Sedentary behavior during leisure time, physical activity and dietary habits as risk factors of overweight among school children aged 14-15 years: case control study

Seafood intake in childhood/adolescence and the risk of obesity: results from a Nationwide Cohort Study

BACKGROUND & AIMS

Obesity has been linked to various detrimental health consequences. While there is established evidence of a negative correlation between seafood consumption and obesity in adults, the current research on the association between seafood intake in childhood/adolescence and the risk of obesity is lacking. Our aim was to evaluate the association between seafood intake in childhood/adolescence and the risk of obesity in a Chinese nationwide cohort.

METHODS

We utilized data from the China Health and Nutrition Survey (CHNS) from the year of 1997 to 2015. Seafood consumption was evaluated through 3-day 24-hour recalls. In our study, overweight/obesity status was determined based on the Chinese Criteria of Overweight and Obesity in School-age Children and Adolescents (WS/T 586-2018), while abdominal obesity status was determined according to the Chinese Criteria of Waist Circumference Screening Threshold among Children and Adolescents (WS/T 611-2018).

RESULTS

During an average follow-up of 7.9 years, 404 cases developed overweight/obesity among 2206 participants in the seafood-overweight/obesity analysis, while 381 cases developed abdominal obesity among 2256 participants in the seafood-abdominal-obesity analysis. The high-consumer group was associated with 35% lower risk of overweight/obesity risk and 26% lower risk of abdominal obesity after fully adjusting for sociodemographic and lifestyle factors, compared with the non-consumer group. Considering different cooking methods, boiled seafood consumption was associated with 43% lower risk of overweight/obesity and 23% lower risk of abdominal obesity in the fully adjusted model, while stir-fried seafood did not demonstrate a statistical significance.

CONCLUSION

Higher intake of seafood in childhood/adolescents, particularly in a boiled way, was associated with lower obesity risk.

Prevalence and associated factors of overweight in Chinese adolescents: A cross-sectional study

Background and Aim

Obesity has been a global public health issue due to the increasing mortality rate and prevalence among children. However, there are scarce studies on obesity prevalence in Hong Kong children. The study aims to identify the risk factors of obesity among primary and secondary school students by assessing the relationship between sociodemographic factors, health-related behaviors, and social relationships.

Methods

Self-administrated surveys were collected from 30 primary schools and 25 secondary schools participating in the "Quality Education Fund Thematic Network on Health Schools" project. Descriptive analysis was conducted to examine the proportions of different characteristics and to compare the disparity between primary and secondary school students with obesity.

Results

A total of 4884 responses were collected. A larger proportion of primary school students with obesity were male (adjusted odds ratio [aOR]: 2.55, 95% confidence interval [CI]: 1.77-3.67, p < 0.001) and actively gamed (aOR: 1.64, 95% CI: 1.07-2.51, p = 0.024). Secondary school students with obesity were male (aOR: 1.61, 95% CI: 1.21-2.13, p = 0.001), had poor self-perceived academic performance (aOR:1.51, 95% CI: 1.10-2.08, p = 0.011) and expressed higher life satisfaction (family) (aOR: 1.13, 95% CI: 1.01-1.26, p = 0.032). There were negative associations found between obesity and physical activity, high consumption of sugary drinks, chocolate or candies, and insufficient consumption of vegetables.

Conclusion

Male sex, physical inactivity, low self-perecived academic performance, and poor dietary behaviors were the risk factors for obesity among primary and secondary school students. The findings highlighted the importance of identifying younger individuals who were at risk of becoming clinically obese. Further studies should explore the effectiveness of various interventions through longitudinal study.

