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Braddock A, Koopman RJ, Smith J, Lee AS, Holt McNair S, Hampl S, Wareg N, Clary M, Miller N, Turer CB. A Longitudinal Effectiveness Study of a Child Obesity Electronic Health Record Tool. J Am Board Fam Med 2022; 35:742-750. [PMID: 35896456 PMCID: PMC10443903 DOI: 10.3122/jabfm.2022.04.210385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 01/12/2022] [Accepted: 02/14/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Primary-care providers, clinic staff, and nurses play an important role in reducing child obesity; yet time restraints and clinical demands compete with effective pediatric weight management and prevention. METHODS To investigate the potential impact of an electronic health record (EHR) enabled tool to assist primary care teams in addressing child obesity, we conducted a controlled effectiveness study of FitTastic compared with usual care on the BMI pattern of 291 children (2 to 17 years) up to 4 years later. RESULTS Per χ2 analysis, a greater proportion of children with baseline overweight/obesity in the EHR tool group than the control group had a favorable BMI pattern (32% vs 13%, P = .03). In logistic regression, FitTastic children were more likely than control children to have a favorable BMI pattern at follow-up (OR 3.8, 95% CI 1.1 to 13.2), adjusted for age, gender, race, and parental education. CONCLUSION Study findings suggest that EHR-enabled tools to assist primary care teams in managing child obesity may be useful for helping to address the weight in children with overweight/obesity, especially in younger children (2 to 5 years). Digital and EHR-enabled technologies may prove useful for partnering health care teams and families in the important tasks of setting positive, family-centered healthy lifestyle behavioral goals and managing child overweight and obesity.
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Affiliation(s)
- Amy Braddock
- From University of Missouri, Columbia, MO (AB, RJK, JS, NW, MC); University of Missouri School of Medicine, Columbia, MO (ASL, SHM); General Pediatrics and Weight Management, Children's Mercy Hospital Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO, University of MO-Kansas City School of Medicine (SH); Cahaba Family Medicine, Pelham, AL (NM); Internal Medicine-Pediatrics, University of Texas Southwestern, Dallas, Texas (CBT).
| | - Richelle J Koopman
- From University of Missouri, Columbia, MO (AB, RJK, JS, NW, MC); University of Missouri School of Medicine, Columbia, MO (ASL, SHM); General Pediatrics and Weight Management, Children's Mercy Hospital Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO, University of MO-Kansas City School of Medicine (SH); Cahaba Family Medicine, Pelham, AL (NM); Internal Medicine-Pediatrics, University of Texas Southwestern, Dallas, Texas (CBT)
| | - Jamie Smith
- From University of Missouri, Columbia, MO (AB, RJK, JS, NW, MC); University of Missouri School of Medicine, Columbia, MO (ASL, SHM); General Pediatrics and Weight Management, Children's Mercy Hospital Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO, University of MO-Kansas City School of Medicine (SH); Cahaba Family Medicine, Pelham, AL (NM); Internal Medicine-Pediatrics, University of Texas Southwestern, Dallas, Texas (CBT)
| | - Andy S Lee
- From University of Missouri, Columbia, MO (AB, RJK, JS, NW, MC); University of Missouri School of Medicine, Columbia, MO (ASL, SHM); General Pediatrics and Weight Management, Children's Mercy Hospital Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO, University of MO-Kansas City School of Medicine (SH); Cahaba Family Medicine, Pelham, AL (NM); Internal Medicine-Pediatrics, University of Texas Southwestern, Dallas, Texas (CBT)
| | - Samuel Holt McNair
- From University of Missouri, Columbia, MO (AB, RJK, JS, NW, MC); University of Missouri School of Medicine, Columbia, MO (ASL, SHM); General Pediatrics and Weight Management, Children's Mercy Hospital Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO, University of MO-Kansas City School of Medicine (SH); Cahaba Family Medicine, Pelham, AL (NM); Internal Medicine-Pediatrics, University of Texas Southwestern, Dallas, Texas (CBT)
| | - Sarah Hampl
