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Ko A, O’Brien D, Rivera P, Mancl L, Hopkins S, Randall C, Nguyen DP, Chi DL. Identifying sources of variation in added sugar intake for Alaska Native children using a hair biomarker. Int J Circumpolar Health 2024; 83:2336286. [PMID: 38560896 PMCID: PMC10986438 DOI: 10.1080/22423982.2024.2336286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 03/25/2024] [Indexed: 04/04/2024] Open
Abstract
Sugars from sugar-sweetened beverages (SSBs) are an important risk factor for tooth decay. The study goal was to determine if there was variation in added sugar intake across communities and between and within households. In this cross-sectional study, intakes of total sugar, added sugar, and sugar-sweetened beverages (SSBs) were estimated for 282 Alaska Native children ages 0-10 years from 131 households in three Yukon-Kuskokwim (YK) Delta communities using biomarker equations based on hair carbon and nitrogen isotope ratios previously developed for the Yup'ik population. ANOVA was used to assess associations between each predictor (community and household) and outcome (estimated total sugars, added sugars, and SSB intake). Between- and within-household variation was estimated using a linear mixed-effects model with a random intercept for households with three or more children. There was no significant difference in mean estimated total sugar (p = 0.29), added sugar (p = 0.24), or SSB intake (p = 0.40) across communities. Significant variations were observed between and within households, with within-household variation amounting to 59% of the between-household variation. Added sugar intake in Alaska Native children from the three study communities is higher than the recommended maximum, and the variation is greater within households than between households.
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Affiliation(s)
- Alice Ko
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Diane O’Brien
- Center for Alaska Native Health Research, Institute of Arctic Biology, Department of Biology and Wildlife, University of Alaska, Fairbanks, AK, USA
| | - Patricia Rivera
- Center for Alaska Native Health Research, Institute of Arctic Biology, Department of Biology and Wildlife, University of Alaska, Fairbanks, AK, USA
| | - Lloyd Mancl
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Scarlett Hopkins
- Departments of Medicine and Obstetrics & Gynecology, Oregon Health & Science University, Portland, OR, USA
| | - Cameron Randall
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Daisy Patiño Nguyen
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Donald L. Chi
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA
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Özer Ö, Uyhan O, Devrilmez E, Orhan İ, Bilgiç M, Uğurlu A, Tabak EY, Yüksel O, Şentürk A, Karakullukçu A, Eler N, Özcan K, Akpınar S. The relationship between attitude toward physical activity and weight gain in children and young adolescence. Front Pediatr 2024; 12:1300613. [PMID: 38774299 PMCID: PMC11106473 DOI: 10.3389/fped.2024.1300613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 04/23/2024] [Indexed: 05/24/2024] Open
Abstract
Introduction The purpose of this study was to investigate the association between attitudes toward physical activity and weight gain among children and young adolescents with an additional focus on the impact of gender on these attitudes. Methods Employing a descriptive survey method, data were systematically gathered via purposive sampling from 11 specific cities in Türkiye, ensuring representation from all seven regions. A total of 3,138 students, aged between 9 and 14 years, participated in this study, with a distribution of 46% girls and 54% boys. To assess the attitudes of children and young adolescents toward physical activity, the Youth Physical Activity Attitude Scale was utilized. Height and body weight measurements were taken to determine the body mass index of participants. SPSS 26.0 software facilitated the statistical analyses, including Pearson correlation analysis to explore relationships between variables. Multivariate Analysis of Variance was employed to evaluate the impact of age, BMI, and gender on attitudes toward physical activity. Results Participants classified as normal weight exhibited a more positive attitude towards physical activity compared to their obese and overweight counterparts. Moreover, a significant gender difference emerged, with boys demonstrating significantly higher positive attitudes toward physical activity than girls. However, no significant difference was observed in negative attitudes based on gender. The study also revealed that an escalation in negative attitudes towards physical activity correlated with students being categorized as underweight, overweight, or obese, as opposed to having a normal weight status. Additionally, a statistically significant divergence in both positive and negative attitudes towards physical activity was found based on age. Specifically, the results indicated that students aged 9 and 14 exhibited lower levels of positive attitude when contrasted with their counterparts of different age groups. Conversely, in the domain of negative attitudes, students at the age of 9 scored higher than their peers in other age categories. Discussion Attitudes towards physical activity can serve as a convenient indicator and guide for assessing the effectiveness of various practices or interventions aimed at promoting physical activity, with recognition of the significant gender difference in positive attitudes among children and young adolescents.
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Affiliation(s)
- Ömer Özer
- Faculty of Sport Science, Department of Physical Education and Sport, Bandırma Onyedi Eylül University, Balıkesir, Türkiye
| | - Osman Uyhan
- Institute of Health Science, Bandırma Onyedi Eylül University, Balıkesir, Türkiye
| | - Erhan Devrilmez
- Faculty of Sport Science, Department of Physical Education and Sport, Karamanoğlu Mehmetbey University, Karaman, Türkiye
| | - İlkay Orhan
- Faculty of Sport Science, Department of Physical Education and Sport, Akdeniz University, Antalya, Türkiye
| | - Mert Bilgiç
- Faculty of Sport Science, Department of Coaching Education, Akdeniz University, Antalya, Türkiye
| | - Alkan Uğurlu
- Faculty of Sport Science, Department of Physical Education and Sport, Akdeniz University, Antalya, Türkiye
| | - Ekrem Yasin Tabak
- Institute of Social Science, Karamanoğlu Mehmetbey University, Karaman, Türkiye
| | - Oğuzhan Yüksel
- Faculty of Sport Science, Department of Recreation, Dumlupınar University, Kütahya, Türkiye
| | - Aydın Şentürk
- Faculty of Sport Science, Department of Coaching Education, Dumlupınar University, Kütahya, Türkiye
| | - Ayla Karakullukçu
- Faculty of Sport Science, Department of Sport Management, Kırıkkale University, Kırkkale, Türkiye
| | - Nebahat Eler
- School of Physical Education and Sport, Department of Coaching Education, Bülent Ecevit University, Zonguldak, Türkiye
| | - Kürşat Özcan
- Faculty of Sport Science, Department of Physical Education and Sport, Nevşehir Hacı Bektaş Veli University, Nevşehir, Türkiye
| | - Selçuk Akpınar
- Faculty of Sport Science, Department of Physical Education and Sport, Nevşehir Hacı Bektaş Veli University, Nevşehir, Türkiye
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Batioja K, Elenwo C, Hendrix-Dicken A, Ali L, Wetherill MS, Hartwell M. Associations of social determinants of health and childhood obesity: a cross-sectional analysis of the 2021 National Survey of Children's Health. J Osteopath Med 2024; 124:231-239. [PMID: 38190347 DOI: 10.1515/jom-2023-0239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/04/2023] [Indexed: 01/10/2024]
Abstract
CONTEXT Childhood obesity is a growing health problem in the United States, with those affected having an increased likelihood of developing chronic diseases at a younger age. Social determinants of health (SDOH) are known to influence overall health. Families who are of low socioeconomic status (SES) have also been shown to be more likely to experience food insecurity. OBJECTIVES Our primary objective was to utilize the National Survey of Children's Health (NSCH) 2021 data to determine the current associations between childhood obesity and SDOH. Secondarily, we estimated the prevalence of select SDOH among children with obesity. METHODS We conducted a cross-sectional analysis of 2021 NSCH to extract data related to the SDOH domains. We extracted sociodemographic variables to utilize as controls and constructed logistic regression models to determine associations, via odds ratios, between SDOH and childhood obesity. RESULTS Within the binary regression models, children with obesity (≥95th percentile) were more likely than children without obesity to experience SDOH in all domains. After controlling for sociodemographic variables, children with obesity were significantly more likely to experience food insecurity when compared to children without obesity (adjusted odds ratio [AOR]=1.39; 95 % confidence interval [CI]: 1.13-1.17). CONCLUSIONS In line with the current American Academy of Pediatrics (AAP) Clinical Practice Guidelines (CPG), improving policies for nutrition programs and addressing the lack of access to nutritious foods may alleviate some food insecurity. Ensuring that children have access to sufficient nutritious foods is critical in addressing childhood obesity and thus decreasing risk of chronic disease.
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Affiliation(s)
- Kelsi Batioja
- Oklahoma State University Center for Health Sciences, Tulsa, OK 74107, USA
- Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine at Cherokee Nation, Tahlequah, OK, USA
| | - Covenant Elenwo
- Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine at Cherokee Nation, Tahlequah, OK, USA
| | - Amy Hendrix-Dicken
- Department of Pediatrics, University of Oklahoma School of Community Medicine, Tulsa, OK, USA
| | - Lamiaa Ali
- Department of Pediatrics, University of Oklahoma School of Community Medicine, Tulsa, OK, USA
| | - Marianna S Wetherill
- College of Public Health - Schusterman Center, University of Oklahoma Health Sciences Center, Tulsa, OK, USA
| | - Micah Hartwell
- Oklahoma State University Center for Health Sciences, Tulsa, OK 74107, USA
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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Leung AKC, Wong AHC, Hon KL. Childhood Obesity: An Updated Review. Curr Pediatr Rev 2024; 20:2-26. [PMID: 35927921 DOI: 10.2174/1573396318666220801093225] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/05/2022] [Accepted: 05/19/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Childhood obesity is an important and serious public health problem worldwide. OBJECTIVE This article aims to familiarize physicians with the evaluation, management, and prevention of childhood. METHODS A PubMed search was conducted in May, 2021, in Clinical Queries using the key terms "obesity" OR "obese". The search included clinical trials, randomized controlled trials, case-control studies, cohort studies, meta-analyses, observational studies, clinical guidelines, case reports, case series, and reviews. The search was restricted to English literature and children. The information retrieved from the above search was used in the compilation of the present article. RESULTS Most obese children have exogenous obesity characterized by a growth rate for height above the 50th percentile, normal intelligence, normal genitalia, and lack of historical or physical evidence of an endocrine abnormality or a congenital syndrome. Obese children are at risk for dyslipidemia, hypertension, diabetes mellitus, non-alcoholic fatty liver disease, obstructive sleep apnea, psychosocial disturbances, impaired quality of life, and shorter life expectancy. The multitude of serious comorbidities necessitates effective treatment modalities. Dietary modification, therapeutic exercise, and behavioral modification are the fundamentals of treatment. Pharmacotherapy and/or bariatric surgery should be considered for obese individuals who do not respond to the above measures and suffer from a serious comorbid condition. CONCLUSION Childhood obesity, once established, is often refractory to treatment. Most treatment programs lead to a brief period of weight loss, followed by rapid re-accumulation of the lost weight after the termination of therapy. As such, preventive activity is the key to solving the problem of childhood obesity. Childhood obesity can be prevented by promoting a healthy diet, regular physical activity, and lifestyle modification. Parents should be encouraged to get involved in school and community programs that improve their children's nutritional status and physical activity.
