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Yu B, Kelly S. Untangling the relationship between BMI and academic achievement in the elementary years. Br J Nutr 2024; 131:351-358. [PMID: 37559412 DOI: 10.1017/s0007114523001757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
Although the negative relationship between BMI and academic achievement (AA) is well documented, no prior studies have investigated the potential bi-directional relationship between BMI and AA in childhood. We investigated the longitudinal relationships between child BMI and AA across different school subjects (reading, math and science) and sexes. To do so, we employed the Early Childhood Longitudinal Study kindergarten cohort (2011), which is a nationally representative sample of American children who entered kindergarten in 2010-2011. We utilised the kindergarten-fifth grade longitudinal sample (n 17 480) and applied cross-lagged panel models with fixed effects to address unobserved heterogeneity. Our results showed significant but small reciprocal relationships between BMI and math/science achievement for girls (n 8540) (year-to-year effect sizes ranged from -0·01 to -0·04), but not for reading. In contrast, we did not find any evidence of reciprocal relationships between BMI and AA for boys (n 8940). Our results reveal that early weight status and academic performance may be jointly responsible for a vicious cycle of poor AA and unhealthy weight. Breaking the cycle from AA may complement existing obesity prevention strategies, particularly for girls in the science, technology, engineering and mathematics field.
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Affiliation(s)
- Baeksan Yu
- Gwangju National University of Education, Department of Education, Gwangju, South Korea
| | - Sean Kelly
- Department of Educational Foundations, Organizations, and Policy, University of Pittsburgh, PA, USA
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Salameh-Dakwar R, Elran-Barak R, Zahra-Zeitoun Y, Soroka G, Froylich D, Assalia A, Latzer Y. Interpersonal Characteristics and Binge Eating among Patients Pursuing Bariatric Surgery. Healthcare (Basel) 2023; 11:2836. [PMID: 37957980 PMCID: PMC10647538 DOI: 10.3390/healthcare11212836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/17/2023] [Accepted: 10/20/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Preoperative binge eating behavior has been associated with difficulties in weight loss maintenance among patients pursuing bariatric surgery. However, limited data exists on the relationship between interpersonal difficulties and binge eating. OBJECTIVES To identify interpersonal factors linked with binge eating among bariatric surgery candidates. SETTING One hundred and seventeen adult bariatric surgery candidates (BMI = 42.2 ± 5.2) from three different hospitals completed questionnaires on the day of their bariatric committee meeting for operation approval. METHODS Binge eating was assessed using the Questionnaire on Eating and Weight Patterns-5 (QEWP-5) as a dichotomous variable. Self-esteem was measured using the Rosenberg Self-Esteem Scale (RSES), and interpersonal characteristics were evaluated using the short version of the Inventory of Interpersonal Problems (IIP-32). Sociodemographic variables (age, gender, income, education) and BMI were considered as confounders. RESULTS Approximately 25% of bariatric surgery candidates reported experiencing binge eating episodes within the previous three months. Participants with binge eating exhibited significantly lower self-esteem and more interpersonal difficulties, particularly in the domains of aggressiveness and dependence, compared to those without binge eating. Logistic regression analysis revealed that aggressiveness was a significant predictor of binge eating in this sample. CONCLUSIONS This study is the first, to the best of our knowledge, to investigate the relationship between interpersonal difficulties and binge eating among bariatric surgery candidates. The findings highlight the significant contribution of aggressiveness to binge eating and emphasize the importance of clinicians assessing patients' interpersonal functioning, particularly with regard to aggressiveness, as a factor that may contribute to the maintenance and occurrence of binge eating behaviors.
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Affiliation(s)
| | - Roni Elran-Barak
- School of Public Health, University of Haifa, Haifa 3498838, Israel
| | | | | | | | | | - Yael Latzer
- School of Public Health, University of Haifa, Haifa 3498838, Israel
- Rambam Medical Center, Haifa 3109601, Israel
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Vajravelu ME, Tas E, Arslanian S. Pediatric Obesity: Complications and Current Day Management. Life (Basel) 2023; 13:1591. [PMID: 37511966 PMCID: PMC10381624 DOI: 10.3390/life13071591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/12/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
Obesity affects approximately 1 in 5 youth globally and increases the risk of complications during adolescence and young adulthood, including type 2 diabetes, dyslipidemia, hypertension, non-alcoholic fatty liver disease, obstructive sleep apnea, and polycystic ovary syndrome. Children and adolescents with obesity frequently experience weight stigma and have an impaired quality of life, which may exacerbate weight gain. Pediatric obesity is typically defined using sex-, age-, and population-specific body mass index percentiles. Once identified, pediatric obesity should always be managed with lifestyle modification. However, adolescents with obesity may also benefit from anti-obesity medications (AOM), several of which have been approved for use in adolescents by the US Food and Drug Administration, including liraglutide, phentermine/topiramate, and semaglutide. For children with specific, rare monogenic obesity disorders, setmelanotide is available and may lead to significant weight loss. Metabolic and bariatric surgery may be used for the management of severe obesity in youth; though highly effective, it is limited to specialized centers and has had relatively low pediatric uptake. In this narrative review using pediatric-focused data from original research, reviews, clinical practice guidelines, governmental agencies, and pharmaceutical companies, we review obesity-related metabolic complications in youth and management strategies, including AOM and bariatric surgery.
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Affiliation(s)
- Mary Ellen Vajravelu
- Center for Pediatric Research in Obesity and Metabolism, UPMC Children's Hospital of Pittsburgh, 4401 Penn Ave., Faculty Pavilion 6th Floor, Pittsburgh, PA 15224, USA
- Division of Pediatric Endocrinology, Diabetes, and Metabolism, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Emir Tas
- Center for Pediatric Research in Obesity and Metabolism, UPMC Children's Hospital of Pittsburgh, 4401 Penn Ave., Faculty Pavilion 6th Floor, Pittsburgh, PA 15224, USA
- Division of Pediatric Endocrinology, Diabetes, and Metabolism, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Silva Arslanian
- Center for Pediatric Research in Obesity and Metabolism, UPMC Children's Hospital of Pittsburgh, 4401 Penn Ave., Faculty Pavilion 6th Floor, Pittsburgh, PA 15224, USA
- Division of Pediatric Endocrinology, Diabetes, and Metabolism, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
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The Association between Obesity and Depression among Children and the Role of Family: A Systematic Review. CHILDREN 2022; 9:children9081244. [PMID: 36010134 PMCID: PMC9406476 DOI: 10.3390/children9081244] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/14/2022] [Accepted: 08/16/2022] [Indexed: 11/26/2022]
Abstract
One of the most critical factors that affects or leads to obesity is depression. However, another point of view is that obesity leads to depression. This systematic review estimates evidence arising from observational and systematic studies concerning the association between obesity and depression in children and adolescents. Moreover, the role of the family environment is investigated in this review. A systematic literature search was performed for research conducted between 2014 and 2021 on PubMed. The basic inclusion criteria were the language, study issue and type, and age of the participants. Studies that examined non-healthy populations, or were not related, or with no access were excluded. Titles and abstracts were screened independently, and full-text manuscripts meeting inclusion criteria were extracted. Finally, twenty-seven studies were retained. Most of them highlighted a positive association between obesity and depression. However, it is not clear whether obesity leads to depression or vice versa. Our review also revealed that the role of the family in this association has not been well studied and understood, since only one study addressed the issue. The evidence from our review emphasizes major public health issues; therefore, appropriate health policies should be developed. Moreover, additional research is required to fully understand the role of the family environment in the association between depression and obesity in childhood.
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Kanellopoulou A, Vassou C, Kornilaki EN, Notara V, Antonogeorgos G, Rojas-Gil AP, Lagiou A, Yannakoulia M, Panagiotakos DB. The Association between Stress and Children's Weight Status: A School-Based, Epidemiological Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9071066. [PMID: 35884050 PMCID: PMC9316103 DOI: 10.3390/children9071066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 07/08/2022] [Accepted: 07/15/2022] [Indexed: 11/20/2022]
Abstract
Given the evidence on how stress affects weight status in children, this research examined this association among Greek students aged 10−12 years old. Overall, 1452 children and their parents from several urban areas participated in an observational study conducted during the period 2014−2016. Participants completed validated questionnaires. International Obesity Task Force guidelines were used for children’s weight status classification. Descriptive statistics and nested logistic regression models were used. Multivariate correspondence analysis was also used to construct a score to evaluate the children’s stress levels. The overall prevalence of overweight/obesity was 27%. More than 80% of the children appeared to have a medium or high level of stress, mainly due to the school environment. School-related stress increased the odds of obesity in children. The association between stress and overweight/obesity status showed a consistent trend (adjusted odds ratios varied from 1.44 to 1.52, p-values < 0.01). Children’s weight status was associated with several school-related stressors. Although the school environment may play an aggravating role in the weight status of children, family plays a catalyst role in this direction. Therefore, actions have to be promoted in the school community so that children become more health literate on a public health level.