- From University of Missouri, Columbia, MO (AB, RJK, JS, NW, MC); University of Missouri School of Medicine, Columbia, MO (ASL, SHM); General Pediatrics and Weight Management, Children's Mercy Hospital Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO, University of MO-Kansas City School of Medicine (SH); Cahaba Family Medicine, Pelham, AL (NM); Internal Medicine-Pediatrics, University of Texas Southwestern, Dallas, Texas (CBT)
| | - Nuha Wareg
- From University of Missouri, Columbia, MO (AB, RJK, JS, NW, MC); University of Missouri School of Medicine, Columbia, MO (ASL, SHM); General Pediatrics and Weight Management, Children's Mercy Hospital Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO, University of MO-Kansas City School of Medicine (SH); Cahaba Family Medicine, Pelham, AL (NM); Internal Medicine-Pediatrics, University of Texas Southwestern, Dallas, Texas (CBT)
| | - Megan Clary
- From University of Missouri, Columbia, MO (AB, RJK, JS, NW, MC); University of Missouri School of Medicine, Columbia, MO (ASL, SHM); General Pediatrics and Weight Management, Children's Mercy Hospital Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO, University of MO-Kansas City School of Medicine (SH); Cahaba Family Medicine, Pelham, AL (NM); Internal Medicine-Pediatrics, University of Texas Southwestern, Dallas, Texas (CBT)
| | - Natalie Miller
- From University of Missouri, Columbia, MO (AB, RJK, JS, NW, MC); University of Missouri School of Medicine, Columbia, MO (ASL, SHM); General Pediatrics and Weight Management, Children's Mercy Hospital Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO, University of MO-Kansas City School of Medicine (SH); Cahaba Family Medicine, Pelham, AL (NM); Internal Medicine-Pediatrics, University of Texas Southwestern, Dallas, Texas (CBT)
| | - Christy B Turer
- From University of Missouri, Columbia, MO (AB, RJK, JS, NW, MC); University of Missouri School of Medicine, Columbia, MO (ASL, SHM); General Pediatrics and Weight Management, Children's Mercy Hospital Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO, University of MO-Kansas City School of Medicine (SH); Cahaba Family Medicine, Pelham, AL (NM); Internal Medicine-Pediatrics, University of Texas Southwestern, Dallas, Texas (CBT)
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Materová E, Pelclová J, Gába A, Frömel K. Surveillance of physical activity and sedentary behaviour in czech children and adolescents: a scoping review of the literature from the past two decades. BMC Public Health 2022; 22:363. [PMID: 35189870 PMCID: PMC8859875 DOI: 10.1186/s12889-022-12766-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 02/09/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND This study aimed to map the available evidence related to physical activity (PA) and sedentary behaviour (SB) in Czech children and adolescents and suggest future directions and improvements to strengthen the surveillance of PA and SB in the Czech Republic. METHODS The search of articles published between January 2000 and December 2020 included the Medline and Medvik databases and a manual search in eight Czech journals related to the topic. This review followed the "Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews". RESULTS Out of 350 identified articles, 79 articles met the criteria for selection and referred to 27 studies. The majority of the articles were cross-sectional (89%), approximately two-thirds of the articles (61%) examined only PA, and half of the articles (51%) employed device-based assessments. Approximately 47% of the articles reported the prevalence of physical inactivity on the basis of inconsistently defined recommendations. Approximately 14%, 23%, and 10% of the articles focused on active transportation, organized PA (including physical education or leisure-time PA), and parent-child PA, respectively. CONCLUSIONS Future studies need to focus on longitudinal design and interventions, randomly selected samples, a mix of device-based and self-reported methods, and the recognition of health-related 24-hour time use patterns. This review advocates the government-supported development of a national surveillance system that will help to reduce insufficient PA and excessive SB.