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Affiliation(s)
- Alexander K C Leung
- Department of Pediatrics, The University of Calgary, The Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Alex H C Wong
- Department of Family Medicine, The University of Calgary, Calgary, Alberta, Canada
| | - Kam Lun Hon
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China
- Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong, China
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Bertrand-Protat S, Chen J, Jonquoy A, Frayon S, Thu Win Tin S, Ravuvu A, Caillaud C, Galy O. Prevalence, causes and contexts of childhood overweight and obesity in the Pacific region: a scoping review. OPEN RESEARCH EUROPE 2023; 3:52. [PMID: 38031554 PMCID: PMC10685071 DOI: 10.12688/openreseurope.15361.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/10/2023] [Indexed: 12/01/2023]
Abstract
Background Non-communicable diseases (NCDs) are a major threat to health and development and account for 75% of deaths in the Pacific Islands Countries and Territories (PICTs). Childhood obesity has been identified as a main risk factor for NCDs later in life. This review compiled overweight and obesity (OWOB) prevalence (anthropometric data) for children aged six to 12 years old living in the Pacific region and identified possible related causes. Methods We conducted a systematic search using PubMed, Google Scholar and ScienceDirect for articles published between January 1980 and August 2022. We also searched for technical reports from Ministries of Health. Guided by the eligibility criteria, two authors independently read the selected articles and reports to extract and summarise relevant information related to overweight and obesity. Results We selected 25 articles, two worldwide analyses of population-based studies and four national reports. Information revealed that childhood OWOB prevalence reached 55% in some PICTs. This review also indicated that age, gender and ethnicity were linked to children's weight status, while dietary practices, sleep time and level of physical activity played a role in OWOB development, as well as the living environment (socio-economic status and food availability), parenting practices and education level. Conclusion This review highlighted that anthropometric data are limited and that comparisons are difficult due to the paucity of surveys and non-standardized methodology. Main causes of overweight and obesity are attributed to individual characteristics of children and behavioural patterns, children's socio-economic environment, parenting practices and educational level. Reinforcement of surveillance with standardised tools and metrics adapted to the Pacific region is crucial and further research is warranted to better understand root causes of childhood OWOB in the Pacific islands. More robust and standardized anthropometric data would enable improvements in national strategies, multisectoral responses and innovative interventions to prevent and control NCDs.
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Affiliation(s)
- Solene Bertrand-Protat
- Interdisciplinary Laboratory of Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia
- Pacific Community, 95 Promenade Roger Laroque, Noumea, New Caledonia
| | - Juliana Chen
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Aurélie Jonquoy
- Pacific Community, 95 Promenade Roger Laroque, Noumea, New Caledonia
| | - Stéphane Frayon
- Interdisciplinary Laboratory of Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia
| | - Si Thu Win Tin
- Pacific Community, 95 Promenade Roger Laroque, Noumea, New Caledonia
| | - Amerita Ravuvu
- Pacific Community, 95 Promenade Roger Laroque, Noumea, New Caledonia
| | - Corinne Caillaud
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
- Discipline of Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Olivier Galy
- Interdisciplinary Laboratory of Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
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Liu C, Yu H. Neighborhood effects on dietary behaviors—evidence from older adults in China. Front Nutr 2022; 9:974471. [PMID: 37082563 PMCID: PMC10111188 DOI: 10.3389/fnut.2022.974471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 09/12/2022] [Indexed: 11/13/2022] Open
Abstract
Individual neighborhood environment is an important predictor of dietary behavior. Using data from four waves of the China Health and Nutrition Survey (CHNS, 2004–2011), this study applied a panel data approach to examine the effects of neighborhood diet quality on the eating behaviors of older adults living in the same community. Results of the fixed effects estimation indicated a significant neighborhood effect within the community, and neighborhoods with high-quality diets had a significantly positive effect on the eating behavior of the elderly. The neighborhood effects on elderly eating behaviors were manifested in improved dietary structure, including decreased consumption of cereals and increased consumption of vegetables and fruits, as well as meat, eggs, and dairy products. In terms of nutrient intake, there was a significant increase in protein intake, and hence, a greater percentage of calories from protein. The estimation results were robust when different estimation methods or diet quality measures were used. Future policies for improving diet quality should consider neighborhood-level conditions, especially in rural areas where residents are closely connected and socially interact with one another.
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Wang L, Morelen D, Alamian A. A prospective cohort study of the association between key family and individual factors and obesity status among youth. Sci Rep 2022; 12:15666. [PMID: 36123368 PMCID: PMC9485130 DOI: 10.1038/s41598-022-19585-8] [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: 10/04/2021] [Accepted: 08/31/2022] [Indexed: 11/08/2022] Open
Abstract
There remains a significant gap in our knowledge of the synergistic nature of family dynamics, child characteristics, and child-rearing features in the etiology of obesity from childhood through adolescence. We assessed the associations of family dynamics (poverty, family structure), child characteristics (child temperament), and child-rearing features (maternal depression, maternal sensitivity, and type of child care) with the development of childhood obesity. Children (n = 1240) whose weights and heights were measured at least once for ten time points (from 2 years through 15 years) from the NICHD Study of Early Child Care and Youth Development were included. Generalized estimating equation (GEE) was used to examine the associations of family and individual factors with the childhood obesity after adjusting for covariates. Adjusted GEE models showed that living below poverty level was associated with an increased odds of obesity (odds ratio = 1.62, 95% confidence interval 1.05, 2.53). Among these key family and individual factors, poverty status was observed to be the strongest predictor of obesity of offspring across time. Findings highlight the importance of systemic-level public health changes in obesity reduction efforts and suggest that poverty-reduction based prevention and intervention are likely more effective targets than more individual/family specific targets.
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Affiliation(s)
- Liang Wang
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, 76798, USA.
| | - Diana Morelen
- Department of Psychology, East Tennessee State University, Johnson City, TN, 37614, USA
| | - Arsham Alamian
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, 33146, USA
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Does a Healthy Lifestyle Lower the Elevated Risk of Obesity Caused by Caesarian Section Delivery in Children and Adolescents? Nutrients 2022; 14:nu14173528. [PMID: 36079786 PMCID: PMC9460904 DOI: 10.3390/nu14173528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/20/2022] [Accepted: 08/23/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Both caesarean section (CS) and lifestyle were linked with child adiposity. This study aimed to investigate whether CS delivery is linked with elevated risk of child adiposity regardless of a healthy lifestyle. Methods: All the subjects in this study came from a baseline survey of a national school-based program on healthy lifestyle interventions against adiposity among Chinese children and adolescents. A questionnaire was used to collect the information on delivery mode and lifestyle. According to the weighted lifestyle score, subjects were categorized into healthy, intermediate, and unhealthy lifestyle. Results: A total of 44,961 children aged 6−18 years were enrolled in the current study. Overall, 41.9% (18,855/44,961) of children were delivered by CS. Compared with children delivered by vaginal delivery, children delivered by CS had a higher adiposity risk (OR = 1.56; 95%CI: 1.46−1.66; p < 0.001) after adjustment for age, sex, region, mother adiposity, ethnicity, and weighted lifestyle factors. Compared with children with a healthy lifestyle, children with an unhealthy lifestyle had a higher risk of child adiposity (OR = 1.31; 95%CI: 1.19−1.44). Children delivered by CS who had an unhealthy lifestyle had a 106% higher (OR = 2.06; 95%CI: 1.79−2.37) risk of child adiposity compared with children delivered by vaginal delivery who had a healthy lifestyle. However, keeping a healthy lifestyle in later life seems not to offset the increased risk of child adiposity caused by CS (OR = 1.59; 95%CI: 1.39−1.82). Conclusions: Both CS and unhealthy lifestyle were linked with child adiposity risk. Keeping a healthy lifestyle did not counteract the elevated risk of child adiposity caused by CS.
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Moreno-Fernandez J, Ochoa JJ, Ojeda ML, Díaz-Castro J. Editorial: Infant and child nutrition, physical activity, oxidative stress and inflammatory signaling. Front Nutr 2022; 9:993643. [PMID: 36082037 PMCID: PMC9446512 DOI: 10.3389/fnut.2022.993643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 08/11/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jorge Moreno-Fernandez
- Department of Physiology, Faculty of Pharmacy, University of Granada, Granada, Spain
- Institute of Nutrition and Food Technology “José Mataix Verdú”, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Granada, Spain
| | - Julio J. Ochoa
- Department of Physiology, Faculty of Pharmacy, University of Granada, Granada, Spain
- Institute of Nutrition and Food Technology “José Mataix Verdú”, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Granada, Spain
- *Correspondence: Julio J. Ochoa
| | - Maria Luisa Ojeda
- Department of Physiology, Faculty of Pharmacy, University of Seville, Seville, Spain
| | - Javier Díaz-Castro
- Department of Physiology, Faculty of Pharmacy, University of Granada, Granada, Spain
- Institute of Nutrition and Food Technology “José Mataix Verdú”, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Granada, Spain
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Tong J, Li X, Liang X, Tang F, Ren Y, Hao G, Peng X, Luo S, Feng Y, Huang D, Zhao L, Liang X. The relationship of remnant cholesterol and abdominal obesity in children: A cross-sectional study. Front Cardiovasc Med 2022; 9:929560. [PMID: 35966536 PMCID: PMC9363601 DOI: 10.3389/fcvm.2022.929560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 06/30/2022] [Indexed: 11/15/2022] Open
Abstract
Background Previous studies found that remnant cholesterol (RC) is a risk factor for cardiovascular diseases and childhood obesity is associated with cardiometabolic diseases. This study aimed to explore the relationship between RC and abdominal obesity in children. Methods A total of 5,959 children, aged 6−12 years old, were selected from a cross-sectional study in urban-rural areas of Chongqing, China. RC was calculated by total cholesterol (TC)—high-density lipoprotein (HDL-C) cholesterol—low-density lipoprotein (LDL-C) cholesterol and was divided into four groups by quartiles (Q1–Q4). Results Compared to children with the lowest RC (Q1), children with higher RC had significantly higher odds of abdominal obesity (Q2: OR = 1.450, 95% CI: 1.131−1.859, p < 0.05; Q3: OR = 2.127, 95% CI: 1.632−2.772, p < 0.001; Q4: OR = 2.386, 95% CI: 1.819−3.130, p < 0.001). In the stratified analyses by urban-rural areas, the odds ratios were greater in rural areas (Q2: OR = 2.228, 95% CI: 1.572−3.160, p < 0.001; Q3: OR = 3.668, 95% CI: 2.191−6.140, p < 0.001; Q4: OR = 6.490, 95% CI: 2.271−18.551, p < 0.001) than in urban areas (Q2: OR = 1.644, 95% CI: 1.192−2.266, p < 0.05; Q3: OR = 2.266, 95% CI: 1.667−3.082, p < 0.001; Q4: OR = 2.711, 95% CI: 2.005−3.665, p < 0.001). Conclusions Our study found that RC was positively correlated with abdominal obesity in children, and this association was higher for children living in rural areas.
