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O. Gorman T, Maher GM, Al Khalaf S, Khashan AS. The association between caesarean section delivery and obesity at age 17 years. Evidence from a longitudinal cohort study in the United Kingdom. PLoS One 2024; 19:e0301684. [PMID: 38820521 PMCID: PMC11142666 DOI: 10.1371/journal.pone.0301684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 03/20/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Childhood and adolescent obesity are major, preventable public health concerns. Studies to date are inconclusive regarding an association between caesarean section (CS) delivery and offspring obesity, with fewer studies conducted in late adolescence. This study examined the association between CS delivery, with a specific focus on planned CS, and induction of labour and adolescent body mass index (BMI) and body fat percentage (BF%) at age 17 years. METHODS Data on 8,880 mother-child pairs from the United Kingdom Millennium Cohort Study were analysed. The exposures were mode of delivery (normal vaginal delivery (VD) (reference), assisted VD, planned CS and emergency CS) and mode of delivery by induction of labour status. Crude and adjusted binary logistic regression and linear regression models were fitted examining BMI and BF% at age 17 years respectively, adjusting for several potential confounders. RESULTS Adolescents born by CS did not have an elevated BMI or BF% compared to those born by normal VD. The fully adjusted results for overweight and obesity in children born by planned CS, compared to VD, were 1.05 (95% CI: 0.86-1.28) and 0.94 (95% CI: 0.72-1.23), respectively. The results were similar for the associations between CS and BF%, and between induction of labour and BMI. CONCLUSION Overall, this large longitudinal study did not support an association between CS or induction of labour and overweight, obesity or BF%. It is possible that previously reported associations are due to residual or unmeasured confounding and/or underlying indications for CS delivery.
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Affiliation(s)
- Tessa O. Gorman
- School of Public Health, University College Cork, Cork, Ireland
- Department of Public Health South West, St. Finbarr’s Hospital, Cork, Ireland
| | - Gillian M. Maher
- School of Public Health, University College Cork, Cork, Ireland
- INFANT Research Centre, University College Cork, Cork, Ireland
| | - Sukainah Al Khalaf
- School of Public Health, University College Cork, Cork, Ireland
- Mohammed Al-Mana College for Medical Sciences, Dammam, Saudi Arabia
| | - Ali S. Khashan
- School of Public Health, University College Cork, Cork, Ireland
- INFANT Research Centre, University College Cork, Cork, Ireland
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Monsur M, Hefner T, Van Allen J, Trina NA, Andalib SY, Cosco N. Effects of Childcare Hands-On Gardening on Preschoolers' (3-5 Years) Physical Activity in Semi-Arid Climate Zone. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:548. [PMID: 38791763 PMCID: PMC11121640 DOI: 10.3390/ijerph21050548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/23/2024] [Accepted: 04/25/2024] [Indexed: 05/26/2024]
Abstract
How hands-on gardening impacts behaviors including healthy eating and physical activity during early childhood can be of critical importance for preventing the early onset of obesity. This study investigates how participating in hands-on gardening impacts preschoolers' (3-5 years old) physical activity (measured by accelerometers) in childcare centers in the semi-arid climate zone. The research was conducted in eight licensed childcare centers located in West Texas with 149 children (n = 149). Four childcare centers in the experimental group received hands-on garden interventions; the other four in the control group did not. In both experimental (intervention) and control (non-intervention) centers, children wore Actigraph GT3X+ accelerometers continuously for 5 days before and for 5 days after intervention (a total of 10 days). Results show that the duration of sedentary behavior of children in the experimental (intervention) group significantly decreased compared to children in the control (non-intervention) group. The finding suggests that the positive effects of childcare hands-on gardening on physical activity extend to semi-arid climate zones where gardening is challenging due to high temperatures and lack of annual rainfall. The research emphasizes the critical need to incorporate hands-on gardening in childcare centers as an obesity prevention strategy nationally in the US and beyond.
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Affiliation(s)
- Muntazar Monsur
- Department of Landscape Architecture (DoLA), Davis College of Agricultural Sciences and Natural Resources, Texas Tech University, Lubbock, TX 79409, USA; (N.A.T.); (S.Y.A.)
| | - Tristen Hefner
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX 79409, USA; (T.H.); (J.V.A.)
| | - Jason Van Allen
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX 79409, USA; (T.H.); (J.V.A.)
| | - Nazia Afrin Trina
- Department of Landscape Architecture (DoLA), Davis College of Agricultural Sciences and Natural Resources, Texas Tech University, Lubbock, TX 79409, USA; (N.A.T.); (S.Y.A.)
| | - S. Y. Andalib
- Department of Landscape Architecture (DoLA), Davis College of Agricultural Sciences and Natural Resources, Texas Tech University, Lubbock, TX 79409, USA; (N.A.T.); (S.Y.A.)
| | - Nilda Cosco
- Department of Landscape Architecture and Environmental Planning, College of Design, North Carolina State University, Raleigh, NC 27695, USA;
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Natale R, Schladant M, Bloyer MH, Hernandez J, Palenzuela J, Agosto Y, Peng Y, Messiah SE. A Randomized Controlled Cluster Trial of an Obesity Prevention Program for Children with Special Health Care Needs: Methods and Implications. Nutrients 2024; 16:1274. [PMID: 38732520 PMCID: PMC11085216 DOI: 10.3390/nu16091274] [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: 03/06/2024] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
Children with disabilities have higher prevalence estimates of obesity than typically developing children. The Healthy Caregivers-Healthy Children Phase 3 (HC3) project implemented an obesity prevention program adapted for children with special health care needs (CSHCN) that includes dietary intake and physical activity (PA) components. The primary outcome was a change in dietary intake, PA, and the body mass index (BMI) percentile. Ten childcare centers (CCCs) serving low-resource families with ≥30 2- to 5-year-olds attending were randomized to either the intervention (n = 5) or control (n = 5). The HC3 CCCs received (1) snack, beverage, PA, and screen time policies via weekly technical assistance; (2) adapted lesson plans for CSHCN; and (3) parent curricula. The control CCCs received a behavioral health attention curriculum. HC3 was delivered over three school years, with data collected at five different timepoints. It was delivered weekly for six months in year one. To ensure capacity building, the HC3 tasks were scaled back, with quarterly intervention delivery in year 2 and annually in year 3. Adaptations were made to the curriculum to ensure appropriate access for CSHCN. Given that the program was being delivered during the COVID-19 pandemic, special modifications were made to follow CDC safety standards. The primary outcome measures included the Environment and Policy Assessment and Observation (EPAO) tool, standardized dietary intake and PA assessments, and the child BMI percentile. CCCs are an ideal setting for targeting CSHCN for obesity prevention efforts as they provide an opportunity to address modifiable risk factors.
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Affiliation(s)
- Ruby Natale
- Mailman Center for Child Development, Department of Pediatrics, University of Miami School of Medicine, Miami, FL 33136, USA; (M.S.); (J.H.); (J.P.); (Y.A.)
| | - Michelle Schladant
- Mailman Center for Child Development, Department of Pediatrics, University of Miami School of Medicine, Miami, FL 33136, USA; (M.S.); (J.H.); (J.P.); (Y.A.)
| | - Martha H. Bloyer
- Department of Physical Therapy, University of Miami, Coral Gables, FL 33136, USA;
| | - Julieta Hernandez
- Mailman Center for Child Development, Department of Pediatrics, University of Miami School of Medicine, Miami, FL 33136, USA; (M.S.); (J.H.); (J.P.); (Y.A.)
| | - Joanne Palenzuela
- Mailman Center for Child Development, Department of Pediatrics, University of Miami School of Medicine, Miami, FL 33136, USA; (M.S.); (J.H.); (J.P.); (Y.A.)
| | - Yaray Agosto
- Mailman Center for Child Development, Department of Pediatrics, University of Miami School of Medicine, Miami, FL 33136, USA; (M.S.); (J.H.); (J.P.); (Y.A.)
| | - Youmeizi Peng
- Mailman Center for Child Development, Department of Pediatrics, University of Miami School of Medicine, Miami, FL 33136, USA; (M.S.); (J.H.); (J.P.); (Y.A.)
| | - Sarah E. Messiah
- University of Texas Health Science Center at Houston School of Public Health, Dallas, TX 75207, USA;
- Center for Pediatric Population Health, University of Texas Health Science Center at Houston School of Public Health, Dallas, TX 75207, USA
- Department of Pediatrics, McGovern Medical School, Houston, TX 77030, USA
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Lee J, Helgeson E, Horning ML, Elgesma KM, Kubik MY, Fulkerson JA. Food Insecurity and Changes in Diet Quality and Body Mass Index z-Scores Among Elementary School Students. Child Obes 2024. [PMID: 38546529 DOI: 10.1089/chi.2023.0185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/19/2024]
Abstract
Background: Previous research has identified food insecurity as a risk factor for obesity but those studies employed cross-sectional designs and were largely focused on adults and young children. In addition, there is a paucity of studies examining the association between food insecurity and changes in children's overall diet quality. This study aimed to assess whether food insecurity is associated with subsequent changes in diet quality and BMI z-scores over 2 years among 7- to 12-year-old children. Methods: We used 2011-2019 secondary data (n = 404) from three randomized controlled trials in Minnesota. Food insecurity was identified using the U.S. Household Food Security Survey Module at baseline (Time 0). Diet quality was determined using the Healthy Eating Index (HEI)-2015 from 24-hour recalls, and BMI z-scores were calculated using measured height and weight. These two outcomes were measured at Time 0, Time 1 (10-12 months from Time 0), and Time 2 (15-24 months from Time 0). Results: Compared with children from food-secure households, those from food-insecure households experienced a 0.13 greater increase in BMI z-scores from Time 0 to Time 2 [95% confidence interval (CI): 0.04 to 0.21] and a 4.5 point increase in HEI-2015 from Time 0 to Time 1 (95% CI: 0.99 to 8.01). Conclusion: Household food insecurity may widen weight disparities among elementary school-aged children. Further studies are needed to identify the role of diet quality in weight changes among children with food insecurity. Clinical Trial Registration Number: NCT01538615, NCT02029976, NCT02973815.
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Affiliation(s)
- Jiwoo Lee
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | - Erika Helgeson
- Division of Biostatistics and Health Data Science, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | | | | | - Martha Y Kubik
- School of Nursing, College of Public Health, George Mason University, Fairfax, VA, USA
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Martins C, Romo-Perez V, Webster EK, Duncan M, Lemos LF, Staiano AE, Okely A, Magistro D, Carlevaro F, Bardid F, Magno F, Nobre G, Estevan I, Mota J, Ning K, Robinson LE, Lenoir M, Quan M, Valentini NC, Cross P, Jones R, Henrique R, Chen ST, Diao Y, Bandeira PR, Barnett LM. Motor Competence and Body Mass Index in the Preschool Years: A Pooled Cross-Sectional Analysis of 5545 Children from Eight Countries. Sports Med 2024; 54:505-516. [PMID: 37747664 PMCID: PMC10939976 DOI: 10.1007/s40279-023-01929-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND AND OBJECTIVE One in five preschool children are overweight/obese, and increased weight status over time increases the risks of poorer future health. Motor skill competence may be a protective factor, giving children the ability to participate in health-enhancing physical activity. Yet, we do not know when the relationship between motor competence and weight status first emerges or whether it is evident across the body mass index (BMI) spectrum. This study examined the association between motor skill competence and BMI in a multi-country sample of 5545 preschoolers (54.36 ± 9.15 months of age; 50.5% boys) from eight countries. METHODS Quantile regression analyses were used to explore the associations between motor skill competence (assessed using the Test of Gross Motor Development, Second/Third Edition) and quantiles of BMI (15th; 50th; 85th; and 97th percentiles), adjusted for sex, age in months, and country. RESULTS Negative associations of locomotor skills, ball skills, and overall motor skill competence with BMI percentiles (p < 0.005) were seen, which became stronger at the higher end of the BMI distribution (97th percentile). Regardless of sex, for each raw score point increase in locomotor skills, ball skills, and overall motor skill competence scores, BMI is reduced by 8.9%, 6.8%, and 5.1%, respectively, for those preschoolers at the 97th BMI percentile onwards. CONCLUSIONS Public health policies should position motor skill competence as critical for children's obesity prevention from early childhood onwards. Robust longitudinal and experimental designs are encouraged to explore a possible causal pathway between motor skill competence and BMI from early childhood.
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Affiliation(s)
- Clarice Martins
- Research Centre in Physical Activity, Health and Leisure, and Laboratory for Integrative and Translational Research in Population Health, University of Porto, Porto, Portugal.
- Department of Physical Education, Federal University of Paraíba, João Pessoa, Brazil.
| | - Vicente Romo-Perez
- Faculty of Education and Sports Sciences, Universidade de Vigo, Vigo, Spain
| | - E Kipling Webster
- Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, TN, USA
| | - Michael Duncan
- Centre for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry, UK
| | - Luís Filipe Lemos
- Research Centre in Physical Activity, Health and Leisure, and Laboratory for Integrative and Translational Research in Population Health, University of Porto, Porto, Portugal
- Faculty of Psychology, Education and Sport, Lusofona University, Porto, Portugal
| | | | - Anthony Okely
- School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
| | - Daniele Magistro
- Department of Sport Science, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Fabio Carlevaro
- Polo Universitario Asti Studi Superiori, Uni-Astiss, Asti, Italy
| | - Farid Bardid
- Strathclyde Institute of Education, University of Strathclyde, Glasgow, UK
| | - Francesca Magno
- Polo Universitario Asti Studi Superiori, Uni-Astiss, Asti, Italy
| | - Glauber Nobre
- Instituto Federal de Educação, Ciência e Tecnologia do Ceará, Ceará, Brazil
| | - Isaac Estevan
- AFIPS Research Group, Department of Teaching of Physical Education, Arts and Music, University of Valencia, Valencia, Spain
| | - Jorge Mota
- Research Centre in Physical Activity, Health and Leisure, and Laboratory for Integrative and Translational Research in Population Health, University of Porto, Porto, Portugal
| | - Ke Ning
- School of Physical Education and Sport, Shaanxi Normal University, Xi'an, China
| | - Leah E Robinson
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - Matthieu Lenoir
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Minghui Quan
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Nadia C Valentini
- School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Penny Cross
- School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
| | - Rachel Jones
- School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
- School of Education, University of Wollongong, Wollongong, NSW, Australia
| | - Rafael Henrique
- Department of Physical Education, Federal University of Pernambuco, Recife, Brazil
| | - Si-Tong Chen
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Yucui Diao
- School of Sport, Shandong Normal University, Jinan, China
| | - Paulo R Bandeira
- Department of Physical Education, Universidade Regional do Cariri, Crato, Brazil
| | - Lisa M Barnett
- Faculty of Health, School of Health and Social Development, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
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Dowda M, Saunders RP, Dishman RK, Pate RR. Association of physical activity, sedentary behavior, diet quality with adiposity: a longitudinal analysis in children categorized by baseline weight status. Int J Obes (Lond) 2024; 48:240-246. [PMID: 37932409 DOI: 10.1038/s41366-023-01405-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND/OBJECTIVES Childhood obesity rates have increased in recent years. The effectiveness of future public health interventions to reduce childhood obesity will be enhanced by a better understanding of behavioral factors that influence adiposity in children as they transition from childhood to adolescence. The purpose of this study was to examine whether initial weight status modifies the longitudinal associations of physical activity, sedentary behavior, and diet quality with changes in adiposity over time. SUBJECTS/METHODS A total of 658 children (45% boys) were stratified into 3 groups based on 5th grade BMI percentiles ( < 85th, 85-95th, > 95th) and followed from 5th grade to 6th and/or 7th grade. Study variables, including fat-mass-index (FMI), moderate-to-vigorous physical activity (MVPA), diet quality, and sedentary behavior, were measured at 5th, 6th, and/or 7th grades. Separate growth curve models were conducted within each weight status group to examine the associations between MVPA, sedentary behavior, diet quality and adiposity, operationalized as FMI. All models controlled for sex, maturity offset, race, and parent education. RESULTS Of the 658 children, 53% were classified with normal weight at baseline, 18% with overweight, and 29% with obesity. Associations between MVPA, sedentary behavior, diet quality and FMI varied within each weight status group. MVPA was negatively associated with adiposity (FMI) for all weight status groups. Diet quality and sedentary behavior were associated with adiposity only in children with obesity at baseline; neither diet quality nor sedentary behavior was associated with FMI for those with overweight. CONCLUSIONS MVPA was negatively associated with adiposity (FMI) in all weight status groups, suggesting that MVPA may protect against higher adiposity. Sedentary behavior and diet quality were associated with adiposity only in children with obesity at baseline; neither sedentary behavior nor diet quality was associated with FMI for children with overweight.
