Sedentary behaviors, physical activity behaviors, and body fat in 6-year-old children: the generation R study

Tri-axial accelerometer-assessed physical activity and its association with weight status in a sample of elementary-school children

BACKGROUND AND AIMS

Objective assessment of physical activity (PA) using accelerometers and pedometers has become more accurate and common practice in the study of childhood overweight. The study aimed: i) to compare PA levels and body shape of boys and girls, and assess compliance of active children with the PA recommendation; ii) to analyse associations between the risk of overweight and the moderate-to-vigorous physical activity (MVPA) in children.

METHODS

The sample comprised 395 children (198 girls) aged 6-10 years. Height and weight were measured, and BMI was calculated subsequently. A tri-axial accelerometer was used to obtain seven consecutive days of MVPA, as well as the weekly time being sedentary. Logistic regression analysis was used to examine the afore-mentioned relationship among the risk of obesity and MVPA, controlling for confounders.

RESULTS

After controlling for wearing time, boys spent significantly more minutes in the moderate-to-vigorous portion of PA than their female counterparts. About 47% of boys were active on week days by achieve the mean value of 60 min/day of MVPA; corresponding percentage for the weekend was just 32%. Among girls, only 22% were active on week days and 29% at the weekend. MVPA was not significantly associated with the risk of being overweight nor in female neither in male children. The final regression model revealed that girls of mothers with high educational level were less likely to be classified as overweight girls.

CONCLUSIONS

Findings revealed no significantly relation between MVPA and obesity risk among Portuguese children. Future research should extend similar design to other lifestyle features of children to clarify potential predictors of being overweight at early ages.

Physical activity and adiposity in preschool children: The Barwon Infant Study

BACKGROUND

The association between physical activity and adiposity in preschool-aged children is unclear.

OBJECTIVE

To assess the cross-sectional association between objectively measured physical activity and body fat in preschool-aged children.

METHODS

In the preschool review in an Australian birth cohort study (n = 1074), mean duration and time accumulated in ≥1-min bouts of physical activity at light-intensity (LPA), moderate- to vigorous-intensity (MVPA) and light- to vigorous-intensity (LMVPA) were computed from accelerometer (ActiGraph GT3X+) data. Percent body fat was assessed by bioelectrical impedance. Associations between physical activity and percent body fat were examined by multiple regression, adjusted for accelerometer wear time, MVPA (in analyses of LPA), maternal body mass index (BMI) and maternal education.

RESULTS

A total of 450 participants (n = 450) had valid data. There was evidence of associations between physical activity and adiposity: each additional hour of LVPA was associated with 0.6% (CI₉₅ -0.2%, 1.3%) higher body fat; ≥1-min bouts of LPA was associated with 1.0% (CI₉₅ 0.1%, 1.9%) higher body fat; each additional hour of MVPA was associated with -0.8% (CI₉₅ -1.6%, -0.1%) less body fat; and ≥1-min bouts of MVPA was associated with -1.3% (CI₉₅ -2.5%, -0.1%) body fat.

CONCLUSIONS

Among a cohort of preschool-aged children, there was evidence that more intensive physical activity assessed by an accelerometer is associated with reduced body fat.

Assessment of the influence of physical activity and screen time on somatic features and physical fitness in 6 to 7-year-old girls

Aim of the study is to assess the relationship between screen time, physical activity and physical fitness among girls 6–7 years-old.

21,528 girls aged 6 and 7 from Poland were assessed in terms of physical fitness. Arm strength, abdominal strength and explosive strength of the lower limbs were measured using the EUROFIT test. Basic somatic features were measured and BMI and WHtR indices were calculated. Spontaneous and organized physical activities as well screen time were assessed by the parents utilizing a questionnaire. The multiple logistic regression method was used to evaluate the influence of screen time and spontaneous physical activity on various components of physical fitness.