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Affiliation(s)
- Eliška Materová
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, tř. Míru 117, 771 11 Olomouc, Czech Republic
| | - Jana Pelclová
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, tř. Míru 117, 771 11 Olomouc, Czech Republic
| | - Aleš Gába
- Department of Natural Sciences in Kinathropology, Faculty of Physical Culture, Palacký University Olomouc, tř. Míru 117, 771 11 Olomouc, Czech Republic
| | - Karel Frömel
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, tř. Míru 117, 771 11 Olomouc, Czech Republic
- Institute of Sport Sciences, the Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
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Caron T, Bernard P, Gadais T. Clinical and school-based intervention strategies for youth obesity prevention: A systematic review. Front Sports Act Living 2022; 4:906857. [PMID: 36923584 PMCID: PMC10008876 DOI: 10.3389/fspor.2022.906857] [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: 03/29/2022] [Accepted: 12/31/2022] [Indexed: 03/03/2023] Open
Abstract
Introduction In the last couple of decades, numerous intervention strategies (ISs) have been formulated in school/community or clinical sectors using physical activity (PA) in order to prevent youth obesity because they have been highly effective in addressing this issue. These two sectors have revealed some interesting information in terms of efficient results and best practice mechanisms, but comparisons between them to learn about their functioning have been rare. Methods Therefore, the aim of this systematic review was to analyze and synthesize PA ISs from school/community or clinical domains for the period 2013-2017, in French or English, targeting youths aged 5-19 years old through primary, secondary, and tertiary prevention. Results In total, 68 full articles were reserved for data extraction and synthesis and 617 were excluded because they did not meet eligibility criteria (61 of 68 were kept for the final analysis). The results identified a number of differences between the studies of the various IS sectors and also a third type of IS, mixed sector. Mixed ISs (clinical and school-community) have a special advantage because they can benefit from the strengths of both school/community-based and clinical-based ISs. Mixed ISs showed the most promising results. This review also highlighted the differences between sectors and their ISs in terms of intervention teams, prevention objectives, duration, materials, and efficiency. Conclusion Future studies should focus on establishing a prevention program in a given geographical area involving all stakeholders with their respective skills/knowledge, in the area of decision-making and in the development of ISs, to ensure that the program is the most efficient and best adapted to its environment.
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Affiliation(s)
- Théo Caron
- Faculté des Sports et de l'EP, Université D'Artois, Liévin, France
| | - Paquito Bernard
- Département des Sciences de l'activité physique, Université du Québec à Montréal, Montréal, QC, Canada.,Research Center, University Institute of Mental Health at Montreal, Montréal, QC, Canada
| | - Tegwen Gadais
- Département des Sciences de l'activité physique, Université du Québec à Montréal, Montréal, QC, Canada.,UNESCO Chair in Curriculum Development (UCCD), Université du Québec à Montréal, Montréal, QC, Canada
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Hohmann A, Yuan X, Schmitt M, Zhang H, Pietzonka M, Siener M. Physical Fitness and Motor Competence in Chinese and German Elementary School Children in Relation to Different Physical Activity Settings. CHILDREN (BASEL, SWITZERLAND) 2021; 8:391. [PMID: 34068840 PMCID: PMC8153568 DOI: 10.3390/children8050391] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/05/2021] [Accepted: 05/11/2021] [Indexed: 02/02/2023]
Abstract
(1) Background: Children with greater physical activity (PA) may show a higher physical fitness (PF) and motor competence (MC) compared to peers with less PA. The purpose of this study was to examine the relationship between moderate-to-vigorous physical activity (MVPA), PF, and MC in 8- to 9-year old children in Germany and China. MVPA was differentiated into five PA settings: family sport, club training, school sport, leisure sport, and outside play. (2) Methods: This longitudinal study comprised N = 577 children (n = 311 girls, n = 266 boys) who were studied over a one-year period. Each child's PF and MC was determined using sports motor tests. The children's PAs were measured using a questionnaire. (3) Results: The children's PA was positively associated with PF and MC. The MVPA-settings: family sport, leisure sport, outside play, school, and club sport, explained between 18 and 23 percent of the variance in selected PF and MC characteristics in a multivariate linear regression analysis. (4) Conclusions: An increase in the children's MVPA might be an appropriate aim in the school sport in Germany as well as in the club sport system in China. Furthermore, family sport should be enhanced in Germany and outside play activities in China, respectively.
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Affiliation(s)
- Andreas Hohmann
- Institute of Sport Science, University of Bayreuth, Universitätsstraße 30, 95447 Bayreuth, Germany; (A.H.); (X.Y.); (M.P.)
| | - Xinchi Yuan
- Institute of Sport Science, University of Bayreuth, Universitätsstraße 30, 95447 Bayreuth, Germany; (A.H.); (X.Y.); (M.P.)
| | - Manfred Schmitt
- Department of Psychology, University of Koblenz-Landau, Fortstraße 7, 76829 Landau in der Pfalz, Germany;
| | - Hui Zhang
- Department of Physical Education and Training, Shanghai University of Sport, 650 Qingyuan Ring Rd, Yangpu District, Shanghai 200438, China;
- Department of Training Science, Zhejiang University, 866 Yuhangtang Rd, Xihu, Hangzhou 310028, China
| | - Micha Pietzonka
- Institute of Sport Science, University of Bayreuth, Universitätsstraße 30, 95447 Bayreuth, Germany; (A.H.); (X.Y.); (M.P.)
| | - Maximilian Siener
- Institute of Sport Science, University of Bayreuth, Universitätsstraße 30, 95447 Bayreuth, Germany; (A.H.); (X.Y.); (M.P.)
