionnaire was used in the other follow-up survey. Candy consumers were those consuming any amount of candy. Candy consumption was calculated (g day(-1) ) from baseline 24-h dietary recalls, and was used as a covariate in the adjusted linear mixed models. Dependent variables included body mass index (BMI) and CVRF measured in young adults. RESULTS At baseline, 92% of children reported consuming candy [46 (45) g day(-1)]; the percentage decreased to 67% [20 (30) g day(-1)] at follow-up. No longitudinal relationship was shown between baseline candy consumption and BMI or CVRF in young adults, suggesting that candy consumption was not predictive of health risks later in life. CONCLUSIONS The consumption of nutrient rich foods consistent with dietary recommendations is important, although modest amounts of candy can be added to the diet without potential adverse long-term consequences to weight or CVRF. Additional studies are needed to confirm these results.
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Affiliation(s)
- C E O'Neil
- Louisiana State University Agricultural Center, Baton Rouge, LA, USA
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Crawford G, Leavy J, Portsmouth L, Jancey J, Leaversuch F, Nimmo L, Reid-Dornbusch L, Hills E. Development of a Systematic Review of Public Health Interventions to Prevent Children Drowning. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/ojpm.2014.43014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Dunham-Snary KJ, Ballinger SW. Mitochondrial genetics and obesity: evolutionary adaptation and contemporary disease susceptibility. Free Radic Biol Med 2013; 65:1229-1237. [PMID: 24075923 PMCID: PMC3859699 DOI: 10.1016/j.freeradbiomed.2013.09.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 09/12/2013] [Accepted: 09/13/2013] [Indexed: 12/22/2022]
Abstract
Obesity is a leading risk factor for a variety of metabolic diseases including cardiovascular disease, diabetes, and cancer. Although in its simplest terms, obesity may be thought of as a consequence of excessive caloric intake and sedentary lifestyle, it is also evident that individual propensity for weight gain can vary. The etiology of individual susceptibility to obesity seems to be complex-involving a combination of environmental-genetic interactions. Herein, we suggest that the mitochondrion plays a major role in influencing individual susceptibility to this disease via mitochondrial-nuclear interaction processes and that environmentally influenced selection events for mitochondrial function that conveyed increased reproductive and survival success during the global establishment of human populations during prehistoric times can influence individual susceptibility to weight gain and obesity.
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Affiliation(s)
- Kimberly J Dunham-Snary
- Division of Molecular and Cellular Pathology, Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Scott W Ballinger
- Division of Molecular and Cellular Pathology, Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
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