Childhood Obesity and Its Comorbidities in High-Risk Minority Populations: Prevalence, Prevention and Lifestyle Intervention Guidelines

The prevalence of childhood obesity and its associated comorbidities is a growing global health problem that disproportionately affects populations in low- and middle-income countries (LMICs) and minority ethnicities in high-income countries (HICs). The increased childhood obesity disparities among populations reflect two concerns: one is HICs' ineffective intervention approaches in terms of lifestyle, nutrition and physical activity in minority populations, and the second is the virtually non-existent lifestyle obesity interventions in LMICs. This article provides guidelines on childhood obesity and its comorbidities in high-risk minority populations based on understanding the prevalence and effectiveness of preventative lifestyle interventions. First, we highlight how inadequate obesity screening by body mass index (BMI) can be resolved by using objective adiposity fat percentage measurements alongside anthropometric and physiological components, including lean tissue and bone density. National healthcare childhood obesity prevention initiatives should embed obesity cut-off points for minority ethnicities, especially Asian and South Asian ethnicities within UK and USA populations, whose obesity-related metabolic risks are often underestimated. Secondly, lifestyle interventions are underutilised in children and adolescents with obesity and its comorbidities, especially in minority ethnicity population groups. The overwhelming evidence on lifestyle interventions involving children with obesity comorbidities from ethnic minority populations shows that personalised physical activity and nutrition interventions are successful in reversing obesity and its secondary cardiometabolic disease risks, including those related to cardiorespiratory capacity, blood pressure and glucose/insulin levels. Interventions combining cultural contextualisation and better engagement with families are the most effective in high-risk paediatric minority populations but are non-uniform amongst different minority communities. A sustained preventative health impact can be achieved through the involvement of the community, with stakeholders comprising healthcare professionals, nutritionists, exercise science specialists and policy makers. Our guidelines for obesity assessment and primary and secondary prevention of childhood obesity and associated comorbidities in minority populations are fundamental to reducing global and local health disparities and improving quality of life.

Genetic associations of leisure sedentary behaviors and the risk of 15 site-specific cancers: A Mendelian randomization study

BACKGROUND AND AIMS

Leisure sedentary behavior (LSB) is associated with the risk of cancer, but the causal relationship between them has not been clarified. The aim of this study was to assess the potential causal association between LSB and risk of 15 site-specific cancers.

METHODS

The causal association between LSB and cancer were assessed with univariate Mendelian randomization (UVMR) and multivariate Mendelian randomization (MVMR). 194 SNPs associated with LSB (from the UK Biobank 408,815 individuals) were adopted as the instrument variables. Sensitivity analyses were performed to ensure the robustness of the results.

RESULTS

UVMR analysis revealed that television watching significantly increased the risk of endometrial cancer (OR = 1.29, 95% CI = 1.02-1.64, p = 0.04) (mainly the endometrioid histology [OR = 1.28, 95% CI = 1.02-1.60, p = 0.031])，breast cancer (OR = 1.16, 95% CI = 1.04-1.30, p = 0.007) (both ER+ breast cancer [OR = 1.17, 95% CI = 1.03-1.33, p = 0.015], and ER- breast cancer [OR = 1.55, 95% CI = 1.26-1.89, p = 2.23 × 10^-5 ]). Although causal association was not found between television watching and ovarian cancer, it was seen in low grade and low malignant potential serous ovarian cancer (OR = 1.49, 95% CI = 1.07-2.08, p = 0.018). However, significant results were not obtained in the UVMR analysis between driving, computer use and the 15 types of cancer. Further MVMR analysis indicated that the above results are independent from most metabolic factors and dietary habits, but mediated by educational attainment.

CONCLUSION

LSB in form of television watching has independent causal association with the risk of endometrial cancer, breast cancer, and ovarian cancer.

Adolescents who practice physical activity have adequate food choices, regardless of the level of somatic maturation and adiposity

OBJECTIVES

Regular physical activity and adequate food are part of a healthy lifestyle for the maintenance of physical and metabolic health. To verify the moderating role of physical activity (PA) in the relationship between dietary patterns and body adiposity in adolescents, according to somatic maturation.

METHODS

Study with cross-sectional design, sample of 336 adolescents of both sexes, aged between 11 and 17 years. Body mass, height, and waist circumference (WC) were evaluated. Body mass index (BMI), BMI z-score (BMI-z), waist-to-height ratio (WHtR), and somatic maturation by peak height velocity (PHV) were calculated. The level of PA was measured by the International Physical Activity Questionnaire and dietary pattern by the Food Frequency Questionnaire ELSA - Brazil (short version). Moderation analyzes were tested using multiple linear regression models, by PROCESS macro for SPSS.