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Affiliation(s)
- Jishuang Tong
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China
- Shimian People's Hospital, Ya'an, China
| | | | - Xiaoyue Liang
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China
| | - Fang Tang
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China
- Chongqing Medical and Pharmaceutical College, Chongqing, China
| | - Yanling Ren
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China
| | - Guang Hao
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Xin Peng
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China
| | - Sunqing Luo
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China
| | - Ye Feng
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China
| | - Daochao Huang
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China
| | - Li Zhao
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China
| | - Xiaohua Liang
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China
- *Correspondence: Xiaohua Liang ,
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Effectiveness of an Intervention Programme on Adherence to the Mediterranean Diet in a Preschool Child: A Randomised Controlled Trial. Nutrients 2022; 14:nu14081536. [PMID: 35458098 PMCID: PMC9025428 DOI: 10.3390/nu14081536] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/03/2022] [Accepted: 04/05/2022] [Indexed: 01/23/2023] Open
Abstract
Background: The Mediterranean diet is considered one of the dietary patterns with the most accumulated scientific evidence on health benefits. In children, it has positive effects in the prevention of obesity and cardiovascular diseases, as well as in the prevention of diabetes. We aimed to evaluate the medium-term efficacy of an intervention programme, targeting adherence to the Mediterranean diet among preschool children. Methods: In a randomised, parallel trial of participants aged 3–5 years, a school garden was attended in the experimental group, and in the control group, the usual content on the human body and health were taught. Adherence to the Mediterranean diet was assessed using the KIDMED questionnaire, controlling for weight, height, body mass index (BMI) and socio-demographic variables. Results: A reduction in BMI was found in the experimental group after one year and at the end of the follow-up period. In the overall score obtained in the KIDMED survey, a statistical trend was found between the two groups (p = 0.076). In multivariate analysis, consumption of pulses more than once a week’ was predictive of improved diet quality, with an Odds Ratio (OR) in the experimental group of 1.382 (95% CI 1.126–1.695; p = 0.009). Conclusions: The experimental approach improved the quality of the participants’ diet, increasing adherence to the Mediterranean diet due to increased consumption of plant-based protein.
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12
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Gago CM, Jurkowski J, Beckerman-Hsu JP, Aftosmes-Tobio A, Figueroa R, Oddleifson C, Mattei J, Kenney EL, Haneuse S, Davison KK. Exploring a theory of change: Are increases in parental empowerment associated with healthier weight-related parenting practices? Soc Sci Med 2022; 296:114761. [PMID: 35123371 PMCID: PMC8894077 DOI: 10.1016/j.socscimed.2022.114761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 01/25/2022] [Accepted: 01/27/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Parent health-related empowerment is defined as the process by which parents realize control over their life situation and take action to promote a healthier lifestyle. For decades, researchers have described the theoretical potential of empowerment in health promotion efforts, though few have empirically examined this hypothesized relationship. This study is one of the first to examine the relationship between parental empowerment and healthy weight parenting practices (i.e., food, physical activity, sleep, and media parenting), as a mechanism for early childhood health promotion in community settings. METHODS Low-income parents of preschool-aged children attending Head Start in Greater Boston between fall 2017 and spring 2019 were invited to complete a survey in the fall and spring of each academic school year (n = 578 with two surveys and n = 45 with four). Parental empowerment and healthy weight parenting practices were assessed using validated surveys. We used a multilevel difference-in-difference approach to estimate changes in healthy weight parenting practices score by changes in parental empowerment score. RESULTS Out of a possible score of four, the unadjusted mean (SD) score in fall was 3.20 (0.40) for empowerment and 3.01 (0.40) for parenting. An increase in parental empowerment was associated with an increase in healthier parenting practices (b = 0.14; 95% CI = 0.08, 0.20; p < 0.0001). CONCLUSIONS Parent empowerment may be an important target in interventions to prevent obesity in low-income children.
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Affiliation(s)
- Cristina M. Gago
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Janine Jurkowski
- Department of Health Policy, Management, and Behavior, State University of New York, Albany, NY, 12222, USA
| | | | | | - Roger Figueroa
- Division of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY, 14853, USA
| | - Carly Oddleifson
- School of Social Work, Boston College, Chestnut Hill, MA, 02467, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Erica L. Kenney
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
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Busnatu SS, Serbanoiu LI, Lacraru AE, Andrei CL, Jercalau CE, Stoian M, Stoian A. Effects of Exercise in Improving Cardiometabolic Risk Factors in Overweight Children: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2022; 10:healthcare10010082. [PMID: 35052246 PMCID: PMC8775269 DOI: 10.3390/healthcare10010082] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/28/2021] [Accepted: 12/29/2021] [Indexed: 12/16/2022] Open
Abstract
This meta-analysis aims to evaluate the effects of exercise in improving cardiometabolic risk factors in overweight children and adolescents until the adolescent age, which is 18 years. A systemic search was conducted using the electronic databases PubMed/Medline, Cochrane Library, and Google Scholar, from inception to 29 June 2021. All statistical analyses were conducted in Review Manager 5.4.1. All studies meeting the inclusion criteria were selected. A random-effect model was used to pool the studies, and the results are reported in the odds ratio (OR) and corresponding 95% Confidence interval (CI). Twelve randomized control trials were selected for meta-analysis. Significant results were obtained for BMI in children after the interventions (0.38 95% CI 0.14, 0.62; p = 0.002; I2 = 65%). LDL level was also found significantly reduced (0.41 95% CI 0.01, 0.82; p = 0.05; I2 = 83%). Other factors such as HDL level, blood pressure, blood glucose level, body weight, and waist circumference were also analyzed. We found that exercise interventions significantly improved several cardiometabolic risk factors such as BMI, LDL level, BP, and blood glucose level. However, no significant effect on HDL concentration, waist circumference, and body weight were found. Long-term interventions are needed to attain improvement in all cardiometabolic risk factors.
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Affiliation(s)
- Stefan Sebastian Busnatu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (S.S.B.); (A.E.L.); (C.L.A.); (C.E.J.); (M.S.); (A.S.)
| | - Liviu Ionut Serbanoiu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (S.S.B.); (A.E.L.); (C.L.A.); (C.E.J.); (M.S.); (A.S.)
- Correspondence:
| | - Andreea Elena Lacraru
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (S.S.B.); (A.E.L.); (C.L.A.); (C.E.J.); (M.S.); (A.S.)
| | - Catalina Liliana Andrei
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (S.S.B.); (A.E.L.); (C.L.A.); (C.E.J.); (M.S.); (A.S.)
| | - Cosmina Elena Jercalau
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (S.S.B.); (A.E.L.); (C.L.A.); (C.E.J.); (M.S.); (A.S.)
| | - Marilena Stoian
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (S.S.B.); (A.E.L.); (C.L.A.); (C.E.J.); (M.S.); (A.S.)
| | - Anca Stoian
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (S.S.B.); (A.E.L.); (C.L.A.); (C.E.J.); (M.S.); (A.S.)
- Department of Diabetes, Nutrition and Metabolic Diseases, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
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14
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Prospective Association of Maternal Educational Level with Child's Physical Activity, Screen Time, and Diet Quality. Nutrients 2021; 14:nu14010160. [PMID: 35011035 PMCID: PMC8747409 DOI: 10.3390/nu14010160] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 11/25/2022] Open
Abstract
Evidence has identified unhealthy lifestyle behaviors as the main contributors to obesity in children, so it is essential to identify factors that could influence children’s lifestyles. The objective of the present study was to analyze the association of baseline maternal educational level with child’s physical activity, screen time, and dietary habits at follow-up. This community-based cohort study was carried out between 2012 and 2014 and included 1405 children aged 8 to 10 years old. Maternal educational level was used as an indicator of child’s socioeconomic status. Physical activity, screen time, and dietary habits were assessed by validated questionnaires. The odds of having commercially baked goods for breakfast [OR 1.47 (95% CI 1.03 to 2.10)], going more than once a week to a fast-food restaurant [OR 1.64 (95% CI 1.20 to 2.26)], and taking sweets and candys several times a day [OR 3.23 (95% CI 2.14 to 4.87) were significantly higher among children whose mothers had a lower educational level compared to their peers whose mothers had a higher level. These associations held for taking sweets and candy several times a day after additional adjustment for the corresponding dietary behavior at baseline. Maternal educational level was inversely associated (p < 0.001) with child’s screen time at follow up and being in the lowest maternal educational category was associated with an increased odds of surpassing the maximum recommended time of screen time of 120 min per day (OR (95% CI) 1.43 (1.07 to 1.90), p = 0.016). Maternal education is a predictor for unhealthy dietary habits and high screen time in children.