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Affiliation(s)
- Aikaterini Kanellopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece; (A.K.); (C.V.); (G.A.); (M.Y.)
| | - Christina Vassou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece; (A.K.); (C.V.); (G.A.); (M.Y.)
| | - Ekaterina N. Kornilaki
- Department of Preschool Education, School of Education, University of Crete, 74100 Rethimno, Greece;
| | - Venetia Notara
- Laboratory of Hygiene and Epidemiology, Department of Public and Community Health, School of Public Health, University of West Attica, 12243 Athens, Greece; (V.N.); (A.L.)
| | - George Antonogeorgos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece; (A.K.); (C.V.); (G.A.); (M.Y.)
| | - Andrea Paola Rojas-Gil
- Department of Nursing, Faculty of Health Sciences, University of Peloponnese, 22100 Tripoli, Greece;
| | - Areti Lagiou
- Laboratory of Hygiene and Epidemiology, Department of Public and Community Health, School of Public Health, University of West Attica, 12243 Athens, Greece; (V.N.); (A.L.)
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece; (A.K.); (C.V.); (G.A.); (M.Y.)
| | - Demosthenes B. Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece; (A.K.); (C.V.); (G.A.); (M.Y.)
- Faculty of Health, University of Canberra, Canberra 2617, Australia
- Correspondence: ; Tel.: +30-210-9549332
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Petrovics P, Nagy A, Sandor B, Palfi A, Szekeres Z, Toth K, Szabados E. Examination of Self-Esteem, Body Image, Eating Attitudes and Cardiorespiratory Performance in Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413172. [PMID: 34948781 PMCID: PMC8701836 DOI: 10.3390/ijerph182413172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/10/2021] [Accepted: 12/11/2021] [Indexed: 11/24/2022]
Abstract
Self-esteem, body image and eating attitudes are important characteristics regarding adolescent mental health. In our present work, we aimed to investigate these psychological items in adolescent boys and girls examining gender differences and correlations with the BMI-for-age and cardiorespiratory performance. 374 students (209 girls with an average age of 16.4 ± 1.08 years, and 165 boys with an average age of 16.5 ± 1.03 years) underwent investigation using the Rosenberg self-esteem scale, EAT-26 and BAT questionnaires. The BMI-for-age was calculated with BMI growth charts and the cardiorespiratory performance was measured with the 20 m shuttle run test. Our results showed that adolescent girls scored lower self-esteem and higher values for BAT and each scale of eating behaviors, such as uncontrolled eating, cognitive restraints and emotional eating compared to boys despite the fact, that obesity and overweight were more common among boys. No significant correlation was found between BMI and psychological test results in either boys or girls, however, subjective body shape and gender predicted self-esteem and BAT scores and the cognitive restraints in the eating attitudes. Uncontrolled and emotional eating were primarily influenced by gender, in which BMI played only a weaker role. Cardiorespiratory performance was positively associated with self-esteem and body image among boys, and it had a negative correlation regarding BMI in both genders.
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Affiliation(s)
- Peter Petrovics
- Institute of Physical Education and Sport Sciences, Faculty of Sciences, University of Pecs, H-7624 Pecs, Hungary;
| | - Alexandra Nagy
- State Hospital for Cardiology, H-8230 Balatonfüred, Hungary;
| | - Barbara Sandor
- Division of Preventive Cardiology and Rehabilitation, 1st Department of Medicine, Medical School, University of Pecs, H-7623 Pecs, Hungary; (B.S.); (A.P.); (Z.S.)
| | - Anita Palfi
- Division of Preventive Cardiology and Rehabilitation, 1st Department of Medicine, Medical School, University of Pecs, H-7623 Pecs, Hungary; (B.S.); (A.P.); (Z.S.)
| | - Zsolt Szekeres
- Division of Preventive Cardiology and Rehabilitation, 1st Department of Medicine, Medical School, University of Pecs, H-7623 Pecs, Hungary; (B.S.); (A.P.); (Z.S.)
| | - Kalman Toth
- Division of Cardiology, 1st Department of Medicine, Medical School, University of Pecs, H-7624 Pecs, Hungary;
| | - Eszter Szabados
- Division of Preventive Cardiology and Rehabilitation, 1st Department of Medicine, Medical School, University of Pecs, H-7623 Pecs, Hungary; (B.S.); (A.P.); (Z.S.)
- Correspondence:
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Parent Involvement in Diet or Physical Activity Interventions to Treat or Prevent Childhood Obesity: An Umbrella Review. Nutrients 2021; 13:nu13093227. [PMID: 34579099 PMCID: PMC8464903 DOI: 10.3390/nu13093227] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/10/2021] [Accepted: 09/14/2021] [Indexed: 12/17/2022] Open
Abstract
Parents substantially influence children’s diet and physical activity behaviors, which consequently impact childhood obesity risk. Given this influence of parents, the objective of this umbrella review was to synthesize evidence on effects of parent involvement in diet and physical activity treatment and prevention interventions on obesity risk among children aged 3–12 years old. Ovid/MEDLINE, Elsevier/Embase, Wiley/Cochrane Library, Clarivate/Web of Science, EBSCO/CINAHL, EBSCO/PsycInfo, and Epistemonikos.org were searched from their inception through January 2020. Abstract screening, full-text review, quality assessment, and data extraction were conducted independently by at least two authors. Systematic reviews and meta-analyses of diet and physical activity interventions that described parent involvement, included a comparator/control, and measured child weight/weight status as a primary outcome among children aged 3–12 years old were included. Data were extracted at the level of the systematic review/meta-analysis, and findings were narratively synthesized. Of 4158 references identified, 14 systematic reviews and/or meta-analyses (eight treatment focused and six prevention focused) were included and ranged in quality from very low to very high. Our findings support the inclusion of a parent component in both treatment and prevention interventions to improve child weight/weight status outcomes. Of note, all prevention-focused reviews included a school-based component. Evidence to define optimal parent involvement type and duration and to define the best methods of involving parents across multiple environments (e.g., home, preschool, school) was inadequate and warrants further research. PROSPERO registration: CRD42018095360.
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Breakfast patterns and weight status among adolescents: a study on the Brazilian National Dietary Survey 2008-2009. Br J Nutr 2021; 127:1549-1556. [PMID: 34180382 DOI: 10.1017/s0007114521002403] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Examining the composition of breakfast concerning weight status is essential for evaluating adolescent health and understanding this gap. This study aimed to identify breakfast patterns and investigate the relationship with weight status among Brazilian adolescents. We used a subsample of 7425 adolescents aged 10-19 years from the 2008-2009 Brazilian Household Budget Survey. Breakfast eaters were those with intake of at least 50 kcal (209·2 kJ) between 05.00 and 10.00 hours. Breakfast dietary patterns were derived by principal component factor analysis with varimax rotation. We performed logistic regression analyses between breakfast patterns and weight status, considering the complexity of the survey sample design. Three breakfast patterns were identified explaining 44·8 % of data variability: (1) the Cereal, protein, fruit beverages and Northern/Northeastern pattern, characterised by high consumption of cookies, meats, dairy products, preparations with maize, eggs, fruit juices/fruit drinks/soya-based drinks, tubers/roots/potatoes and cereals, and negative adherence to cold cut meat and savoury snacks/crackers; (2) the Protein-based pattern, characterised by positive loadings for cold cut meat, milk and cheese, and negative for cookies, fruit juices/fruit drinks/soya-based drinks, tubers/roots/potatoes and cereals; and (3) the Mixed pattern, with positive loadings for cakes, coffee/tea, bread, fruit juices/fruit drinks/soya-based drinks, chocolate/desserts and savoury snacks/crackers. No association was found between skipping and weight status. Overweight adolescents had lower adherence to the Cereal, protein, fruit beverages and Northern/Northeastern pattern (OR = 0·67; 95 % CI 0·47, 0·96). This is the first study to address dietary patterns at the meal level with adolescent population-based data, which requires further investigation.