Physically active (PA) girls (≥1h/day) and those who participated in additional physical activities (APA) during the week had significantly higher height, weight, and BMI (p<0.001), but not WHtR. They had a higher level of flexibility, explosive strength of the lower limbs and arm strength (p<0.001). With an increase in screen time, the BMI, WHtR increased significantly and explosive strength of the lower limbs, abdominal strength and arm strength were lower. Regression analysis showed that more frequent participation in extracurricular activities increased the values of BMI and WHtR in quartile 4 (Q4), and strength components: Q2–Q4 (p<0.05). Spontaneous physical activity was positively related to the values of BMI, WHtR (both: Q4; p<0.05), explosive force of lower limbs (Q3–Q4; p=0.001), and negatively related to arm strength (Q2; p=0.001). Screen time (≥2hrs/day) increased odds for higher BMI values (p<0.05). Each screen time category decreased the odds of achieving abdominal muscle strength related to the quartiles: Q2–Q4 (p<0.05), arm strength (Q4: p<0.05). ST (1 <2hrs/day) decreased arm strength (Q3; p= 0.045). Our research has shown that screen time-related sedentary behavior and physical activity affect overweight and obesity indices (especially BMI) and strength abilities. The observed associations more often affected girls with a higher level of fitness The results observed in girls aged 6-7 indicate a need for early intervention aimed at limiting time spent watching TV and computer use, as well as to encourage both spontaneous and organized physical activities.

High-intensity Interval Training Improves Inflammatory Mediators in Obese Women: Based on the Study of the UCP2 Ala55Val Gene

Background: Increased inflammatory mediators in obesity are associated with metabolic syndrome. Exercise is an effective effort to reduce the incidence of obesity. The High-Intensity Interval Training (HIIT) program is an exercise which include combination of high-intensity exercise and rest periods. The decrease in body fat levels due to physical training will further affect inflammatory mediators such as IL6 and TNFα. Besides training factor, genetic also play a role on obesity. One of the genes that influence obesity is the UCP2 Ala55Val gene. Objectives: This research aims to see the effect of HIIT on the levels of inflammatory mediators in obese patients based on the study of the Ala55Val UCP2 gene. Methods: This study was a Quasi-Experimental Pre and Post Design Without Control Group. Thirty obese women (BMI≥25 kg/m2) were given High-Intensity Interval Training (HIIT) as an intervention by comparing the data before and after the intervention. The training intervention was conducted for 12 weeks, consisting of two weeks of adaptation and ten weeks of HIIT intervention. The body weight, BMI and inflammatory mediators (TNFα and IL 6) before and after the intervention were analyzed using the Dependent T-Test and Wilcoxon Test as a nonparametric test. Independent T-Test and Mann Whitney test used to determine the effect of the UCP2 Ala55Val gene on changes in body weight, BMI and the inflammatory mediator. The test results were considered significantly different if p<0.05. Results: Bivariate analysis using Dependent T-Test showed that HIIT significantly improved Body Weight, BMI and IL6 with p=0.0001. Wilcoxon Test showed that HIIT significantly improved TNFα with p=0.0001. Independent T-Test showed no difference in body weight (p=0.719), BMI (p=0.663) and TNFα (p=0.264) improvement in the two genotypes of the UCP2 Ala55Val gene. Mann Whitney Test showed no difference in IL6 (p=0.288) improvement in the two genotypes of the UCP2 Ala55Val gene. Conclusion: The research concluded that the 12-week HIIT interventions improved inflammatory mediators by reducing IL6 and TNFα in obese women. There was no effect of genetic variation on the response to training intervention.

Dexamethasone-induced sarcopenia and physical frailty in children with acute lymphoblastic leukemia: Protocol for a prospective cohort study (Preprint)

Background

During treatment for pediatric acute lymphoblastic leukemia (ALL), children receive high doses of dexamethasone for its apoptotic effect on leukemia cells; however, muscle atrophy is a well-known serious side effect. Muscle atrophy (loss of muscle mass) accompanied by a decreased muscle strength may lead to a generalized impaired skeletal muscle state called sarcopenia. Loss of muscle mass is also an indicator of physical frailty, which is defined as a state of increased vulnerability that is characterized by co-occurrence of low muscle mass, muscle weakness, fatigue, slow walking speed, and low physical activity. Both sarcopenia and physical frailty are related to an increased risk of infections, hospitalizations, and decreased survival in children with chronic diseases.

Objective

This study aims to (1) estimate the occurrence of sarcopenia and physical frailty in children during ALL maintenance therapy, (2) evaluate the effect of administering dexamethasone, and (3) explore determinants associated with these outcomes.