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Affiliation(s)
- Marsha Dowda
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC, 29208, USA.
| | - Ruth P Saunders
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC, 29208, USA
| | - Rod K Dishman
- Department of Kinesiology, The University of Georgia, Ramsey Student Center, 330 River Road, Athens, GA, 30602-6554, USA
| | - Russell R Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC, 29208, USA
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Ross MG, Kavasery MP, Cervantes MK, Han G, Horta B, Coca KP, Costa SO, Desai M. High-Fat, High-Calorie Breast Milk in Women with Overweight or Obesity and Its Association with Maternal Serum Insulin Concentration and Triglycerides Levels. CHILDREN (BASEL, SWITZERLAND) 2024; 11:141. [PMID: 38397253 PMCID: PMC10887191 DOI: 10.3390/children11020141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/25/2024]
Abstract
The childhood obesity epidemic continues to be a challenge. Maternal obesity and excessive infant weight gain are strong predictors of childhood obesity, which itself is a major risk factor for adult obesity. The primary source of nutrition during early life is breast milk, and its composition is impacted by maternal habitus and diet. We thus studied the relationship between maternal BMI, serum lipids and insulin, and breast milk fat and calorie content from foremilk to hindmilk. Women who were exclusively breastfeeding at 7-8 weeks postpartum were BMI classified as Normal (18.5-24.9, n = 9) and women with Overweight/Obese (OW/OB ≥ 25, n = 13). Maternal blood and continuous breast milk samples obtained from foremilk to hindmilk were analyzed, and infant milk intake was assessed. Women with OW/OB had significantly higher milk fat and calorie content in the first foremilk and last hindmilk sample as compared to Normal BMI women. Amongst all women, maternal serum triglycerides, insulin, and HOMA were significantly correlated with foremilk triglyceride concentration, suggesting that maternal serum triglyceride and insulin action contribute to human milk fat content. As the milk fat content of OW/OB women has caloric implications for infant growth and childhood obesity, these results suggest the potential for modulating milk fat content by a reduction in maternal serum lipids or insulin.
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Affiliation(s)
- Michael G. Ross
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California Los Angeles at Harbor-UCLA, Torrance, CA 90502, USA;
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, RB3 Building, Torrance, CA 90502, USA; (M.P.K.); (M.K.C.); (G.H.)
- Department of Obstetrics and Gynecology, Charles R. Drew University, Los Angeles, CA 90059, USA
| | - Manasa P. Kavasery
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, RB3 Building, Torrance, CA 90502, USA; (M.P.K.); (M.K.C.); (G.H.)
| | - MacKenzie K. Cervantes
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, RB3 Building, Torrance, CA 90502, USA; (M.P.K.); (M.K.C.); (G.H.)
| | - Guang Han
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, RB3 Building, Torrance, CA 90502, USA; (M.P.K.); (M.K.C.); (G.H.)
| | - Bernardo Horta
- School of Medicine, Universidade Federal de Pelotas, Pelotas 96010-610, Brazil;
| | - Kelly P. Coca
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo 04023-900, Brazil;
| | - Suleyma O. Costa
- Laboratory of Metabolic Disorders, School of Applied Sciences, University of Campinas, Campinas 13083-970, Brazil;
| | - Mina Desai
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California Los Angeles at Harbor-UCLA, Torrance, CA 90502, USA;
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, RB3 Building, Torrance, CA 90502, USA; (M.P.K.); (M.K.C.); (G.H.)
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Zuñiga Vinueza AM, Jaramillo AP. The Effectiveness of a Healthy Lifestyle in Obese Pediatric Patients: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e48525. [PMID: 38073975 PMCID: PMC10708958 DOI: 10.7759/cureus.48525] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2023] [Indexed: 06/24/2024] Open
Abstract
Child and adolescent obesity represents a significant and escalating health concern in the United States. Notably, Hispanic adolescents face a higher prevalence of obesity and an increased risk of cardiovascular disease compared to their peers from different racial and ethnic backgrounds. This was obtained through systematic investigations in which different approaches were used. Therefore, obesity interventions of long duration, at least one year, and with a beginning phase intensive enough to produce significant early weight loss may be needed for adolescents with obesity. Surprisingly, despite this elevated risk, there is a glaring underrepresentation of Hispanics in obesity intervention studies aimed at youth. It is therefore imperative to develop interventions tailored specifically to overweight adolescents, with a particular focus on the Hispanic population. While researchers have addressed numerous interventions targeting adolescent obesity, many of these initiatives have demonstrated limited treatment efficacy, failed to achieve all desired treatment objectives, experienced high attrition rates, and encountered waning participant engagement. To evaluate the impact of adopting a healthy lifestyle among pediatric patients struggling with obesity, we undertook a comprehensive systematic review of the literature, and with the information obtained from the articles chosen, we will undergo a meta-analysis. Our review encompassed a 10-year span of published literature, drawing upon online databases including the Cochrane Library, PubMed, Web of Science, PubMed Central, and Google Scholar. Our review exclusively considered randomized controlled trials that focused on the effectiveness of various lifestyle modifications for pediatric patients grappling with obesity. We synthesized the pooled incidence, risk ratio, and associated 95% confidence intervals to gauge the efficacy of these interventions, employing the fixed-effect model to account for potential between-study variations rather than the random-effect model. After the calculation of each one of the studies selected, we could conclude that it gave good outcomes after the modification of lifestyle in these patients, giving a statistical significance and p-value in our three representative figures of <0.001.
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Kshatriya M, Wang KW, Hildebrand J, Crawford R, Nadarajah A, Youssef M, Rivas A, Kaushal A, Banfield LE, Thabane L, Samaan MC. The Effectiveness of Indigenous Knowledge-Based Lifestyle Interventions in Preventing Obesity and Type 2 Diabetes Mellitus in Indigenous Children in Canada: A Systematic Review. Adolesc Health Med Ther 2023; 14:175-193. [PMID: 37790916 PMCID: PMC10544169 DOI: 10.2147/ahmt.s405814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 09/20/2023] [Indexed: 10/05/2023] Open
Abstract
Background Indigenous children in Canada have high rates of obesity and type 2 diabetes mellitus (T2DM). Culturally appropriate interventions, guided by an Indigenous knowledge-based view of health, are crucial to target these conditions. The objective of this systematic review was to assess the impact of indigenous Knowledge-based lifestyle interventions on the prevention of obesity and T2DM in Indigenous children in Canada. Methods Database searches were conducted from inception until February 22, 2022. The main outcomes were changes in Body Mass Index (BMI) z-score and the development of T2DM. The other outcomes included adiposity, metabolic, and lifestyle determinants of health. The GRADE approach was used to assess confidence in the evidence. Results Four non-randomized controlled trials (non-RCTs) and six uncontrolled studies were identified. Peer-led interventions led to a reduction in BMI z-score and waist circumference. GRADE assessment revealed very low quality of evidence due to a lack of randomization and small sample sizes. There were no diabetes-specific reported programs. Conclusion Limited evidence from non-randomized studies suggest that peer-led indigenous Knowledge-based lifestyle interventions improve BMI z-score and central adiposity. There is a need for community-owned and adequately powered randomized studies for interventions that aim to treat and prevent obesity and T2DM in Indigenous children in Canada. Systematic Review Registration PROSPERO CRD42017072781.
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Affiliation(s)
- Maya Kshatriya
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Global Health Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Kuan-Wen Wang
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Julia Hildebrand
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Rebecca Crawford
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Indigenous Undergraduate Summer Research Program, McMaster University, Hamilton, Ontario, Canada
| | - Ajantha Nadarajah
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Global Health Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Michael Youssef
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Angelica Rivas
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Michael G. De Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Ashleen Kaushal
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Laura E Banfield
- Health Sciences Library, McMaster University, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Biostatistics Unit, St. Joseph’s Healthcare-Hamilton, Hamilton, Ontario, Canada
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Centre for Evaluation of Medicines, St. Joseph’s Health Care, Hamilton, Ontario, Canada
| | - M Constantine Samaan
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Global Health Graduate Program, McMaster University, Hamilton, Ontario, Canada
- Michael G. De Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
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10
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Rhee KE, Strong D. Should We "Wait and See"?: Change in Weight Status Among US Adolescents in the Population Assessment of Tobacco and Health Study. Child Obes 2023; 19:373-381. [PMID: 35960810 DOI: 10.1089/chi.2022.0079] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Many parents and providers adopt a "wait and see" approach to obesity (OB) management. The goal of this study was to determine the likelihood that youth with overweight (OW) or OB would become normal weight over time. Methods: Data from the nationally representative Population Assessment of Tobacco and Health Study were used to examine the proportion of teens (aged 12-17 years) with OW/OB who tracked into a lower weight category over four waves of data collection (2013-2018). Analysis was restricted to those who completed all four waves of assessments (n = 10,086). Repeated-measures logistic regression models were used to describe the odds of having a BMI within the normal weight range at Waves 2-4, given an OW or obese weight status in the previous wave. Results: At Wave 1, 65% of the sample was normal weight, 18% had OW, and 17% had OB. By Wave 4, 24% had OW and 20% had OB. The adjusted odds of reporting a normal weight relative to OW/OB decreased by 13% each year. In Wave 4, only 2% [standard error (SE) 0.4%] of boys and 2% (SE 0.3%) of girls transitioned from OB to normal weight. For youth with OB in Wave 1, the probability of being in the normal weight category in Wave 2 was 0.04 (95% confidence interval 0.035-0.052), and decreased thereafter. Conclusion: Very few teens were able to return to normal weight once they developed OW/OB. Adopting a "wait and see" approach to OB management may be detrimental to a child's health.
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Affiliation(s)
- Kyung E Rhee
- Department of Pediatrics, University of California, San Diego, San Diego, CA, USA
| | - David Strong
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, CA, USA
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11
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Budge M, Sharifi M, Maciejewski KR, Diehl D, Paige M, Nogelo P, Rosenthal MS, Fenick AM. A Mixed-Methods Analysis of a Special Supplemental Nutrition Program for Women, Infants, and Children and Primary Care Partnership to Promote Responsive Feeding for Infants in Group Well-Child Care. Acad Pediatr 2023; 23:304-313. [PMID: 36599376 DOI: 10.1016/j.acap.2022.12.017] [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: 08/23/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To evaluate the Healthy Eating through Group Well-Child Care (GWCC) intervention, a Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and primary care partnership which seeks to promote responsive feeding practices among low-income caregivers, by examining its impact on infant growth and exploring the experiences of caregivers who participated in this intervention. METHODS Using a difference-in-differences approach, we examined change in weight-for-length among infants in GWCC before versus after implementation of the intervention compared with infants in individual well-child care (IWCC) over the same time-period. In parallel, we conducted semi-structured interviews in English and Spanish with caregivers who participated in the intervention to explore their perspectives and analyzed transcripts via the constant comparative method to identify salient themes. RESULTS Using electronic health record data from 279 GWCC and 6134 IWCC participants, we found no significant difference in first-year weight-for-length trajectory associated with participation in the intervention. We reached thematic saturation after 19 interviews with 22 caregivers and identified four major themes around feeding: 1) structural barriers limit access to healthy foods through WIC, 2) conflicting sources of nutrition advice challenge parental decision making, 3) exposure to novel foods facilitated further experimentation with healthier foods, and 4) discussion of responsive feeding facilitated awareness and adoption. CONCLUSIONS A primary care and WIC partnership to promote responsive feeding in the context of GWCC was well received by caregivers but was not associated with improved weight-for-length among infants. Structural barriers to implementing responsive feeding and healthy eating practices may have impacted lack of measurable results from the intervention.
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Affiliation(s)
| | - Mona Sharifi
- Department of Pediatrics, Yale School of Medicine (M Sharifi, MS Rosenthal, and AM Fenick), New Haven, Conn
| | - Kaitlin R Maciejewski
- Yale Center for Analytical Sciences, Yale School of Public Health (KR Maciejewski), New Haven, Conn
| | - Deborah Diehl
- WIC Program, Yale New Haven Health (D Diehl and M Paige), New Haven, Conn
| | - Mary Paige
- WIC Program, Yale New Haven Health (D Diehl and M Paige), New Haven, Conn
| | - Patricia Nogelo
- Social Work Department, Yale New Haven Hospital (P Nogelo), New Haven, Conn
| | - Marjorie S Rosenthal
- Department of Pediatrics, Yale School of Medicine (M Sharifi, MS Rosenthal, and AM Fenick), New Haven, Conn
| | - Ada M Fenick
- Department of Pediatrics, Yale School of Medicine (M Sharifi, MS Rosenthal, and AM Fenick), New Haven, Conn.
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12
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O'Byrne E, McCusker C, McSweeney S. The impact of the "Attachment and Biobehavioural Catch-Up" program on attachment related parent behavior-A systematic review. Infant Ment Health J 2023; 44:76-91. [PMID: 36565696 DOI: 10.1002/imhj.22025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 11/08/2022] [Indexed: 12/25/2022]
Abstract
"Attachment and Biobehavioural Catch-Up" (ABC) is a 10 session home visiting program, grounded in attachment theory. It aims to improve child emotion regulation, attachment and behavioral outcomes through changing caregivers' attachment related behaviors. There is increasing evidence with respect to the effectiveness of ABC in producing positive child outcomes, but the intervention's direct effect on parent outcomes remains unclear. This review examined the association of ABC with attachment related parent outcomes. The PubMed, EMBASE, PyschINFO and SCOPUS databases were searched for relevant studies in August 2021, and again in April 2022. The eligibility criteria for included studies were (1) infants aged 0-27 months at time of the ABC intervention, (2) "at risk" parents, (3) controlled trials published in peer-reviewed journals and (4) utilized a measure of attachment related parent outcomes. Eleven eligible studies were included. The findings showed ABC had a significant small to medium effect on a variety of attachment related parent outcomes among parents presenting with multiple psychosocial risk factors. "Sensitivity" was measured most frequently, with small to medium main effect sizes recorded at follow-up, compared to controls. Implications for the clinical effectiveness of the ABC program in community settings are discussed. Future research should clarify who ABC is most effective for and how it compares to similar interventions.