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Gal E, Gal-Mishael R, Vissoker RE, Hedley D, Bury SM, Stolar O. Eating Challenges in Children with Autism Spectrum Disorder: Development and Validation of the "Aut-Eat" Questionnaire (AEQ). J Autism Dev Disord 2021; 52:811-822. [PMID: 33792802 DOI: 10.1007/s10803-021-04978-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2021] [Indexed: 11/29/2022]
Abstract
The Aut-Eat Questionnaire (AEQ) provides a novel and comprehensive assessment of eating problems and patterns in children with ASD. To establish the internal consistency and discriminant validity of the AEQ, parents of children with ASD (n = 105, Mage = 40.85, SD = 15.67 months) or typical development (TD; n = 98, Mage = 50.33, SD = 16.50 months) completed the AEQ. Questionnaire construction, content validity, factor analysis, internal consistency and discriminant validity are reported. The AEQ was reliable with high internal consistency in most domains. Significant differences were found between groups in all domains. The AEQ is a reliable and valid tool and may help to characterize eating difficulties in this population.
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Affiliation(s)
- Eynat Gal
- Department of Occupational Therapy, University of Haifa, Mount Carmel, 31905, Haifa, Israel.
| | - Rotem Gal-Mishael
- Department of Occupational Therapy, University of Haifa, Mount Carmel, 31905, Haifa, Israel
| | - Roni Enten Vissoker
- Department of Occupational Therapy, University of Haifa, Mount Carmel, 31905, Haifa, Israel
| | - Darren Hedley
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, Australia
| | - Simon M Bury
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, Australia
| | - Orit Stolar
- Shamir Medical Center, Department of Pediatrics, Autism Center, Zerifin, Israel
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Dahill LM, Touyz S, Morrison NMV, Hay P. Parental appearance teasing in adolescence and associations with eating problems: a systematic review. BMC Public Health 2021; 21:450. [PMID: 33676473 PMCID: PMC7936414 DOI: 10.1186/s12889-021-10416-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 02/09/2021] [Indexed: 01/29/2023] Open
Abstract
Background The adolescent years see significant physical and emotional development that lay foundations for patterns of behaviour that can continue into adult life, including the shaping of eating behaviours. Given parents are key socio-environmental drivers and influencers of adolescent behaviours around physical health and wellbeing, it is critical to consider if specific forms of parental communication are potentially contributing to the associated emotional difficulties experienced in the adolescent years. The aim of this research was to systematically review the myriad of literature pertaining to the prevalence of parental weight or appearance-based teasing and adolescent eating problems to examine how the scientific and clinical community currently understands the relationship between these domains. Methods A systematic search of the literature, using the SCOPUS, APA PsycINFO, Medline, CINAHL databases, reference lists and Google Scholar, was undertaken to identify relevant literature for parental teasing and problem eating in adolescents aged 10–19 years, published between January 1980 to October 2020, in English or French. Results Six studies met criteria for inclusion, all were cross-sectional studies and two included additional prospective data. Although parents were not the most common perpetrators of teasing, often subsidiary to that of peers and siblings, the influence and impact of parental teasing remained significant, and in some cases, appeared to interact with sibling-based teasing. This teasing was associated with problem eating behaviours for adolescents. Conclusions There is evidence in the literature to suggest the existence of an association between ‘eating problems’ amongst adolescents and exposure to parental appearance or weight teasing. Parents are unlikely to be aware of the perception or impact of the words they use or the wider influence these words may have. Future research should employ representative longitudinal designs to develop a greater understanding of the relationships between parental communications around their adolescent’s appearance or weight and how that communication is perceived by adolescents within complex family processes. Trial registration PROSPERO 2018 CRD42018109623. Prospectively registered 15th October 2018. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10416-5.
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Affiliation(s)
- Lucy M Dahill
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Stephen Touyz
- Department of Psychology, University of Sydney, Sydney, Australia
| | - Natalie M V Morrison
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.,School of Medicine, Western Sydney University, Penrith, Australia
| | - Phillipa Hay
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.,School of Medicine, Western Sydney University, Penrith, Australia
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Mazurak N, Cook J, Weiland A, Ritze Y, Urschitz M, Junne F, Zipfel S, Enck P, Mack I. Impact of Childhood Obesity and Psychological Factors on Sleep. Front Psychiatry 2021; 12:657322. [PMID: 34305673 PMCID: PMC8298750 DOI: 10.3389/fpsyt.2021.657322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 06/08/2021] [Indexed: 11/13/2022] Open
Abstract
The aim of the study was to analyze sleep duration and behaviors in relation to psychological parameters in children and adolescents with obesity seeking inpatient weight-loss treatment in comparison to normal-weight children, and whether or not these variables would improve during the time course of treatment. Sixty children or adolescents with overweight and obesity (OBE) and 27 normal-weight (NW) peers (age: 9-17) were assessed for subjective sleep measures through self-reported and parent-reported questionnaires, as well as body weight, body composition, and psychological questionnaires. The OBE participants were assessed upon admission and before discharge of an inpatient multidisciplinary weight-loss program. NW participants' data were collected for cross-sectional comparison. In comparison to NW, children and adolescents with OBE had a shorter self-reported sleep duration and had poorer sleep behaviors and more sleep-disordered breathing as reported by their parents. No change in sleep measures occurred during the inpatient treatment. Psychological factors including higher anxiety, depression, and destructive-anger-related emotion regulation were moderate predictors for unfavorable sleep outcomes, independent of weight status. Children with obesity had less favorable sleep patterns, and psychological factors influenced sleep in children, independent of weight. More research is needed on the relationship and direction of influence between sleep, psychological factors, and obesity, and whether they can be integrated in the prevention and management of childhood obesity and possibly also other pediatric diseases.
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Affiliation(s)
- Nazar Mazurak
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Tübingen, Germany
| | - Jessica Cook
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Tübingen, Germany
| | - Alisa Weiland
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Tübingen, Germany
| | - Yvonne Ritze
- Institute of Medical Psychology and Behavioral Neurobiology, University Hospital, Tübingen, Germany
| | - Michael Urschitz
- Division of Paediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Tübingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Tübingen, Germany
| | - Paul Enck
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Tübingen, Germany
| | - Isabelle Mack
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Tübingen, Germany
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Batzios SP, Provatidou M, Christoforidis A, Sidiropoulos H, Cassimos DC. Adolescent obesity: Confessions of the young mind. Metabol Open 2020; 7:100044. [PMID: 32812940 PMCID: PMC7424820 DOI: 10.1016/j.metop.2020.100044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 06/14/2020] [Accepted: 07/09/2020] [Indexed: 11/24/2022] Open
Abstract
Background Obesity represents a worldwide leading health problem. Although the proportion of adolescent obesity is continuously rising, yet little is known considering adolescent's opinions regarding this condition. Aim To investigate adolescent's perceptions in relation to various aspects of obesity in a prospective cohort study. Subjects and methods The study population included primary school adolescents, 11-12 years of age. Anthropometric measurements of participants included height and weight. Overweight and obese participants were classified using the International Obesity Task Force criteria. A structured questionnaire assessing physical activity, dietary habits, parental guidance regarding dietary intake and psychological aspects in relation to social functioning, body weight and image was completed by each adolescent. Results Three hundred and thirty-five adolescents (181 boys) formed the study group. Obese participants were found to have significantly fewer friends (p = .050) and preferred indoor sedentary activities (p = .041). No differences were observed within the groups when questioned about their eating habits in terms of appetite and hunger. The majority of participants reported frequent consumption of homemade snacks in school resulting in no significant difference within the groups. Finally, body weight satisfaction was recorded for only 5.66% of the obese children, 25.66% and 68.64% of overweight and normal-weight participants respectively. Conclusions Our findings support the notion that adolescents are perfectly capable of expressing their opinions. When planning interventional programs for the management of adolescent obesity their views should be strongly considered.