Methods

This prospective study is being pursued within the framework of the DexaDays-2 study: a randomized controlled trial on neurobehavioral side effects in pediatric patients with ALL. A total of 105 children (3-18 years) undergoing ALL maintenance treatment at the Princess Máxima Center for Pediatric Oncology are included in this study. Sarcopenia/frailty assessments are performed before and just after a 5-day dexamethasone course. A subset of 50 children participating in the DexaDays-2 trial because of severe dexamethasone-induced neurobehavioral problems were assessed at 3 additional timepoints. The sarcopenia/frailty assessment consists of bioimpedance analysis (skeletal muscle mass [SMM]), handheld dynamometry (handgrip strength), Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (fatigue), Timed Up and Go Test (TUG; walking speed), and physical activity questionnaires. To evaluate potential change in sarcopenia/frailty components after a 5-day dexamethasone administration, a paired Student t test or Mann-Whitney U test will be used. Because of the presence of repeated measurements, generalized linear mixed models will be used to estimate the effect of dexamethasone on sarcopenia and frailty outcomes. Multivariable regression models will be estimated to investigate associations between the assessment scores and patient and treatment-related factors.

Results

Patient accrual started in 2018 and was finalized in spring 2021. From autumn 2021 onward final data analyses will be performed.

Conclusions

This first study combining parameters of sarcopenia and physical frailty is of importance because these conditions can seriously complicate continuation of ALL therapy, independence in physical functioning, reaching motor milestones, and participating in daily life activities. The results will provide knowledge about these complications, the association between dexamethasone treatment and muscle loss and other components of frailty, and therefore insights into the severity of this side effect. By exploring potential determinants that may be associated with sarcopenia and physical frailty, we may be able to identify children at risk at an earlier stage and provide timely interventions.

International Registered Report Identifier (IRRID)

DERR1-10.2196/33517

Physical and Sedentary Activities and Childhood Overweight/Obesity: A Cross-Sectional Study among First-Year Children of Primary Schools in Modena, Italy

Children obesity is a serious public health issue. This study aimed to investigate physical/sedentary activities of first-year primary schools children in Modena, and their association with overweight/obesity and dietary habits of children and family characteristics to identify the risk factors for unhealthy lifestyles. Child physical/sedentary activities were gathered through an anonymous questionnaire administered to parents, as well as family characteristics and weight/height of child and parents. Logistic regression models, eventually adjusted for parents' sociodemographic characteristics, were used to analyze data. Questionnaires were delivered by 660 families (74.2%), of which 72 without anthropometric data were excluded. Three out of four children spent in physical activities less than 7 h/week, while 63.9% dedicated to sedentary activities two or more hours/day. From multivariate analysis, the habit significantly affecting children's overweight/obesity was spending time on tablets/Personal Computers/mobile phones/videogames. Higher parental education level resulted in a protective factor for implementing unhealthy lifestyles in terms of time dedicated to physical/sedentary activities. Our results suggest the need of interventions to increase time for physical activity and to promote a responsible use of digital media involving the entire families to reach all parents regardless of their education and nationality with a possible relapse on other family members.

Changes in physical activity behavior and development of cardiovascular risk in children

The study aimed to investigate the association of changes in physical activity, screen time, and cardiorespiratory fitness (CRF) with development of body mass index (BMI), blood pressure (BP), and retinal microvascular health in children over four years. In 2014, 391 children aged 6-8 years were screened, and thereof 262 children were reexamined after four years following standardized protocols. Retinal arteriolar (CRAE) and venular diameters were measured by a retinal vessel analyzer. CRF was objectively assessed by a 20 m shuttle run, physical activity, and screen time by use of a questionnaire. Children who achieved higher CRF levels reduced their BMI (β [95% CI] -0.35 [-0.46 to -0.25] kg/m² per stage, P ≤ .001) and thereby developed wider CRAE (β [95% CI] 0.25 [0.24 to 0.48] µm per stage, P = .03) at follow-up. Moreover, children with elevated or high systolic BP at baseline, but lower levels of screen time during the observation period, had wider CRAE at follow-up (β [95% CI] -0.37 [-0.66 to -0.08] µm per 10 min/d, P = .013). Change in CRF was not directly associated with better microvascular health at follow-up. However, an increase of CRF over four years was associated with a reduced BMI and consequently wider retinal arterioles at follow-up. In children with elevated or high systolic BP, a reduction of screen time significantly improved retinal microvascular health as a primary prevention strategy to promote childhood health and combat development of manifest CV disease later in life.