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Affiliation(s)
- Emma O'Byrne
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Chris McCusker
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Shane McSweeney
- School of Applied Psychology, University College Cork, Cork, Ireland
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13
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Bailey-Davis L, Moore AM, Poulsen MN, Dzewaltowski DA, Cummings S, DeCriscio LR, Hosterman JF, Huston D, Kirchner HL, Lutcher S, McCabe C, Welk GJ, Savage JS. Comparing enhancements to well-child visits in the prevention of obesity: ENCIRCLE cluster-randomized controlled trial. BMC Public Health 2022; 22:2429. [PMID: 36572870 PMCID: PMC9792161 DOI: 10.1186/s12889-022-14827-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/06/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Obesity disproportionally impacts rural, lower-income children in the United States. Primary care providers are well-positioned to engage parents in early obesity prevention, yet there is a lack of evidence regarding the most effective care delivery models. The ENCIRCLE study, a pragmatic cluster-randomized controlled trial, will respond to this gap by testing the comparative effectiveness of standard care well-child visits (WCV) versus two enhancements: adding a patient-reported outcome (PRO) measure (PRO WCV) and PRO WCV plus Food Care (telehealth coaching and a grocery store tour). METHODS A total of 2,025 parents and their preschool-aged children (20-60 months of age) will be recruited from 24 Geisinger primary care clinics, where providers are randomized to the standard WCV, PRO WCV, or PRO WCV plus Food Care intervention arms. The PRO WCV includes the standard WCV plus collection of the PRO-the Family Nutrition and Physical Activity (FNPA) risk assessment-from parents. Parents complete the PRO in the patient-portal or in the clinic (own device, tablet, or kiosk), receive real-time feedback, and select priority topics to discuss with the provider. These results are integrated into the child's electronic health record to inform personalized preventive counseling by providers. PRO WCV plus Food Care includes referrals to community health professionals who deliver evidence-based obesity prevention and food resource management interventions via telehealth following the WCV. The primary study outcome is change in child body mass index z-score (BMIz), based on the World Health Organization growth standards, 12 months post-baseline WCV. Additional outcomes include percent of children with overweight and obesity, raw BMI, BMI50, BMIz extended, parent involvement in counseling, health behaviors, food resource management, and implementation process measures. DISCUSSION Study findings will inform health care systems' choices about effective care delivery models to prevent childhood obesity among a high-risk population. Additionally, dissemination will be informed by an evaluation of mediating, moderating, and implementation factors. TRIAL REGISTRATION ClinicalTrials.gov identifier (NCT04406441); Registered May 28, 2020.
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Affiliation(s)
- Lisa Bailey-Davis
- grid.280776.c0000 0004 0394 1447Department of Population Health Sciences, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA ,Center for Obesity & Metabolic Research, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - Amy M. Moore
- grid.29857.310000 0001 2097 4281Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA 16802 USA
| | - Melissa N. Poulsen
- grid.280776.c0000 0004 0394 1447Department of Population Health Sciences, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - David A. Dzewaltowski
- grid.266813.80000 0001 0666 4105College of Public Health, University of Nebraska Medical Center, 984365 Nebraska Medical Center, Omaha, NE 68198 USA
| | - Stacey Cummings
- Department of Pediatrics, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - Laina R. DeCriscio
- Health and Wellness, Steele Institute, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - Jennifer Franceschelli Hosterman
- Department of Pediatrics, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA ,Departments of Internal Medicine and Pediatrics, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - Daniel Huston
- Health and Wellness, Steele Institute, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - H. Lester Kirchner
- grid.280776.c0000 0004 0394 1447Department of Population Health Sciences, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - Shawnee Lutcher
- Center for Obesity & Metabolic Research, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - Carolyn McCabe
- grid.280776.c0000 0004 0394 1447Department of Population Health Sciences, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA ,Center for Obesity & Metabolic Research, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - Gregory J. Welk
- grid.34421.300000 0004 1936 7312Department of Kinesiology, Iowa State University, 103E Forker, 534 Wallace Rd, Ames, IA 50011 USA
| | - Jennifer S. Savage
- grid.29857.310000 0001 2097 4281Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA 16802 USA
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14
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Heerman WJ, Perrin EM, Yin HS, Schildcrout JS, Delamater AM, Flower KB, Sanders L, Wood C, Kay MC, Adams LE, Rothman RL. The Greenlight Plus Trial: Comparative effectiveness of a health information technology intervention vs. health communication intervention in primary care offices to prevent childhood obesity. Contemp Clin Trials 2022; 123:106987. [PMID: 36323344 DOI: 10.1016/j.cct.2022.106987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 10/17/2022] [Accepted: 10/26/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND The first 1000 days of a child's life are increasingly recognized as a critical window for establishing a healthy growth trajectory to prevent childhood obesity and its associated long-term comorbidities. The purpose of this manuscript is to detail the methods for a multi-site, comparative effectiveness trial designed to prevent childhood overweight and obesity from birth to age 2 years. METHODS This study is a multi-site, individually randomized trial testing the comparative effectiveness of two active intervention arms: 1) the Greenlight intervention; and 2) the Greenlight Plus intervention. The Greenlight intervention is administered by trained pediatric healthcare providers at each well-child visit from 0 to 18 months and consists of a low health literacy toolkit used during clinic visits to promote shared goal setting. Families randomized to Greenlight Plus receive the Greenlight intervention plus a health information technology intervention, which includes: 1) personalized, automated text-messages that facilitate caregiver self-monitoring of tailored and age-appropriate child heath behavior goals; and 2) a web-based, personalized dashboard that tracks child weight status, progress on goals, and electronic Greenlight content access. We randomized 900 parent-infant dyads, recruited from primary care clinics across six academic medical centers. The study's primary outcome is weight for length trajectory from birth through 24 months. CONCLUSIONS By delivering a personalized and tailored health information technology intervention that is asynchronous to pediatric primary care visits, we aim to achieve improvements in child growth trajectory through two years of age among a sample of geographically, socioeconomically, racially, and ethnically diverse parent-child dyads.
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Affiliation(s)
- William J Heerman
- Vanderbilt University Medical Center, Department of Pediatrics, 2200 Children's Way, Suite 2404, Nashville, TN 37232, United States of America.
| | - Eliana M Perrin
- Johns Hopkins University, Department of Pediatrics, Schools of Medicine and Nursing, 200 N. Wolfe St, Rubenstein Building-2071, Baltimore, MD 21287, United States of America.
| | - H Shonna Yin
- New York University School of Medicine, Departments of Pediatrics and Population Health, 550 First Avenue, New York, NY 10016, United States of America.
| | - Jonathan S Schildcrout
- Vanderbilt University Medical Center, Department of Biostatistics, 1161 21st Ave S # D3300, Nashville, TN 37232, United States of America.
| | - Alan M Delamater
- University of Miami Miller School of Medicine, Department of Pediatrics, 1601 NW 12(th) Ave., Miami, FL 33136, United States of America.
| | - Kori B Flower
- University of North Carolina at Chapel Hill, Division of General Pediatrics and Adolescent Medicine, 231 MacNider Building, CB# 7225, 321 S. Columbia Street, UNC School of Medicine, Chapel Hill, NC 27599-7225, United States of America.
| | - Lee Sanders
- Stanford University School of Medicine, United States of America.
| | - Charles Wood
- Duke University School of Medicine, Department of Pediatrics, Division of General Pediatrics and Adolescent Health, 3116 N. Duke St., Durham, NC 27704, United States of America.
| | - Melissa C Kay
- Duke University School of Medicine, Department of Pediatrics, Division of General Pediatrics and Adolescent Health, 3116 N. Duke St., Durham, NC 27704, United States of America.
| | - Laura E Adams
- Vanderbilt University Medical Center, Department of Pediatrics, 2200 Children's Way, Suite 2404, Nashville, TN 37232, United States of America.
| | - Russell L Rothman
- Vanderbilt University Medical Center, Institute of Medicine and Public Health, 1161 21st Ave S # D3300, Nashville, TN 37232, United States of America.
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15
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Cluster-randomised trial of the impact of an obesity prevention intervention on childcare centre nutrition and physical activity environment over 2 years. Public Health Nutr 2022; 25:3172-3181. [PMID: 34593076 PMCID: PMC9991736 DOI: 10.1017/s1368980021004109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The prevalence of obesity among pre-school-aged children in the USA remains unacceptably high. Here, we examine the impact of Healthy Caregivers-Healthy Children (HC2) Phase 2, a childcare centre (CCC)-based obesity prevention intervention on changes in the CCC nutrition and physical activity environment over 2 school years. DESIGN This was a cluster-randomised trial with twelve CCC receiving the HC2 intervention arm and twelve in the control arm. The primary outcome was change in the Environment and Policy Assessment and Observation (EPAO) tool over 2 school years (Fall 2015, Spring 2016 and Spring 2017). Changes in EPAO physical activity and nutrition score were analysed via a: (1) random effects mixed models and (2) mixed models to determine the effect of HC2 v. control. SETTING The study was conducted in twenty-four CCC serving low-income, ethnically diverse families in Miami-Dade County. PARTICIPANTS Intervention CCC received (1) teachers/parents/children curriculum, (2) snack, beverage, physical activity, and screen time policies, and (3) menu modifications. RESULTS Two-year EPAO nutrition score changes in intervention CCC were almost twice that of control CCC. The EPAO physical activity environment scores only slightly improved in intervention CCC v. control CCC. Intervention CCC showed higher combined EPAO physical activity and nutrition scores compared to control CCC over the 2-year study period (β = 0·09, P = 0·05). CONCLUSIONS Obesity prevention programmes can have a positive impact on the CCC nutrition environment and can promote healthy weight in early childhood. CCC may need consistent support to improve the physical activity environment to ensure the policies remain intact.
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16
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Tripicchio GL, Kubik MY, Lee J, Fisher JO. More-To-Less Home Healthful Foods Ratio is Associated With Diet Quality in Preadolescents With Elevated Body Mass Index. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:939-946. [PMID: 35909037 PMCID: PMC10434829 DOI: 10.1016/j.jneb.2022.04.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 04/14/2022] [Accepted: 04/25/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To examine home food availability (HFA) and the association with diet quality in preadolescents with elevated body mass index. METHODS A cross-sectional analysis examined HFA and diet quality (using the 2015-Health Eating Index [HEI] derived from 1 or 2 24-hour dietary recalls) among preadolescents (n = 111; aged 8-12 years; body mass index ≥ 75th percentile). A novel ratio of more-to-less healthful items was created to represent HFA. Multivariate linear regression models examined the HFA ratio and individual food and beverage groups as correlates of HEI. RESULTS The HFA ratio was associated with higher HEI (β = 5.3 [1.3]; P < 0.001). Home food availability of sweets (β = -2.6 [0.9]; P = 0.003) and sugar-sweetened beverages (β = -2.3 [1.0]; P = 0.02) were associated with lower HEI. Home food availability of fruits was associated with higher HEI (β = 1.3 [0.7]; P = 0.05). CONCLUSIONS AND IMPLICATIONS Structuring the HFA so that more healthful choices are available relative to less healthful foods could be an effective approach for improving diet quality in preadolescents at risk for obesity.
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Affiliation(s)
- Gina L Tripicchio
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA.
| | | | - Jiwoo Lee
- School of Nursing, University of Minnesota, Minneapolis, MN
| | - Jennifer Orlet Fisher
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA
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17
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Macchi AK, Banna J, Moreira S, Campos M, Palacios C. Effect of a Short Messaging Service (SMS) intervention delivered to caregivers on energy, nutrients, and food groups intake in infant participants of the WIC program. Front Public Health 2022; 10:986330. [PMID: 36249246 PMCID: PMC9559930 DOI: 10.3389/fpubh.2022.986330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/12/2022] [Indexed: 01/26/2023] Open
Abstract
Objectives To test the effect of a weekly test message (SMS) intervention for improving feeding practices on infant intake of energy, nutrients, and specific food groups. Methods This study was a multi-site, randomized clinical trial, in 202 caregivers of healthy term infants participating in either the Puerto Rico or Hawaii WIC program. Participants were randomized to receive weekly SMS about either infant's general health issues (control) or SMS for improving feeding practices (intervention) to complement WIC messages for 4 months. Anthropometrics and demographics were assessed at baseline. A validated infant food frequency questionnaire was assessed at the four-month visit to assess intake of general food groups. Data was summarized as median (25th and 75th percentiles) or percentage and differences between study arms was compared using Mann Whitney or chi-square. Results A total of 163 participants completed the study (n = 84 control and n = 79 intervention). Baseline characteristics were similar between both groups. At 4-6 months of age, compared to the control group, the intervention group had a significantly higher intake of total grains (0.28 oz; 0.00, 0.60; P = 0.033), protein (13.5 g, 10.5, 18.3; P = 0.022), calcium (472 mg; 418, 667; P = 0.012), and zinc (4.39 mg; 2.61, 6.51; P = 0.028). No differences were seen in the other food groups, including breastmilk. Conclusions for practice Feeding SMS to complement WIC messages led to higher intakes of some key nutrients but did not have an overall improvement in the intake of food groups. Messaging also did not delay the introduction of complimentary foods or improve breastfeeding rates. Future studies should evaluate the use of more intensive SMS interventions for continued care between WIC visits.
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Affiliation(s)
- Alison K. Macchi
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States
| | - Jinan Banna
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Stephanie Moreira
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Maribel Campos
- Center for Community Outreach for Health Across the Lifespan (COHeAL), University of Puerto Rico, San Juan, PR, United States
| | - Cristina Palacios
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States,*Correspondence: Cristina Palacios
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18
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Kawuki J, Musa TH, Ghimire U, Obore N, Papabathini SS. The 100 top-cited articles on childhood obesity: a bibliometric analysis. GLOBAL HEALTH JOURNAL 2022. [DOI: 10.1016/j.glohj.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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19
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Eli K, Neovius C, Nordin K, Brissman M, Ek A. Parents' experiences following conversations about their young child's weight in the primary health care setting: a study within the STOP project. BMC Public Health 2022; 22:1540. [PMID: 35962359 PMCID: PMC9375316 DOI: 10.1186/s12889-022-13803-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 07/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In primary healthcare, conversations between clinicians and parents about young children's overweight are key to providing support and initiating weight management. However, given the sensitivity of this topic, these conversations are difficult for both clinicians and parents and are sometimes delayed or avoided. To understand the emotional impact of these conversations, this study aims to shed light on parents' experiences following conversations with primary care nurses about their child's overweight. METHODS Participants were recruited through a childhood obesity randomized controlled trial (RCT) conducted in Sweden. Telephone-based semi-structured interviews were conducted with 17 parents (mean age 40; the majority were women (n = 12/17), had a university degree (n = 14/17) and were born in Sweden (n = 13/16)). Their children were between 3 and 7 years old (mean age 4.8 years) with overweight (n = 7) or obesity (n = 10). The interviews were recorded, transcribed, and analyzed using thematic analysis. RESULTS Two main themes were developed. Theme 1, 'Receiving the overweight/obesity diagnosis', explores parents' reactions to the conversation with the primary care nurse. Depending on how the nurse presented the topic, conversations either fostered an alliance between the parent and the nurse, encouraging parents to reflect and develop insights about the child's and the family's needs (subtheme Conversations that empower), or felt limited, uncomfortable, or belittling (subtheme Conversations that provoke resistance). Theme 2, 'Parenting a child with a formal diagnosis of obesity', explores challenges parents faced following the weight conversations, including managing their own feelings and concerns (subtheme Fear of transferring weight anxiety), dealing with others' reactions (subtheme Involve family and manage surroundings) and asking for and receiving support from health care professionals (subtheme Obtain support from health care professionals). CONCLUSIONS While conversations with primary care nurses about children's weight were often emotional, most parents felt these conversations were ultimately helpful, as they encouraged them to enact positive lifestyle changes. Importantly, when nurses initiated conversations in a responsive, non-blaming way, inviting parents to reflect on their situation, parents felt more supported and empowered. These findings convey the importance of providing communication skills training to pediatric healthcare professionals, with particular focus on childhood overweight and obesity. TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT03800823 ; 11 Jan 2019.