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Tokarek J, Gadzinowska J, Młynarska E, Franczyk B, Rysz J. What Is the Role of Gut Microbiota in Obesity Prevalence? A Few Words about Gut Microbiota and Its Association with Obesity and Related Diseases. Microorganisms 2021; 10:microorganisms10010052. [PMID: 35056501 PMCID: PMC8777962 DOI: 10.3390/microorganisms10010052] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/22/2021] [Accepted: 12/26/2021] [Indexed: 01/09/2023] Open
Abstract
Obesity is becoming the most dangerous lifestyle disease of our time, and its effects are already being observed in both developed and developing countries. The aim of this study was to investigate the impact of gut microbiota on the prevalence of obesity and associated morbidities, taking into consideration underlying molecular mechanisms. In addition to exploring the relationship between obesity and fecal microorganisms with their metabolites, the study also focused on the factors that would be able to stimulate growth and remodeling of microbiota. Assessed articles were carefully classified according to a predetermined criterion and were critically appraised and used as a basis for conclusions. The considered articles and reviews acknowledge that intestinal microbiota forms a multifunctional system that might significantly affect human homeostasis. It has been proved that alterations in the gut microbiota are found in obese and metabolically diseased patients. The imbalance of microbiome composition, such as changes in Bacteroidetes/Firmicutes ratio and presence of different species of genus Lactobacillus, might promote obesity and comorbidities (type 2 diabetes mellitus, hypertension, dyslipidemia, depression, obstructive sleep apnea). However, there are also studies that contradict this theory. Therefore, further well-designed studies are needed to improve the knowledge about the influence of microbiota, its metabolites, and probiotics on obesity.
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16
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Wang ZH, Zou ZY, Dong YH, Xu RB, Yang YD, Ma J. A Healthy Lifestyle Offsets the Increased Risk of Childhood Obesity Caused by High Birth Weight: Results From a Large-Scale Cross-Sectional Study. Front Nutr 2021; 8:736900. [PMID: 34859028 PMCID: PMC8631431 DOI: 10.3389/fnut.2021.736900] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 10/06/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To investigate whether a healthy lifestyle is associated with the lower childhood obesity regardless of birth weight. Methods: Participants were selected from a large-scale cross-sectional study conducted in the seven provinces across China. Birth weight and lifestyle factors were collected through a questionnaire. A weighted healthy lifestyle score was calculated and categorized into favorable, intermediate, and unfavorable lifestyles. Results: A total of 47,768 participants were enrolled in this study. Overall, 16.4% of the participants followed a favorable lifestyle, 62.8% followed an intermediate lifestyle, and 20.8% followed an unfavorable lifestyle. Compared with the participants who were born normal birth weight (NBW), participants who were born high birth weight (HBW) (OR = 1.58; 95% CI 1.48-1.77) and very high birth weight (VHBW) (OR = 1.79; 95% CI: 1.47-2.18) had higher obesity risk, however, the participants who were born low birth weight (LBW) had lower obesity risk (OR = 0.81; 95% CI: 0.68-0.96). Participants with an unfavorable lifestyle were associated with a higher risk of childhood obesity compared with the participants with favorable lifestyle (OR = 1.25; 95%CI: 1.14-1.38). Participants who were born VHBW and with an unfavorable lifestyle had 2.76 times (95% CI: 1.78-4.28) further risk of childhood obesity compared with the participants who were born NBW and with a favorable lifestyle. However, adherence to a favorable lifestyle seems to counteract the elevated risk of childhood obesity by VHBW (OR = 1.37; 95% CI: 0.84-2.24). Conclusion: Both the HBW and unfavorable lifestyle were significantly associated with risk of childhood obesity. Adherence to a favorable lifestyle decreased the risk of childhood obesity among the participants with VHBW. A more longitudinal study is required to repeat the finding to inform tailored prevention programs.
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Affiliation(s)
- Zheng-He Wang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Zhi-Yong Zou
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China
| | - Yan-Hui Dong
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China
| | - Rong-Bin Xu
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Yi-de Yang
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Jun Ma
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China
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17
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Bekelman TA, Ringham BM, Sauder KA, Johnson SL, Harrall KH, Glueck DH, Dabelea D. Adherence to index-based dietary patterns in childhood and BMI trajectory during the transition to adolescence: the EPOCH study. Int J Obes (Lond) 2021; 45:2439-2446. [PMID: 34304241 PMCID: PMC8542564 DOI: 10.1038/s41366-021-00917-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 07/10/2021] [Accepted: 07/19/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND In the United States, one in five adolescents are obese. Index-based dietary patterns are measures of the overall diet that have the potential to serve as valuable obesity risk stratification tools. However, little is known about the association between adherence to index-based dietary patterns in childhood and BMI during the transition from childhood to adolescence. OBJECTIVE To prospectively examine the relationship between adherence to three index-based dietary patterns in childhood and BMI trajectory during the transition to adolescence. METHODS The study included 581 children enrolled in a Colorado prospective cohort study conducted between 2006 and 2015. Dietary intake was assessed with the Block Kids Food Frequency Questionnaire at age 10 years. Scores were calculated for the Healthy Eating Index-2010 (HEI-2010), the alternate Mediterranean (aMED) diet, and the Dietary Approaches to Stop Hypertension (DASH) diet. Weight and height were assessed via anthropometry at two research visits (ages 10 and 16 years), with interim clinical measurements extracted from Kaiser Permanente medical records. Separate mixed models were used to assess the association between each diet index score and BMI over a 6-year period. Models were stratified by sex and adjusted for age, race/ethnicity, income, and exposure to gestational diabetes. RESULTS Median (IQR) number of BMI assessments was 14 (10-18). Among girls, for every ten-unit increase in HEI-2010 score, there was an average 0.64 kg/m2 decrease (p = 0.007) in BMI over time, after adjustment for covariates. Among girls, there was no association between BMI and aMED (β = -0.19, p = 0.24) or DASH (β = 0.28, p = 0.38). Among boys, there was no statistically significant association between BMI and HEI-2010 (0.06, p = 0.83), aMED (0.07, p = 0.70), or DASH (0.42, p = 0.06). CONCLUSIONS Efforts to prevent adolescent obesity could benefit from considering the degree of adherence to federal dietary guidance, as assessed by the HEI, in the period preceding adolescence, especially among girls.
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Affiliation(s)
- Traci A. Bekelman
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, Colorado,Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado
| | - Brandy M. Ringham
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, Colorado
| | - Katherine A. Sauder
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, Colorado,Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado,Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Susan L. Johnson
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Kylie H. Harrall
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, Colorado
| | - Deborah H. Glueck
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, Colorado,Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, Colorado,Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado,Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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18
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Bunik M, Shek L, Valenzuela M, Munson AL, Federspiel D, Helmkamp L, Haemer M, Dickinson LM. Bikes for Life: Measuring the effects of a bicycle distribution program on 6 to 12-year-old children's BMI and health behaviors. Obes Res Clin Pract 2021; 15:491-498. [PMID: 34521597 DOI: 10.1016/j.orcp.2021.09.003] [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: 07/13/2020] [Revised: 08/26/2021] [Accepted: 09/03/2021] [Indexed: 11/19/2022]
Abstract
Treating pediatric obesity is challenging. The objective was to evaluate effect of receiving a bicycle on (a) physical activity, (b) sedentary activity, (c) Body Mass Index (BMI), and (d) eating habits. A stepped-wedge randomized controlled trial of 6- to 12-year-old patients with overweight/obesity was conducted April 2012-2018. Participants were randomized to wait 0, 2, 4, or 6 months for a bicycle. Outcomes on activity, BMI and eating were collected at 3, 6, 9- and 12-months after children received a bicycle. A total of 525 participants with 387 (74%) completed 3-month follow-up questionnaire, and 346 (66%) completed 12-month follow-up visit. Participants were mostly Latino/a (71%) and low income (58%), and 31% had never ridden a bicycle. Median baseline BMI was 98th percentile. At 3 months, 62% reported bicycle use last week, on average 3.6 days. Time spent on sedentary activities decreased by 48 min/day (p = 0.04), and time spent playing sports increased by 1.7 h/week (p < 0.01). No reduction in BMI was seen. Consumption of sugary drinks decreased (by 0.59 servings/week, p < 0.01), and consumption of vegetables increased (0.71 servings/week, p = 0.04). At 12 months, sedentary time, sugary drink and vegetable consumption remained significantly more favorable than at enrollment (p < 0.01, p < 0.01, p = 0.04 respectively), but not significantly different (p = 0.47 for sedentary, p = 0.73 for sugary drink) and significantly less favorable (p < 0.01 for vegetables) than at the time of intervention. Participants reported riding bicycle, improved activity and dietary habits, though reversion towards baseline behavior was seen by one year and no change in BMI from enrollment.
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Affiliation(s)
- Maya Bunik
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO 80045, United States; Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, 13001 E 17th Pl, Aurora, CO 80045, United States.
| | - Laura Shek
- Child Health Advocacy Institute, Children's Hospital Colorado, 13123 E 16th Ave, Aurora, CO 80045, United States.
| | - Maria Valenzuela
- Child Health Advocacy Institute, Children's Hospital Colorado, 13123 E 16th Ave, Aurora, CO 80045, United States.
| | - Anna-Lisa Munson
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO 80045, United States; Pediatrics, Denver Health, 777 Bannock St, Denver, CO 80204, United States.
| | - Deborah Federspiel
- Child Health Advocacy Institute, Children's Hospital Colorado, 13123 E 16th Ave, Aurora, CO 80045, United States.
| | - Laura Helmkamp
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, 13001 E 17th Pl, Aurora, CO 80045, United States.
| | - Matthew Haemer
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO 80045, United States; Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, 13001 E 17th Pl, Aurora, CO 80045, United States.
| | - L Miriam Dickinson
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, 13001 E 17th Pl, Aurora, CO 80045, United States; Department of Family Medicine, University of Colorado Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO 80045, United States.