A cross-sectional study using the Childhood Measurement Programme for Wales to examine population-level risk factors associated with childhood obesity

OBJECTIVE

The aim of this cross-sectional study was to examine the association between childhood obesity and modifiable population-level risk factors, after accounting for deprivation.

DESIGN

A review of the literature identified population-level risk factors including a healthy childcare setting, the local food environment, accessible open space, community safety and crime. Data for these risk factors were then identified and matched by each of the twenty-two local government areas in Wales to each child that had data on height and weight in the Wales Childhood Measurement Programme (CMP) (2012-2017). Multivariable logistic regression was used to identify associations with childhood obesity.

SETTING

The current study was undertaken in Wales, UK, where approximately one in eight 4-5-year-olds are classified as obese.

PARTICIPANTS

All participants were children aged 4 or 5 years who attend school, measured as part of the CMP, between 2012 and 2017 (n 129 893, mean age 5·0 (sd 0·4) years).

RESULTS

After adjusting for deprivation, small but statistically significant associations were found between childhood obesity and percentage of land available as accessible open space OR 0·981 (95 % CI: 0·973, 0·989) P < 0·001) and density of fast food outlets OR 1·002 (95 % CI 1·001, 1·004, P = 0·001). No other population-level risk factors were associated with childhood obesity.

CONCLUSIONS

The current study indicates that, even after accounting for deprivation, risk factors such as the density of fast food outlets and access to green space should be considered when tackling childhood obesity as a public health issue.

Estimating Reductions in Ethnic Inequalities in Child Adiposity from Hypothetical Diet, Screen Time, and Sports Participation Interventions

BACKGROUND

Childhood obesity is a global epidemic, and its prevalence differs by ethnicity. The objective of this study was to estimate the change in ethnic inequalities in child adiposity at age 10 resulting from interventions on diet at age 8 and screen time and sports participation at age 9.

METHODS

We conducted a population-based cohort study, the Generation R Study, from 9,749 births in Rotterdam (2002-2006), of which 9,506 children remained in the analysis. We measured ethnicity, diet, screen time, and sports participation through questionnaires; we measured weight, body mass index (BMI), fat mass index, and fat-free mass index directly. We used sequential G-estimation to estimate the reduction in inequality that would result from the interventions.

RESULTS

We observed that sociodemographic characteristics, diet, screen time, sports participation, and all adiposity measurements were more favorable in children from Western versus non-Western ethnic backgrounds: weight = -1.2 kg (95% confidence interval [CI] = -1.7, -0.8), BMI = -1.0 kg/m (CI = -1.2, -0.9), and fat mass index = -0.8 kg/m (CI = -0.9, -0.7). We estimated that extreme intervention (maximum diet score of 10, no screen time, and >4 hours/week of sports) reduced ethnic inequalities by 21% (CI = 8%, 35%) for weight, 9% (CI = 4%, 14%) for BMI, and 9% (CI = 6%, 13%) for fat mass index. A diet score ≥5 points, screen time ≤2 hours/day, and sports participation >2 hours/week reduced ethnic inequalities by 17% (CI = 6%, 28%) for weight, 7% (CI = 3%, 11%) for BMI, and 7% (CI = 4%, 10%) for fat mass index.

CONCLUSIONS

Our results are consistent with the hypothesis that interventions integrating diet, screen time, and sports participation have a moderate impact on reducing ethnic inequalities in child adiposity.

Video Games, Obesity, and Children

PURPOSE OF REVIEW

To examine associations between video game play and obesity in children.

RECENT FINDINGS

Based on a scoping review of 26 studies (25 cross-sectional; 1 longitudinal) published in 2013-2018, 14 studies (53%) reported no association between video game play and obesity, and 12 studies reported positive associations. In a review of 8 systematic reviews, there was preliminary evidence on the effectiveness of exergame (physically active) play for weight reduction and to attenuate weight gain but little indication that interventions effectively reduced video game play or general screen time. This review found ambiguous evidence on the extent to which video game play is or is not significantly associated with obesity in children and preliminary evidence of exergame play as a tool for weight reduction and attenuation of weight gain. Several gaps existed in understanding the relationship between video game play and obesity, and prospective and interventional trials are needed.