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Affiliation(s)
- Karin Eli
- Unit for Biocultural Variation and Obesity, School of Anthropology and Museum Ethnography, University of Oxford, Oxford, UK.,Warwick Medical School, University of Warwick, Coventry, UK
| | - Catharina Neovius
- Regional Unit for the Well-Baby Clinics, Sachsska Children's Hospital, Stockholm, Sweden
| | - Karin Nordin
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Markus Brissman
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Occupational Therapy & Physiotherapy, Allied Health Professionals Function, Karolinska, University Hospital, Stockholm, Sweden
| | - Anna Ek
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
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20
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Bichteler A, Barton JM, Lumeng JC, Gershoff ET. Patterns of Childhood Body Mass Index Percentile Gains as Predictors of Adolescent Body Mass Index, Waist Circumference, and Blood Pressure. Acad Pediatr 2022; 22:769-776. [PMID: 34861461 PMCID: PMC9156720 DOI: 10.1016/j.acap.2021.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 11/20/2021] [Accepted: 11/24/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To examine whether patterns of body mass index (BMI) percentile gains across childhood predict BMI percentile, overweight and obesity, waist circumference, and elevated or prehypertensive blood pressure at age 15. METHODS Trained technicians in the Study of Early Child Care and Youth Development assessed children's weight and height from birth to 15 years and waist circumference and blood pressure at age 15 (n = 1132). Children's BMI percentile trajectories from age 2 to age 13 along with 28 demographic and social covariates were used to predict BMI percentile, waist circumference, overweight, obesity, and elevated or prehypertensive blood pressure. Linear and logistic regressions were used to predict BMI percentile, overweight, obesity, waist circumference, and elevated or prehypertensive blood pressure. RESULTS Children were classified into one"?>1 of 4four"?> BMI percentile trajectories: "low stable" (28.4%), "low-to-high" (11.8%), "median stable" (29.0%), and "high rising" (30.7%). Children in trajectory classes characterized by persistent above average BMI percentile or by periods of rapid BMI percentile gains were more likely than their peers to experience poor weight and elevated or prehypertensive outcomes in adolescence. Trajectory class membership explained substantially more variance in adolescent health outcomes than demographic covariates alone. Estimated maternal BMI was a key independent predictor of adolescent outcomes. CONCLUSIONS Different patterns of BMI percentile gains, namely those with rapid gains or persistently above average BMI percentile, from ages 2 to 13 predicted weight, waist circumference, and elevated or prehypertensive blood pressure at age 15, above and beyond demographic and social characteristics.
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Affiliation(s)
- Anne Bichteler
- Department of Human Development and Family Sciences, University of Texas at Austin (A Bichteler and ET Gershoff), Austin, Tex
| | - Jennifer M Barton
- Family Resiliency Center, University of Illinois at Urbana-Champaign (JM Barton), Urbana, Ill.
| | - Julie C Lumeng
- Department of Pediatrics, University of Michigan Medical School (JC Lumeng), Ann Arbor, Mich; Department of Nutritional Sciences, University of Michigan School of Public Health (JC Lumeng), Ann Arbor, Mich
| | - Elizabeth T Gershoff
- Department of Human Development and Family Sciences, University of Texas at Austin (A Bichteler and ET Gershoff), Austin, Tex
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21
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Maternal Pre-Pregnancy Obesity and Gestational Diabetes Mellitus Increase the Risk of Childhood Obesity. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9070928. [PMID: 35883912 PMCID: PMC9323254 DOI: 10.3390/children9070928] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/10/2022] [Accepted: 06/18/2022] [Indexed: 11/17/2022]
Abstract
Previous studies have shown inconsistent results regarding the effects of maternal gestational diabetes mellitus (GDM) and pre-pregnancy obesity (PPO) on childhood obesity. This study aimed to determine the risk for early childhood obesity based on maternal GDM and PPO. This nationwide study used data obtained from the National Health Information Database in South Korea. The participants were divided into four groups based on maternal GDM and PPO, and 1:1 matching was performed. Each group had 1319 participants. A generalized estimating equation model was used to analyze the changes in body mass index percentile of children with age, and simple and multiple conditional logistic regression models were used to compare the prevalence of childhood obesity at 5 years. Children whose mothers had both PPO and GDM, only PPO, or only GDM had a 4.46 (95% CI: 3.28−6.05, p < 0.001), 3.11 (95% CI: 2.27−4.26, p < 0.001), or 1.58 (95% CI: 1.12−2.23, p = 0.010) times higher risk, respectively, of developing childhood obesity than children whose mothers had neither PPO nor GDM. Maternal PPO increases the risk for childhood obesity to a higher degree than maternal GDM, and the presence of both increases the risk even further.
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22
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Yau KW, Tang TS, Görges M, Pinkney S, Kim AD, Kalia A, Amed S. Effectiveness of Mobile Apps in Promoting Healthy Behavior Changes and Preventing Obesity in Children: Systematic Review. JMIR Pediatr Parent 2022; 5:e34967. [PMID: 35343908 PMCID: PMC9002598 DOI: 10.2196/34967] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 02/08/2022] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Mobile apps have been increasingly incorporated into healthy behavior promotion interventions targeting childhood obesity. However, their effectiveness remains unclear. OBJECTIVE This paper aims to conduct a systematic review examining the effectiveness of mobile apps aimed at preventing childhood obesity by promoting health behavior changes in diet, physical activity, or sedentary behavior in children aged 8 to 12 years. METHODS MEDLINE, Embase, PsycINFO, CINAHL, and ERIC were systematically searched for peer-reviewed primary studies from January 2008 to July 2021, which included children aged 8 to 12 years; involved mobile app use; and targeted at least one obesity-related factor, including diet, physical activity, or sedentary behavior. Data extraction and risk of bias assessments were conducted by 2 authors. RESULTS Of the 13 studies identified, most used a quasi-experimental design (n=8, 62%). Significant improvements in physical activity (4/8, 50% studies), dietary outcomes (5/6, 83% studies), and BMI (2/6, 33% studies) were reported. All 6 multicomponent interventions and 57% (4/7) of standalone interventions reported significant outcomes in ≥1 behavioral change outcome measured (anthropometric, physical activity, dietary, and screen time outcomes). Gamification, behavioral monitoring, and goal setting were common features of the mobile apps used in these studies. CONCLUSIONS Apps for health behavior promotion interventions have the potential to increase the adoption of healthy behaviors among children; however, their effectiveness in improving anthropometric measures remains unclear. Further investigation of studies that use more rigorous study designs, as well as mobile apps as a standalone intervention, is needed.
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Affiliation(s)
- Kiana W Yau
- Department of Medicine, The University of British Columbia, Vancouver, BC, Canada.,Research Institute, BC Children's Hospital, Vancouver, BC, Canada
| | - Tricia S Tang
- Department of Medicine, The University of British Columbia, Vancouver, BC, Canada.,Research Institute, BC Children's Hospital, Vancouver, BC, Canada
| | - Matthias Görges
- Research Institute, BC Children's Hospital, Vancouver, BC, Canada.,Department of Anesthesiology, Pharmacology and Therapeutics, The University of British Columbia, Vancouver, BC, Canada
| | - Susan Pinkney
- Research Institute, BC Children's Hospital, Vancouver, BC, Canada.,Department of Pediatrics, The University of British Columbia, Vancouver, BC, Canada
| | - Annie D Kim
- Department of Pediatrics, The University of British Columbia, Vancouver, BC, Canada
| | - Angela Kalia
- Department of Pediatrics, The University of British Columbia, Vancouver, BC, Canada
| | - Shazhan Amed
- Research Institute, BC Children's Hospital, Vancouver, BC, Canada.,Department of Pediatrics, The University of British Columbia, Vancouver, BC, Canada
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23
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Moreno JP, Dadabhoy H, Musaad S, Baranowski T, Thompson D, Alfano CA, Crowley SJ. Evaluation of Circadian Rhythm and Sleep Focused mHealth Intervention for the Prevention of Accelerated Summer Weight Gain among Elementary School-Age Children: Protocol for a Randomized Controlled Feasibility Study (Preprint). JMIR Res Protoc 2022; 11:e37002. [PMID: 35576573 PMCID: PMC9152728 DOI: 10.2196/37002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background The i♥rhythm project is a mobile health adaptation of interpersonal and social rhythm therapy designed to promote healthy sleep and behavioral rhythms among 5-8-year olds during summer for the prevention of accelerated summer weight gain. Objective This pilot study will examine the feasibility, acceptability, and preliminary efficacy of the i♥rhythm intervention. This will ensure that the research protocol and procedures work as desired and are acceptable to families in preparation for the fully powered randomized controlled trial. The proposed study will examine the willingness of participants to participate in the intervention and determine whether modifications to the intervention, procedures, and measures are needed before conducting a fully powered study. We will assess our ability to (1) recruit, consent, and retain participants; (2) deliver the intervention; (3) implement the study and assessment procedures; (4) assess the reliability of the proposed measures; and (5) assess the acceptability of the intervention and assessment protocol. Methods This study will employ a single-blinded 2-group randomized control design (treatment and no-treatment control) with randomization occurring after baseline (Time 0) and 3 additional evaluation periods (postintervention [Time 1], and 9 months [Time 2] and 12 months after intervention [Time 3]). A sample of 40 parent-child dyads will be recruited. Results This study was approved by the institutional review board of Baylor College of Medicine (H-47369). Recruitment began in March 2021. As of March 2022, data collection and recruitment are ongoing. Conclusions This study will address the role of sleep and circadian rhythms in the prevention of accelerated summer weight gain and assess the intervention’s effects on the long-term prevention of child obesity. Trial Registration ClinicalTrials.gov NCT04445740; https://clinicaltrials.gov/ct2/show/NCT04445740. International Registered Report Identifier (IRRID) DERR1-10.2196/37002
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Affiliation(s)
- Jennette P Moreno
- Children's Nutrition Research Center, Department of Pediatrics-Nutrition, Baylor College of Medicine, Houston, TX, United States
| | - Hafza Dadabhoy
- Children's Nutrition Research Center, Department of Pediatrics-Nutrition, Baylor College of Medicine, Houston, TX, United States
| | - Salma Musaad
- Children's Nutrition Research Center, Department of Pediatrics-Nutrition, Baylor College of Medicine, Houston, TX, United States
| | - Tom Baranowski
- Children's Nutrition Research Center, Department of Pediatrics-Nutrition, Baylor College of Medicine, Houston, TX, United States
| | - Debbe Thompson
- Children's Nutrition Research Center, Department of Pediatrics-Nutrition, Baylor College of Medicine, Houston, TX, United States
| | - Candice A Alfano
- Sleep and Anxiety Center of Houston, Department of Psychology, University of Houston, Houston, TX, United States
| | - Stephanie J Crowley
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
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24
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Fuller A, Siddiqi A, Shahidi FV, Anderson LN, Hildebrand V, Keown-Stoneman CDG, Maguire JL, Birken C. Understanding income-related differences in distribution of child growth, behaviour and development using a cross-sectional sample of a clinical cohort study. BMJ Open 2022; 12:e056991. [PMID: 35168982 PMCID: PMC8852748 DOI: 10.1136/bmjopen-2021-056991] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Children from low-income households are at an increased risk of social, behavioural and physical health problems. Prior studies have generally relied on dichotomous outcome measures. However, inequities may exist along the range of outcome distribution. Our objective was to examine differences in distribution of three child health outcomes by income categories (high vs low): body mass index (BMI), behaviour difficulties and development. DESIGN AND SETTING This was a cross-sectional study using data from a primary care-based research network with sites in three Canadian cities, and 15 practices enrolling participants. PARTICIPANTS, INDEPENDENT VARIABLE AND OUTCOMES The independent variable was annual household income, dichotomised at the median income for Toronto (<$C80 000 or ≥$C80 000). Outcomes were: (1) growth (BMI z-score (zBMI) at 5 years, 1628 participants); (2) behaviour (Strengths and Difficulties Questionnaire (SDQ) at 3-5 years, 649 participants); (3) development (Infant Toddler Checklist (ITC) at 18 months, 1405 participants). We used distributional decomposition to compare distributions of these outcomes for each income group, and then to construct a counterfactual distribution that describes the hypothetical distribution of the low-income group with the predictor profile of the higher-income group. RESULTS We included data from 1628 (zBMI), 649 (SDQ) and 1405 (ITC) children. Children with lower family income had a higher risk distribution for all outcomes. For all outcomes, thecounterfactual distribution, which represented the distribution of children with lower-income who were assigned the predictor profile of the higher-income group, was more favourable than their observed distributions. CONCLUSION Comparing the distributions of child health outcomes and understanding different risk profiles for children from higher-income and lower-income groups can offer a deeper understanding of inequities in child health outcomes. These methods may offer an approach that can be implemented in larger datasets to inform future interventions.
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Affiliation(s)
- Anne Fuller
- Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
- Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
| | - Arjumand Siddiqi
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Faraz V Shahidi
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute for Work and Health, Toronto, Ontario, Canada
| | - Laura N Anderson
- Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Vincent Hildebrand
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Economics, York University - Glendon Campus, Toronto, Ontario, Canada
| | - Charles D G Keown-Stoneman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | - Jonathon L Maguire
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
- Paediatrics, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Catherine Birken
- Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
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25
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Wood AP, McMillan AG, Imai S, Swift D, DuBose KD. Associations of Percent Body Fat and Motor Skill Development in Preschool-Aged Children: National Youth Fitness Survey. Child Obes 2022; 18:50-55. [PMID: 34382836 DOI: 10.1089/chi.2021.0026] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Background: Body composition and motor skill development are important for the engagement in physical activity and healthy development of children. This study examined the associations between body composition and motor skill development in 3- to 5-year-old children. Methods: Data from preschool-aged children (N = 342, 51% males) who participated in the 2012 National Youth Fitness Survey were analyzed. Skinfold measurements (subscapular, calf, and triceps) were taken and percent body fat (%BF) was calculated using sex-specific equations. Lean muscle mass and fat mass were also calculated. Motor skill development was determined by the Test of Gross Motor Development-2nd Edition. Regression analyses were performed to determine the associations among %BF and locomotor skills, object control skills, and overall gross motor quotient (GMQ), controlling for sex, race, and poverty index ratio. Results: Most children were classified as with underweight/healthy weight (69%) and 31% were either with overweight or obesity. Average %BF was 17.02% ± 0.27%. The standard scores for locomotor skills, object control skills, and GMQ were 9.99 ± 0.16, 8.52 ± 0.14, and 95.57 ± 0.68, respectively. These scores were considered average. Regression analyses indicated that neither the %BF nor sum of skinfolds was associated with locomotor skills (β = -0.07 ± 0.05, p = 0.63; β = -0.03 ± 0.03, p = 0.22), object control skills (β = 0.03 ± 0.04, p = 0.55; β = 0.00 ± 0.02, p = 0.87), or GMQ (β = -0.13 ± 0.28, p = 0.63; β = -0.09 ± 0.14, p = 0.52). Furthermore, neither lean muscle mass nor fat mass was related with any motor skill measure (p > 0.05). Conclusions: Using different measures of body composition may provide additional insight into associations between obesity and motor skill development in preschool-aged children. Given the inconsistent findings in the literature, additional research is needed to elucidate these associations.
