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Roberts DK, Sarver DE, Cash AR, Walker BH, Lim CS. Understanding health behaviors that modify the risk for obesity in ADHD. J Pediatr Psychol 2024; 49:372-381. [PMID: 38516857 DOI: 10.1093/jpepsy/jsae018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/31/2024] [Accepted: 02/28/2024] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVE Research provides support for the associated risk of inadequate sleep duration, limited physical activity, and excessive media use in attention-deficit/hyperactivity disorder (ADHD) and obesity. The present study aims to (1) examine the association between ADHD and overweight or obese status (OW/OB); (2) comprehensively examine sleep duration, physical activity, and media use as potential moderators of OW/OB; and (3) examine the moderating effects of these health behaviors cross-sectionally by comparing medicated youth with ADHD, unmedicated youth with ADHD, and youth without ADHD. METHODS Data were acquired from the 2018 and 2019 National Survey of Children's Health, a nationally representative survey of caregivers conducted across the United States. The current study used data for youth 11-17 years old with a final sample size of 26,644. Hours of sleep, physical activity, and media use per day were dichotomized based on national recommendation guidelines for each health behavior (i.e., either meeting or not meeting guidelines). RESULTS The OW/OB prevalence rate was 7% greater among unmedicated youth with ADHD than among medicated youth with ADHD. Medicated youth with ADHD and peers without ADHD had similar OW/OB rates. Among medicated youth with ADHD, physical activity, sleep duration, and media use did not contribute to OW/OB risk after controlling for family poverty level. However, among unmedicated youth with ADHD, meeting sleep duration guidelines was linked to a lower OW/OB risk. CONCLUSION Overall, findings suggest that clinical providers and parents may wish to prioritize improved sleep duration in the management of OW/OB risk in youth with ADHD.
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Affiliation(s)
- Delanie K Roberts
- Department of Psychology, Children's Hospital of Los Angeles, Los Angeles, CA, United States
| | - Dustin E Sarver
- Department of Psychiatry and Human Behavior, Center for Advancement of Youth, University of Mississippi Medical Center, Jackson, MS, United States
- Department of Pediatrics, Center for Advancement of Youth, University of Mississippi Medical Center, Jackson, MS, United States
| | - Annah R Cash
- Department of Psychology, Child Study Center, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States
| | - Benjamin H Walker
- Department of Population Health, University of Mississippi Medical Center, Jackson, MS, United States
| | - Crystal S Lim
- Department of Health Psychology, University of Missouri, Columbia, MO, United States
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Jakasania A, Lahariya C, Pandya C, Raut AV, Sharma R, K S, Mundra A, Kapoor JP, Khajuria S, Gupta SS. School Health Services in India: Status, Challenges and the Way Forward. Indian J Pediatr 2023; 90:116-124. [PMID: 37751041 DOI: 10.1007/s12098-023-04852-x] [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: 06/25/2023] [Accepted: 08/22/2023] [Indexed: 09/27/2023]
Abstract
Schools provide a crucial platform for health and well-being interventions targeting children and adolescents. Early promotive and preventive initiatives are vital for enabling children and adolescents to reach their optimal potential, thereby adding to the country's social return-on-investment, creating a favourable demographic dividend. This review analyses the evolution of school health initiatives in India, including the current curriculum proposed under the Ayushman Bharat program. The manuscript highlights the challenges, and gaps in implementation of the current school health programs and proposes potential pathways for bridging these gaps for promotion of adolescent well-being. The review also discusses the concept of Health Promoting Schools and suggests adaptations and key recommendations to Indian context regarding 'how' to translate it into on-field reality based on the appraisal of successful case studies from other countries. Though India started school health services more than 100 y ago, the school health programmes in most Indian states are weak and fragmented, with piecemeal health screening with minimal focus on health promotion and well-being. The recently launched School Health and Wellness initiative under the Ayushman Bharat program has lots of promise. However, it needs to be translated into effective implementation to prevent it from meeting the fate of its forerunner programs. The school health program needs to move beyond the screening centric approach and be aspirational and holistic in nature focusing upon the overall well-being of the adolescents. Concerted efforts through intersectoral convergence are needed to optimally utilise the platforms of schools for promotion of adolescent well-being.
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Affiliation(s)
- Arjunkumar Jakasania
- Department of Community Medicine, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, 442001, Maharashtra, India
| | - Chandrakant Lahariya
- Integrated Department of Health Policy, Epidemiology, Preventive Medicine and Pediatrics, Foundation for People-Centric Health Systems, New Delhi, 110029, India
| | - Chitra Pandya
- Medicine Beyond Classroom, c/o Varun Complete Healthcare, Vadodara, 390006, Gujarat, India.