RESULTS

An inverse interaction of PA was observed in the relationship between food consumption factor 5 (ultra-processed foods category) and WC in boys categorized as pre-pubertal and pubertal PHV (β=-5.344; CI95 % -10.108 -0.580; p=0.028). For girls, no interaction was observed in any of the models analyzed.

CONCLUSIONS

It was observed that the level of PA can influence food choices in prepubertal and pubertal boys, since the active boys showed better dietary pattern and lower central adiposity. Therefore, the findings reinforce the need to encourage the regular practice of physical activities from an early age, mainly aimed at preventing obesity in children and adolescents.

Physical Activity and Sedentary Behavior in High School Students: A Quasi Experimental Study via Smartphone during the COVID-19 Pandemic

The objective of this study was to evaluate whether exposure to information about physical activity and its barriers can increase the level of physical activity and reduce the time exposed to sedentary behaviors in high school students involved in integrated professional and technological education during the coronavirus disease 2019 pandemic. This quasi experimental study was conducted with integrated education high school students, divided into two groups: Intervention Group (IG; n = 59) and Control Group (CG; n = 54). Physical activity and sedentary behavior were identified and measured using the International Physical Activity Questionnaire pre-and post-intervention for both groups. IG students received educational material thrice a week for four weeks. The focus of the material was the importance of physical activity and need to reduce the time exposed to sedentary behavior. The results revealed that IG students showed an average daily reduction of 47.14 min in time exposed to sedentary behaviors, while the CG students showed an increase of 31.37 min. Despite this, the intervention was not effective in improving physical activity levels in the IG and the mean reduction in the time exposed to sedentary behavior was not significant (p = 0.556). The intervention was ineffective in increasing the practice of physical activity and reducing the time exposed to sedentary behavior.

Screen time increases overweight and obesity risk among adolescents: a systematic review and dose-response meta-analysis

BACKGROUND

Adolescence is a critical period in human life, associated with reduced physical activity and increased sedentary behaviors. In this systematic review and dose-response meta-analysis, we evaluated the association between screen time and risk of overweight/obesity among adolescents.

METHODS

A systematic search in electronic databases, including PubMed, Embase, and Scopus was performed up to September 2021. All published studies evaluating the association between screen time and risk of overweight/obesity among adolescents were retrieved. Finally, a total of 44 eligible studies were included in the meta-analysis.

RESULTS

The results of the two-class meta-analysis showed that adolescents at the highest category of screen time were 1.27 times more likely to develop overweight/obesity (OR = 1.273; 95% CI = 1.166-1.390; P < 0.001; I-squared (variation in ES attributable to heterogeneity) = 82.1%). The results of subgrouping showed that continent and setting were the possible sources of heterogeneity. Moreover, no evidence of non-linear association between increased screen time and risk of overweight/obesity among adolescents was observed (P-nonlinearity = 0.311).

CONCLUSION

For the first time, the current systematic review and meta-analysis revealed a positive association between screen time and overweight/obesity among adolescents without any dose-response evidence.

TRIAL REGISTRATION

The protocol of the current work has been registered in the PROSPERO system (Registration number: CRD42021233899 ).

The Impact of Physical Activity at School on Children's Body Mass during 2 Years of Observation

(1) Background: Children's overweight and obesity are a growing public health problem. The aim of this study was to assess the influence of physical activity (PA) at school on body mass of children aged 10-12 during 2 years of observation. (2) Methods: Primary school children (n = 245, 48% girls and 52% boys) took part in the study. Children were divided in two groups, (1) of standard PA and (2) of elevated PA at school corresponding to 4 and 10 h of physical education lessons (PE) a week, respectively. Weight, height, and body mass index (BMI) were measured starting from the 4th grade and ending at the 6th grade of school. (3) Results: The number of children with excessive body weight (overweight and obese) increased by ¼ in children of standard PA while slightly decreased in children of elevated PA. Many more children of elevated PA changed body mass category from overweight to healthy weight than those of standard PA. Girls, especially of standard PA, had more often excessive body weight compared to boys. (4) Conclusions: Increasing time of physical activity at school by elevation of the number of PE lessons favorably affects the body mass of children.