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Affiliation(s)
- Spyros P Batzios
- 1st Pediatric Department, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Athanasios Christoforidis
- 1st Pediatric Department, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Dimitrios C Cassimos
- Pediatric Department, University Hospital of Alexandroupolis, Dimokritio University of Thrace, Alexandroupolis, Greece
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Blanco M, Solano S, Alcántara AI, Parks M, Román FJ, Sepúlveda AR. Psychological well-being and weight-related teasing in childhood obesity: a case-control study. Eat Weight Disord 2020; 25:751-759. [PMID: 31077019 DOI: 10.1007/s40519-019-00683-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 03/20/2019] [Indexed: 12/24/2022] Open
Abstract
PURPOSE The prevalence of childhood obesity continues to increase worldwide. The aims of this study were to (1) assess the psychological well-being and rates of teasing of Spanish children with obesity (OG) and compare them with their non-overweight peers (NG), and (2) analyze the mediating role of weight-related teasing on the relation between children's BMI z score and psychological well-being. METHODS The cross-sectional study included 50 preadolescents with obesity, matched with non-overweight children according to age, sex, and socioeconomic status, who were assessed via self-report instruments measuring anxiety, depression, self-esteem, and teasing. RESULTS The OG reported higher anxiety, depression, and teasing, and lower self-esteem. SEM revealed that children who scored worse on instruments assessing psychological well-being had higher BMI z scores. Weight-related teasing predicted poor psychological well-being scores and weight-related teasing mediated the relation between BMI and psychological well-being. CONCLUSIONS The high rates of anxiety, depression, and weight-related teasing, as well as the low self-esteem, which was observed amongst the children with obesity, raise concerns about the quality of life of this population. Furthermore, the finding that weight-related teasing mediated the relationship between BMI and psychological well-being adds to a growing body of research, highlighting the harmful effects of weight-related stigma. Overall, these results highlight the importance of early intervention to assess for, and address, the presence of weight-related teasing and psychological well-being difficulties in preadolescents with obesity. LEVEL OF EVIDENCE Level III, case-control study.
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Affiliation(s)
- M Blanco
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Cantoblanco Campus, 28049, Madrid, Spain.
| | - S Solano
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Cantoblanco Campus, 28049, Madrid, Spain
| | - A I Alcántara
- Pediatric Service, Daroca Primary Health Care Center, Madrid, Spain
| | - M Parks
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Cantoblanco Campus, 28049, Madrid, Spain
| | - F J Román
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Cantoblanco Campus, 28049, Madrid, Spain
| | - A R Sepúlveda
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Cantoblanco Campus, 28049, Madrid, Spain
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Rao WW, Zong QQ, Zhang JW, An FR, Jackson T, Ungvari GS, Xiang Y, Su YY, D'Arcy C, Xiang YT. Obesity increases the risk of depression in children and adolescents: Results from a systematic review and meta-analysis. J Affect Disord 2020; 267:78-85. [PMID: 32063576 DOI: 10.1016/j.jad.2020.01.154] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 12/28/2019] [Accepted: 01/26/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Clinical depression (including major depression, dysthymia, and unspecified depression) is common in children and adolescents with obesity and overweight. The objective of this systematic review and meta-analysis was to examine prevalence of clinical depression among overweight and obese children. METHODS PubMed, EMBASE, Web of Science, Medline, Cochrane library, and PsycINFO databases were systematically and independently searched by three researchers from the inception dates to April 01, 2019. The fixed-effects model was used to perform meta-analysis. Data analyses were performed with STATA Version 12.0. RESULTS Eleven studies with 69,893 subjects were included; 5 studies examined major depressive disorder (MDD), while the remaining 6 studies examined other types of clinical depression. In the overweight and obese group, the prevalence of clinical depression ranged from 1.7% to 26.7% in obese subjects and from 4.0% to 16.9% in overweight subjects. In studies on MDD, prevalence ranged from 10.1% to 26.7% in obese subjects and from 9.0% to 16.9% in overweight subjects. The odd ratios (ORs) of clinical depression ranged from 0.92 to 4.39 between obese subjects and healthy controls (i.e., normal-weight controls), and ranged from 0.96 to 1.67 between overweight subjects and controls. Compared to healthy controls, obese (OR = 1.851, 95% CI: 1.410-2.429) but not overweight (OR = 1.068, 95% CI: 0.889-1.283) children and adolescents were more likely to have MDD. CONCLUSION Obese children and adolescents had a significantly higher risk for MDD compared with healthy controls. Considering the negative health outcomes of depression, regular screening and effective treatments should be implemented for obese children and adolescents.
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Affiliation(s)
- Wen-Wang Rao
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China
| | - Qian-Qian Zong
- School of Nursing, Capital Medical University, Beijing, China; The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Ji-Wen Zhang
- School of Nursing, Capital Medical University, Beijing, China
| | - Feng-Rong An
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Todd Jackson
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macau, SAR, China
| | - Gabor S Ungvari
- The University of Notre Dame Australia, Fremantle, Australia; Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia
| | - Yifan Xiang
- Pui Ching Middle School Macau, Macau SAR, China
| | - Ying-Ying Su
- School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada
| | - Carl D'Arcy
- School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada; Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Yu-Tao Xiang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China.
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15
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Community engagement and pediatric obesity: Incorporating social determinants of health into treatment. J Clin Transl Sci 2019; 4:279-285. [PMID: 33244407 PMCID: PMC7681165 DOI: 10.1017/cts.2019.447] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Childhood obesity is a complex and multi-faceted problem, with contributors ranging from individual health behaviors to public policy. For clinicians who treat pediatric obesity, environmental factors that impact this condition in a child or family can be difficult to address in a clinical setting. Community-clinic partnerships are one method to address places and policies that influence a person’s weight and health; however, such partnerships are typically geared toward community-located health behavior change rather than the deeper social determinants of health (SDH), limiting effective behavioral change. Community-engaged research offers a framework for developing community-clinic partnerships to address SDH germane to obesity treatment. In this paper, we discuss the relationship between SDH and pediatric obesity treatment, use of community-clinic partnerships to address SDH in obesity treatment, and how community engagement can be a framework for creating and harnessing these partnerships. We present examples of programs begun by one pediatric obesity clinic using community-engagement principles to address obesity.
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17
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Gouveia MJ, Canavarro MC, Moreira H. Is Mindful Parenting Associated With Adolescents' Emotional Eating? The Mediating Role of Adolescents' Self-Compassion and Body Shame. Front Psychol 2018; 9:2004. [PMID: 30416465 PMCID: PMC6212517 DOI: 10.3389/fpsyg.2018.02004] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 10/01/2018] [Indexed: 12/16/2022] Open
Abstract
This study aimed to explore whether parents' mindful parenting skills were associated with adolescents' emotional eating through adolescents' levels of self-compassion and body shame. The sample included 572 dyads composed of a mother or a father and his/her child (12-18 years old), with normal weight (BMI = 5-85th percentile) or with overweight/obesity with or without nutritional treatment (BMI ≥ 85th percentile) according to the WHO Child Growth Standards. Parents completed self-report measures of mindful parenting (Interpersonal Mindfulness in Parenting Scale), and adolescents completed measures of self-compassion (Self-Compassion Scale-Short Form), body shame (Experience of Shame Scale), and emotional eating (Dutch Eating Behavior Questionnaire). Two path models, one with the total score for mindful parenting and the other with its dimensions, were tested in AMOS. Mindful parenting, specifically the dimension of compassion for the child, was indirectly associated with emotional eating through adolescents' self-compassion (point estimate = -0.27, p = 0.03, CI 95% [-0.61, -0.06]) and through self-compassion and body shame sequentially (point estimate = -0.19, p = 0.03, CI 95% [-0.37, -0.05]). The path model was invariant across weight groups but not across adolescents' sex (the indirect effects were significant among girls only). This study provides a novel comprehensive model of how mindful parenting, especially the dimension of compassion for the child, can be associated with adolescents' emotional eating behaviors by suggesting a potential sequence of mechanisms that may explain this association. This study suggests the beneficial effect of both mindful parenting and adolescents' self-compassion skills for adolescent girls struggling with feelings of body shame and emotional eating behaviors.
