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Lee J, Helgeson E, Horning ML, Elgesma KM, Kubik MY, Fulkerson JA. Food Insecurity and Changes in Diet Quality and Body Mass Index z-Scores Among Elementary School Students. Child Obes 2024. [PMID: 38546529 DOI: 10.1089/chi.2023.0185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/19/2024]
Abstract
Background: Previous research has identified food insecurity as a risk factor for obesity but those studies employed cross-sectional designs and were largely focused on adults and young children. In addition, there is a paucity of studies examining the association between food insecurity and changes in children's overall diet quality. This study aimed to assess whether food insecurity is associated with subsequent changes in diet quality and BMI z-scores over 2 years among 7- to 12-year-old children. Methods: We used 2011-2019 secondary data (n = 404) from three randomized controlled trials in Minnesota. Food insecurity was identified using the U.S. Household Food Security Survey Module at baseline (Time 0). Diet quality was determined using the Healthy Eating Index (HEI)-2015 from 24-hour recalls, and BMI z-scores were calculated using measured height and weight. These two outcomes were measured at Time 0, Time 1 (10-12 months from Time 0), and Time 2 (15-24 months from Time 0). Results: Compared with children from food-secure households, those from food-insecure households experienced a 0.13 greater increase in BMI z-scores from Time 0 to Time 2 [95% confidence interval (CI): 0.04 to 0.21] and a 4.5 point increase in HEI-2015 from Time 0 to Time 1 (95% CI: 0.99 to 8.01). Conclusion: Household food insecurity may widen weight disparities among elementary school-aged children. Further studies are needed to identify the role of diet quality in weight changes among children with food insecurity. Clinical Trial Registration Number: NCT01538615, NCT02029976, NCT02973815.
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Affiliation(s)
- Jiwoo Lee
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | - Erika Helgeson
- Division of Biostatistics and Health Data Science, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | | | | | - Martha Y Kubik
- School of Nursing, College of Public Health, George Mason University, Fairfax, VA, USA
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Webber-Ritchey KJ, Habtezgi D, Wu X, Samek A. Examining the Association Between Parental Factors and Childhood Obesity. J Community Health Nurs 2023; 40:94-105. [PMID: 36920112 PMCID: PMC10020867 DOI: 10.1080/07370016.2022.2125809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
PURPOSE To examine associations between parent's diet and BMI (body mass index) and child's sedentary behavior and physical activity (PA) with child's BMI. DESIGN A descriptive design. METHODS Study participants were a parent-child dyad in a subsample of families enrolled in Chicago Heights Early Childhood Center. FINDINGS Approximately 80% of parents had a BMI classifying as overweight or obese. Associations between children's sedentary behavior, PA, and BMI were insignificant. CONCLUSIONS Findings highlight the importance of including parents when developing strategies for promoting healthy behavior of children. CLINICAL EVIDENCE Community health nurses are well-positioned to promote healthy behaviors.
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Affiliation(s)
- Kashica J. Webber-Ritchey
- Department: College and Science Health, School of Nursing, Institution: DePaul University, Chicago IL 60614, USA
| | - Desale Habtezgi
- Department: College and Science Health, Mathematical Sciences, Institution: DePaul University, Chicago IL 60614, USA
| | - Xiaoxia Wu
- Department: College and Science Health, Mathematical Sciences, Institution: DePaul University, Chicago IL 60614, USA
| | - Anya Samek
- Department: Rady School of Management, Economics, Institution: University of California San Diego, La Jolla CA 92093, USA
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Whelan JL, Armstrong CL, Schroyer R, O’Neil J. Parent/caregiver's role in nutrition, physical activity, and food access among children diagnosed with spina bifida. J Pediatr Rehabil Med 2023; 16:639-647. [PMID: 38160371 PMCID: PMC10789329 DOI: 10.3233/prm-230016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 11/17/2023] [Indexed: 01/03/2024] Open
Abstract
PURPOSE This pilot study aimed to determine the parent/caregiver's role in nutrition/eating habits, physical activity behaviors, and food access among children diagnosed with spina bifida (SB). METHODS Parents/caregivers of children with SB were asked to participate at a single, outpatient SB clinic. Demographic, biomedical data, parent/caregiver nutrition knowledge, family nutrition and physical activity (FNPA), and food security survey scores were compared. Descriptive, regression, and correlational statistics were conducted for analysis via SPSS 29. RESULTS Of the 117 parents/caregivers surveyed, completed data suggested most were overweight/obese (average body mass index [BMI] of 30.63 kg/m2±8.40; n = 99) with an average nutrition knowledge score of 71% (17.83±3.33). As FNPA scores decreased, the patient/child's maximum BMI z scores increased (β= -0.043; confidence interval -0.079, -0.007; p = 0.020), suggesting the less active and/or less healthy eating habits, the higher body mass was noted for the child. Forty four percent of children (n = 99) were in the overweight/obese weight range based on maximum BMI z score. CONCLUSION These findings suggest there is a need for parental/caregiver nutrition education to assist children with SB with meal and activity planning to achieve optimal health.