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Sigmund E, Sigmundová D, Badura P, Voráčová J, Vladimír H, Hollein T, Pavelka J, Půžová Z, Kalman M. Time-trends and correlates of obesity in Czech adolescents in relation to family socioeconomic status over a 16-year study period (2002-2018). BMC Public Health 2020; 20:229. [PMID: 32054463 PMCID: PMC7020383 DOI: 10.1186/s12889-020-8336-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 02/07/2020] [Indexed: 12/13/2022] Open
Abstract
Background The main objective of the study is to analyse the changes in the prevalence of obesity among Czech adolescents between 2002 and 2018 with regard to the socioeconomic status (SES) of adolescents’ families and to find SES-separated correlates of adolescents’ obesity in 2018. Methods A nationally representative sample of 29,879 adolescents (49.6% of them boys) aged 10.5–16.5 years was drawn from the Health Behaviour in School-aged Children cross-sectional, self-reported questionnaire surveys conducted in 2002, 2006, 2010, 2014, and 2018 in Czechia. Chi-square (χ2) tests were performed to assess the changes in the prevalence of obesity in both genders and all SES categories of adolescents between 2002 and 2018, and SES category-related differences in the prevalence of obesity in 2018 separately for boys and girls. A series of multiple stepwise logistic regression (backward elimination) analyses were used to reveal obesity correlates separately for SES categories of adolescents. Results Across the quadrennial surveys from 2002 to 2018, we observed a clear increase in the prevalence of obesity in all SES categories of adolescents, which was most striking (p < 0.05) in adolescents with low SES (boys: + 7.5% points (p.p.); girls + 2.4 p.p.). When all the survey cycles were compared, the highest prevalence of obesity was evident in the low-SES adolescents in 2018, both in girls (5.1%) and boys (12.0%). Regardless of the adolescent SES category, the lower odds of obesity were significantly (p < 0.05) associated with regular vigorous physical activity (PA), participation in organized sport, and daily consumption of sweets. In addition, at least 60 min of moderate-to-vigorous PA significantly reduced the odds of obesity in adolescents of low and high SES categories. Conclusions An unreasonable increase in the prevalence of obesity in adolescents with low SES highlights the need to prevent obesity in adolescents with a low-SES background. Additionally, significantly higher odds of obesity in 11- and 13-year-old adolescents from low-SES families, compared with their peers aged 15, indicated an expectable rise in obesity in older low-SES adolescents in the near future.
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Affiliation(s)
- Erik Sigmund
- Faculty of Physical Culture, Institute of Active Lifestyle, Palacký University Olomouc, 771 11, Olomouc, Czech Republic.