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Affiliation(s)
- Maria João Gouveia
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
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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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19
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Sagar R, Gupta T. Psychological Aspects of Obesity in Children and Adolescents. Indian J Pediatr 2018; 85:554-559. [PMID: 29150753 DOI: 10.1007/s12098-017-2539-2] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 10/18/2017] [Indexed: 10/18/2022]
Abstract
Childhood obesity is multi factorial health condition, so the simple evaluation of body fat will not be sufficed to manage the global epidemic of childhood obesity. Literature consistently provides evidence for physical health risks associated with childhood obesity; however in recent times, mental health of the obese children has also gained attention of the researchers as well as clinicians. Obese children experience number of psycho-social problems that significantly affect their quality of life and wellbeing. Co-morbid psychosocial and emotional problems of obesity generally act as causal or maintaining factors of obesity and thus significantly affect the treatment outcome. Therefore it becomes imperative for the clinicians/pediatricians to broaden their clinical assessment and include screening of important psycho-social factors within the clinical examination of childhood obesity. This article provides an evidence based comprehensive overview about the psychological factors and psychiatric factors (depression, anxiety, eating disorder, stress, body shape concerns, low self esteem) associated with childhood obesity that can further be utilized in the evaluation and management of this epidemic. The article also elaborates the role of current evidence based psychological approaches such as Cognitive Behavior Therapy (CBT) for management of obesity in children and adolescents. CBT techniques combined with lifestyle intervention and involving parents have been recommended by literature repetitively. However, there are a number of environmental, familial and personal barriers that hinder the whole process of weight loss in children. The article also discusses potential strategies to overcome those barriers.
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Affiliation(s)
- Rajesh Sagar
- Department of Psychiatry, AIIMS, New Delhi, India.
| | - Tanu Gupta
- Department of Psychiatry, AIIMS, Jodhpur, India
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20
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Abstract
Stress and negative emotions pose a major threat to public health, by increasing the risk of obesity. Since the management process for emotions (emotion regulation; ER) is developed in childhood, we present a novel conceptual framework model for the role of ER in the prevention and treatment of childhood obesity. A narrative review of the literature by electronic database search (MEDLINE, Web of Knowledge and Scopus) was conducted of observational and interventional/experimental literature on ER and obesity and the underlying concepts. We also present an overview of ER intervention techniques. Our model indicates that childhood ER is a link between stress and obesity. Stress along with ineffective ER leads to abnormal cortisol patterns, emotional eating, sedentary lifestyle, reduction of physical activity, and sleep problems. Simultaneously, a healthy lifestyle could show benefits on ER and in developing adaptive ER strategies. In the development of obesity and ER, parents also play a role. By contrast, effective ER skills decrease obesity-related unhealthy behaviour and enhance protective factors, which boost health. The literature contains some observational studies of children but very few intervention studies, most of which are pilot or on-going studies. In conclusion, encouraging effective ER could be a useful new approach for combating and treating childhood obesity. Future ER intervention studies are needed to confirm the validity of this model in children.
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21
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Gori D, Guaraldi F, Cinocca S, Moser G, Rucci P, Fantini MP. Effectiveness of educational and lifestyle interventions to prevent paediatric obesity: systematic review and meta-analyses of randomized and non-randomized controlled trials. Obes Sci Pract 2017; 3:235-248. [PMID: 29071100 PMCID: PMC5649699 DOI: 10.1002/osp4.111] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 04/05/2017] [Accepted: 04/06/2017] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE This review and meta-analysis aim at updating a previous meta-analysis carried out by Waters et al. on the efficacy of interventions aimed at preventing childhood obesity and at identifying predictors of outcome. METHODS Using an ad-hoc search string, PubMed database was searched for studies assessing body mass index reduction associated with programmes lasting ≥12 weeks in overweight and obese children aged 2-18 years. Studies designed for children with eating disorders or relevant comorbidities were excluded. Studies meeting inclusion criteria were classified according to patient age (<6, 6-12 and 13-18 years), and intervention type (physical activity, diet or both), setting (educational, family or both) and duration (≤1 or >1 year). The search was also extended to other databases. Hand-searching techniques were also applied. The Cochrane 'risk of bias' was applied for quality assessment. RESULTS Seventy-two studies were meta-analysed. Overall, the best results were achieved by programmes combining diet and physical activity (n = 39). With regard to the setting, programmes involving both school and family and lasting ≤1 year were the most efficacious for 6- to 12-year-old children (n = 26); family-based-only interventions were also effective in children <6 years old (n = 2), although results have to be interpreted cautiously because of the small number of patients enrolled and the high study heterogeneity. In 13- to 18-year-old patients, interventions delivered at school (n = 8) were substantially unsuccessful. CONCLUSIONS Interventions for childhood obesity prevention should include both diet and physical activity, be preferentially targeted towards school age children and involve both the school and family setting. However, because of the important methodological limitations associated with currently available literature, additional studies are needed to draw definite conclusions.
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Affiliation(s)
- D Gori
- Department of Biomedical and Neuromotor Sciences (DIBINEM) University of Bologna Bologna Italy
| | - F Guaraldi
- Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences University of Turin Turin Italy
| | - S Cinocca
- School of Hygiene and Preventive Medicine University of Bologna Bologna Italy
| | - G Moser
- School of Hygiene and Preventive Medicine University of Bologna Bologna Italy
| | - P Rucci
- Department of Biomedical and Neuromotor Sciences (DIBINEM) University of Bologna Bologna Italy
| | - M P Fantini
- Department of Biomedical and Neuromotor Sciences (DIBINEM) University of Bologna Bologna Italy
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22
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Murray M, Dordevic AL, Bonham MP. Systematic Review and Meta-Analysis: The Impact of Multicomponent Weight Management Interventions on Self-Esteem in Overweight and Obese Adolescents. J Pediatr Psychol 2017; 42:379-394. [DOI: 10.1093/jpepsy/jsw101] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 11/30/2016] [Indexed: 11/13/2022] Open
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Azarpazhooh A, Sekhavat A, Sigal MJ. Validity of a simplified screening instrument for assessing overweight children in a dental setting: a cross sectional study. BMC Pediatr 2017; 17:56. [PMID: 28212686 PMCID: PMC5316148 DOI: 10.1186/s12887-017-0808-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 02/07/2017] [Indexed: 11/16/2022] Open
Abstract
Background Obesity, with its rising prevalence among Canadians and its estimated cost of $2 billion annually in Canada, is no longer considered a cosmetic issue, but a major health issue that imposes a great burden on the healthcare system and economy. This cross sectional study aims to evaluate the feasibility of identifying the weight status of 6 to 11 year-old children in a university dental clinic using a simplified overweight screening instrument. Methods One hundred sixty eight healthy children were enrolled. Weight and height were measured and overweight/obesity status was assessed using two techniques: 1) the 2007 World Health Organization Body Mass Index (BMI)-for-age reference Tables, 2) simplified overweight screening instrument without BMI calculation. Measures of overall, positive, and negative percent agreement between the two approaches were computed. Results The children’s average weight, height, BMI and BMI z-score were respectively 32.6 ± 9.5 kg, 133.8 ± 10.7 cm, 17.8 ± 3.2, and 0.4 ± 1.0. The overall, positive, and negative percent agreement between the two screening approaches were respectively, 89%, 100%, and 83%. Conclusion This study demonstrated the feasibility and parental acceptance of weight, height and BMI measurement in a dental setting and evidence that supports the validity of a new simplified approach to assess children’s weight status without having to compute BMI. Trial registration NCT02637752. Registered 18 December 2015. Electronic supplementary material The online version of this article (doi:10.1186/s12887-017-0808-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Amir Azarpazhooh
- Faculty of Dentistry, University of Toronto, 710F-481 University Ave, Toronto, ON, M5G 2P1, Canada. .,Department of Dentistry, Mount Sinai Hospital, Toronto, Canada. .,Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Canada. .,Toronto Health Economics and Technology Assessment Collaborative, University of Toronto, Toronto, Canada.
| | - Anoushe Sekhavat
- Faculty of Dentistry, University of Toronto, 710F-481 University Ave, Toronto, ON, M5G 2P1, Canada
| | - Michael J Sigal
- Faculty of Dentistry, University of Toronto, 710F-481 University Ave, Toronto, ON, M5G 2P1, Canada.,Department of Dentistry, Mount Sinai Hospital, Toronto, Canada
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Xu F, Marchand S, Corcoran C, DiBiasio H, Clough R, Dyer CS, Nobles J, White J, Greaney ML, Greene GW. A Community-Based Nutrition and Physical Activity Intervention for Children Who Are Overweight or Obese and Their Caregivers. J Obes 2017; 2017:2746595. [PMID: 29312784 PMCID: PMC5651117 DOI: 10.1155/2017/2746595] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 09/12/2017] [Accepted: 09/17/2017] [Indexed: 01/06/2023] Open
Abstract
There is a need for efficacious interventions to reduce the prevalence of childhood obesity, and a limited body of research suggests that collaborative community-based programs designed for children and their caregivers may be effective in reducing obesity rates. This paper reports the results of a community-based obesity intervention, South County Food, Fitness and Fun (SCFFF), designed for preadolescent children who are overweight or obese and their caregivers. SCFFF was developed in response to community concerns. Families were referred to the program by their physician and participated in the program at no cost. The 16-week intervention includes weekly group nutrition and physical activity sessions. Analyses determined that 65 out of the 97 children who completed SCFFF provided 2-year follow-up data and had reduced BMI z-scores over 2 years following the intervention. These participants decreased their energy, fat, carbohydrate, saturated fat, and sodium intake and increased core body strength and endurance from baseline to the end of the intervention. SCFFF was effective in reducing relative weight and improving diet and core muscle strength and endurance in children who are overweight or obese.