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Affiliation(s)
- JoAnne L. Whelan
- Indiana University – Indianapolis, Indianapolis, IN, USA
- Indiana University Health – Riley Hospital for Children, Indianapolis, IN, USA
| | | | - Rebecca Schroyer
- Indiana University Health – Riley Hospital for Children, Indianapolis, IN, USA
| | - Joseph O’Neil
- Developmental Pediatrics, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA
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Agaba M, Azupogo F, Brouwer ID. Maternal nutritional status, decision-making autonomy and the nutritional status of adolescent girls: a cross-sectional analysis in the Mion District of Ghana. J Nutr Sci 2022; 11:e97. [PMID: 36405098 PMCID: PMC9641508 DOI: 10.1017/jns.2022.95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 09/29/2022] [Accepted: 10/04/2022] [Indexed: 11/05/2022] Open
Abstract
A mother's nutritional status and participation in household decision-making, a proxy for empowerment, are known determinants of improved nutrition and health outcomes for infants and young children; however, little is known about the association among adolescents. We examined the association between maternal nutritional status, decision-making autonomy and adolescent girls' nutritional status. We analysed data of 711 mother-adolescent girl pairs aged 10-17 years from the Mion District, Ghana. Maternal nutritional status and decision-making autonomy were the independent variables while the outcomes were adolescent girls' nutritional status as defined by anaemia, stunting and body mass index-for-age Z-score categories. Girl-level (age, menarche status and the frequency of animal-source food consumption), mother-level (age, education level, and monthly earnings) and household-level (wealth index, food security status and family size) covariates were adjusted for in the analysis. All associations were examined with hierarchical survey logistic regression. There was no association between maternal height and adolescent girls being anaemic, underweight or overweight/obese. Increasing maternal height reduced the odds of being stunted [adjusted odds ratio (OR) 0⋅92, 95 % CI (0⋅89, 0⋅95)] for the adolescent girl. Maternal overweight/obesity was positively associated with the girl being anaemic [OR 1⋅35, 95 % CI (1⋅06, 1⋅72)]. The adolescent girl was more than five times likely to be thin [OR 5⋅28, 95 % CI (1⋅64-17⋅04)] when the mother was underweight. Maternal decision-making autonomy was inversely associated with stunting [OR 0⋅88, 95 % CI (0⋅79, 0⋅99)] among the girls. Our findings suggest that intergenerational linkages of a mother's nutritional status are not limited to childhood but also during adolescence.