| | - Abhishek V Raut
- Department of Community Medicine, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, 442001, Maharashtra, India
| | - Radhika Sharma
- Department of Community Medicine, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, 442001, Maharashtra, India
| | - Sophiya K
- Department of Community Medicine, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, 442001, Maharashtra, India
| | - Anuj Mundra
- Department of Community Medicine, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, 442001, Maharashtra, India
| | - Jai Pal Kapoor
- Senior Advisor, School Health Services, Foundation for People-centric Health Services, New Delhi, 110029, India
| | - Sindhuja Khajuria
- Centre for Health Communications, Foundation for People-Centric Health Systems, New Delhi, 110029, India
| | - Subodh S Gupta
- Department of Community Medicine, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, 442001, Maharashtra, India
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Knight F, Kuri S, Damu C, Mejia C, Correa Guzmán N, Bergeron G, Restrepo-Mesa SL. Exploring the potential of meeting adolescent girls' nutrient needs in urban Colombia using food-based recommendations. Ann N Y Acad Sci 2023; 1528:58-68. [PMID: 37589163 DOI: 10.1111/nyas.15050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
During adolescence, many young people gain greater food choice agency but also become increasingly exposed and susceptible to environmental pressures that influence their food choices. This coincides with increased nutritional needs, especially for girls. In urban Colombia, adolescent diets are often high in undesirable foods and low in nutritious foods, contributing to overweight and micronutrient deficiencies. This study aimed to explore the potential of improving diet quality using food-based recommendations (FBRs) within the parameters of local food systems and adolescents' existing dietary patterns to inform context-specific programmatic responses to malnutrition. We applied linear programming analysis to dietary data from 13- to 20-year-old girls in Medellin to identify problem nutrients, local micronutrient sources, and promising FBRs. Iron and, to a lesser extent, calcium targets were difficult to meet using optimized diets based on local foods, especially for 13- to 17-year-olds. High habitual consumption of foods with excessive salt, fat, or sugar provided >5% of micronutrients in optimized diets. Otherwise, significant micronutrient sources included legumes, meat, dairy, bread, potatoes, and fruit. FBRs met targets for 10 micronutrients but only 32%-39% recommended nutrient intake for iron. FBRs, including occasionally consumed foods and supplements, met all intake targets for less cost, indicating a need to increase access to nutrient-dense products.
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Affiliation(s)
- Frances Knight
- Nutrition Division, United Nations World Food Programme, Rome, Italy
- London School of Hygiene and Tropical Medicine, London, UK
| | - Sabrina Kuri
- Nutrition Division, United Nations World Food Programme, Rome, Italy
| | - Claudia Damu
- Nutrition Division, United Nations World Food Programme, Rome, Italy
| | - Carla Mejia
- Regional Bureau for Latin America and the Caribbean, United Nations World Food Programme, Panama City, Panama
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Verlenden J, Kaczkowski W, Li J, Hertz M, Anderson KN, Bacon S, Dittus P. Associations between Adverse Childhood Experiences and Pandemic-Related Stress and the Impact on Adolescent Mental Health during the COVID-19 Pandemic. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 17:1-15. [PMID: 36532141 PMCID: PMC9747542 DOI: 10.1007/s40653-022-00502-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 06/01/2023]
Abstract
Vulnerabilities of adolescents during times of crisis have been previously identified, but little research has investigated the compounding effects of lifetime adversities and pandemic-related stress on adolescent mental health. This study uses adolescent self-report data to model relationships between stress exposures and indicators of poor mental health from the longitudinal COVID Experiences (CovEx) Surveys. These surveys were administered online in English to U.S. adolescents ages 13-19 using the NORC AmeriSpeak® panel, a probability-based panel designed to be representative of the U.S. household population. Two waves of data were collected (Wave 1: October-November 2020, n = 727; Wave 2: March-May 2021, n = 569). Measures included demographics, adverse childhood experiences (ACEs, 8 items), pandemic-related stress (Pandemic-Related Stress Index [PRSI], 7 items), and depression symptoms (Patient Health Questionnaire for Adolescents [PHQ-A], 9 items). Path analyses were conducted to examine pathways between Wave 1 ACEs, Wave 1 PRSI, and Wave 2 PHQ with covariates of sex and race/ethnicity. Females had higher ACEs, PRSI, and PHQ scores than males. The PRSI score at Wave 1 was positively associated with the PHQ at Wave 2 (b = 0.29, SE = 0.14, p < 0.001). ACEs at Wave 1 were positively associated with PRSI at Wave 1 (b = 0.31, SE = 0.03, p < 0.001) and with PHQ at Wave 2 (b = 0.32, SE = 0.12, p < 0.001). The direct effect of ACEs on PHQ (b = 0.23, SE = 0.12, p < 0.001) remained significant even after accounting for the indirect effect of pandemic-related stress (b = 0.09, SE = 0.05, p < 0.001). Pandemic-related stress had a direct, adverse impact on adolescent depressive symptoms and demonstrates a compounding effect of childhood adversity and pandemic-related stress on depression. Findings can aid the design of interventions that promote mental health and support adolescent coping and recovery. Supplementary Information The online version contains supplementary material available at 10.1007/s40653-022-00502-0.
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Affiliation(s)
- Jorge Verlenden
- Centers for Disease Control and Prevention (CDC), National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Adolescent and School Health (CDC/NCHHSTP/DASH), Atlanta, GA USA
| | - Wojciech Kaczkowski
- Centers for Disease Control and Prevention (CDC), National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Adolescent and School Health (CDC/NCHHSTP/DASH), Atlanta, GA USA
| | - Jingjing Li
- Centers for Disease Control and Prevention (CDC), National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Adolescent and School Health (CDC/NCHHSTP/DASH), Atlanta, GA USA
| | - Marci Hertz
- Centers for Disease Control and Prevention (CDC), National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Adolescent and School Health (CDC/NCHHSTP/DASH), Atlanta, GA USA
| | - Kayla N. Anderson
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Violence Prevention (CDC/NCIPC/DVP), Atlanta, GA USA
| | - Sarah Bacon
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Office of Strategy and Innovation (CDC/NCIPC/OSI), Atlanta, GA USA
| | - Patricia Dittus
- Centers for Disease Control and Prevention (CDC), National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Adolescent and School Health (CDC/NCHHSTP/DASH), Atlanta, GA USA
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