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Affiliation(s)
- Aaron P Wood
- Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, TN, USA
| | - Amy Gross McMillan
- Department of Physical Therapy, East Carolina University, Greenville, NC, USA
| | - Satomi Imai
- Department of Public Health, and East Carolina University, Greenville, NC, USA
| | - Damon Swift
- Department of Kinesiology, East Carolina University, Greenville, NC, USA.,East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, NC, USA
| | - Katrina D DuBose
- Department of Kinesiology, East Carolina University, Greenville, NC, USA.,East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, NC, USA
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26
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Grammer AC, Balantekin KN, Barch DM, Markson L, Wilfley DE. Parent-Child influences on child eating self-regulation and weight in early childhood: A systematic review. Appetite 2022; 168:105733. [PMID: 34619243 PMCID: PMC8671268 DOI: 10.1016/j.appet.2021.105733] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 09/17/2021] [Accepted: 10/01/2021] [Indexed: 11/15/2022]
Abstract
Individual differences in child eating self-regulation are associated with excess weight gain and may be explained, in part, by the family feeding environment and a child's general propensity to self-regulate outside of the context of eating (i.e., general self-regulation). Several studies have examined the associations between food parenting behaviors, child eating and general self-regulation, and child weight separately. However, there are a paucity of data on whether and how these factors interact to confer risk for weight gain in early childhood. The current systematic review identified 32 longitudinal studies that examined unidirectional or bidirectional associations among one or more of the following paths: food parenting behaviors and child eating self-regulation (path 1); child eating self-regulation and child weight (path 2); child eating self-regulation and child general self-regulation (path 3); food parenting behaviors and child general self-regulation (path 4); and child general self-regulation and child weight (path 5). Results indicated relationships of food parenting behaviors to child eating self-regulation, child weight to child eating self-regulation, and child general self-regulation to child weight. However, there were scant longitudinal data that examined paths 3 and 4. Further research on the developmental correlates of child eating self-regulation is needed to identify parent and child targets for early childhood obesity prevention.
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Affiliation(s)
- Anne Claire Grammer
- Department of Psychological and Brain Sciences, Washington University in St. Louis, 1 Brookings Drive, St. Louis, MO 63130, USA; Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, St. Louis, MO 63110, USA.
| | - Katherine N Balantekin
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, 14214, USA
| | - Deanna M Barch
- Department of Psychological and Brain Sciences, Washington University in St. Louis, 1 Brookings Drive, St. Louis, MO 63130, USA; Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, St. Louis, MO 63110, USA; Department of Radiology, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, St. Louis, MO 63110, USA
| | - Lori Markson
- Department of Psychological and Brain Sciences, Washington University in St. Louis, 1 Brookings Drive, St. Louis, MO 63130, USA
| | - Denise E Wilfley
- Department of Psychological and Brain Sciences, Washington University in St. Louis, 1 Brookings Drive, St. Louis, MO 63130, USA; Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, St. Louis, MO 63110, USA
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27
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Zatoński T, Pazdro-Zastawny K, Kolator M, Krajewska J, Basiak-Rasała A, Górna S, Zatoński M. A study on health and the association between overweight/obesity and otorhinolaryngological diseases in 6- to 17-year-old children from Wroclaw, Poland. Arch Med Sci 2022; 18:413-421. [PMID: 35316915 PMCID: PMC8924849 DOI: 10.5114/aoms.2020.97285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 07/21/2019] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Childhood overweight and obesity have become a global problem in the past three decades. There are very few studies which examine the correlation between body mass index (BMI) and the development of otorhinolaryngological diseases in children. The objective of the study was to determine the association between overweight or obesity in children and the occurrence of otorhinolaryngological diseases. MATERIAL AND METHODS The survey study was based on a parent-reported multidisciplinary questionnaire on children's medical status among elementary and junior high school children in the city of Wroclaw, the capital city of Poland's Lower Silesia region. The children were taking part in the pro-health campaign "Let's Get the Kids Moving". RESULTS The study was conducted among 2,913 children. A statistically significant correlation was observed between the assessment of the children's BMI and the occurrence of adenoid hypertrophy. Adenoid hypertrophy was more common in the overweight and obese children. The children with adenoid hypertrophy had higher BMI than the children without adenoid hypertrophy. There was a statistically significant correlation between BMI and the incidence of adenoidectomy. There was a statistically significant correlation between BMI and the incidence of tonsillectomy. CONCLUSIONS The development and introduction of preventive programs like "Let's Get the Kids Moving" in the future will contribute to building a healthier society. The study findings suggest that primal prevention may lead to a decrease in the development of otorhinolaryngological diseases. We also showed that higher body mass correlates with higher prevalence of otorhinolaryngological diseases. Further studies are needed to establish the etiopathology of this association.
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Affiliation(s)
| | | | | | | | | | - Sara Górna
- Wroclaw Medical Univeristy, Wroclaw, Poland
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28
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Parker MK, Davy BM, Hedrick VE. Current Knowledge Base of Beverage Health Impacts, Trends, and Intake Recommendations for Children and Adolescents: Implications for Public Health. Curr Nutr Rep 2021; 10:427-434. [PMID: 34797556 DOI: 10.1007/s13668-021-00376-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 01/18/2023]
Abstract
PURPOSE OF REVIEW Improving beverage patterns is important for promoting the health of children and adolescents. Food preferences can begin developing at a young age; thus, children and adolescents should be provided healthy beverages in accordance with current recommendations. The purpose of this review is to identify and summarize existing beverage recommendations for children and adolescents. This review also discusses the health impacts of beverages and how beverage consumption has changed among children and adolescents over time. RECENT FINDINGS The mean number of calories that children and adolescents are consuming from beverages on a given day has declined in recent years. However, sugar-sweetened beverages (SSB) are the primary source of added sugars in this population. Therefore, SSB consumption remains a concern, and reducing the intake of SSB is still considered a top priority for helping to improve dietary quality. This review uniquely compiles recommendations into one convenient table for the entire age range of 0-19 years and includes recommendations that can be more adequately individualized. Beverage categories where beverage recommendations from authoritative sources are lacking have also been identified. Potential methods that can be implemented to improve beverage patterns and current public policy recommendations have been discussed to provide actionable steps that public health professionals can utilize in practice. The comprehensive table of beverage recommendations could be useful for professionals promoting the health of children and adolescents in research, clinical, and public health settings.
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Affiliation(s)
- Molly K Parker
- Virginia Tech, 295 West Campus Drive, 337 Wallace Hall, Blacksburg, VA, 24061, USA
| | - Brenda M Davy
- Virginia Tech, 295 West Campus Drive, 266B Wallace Hall, Blacksburg, VA, 24061, USA
| | - Valisa E Hedrick
- Virginia Tech, 295 West Campus Drive, 335A Wallace Hall, Blacksburg, VA, 24061, USA.
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29
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Lindquist K, Mann G, Farris A, Gordon K, Misyak S. Parent Perspectives of Packing School Lunches. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2021. [DOI: 10.1080/19320248.2021.1994081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Kayla Lindquist
- Department Nutrition and Hospitality Management, University of Mississippi, University, MS, USA
| | - Georgianna Mann
- Department Nutrition and Hospitality Management, University of Mississippi, University, MS, USA
| | - Alisha Farris
- Nutrition and Foods Program, Appalachian State University, Boone, USA
| | - Kymberle Gordon
- Department Nutrition and Hospitality Management, University of Mississippi, University, MS, USA
| | - Sarah Misyak
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
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30
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Topham GL, Washburn IJ, Hubbs-Tait L, Kennedy TS, Rutledge JM, Page MC, Swindle T, Shriver LH, Harrist AW. The Families and Schools for Health Project: A Longitudinal Cluster Randomized Controlled Trial Targeting Children with Overweight and Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8744. [PMID: 34444492 PMCID: PMC8393339 DOI: 10.3390/ijerph18168744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/10/2021] [Accepted: 08/12/2021] [Indexed: 02/07/2023]
Abstract
This cluster randomized controlled trial aimed at overweight and obese children compared three treatments. Two psychoeducation interventions for parents and children were conducted: Family Lifestyle (FL) focused on food and physical activity; Family Dynamics (FD) added parenting and healthy emotion management. A third Peer Group (PG) intervention taught social acceptance to children. Crossing interventions yielded four conditions: FL, FL + PG, FL + FD, and FL + FD + PG-compared with the control. Longitudinal BMI data were collected to determine if family- and peer-based psychosocial components enhanced the Family Lifestyle approach. Participants were 1st graders with BMI%ile >75 (n = 538: 278 boys, 260 girls). Schools were randomly assigned to condition after stratifying for community size and percent American Indian. Anthropometric data were collected pre- and post-intervention in 1st grade and annually through 4th grade. Using a two-level random intercept growth model, intervention status predicted differences in growth in BMI or BMI-M% over three years. Children with obesity who received the FL + FD + PG intervention had lower BMI gains compared to controls for both raw BMI (B = -0.05) and BMI-M% (B = -2.36). Interventions to simultaneously improve parent, child, and peer-group behaviors related to physical and socioemotional health offer promise for long-term positive impact on child obesity.
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Affiliation(s)
- Glade L. Topham
- Department of Applied Human Sciences, Kansas State University, Manhattan, KS 66506, USA
| | - Isaac J. Washburn
- Department of Human Development & Family Science, Oklahoma State University, Stillwater, OK 74078, USA; (I.J.W.); (L.H.-T.); (A.W.H.)
| | - Laura Hubbs-Tait
- Department of Human Development & Family Science, Oklahoma State University, Stillwater, OK 74078, USA; (I.J.W.); (L.H.-T.); (A.W.H.)
| | - Tay S. Kennedy
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK 74078, USA;
| | - Julie M. Rutledge
- School of Human Ecology, Louisiana Tech University, Ruston, LA 71272, USA;
| | - Melanie C. Page
- Department of Psychology, West Virginia University, Morgantown, WV 26506, USA;
| | - Taren Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;
| | - Lenka H. Shriver
- Department of Nutrition, University of North Carolina Greensboro, Greensboro, NC 27412, USA;
| | - Amanda W. Harrist
- Department of Human Development & Family Science, Oklahoma State University, Stillwater, OK 74078, USA; (I.J.W.); (L.H.-T.); (A.W.H.)
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Weight gain in children after adenotonsillectomy: undesirable weight gain or catch-up growth? Sleep Med 2021; 85:147-149. [PMID: 34329898 DOI: 10.1016/j.sleep.2021.07.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 07/05/2021] [Accepted: 07/07/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE/BACKGROUND Obesity and obstructive sleep apnea (OSA) are consequential conditions with significant overlap in the pediatric population. Early studies documented catch-up growth in underweight children after adenotonsillectomy, but more recent studies suggested that normal and even overweight children may experience excess weight gain after adenotonsillectomy. We performed a secondary analysis of Childhood Adenotonsillectomy Trial (CHAT) data to test whether there was an effect of early adenotonsillectomy on undesirable weight gain, defined as an increase in body mass index (BMI) Z score in an already overweight or obese child or a change from baseline normal or underweight to a follow up BMI Z score classified as overweight. PATIENTS/METHODS We included 398 children with moderate OSA and complete anthropomorphic data randomized to adenotonsillectomy versus watchful waiting with supportive care. Pearson's χ2 and independent t tests were used to compare demographic, activity, sleep and anthropomorphic characteristics between children who did and did not experience undesirable weight gain over seven months. Logistic regression was used to test for an association between adenotonsillectomy and undesirable weight gain, both unadjusted and adjusted for age, sex, Black race, average parent-reported weekly activity level, mother's body mass index, average nightly sleep duration and either baseline or follow up AHI (in separate models). RESULTS Forty three percent (n = 172) experienced undesirable weight gain. A similar percentage of children in both arms experienced undesirable weight gain (45% adenotonsillectomy vs 41% watchful waiting). Neither unadjusted nor adjusted regression analysis demonstrated a significant effect of adenotonsillectomy on undesirable weight gain. CONCLUSION Adenotonsillectomy may not be an independent risk factor for undesirable weight gain in children.
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Compliance with the 24-Hour Movement Behavior Guidelines and Associations with Adiposity in European Preschoolers: Results from the ToyBox-Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147499. [PMID: 34299954 PMCID: PMC8307342 DOI: 10.3390/ijerph18147499] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/10/2021] [Accepted: 07/12/2021] [Indexed: 02/01/2023]
Abstract
In 2019, the World Health Organization (WHO) published 24 h movement behavior guidelines for preschoolers with recommendations for physical activity (PA), screen time (ST), and sleep. The present study investigated the proportion of preschoolers complying with these guidelines (on a total week, weekdays and weekend days), and the associations with adiposity. This cross-sectional study included 2468 preschoolers (mean age: 4.75 years; 41.9% boys) from six European countries. The associations were investigated in the total sample and in girls and boys separately. PA was objectively assessed by step counts/day. Parent-reported questionnaires provided ST and sleep duration data. Generalized estimating equations were used to analyze the association between guideline compliance and adiposity indicators, i.e., body mass index (BMI) z-score and waist to height ratio (WHR). Only 10.1% of the preschoolers complied with the 24 h movement behavior guidelines, 69.2% with the sleep duration guideline, 39.8% with the ST guideline and 32.7% with the PA guideline. No association was found between guideline compliance with all three movement behaviors and adiposity. However, associations were found for isolated weekday screen time (BMI z-scores and WHR: p = 0.04) and weekend day sleep duration (BMI z-scores and WHR: p = 0.03) guideline compliance with both lower adiposity indicators. The latter association for sleep duration was also found in girls separately (BMI z-scores: p = 0.02; WHR: p = 0.03), but not in boys. Longitudinal studies, including intervention studies, are needed to increase preschoolers’ guideline compliance and to gain more insight into the manifestation of adiposity in children and its association with 24 h movement behaviors from a young age onwards.
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Lee J, Kubik MY, Fulkerson JA. Fruit and Vegetable Snack Consumption Among Children With a Body Mass Index at or Above the 75th Percentile. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:619-624. [PMID: 33674237 PMCID: PMC8277684 DOI: 10.1016/j.jneb.2021.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To describe fruit and vegetable (FV) consumption as snacks and the association with diet quality and compare the snacking environment and child and parent characteristics between children who consumed FV as snacks and those who did not. METHODS This secondary analysis study used baseline data from a healthy weight management study with 8- to 12-year-old children with a body mass index ≥75th percentile. Data collection included 24-hour dietary recalls, measured height/weight, and child and parent surveys. RESULTS Children (n = 119) consumed 0.1 cup equivalent per 1,000 kcal of FV as snacks, the equivalent of 16.9% of their daily FV consumption. More FV consumption as snacks occurred at home when a parent was present and was associated with higher parent support for FV consumption as snacks (P = 0.03). CONCLUSIONS AND IMPLICATIONS Renewed attention to strategies to promote FV consumption as snacks, especially at away-from-home locations, is merited.
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Affiliation(s)
- Jiwoo Lee
- School of Nursing, University of Minnesota, Minneapolis, MN.