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Affiliation(s)
- Furong Xu
- Department of Kinesiology, University of Rhode Island, Independence Square II, Kingston, RI 02881, USA
| | | | - Celeste Corcoran
- Coastal Medical Narragansett Bay Pediatrics, 65 Village Square Drive, South Kingstown, RI 02879, USA
| | - Heather DiBiasio
- Wakefield Pediatrics, LLC, 46 Holley Street, Wakefield, RI 02879, USA
| | - Rachel Clough
- Busy Bodies Studio, 12 High Street, South Kingstown, RI 02879, USA
| | - Christopher S. Dyer
- Department of Kinesiology, University of Rhode Island, Independence Square II, Kingston, RI 02881, USA
| | - Jennifer Nobles
- Department of Nutrition and Food Sciences, University of Rhode Island, Fogarty Hall, Kingston, RI 02881, USA
| | - Jade White
- Department of Nutrition and Food Sciences, University of Rhode Island, Fogarty Hall, Kingston, RI 02881, USA
| | - Mary L. Greaney
- Department of Kinesiology, University of Rhode Island, Independence Square II, Kingston, RI 02881, USA
| | - Geoffrey W. Greene
- Department of Nutrition and Food Sciences, University of Rhode Island, Fogarty Hall, Kingston, RI 02881, USA
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Association of childhood and teen school performance and obesity in young adulthood in the US National Longitudinal Survey of Youth. Prev Med 2016; 89:57-63. [PMID: 27196145 DOI: 10.1016/j.ypmed.2016.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 05/06/2016] [Accepted: 05/15/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND The literature suggests an association between poor school performance and obesity. However, little is known about academic achievement and behavior as possible risk factors for future obesity. METHOD The analysis was based on data from 3172 participants aged 6 to 25years from the US National Longitudinal Survey conducted 1986 to 2010. Academic achievement, behavior problems and body mass index (BMI) were assessed at childhood (6-9) and teenhood (10-14). Height and weight were self-reported at pre-young adulthood (15-18) and young adulthood (19-25). RESULTS Based on logistic regression stratified by sex and race/ethnicity, academic and behavioral deficiencies during childhood and teenhood were risk factors for young adult obesity with some sex and ethnic/racial differences. The highest prevalence rates of obesity by race/ethnicity and sex are as follows: black/Hispanic females, those in the lowest quartile of teen reading and math (32.8%); black/Hispanic males, those in lowest quartile of teen reading (26.1%); white males, those in the highest quartile of behavioral problems (21.9%); and white females, those in the lowest quartile teen math (23.2%). CONCLUSION Poor school performance in childhood and teenhood is associated with an increased risk of adult obesity. Prospective studies should further examine the association of school performance and adult obesity and whether programs directed at improving school performance may have secondary gains in preventing obesity.
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Kang NR, Lee JS, Kang KS, Kwack YS. Mental Health Problems in Child and Adolescent Obesity. Soa Chongsonyon Chongsin Uihak 2016. [DOI: 10.5765/jkacap.2016.27.2.119] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Na Ri Kang
- Department of Psychiatry, Jeju National University Hospital, Jeju, Korea
| | - Ji Sun Lee
- Department of Psychiatry, Jeju National University Hospital, Jeju, Korea
| | - Ki Soo Kang
- Department of Pediatrics, Jeju National University School of Medicine, Jeju, Korea
| | - Young Sook Kwack
- Department of Psychiatry, Jeju National University School of Medicine, Jeju, Korea
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27
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Knol LL, Myers HH, Black S, Robinson D, Awololo Y, Clark D, Parker CL, Douglas JW, Higginbotham JC. Development and Feasibility of a Childhood Obesity Prevention Program for Rural Families: Application of the Social Cognitive Theory. AMERICAN JOURNAL OF HEALTH EDUCATION 2016; 47:204-214. [PMID: 28392882 PMCID: PMC5383209 DOI: 10.1080/19325037.2016.1179607] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Effective childhood obesity prevention programs for preschool children are limited in number and focus on changes in the child care environment rather than the home environment. PURPOSE The purpose of this project was to develop and test the feasibility of a home environment obesity prevention program that incorporates mindful eating strategies and Social Cognitive Theory (SCT) constructs. Home Sweet Home is specifically designed for rural parents and grandparents of preschool-age children. METHODS HSH was developed using community-based participatory research practices and constructs from the SCT. Three community-based education sessions were delivered. Pre- and post-intervention data were collected from 47 grandparents and mothers.F. RESULTS Three of the four selected behavioral outcomes improved between pre- and post-intervention. The number of hours engaged in sedentary behaviors and intake of "red light" foods decreased while three of four mindful eating scores increased. Graduates of the program were able to decrease the number of "red light" foods available in their homes. DISCUSSION Improvements in mindful eating and several key behaviors were observed after a three week mindful eating/home environment intervention. TRANSLATION TO HEALTH EDUCATION PRACTICE Health educators should incorporate mindful eating strategies and use the SCT when designing childhood obesity prevention programs.
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Affiliation(s)
- Linda L Knol
- The University of Alabama, Department of Human Nutrition and Hospitality Management
| | | | - Sheila Black
- The University of Alabama, Department of Psychology
| | | | | | | | - Carson L Parker
- University of Alabama, Department of Human Nutrition and Hospitality Management
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Patiño-Villena B, Chirlaque MD, Salmerón D, González E, Navarro C. [Validity of anthropometric measurements and weight perceptions reported by relatives of children under 4 years old]. GACETA SANITARIA 2016; 30:300-3. [PMID: 27268022 DOI: 10.1016/j.gaceta.2016.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 03/21/2016] [Accepted: 03/30/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To assess the validity of weight and height measurements reported by parents and the perception of their children's weight status in order to assess the prevalence of overweight children under 4 years old. METHODS Cross-sectional study. Anthropometric data was collected by self-report questionnaires completed by parents of children 3-45 months old: 1) information from paediatric check-ups (gold standard); 2) information reported from the home environment; and 3) data from individual perceptions. WHO standards were used. RESULTS Reported height was underestimated, thus reported weight/height and BMI/age were overestimated. Overweight prevalence according to paediatric check-ups was 18.6%, compared to 26.5% reported prevalence, showing a moderate concordance (Kappa: 0.47 [0.34-0.60]), 70% sensitivity and 84% specificity. Subjective perception was 11.2%, representing 30% sensitivity and 93% specificity. CONCLUSIONS The reported information has little validity for population-based studies, as height is underestimated and overweight status is not correctly perceived due to distortion of individual perception. Questionnaires must be validated and awareness raised among families.
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Affiliation(s)
| | - María Dolores Chirlaque
- Servicio de Epidemiología, Consejería de Sanidad, IMIB-Arrixaca, Murcia, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Departamento de Ciencias Socio-Sanitarias, Universidad de Murcia, Murcia, España
| | - Diego Salmerón
- Servicio de Epidemiología, Consejería de Sanidad, IMIB-Arrixaca, Murcia, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Departamento de Ciencias Socio-Sanitarias, Universidad de Murcia, Murcia, España
| | - Eduardo González
- Servicios Municipales de Salud, Ayuntamiento de Murcia, Murcia, España
| | - Carmen Navarro
- Servicio de Epidemiología, Consejería de Sanidad, IMIB-Arrixaca, Murcia, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Departamento de Ciencias Socio-Sanitarias, Universidad de Murcia, Murcia, España
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29
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Childhood obesity-related endothelial dysfunction: an update on pathophysiological mechanisms and diagnostic advancements. Pediatr Res 2016; 79:831-7. [PMID: 26866906 DOI: 10.1038/pr.2016.22] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 11/22/2015] [Indexed: 12/20/2022]
Abstract
Childhood obesity jeopardizes a healthy future for our society's children as it is associated with increased cardiovascular morbidity and mortality later on in life. Endothelial dysfunction, the first step in the development of atherosclerosis, is already present in obese children and may well represent a targetable risk factor. Technological advancements in recent years have facilitated noninvasive measurements of endothelial homeostasis in children. Thereby this topic ultimately starts to get the attention it deserves. In this paper, we aim to summarize the latest insights on endothelial dysfunction in childhood obesity. We discuss methodological advancements in peripheral endothelial function measurement and newly identified diagnostic markers of vascular homeostasis. Finally, future challenges and perspectives are set forth on how to efficiently tackle the catastrophic rise in cardiovascular morbidity and mortality that will be inflicted on obese children if they are not treated optimally.