| | - Dagmar Sigmundová
- Faculty of Physical Culture, Institute of Active Lifestyle, Palacký University Olomouc, 771 11, Olomouc, Czech Republic
| | - Petr Badura
- Faculty of Physical Culture, Institute of Active Lifestyle, Palacký University Olomouc, 771 11, Olomouc, Czech Republic.,Faculty of Physical Culture, Department of Recreation and Leisure Studies, Palacký University Olomouc, 771 11, Olomouc, Czech Republic
| | - Jaroslava Voráčová
- Faculty of Physical Culture, Department of Social Sciences in Kinanthropology, Palacký University Olomouc, 771 11, Olomouc, Czech Republic
| | - Hobza Vladimír
- Faculty of Physical Culture, Department of Recreation and Leisure Studies, Palacký University Olomouc, 771 11, Olomouc, Czech Republic
| | - Tomáš Hollein
- Faculty of Physical Culture, Department of Recreation and Leisure Studies, Palacký University Olomouc, 771 11, Olomouc, Czech Republic
| | - Jan Pavelka
- Faculty of Physical Culture, Department of Recreation and Leisure Studies, Palacký University Olomouc, 771 11, Olomouc, Czech Republic
| | - Zuzana Půžová
- Faculty of Physical Culture, Department of Recreation and Leisure Studies, Palacký University Olomouc, 771 11, Olomouc, Czech Republic
| | - Michal Kalman
- Faculty of Physical Culture, Department of Recreation and Leisure Studies, Palacký University Olomouc, 771 11, Olomouc, Czech Republic
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Yuksel HS, Şahin FN, Maksimovic N, Drid P, Bianco A. School-Based Intervention Programs for Preventing Obesity and Promoting Physical Activity and Fitness: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E347. [PMID: 31947891 PMCID: PMC6981629 DOI: 10.3390/ijerph17010347] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 12/16/2019] [Accepted: 12/23/2019] [Indexed: 01/08/2023]
Abstract
With the significant decrease in physical activity rates, the importance of intervention programs in the schools, where children spend a significant part of the day, has become indisputable. The purpose of this review is to systematically examine the possibility of school-based interventions on promoting physical activity and physical fitness as well as preventing obesity. A systematic approach adopting PRISMA statement was implemented in this study. Three different databases (2010-2019) were screened and primary and secondary school-based intervention programs measuring at least one variable of obesity, physical activity, or physical fitness were included. The risk of bias was assessed using the validated quality assessment tool for quantitative studies. Among 395 potentially related studies, 19 studies were found to meet the eligibility criteria. A general look at the studies examined reveals that among the outcomes, of which most (18/19) were examined, a significant improvement was provided in at least one of them. When the program details are examined, it can be said that the success rate of the physical activity-oriented programs is higher in all variables. School-based interventions can have important potential for obesity prevention and promotion of physical activity and fitness if they focus more on the content, quality, duration and priority of the physical activity.
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Affiliation(s)
| | - Fatma Neşe Şahin
- Faculty of Sport Sciences, Ankara University, 06830 Ankara, Turkey
| | - Nebojsa Maksimovic
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Patrik Drid
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Antonino Bianco
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy
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Brown T, Moore TH, Hooper L, Gao Y, Zayegh A, Ijaz S, Elwenspoek M, Foxen SC, Magee L, O'Malley C, Waters E, Summerbell CD. Interventions for preventing obesity in children. Cochrane Database Syst Rev 2019; 7:CD001871. [PMID: 31332776 PMCID: PMC6646867 DOI: 10.1002/14651858.cd001871.pub4] [Citation(s) in RCA: 275] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
EDITORIAL NOTE This Cochrane review is now out of date and should not be used for reference. It has been split into four age groups and updated. Please refer to the 5‐11 and 12‐18 age group Cochrane reviews which were published in May 2024: https://doi.org/10.1002/14651858.CD015328.pub2 https://doi.org/10.1002/14651858.CD015330.pub2 The 2‐4 age group Cochrane review is planned for publication in September 2024. BACKGROUND Prevention of childhood obesity is an international public health priority given the significant impact of obesity on acute and chronic diseases, general health, development and well-being. The international evidence base for strategies to prevent obesity is very large and is accumulating rapidly. This is an update of a previous review. OBJECTIVES To determine the effectiveness of a range of interventions that include diet or physical activity components, or both, designed to prevent obesity in children. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, PsychINFO and CINAHL in June 2015. We re-ran the search from June 2015 to January 2018 and included a search of trial registers. SELECTION CRITERIA Randomised controlled trials (RCTs) of diet or physical activity interventions, or combined diet and physical activity interventions, for preventing overweight or obesity in children (0-17 years) that reported outcomes at a minimum of 12 weeks from baseline. DATA COLLECTION AND ANALYSIS Two authors independently extracted data, assessed risk-of-bias and evaluated overall certainty of the evidence using GRADE. We extracted data on adiposity outcomes, sociodemographic characteristics, adverse events, intervention process and costs. We meta-analysed data as guided by the Cochrane Handbook for Systematic Reviews of Interventions and presented separate meta-analyses by age group for child 0 to 5 years, 6 to 12 years, and 13 to 18 years for zBMI and BMI. MAIN RESULTS We included 153 RCTs, mostly from the USA or Europe. Thirteen studies were based in upper-middle-income countries (UMIC: Brazil, Ecuador, Lebanon, Mexico, Thailand, Turkey, US-Mexico border), and one was based in a lower middle-income country (LMIC: Egypt). The majority (85) targeted children aged 6 to 12 years.Children aged 0-5 years: There is moderate-certainty evidence from 16 RCTs (n = 6261) that diet combined with physical activity interventions, compared with control, reduced BMI (mean difference (MD) -0.07 kg/m2, 95% confidence interval (CI) -0.14 to -0.01), and had a similar effect (11 RCTs, n = 5536) on zBMI (MD -0.11, 95% CI -0.21 to 0.01). Neither diet (moderate-certainty evidence) nor physical activity interventions alone (high-certainty evidence) compared with control reduced BMI (physical activity alone: MD -0.22 kg/m2, 95% CI -0.44 to 0.01) or zBMI (diet alone: MD -0.14, 95% CI -0.32 to 0.04; physical activity alone: MD 0.01, 95% CI -0.10 to 0.13) in children aged 0-5 years.Children aged 6 to 12 years: There is moderate-certainty evidence from 14 RCTs (n = 16,410) that physical activity interventions, compared with control, reduced BMI (MD -0.10 kg/m2, 95% CI -0.14 to -0.05). However, there is moderate-certainty evidence that they had little or no effect on zBMI (MD -0.02, 95% CI -0.06 to 0.02). There is low-certainty evidence from 20 RCTs (n = 24,043) that diet combined with physical activity interventions, compared with control, reduced zBMI (MD -0.05 kg/m2, 95% CI -0.10 to -0.01). There is high-certainty evidence that diet interventions, compared with control, had little impact on zBMI (MD -0.03, 95% CI -0.06 to 0.01) or BMI (-0.02 kg/m2, 95% CI -0.11 to 0.06).Children aged 13 to 18 years: There is very low-certainty evidence that physical activity interventions, compared with control reduced BMI (MD -1.53 kg/m2, 95% CI -2.67 to -0.39; 4 RCTs; n = 720); and low-certainty evidence for a reduction in zBMI (MD -0.2, 95% CI -0.3 to -0.1; 1 RCT; n = 100). There is low-certainty evidence from eight RCTs (n = 16,583) that diet combined with physical activity interventions, compared with control, had no effect on BMI (MD -0.02 kg/m2, 95% CI -0.10 to 0.05); or zBMI (MD 0.01, 95% CI -0.05 to 0.07; 6 RCTs; n = 16,543). Evidence from two RCTs (low-certainty evidence; n = 294) found no effect of diet interventions on BMI.Direct comparisons of interventions: Two RCTs reported data directly comparing diet with either physical activity or diet combined with physical activity interventions for children aged 6 to 12 years and reported no differences.Heterogeneity was apparent in the results from all three age groups, which could not be entirely explained by setting or duration of the interventions. Where reported, interventions did not appear to result in adverse effects (16 RCTs) or increase health inequalities (gender: 30 RCTs; socioeconomic status: 18 RCTs), although relatively few studies examined these factors.Re-running the searches in January 2018 identified 315 records with potential relevance to this review, which will be synthesised in the next update. AUTHORS' CONCLUSIONS Interventions that include diet combined with physical activity interventions can reduce the risk of obesity (zBMI and BMI) in young children aged 0 to 5 years. There is weaker evidence from a single study that dietary interventions may be beneficial.However, interventions that focus only on physical activity do not appear to be effective in children of this age. In contrast, interventions that only focus on physical activity can reduce the risk of obesity (BMI) in children aged 6 to 12 years, and adolescents aged 13 to 18 years. In these age groups, there is no evidence that interventions that only focus on diet are effective, and some evidence that diet combined with physical activity interventions may be effective. Importantly, this updated review also suggests that interventions to prevent childhood obesity do not appear to result in adverse effects or health inequalities.The review will not be updated in its current form. To manage the growth in RCTs of child obesity prevention interventions, in future, this review will be split into three separate reviews based on child age.