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Sidell M, Martinez MP, Chow T, Xiang AH. Types of diabetes during pregnancy and longitudinal BMI in offspring from birth to age 10 years. Pediatr Obes 2021; 16:e12776. [PMID: 33634964 DOI: 10.1111/ijpo.12776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 01/20/2021] [Accepted: 01/25/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine longitudinal BMI trajectory from birth to age 10 years in a clinical cohort after exposure to maternal pre-existing type 1 (T1D), type 2 (T2D), gestational diabetes managed with or without anti-diabetes medication, and no diabetes during pregnancy. METHODS Data included 218 227 singleton children born in 2008-2015 from a population-based integrated healthcare system; 537 exposed to maternal T1D, 7836 to T2D, 6982 to medicated GDM and 12 576 to unmedicated GDM. Differences in BMI over time among groups were assessed by non-linear mixed-effects models adjusting for covariates. RESULTS Children's BMI was significantly lower 6-months after birth for all diabetes exposed groups compared to no diabetes. Beginning at approximately age 2.5 years, BMI was significantly higher for T1D, T2D and medicated GDM groups compared to the no diabetes group. At age 3, the growth pattern started separating with highest BMI in T1D and T2D groups, followed by medicated GDM, unmedicated GDM, and the no diabetes groups. By age 7, BMI was significantly higher for the unmedicated GDM group compared to the no diabetes group. Adjusted BMI was generally comparable between T1D and T2D groups for all ages. Starting at age 5, T1D, T2D and medicated GDM groups had BMI greater than one SD over the BMI in the no diabetes group. CONCLUSION In a clinical cohort with standard diabetes management approaches, a hierarchical BMI growth pattern exists in offspring exposed to different types of diabetes during pregnancy after adjusting for important covariates, starting as early as age 3 years.
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Affiliation(s)
- Margo Sidell
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Mayra P Martinez
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Ting Chow
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Anny H Xiang
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
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20
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Fang K, He Y, Fang Y, Lian Y. Relationship of Sodium Intake with Overweight/Obesity among Chinese Children and Adolescents: Data from the CNNHS 2010-2012. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094551. [PMID: 33923000 PMCID: PMC8123343 DOI: 10.3390/ijerph18094551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/14/2021] [Accepted: 04/23/2021] [Indexed: 12/20/2022]
Abstract
This study aims to examine association between sodium intake and overweight/obesity among Chinese children and adolescents. Data were obtained from China National Nutrition and Health Surveillance (CNNHS), 2010–2012. All participants recruited in this study aged 7–18 years old and provided complete dietary data on three-day consecutive 24 h dietary recalls combining with the household weighing method. Body Mass Index (BMI) was used to define overweight/obesity, and waist-to-height ratio (WHtR) was used to define abdominal obesity. Sodium intake showed association with risk of overweight/obesity assessed by BMI in the highest tertile group with OR of 1.48 (95%CI 1.13–1.94) and 1.89 (95%CI 1.33–2.67) for WHtR. After adjusted for gender, age, household income, area, energy, carbohydrates, protein, fat, saturated fatty acids, and fiber intake, the relationship between sodium intake and overweight/obesity and abdominal obesity are not changed. The same results were founded in subjects aged 10–18 years old. Our results reveal a positive association between sodium intake and overweight/obesity in Chinese children and adolescents, independent of energy consumption.
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Affiliation(s)
| | - Yuna He
- Correspondence: ; Tel.: +86-010-67791292
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21
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Williams N, Mann G, Cafer A, Evers C, Kaiser K. “Bring back the salad bar”: perceptions of health in rural delta middle school students. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2021. [DOI: 10.1080/19320248.2021.1894298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Natalie Williams
- Department Nutrition and Hospitality Management, University of Mississippi, University, MS 38677, USA
| | - Georgianna Mann
- Department Nutrition and Hospitality Management, University of Mississippi, University, MS 38677, USA
| | - Anne Cafer
- University of Mississippi, University, MS 38677543, Lamar Hall, USA
| | - Charles Evers
- School of Medicine, 1670 University Blvd, University of Alabama, Birmingham, USA
| | - Kimberly Kaiser
- Department of Legal Studies, M302 Mayes, University of Mississippi, University, MS 38677, USA
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22
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Ranking of a wide multidomain set of predictor variables of children obesity by machine learning variable importance techniques. Sci Rep 2021; 11:1910. [PMID: 33479310 PMCID: PMC7820584 DOI: 10.1038/s41598-021-81205-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 01/04/2021] [Indexed: 12/14/2022] Open
Abstract
The increased prevalence of childhood obesity is expected to translate in the near future into a concomitant soaring of multiple cardio-metabolic diseases. Obesity has a complex, multifactorial etiology, that includes multiple and multidomain potential risk factors: genetics, dietary and physical activity habits, socio-economic environment, lifestyle, etc. In addition, all these factors are expected to exert their influence through a specific and especially convoluted way during childhood, given the fast growth along this period. Machine Learning methods are the appropriate tools to model this complexity, given their ability to cope with high-dimensional, non-linear data. Here, we have analyzed by Machine Learning a sample of 221 children (6–9 years) from Madrid, Spain. Both Random Forest and Gradient Boosting Machine models have been derived to predict the body mass index from a wide set of 190 multidomain variables (including age, sex, genetic polymorphisms, lifestyle, socio-economic, diet, exercise, and gestation ones). A consensus relative importance of the predictors has been estimated through variable importance measures, implemented robustly through an iterative process that included permutation and multiple imputation. We expect this analysis will help to shed light on the most important variables associated to childhood obesity, in order to choose better treatments for its prevention.
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Doherty AM, Lacko AM, Popkin BM. Sugar-sweetened beverage (SSB) consumption is associated with lower quality of the non-SSB diet in US adolescents and young adults. Am J Clin Nutr 2020; 113:657-664. [PMID: 33381808 PMCID: PMC7948860 DOI: 10.1093/ajcn/nqaa342] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 10/26/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Since 2003-4, the United States has seen large declines in sugar-sweetened beverage (SSB) intake overall, especially among non-Hispanic white (NHW) subpopulations. However, obesity prevalence has not shown comparable declines in the 2 highest SSB-consuming groups, adolescents and young adults. Little is understood about the quality of the diet excluding SSBs (non-SSB diet). OBJECTIVES The objective of this study was to evaluate differences in non-SSB diet quality in SSB consumers and nonconsumers in adolescents and young adults and in the 3 major race/ethnic subgroups. METHODS This study utilized data from the NHANES, a cross-sectional, nationally representative survey of the US population. Data from 6426 participants aged 12-29 y from the NHANES (2009-2014) was included. Quality of the non-SSB diet was measured using the 2015 Healthy Eating Index (HEI). Multivariate linear regressions controlled for sociodemographic characteristics and included interactions by race/ethnicity [NHWs, non-Hispanic blacks (NHBs), Hispanics]. Individuals were classified as non-, low- (<10% of daily calories), or high-SSB consumers (≥10% of daily calories), according to the US Dietary Guidelines added sugar intake recommendation. RESULTS Non-SSB HEI scores differed among SSB consumer groups (53 for adolescent nonconsumers compared with 46 for high consumers, P < 0.001; 57 for young adult nonconsumers compared with 45 for high consumers, P < 0.001), although all scores were low and require improvement. Among NHBs, significant differences in non-SSB HEI were found only between non- and low-SSB consumers. In Hispanics, associations varied by age group, with significant differences found for young adults but no association found for adolescents. CONCLUSIONS Low non-SSB HEI scores in SSB consumers suggest that reducing SSB consumption alone will not be a sufficient strategy for improving dietary quality in adolescents and young adults. Future policies must also consider improving the non-SSB diet.
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Affiliation(s)
- Alex M Doherty
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Allison M Lacko
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Duan R, Kou C, Jie J, Bai W, Lan X, Li Y, Yu X, Zhu B, Yuan H. Prevalence and correlates of overweight and obesity among adolescents in northeastern China: a cross-sectional study. BMJ Open 2020; 10:e036820. [PMID: 32737093 PMCID: PMC7398099 DOI: 10.1136/bmjopen-2020-036820] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES To estimate the prevalence of overweight/obesity among adolescents and evaluate the associated factors in this group in Changchun City in northeastern China. METHODS A cross-sectional study of 1955 adolescents aged 11-18 years was conducted in Changchun City using stratified cluster sampling. Parents and caregivers of children completed the questionnaires as requested without objection. The questionnaire included demographic characteristics and anthropometric parameters. Univariate and multivariate logistic regression analyses were performed to analyse the relationship between overweight/obesity and related factors. RESULTS In total, the prevalence of overweight was 12.7% (male 17.4%; female 10.1%) and of obesity was 4.9% (male 8.8%; female 3.1%) in Changchun, Jilin Province. The prevalence of overweight and obesity was higher in boys than in girls (p<0.001). Multivariate logistic regression showed that overweight and obesity were significantly associated with male sex (OR=1.91, 95% CI 1.48 to 2.47), eating fresh fruits more than 2 days per week (OR=1.41, 95% CI 1.09 to 1.84) and eating quickly (OR=1.37, 95% CI 1.06 to 1.78). Students who were not picky (OR=0.69, 95% CI 0.53 to 0.90) were less likely to be overweight, and adolescents whose father was overweight or obese (OR=0.67, 95% CI 0.52 to 0.86) or whose mother was overweight or obese (OR=0.72, 95% CI 0.52 to 0.99) were less likely to be overweight. CONCLUSION The prevalence of overweight and obesity among adolescents in Changchun has been high in recent years, and the prevalence was higher among boys than among girls. Sex, dietary habits (weekly frequency of fruit consumption, picky eating and slowness in eating) and parental weight were important factors for overweight and obesity in adolescents. Further research should be conducted on the health of adolescents in China, and further intervention measures should be implemented to reduce the prevalence of overweight/obesity.
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Affiliation(s)
- Ruixin Duan
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
- Pulmonary Division and Sleep Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Changgui Kou
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Jing Jie
- Pulmonary Division and Sleep Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Wei Bai
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xiaoxin Lan
- Pulmonary Division and Sleep Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Yuanyuan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xiao Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Bo Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Haibo Yuan
- Pulmonary Division and Sleep Center, The First Hospital of Jilin University, Changchun, Jilin, China
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Buro AW, Gray HL, Kirby RS, Berkman K, Agazzi H, Shaffer-Hudkins E. Diet quality in an ethnically diverse sample of children and adolescents with autism spectrum disorder compared with nationally representative data. Disabil Health J 2020; 14:100981. [PMID: 32811783 DOI: 10.1016/j.dhjo.2020.100981] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 07/14/2020] [Accepted: 07/23/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Children with developmental disabilities are at an increased risk of unhealthy eating habits, which may contribute to compromised growth and development. Children with autism spectrum disorder (ASD) exhibit unique risk factors for unhealthy dietary patterns, including sensory issues and cognitive rigidity at mealtimes. OBJECTIVE This cross-sectional study examined diet quality in a sample of children with ASD in Florida compared to nationally representative National Health and Nutrition Examination Survey (NHANES) 2009-2014/2013-2014 data using the Healthy Eating Index-2015 (HEI-2015). METHODS A 24-h food record was completed by 41 parents of children with ASD aged 2-17 years, and food and beverage items consumed by each child were reported per standardized 24-h recall protocol. Two models were used to compare mean total and component HEI-2015 scores to NHANES means: (1) comparing means for our full sample to published NHANES means for children aged 2-18 years and (2) a matched model with subjects matched 1:1 by age, gender, race/ethnicity, and parent education level. RESULTS HEI component scores were significantly lower (poorer) in children with ASD for whole fruit, total vegetables, dairy, total protein foods, and seafood and plant protein. Whole grains, fatty acids, added sugars, and refined grains scores were higher (better) in our sample. However, total HEI scores and HEI scores for all 13 components were similar among children with ASD and the matched cases from the NHANES data. CONCLUSIONS There are potential discrepancies in diet quality between children with ASD and general population. Further research with a larger sample size, reporting both total and component HEI scores, is needed.