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Affiliation(s)
- Monicah Agaba
- Wageningen University and Research, 239 Hoevestein, 6708AK Wageningen, The Netherlands
| | - Fusta Azupogo
- Department of Family and Consumer Sciences, Faculty of Agriculture, Food and Consumer Sciences, University for Development Studies, Tamale, Ghana
| | - Inge D. Brouwer
- Division of Human Nutrition, Wageningen University and Research Centre, Stippeneng 4, 6708WE Wageningen, The Netherlands
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Reduced Consumption of Sugar-Sweetened Beverages Is Associated with Lower Body Mass Index Z-Score Gain among Chinese Schoolchildren. Nutrients 2022; 14:nu14194088. [PMID: 36235739 PMCID: PMC9571809 DOI: 10.3390/nu14194088] [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: 08/29/2022] [Revised: 09/21/2022] [Accepted: 09/28/2022] [Indexed: 11/06/2022] Open
Abstract
To examine whether reducing sugar-sweetened beverage (SSB) consumption is associated with reduced body mass index z-score gain among Chinese schoolchildren in Nanjing, China, a randomized controlled trial (RCT) was conducted in four selected primary schools from September 2019 to September 2020. Students in the third grade in the Intervention Group received school-based and home-based interventions for two consecutive semesters to reduce SSB consumption, while two schools in the Control Group did not receive any interventions. Weight changes were expressed as body mass index (BMI) z-scores as standard deviations of the BMI distribution per age and sex group. Changes in SSB consumption before and after the interventions were categorized into Level-Up if it increased, Level-Same if it was maintained and Level-Down if it decreased. Multivariable linear regression models were used to explore the association of different levels of changes in SSB consumption pre- and post-intervention with the BMI z-score. Among 1633 participants who completed the trial, the mean age at baseline was 9.36 years (±0.48 SD).The median baseline BMI z-score was −0.24 (25th percentile −0.72; 75th percentile 0.58). After the intervention, the median BMI z-score increased by 0.06 (−0.17~0.37) in the Intervention Group and by 0.14 (−0.08~0.41) in the Control Group (p < 0.001). A higher increase in BMI was found in the Control Group than in the Intervention Group (1.20 vs. 0.94) during the 12-month period. Among participants whose parents’ educational attainment was above 9 years, the median BMI z-score increased by 0.07 (−0.17~0.37) in the Intervention Group and by 0.16 (−0.06~0.41) in the Control Group (p < 0.001). In a linear regression analysis adjusted for potential confounders, the BMI z-score decreased by 0.057 more in Level-Down than in Level-Up (95% CI: −0.103 to −0.012, p = 0.014). These results indicate that the decreased consumption of SSBs might have reduced the prevalence of overweight in schoolchildren in China, especially in students whose parents had high educational levels.
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Zhang D, Zheng J. The Burden of Childhood Asthma by Age Group, 1990-2019: A Systematic Analysis of Global Burden of Disease 2019 Data. Front Pediatr 2022; 10:823399. [PMID: 35252064 PMCID: PMC8888872 DOI: 10.3389/fped.2022.823399] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 01/21/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Asthma is a common respiratory disease in children. We aimed to update information about the incidence and mortality and disability-adjusted life years (DALYs) of childhood asthma and provide evidence-based recommendations for childhood asthma prevention. METHODS Data were obtained from the Global Burden of Disease (GBD) study, which was conducted from 1990 to 2019 in 204 countries. First, we estimated incidence, mortality and DALY rates of childhood asthma using a Bayesian meta-regression model. Second, we analyzed the relationship between the sociodemographic index (SDI) and DALYs in different age groups. Third, we studied changes in trends of the age-standardized DALY rate between 1990 and 2019 based on age group, SDI, and risk factors. RESULTS Globally, the number of deaths due to childhood asthma and the incidence and DALY rates were 12.9 thousand (95% UI 10.6 to 15.7), 22 million (95% UI 15 to 31), and 5.1 million (95% UI 3.4 to 7.5) in 2019, decreasing by 65.1% (95% UI 47.6 to 72.4), 5.3% (95% UI 2.6 to 8.8) and 30% (95% UI 18 to 41) from those in 1990, respectively. With the exception of high-SDI regions, the age-standardized DALY rate in all age groups in all SDI regions declined. In 2019, the age-standardized DALY rate in 1- to 4-year-old individuals was highest in low-SDI regions and that of 5- to 19-year-old individuals was highest in high-SDI regions. In contrast to low-SDI regions, individuals in high-SDI regions had a higher risk of DALYs due to asthma, except in those aged 1 to 4 years. A high body mass index (BMI) was a stronger risk factor than occupational asthmagens for childhood asthma. CONCLUSION Our findings provide insight into asthma prevention and treatment through the identification of key factors related to childhood asthma. Based on the data available, different risk factors according to age group and region/country suggest different prevention strategies, which is key for preventing childhood asthma.