Health Behaviors of Austrian Secondary Level Pupils at a Glance: First Results of the From Science 2 School Study Focusing on Sports Linked to Mixed, Vegetarian, and Vegan Diets

Attaining healthy behaviors is essential at any life stage, particularly childhood, due to the strong link between children’s lifestyle and the subsequent adult state of health. This multidisciplinary study aimed to assess lifestyle behaviors of Austrian pupils of secondary schools I and II, with a specific focus on PA habits and diet types based on a large sample. In total, 8845 children/adolescents participated in the short standardized online survey on relevant health-related aspects nationwide. Valid and complete data was provided by 8799 pupils, including 1.14% of the eligible 771,525; 63% girls, 76% having a normal body weight, 70% attending secondary schools II, and more pupils/students living in rural vs. urban areas (3:1 ratio). Across the total sample, 11.8% were considered overweight/obese with a higher prevalence of overweight/obesity in boys than girls (15.5% vs. 9.6%) and urban vs. rural participants (13.9% vs. 10.8%; p < 0.05). The majority of participants (84.5%) reported a mixed diet, while 7.2% and 8.5% reported a vegan and vegetarian diet, respectively. Vegans reported a lesser alcohol intake (p < 0.05) compared to non-vegan pupils (no difference in dietary subgroups for smoking). Although overall PA and dietary behaviors suggest an appropriate health status among Austrian youth, attention should be focused on policies to increase healthy lifestyle habits at best through a dual approach to health permanently combining regular PA, sports, and exercise with a healthy diet, which would contribute to matching the current recommendations for improving individual and public health.

Red meat, overweight and obesity: A systematic review and meta-analysis of observational studies

AIM

The present study aimed to review and perform a meta-analysis summarizing the available evidence on the association between red meat consumption and obesity.

METHODS

A computerized search strategy was performed up to Feb 9, 2020. PubMed, Scopus, and web of science were used to conduct a comprehensive search for all relevant publications. The quality of the included articles was determined by using the Newcastle-Ottawa Scale. A random-effects model was conducted for analysis of the included cross-sectional studies. In the case of significant heterogeneity, subgroup analyses were conducted to explore possible sources of inter-study heterogeneity.

RESULTS

In the overall pooled estimate of 3 studies, it was shown that red meat consumption was not associated with overweight (pooled effect size: 1.19, 95% CI: 0.97-1.46, p = 0.099). The results from combining 7 studies showed a non-significant association between red meat intake and obesity (pooled effect size: 1.16, 95% CI: 0.93-1.44, p = 0.199) with significant heterogeneity among studies (I² = 87.3%, p_{heterogeneity} < 0.0001).

CONCLUSION

In conclusion, results extend the evidence that red meat consumption was not associated with the risk of overweight as well as no association between total meat consumption and obesity.

Physical activity and sedentary behaviors (screen time and homework) among overweight or obese adolescents: a cross-sectional observational study in Yazd, Iran

BACKGROUND

The growing number of adolescents who are overweight or obese (OW / OB) is a public concern. The present study was aimed to evaluate physical activity (PA) and sedentary behaviors (SB) (screen time (ST) and homework time (HT)) among Yazd OW/OB adolescents.

METHODS

This cross-sectional study was performed among 510 students aged 12-16 in Yazd, Iran. The general information, PA, and SB (ST and HT) were collected by interview based on the WHO standard questionnaire. Anthropometric data were assessed by precise instruments. Daily energy intake (Energy) was obtained from a 7-day food record. Nutritionist 4 software (version I) was run to estimate the energy.