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Affiliation(s)
- Acadia W Buro
- College of Public Health, University of South Florida, Tampa, FL, 33612, USA.
| | - Heewon L Gray
- College of Public Health, University of South Florida, Tampa, FL, 33612, USA
| | - Russell S Kirby
- College of Public Health, University of South Florida, Tampa, FL, 33612, USA
| | - Karen Berkman
- Center for Autism & Related Disabilities, Department of Child and Family Studies, University of South Florida, 13301 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Heather Agazzi
- Department of Pediatrics, University of South Florida, 13101 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Emily Shaffer-Hudkins
- Department of Pediatrics, University of South Florida, 13101 Bruce B Downs Blvd, Tampa, FL, 33612, USA
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The effect of comprehensive intervention for childhood obesity on dietary diversity among younger children: Evidence from a school-based randomized controlled trial in China. PLoS One 2020; 15:e0235951. [PMID: 32678852 PMCID: PMC7367455 DOI: 10.1371/journal.pone.0235951] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 06/24/2020] [Indexed: 11/19/2022] Open
Abstract
Background Little evidence from developing countries on dietary transition demonstrates the effects of comprehensive childhood obesity interventions on dietary diversity and food variety among younger children. This study aimed to evaluate the effects of comprehensive childhood obesity interventions on dietary diversity among younger children. Methods A total of 4846 children aged 7–13 years were included based on a multicenter randomized controlled trial for childhood obesity interventions in 38 primary schools. Nutrition education intervention (NE), physical activity intervention (PA) and comprehensive intervention including both NE and PA (CNP) were carried out separately for 2 semesters. Dietary Diversity Score (DDS9 and DDS28 for 9 and 28 food groupings, respectively), Food Variety Score (FVS, the number of food items) and the proportions of different foods consumed were calculated according to the food intake records collected with the 24-h dietary recall method. Results The intervention effects per day of comprehensive intervention group were 0 (95% Confidence Interval (CI): 0, 0.1; p = 0.382) on DDS9, 0.1 (95% CI: -0.1, 0.2; p = 0.374) on DDS28 and 0.1 (95% CI: -0.1, 0.3; p = 0.186) on FVS of overall diet, which was 0.1 (95% CI: 0, 0.1; p < 0.001) on DDS9, 0 (95% CI: 0, 0.1; p = 0.168) on DDS28 and 0.1 (95% CI: 0, 0.1; p = 0.067) on FVS of dietary scores of breakfast only. Additionally, CNP group had greater increases in cereals, meat and fruits, and more decreases in eggs, fish and dried legumes consumption proportions as compared with the control group. Decreasing side effect on dietary diversity and food variety were found for PA intervention, but not for NE intervention only. Conclusions Though the comprehensive obesity intervention didn’t improve the overall dietary diversity per day, the positive intervention effects were observed on breakfast foods and some foods’ consumption.
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Katsagoni CN, Psarra G, Georgoulis M, Tambalis K, Panagiotakos DB, Sidossis LS. High and moderate adherence to Mediterranean lifestyle is inversely associated with overweight, general and abdominal obesity in children and adolescents: The MediLIFE-index. Nutr Res 2020; 73:38-47. [DOI: 10.1016/j.nutres.2019.09.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 09/20/2019] [Accepted: 09/24/2019] [Indexed: 12/24/2022]
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Xu F, Cohen SA, Greaney ML, Hatfield DL, Greene GW. Racial/Ethnic Disparities in US Adolescents' Dietary Quality and Its Modification by Weight-Related Factors and Physical Activity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234803. [PMID: 31795448 PMCID: PMC6926511 DOI: 10.3390/ijerph16234803] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/26/2019] [Accepted: 11/27/2019] [Indexed: 12/31/2022]
Abstract
There are well-known disparities in the prevalence of obesity across racial-ethnic groups, although the behavioral and psychological factors driving these disparities are less well understood. Therefore, the objectives of this study were: (1) to examine differences in dietary quality by race/ethnicity and weight-related variables [body mass index (BMI), weight loss attempt, and weight dissatisfaction] and physical activity (PA) using the Health Eating Index-2015 (HEI-2015); and (2) to investigate the interactions and independent associations of race/ethnicity, weight-related variables and PA on dietary quality. Data for adolescents aged 12–19 years (n = 3373) were abstracted from the 2007–2014 National Health and Nutrition and Examination Survey and analyzed using multiple PROC SURVEYREG, adjusting for demographics and accounting for complex sampling. Analyses determined that Hispanic males had better overall HEI-2015 scores than non-Hispanic whites (48.4 ± 0.5 vs. 45.7 ± 0.6, p = 0.003) or blacks (48.4 ± 0.5 vs. 45.5 ± 0.5, p < 0.001). Hispanic females also had better dietary quality than non-Hispanic whites (50.2 ± 0.4 vs. 47.5 ± 0.5, p < 0.001) and blacks (50.2 ± 0.4 vs. 47.1 ± 0.5, p < 0.001). Meeting the PA recommendation modified racial/ethnic differences in dietary quality for females (p = 0.011) and this was primarily driven by the associations among non-Hispanic white females (ΔR2 = 2.6%, p = 0.0004). The study identified racial/ethnic and gender differences among adolescents in factors that may promote obesity. Results may be useful for obesity prevention efforts designed to reduce health disparities in adolescents.
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Affiliation(s)
- Furong Xu
- Department of Kinesiology, University of Rhode Island, Independence Square II, Kingston, RI 02881, USA;
- Correspondence: ; Tel.: +1-401-874-2412
| | - Steven A. Cohen
- Department of Health Studies, University of Rhode Island, Independence Square II, Kingston, RI 02881, USA; (S.A.C.); (M.L.G.)
| | - Mary L. Greaney
- Department of Health Studies, University of Rhode Island, Independence Square II, Kingston, RI 02881, USA; (S.A.C.); (M.L.G.)
| | - Disa L. Hatfield
- Department of Kinesiology, University of Rhode Island, Independence Square II, Kingston, RI 02881, USA;
| | - Geoffrey W. Greene
- Department of Nutrition and Food Sciences, University of Rhode Island, Fogarty Hall, Kingston, RI 02881, USA;
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An R, Ji M, Clarke C, Guan C. Impact of State Laws Governing Physical Education on Attendance Among US High School Students, 2003 to 2017. Am J Health Promot 2019; 33:1144-1151. [PMID: 31272188 DOI: 10.1177/0890117119858016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE This study assessed the influence of state laws governing physical education (PE) on weekly PE class attendance among US high school students. DESIGN Cross-sectional. SETTING 2003 to 2017 US national Youth Risk Behavior Survey (YRBS). PARTICIPANTS A total of 533 468 high school students. MEASURES Data on state laws governing PE came from National Cancer Institute's Classification of Laws Associated with School Students (CLASS). Eight distinct state PE policies were scored, with higher scores denoting stronger laws. ANALYSIS Individual-level YRBS data were merged with CLASS data based on students' residential state and survey year. State fixed-effect negative binomial regressions were performed, adjusting for individual-level characteristics and YRBS survey design. RESULTS A 1-score increase in state laws governing PE class time, staffing for PE, joint use agreement for physical activity, assessment of health-related fitness, and PE curriculum was associated with an increase in weekly PE attendance by 0.30, 0.28, 0.22, 0.20, and 0.13 days (P < .001), respectively. In contrast, a 1-score increase in state laws governing moderate-to-vigorous-intensity physical activity time in PE, PE proficiency, and recess time was associated with a reduction in weekly PE attendance by 0.25, 0.15, and 0.09 days (P < .001), respectively. The effects of most state PE policies on PE class attendance were larger among girls than boys. CONCLUSION State PE policies differentially impacted US high school students' PE class attendance, with larger effects on female students.
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Affiliation(s)
- Ruopeng An
- Department of Kinesiology and Community Health, University of Illinois, Champaign, IL, USA.,Brown School, Washington University, St Louis, MO, USA
| | - Mengmeng Ji
- Brown School, Washington University, St Louis, MO, USA
| | | | - Chenghua Guan
- School of Economics and Resource Management, Beijing Normal University, Beijing, China
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Dugas C, Bélanger M, Perron J, Weisnagel SJ, Tchernof A, Marc I, Robitaille J. Is A Healthy Diet Associated with Lower Anthropometric and Glycemic Alterations in Predisposed Children Born from Mothers with Gestational Diabetes Mellitus? Nutrients 2019; 11:nu11030570. [PMID: 30866420 PMCID: PMC6470518 DOI: 10.3390/nu11030570] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 02/22/2019] [Accepted: 03/02/2019] [Indexed: 12/16/2022] Open
Abstract
Children born from mothers with gestational diabetes mellitus (GDM) are at high-risk of obesity and type 2 diabetes. To date, there is a lack of effective strategies to prevent these complications. The aim of this study was to evaluate the association between diet quality and anthropometric and glycemic profiles of children exposed (GDM+) and unexposed (GDM⁻) to GDM. A total of 104 GDM+ and 38 GDM⁻ children were included. Two 24-h dietary recall questionnaires were used to assess dietary intakes. The Healthy Eating Index adapted for the Canadian population (HEI-C) was used to assess diet quality. Spearman correlations adjusted for children's age and sex were computed. Mean age was 6.0 ± 2.5 and 6.8 ± 2.3 years for GDM+ and GDM⁻, respectively (p = 0.03). Total HEI-C score was negatively associated with the android-to-gynoid fat mass ratio (r = -0.29, p = 0.03) and homeostasis model assessment for insulin resistance (HOMA-IR) index (r = -0.22, p = 0.04) in GDM+ children only. The prevalence of being overweight or obese during childhood was 4-fold higher among GDM+ children with a HEI-C score ≤70 compared to GDM+ children with a HEI-C score >70. Results of this study show that a healthy diet is associated with a better cardiometabolic health profile in GDM+ children, including a lower risk of being overweight or obese.