Musculoskeletal pain in 6-year-old children: the Generation R Study

Musculoskeletal (MSK) pain is frequently reported among adolescents and children and is a common reason for consultation in primary care. Our aim is to examine its prevalence in 6-year-old children in a general population and to assess associations with physical and psychosocial factors. Data from the Generation R Study, a population-based cohort, was used. Prevalence and characteristics of MSK pain were assessed with parent-reported questionnaires at 6 years of age (N = 6200). Demographics and data on physical activity, sedentary behaviors, previous reported MSK pain, and behavioral problems were extracted from questionnaires. The body mass index SD score was calculated from objectively measured weight and height. A 3-month prevalence of 10.0% was found for MSK pain in children, of which one-third was chronic, and 44.6% experienced together with pain at other sites. Univariate analyses showed that boys and children with lower socioeconomic status reported MSK pain more frequently compared to other pain and no pain. Although no associations were found between MSK pain and children's body mass index and physical activity level, children with MSK pain were more likely to watch television ≥2 hours/day. Multivariable analysis showed significant associations for MSK pain at 3 years of age (odds ratio 5.10, 95% confidence interval 3.25-7.98) and behavioral problems (odds ratio 2.10, 95% confidence interval 1.19-3.72) with the presence of MSK pain. So, MSK pain is already common in young children and is often chronic or recurrent. Previous reported MSK pain and behavioral problems are independently associated with MSK pain in the studied population.

Sociodemographic Differences in Young Children Meeting 24-Hour Movement Guidelines

BACKGROUND

Little is known about variation in meeting the 24-Hour Movement Guidelines (including physical activity [PA], sleep, and screen time [ST]) in early childhood. The aim was to evaluate sociodemographic differences in meeting the 24-Hour Movement Guidelines.

METHODS

Parents of 3-4 year old children reported sociodemographic information and ST. Sleep and PA were measured using accelerometry, and height and weight were objectively measured. The 24-Hour Movement Guidelines include daily PA (total PA: ≥3 h; including ≥1 h of moderate to vigorous), sleep (10-13 h), and ST (≤1 h). Meeting guidelines by age, sex, race, poverty level, and weight status were assessed using chi-square and linear regression models.

RESULTS

Of 107 children, 57% were white and 26% lived in households at or below the poverty level. Most children met the PA (91.5%) and sleep (86.9%) guidelines, but few met ST (14.0%) or all 3 (11.3%) guidelines. African American children and children who lived at or below the poverty level were less likely to meet the sleep, ST, and all 3 guidelines compared with others (P < .01 for all). There were no other differences.

CONCLUSION

These results suggest future interventions should focus on reducing differences in movement, namely in sleep and ST.

Exploring the myth of the chubby gamer: A meta-analysis on sedentary video gaming and body mass

RATIONALE

High body mass and obesity are frequently linked to the use of sedentary media, like television (TV) or non-active video games. Empirical evidence regarding video gaming, however, has been mixed, and theoretical considerations explaining a relationship between general screen time and body mass may not generalize to non-active video gaming.

OBJECTIVE

The current meta-analysis had two main goals. First, we wanted to provide an estimate of the average effect size of the relationship between sedentary video gaming and body mass. In doing so we acknowledged several context variables to gauge the stability of the average effect. Second, to provide additional evidence on processes, we tested the displacement effect of physical activity by video gaming time with the help of a meta-analytic structural equation model (MASEM).

METHOD

Published and unpublished studies were identified through keyword searches in different databases and references in relevant reports were inspected for further studies. We present a random-effects, three-level meta-analysis based on 20 studies (total N = 38,097) with 32 effect sizes.

RESULTS

The analyses revealed a small positive relationship between non-active video game use and body mass, ρˆ=.09, 95% CI [0.03, 0.14], indicating that they shared less than 1% in variance. The studies showed significant heterogeneity, Q (31) = 593.03, p < .001, I² = 95.13. Moderator analyses revealed that the relationship was more pronounced for adults, ρˆ=.22, 95% CI [0.04, 0.40], as compared to adolescents, ρˆ=.01, 95% CI [-0.21, 0.23], or children, ρˆ=.09, 95% CI [-0.07, 0.25]. Meta-analytic structural equation modeling found little evidence for a displacement of physical activity through time spent on video gaming.