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Affiliation(s)
- Tamara Brown
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
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Cronholm F, Rosengren BE, Karlsson C, Karlsson MK. A comparative study found that a seven-year school-based exercise programme increased physical activity levels in both sexes. Acta Paediatr 2018; 107:701-707. [PMID: 29194764 DOI: 10.1111/apa.14172] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 11/28/2017] [Indexed: 12/28/2022]
Abstract
AIM This study assessed whether a Swedish school-based exercise intervention programme could increase total physical activity. METHODS We followed up 228 children who started school in 1998-2000 seven years later, when they had reached a mean age of 14.8. The 152 children (59% boys) at the intervention school did 200 minutes of physical education per week during that period, and the 76 children (50% boys) in the three control schools did the standard 60 minutes. Questionnaires assessed the durations of total and leisure-time physical activity and screen-time activity at baseline and after five and seven years. RESULTS Physical activity and screen-time activity were similar between the two groups before the study started. The intervention group then achieved higher durations of total physical activity than the controls (p < 0.001) and these levels remained in the sex-specific evaluations. There were no differences between the groups in the durations of leisure-time activity (p 0.08-0.77) or screen-time activity (p 0.31-0.91). CONCLUSION A school-based exercise intervention programme increased the total duration of physical activity in both sexes without any compensatory increase in screen-time activity. The findings contradict the activity-stat theory, which stated that the duration of physical activity in children is constant.
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Affiliation(s)
- Felix Cronholm
- Clinical and Molecular Osteoporosis Research Unit; Department of Orthopedics and Clinical Sciences; Lund University; Skåne University Hospital; Malmö Sweden
| | - Björn E. Rosengren
- Clinical and Molecular Osteoporosis Research Unit; Department of Orthopedics and Clinical Sciences; Lund University; Skåne University Hospital; Malmö Sweden
| | - Caroline Karlsson
- Clinical and Molecular Osteoporosis Research Unit; Department of Orthopedics and Clinical Sciences; Lund University; Skåne University Hospital; Malmö Sweden
| | - Magnus K. Karlsson
- Clinical and Molecular Osteoporosis Research Unit; Department of Orthopedics and Clinical Sciences; Lund University; Skåne University Hospital; Malmö Sweden
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Sigmund E, Badura P, Sigmundová D, Voráčová J, Zacpal J, Kalman M, Pavelka J, Vokacová J, Hobza V, Hamrik Z. Trends and correlates of overweight/obesity in Czech adolescents in relation to family socioeconomic status over a 12-year study period (2002-2014). BMC Public Health 2018; 18:122. [PMID: 29321055 PMCID: PMC5764007 DOI: 10.1186/s12889-017-5013-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 12/20/2017] [Indexed: 11/24/2022] Open
Abstract
Background This study examined a) trends in overweight/obesity, moderate-to-vigorous physical activity (MVPA), and screen time (ST) among Czech adolescents over a 12-year study period (2002–2014) in relation to family affluence (FA) and b) correlates of adolescent overweight/obesity from different FA categories. Methods A nationally representative sample of 18,250 adolescents (51.4% girls) aged 10.5–16.5 years was drawn from the Czech Health Behaviour in School-aged Children questionnaire-based surveys in 2002, 2006, 2010, and 2014. Using the FA scale, the socioeconomic status (SES) of the respondents’ families was assessed. SES-stratified trends in the prevalence of overweight/obesity meeting the MVPA (≥60 min/day), and ST (≤2 h/day) recommendations were assessed using logistic regression. Results A trend-related significant increase (p < 0.05) in the prevalence of overweight/obesity was observed in low−/medium-FA boys and medium−/high-FA girls. Unlike in high-FA adolescents, a significant decrease was revealed in the rates of meeting the MVPA recommendation in low-FA boys (28.9%2002 → 23.3%2014, OR = 0.75, 95% CI = 0.59–0.95, p < 0.05) and girls (22.3%2002 → 17.3%2014, OR = 0.73, 95% CI = 0.57–0.92, p < 0.01). A significant (p < 0.001) trend-related increase in excessive ST was evident in adolescents regardless of gender and FA category. Generally, girls and older adolescents had lower odds of overweight/obesity than boys and 11-year-old adolescents. While in the high-FA category of adolescents, achieving 60 min of MVPA daily and the absence of excessive ST on weekdays significantly (p < 0.01) reduced their odds of being overweight/obese, in low-FA adolescents this was not the case. Conclusions High rates of overweight/obesity and a poor level of daily MVPA among low-FA children provide disturbing evidence highlighting the necessity of public health efforts to implement obesity reduction interventions for this disadvantaged population.