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Affiliation(s)
- Daoqi Zhang
- Department of Internal Medicine Teaching and Research Section, Xuancheng Vocational and Technical College, Xuancheng, China
| | - Jinxin Zheng
- Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Kharisma FAM, Riolina A. Dietary Pattern in Junior High School Students: Literature Review. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2021. [DOI: 10.29333/ejgm/11320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Jarnig G, Jaunig J, van Poppel MNM. Association of COVID-19 Mitigation Measures With Changes in Cardiorespiratory Fitness and Body Mass Index Among Children Aged 7 to 10 Years in Austria. JAMA Netw Open 2021; 4:e2121675. [PMID: 34436611 PMCID: PMC8391099 DOI: 10.1001/jamanetworkopen.2021.21675] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/12/2021] [Indexed: 01/13/2023] Open
Abstract
Importance Previous studies have shown reductions in self-reported physical activity levels in children associated with implementation of COVID-19 mitigation measures, and data on objectively assessed health parameters are limited. Objective To examine the association of COVID-19 mitigation measures with changes in cardiorespiratory fitness (CRF) measures and body mass index (BMI) among primary schoolchildren. Design, Setting, and Participants This cohort study included children aged 7 to 10 years from 12 randomly selected primary schools in urban and rural districts of Klagenfurt, Austria. Baseline CRF and BMI measurements were obtained in September 2019 before COVID-19 mitigation measures were implemented, and follow-up measurements were obtained in June and September 2020. Exposures COVID-19 mitigation measures. Main Outcomes and Measures Cardiorespiratory fitness was measured with a 6-minute endurance run test. Height and weight were objectively measured. Standard deviation scores were calculated for CRF and BMI. Changes over time were analyzed using analyses of variance. Secondary analyses were performed for subgroups stratified by sex. Results A total of 764 children (383 girls [50.1%]) aged 7 to 10 years had all measurements completed. From September 2019 to September 2020, CRF SD scores changed by -1.06 (95% CI, -1.13 to -1.00), with a similar decrease in both boys and girls. Body mass index SD scores had increased by 0.12 (95% CI, 0.06-0.16) in June 2020 and by 0.16 (95% CI, 0.12-0.20) in September 2020 compared with September 2019. The increase in BMI SD scores (from September 2019 to September 2020) was greater among boys (0.23; 95% CI, 0.18-0.29) than among girls (0.09; 95% CI, 0.04-0.15). During the 1-year period, the percentage of children with overweight or obesity increased from 20.3% (155 children) to 24.1% (184 children) (difference, 3.8% [29 children]). Conclusions and Relevance In this cohort study of children in Austria, COVID-19 mitigation measures were associated with decreases in CRF measures and increases in BMI. The findings suggest that collaborative efforts are needed to reverse these changes in children's health to prevent long-term negative health outcomes.
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Affiliation(s)
- Gerald Jarnig
- Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Johannes Jaunig
- Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
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Conrad Z, Hatfield DP, Hennessy E, Maneval E, Ty E, Pankey CL. Evaluating Moderation of Parent-Teen Overweight/Obesity Relation by Household Socioeconomic Status. Curr Dev Nutr 2021; 5:nzab030. [PMID: 33959690 PMCID: PMC8085476 DOI: 10.1093/cdn/nzab030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/24/2021] [Accepted: 03/31/2021] [Indexed: 12/15/2022] Open
Abstract
Evidence links parent-offspring weight status, but few studies have evaluated whether markers of socioeconomic status moderate this relation. The 2014 Family Life, Activity, Sun, Health, and Eating study was used to assess intergenerational weight status in a national sample of parent-teen dyads. Multivariable logistic regression models assessed the relation between parent-teen weight status, controlling for teen and parent dietary factors, physical activity, demographic factors, and socioeconomic factors. Models with interaction assessed moderation by household food security status and participation in federal assistance programs. In fully adjusted models, sons were 2.66 (95% CI: 1.56, 4.55) times more likely to have overweight/obesity if their mother had overweight/obesity, and daughters were 3.35 (95% CI: 1.91, 5.86) times more likely. This relation was stronger in mother-son pairs in households with lower food security. These findings provide important new information that can be used to inform nutritional counseling efforts and educational programs that support families with socioeconomic disadvantage.
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Affiliation(s)
- Zach Conrad
- Department of Health Sciences, William & Mary, Williamsburg, VA, USA
| | - Daniel P Hatfield
- Division of Nutrition Interventions, Communication and Behavior Change, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- ChildObesity180, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Erin Hennessy
- Division of Nutrition Interventions, Communication and Behavior Change, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- ChildObesity180, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | | | - Esther Ty
- College of Arts & Sciences, William & Mary, Williamsburg, VA, USA
| | - Christopher L Pankey
- Department of Biomedical Sciences, West Virginia School of Osteopathic Medicine, Lewisburg, WV, USA
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