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Affiliation(s)
- Camille Dugas
- School of Nutrition, Laval University, 2425 rue de l'Agriculture, Quebec City, QC G1V 0A6, Canada.
- Institute of Nutrition and Functional Foods (INAF), Laval University, 2440 Boulevard Hochelaga, Quebec City, QC G1V 0A6, Canada.
- Endocrinology and Nephrology Axis, CHU de Québec Research Center, 2705 Boulevard Laurier, Quebec City, QC G1V 4G2, Canada.
| | - Mélissa Bélanger
- School of Nutrition, Laval University, 2425 rue de l'Agriculture, Quebec City, QC G1V 0A6, Canada.
- Institute of Nutrition and Functional Foods (INAF), Laval University, 2440 Boulevard Hochelaga, Quebec City, QC G1V 0A6, Canada.
- Endocrinology and Nephrology Axis, CHU de Québec Research Center, 2705 Boulevard Laurier, Quebec City, QC G1V 4G2, Canada.
| | - Julie Perron
- Institute of Nutrition and Functional Foods (INAF), Laval University, 2440 Boulevard Hochelaga, Quebec City, QC G1V 0A6, Canada.
| | - S John Weisnagel
- Endocrinology and Nephrology Axis, CHU de Québec Research Center, 2705 Boulevard Laurier, Quebec City, QC G1V 4G2, Canada.
- Diabetes Research Unit, Laval University Medical Research Center, 2705 Boulevard Laurier, Quebec City, QC G1V 4G2, Canada.
| | - André Tchernof
- School of Nutrition, Laval University, 2425 rue de l'Agriculture, Quebec City, QC G1V 0A6, Canada.
- Institute of Nutrition and Functional Foods (INAF), Laval University, 2440 Boulevard Hochelaga, Quebec City, QC G1V 0A6, Canada.
| | - Isabelle Marc
- Endocrinology and Nephrology Axis, CHU de Québec Research Center, 2705 Boulevard Laurier, Quebec City, QC G1V 4G2, Canada.
| | - Julie Robitaille
- School of Nutrition, Laval University, 2425 rue de l'Agriculture, Quebec City, QC G1V 0A6, Canada.
- Institute of Nutrition and Functional Foods (INAF), Laval University, 2440 Boulevard Hochelaga, Quebec City, QC G1V 0A6, Canada.
- Endocrinology and Nephrology Axis, CHU de Québec Research Center, 2705 Boulevard Laurier, Quebec City, QC G1V 4G2, Canada.
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An R, Shen J, Yang Q, Yang Y. Impact of built environment on physical activity and obesity among children and adolescents in China: A narrative systematic review. JOURNAL OF SPORT AND HEALTH SCIENCE 2019; 8:153-169. [PMID: 30997262 PMCID: PMC6451055 DOI: 10.1016/j.jshs.2018.11.003] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 09/19/2018] [Accepted: 10/04/2018] [Indexed: 05/08/2023]
Abstract
BACKGROUND Neighborhood built environment may profoundly influence children's physical activity (PA) and body weight. This study systematically reviewed scientific evidence regarding the impact of built environment on PA and obesity among children and adolescents in China. METHODS A keyword and reference search was conducted in Active Living Research, Cochrane Library, PubMed, and Web of Science. Studies that met all of the following criteria were included in the review: (1) study designs-experimental studies, observational studies, and qualitative studies; (2) study subjects-Chinese children and/or adolescents aged ≤17 years; (3) exposures-neighborhood built environment; (4) outcomes-PA and/or body weight status; (5) article type-peer-reviewed publications; (6) time window of search-from the inception of an electronicbibliographic database to May 31, 2018; (7) country-China; and (8) language-articles written in English. RESULTS A total of 20 studies, including 16 cross-sectional studies, 3 longitudinal studies, and 1 descriptive study, met the predetermined selection criteria and were included in the review. A total of 13 studies adopted subjective built environment measures reported by parents and/or children,2 adopted objective measures (e.g., geographical information system, field observations), and 5 adopted both objective and subjective measures. PA behaviors included PA, physical inactivity, sedentary behavior, active/passive commuting from/to school, and park visits. Among the 16 studies that provided some quantitative estimates of the influence of built environment on PA and body weight status, all reported a statistically significant relationship in the expected direction. Availability and accessibility in proximity to greenspaces, parks, recreational facilities, and sidewalks were found to be associated with increased PA levels, reduced sedentary behaviors, and/or active commuting among Chinese childrenand adolescents. In contrast, the absence of bike lanes and living in higher density residential areas were associated with increased likelihood of childhood overweight and obesity. CONCLUSION Neighborhood built environment plays an important role in Chinese children's PA engagement and weight outcomes. Building new exercise facilities and enhancing the accessibility of existing facilities hold the potential to enhance PA engagement among Chinese children and adolescents. In addition, urban designs that incorporate sidewalks, bike lanes, walking paths, less motorized traffic, and lower residential density are likely to promote PA and prevent childhood obesity in China.
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Affiliation(s)
- Ruopeng An
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA
| | - Jing Shen
- College of Education, Beijing Sport University, Beijing 100084, China
| | - Qiuying Yang
- College of Physical Education and Health, East China Normal University, Shanghai 200241, China
| | - Yan Yang
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA
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Xu F, Cohen SA, Greaney ML, Greene GW. The Association between US Adolescents' Weight Status, Weight Perception, Weight Satisfaction, and Their Physical Activity and Dietary Behaviors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091931. [PMID: 30189607 PMCID: PMC6163799 DOI: 10.3390/ijerph15091931] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 09/02/2018] [Accepted: 09/02/2018] [Indexed: 11/16/2022]
Abstract
Background: It remain unclear that the association between weight status, weight perception, weight satisfaction and the clustering of physical activity (PA) and dietary behaviors in adolescents. Method: A cross-sectional analysis of National Health and Nutrition Examination Survey and the US Department of Agriculture's Food Patterns Equivalents 2007⁻2014 data from adolescents aged 12⁻17 years (n = 2965) was conducted. Multivariable logistic regression models adjusted for demographic characteristics examined the association between weight status, weight perception, weight satisfaction, and the four created lifestyle groups (healthier behaviors, healthier diet only, physically active only, unhealthier behaviors). Results: Males with obesity were more likely to be in the healthier diet only group than males with a normal weight (OR = 1.90, 95% CI: 1.02, 3.52). Similar patterns were found in males who perceived themselves as being overweight or having obesity (OR = 2.09, 95% CI: 1.09, 3.99) and males with obesity who perceived their weight status accurately (OR = 2.33, 95% CI: 1.12, 4.88). Female respondents who were satisfied with their weight were 59% less likely to be in the healthier diet only group than healthier behaviors group compared with females who were weight dissatisfied (OR = 0.41, 95% CI: 0.23, 0.75). This pattern was not observed in males. Conclusions: Clustering PA and dietary behaviors were associated with weight status and weight perception for males but not females. Weight satisfaction was associated with clustered PA and dietary behaviors for females. These findings are important for obesity prevention policies and programs to better address adolescents' obesity and reduce health disparities in this population.
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Affiliation(s)
- Furong Xu
- Department of Kinesiology, University of Rhode Island, Independence Square II, Kingston, RI 02881, USA.
| | - Steven A Cohen
- Health Studies Program, University of Rhode Island, Independence Square II, Kingston, RI 02881, USA.
| | - Mary L Greaney
- Health Studies Program, University of Rhode Island, Independence Square II, Kingston, RI 02881, USA.
| | - Geoffrey W Greene
- Department of Nutrition and Food Sciences, University of Rhode Island, Fogarty Hall, Kingston, RI 02881, USA.
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Burns RD, Brusseau TA, Fu Y. Moderators of School-Based Physical Activity Interventions on Cardiorespiratory Endurance in Primary School-Aged Children: A Meta-Regression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081764. [PMID: 30115882 PMCID: PMC6121563 DOI: 10.3390/ijerph15081764] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 08/01/2018] [Accepted: 08/14/2018] [Indexed: 01/09/2023]
Abstract
The purpose of this study was to examine potential moderators of school-based physical activity interventions on cardiorespiratory endurance in primary school-aged children using meta-regression. An Internet search with several databases was employed, extracting school-based pediatric physical activity intervention studies published within the past 30 years. Studies were included if there was a control or comparison group, if the study sample included primary school-aged children, if the targeted outcome of cardiorespiratory endurance was objectively assessed, if the intervention was at least partially school-based, and if the effect estimate's variability was reported. An inverse-variance random effects meta-regression was employed using the primary predictors of component number (single component or multi-component) and intervention length using 20 extracted studies with 23 total effects. The overall pooled effect on cardiorespiratory endurance was statistically significant (Hedges' g = 0.30, 95% C.I.: 0.19⁻0.40; p < 0.001). Using random effects meta-regression, neither component number (b = ⁻0.09, 95% C.I.: ⁻0.40⁻0.23; p = 0.560) or intervention length (b = 0.001, 95% C.I.: ⁻0.002⁻0.004; p = 0.427) yielded a significant modifying effect on cardiorespiratory endurance. School-based physical activity interventions have a significant pooled effect on cardiorespiratory endurance in primary school-aged children. Component number and intervention length does not modify this effect, suggesting other sources for between-study heterogeneity.
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Affiliation(s)
- Ryan D Burns
- Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, UT 84112, USA.
| | - Timothy A Brusseau
- Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, UT 84112, USA.
| | - You Fu
- School of Community Health Sciences, University of Nevada Reno, Reno, NV 89557, USA.