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Goncalves WSF, Byrne R, de Lira PIC, Viana MT, Trost SG. Psychometric properties of instruments to measure parenting practices and children's movement behaviors in low-income families from Brazil. BMC Med Res Methodol 2021; 21:129. [PMID: 34162323 PMCID: PMC8223314 DOI: 10.1186/s12874-021-01320-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/18/2021] [Indexed: 11/10/2022] Open
Abstract
Background Childhood obesity has increased remarkably in low and middle-income (LMIC) countries. Movement behaviors (physical activity, screen time, and sleep) are crucial in the development of overweight and obesity in young children. Yet, few studies have investigated the relationship between children’s movement behaviors and parenting practices because validated measures for use among families from LMIC are lacking. This study evaluated the psychometric properties of previously validated measures of young children’s physical activity, screen time, and sleep and parenting practices, translated and culturally adapted to Brazilian families. Methods A total of 78 parent-child dyads completed an interviewer-administered survey twice within 7 days. Child physical activity, sedentary time and sleep were concurrently measured using a wrist-worn accelerometer. Internal consistency and test-retest reliability was assessed using McDonald’s Omega and Intraclass Correlation Coefficients (ICC’s). Concurrent validity was evaluated by calculating Spearman correlations between parent reported child behaviors and accelerometer measured behaviors. Results Seventeen of the 19 parenting practices scales exhibited acceptable internal consistency reliability (Ω ≥ 0.70). Test-retest reliability ICC’s were acceptable and ranged from 0.82 - 0.99. Parent reported child physical activity was positively correlated with objectively measured total movement (rho= 0.29 - 0.46, p < .05) and energetic play (rho= 0.29 – 0.40, p < .05). Parent reported child screen time was positively correlated with objectively measured sedentary time; (rho = 0.26, p < .05), and inversely correlated with total movement (rho = - 0.39 – - 0.41, p < .05) and energetic play (rho = - 0.37 – - 0.41, p < .05). Parent reported night-time sleep duration was significantly correlated with accelerometer measured sleep duration on weekdays (rho = 0.29, p < .05), but not weekends. Conclusions Measurement tools to assess children’s movement behaviors and parenting practices, translated and culturally adapted for use in Brazilian families, exhibited acceptable evidence of concurrent validity, internal consistency, and test-retest reliability. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-021-01320-y.
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Affiliation(s)
- Widjane Sheila Ferreira Goncalves
- Centre for Children's Health Research, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | - Rebecca Byrne
- Centre for Children's Health Research, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | | | | | - Stewart G Trost
- Centre for Children's Health Research, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia. .,Centre for Children's Health Research (CCHR), Level 6, 62 Graham St, South Brisbane, QLD, 4101, Australia.
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Gato-Moreno M, Martos-Lirio MF, Leiva-Gea I, Bernal-López MR, Vegas-Toro F, Fernández-Tenreiro MC, López-Siguero JP. Early Nutritional Education in the Prevention of Childhood Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126569. [PMID: 34207231 PMCID: PMC8296335 DOI: 10.3390/ijerph18126569] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 12/14/2022]
Abstract
Early childhood is a critical period for obesity prevention. This randomized controlled study evaluated the effectiveness of an educational intervention preventing obesity in preschool-age children. A nutritional education intervention, with a follow-up session one year later, was conducted with parents of children aged 3 to 4 years of public schools in the province of Málaga. The main outcome variable was the body mass index z-score (zBMI). The prevalence of overweight or obesity was the secondary outcome variable. The sample comprised 261 students (control group = 139). Initial BMI, weight, height-for-age and prevalence of overweight and obesity were similar for both groups. After the first year of the intervention, the zBMI of the intervention group decreased significantly from 0.23 to 0.10 (p = 0.002), and the subgroup of patients with baseline zBMI above the median decreased from 1 to 0.72 (p = 0.001), and in the second year from 1.01 to 0.73 (p = 0.002). The joint prevalence of overweight and obesity increased in the control group (12.2% to 20.1%; p = 0.027), while in the intervention group, there were no significant changes. This preschool educational intervention with parents improved their children’s BMI, especially those with a higher BMI for their age, and favored the prevention of overweight or obesity.
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Affiliation(s)
- Mario Gato-Moreno
- Department of Pediatric Endocrinology, Regional University Hospital of Málaga, 29011 Málaga, Spain; (M.G.-M.); (M.F.M.-L.); (F.V.-T.); (M.C.F.-T.); (J.P.L.-S.)
| | - María F. Martos-Lirio
- Department of Pediatric Endocrinology, Regional University Hospital of Málaga, 29011 Málaga, Spain; (M.G.-M.); (M.F.M.-L.); (F.V.-T.); (M.C.F.-T.); (J.P.L.-S.)
| | - Isabel Leiva-Gea
- Department of Pediatric Endocrinology, Regional University Hospital of Málaga, 29011 Málaga, Spain; (M.G.-M.); (M.F.M.-L.); (F.V.-T.); (M.C.F.-T.); (J.P.L.-S.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain;
- Department of Pharmacology and Pediatrics, Faculty of Medicine, University of Málaga, 29016 Málaga, Spain
- Correspondence:
| | - M. Rosa Bernal-López
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain;
- Department of Internal Medicine, Regional University Hospital of Málaga, 29009 Málaga, Spain
- CIBER Fisiopatologia de la Obesidad y la Nutricion (Ciber Obn), Carlos III Health Institute, 28029 Madrid, Spain
| | | | - María C. Fernández-Tenreiro
- Department of Pediatric Endocrinology, Regional University Hospital of Málaga, 29011 Málaga, Spain; (M.G.-M.); (M.F.M.-L.); (F.V.-T.); (M.C.F.-T.); (J.P.L.-S.)
| | - Juan P. López-Siguero
- Department of Pediatric Endocrinology, Regional University Hospital of Málaga, 29011 Málaga, Spain; (M.G.-M.); (M.F.M.-L.); (F.V.-T.); (M.C.F.-T.); (J.P.L.-S.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain;
- Department of Pharmacology and Pediatrics, Faculty of Medicine, University of Málaga, 29016 Málaga, Spain
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Zbořilová V, Přidalová M, Kaplanová T. Body Fat Mass, Percent Body Fat, Fat-Free Mass, and Skeletal Muscle Mass Reference Curves for Czech Children Aged 6-11 Years. CHILDREN (BASEL, SWITZERLAND) 2021; 8:366. [PMID: 34064402 PMCID: PMC8147804 DOI: 10.3390/children8050366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/20/2021] [Accepted: 05/02/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Negative lifestyle trends are reflected in overweight and obese children, in which their lack of physical activity results in decreased muscle mass. This study aimed to define age- and sex-specific reference curves for body fat mass (BFM), skeletal muscle mass (SMM), fat-free mass (FFM), and percent body fat (%BF) in Czech children. METHODS Body composition was measured by segmental bioelectrical impedance (BIA, InBody 720). The research sample included 2093 children aged 6-11 years (1008 boys and 1085 girls). Only children whose parents provided informed consent were included. Statistical analysis was performed using SPSS v. 22. The statistical analysis was performed separately by age and sex. Anthropometric data were summarized as means and standard deviation. The percentile curves (P3, P10, P25, P50, P75, P90, and P97) of BFM, FFM, %BF, and SMM were calculated using the gamlss package in R 3.4.2 (R Foundation for Statistical Computing, Vienna, Austria). RESULTS This study developed age- and gender-specific percentile curves of SMM, FFM, BFM, and %BF for Czech children aged 6-11 years. During childhood, BFM and %BF increased in boys, peaking at approximately 11 years of age. Girls displayed a different pattern of age-related changes in BFM and %BF compared to that in boys. These parameters gradually increased during childhood. This pattern was also observed for SMM and FFM in both sexes. CONCLUSIONS The purpose of this study was to serve as a reference to improve methods to evaluate body composition in Czech children and for comparison with studies worldwide.
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Affiliation(s)
- Vendula Zbořilová
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacký University, 771 11 Olomouc, Czech Republic; (M.P.); (T.K.)
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Sanders LM, Perrin EM, Yin HS, Delamater AM, Flower KB, Bian A, Schildcrout JS, Rothman RL. A Health-Literacy Intervention for Early Childhood Obesity Prevention: A Cluster-Randomized Controlled Trial. Pediatrics 2021; 147:peds.2020-049866. [PMID: 33911032 PMCID: PMC8086006 DOI: 10.1542/peds.2020-049866] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/27/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Children who become overweight by age 2 have greater risk of long-term obesity and health problems. The study aim was to assess the effectiveness of a primary care-based intervention on the prevalence of overweight at age 24 months. METHODS In a cluster-randomized trial, sites were randomly assigned to the Greenlight intervention or an attention-control arm. Across 4 pediatric residency clinics, we enrolled infant-caregiver dyads at the 2-month well-child visit. Inclusion criteria included parent English- or Spanish-speaking and birth weight ≥1500 g. Designed with health-literacy principles, the intervention included a parent toolkit at each well-child visit, augmented by provider training in clear-health communication. The primary outcome was proportion of children overweight (BMI ≥85th percentile) at age 24 months. Secondary outcomes included weight status (BMI z score). RESULTS A total of 459 intervention and 406 control dyads were enrolled. In total, 49% of all children were overweight at 24 months. Adjusted odds for overweight at 24 months (treatment versus control) was 1.02 (95% confidence interval [CI]: 0.63 to 1.64). Adjusted mean BMI z score differences (treatment minus control) were -0.04 (95% CI: -0.07 to -0.01), -0.09 (95% CI: -0.14 to -0.03), -0.19 (-0.33 to -0.05), -0.20 (-0.36 to -0.03), -0.16 (95% CI: -0.34 to 0.01), and 0.00 (95% CI -0.21 to 0.21) at 4, 6, 12, 15, 18, and 24 months, respectively. CONCLUSIONS The intervention resulted in less weight gain through age 18 months, which was not sustained through 24 months. Clinic-based interventions may be beneficial for early weight gain, but greater intervention intensity may be needed to maintain positive effects.
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Affiliation(s)
- Lee M. Sanders
- Division of General Pediatrics, Department of Pediatrics, Center for Policy, Outcomes and Prevention, Stanford University, Stanford, California
| | - Eliana M. Perrin
- Division of Primary Care and Duke Center for Childhood Obesity Research, Department of Pediatrics, Medical Center, Duke University, Durham, North Carolina
| | - H. Shonna Yin
- Department of Pediatrics and Population Health, School of Medicine, New York University and Department of Pediatrics, Bellevue Hospital Center, New York City, New York
| | - Alan M. Delamater
- Department of Pediatrics, School of Medicine, University of Miami, Miami, Florida
| | | | - Aihua Bian
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jonathan S. Schildcrout
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Russell L. Rothman
- Center for Health Services Research, Vanderbilt University Medical Center, Nashville, Tennessee; and
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Kubik MY, Lee J, Fulkerson JA, Gurvich OV, Sirard JR. School-Based Secondary Obesity Prevention for Eight- to Twelve-Year-Olds: Results from the Students, Nurses, and Parents Seeking Healthy Options Together Randomized Trial. Child Obes 2021; 17:185-195. [PMID: 33601934 PMCID: PMC8418450 DOI: 10.1089/chi.2020.0321] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objective: The primary aim of this randomized controlled trial, conducted in Minneapolis/St. Paul, Minnesota (2014-2019), was to evaluate the effects of a school-based, school nurse-delivered, secondary obesity prevention intervention to reduce excess weight gain among preadolescent children with obesity or at risk of developing obesity. Methods: Parent/child dyads (n = 132) were randomized to the 9-month Students, Nurses, and Parents Seeking Healthy Options Together (SNAPSHOT) intervention (32.5 contact hours) or newsletter-only control group. Eligible children were 8 to 12 years old, proficient in English, and with a BMI ≥75th percentile, calculated using height/weight reported by a parent, school nurse, or clinician. The primary outcome was child BMI for sex/age z-score (BMIz) at postintervention (12 months) and follow-up (24 months). Results: Among children, 63% were non-White, 51% were male, and 51% with obesity, including 21% with severe obesity. Among families, 59% received economic assistance and 30% reported food insecurity. The mean number of intervention contact hours received was 20 (range: 0-32.5). Among dyads (n = 54) receiving the intervention, parents were very satisfied/satisfied with SNAPSHOT and SNAPSHOT staff, 96% and 100%, respectively, and very likely/likely (97%) to recommend SNAPSHOT to others. Most (70%) children liked the kid group sessions "a lot." In an intent-to-treat analysis, there were no significant between-group differences in child BMIz at 12 [0.04; 95% confidence interval (CI) -0.07 to 0.16] or 24 months (0.06; 95% CI -0.08 to 0.20), with participant retention of 92% and 93%, respectively. Conclusions: The SNAPSHOT intervention was well received, but did not improve BMI in a mostly diverse, low-income preadolescent population. Approaches to intervention delivery that are feasible, maximize accessibility, and optimize clinician and school nurse collaboration warrant consideration. Clinical trial registration identifier NCT02029976.
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Affiliation(s)
- Martha Y. Kubik
- School of Nursing, College of Health and Human Services, George Mason University, Fairfax, VA, USA
| | - Jiwoo Lee
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | | | - Olga V. Gurvich
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | - John R. Sirard
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA
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Pine AE, Schvey NA, Shank LM, Burke NL, Neyland MKH, Hennigan K, Young JF, Wilfley DE, Klein DA, Jorgensen S, Seehusen D, Hutchinson J, Quinlan J, Yanovski JA, Stephens M, Sbrocco T, Tanofsky-Kraff M. A Pilot Feasibility Study of Interpersonal Psychotherapy for the Prevention of Excess Weight Gain Among Adolescent Military-dependent Girls. Mil Med 2021; 186:344-350. [PMID: 33241297 PMCID: PMC7909453 DOI: 10.1093/milmed/usaa514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/04/2020] [Accepted: 11/09/2020] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Adolescent military-dependents face unique psychosocial stressors due to their parents' careers, suggesting they may be particularly vulnerable to excess weight gain and symptoms of depression and anxiety. Despite these risk factors, there is a lack of tested preventative interventions for these youths. Given the transient nature of military family deployments, research may be hindered due to difficulty in collecting long-term prospective outcome data, particularly measured height and weight. The primary aim of this study was to examine the feasibility and acceptability of collecting body mass index (BMI, kg/m2) outcome data up to 2 years following a randomized controlled pilot trial of an adapted interpersonal psychotherapy (IPT) program aimed at preventing excess weight gain and improving psychological functioning for adolescent military-dependents. In exploratory analyses, patterns in body composition over time were examined. MATERIALS AND METHODS Twenty-seven adolescent military-dependent girls (baseline: Mage: 14.4 ± 1.6 years; MBMI: 30.7 ± 4.9 kg/m2; MBMI-z: 1.9 ± 0.4) participated in this study. After a baseline assessment, utilizing a computerized program to create a randomization string, girls were assigned to either an IPT or a health education (HE) program. Participants completed three follow-up visits (posttreatment, 1-year follow-up, and 2-year follow-up). Girls completed a Treatment Acceptability Questionnaire at posttreatment; at all time points, height and fasting weight were collected. For the primary aim, Fisher's exact tests examined the rate of obtained follow-up data and lost to follow-up status between the two groups, Mann-Whitney U tests examined the session attendance between groups, and treatment acceptability ratings were compared between the two groups at posttreatment using an independent samples t-test. For the exploratory aim, one-way analyses of covariance (ANCOVAs) examined the group differences in BMI at each time point, adjusting for baseline values, and paired samples t-tests examined the within-group differences at each time point relative to baseline. Using imputed data in the full intent-to-treat sample, mixed model ANCOVAs were conducted to examine the group differences over time. RESULTS Across both groups, girls attended an average of 72.0% of sessions. At least partial data were collected at posttreatment, 1-year follow-up, and 2-year follow-up for 96.3%, 85.2%, and 74.1% of the participants, respectively. There were no significant group differences in follow-up data collection rates, follow-up status, number of sessions attended, or treatment acceptability. BMI-z stabilized across groups, and there were no group differences in BMI-z. In adjusted ANCOVA models with imputed data, no significant group-by-time effects emerged. CONCLUSIONS For this randomized controlled prevention trial, long-term outcome data collection of measured BMI was possible in adolescent military-dependents and IPT was an acceptable and feasible intervention. An adequately powered trial is required to assess the efficacy of this intervention among military-dependents for obesity prevention and improvements in BMI.