RESULTS

There was a high prevalence of SB > 2h/day (97.6), ST > 2h/day (70.3%), overweight or obesity (40%), abdominal obesity (36.9%), physical inactivity (29.8%) among the students. The younger age (p = 0.014), energy (p < 0.001), no access to the yard (p < 0.001), family size ≤ 2 (p = 0.023), passive transportation, (p = 0.001), the highest school days' HT (p = 0.033) and SB (p = 0.021), and the highest weekends' HT among the students were the risk factors for OW/OB. The highest PA level was associated with a lower risk of OW/OB (p < 0.001). The findings were not the same in both sexes. Compared to the normal weight students, OW / OB spent more time on school days and weekdays for ST (P <0.001), HT (P <0.001, P = 0.005) and SB (P <0.001), respectively. OW/OB students showed a higher weekends' ST (p < 0.001) and lower HT (p = 0.048) than normal-weight students.

CONCLUSION

The prevalence of SB, ST, OW/OB, and physical inactivity were common. The school days and weekends' HT, the school days' SB and HT, age, energy, PA, and access to the yard, family size, and passive transportation were related to the greater chances of OW/OB students. Given that the expansion of online education and self-isolation in a new situation with COVID-19, it seems we will meet the worrying results.

The Double Burden of Malnutrition and Associated Factors among South Asian Adolescents: Findings from the Global School-Based Student Health Survey

The health and nutrition of the global adolescent population have been under-researched, in spite of its significant size (1.2 billion). This study investigates the prevalence and associated factors of malnutrition (stunting, thinness and overweight) among adolescents living in South Asia. The sample analysed was 24,053 South Asian schooled adolescents aged 12-15 years that participated in the cross-sectional Global School-Based Student Health Survey (GSHS) between 2009 and 2016. The prevalence of stunting, thinness and overweight was calculated using the World Health Organization (WHO) Child Growth Reference 2007. Associations between the three forms of malnutrition and their possible associated factors were assessed with binary logistic regression analysis using bootstrapping as a resampling method. The overall prevalence of stunting in South Asia was 13%, thinness was 10.8% and overweight was 10.8%. In the logistic regression model of the overall pooled sample, the factors associated with adolescent malnutrition were: age, hygiene behaviours, social support, sedentary behaviour, and tobacco use. A substantial proportion of stunting, thinness and overweight was found among school-going South Asian adolescents, indicating that the double burden of malnutrition is present in this population. Future research should seek to further understand the relationship between all forms of malnutrition and its associated factors in the adolescent population.

Psychosocial, Eating Behavior, and Lifestyle Factors Influencing Overweight and Obesity in Adolescents

BACKGROUND

Adolescent overweight and obesity (AOO) is a global public health problem and risk for noncommunicable diseases. Understanding context-specific risks is crucial for interventions.

OBJECTIVE

Determine the prevalence of AOO in the Indonesian National Health Survey (INHS) 2013, assess the 5-year trend from 2013 to 2018, and identify risks.

METHODS

We selected adolescents aged 10 to 19 years (n = 174 290) from the INHS 2013 and used hierarchical logistic regression to identify gender-specific risks for those aged 15 to 19 years (n = 77 534). Change in AOO was assessed by comparison to INHS 2018 reports.

RESULTS

The national AOO prevalence increased over 5 years by 48% in young adolescents (13-15 years) and 85% in older ones (16-18 years). High prevalence areas included the urban location of Jakarta (20.9%) and the remote rural region of Papua (19.4%). Overall, AOO risks were being sedentary, male, lower education, married, younger adolescent, and school enrollment, with urban residence and higher wealth being persistent risks for all analyses. Data for depressive symptoms were available for older adolescents whose additional risks were being sedentary, depressive symptoms, and high-fat diet. Male risks were being sedentary and lower education, and female risks were being married, depressive symptoms, high-fat intake, and lower education. Higher intake of fruits and vegetables and fewer sweets did not protect against AOO if a high-fat diet was consumed.

CONCLUSIONS

Adolescent overweight and obesity in Indonesia is rapidly increasing, especially in older adolescents and males, and with gender-specific risks. Customized multisectoral interventions to identify strategies for lifestyle change are urgently needed.

The effect of residential greenness and city park visiting habits on preschool Children's mental and general health in Lithuania: A cross-sectional study

AIM

The aim of this study was to determine the association between levels of residential surrounding greenness, preschool children's park use, sedentary behaviour, and mental and general health.