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Sato PM, Steeves EA, Carnell S, Cheskin LJ, Trude AC, Shipley C, Mejía Ruiz MJ, Gittelsohn J. A youth mentor-led nutritional intervention in urban recreation centers: a promising strategy for childhood obesity prevention in low-income neighborhoods. HEALTH EDUCATION RESEARCH 2016; 31:195-206. [PMID: 26936480 PMCID: PMC5007578 DOI: 10.1093/her/cyw011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 02/03/2016] [Indexed: 05/25/2023]
Abstract
B'More Healthy Community for Kids (BHCK) is an ongoing multi-level intervention to prevent childhood obesity in African-American low-income neighborhoods in Baltimore city, MD. Although previous nutrition interventions involving peer mentoring of youth have been successful, there is a lack of studies evaluating the influence of cross-age peers within interventions targeting youth. This article evaluates the implementation of the BHCK intervention in recreation centers, and describes lessons learned. Sixteen youth leaders delivered bi-weekly, interactive sessions to 10- to 14-y olds. Dose, fidelity and reach are assessed, as is qualitative information regarding what worked well during sessions. Dose is operationalized as the number of interactive sessions, and taste tests, giveaways and handouts per session; fidelity as the number of youth leaders participating in the entire intervention and per session and reach as the number of interactions with the target population. Based on a priori set values, number of interactive sessions was high, and number of taste tests, giveaways and handouts was moderate to high (dose). The number of participating youth leaders was also high (fidelity). Of the 14 planned sessions, the intervention was implemented with high/moderate reach. Data suggest that working with cross-age peers is a promising nutritional intervention for recreation centers.
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Affiliation(s)
- Priscila M Sato
- Department of Health, Clinics and Institutions, Institute of Health and Society, Federal University of São Paulo, Santos, SP 11015-020, Brazil,
| | | | | | - Lawrence J Cheskin
- Department of Medicine, Global Obesity Prevention Center, Johns Hopkins Hospital, Baltimore, MD 21205-2179, USA and
| | - Angela C Trude
- Department of Human Nutrition, Global Obesity Prevention Center, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205-2179, USA
| | - Cara Shipley
- Department of Human Nutrition, Global Obesity Prevention Center, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205-2179, USA
| | - M J Mejía Ruiz
- Department of Human Nutrition, Global Obesity Prevention Center, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205-2179, USA
| | - Joel Gittelsohn
- Department of Human Nutrition, Global Obesity Prevention Center, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205-2179, USA
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Dalen J, Brody JL, Staples JK, Sedillo D. A Conceptual Framework for the Expansion of Behavioral Interventions for Youth Obesity: A Family-Based Mindful Eating Approach. Child Obes 2015; 11:577-84. [PMID: 26325143 PMCID: PMC4599132 DOI: 10.1089/chi.2014.0150] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Currently, over 30% of US youth are overweight and 1 in 6 have metabolic syndrome, making youth obesity one of the major global health challenges of the 21st century. Few enduring treatment strategies have been identified in youth populations, and the majority of standard weight loss programs fail to adequately address the impact of psychological factors on eating behavior and the beneficial contribution of parental involvement in youth behavior change. METHODS A critical need exists to expand treatment development efforts beyond traditional education and cognitive-behavioral programs and explore alternative treatment models for youth obesity. Meditation-based mindful eating programs represent a unique and novel scientific approach to the current youth obesity epidemic given that they address key psychological variables affecting weight. RESULTS The recent expansion of mindfulness programs to include family relationships shows the immense potential for broadening the customarily individual focus of this intervention to include contextual factors thought to influence youth health outcomes. CONCLUSIONS This article provides an overview of how both mindful eating and family systems theory fits within a conceptual framework in order to guide development of a comprehensive family-based mindful eating program for overweight youth.
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Affiliation(s)
- Jeanne Dalen
- Oregon Research Institute, Center for Family and Adolescent Research, Albuquerque, NM.,University of New Mexico Health Sciences Center, Albuquerque, NM
| | - Janet L. Brody
- Oregon Research Institute, Center for Family and Adolescent Research, Albuquerque, NM
| | | | - Donna Sedillo
- Oregon Research Institute, Center for Family and Adolescent Research, Albuquerque, NM
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Sanders RH, Han A, Baker JS, Cobley S. Childhood obesity and its physical and psychological co-morbidities: a systematic review of Australian children and adolescents. Eur J Pediatr 2015; 174:715-46. [PMID: 25922141 DOI: 10.1007/s00431-015-2551-3] [Citation(s) in RCA: 154] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 04/14/2015] [Accepted: 04/16/2015] [Indexed: 12/11/2022]
Abstract
UNLABELLED Australia is predicted to have the highest overweight/obesity rate in the world by 2022 outranking the USA and UK. The purpose of this systematic review was to evaluate the associations between childhood obesity and physical and psychological health co-morbidities. Therefore, a systematic literature search was conducted from six databases (2004-2014). Studies were included if they investigated obesity-related co-morbidities with participants residing in Australia aged 0-18 years. Forty-seven studies fulfilled selection criteria. Evidence suggests that overweight/obese Australian children and adolescents, compared to normal-weight peers, had more cardio-metabolic risk factors and higher risk factors of non-alcohol fatty liver disease and were experiencing more negative psychological outcomes (depression, low self-esteem and lower scores of health-related quality of life). Many other health consequences have either not been investigated in Australia, or as frequently as in other countries. CONCLUSIONS Given Australia's current overweight/obesity prevalence and trajectory, Australia-based studies are needed to identify the suspected co-morbidities, understand the range of individual, social and environmental mechanisms driving obesity, and help identify policies, interventions and strategies that will change the future trajectory and 'disease burden' both in Australia and internationally. WHAT IS KNOWN • Trend analyses have shown that obesity prevalence in Australia is increasing and will outrank UK and the USA by 2022. • Every third Australian child/adolescent between 5 and 19 years old is predicted to be classified as overweight or obese by 2025. • Childhood obesity is associated with multiple immediate physical and psychological health co-morbidities as well as co-morbidities in adulthood. These have often been identified and examined individually. What is New: • This paper presents a holistic picture of childhood obesity and the associated multiple co-morbidities in Australia. • The extensive health-related outcomes from childhood obesity and those requiring further research are identified. • The findings of this paper will influence the development of local/regional, state and national strategies to change Australia's future trajectory.
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Affiliation(s)
- Ross H Sanders
- Exercise and Sport Science, Faculty of Health Sciences, University of Sydney, Cumberland Campus C42, 75 East Street, Sydney, NSW, 2141, Australia,
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33
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Zeiler M, Waldherr K, Philipp J, Nitsch M, Dür W, Karwautz A, Wagner G. Prevalence of Eating Disorder Risk and Associations with Health-related Quality of Life: Results from a Large School-based Population Screening. EUROPEAN EATING DISORDERS REVIEW 2015; 24:9-18. [PMID: 26010077 DOI: 10.1002/erv.2368] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 04/13/2015] [Accepted: 04/20/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The objective of this study was to investigate the prevalence of eating disorder (ED) risk as well as associated psychopathology and health-related quality of life (HrQoL) in a large population sample of Austrian adolescents. METHOD A sample of 3610 adolescents aged 10-18 years was recruited from 261 schools representative for the Austrian population. The SCOFF questionnaire was used to identify participants at risk for EDs, and the Youth Self-Report and KIDSCREEN were used to assess general psychopathology and HrQoL. RESULTS In total, 30.9% of girls and 14.6% of boys were screened at risk for EDs. SCOFF scores were significantly associated with internalising and externalising behavioural problems as well as HrQoL after controlling for sex, age and body mass index. The SCOFF score further turned out to be an independent predictor of HrQoL. DISCUSSION The high prevalence of ED risk among Austrian adolescents points out the need for prevention in this field. Variables indicating eating pathology should be included in general mental health screenings.