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Jessri M, Ng AP, L'Abbé MR. Adapting the Healthy Eating Index 2010 for the Canadian Population: Evidence from the Canadian National Nutrition Survey. Nutrients 2017; 9:E910. [PMID: 28825674 PMCID: PMC5579703 DOI: 10.3390/nu9080910] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 07/20/2017] [Accepted: 07/27/2017] [Indexed: 01/24/2023] Open
Abstract
The Healthy Eating Index (HEI) is a diet quality index shown to be associated with reduced chronic disease risk. Older versions of the HEI have been adapted for Canadian populations; however, no Canadian modification of the Healthy Eating Index-2010 (HEI-2010) has been made. The aims of this study were: (a) to develop a Canadian adaptation of the HEI-2010 (i.e., Healthy Eating Index-Canada 2010 (HEI-C 2010)) by adapting the recommendations of the HEI-2010 to Canada's Food Guide (CFG) 2007; (b) to evaluate the validity and reliability of the HEI-C 2010; and (c) to examine relationships between HEI-C 2010 scores with diet quality and the likelihood of being obese. Data from 12,805 participants (≥18 years) were obtained from the Canadian Community Health Survey Cycle 2.2. Weighted multivariate logistic regression was used to test the association between compliance to the HEI-C 2010 recommendations and the likelihood of being obese, adjusting for errors in self-reported dietary data. The total mean error-corrected HEI-C 2010 score was 50.85 ± 0.35 out of 100. Principal component analysis confirmed multidimensionality of the HEI-C 2010, while Cronbach's α = 0.78 demonstrated internal reliability. Participants in the fourth quartile of the HEI-C 2010 with the healthiest diets were less likely to consume refined grains and empty calories and more likely to consume beneficial nutrients and foods (p-trend < 0.0001). Lower adherence to the index recommendations was inversely associated with the likelihood of being obese; this association strengthened after correction for measurement error (Odds Ratio: 1.41; 95% Confidence Interval: 1.17-1.71). Closer adherence to Canada's Food Guide 2007 assessed through the HEI-C 2010 was associated with improved diet quality and reductions in the likelihood of obesity when energy intake and measurement errors were taken into account. Consideration of energy requirements and energy density in future updates of Canada's Food Guide are important and necessary to ensure broader application and usability of dietary quality indexes developed based on this national nutrition guideline.
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Affiliation(s)
- Mahsa Jessri
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 150 College St., Toronto, ON M5S 3E2, Canada.
| | - Alena Praneet Ng
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 150 College St., Toronto, ON M5S 3E2, Canada.
| | - Mary R L'Abbé
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 150 College St., Toronto, ON M5S 3E2, Canada.
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Arriscado D, Knox E, Zabala M, Zurita-Ortega F, Dalmau JM, Muros JJ. Different healthy habits between northern and southern Spanish school children. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2017; 25:653-660. [PMID: 29177127 PMCID: PMC5681975 DOI: 10.1007/s10389-017-0823-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 07/19/2017] [Indexed: 12/11/2022]
Abstract
AIM Healthy habits are influenced by several factors such as geographical location. The aims of this study were to describe and compare healthy habits within two populations of sixth-grade primary school children (aged 11-12 years) from northern and southern Spain. SUBJECTS AND METHODS A cross-sectional study using two representative samples of school children was conducted. Participants came from Logroño (n = 329) in the north and Granada (n = 284) in the south of Spain. Socio-demographic and anthropometric variables, adherence to the Mediterranean diet, aerobic fitness, and healthy lifestyles were recorded. RESULTS Boys reported a higher level of physical activity and aerobic fitness than girls (p = 0.000). Southern school children reported significantly higher adherence to the Mediterranean diet (♀: p = 0.041; ♂: p = 0.008), lower aerobic fitness (♀: p = 0.000; ♂: p = 0.042) and hours of nightly sleep (♀: p = 0.008, ♂: p = 0.007) than northern school children. Southern boys also reported lower levels of physical activity (p = 0.013). There were slight or moderate correlations among all habits measured (physical activity, diet, screen and sleep time). Additionally, the physical activity level was inversely related to weight status. Overweight and obese northern boys reported less physical activity than healthy-weight northern boys (p = 0.020) and overweight and obese southern girls reported less physical activity than healthy-weight southern girls (p = 0.024). CONCLUSIONS Results showed differences in physical activity, eating and sleep habits, and aerobic fitness according to geographical location. The relationships found among lifestyle habits indicate the need for health promotion interventions nationally and considering the differences discussed here.
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Affiliation(s)
- Daniel Arriscado
- Department of Education, International University of La Rioja, Logroño, La Rioja Spain
| | - Emily Knox
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Mikel Zabala
- Department of Physical Education, University of Granada, Granada, Spain
| | - Félix Zurita-Ortega
- Department of Didactics of Musical, Plastic and Corporal Expression, University of Granada, Granada, Spain
| | - Jose Maria Dalmau
- Department of Educational Sciences, University of La Rioja, Logroño, La Rioja Spain
| | - Jose Joaquin Muros
- Department of Nutrition and Food Science, School of Pharmacy, University of Granada, Campus Universitario de la Cartuja s/n, P.C.:18071 Granada, Spain
- School of Medicine, University of Nottingham, Nottingham, UK
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Communication Strategies to Improve Healthy Food Consumption among Schoolchildren: Focus on Milk. BEVERAGES 2017. [DOI: 10.3390/beverages3030032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
This work provides an updated picture of communication strategies developed to improve healthy dietary habits in schoolchildren, with a focus on the importance of milk consumption. The paper has investigated two main areas: the definition of the main orientations and key points of research approach relative to the communication methods, with special attention to multiple strategies and the identification of their peculiarities to increase daily milk consumption. The school environment is considered as a unique environment to help increase the adoption of a correct dietary habit and lifestyle; it increases physical activity by facilitating the flow of health-related information. In this regard, several studies have highlighted the importance and effectiveness of school-based interventions on a large-scale, also considering multiple contexts, early interventions as well as the involvement of teachers, students and families. The effective actions range from interventions on prices and the availability of desirable and undesirable foods to educational programmes that improve food knowledge and the choices of students and/or their parents. From the nutritional point of view, milk is an important component of a well-balanced diet—especially for children—because it contains essential nutrients. It is a substantial contributor to the daily energy intake; however, its consumption often declines with aging and becomes insufficient. Therefore, developing strategies to increase its consumption is an important objective to reach.
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Rerksuppaphol L, Rerksuppaphol S. Internet Based Obesity Prevention Program for Thai School Children- A Randomized Control Trial. J Clin Diagn Res 2017; 11:SC07-SC11. [PMID: 28511471 DOI: 10.7860/jcdr/2017/21423.9368] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 11/15/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Internet based obesity prevention program is one approach in learning strategies to improve healthy behaviour. It has been advocated as one strategy to address the rising prevalence of childhood obesity; however, their efficacy is not seen consistently. AIM The purpose of this study was to assess the efficacy of internet based obesity prevention program in Thai school children. MATERIALS AND METHODS Healthy children studying in public schools in one township of central Thailand were randomly assigned to either the intervention (internet based) program or the control group. Anthropometric characteristics were recorded at baseline and for the next four following months at monthly intervals. Changes in the percentage of overweight/obese children and changes in BMI at the end of study were considered as the primary and secondary outcome, respectively. RESULTS A total of 217 children, mean age of 10.7 years, were included into the final analysis. Baseline anthropometric parameters and percentages of overweight/obesity were not significantly different between groups. At the end of the study, the control group had a higher percentage of overweight/obesity than the intervention group (56.6% vs. 39.6%, respectively; p-value=0.009). Children in the control group had a significantly higher increase in net BMI gains than those in the intervention group (1.24kg/m2 vs. 0.40kg/m2, p-value=0.027). The intervention group had no changes in BMI z-score (-0.001, 95%CI -0.19 to 0.18, p-value=0.988), contrary to those in the control group, which had significant gain of BMI z-score at the end of study (0.45, 95%CI 0.27 to 0.63, p-value<0.001). CONCLUSION Internet the based obesity prevention program was effective in modifying anthropometric outcome and helped to address the rising prevalence of overweight and obese status in Thai children.
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Affiliation(s)
- Lakkana Rerksuppaphol
- Assistant Professor, Department of Preventive Medicine, Faculty of Medicine, Srinakharinwirot University, Thailand
| | - Sanguansak Rerksuppaphol
- Associate Professor, Department of Paediatrics, Faculty of Medicine, Srinakharinwirot University, Thailand
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Cook WK, Tseng W, Bautista R, John I. Ethnicity, socioeconomic status, and overweight in Asian American adolescents. Prev Med Rep 2016; 4:233-7. [PMID: 27413687 PMCID: PMC4929066 DOI: 10.1016/j.pmedr.2016.06.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 04/28/2016] [Accepted: 06/06/2016] [Indexed: 11/18/2022] Open
Abstract
Asian American children and adolescents are an under-investigated subpopulation in obesity research. This study aimed to identify specific profiles of Asian subgroups at high risk of adolescent overweight with special attention to Asian ethnicity, socioeconomic status (SES), and their interaction. Multiple logistic regression models were fitted using a sample of 1533 Asian American adolescents ages 12–17 from the 2007–2012 California Health Interview Survey (CHIS). In addition to Asian ethnicity and socioeconomic status (assessed by family income and parental education level), age, gender, nativity, and two lifestyle variables, fast food consumption and physical activity, were also controlled for in these models. Key predictors of overweight in Asian American adolescents included certain Asian ethnicities (Southeast Asian, Filipino, and mixed ethnicities), low family income (< 300% of the Federal Poverty Level), and being male. Multiplicative interaction terms between low family income and two ethnicities, Southeast Asian and Vietnamese that had the lowest SES among Asian ethnic groups, were significantly associated with greatly elevated odds of being overweight (ORs = 12.90 and 6.67, respectively). These findings suggest that high risk of overweight in Asian American adolescents associated with low family incomes may be further elevated for those in low-income ethnic groups. Future research might investigate ethnic-group SES as a meaningful indicator of community-level socioeconomic disparities that influence the health of Asian Americans. Southeast Asian and Filipino ethnicities were associated with adolescent overweight. Low family income was positively associated with Asian adolescent overweight. Ethnicity and low family income interacted to increase risk of adolescent overweight.
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Affiliation(s)
- Won Kim Cook
- Asian & Pacific Islander American Health Forum, United States
- Corresponding author.
| | | | | | - Iyanrick John
- Asian & Pacific Islander American Health Forum, United States
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