Cross-sectional changes in weight status and weight related behaviors among Australian children and Australian Indigenous children between 2010 and 2015

Cardiometabolic health markers among Aboriginal adolescents from the Next Generation Youth Wellbeing Cohort Study

OBJECTIVE

The objective of this study was to investigate cardiometabolic health markers among Aboriginal adolescents aged 10-24 years and relationships with age, gender, and body composition.

METHODS

Baseline data (2018-2020) from the Next Generation Youth Wellbeing Cohort Study (Western Australia, New South Wales, and Central Australia) on clinically assessed body mass index, waist/height ratio, blood pressure, glycated haemoglobin (HbA1c), total and high-density lipoprotein cholesterol, total/high-density lipoprotein cholesterol ratio, and triglycerides were analysed.

RESULTS

Among 1100 participants, the proportion with individual health markers within the ideal range ranged from 59% for total cholesterol to 91% for HbA1c. Four percent had high blood pressure, which was more common with increasing age and among males; 1% had HbA1c indicative of diabetes. Healthier body composition (body mass index and waist/height ratio) was associated with having individual health markers in the ideal range and with an ideal cardiometabolic profile.

CONCLUSIONS

Most Aboriginal adolescents in this study had cardiometabolic markers within the ideal range, though markers of high risk were present from early adolescence. Ideal health markers were more prevalent among those with healthy body composition.

IMPLICATIONS FOR PUBLIC HEALTH

Specific screening and management guidelines for Aboriginal adolescents and population health initiatives that support maintenance of healthy body composition could help improve cardiometabolic health in this population.

Health behaviours associated with healthy body composition among Aboriginal adolescents in Australia in the 'Next Generation: Youth Well-being study'

This study described the distribution of healthy body composition among Aboriginal adolescents in Australia aged 10-24 years and examined associations with health behaviours and self-rated health. Data were cross-sectional from the 'Next Generation: Youth Well-being study' baseline (N = 1294). We used robust Poisson regression to quantify associations of self-reported health behaviours (physical activity, screen time, sleep, consumption of vegetables, fruit, soft drinks and fast food, and tobacco smoking and alcohol) and self-rated health to healthy body mass index (BMI) and waist/height ratio (WHtR). Overall, 48% of participants had healthy BMI and 64% healthy WHtR, with healthy body composition more common among younger adolescents. Higher physical activity was associated with healthy body composition (5-7 days last week vs none; adjusted prevalence ratio (aPR) healthy BMI 1.31 [95% CI 1.05-1.64], and healthy WHtR 1.30 [1.10-1.54]), as was recommended sleep duration (vs not; aPR healthy BMI 1.56 [1.19-2.05], and healthy WHtR 1.37 [1.13-1.67]). There was a trend for higher proportion of healthy body composition with more frequent fast food consumption. Healthy body composition was also associated with higher self-rated health ('very good/excellent' vs 'poor/fair'; aPR healthy BMI 1.87 [1.45-2.42], and healthy WHtR 1.71 [1.40-2.10]). Culturally appropriate community health interventions with a focus on physical activity and sleep may hold promise for improving body composition among Aboriginal adolescents.

Cardiometabolic Risk Markers for Aboriginal and Torres Strait Islander Children and Youths: A Systematic Review of Data Quality and Population Prevalence

Cardiovascular disease and type 2 diabetes mellitus are leading contributors to the health inequity experienced by Aboriginal and Torres Strait Islander peoples, and their antecedents can be identified from early childhood. We aimed to establish the quality of available data and the prevalence of cardiometabolic risk markers among Aboriginal and Torres Strait Islander children and youths (0-24-year-olds) to inform public health approaches. A systematic review of the peer-reviewed and grey literature was conducted between 1 January 2000-28 February 2021. Included studies reported population prevalence of cardiometabolic risks, including elevated blood pressure, obesity, central adiposity, dyslipidaemia, hyperglycaemia, and 'metabolic syndrome' for Aboriginal and Torres Strait Islander people aged 0-24 years. Fifteen studies provided population estimates. Data quality was limited by low response rates (10/15 studies) and suboptimal outcome measurements. Obesity is the most reported risk (13/15 studies). Aboriginal and Torres Strait Islander children have an excess risk of obesity from early childhood and prevalence increases with age: 32.1% of Aboriginal and Torres Strait Islander 18-24-year-olds had obesity and 50.8% had central adiposity. In a cohort of 486 9-14-year-olds in Darwin, 70% had ≥1 component of metabolic syndrome; 14% met the full criteria for the syndrome. The prevalence of cardiometabolic risk in Aboriginal and Torres Strait Islander young people is difficult to estimate due to limitations in measurement quality and sampling representativeness. Available data suggest that cardiometabolic risk markers are evident from early childhood. The establishment of national and state-level datasets and a core outcome set for cardiometabolic screening would provide opportunities for preventative action.

Footprints in Time: Physical Activity Levels and Sociodemographic and Movement-Related Associations Within the Longitudinal Study of Indigenous Children

BACKGROUND

Emerging evidence suggests that Indigenous children have higher physical activity levels that non-Indigenous children, yet little is known of the factors that influence these levels or how they may be optimized. This study examines correlates of achieving ≥1 hour/day of physical activity among Indigenous Australian children aged 8-13 years.

METHODS

Data were collected through parental self-report in the Longitudinal Study of Indigenous Children. Proportions of children achieving ≥1 hour/day physical activity, approximating the Australian aerobic physical activity recommendations, were calculated, and associations with sociodemographic, family composition, and movement-related factors were quantified using multiple logistic regression analyses.

RESULTS

Half of the 1233 children achieved ≥1 hour/day physical activity. Children from families with low parental education and unemployment, remote residence, low socioeconomic status, and without a father in the household were more likely to meet the recommendations. Achieving ≥1 hour/day of physical activity was also associated with low levels of playing electronic games and total screen time.

CONCLUSIONS

Sociodemographic correlates of physical activity among Indigenous Australian children run counter to those typically found in non-Indigenous Australian children. Further longitudinal examination of the predictors of these associations would provide a greater understanding of Indigenous physical activity determinants, to inform strategies to facilitate participation.

Elements of Effective Population Surveillance Systems for Monitoring Obesity in School Aged Children

The continuing high prevalence of child overweight and obesity globally means that it remains the most common chronic health condition in children. Population-based child obesity surveillance systems are critical for monitoring trends in obesity and related behaviours, and determining the overall effect of child obesity prevention strategies. Effective surveillance systems may vary in methods, scope, purpose, objectives, and attributes, and our aim was to provide an overview of child obesity surveillance systems globally, and to highlight main components and other types of survey data that can enhance our understanding of child obesity. Measures of adiposity, including body mass index and waist circumference are essential, but effective surveillance must also include measures of weight-related behaviours, including diet, physical activity, sedentary time, and sleep. While objective measures are desirable, the variability in psychometrics and rapid evolution of wearable devices is potentially problematic for examining long-term trends over time and how behaviours may change. Questionnaires on self-reported behaviours are often used but also have limitations. Because the determinants of obesity are not only functioning at the individual level, some measures of the broader environmental and commercial determinants, including the built and food environments, are useful to guide upstream policy decisions.