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Affiliation(s)
- Abigail E Pine
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD 20814, USA
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD 20814, USA
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, MD 20892, USA
| | - Lisa M Shank
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD 20814, USA
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, MD 20892, USA
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, MD 20814, USA
| | - Natasha L Burke
- Department of Psychology, Fordham University, Bronx, NY 10458, USA
| | - M K Higgins Neyland
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD 20814, USA
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, MD 20814, USA
- Metis Foundation, San Antonio, TX 78205, USA
| | - Kathrin Hennigan
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD 20814, USA
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, MD 20814, USA
- Metis Foundation, San Antonio, TX 78205, USA
| | - Jami F Young
- Department of Child and Adolescent Psychiatry, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Denise E Wilfley
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO 63130, USA
| | - David A Klein
- Departments of Family Medicine and Pediatrics, USU, Bethesda, MD 20814, USA
- Malcolm Grow Medical Clinics and Surgery Center, Joint Base Andrews, MD 20762, USA
| | - Sarah Jorgensen
- Department of Family Medicine, Fort Belvoir Community Hospital, Fort Belvoir, VA 22060, USA
| | - Dean Seehusen
- Department of Family Medicine, Medical College of Georgia, Augusta, GA 30912, USA
| | | | - Jeffrey Quinlan
- Departments of Family Medicine and Pediatrics, USU, Bethesda, MD 20814, USA
| | - Jack A Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, MD 20892, USA
| | - Mark Stephens
- Departments of Family and Community Medicine and Humanities, Pennsylvania State University, Old Main, State College, PA 16801, USA
| | - Tracy Sbrocco
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD 20814, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD 20814, USA
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, MD 20892, USA
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, MD 20814, USA
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Fiori F, Bravo G, Parpinel M, Messina G, Malavolta R, Lazzer S. A 3-year school-based intervention improved physical fitness and reduced the prevalence of overweight and obesity in Italian prepubertal children. J Sports Med Phys Fitness 2021; 61:1682-1689. [PMID: 33565753 DOI: 10.23736/s0022-4707.21.12011-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Schools constitute the ideal setting in which children's physical activity, physical fitness, and health status can improve. However, intervention protocols and their effectiveness vary considerably. The purpose of the study was to investigate the differences in physical fitness and overweight and obesity prevalence between children attending structured physical education classes held by a specialized teacher (EXP) or traditional classes of equal duration held by an ordinary teacher (TRAD). METHODS Anthropometric and fitness parameters were assessed in a convenience sample of 12,519 1st grade schoolchildren over 3 subsequent school years. Six field-based tests were used to assess physical fitness. RESULTS Physical fitness improved more in the EXP group than in the TRAD group, except for flexibility (sit and reach). At the end of the 3rd year, the EXP children performed better than did the TRAD children (P<0.001) in Léger (girls: +34%, boys: +30%), agility shuttle (girls: -10%, boys: -9%), long jump (girls: +9%, boys: +8%), frontal basketball throw (girls: +11%, boys: +10%), and standing balance (girls: +18%, boys: +28%). The prevalence of obesity and overweight was 5% lower in the EXP than in the TRAD group at the 3-year follow-up. CONCLUSIONS The proposed teacher-driven intervention, which was focused on the quality rather than the duration of time spent in the gym during school hours, was effective in improving children's physical fitness. Furthermore, the decrease in the prevalence of obesity and overweight suggests the intervention can improve heavier children's weight status.
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Affiliation(s)
- Federica Fiori
- Department of Medicine, University of Udine, Udine, Italy -
| | - Giulia Bravo
- Department of Medicine, University of Udine, Udine, Italy
| | - Maria Parpinel
- Department of Medicine, University of Udine, Udine, Italy
| | - Giovanni Messina
- Regional School of Sport, Italian Olympic Committee, Trieste, Italy
| | | | - Stefano Lazzer
- Department of Medicine, University of Udine, Udine, Italy.,School of Sport Sciences, University of Udine, Udine, Italy
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Tommerup K, Smith AD, Evans EH, Croker H, Steptoe A, Tovee MJ, Fildes A, Llewellyn C. The acceptability and feasibility of using a 3D body size scale to initiate conversations about weight in toddlerhood: a mixed-methods study. Pediatr Obes 2021; 16:e12715. [PMID: 32820620 DOI: 10.1111/ijpo.12715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/28/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Health Care Professionals struggle to initiate conversations about overweight in toddlerhood. A novel 3D body size scale (3D BSS) may facilitate engagement with this topic during pediatric appointments. OBJECTIVES To explore barriers and facilitators to using the 3D BSS through a mixed-methods design. METHODS For the qualitative phase, parents of toddlers (n = 38) participated in semi-structured interviews introducing the 3D BSS of 4-5-year-old children. For the quantitative phase, pre- and post-interview questionnaires were administered to ascertain the acceptability of the 3D BSS. RESULTS Parents rated the 3D BSS as "very" (n = 20, 52.6%) to "moderately" (n = 12, 31.6%) acceptable. Thematic analysis revealed four barriers to acceptability: i) the sensitive nature of child weight, ii) the belief that weight does not determine health, iii) the visual normalisation of overweight and iv) the need to account for individual variation in growth patterns. However, these barriers could be overcome through three facilitators: i) the provision of expert guidance ii) the value of simple tools, and iii) tailoring conversations to familial needs. CONCLUSIONS Parents considered the 3D BSS an acceptable visual resource to discuss child weight during routine appointments. However, the acceptability of the tool was conditional on a sensitive, collaborative, and tailored delivery approach.
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Affiliation(s)
- Kristiane Tommerup
- Obesity Research Group, Department of Behavioural Science and Health, University College London (UCL), London, UK
| | - Andrea D Smith
- Obesity Research Group, Department of Behavioural Science and Health, University College London (UCL), London, UK
| | | | - Helen Croker
- Great Ormond Street Institute of Child Health, Faculty of Population Health Sciences, University College London (UCL), London, UK
| | - Andrew Steptoe
- Obesity Research Group, Department of Behavioural Science and Health, University College London (UCL), London, UK
| | - Martin J Tovee
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Alison Fildes
- School of Psychology, University of Leeds, Leeds, UK
| | - Clare Llewellyn
- Obesity Research Group, Department of Behavioural Science and Health, University College London (UCL), London, UK
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Natale RA, Atem F, Weerakoon S, Lebron C, Mathew MS, Sardinas K, Chang C, Shelnutt KP, Spector R, Altare F, Messiah SE. An Implementation Approach Comparison of a Child Care Center-Based Obesity Prevention Program. J Dev Behav Pediatr 2021; 42:135-145. [PMID: 32947578 PMCID: PMC9336224 DOI: 10.1097/dbp.0000000000000861] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 06/01/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To compare the effectiveness of the Healthy Caregivers-Healthy Children (HC2) phase 1 (2011-2014) and 2 (2015-2018) child care center (CCC)-based obesity prevention intervention(s) on child dietary practices and body mass index percentile (PBMI) outcomes over 2 years. Phase 1 was implemented via a university-based research team, and phase 2 was delivered via a train-the-trainers approach (university-based research team trains preschool-based coaches, who in turn train CCC teachers to implement and disseminate HC2). METHODS Phase 1 and 2 were both cluster randomized controlled trials of the HC2 obesity prevention intervention. Phase 1 was composed of 1224 children in 28 CCCs (12 intervention and 16 control). Phase 2 was composed of 825 children in 24 CCCs (12 intervention and 12 control). Both phases included CCCs serving low-resource, predominantly ethnic minority families. RESULTS The mean rate of weekly fruit consumption significantly increased (β = 0.16, p = 0.001) in phase 1, whereas vegetable intake significantly increased (β = 0.16, p = 0.002) in phase 2 intervention CCCs. Fried (β = -0.36, p < 0.001), fast (β = -0.16, p = 0.001), and other unhealthy food (β = -0.57, p < 0.001) consumption significantly decreased in phase 1 only. The mean rate of snack food consumption significantly decreased in phase 2 (β = -0.97, p < 0.001). Mean child PBMI remained in the healthy range over 2 years for all groups in both study phases. CONCLUSION A university-based research team implementation and dissemination approach seemed to be more effective than a train-the-trainers implementation method in improving dietary intake patterns. This finding suggests that CCCs may need robust educational support beyond their existing internal resources for long-term positive dietary intake pattern changes.
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Affiliation(s)
- Ruby A. Natale
- Department of Pediatrics, University of Miami, Miami, FL
| | - Folefac Atem
- Department of Biostatistics, University of Texas Health Science Center School of Public Health, Dallas Campus, Dallas TX
| | - Sitara Weerakoon
- Department of Biostatistics, University of Texas Health Science Center School of Public Health, Dallas Campus, Dallas TX
| | - Cynthia Lebron
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - M. Sunil Mathew
- Department of Biostatistics, University of Texas Health Science Center School of Public Health, Dallas Campus, Dallas TX
| | | | - Catherina Chang
- Ron and Kathy Assaf College of Nursing, Nova Southeastern University, Davie, FL
| | - Karla P. Shelnutt
- Department of Family, Youth and Community Sciences, University of Florida, Gainesville, FL
| | | | | | - Sarah E. Messiah
- Department of Pediatrics, University of Miami, Miami, FL
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
- Department of Epidemiology, Human Genetics & Environmental Sciences, University of Texas Health Science Center School of Public Health, Dallas Campus, Dallas, TX
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Torres C, Brophy-Herb HE, McCaffery H, Struza J, Williams JM, Choi HH, Horodynski MA, Contreras D, Kerver J, Kaciroti N, Lumeng JC. Maternal Mindfulness Is Associated With Lower Child Body Mass Index Z Score. Acad Pediatr 2021; 21:70-75. [PMID: 32590057 PMCID: PMC7755689 DOI: 10.1016/j.acap.2020.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 06/11/2020] [Accepted: 06/17/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Parental mindfulness may be a novel intervention target for child obesity prevention. OBJECTIVE To examine associations between maternal mindfulness and child body mass index z-score (BMIz). METHODS In a secondary data analysis of preintervention data from a randomized controlled trial, we assessed survey and anthropometric data from English-speaking mother/child dyads enrolled in Head Start in south central Michigan (n = 105). Surveys included demographic information, child dietary intake, family meal frequency, and the Philadelphia Mindfulness Questionnaire. Multivariable linear regression examined associations between maternal mindfulness and child BMIz, child intake of fruits and vegetables, and frequency of family meals. RESULTS Children were M = 53.7 (standard deviation [SD] 7.5) months old, and mothers were M = 31.6 (SD 8.3) years old. The sample of children was 39% white, 26% black, 14% Hispanic, and 35% of children were overweight or obese. Mean maternal BMI was 32.0 (SD 8.3). Greater mindfulness was associated with child BMIz (β = -.02 (SE 0.01), P = .027) adjusting for child race/ethnicity, household food security, maternal education, maternal age, and maternal BMI. Mindfulness was not associated with child fruit intake, child vegetable intake or frequency of family meals. The results were consistent with alternative outcomes of BMI percentile (P = .016) and BMI at the trend level (P = .0595) at the trend level. CONCLUSIONS Greater maternal mindfulness was associated with lower child BMIz. Future work should consider mechanisms of association. Pediatric providers might consider supporting maternal mindfulness as one element of multicomponent strategies for child obesity prevention.
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Affiliation(s)
- Chioma Torres
- Department of Pediatrics, University of Michigan Medical School (C Torres, J Struza, and JC Lumeng), Ann Arbor, Mich.
| | - Holly E Brophy-Herb
- Department of Human Development and Family Studies, Michigan State University (HE Brophy-Herb, JM Williams, and HH Choi), East Lansing, Mich
| | - Harlan McCaffery
- Center for Human Growth and Development, University of Michigan (H McCaffery, N Kaciroti, and JC Lumeng), Ann Arbor, Mich
| | - Julie Struza
- Department of Pediatrics, University of Michigan Medical School (C Torres, J Struza, and JC Lumeng), Ann Arbor, Mich
| | - Jessica M Williams
- Department of Human Development and Family Studies, Michigan State University (HE Brophy-Herb, JM Williams, and HH Choi), East Lansing, Mich
| | - Hailey Hyunjin Choi
- Department of Human Development and Family Studies, Michigan State University (HE Brophy-Herb, JM Williams, and HH Choi), East Lansing, Mich
| | - Mildred A Horodynski
- College of Nursing, Michigan State University (MA Horodynski), East Lansing, Mich
| | - Dawn Contreras
- Michigan State University Extension, Michigan State University (D Contreras), East Lansing, Mich
| | - Jean Kerver
- Department of Epidemiology and Biostatistics, Michigan State University (J Kerver), East Lansing, Mich
| | - Niko Kaciroti
- Center for Human Growth and Development, University of Michigan (H McCaffery, N Kaciroti, and JC Lumeng), Ann Arbor, Mich
| | - Julie C Lumeng
- Department of Pediatrics, University of Michigan Medical School (C Torres, J Struza, and JC Lumeng), Ann Arbor, Mich; Center for Human Growth and Development, University of Michigan (H McCaffery, N Kaciroti, and JC Lumeng), Ann Arbor, Mich; Department of Nutritional Sciences, University of Michigan School of Public Health (JC Lumeng), Ann Arbor, Mich
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Erzse A, Christofides N, Stacey N, Lebard K, Foley L, Hofman K. Availability and advertising of sugar sweetened beverages in South African public primary schools following a voluntary pledge by a major beverage company: a mixed methods study. Glob Health Action 2021; 14:1898130. [PMID: 33910480 PMCID: PMC8288764 DOI: 10.1080/16549716.2021.1898130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/28/2021] [Indexed: 10/31/2022] Open
Abstract
Background: Towards the end of the 2017 school year, a prominent beverage company in South Africa pledged to remove their sugar-sweetened beverages (SSBs) and advertisements from primary schools in order to contribute to the realization of a healthy school environment.Objectives: To assess the availability and advertising of the company's beverages in public primary schools in Gauteng province following their voluntary pledge to remove the products, and to explore perceptions of school staff regarding SSB availability in schools and processes related to the implementation of the pledge.Methods: In 2019, we conducted a representative survey of public sector primary (elementary) schools in Gauteng province, South Africa. A random sample of schools was drawn, with schools stratified by whether or not they charge fees. This was a proxy for the socioeconomic status of the locale and student body. At each school, the availability of beverages and presence of advertising or not was assessed by an observational audit tool and differences across fee status assessed by Pearson χ 2 test. Semi-structured interviews were conducted with a purposive sample of school officials. Data from the interviews were coded and thematic analysis conducted.Results: Two years following a voluntary pledge, the company's carbonated SSBs were available for sale in 54% (CI: 45-63%) of schools with tuck shops and advertised in 31% (CI: 25-39%). Qualitative interviews revealed a complex landscape of actors within schools, which, combined with indifference or resistance to the pledge, may have contributed to the continued availability of SSBs.Conclusions: Though we were unable to examine SSB availability before and after the pledge, our findings provide some preliminary evidence that voluntary pledges by commercial entities are not sufficient to remove SSBs and advertisements from schools. Mandatory regulations coupled with in-depth engagement with schools may be an avenue to pursue in the future.