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Affiliation(s)
- Michael Zeiler
- Ludwig Boltzmann Institute Health Promotion Research, Austria
| | - Karin Waldherr
- Ludwig Boltzmann Institute Health Promotion Research, Austria.,Ferdinand Porsche Distance University of Applied Sciences (FernFH), Austria
| | - Julia Philipp
- Department for Child and Adolescent Psychiatry, Medical University of Vienna, Austria
| | - Martina Nitsch
- Ludwig Boltzmann Institute Health Promotion Research, Austria
| | - Wolfgang Dür
- Ludwig Boltzmann Institute Health Promotion Research, Austria
| | - Andreas Karwautz
- Department for Child and Adolescent Psychiatry, Medical University of Vienna, Austria
| | - Gudrun Wagner
- Department for Child and Adolescent Psychiatry, Medical University of Vienna, Austria
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34
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Farpour-Lambert NJ, Baker JL, Hassapidou M, Holm JC, Nowicka P, O'Malley G, Weiss R. Childhood Obesity Is a Chronic Disease Demanding Specific Health Care--a Position Statement from the Childhood Obesity Task Force (COTF) of the European Association for the Study of Obesity (EASO). Obes Facts 2015; 8:342-9. [PMID: 26469067 PMCID: PMC5644867 DOI: 10.1159/000441483] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 09/04/2015] [Indexed: 12/26/2022] Open
Abstract
Childhood obesity is one of the greatest health challenges of the 21st century. The EASO COTF is convinced that classifying obesity as a chronic disease in children and adolescents is a crucial step for increasing individual and societal awareness, and for improving early diagnosis and intervention. Such a classification will enhance the development of novel preventive and treatment approaches, health care policies and systems, and the education of healthcare workers. The management of obesity prior to the appearance of co-morbidities may prevent their escalation into significant medical and psychosocial problems, and reduce their economic and societal impact. Childhood is a unique window of opportunity to influence lifetime effects on health, quality of life, prevention of non-communicable chronic diseases and disabilities. The Convention on the Rights of the Child by UNICEF states that parties shall strive to ensure that no child is deprived of his or her right of access to health care services. The EASO COTF is aiming to address these issues via educational activities for health care workers, identification of research agendas, and the promotion of collaborations among clinicians, researchers, health institutions, organizations and states across Europe.
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Affiliation(s)
- Nathalie J. Farpour-Lambert
- Obesity Prevention and Care Program Contrepoids, Service of Therapeutic Education for Chronic Diseases, Department of Community Medicine, Primary Care and Emergency, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland
- *Nathalie J. Farpour-Lambert, Obesity Prevention and Care Program Contrepoids, Service of Therapeutic Education for Chronic Diseases, Department of Community Medicine, Primary Care and Emergency, University Hospitals of Geneva and University of Geneva, 1211 Geneva 14, Switzerland,
| | - Jennifer L. Baker
- Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Maria Hassapidou
- Alexander Technological Educational Institute of Thessaloniki, Department of Nutrition and Dietetics, Thessaloniki, Greece
| | - Jens Christian Holm
- The Children's Obesity Clinic, Department of Paediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark
| | - Paulina Nowicka
- Division of Pediatrics, Karolinska Institute, Stockholm, Sweden
| | - Grace O'Malley
- Physiotherapy Department; Temple Street Children's University Hospital, Dublin, Ireland
| | - Ram Weiss
- Department of Human Metabolism and Nutrition and the Department of Pediatrics, The Hadassah Hebrew University School of Medicine Jerusalem, Israel
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35
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Mameli C, Galli E, Dilillo D, Alemanno A, Catalani L, Cau S, Fransos L, Lucidi F, Macrì A, Marconi P, Mostaccio A, Presti G, Rovera G, Rotilio G, Rubeo M, Tisiot C, Zuccotti G. Psychosocial, behavioural, pedagogical, and nutritional proposals about how to encourage eating a healthy breakfast. Ital J Pediatr 2014; 40:73. [PMID: 25125024 PMCID: PMC4237809 DOI: 10.1186/s13052-014-0073-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 08/04/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Even if more and more evidences have highlighted the importance of breakfast in the growth and development of children, from 10 to 30% of US and European children and adolescents regularly skip breakfast. Thus, there is still a lot to be done before breakfast becomes a daily habit. The aim of this paper is to try and understand how it is possible to overcome the real or imaginary difficulties associated with skipping breakfast by psychosocial, behavioural, pedagogical and nutritional proposals. DISCUSSION Schools are the best context where perform healthy interventions because it is here that children learn about the importance of good health at an age when the school still plays a major role in their education. Some school interventions, based on solid theories as the Self Determination Theory and the Behaviour Analysis, have been implemented in the last years to promote health behaviour such as intake of fruit and vegetables and physical activities. Cognitive behaviour therapy is the most closely monitored type of treatment/cure for obesity in randomised controlled trials. Moreover some associations such as the National Association of Food Science Specialists have drawn an own method to encourage food education at school and promote the importance of prevention. These projects could be used as starting point to perform interventions focus on breakfast. SUMMARY Increase the consumption of breakfast between children is very important. Efforts should be done to drawn new school projects based on scientific-evidences.
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Affiliation(s)
- Chiara Mameli
- Department of Paediatrics, University of Milan, “Luigi Sacco” Hospital, Milan, Italy
| | - Erica Galli
- Department of Paediatrics, University of Milan, “Luigi Sacco” Hospital, Milan, Italy
| | - Dario Dilillo
- Department of Paediatrics, University of Milan, “Luigi Sacco” Hospital, Milan, Italy
| | | | | | - Silvia Cau
- Istituto Universitario di Lingue Moderne - IULM University of Milan, Milan, Italy
| | - Lucia Fransos
- Italian Association of Food Science Specialists (ANSiSA), Milan, Italy
| | - Fabio Lucidi
- Department of Psychology of Developmental and Socialisation Processes, University “La Sapienza” of Rome, Rome, Italy
| | | | - Paolo Marconi
- Italian Association of Food Science Specialists (ANSiSA), Milan, Italy
| | | | | | - Giuseppe Rovera
- Italian Association of Food Science Specialists (ANSiSA), Milan, Italy
| | | | - Mariagrazia Rubeo
- Italian Eating and Weight Disorders Association (AIDAP), Rome, Italy
| | - Carla Tisiot
- Association of Italian Pedagogists (ANPE), Rome, Italy
| | - Gianvincenzo Zuccotti
- Department of Paediatrics, University of Milan, “Luigi Sacco” Hospital, Milan, Italy
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36
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Stein D, Weinberger-Litman SL, Latzer Y. Psychosocial perspectives and the issue of prevention in childhood obesity. Front Public Health 2014; 2:104. [PMID: 25133140 PMCID: PMC4116804 DOI: 10.3389/fpubh.2014.00104] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 07/15/2014] [Indexed: 11/13/2022] Open
Abstract
A dramatic increase in childhood overweight/obesity has been recognized globally over the past 50 years. This observed increase may reflect genetic, as well as psychological, environmental, and socio-cultural influences. In the first part of this review, we present an updated summary of the psychosocial factors associated with this change and discuss possible ways in which they operate. Among these factors, lower socio economic status (in both industrialized and non-industrialized countries), being female, belonging to a minority group, and being exposed to adverse life events may all be associated with a greater risk of childhood overweight/obesity. These influences may be mediated via a variety of mechanisms, in particular above-average food intake of low nutritional quality and reduction in physical activity. Other important psychosocial mediators include the influence of the family and peer environment, and exposure to the media. In the second part of the review, we discuss the potential of psychosocial prevention programs to intervene in the processes involved in the rise of childhood overweight/obesity. Two points are emphasized. First, prevention programs should be multidisciplinary, combining the knowledge of experts from different professions, and taking into consideration the important role of the family environment and relevant influential social organizations, particularly school. Second, effective change is unlikely to occur without large-scale programs carried out on a public policy level.
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Affiliation(s)
- Daniel Stein
- Pediatric Psychosomatic Department, Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center , Tel Hashomer , Israel ; Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel
| | | | - Yael Latzer
- Faculty of Social Welfare and Health Sciences, Haifa University , Haifa , Israel ; Eating Disorders Clinic, Psychiatric Division, Rambam Medical Center , Haifa , Israel
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