METHODS

This cross-sectional study included 1489 4-6-year-old children - residents of Kaunas city, Lithuania. Responses to the questionnaires completed by parents were used to ascertain children's general and mental health. We estimated exposure to greenness by the normalised difference vegetation index (NDVI), and time spent in a park (i.e. park use). We used multivariate logistic regression models to explore the independent associations between health outcomes and surrounding greenness and time spent in the nearest city park, controlling for potential confounders.

RESULTS

Of all the studied children, 14% had poor perceived general health, and 44.7% spent 5 or more hours per week in city parks. A significant increase in sedentary behaviour was observed in children with poor health. Every additional hour of time spent in parks was associated with decreased sedentary behaviour and a lower risk of poor health; meanwhile, lower residential greenness was associated with poorer mental and general health. Compared with NDVI-100 m > median and park use exceeding 5 h per week, lower greenness exposure and shorter park usage were associated with the risk of poor health (adjusted odds ratio 2.32 (95% CI: 1.43, 3.78) and the general risk of mental difficulties (adjusted odds ratio 1.43 (95% CI: 1.03, 2.18) in 4-6-year-old children.

CONCLUSIONS

Lower residential greenness levels and less time spent in a park were associated with poorer general and mental health among 4-6-year-old children. Physical activity in green spaces is recommended as a measure to prevent poor general and mental health among children.

Screen time and childhood overweight/obesity: A systematic review and meta-analysis

BACKGROUND

Controlling childhood overweight/obesity would help early prevention on children from getting chronic noncommunicable diseases, exposing to screen for long periods may increase the risk of overweight/obesity due to lack of physical activity and tend to intake too much energy, and the relationship between screen time and overweight/obesity is inconsistent. Thus, the object of the present study was to estimate the relationship between screen time and overweight/obesity in children (<18 years) by systematically review prevalence studies.

METHODS

We collected data from relevant studies published up to May 2019 using predefined inclusion/exclusion criteria. And all the literatures were searched in PubMed, ScienceDirect, Embase, and Web of Science.

RESULTS

A total of 16 studies met the criteria and were included in the meta-analysis. When compared with the screen time <2 hr/day, an increased overweight/obesity risk among children was shown in the screen time ≥2 hr/day (OR = 1.67; 95% CI [1.48, 1.88], P < .0001). The subgroup analysis showed a positive association between the different types of screen time and overweight/obesity among children.

CONCLUSION

Based on our study, increasing screen time could be a risk factor for being overweight/obesity in children and adolescents.

Off-Training Levels of Physical Activity and Sedentary Behavior in Young Athletes: Preliminary Results during a Typical Week

The level of physical activity (PA) and sedentary behavior (SED) off-training of young athletes may reveal the quality of recovery from training and highlight health related issues. Thus, the aim was to identify and describe young athletes' PA and SED off-training, according to daily life activities. Eight athletes (15.7 ± 2 years, 1.72 ± 0.6 m height, 62.9 ± 10.2 kg) of a sport talent program wore on their waist a tri-axial accelerometer (ActiGraph^® wGT9X-link, Shalimar, FL, USA) at 30 Hz for 15 consecutive days, and reported their schedule. A two-step cluster analysis classified three groups according to sedentary PA and MVPA. The Sedentary (56.9%), presented the highest sedentary PA (mean [CI], 37.37 [36.45⁻38.29] min/hour); The Hazardous (19.4%) had the lowest values of sedentary and MVPA (10.07 [9.41⁻10.36] min/hour and 8.67 [7.64⁻9.70] min/hour, respectively). Balanced (23.7%) had the highest MVPA (28.61 [27.16⁻30.07] min/hour). Sedentary had the lowest count of home time associated (20%) and higher school (26%) time when compared to the Hazardous (13%). The Balanced showed the highest count of school (61%) and home time (47%). Different profiles for young athletes revealed alarming behavior in the associations with sedentary PA, sitting and SED breaks, which may influence performance and health.