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Affiliation(s)
- Agnes Erzse
- SAMRC/Centre for Health Economics and Decision Science, PRICELESS, Faculty of Health Sciences, University of Witwatersrand School of Public Health, Johannesburg, South Africa
| | - Nicola Christofides
- Faculty of Health Sciences, University of Witwatersrand School of Public Health, Johannesburg, South Africa
| | - Nicholas Stacey
- SAMRC/Centre for Health Economics and Decision Science, PRICELESS, Faculty of Health Sciences, University of Witwatersrand School of Public Health, Johannesburg, South Africa
| | - Kelsey Lebard
- SAMRC/Centre for Health Economics and Decision Science, PRICELESS, Faculty of Health Sciences, University of Witwatersrand School of Public Health, Johannesburg, South Africa
| | - Louise Foley
- MRC Epidemiology Unit, University of Cambridge, UK
| | - Karen Hofman
- SAMRC/Centre for Health Economics and Decision Science, PRICELESS, Faculty of Health Sciences, University of Witwatersrand School of Public Health, Johannesburg, South Africa
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Leerkes EM, Buehler C, Calkins SD, Shriver LH, Wideman L. Protocol for iGrow (Infant Growth and Development Study): biopsychosocial predictors of childhood obesity risk at 2 years. BMC Public Health 2020; 20:1912. [PMID: 33317498 PMCID: PMC7734916 DOI: 10.1186/s12889-020-10003-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 12/03/2020] [Indexed: 11/26/2022] Open
Abstract
Background Childhood obesity remains a significant public health problem. To date, most research on the causes and correlates of obesity has focused on a small number of direct predictors of obesity rather than testing complex models that address the multifactorial nature of the origins of obesity in early development. We describe the rationale and methods of iGrow (Infant Growth and Development Study) which will test multiple pathways by which (a) prenatal maternal psychobiological risk predicts infant weight gain over the first 6 months of life, and (b) this early weight gain confers risk for obesity at age 2. Infant hormonal and psychobiological risk are proposed mediators from prenatal risk to early weight gain, though these are moderated by early maternal sensitivity and obesogenic feeding practices. In addition, higher maternal sensitivity and lower obesogenic feeding practices are proposed predictors of adaptive child self-regulation in the second year of life, and all three are proposed to buffer/reduce the association between high early infant weight gain and obesity risk at age 2. Methods iGrow is a prospective, longitudinal community-based study of 300 diverse mothers and infants to be followed across 5 data waves from pregnancy until children are age 2. Key measures include (a) maternal reports of demographics, stress, well-being, feeding practices and child characteristics and health; (b) direct observation of maternal and infant behavior during feeding, play, and distress-eliciting tasks during which infant heart rate is recorded to derive measures of vagal withdrawal; (c) anthropometric measures of mothers and infants; and (d) assays of maternal prenatal blood and infant saliva and urine. A host of demographic and other potential confounds will be considered as potential covariates in structural equation models that include tests of mediation and moderation. Efforts to mitigate the deleterious effects of COVID-19 on study success are detailed. Discussion This study has the potential to inform (1) basic science about early life processes casually related to childhood obesity and (2) development of targeted intervention and prevention approaches that consider mother, infant, and family risks and resources.
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Affiliation(s)
- Esther M Leerkes
- UNC Greensboro, Department of Human Development and Family Studies, Greensboro, NC, 27402-6170, USA.
| | - Cheryl Buehler
- UNC Greensboro, Department of Human Development and Family Studies, Greensboro, NC, 27402-6170, USA
| | - Susan D Calkins
- UNC Greensboro, Office of Research and Engagement, Greensboro, NC, 27402-6170, USA
| | - Lenka H Shriver
- UNC Greensboro, Department of Nutrition, Greensboro, NC, 27402-6170, USA
| | - Laurie Wideman
- UNC Greensboro, Department of Kinesiology, Greensboro, NC, 27402-6170, USA
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Vinke PC, Tigelaar C, Küpers LK, Corpeleijn E. The Role of Children's Dietary Pattern and Physical Activity in the Association Between Breastfeeding and BMI at Age 5: The GECKO Drenthe Cohort. Matern Child Health J 2020; 25:338-348. [PMID: 33258042 PMCID: PMC7870607 DOI: 10.1007/s10995-020-03063-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2020] [Indexed: 12/26/2022]
Abstract
Objectives Breastfeeding is protective against childhood obesity, but the role of childhood lifestyle in this association is unclear. We investigated whether physical activity and dietary pattern at age 5 differed between breastfed and non-breastfed children, and how they relate to Body Mass Index (BMI) Z-scores. Methods 1477 children of the Dutch GECKO Drenthe birth cohort were included. At one month, children were categorized as breastfed (receiving breast milk exclusively or in combination with formula milk) or non-breastfed (receiving formula milk exclusively). At age 5, height and weight were objectively measured, physical activity was measured by ActiGraph GT3x and dietary patterns were assessed with a parent-reported food pattern questionnaire, assessing the consumption frequency of selected food items at seven occasions over the day. Results Non-breastfed children had higher BMI Z-scores (0.36 ± 0.90 vs. 0.20 ± 0.80 SD, p = 0.002), more frequently consumed sugar-sweetened beverages (25.0 ± 10.5 vs. 22.5 ± 9.71 times per week, p < 0.001), and consumed relatively less whole-wheat or brown bread (p = 0.007). Differences in sugar-sweetened beverage consumption were most pronounced during main meals. Total fruit consumption, sedentary time and moderate-to-vigorous physical activity levels did not differ between the groups. Multivariable adjusted linear regression analyses showed that the differences in BMI-z score between non-breastfed and breastfed children were not explained by the differences in sugar-sweetened beverages or type of bread consumed. Conclusions Infant breastfeeding itself is indicative of healthy dietary behaviors in early life, and is also more likely to be followed by a favorable dietary pattern at toddler age. However, the differences in dietary habits between breastfed and non-breastfed children did not explain the difference in BMI Z-score at the age of 5. Electronic supplementary material The online version of this article (10.1007/s10995-020-03063-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Petra Corianne Vinke
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, P.O. Box 30 001, Groningen, 9700 RB, The Netherlands.
| | - Carolien Tigelaar
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, P.O. Box 30 001, Groningen, 9700 RB, The Netherlands
| | - Leanne Karen Küpers
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, P.O. Box 30 001, Groningen, 9700 RB, The Netherlands.,Division of Human Nutrition and Health, Wageningen University & Research, PO Box 8129, Wageningen, 6700 EV, The Netherlands
| | - Eva Corpeleijn
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, P.O. Box 30 001, Groningen, 9700 RB, The Netherlands
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Campos M, Pomeroy J, Mays MH, Lopez A, Palacios C. Intervention to promote physical activation and improve sleep and response feeding in infants for preventing obesity early in life, the baby-act trial: Rationale and design. Contemp Clin Trials 2020; 99:106185. [PMID: 33099015 PMCID: PMC7860210 DOI: 10.1016/j.cct.2020.106185] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 09/15/2020] [Accepted: 10/15/2020] [Indexed: 11/18/2022]
Abstract
Infant obesity is increasing in the US, particularly among Hispanics. Rapid weight gain during infancy increases the risk of obesity later in life and could be prevented through multi-modal interventions addressing multiple risk factors through population-level programs. OBJECTIVES 1) determine the extent to which the intervention, compared with the usual care control condition, improves healthy weight gain and specific behaviors (physical activity, sleep, diet) in the first year of life and 2) evaluate the cost of the intervention as a modification of the current WIC standard of care. METHODS The lifestyle intervention focuses on age-appropriate infant physical activation, healthy sleep and sedentary patterns, and response feeding, by improving parenting skills delivered through a combination of technology (web-platform and text messages) and phone counseling. It is being tested among caregivers of infant participants of the Puerto Rico WIC program through a cluster-randomized controlled trial in 14 WIC clinics in San Juan starting in pregnancy until the infant is 12 months of age. The main outcome is infant rate of weight gain at 12 months; secondary outcomes include objectively measured hours of infant movement, sedentary behaviors and sleep, diet quality score and response feeding behaviors. We are also recording fees, time and personnel involved in the intervention development, maintenance and dissemination. CONCLUSIONS If successful, the intervention could be incorporated as a 'best practice' through WIC policy as a means to strengthen obesity prevention efforts to improve minority health and eliminate health disparities among Hispanics and possibly other at-risk groups beyond the childhood period. Clinicaltrials.gov registration: NCT03517891.
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Affiliation(s)
- M Campos
- Dental and Craniofacial Genomics Core, Endocrinology Section School of Medicine, University of Puerto Rico, San Juan 00936-5067, Puerto Rico.
| | - J Pomeroy
- Clinical Research Center, Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, WI, USA.
| | - M H Mays
- Biomedical Informatics Core, Puerto Rico Clinical and Translational Research Consortium, San Juan, Puerto Rico.
| | - A Lopez
- Sports and Leisure Management program and Adapted Physical Education program, School of Education, Metropolitan University, San Juan Puerto Rico.
| | - C Palacios
- Dietetics and Nutrition Department, Robert Stempel College of Public Health & Social Work, Florida International University, Miami USA.
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Slaton A, Kowalski AJ, Zemanick A, Pulling Kuhn A, Hager ER, Black MM. Motor Competence and Attainment of Global Physical Activity Guidelines among a Statewide Sample of Preschoolers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228546. [PMID: 33217996 PMCID: PMC7698764 DOI: 10.3390/ijerph17228546] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/06/2020] [Accepted: 11/13/2020] [Indexed: 12/22/2022]
Abstract
Global physical activity guidelines for preschoolers include 60 min of moderate-to-vigorous physical activity (MVPA) daily. This study, based on the developmental model of motor skill competence, examines how motor competence relates to preschoolers’ likelihood of meeting global guidelines using ankle accelerometry. We measured physical activity using 24-h ankle-placement accelerometry (Actical) for at least two consecutive days (87% with six-seven days), motor competence using the Test of Gross Motor Development-2 (TGMD-2), and BMI-for-age z-scores (BMIz) using anthropometry and age- and sex-specific CDC norms. Caregivers provided demographic characteristics of children’s age, sex, and race. We used multivariable logistic regression to examine how motor competence, BMIz weight status, and demographic characteristics related to meeting global physical activity guidelines. The sample included 588 preschoolers, age 3–5 years; 55% male; 60% white; and 28% overweight/obese; 75% attained the recommended 60 min of MVPA per day. The odds of meeting MVPA guidelines were associated with higher gross motor quotient, higher object control scores, sex (male), age (older), and race (white), but not with BMIz weight status. Findings support the use of 24-h ankle accelerometry among preschoolers and are consistent with the developmental model of motor competence applied to preschoolers, whereby object control competence relates positively to attaining global physical activity guidelines.
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Affiliation(s)
- Anthony Slaton
- Department of Pediatrics, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (A.S.); (A.J.K.); (A.Z.); (A.P.K.); (E.R.H.)
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hofstra University, Hempstead, NY 11549, USA
| | - Alysse J. Kowalski
- Department of Pediatrics, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (A.S.); (A.J.K.); (A.Z.); (A.P.K.); (E.R.H.)
| | - Amy Zemanick
- Department of Pediatrics, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (A.S.); (A.J.K.); (A.Z.); (A.P.K.); (E.R.H.)
| | - Ann Pulling Kuhn
- Department of Pediatrics, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (A.S.); (A.J.K.); (A.Z.); (A.P.K.); (E.R.H.)
| | - Erin R. Hager
- Department of Pediatrics, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (A.S.); (A.J.K.); (A.Z.); (A.P.K.); (E.R.H.)
- Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, MD 21201, USA
| | - Maureen M. Black
- Department of Pediatrics, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (A.S.); (A.J.K.); (A.Z.); (A.P.K.); (E.R.H.)
- Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, MD 21201, USA
- RTI International, Research Triangle Park, Durham, NC 27709, USA
- Correspondence:
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Schroeder K, Kubik MY, Sirard JR, Lee J, Fulkerson JA. Sleep is Inversely Associated with Sedentary Time among Youth with Obesity. Am J Health Behav 2020; 44:756-764. [PMID: 33081874 PMCID: PMC7890749 DOI: 10.5993/ajhb.44.6.2] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objective: Pathways underlying the sleep-obesity relationship in youth are poorly understood. In this study, we examined associations of sleep with sedentary time and moderate-to-vigorous physical activity (MVPA) among youth, stratified by weight category (obesity versus no obesity). A sub-aim examined whether controlling for screen time changed the sleep-sedentary time association. Methods: Methods entailed secondary analysis of baseline data collected June-August 2014-2017 during a school-based healthy weight management trial in Minneapolis/St. Paul, Minnesota. Participants (N = 114) were 8-to-12 years old with BMI ≥ 75th percentile, most of whom were members of racial/ethnic minority groups (57%) or from households receiving economic assistance (55%). Mean nightly sleep duration and daily screen time were measured by survey, MVPA and sedentary time by accelerometer, and height and weight by research staff. Multivariate linear regression examined associations of sleep with sedentary time and MVPA. Results: Sleep was inversely associated with hours of sedentary time (β = -1.34 [-2.11, -0.58] p = .001) and percent of time spent sedentary (β = -2.92 [-4.83, -1.01], p = .004), for youth with obesity only. The association was unchanged by screen time. Sleep was not significantly associated with MVPA in total sample or stratified models. Conclusions: Associations among sleep, activity levels, and obesity may differ based upon movement type (sedentary time vs MVPA) and weight category (obesity vs no obesity).
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Affiliation(s)
- Krista Schroeder
- Krista Schroeder, Assistant Professor, Temple University College of Public Health, Department of Nursing, Philadelphia, PA, United States;,
| | - Martha Y Kubik
- Martha Y. Kubik, Professor, Temple University College of Public Health, Department of Nursing, Philadelphia, PA, United States
| | - John R Sirard
- John R. Sirard, Associate Professor, Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, United States
| | - Jiwoo Lee
- Jiwoo Lee, Assistant Professor, Cora Meidl Siehl Endowed Chair in Nursing Research, University of Minnesota School of Nursing, Minneapolis, MN, United States
| | - Jayne A Fulkerson
- Jayne A. Fulkerson, Professor and Cora Meidl Siehl Endowed Chair in Nursing Research, University of Minnesota School of Nursing, Minneapolis, MN, United States
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Parra-Soto S, Ortega A, Celis-Morales C, Kain J. Perception that Mothers and / or Guardians of Overweight or Obese Preschool Children Have of a Text Messaging Program to Support Behaviour Change in their Children. Glob Pediatr Health 2020; 7:2333794X20961575. [PMID: 33110932 PMCID: PMC7555567 DOI: 10.1177/2333794x20961575] [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: 10/02/2019] [Revised: 02/02/2020] [Accepted: 08/04/2020] [Indexed: 11/13/2022] Open
Abstract
In most childhood obesity preventive programs, parents are targeted as they are key in achieving lifestyle behavior change in their children. Because their participation is generally low, new technologies, such as text messaging, are being tested to assess if their participation increases. The objective of this study was to determine the perception that mothers of overweight/ obese preschool children have of a textmessaging program developed to support their children’s lifestyle behavior change. Text messages were sent to 60 mothers twice a week for 12 weeks; 58 of them said they received all of them. During the process mothers were contacted twice regarding their opinion on all aspects related to the messages. At follow-up, we determined perception by in depth interviews administered to participants. Results show that text messaging implemented in a personalized manner was considered successful in regards to providing useful information to support their children’s behavior change.
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Affiliation(s)
- Solange Parra-Soto
- Institute of Nutrition and Food Technology (INTA), University of Chile.,Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Alejandra Ortega
- Institute of Nutrition and Food Technology (INTA), University of Chile
| | - Carlos Celis-Morales
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.,Grupo de Estudio en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca, Chile.,Centro de Investigaciones en Fisiología del Ejercicio (CIFE), Universidad Mayor, Santiago, Chile
| | - Juliana Kain
- Institute of Nutrition and Food Technology (INTA), University of Chile
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