CONCLUSION

These results do not corroborate the assumption of a strong link between video gaming and body mass as respective associations are small and primarily observed among adults.

Femoral stress is prominently associated with fracture risk in children: The Generation R Study

Bone modeling is an important process in the growing skeleton. An inadequate bone modeling in response to mechanical loads would lead some children to develop weaker bones than others. The resulting higher stresses in the bones would render them more susceptible to fracture. We aimed to examine the association between femoral stress (FS) derived from structural parameters and BMD in relation to incident fractures in children. Bone stress was evaluated at the medial femoral neck, a skeletal site subject to large forces during normal locomotion. This study comprises 1840 children from the Generation R Study, with whole body and hip DXA scans at a mean age of 6.01 years. Hip structural analysis (HSA) was used to measure femur geometry for the FS calculation. Data on fractures occurring over the following 4 years after the DXA assessment were obtained by questionnaire. Incident fracture was observed in 7.6% of the participating children. Cox-multivariate regression analysis, described as hazard ratios (HR), showed that after adjustment for sex, ethnicity, age, weight and lean mass fraction, there was a significant increase in the risk of incident fracture for every standard deviation (SD) decrease in total body BMD (HR: 1.35, 95% CI 1.05-1.74, p-value = 0.021), femoral neck BMD (HR: 1.31, 95% CI 1.09-1.58, p-value = 0.005) and narrow neck BMD (HR: 1.39, 95% CI 1.14-1.68, p-value = 0.001). Whereas, every increment of one SD in femoral stress resulted in 1.33 increased risk of incident fractures (HR: 1.33, 95% CI 1.13-1.57, p-value = 0.001). This association remained (borderline) significant after the adjustment for DXA derived BMD measurements. Our results show that increased bone stress may underlie greater susceptibility to traumatic fractures in children (partially independent of BMD) and underscore the utility of hip DXA scans for the assessment of paediatric bone health and specifically fracture risk.

Association of Blood Pressure and Arterial Stiffness With Cognition in 2 Population-Based Child and Adult Cohorts

Background High blood pressure levels and higher arterial stiffness have been shown to be associated with lower cognition during adulthood, possibly by accumulative changes over time. However, vascular factors may already affect the brain during early life. Methods and Results We examined the relation between cognition and vascular factors within 5853 children from the Generation R Study (mean age 6.2 years) and 5187 adults from the Rotterdam Study (mean age 61.8 years). Diastolic and systolic blood pressure and arterial stiffness were assessed, the latter by measuring pulse-wave velocity and pulse pressure. For cognition, the Generation R Study relied on nonverbal intelligence, whereas the Rotterdam Study relied on a cognitive test battery to calculate the g-factor, a measure of global cognition. In the Generation R Study, standardized diastolic blood pressure showed a significant association with standardized nonverbal intelligence (β=-0.030, 95% confidence interval=[-0.054; -0.005]) after full adjustment. This association held up after excluding the top diastolic blood pressure decile (β=-0.042 [-0.075; -0.009]), suggesting that the relation holds in normotensives. Within the Rotterdam Study, standardized cognition associated linearly with standardized systolic blood pressure (β=-0.036 [-0.060; -0.012]), standardized pulse-wave velocity (β=-0.064 [-0.095; -0.033]), and standardized pulse pressure (β=-0.044 [-0.069; -0.020], and nonlinearly with standardized diastolic blood pressure (quadratic term β=-0.032 [-0.049; -0.015]) after full adjustment. Conclusions Blood pressure and cognition may already be related in the general population during early childhood, albeit differently than during adulthood.

A scoping review of epidemiologic risk factors for pediatric obesity: Implications for future childhood obesity and dental caries prevention research

RESEARCH QUESTIONS

What are the non-modifiable (socioeconomic, genetic) and modifiable factors (physical activity, dietary behaviors) related to childhood (under age 12) obesity? How can this knowledge be applied to oral health professionals' efforts to prevent or manage dental caries in children?

OBJECTIVES

Studies have identified risk factors for childhood obesity. The purpose of this scoping review was to develop a conceptual model to identify non-modifiable and modifiable risk factors for childhood obesity and to illustrate how these findings are relevant in developing interventions aimed at preventing obesity and dental caries in children.

METHODS

The authors searched PubMed and Embase and limited the study to English-language publications. A total of 2,572 studies were identified. After de-duplication, 2,479 studies remained and were downloaded into a citation-management tool. Two authors screened the titles and abstracts for relevance. Two hundred and sixty studies remained and were retrieved for a full-text review, and 80 studies were excluded, resulting in 180 studies included in the scoping review. An inductive content analytic methods was used to organize all statistically significant obesity risk factors into seven domains, which were classified as non-modifiable or modifiable; then a conceptual model of common risk factors associated with childhood obesity and dental caries was developed.

RESULTS

Non-modifiable obesity risk factors include biological and developmental (e.g., genes, developmental conditions, puberty), sociodemographic and household (e.g., race/ethnicity, socioeconomic status, parent education, unemployment), cultural (e.g., degree of acculturation), and community (e.g., neighborhood composition). Modifiable risk factors included behavioral (e.g., diet, physical activity, weight), psychosocial (e.g., maternal stress, family functioning, parenting practices, child temperament), and medical (e.g., parent smoking, maternal health, child health).

CONCLUSIONS

Identifying common risk factors has important implications for future oral health research aimed at preventing childhood obesity and dental caries. Epidemiologic knowledge gleaned from the literature can be used to develop rigorous interventions and programs aimed at preventing these highly prevalent diseases and improving health outcomes for children.

Active transport and obesity prevention - A transportation sector obesity impact scoping review and assessment for Melbourne, Australia

Given the alarming prevalence of obesity worldwide and the need for interventions to halt the growing epidemic, more evidence on the role and impact of transport interventions for obesity prevention is required. This study conducts a scoping review of the current evidence of association between modes of transport (motor vehicle, walking, cycling and public transport) and obesity-related outcomes. Eleven reviews and thirty-three primary studies exploring associations between transport behaviours and obesity were identified. Cohort simulation Markov modelling was used to estimate the effects of body mass index (BMI) change on health outcomes and health care costs of diseases causally related to obesity in the Melbourne, Australia population. Results suggest that evidence for an obesity effect of transport behaviours is inconclusive (29% of published studies reported expected associations, 33% mixed associations), and any potential BMI effect is likely to be relatively small. Hypothetical scenario analyses suggest that active transport interventions may contribute small but significant obesity-related health benefits across populations (approximately 65 health adjusted life years gained per year). Therefore active transport interventions that are low cost and targeted to those most amenable to modal switch are the most likely to be effective and cost-effective from an obesity prevention perspective. The uncertain but potentially significant opportunity for health benefits warrants the collection of more and better quality evidence to fully understand the potential relationships between transport behaviours and obesity. Such evidence would contribute to the obesity prevention dialogue and inform policy across the transportation, health and environmental sectors.

Systematic review of sedentary behaviour and health indicators in school-aged children and youth: an update

This systematic review is an update examining the relationships between objectively and subjectively measured sedentary behaviour and health indicators in children and youth aged 5–17 years. EMBASE, PsycINFO, and Medline were searched in December 2014, and date limits were imposed (≥February 2010). Included studies were peer-reviewed and met the a priori-determined population (apparently healthy children and youth, mean age: 5–17 years), intervention (durations, patterns, and types of sedentary behaviours), comparator (various durations, patterns, and types of sedentary behaviours), and outcome (critical: body composition, metabolic syndrome/cardiovascular disease risk factors, behavioural conduct/pro-social behaviour, academic achievement; important: fitness, self-esteem) study criteria. Quality of evidence by outcome was assessed using the Grading of Recommendations Assessment, Development, and Evaluation framework. Due to heterogeneity, a narrative analysis was conducted. A total of 235 studies (194 unique samples) were included representing 1 657 064 unique participants from 71 different countries. Higher durations/frequencies of screen time and television (TV) viewing were associated with unfavourable body composition. Higher duration/frequency of TV viewing was also associated with higher clustered cardiometabolic risk scores. Higher durations of TV viewing and video game use were associated with unfavourable behavioural conduct/pro-social behaviour. Higher durations of reading and doing homework were associated with higher academic achievement. Higher duration of screen time was associated with lower fitness. Higher durations of screen time and computer use were associated with lower self-esteem. Evidence ranged from “very low” to “moderate” quality. Higher quality studies using reliable and valid sedentary behaviour measures should confirm this largely observational evidence.