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Affiliation(s)
- Erik Sigmund
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Tr. Miru 117, 77111, Olomouc, Czech Republic.
| | - Petr Badura
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Tr. Miru 117, 77111, Olomouc, Czech Republic
| | - Dagmar Sigmundová
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Tr. Miru 117, 77111, Olomouc, Czech Republic
| | - Jaroslava Voráčová
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Tr. Miru 117, 77111, Olomouc, Czech Republic
| | - Jiří Zacpal
- Department of Computer Science, Faculty of Science, Palacký University Olomouc, Tr. 17. Listopadu, 77146, Olomouc, Czech Republic
| | - Michal Kalman
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Tr. Miru 117, 77111, Olomouc, Czech Republic
| | - Jan Pavelka
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Tr. Miru 117, 77111, Olomouc, Czech Republic
| | - Jana Vokacová
- Department of Social Sciences in Kinanthropology, Faculty of Physical Culture, Palacký University Olomouc, Tr. Miru 117, 77111, Olomouc, Czech Republic
| | - Vladimír Hobza
- Department of Recreation and Leisure Studies, Faculty of Physical Culture, Palacký University Olomouc, Tr. Miru 117, 77111, Olomouc, Czech Republic
| | - Zdenek Hamrik
- Department of Recreation and Leisure Studies, Faculty of Physical Culture, Palacký University Olomouc, Tr. Miru 117, 77111, Olomouc, Czech Republic
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Sigmund E, Sigmundová D, Baďura P, Voráčová J. Relationship between Czech Parent and Child Pedometer-assessed Weekday and Weekend Physical Activity and Screen Time. Cent Eur J Public Health 2016; 23 Suppl:S83-90. [PMID: 26849550 DOI: 10.21101/cejph.a4181] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 09/16/2015] [Indexed: 11/15/2022]
Abstract
AIM Uncovering the influences of parents' behaviour on their children's physical activity provides an insight into the lifestyle of families and development of effective family-based interventions. The aim of this study was to determine the relationship between parents' behaviour (step count (SC) and screen time (ST)) and children's SC on weekdays and at weekends. METHODS The participants (388 parents aged 35-45 and their 485 children aged 9-12) were randomly recruited from 21 Czech government funded primary schools. The participants recorded SC and ST duration for seven consecutive days (≥ 10 h/day) during April-May and September-October 2013. The associations between parents' behaviour (SC and ST) and children's SC were estimated using general linear regression separately for weekdays and weekends. Each 1,000 SC increase in mothers' (fathers') SC/weekday was associated with an extra 261 SC/day in their daughters and 413 (244) SC/day in their sons. RESULTS Each 1,000 SC increase in mothers' (fathers') SC/weekend day was associated with an extra 523 (386) SC/day in their daughters and 508 (435) SC/day in their sons. A reduction in mothers' ST by 30 minutes per weekend day was associated with an extra 494 SC/day in their daughters and 467 SC/day in their sons. CONCLUSIONS This study reveals a quantifiable relationship between parent-child SC/day and mothers' ST and children's SC at weekends. Weekend days are more suitable for the implementation of family-based interventions.
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Affiliation(s)
- Erik Sigmund
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | - Dagmar Sigmundová
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | - Petr Baďura
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | - Jaroslava Voráčová
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
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Temporal Trends in Overweight and Obesity, Physical Activity and Screen Time among Czech Adolescents from 2002 to 2014: A National Health Behaviour in School-Aged Children Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:11848-68. [PMID: 26393638 PMCID: PMC4586711 DOI: 10.3390/ijerph120911848] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Revised: 09/10/2015] [Accepted: 09/14/2015] [Indexed: 11/17/2022]
Abstract
This study examines trends in overweight and obesity, physical activity (PA) and screen time (ST) among Czech adolescents over a recent 12-year study period. Nationally representative samples consisted of 19,940 adolescents (9760 boys and 10,180 girls) aged 10.5-16.5 years from the Czech Health Behaviour in School-aged Children (HBSC) questionnaire-based surveys conducted in 2002, 2006, 2010 and 2014. Trends in the prevalence of overweight/obesity, meeting the recommendations for moderate-to-vigorous PA (MVPA) (≥60 min per day of MVPA) and excessive ST (>2 h per day) were estimated using logistic regression. Significant increases (p < 0.001) in the prevalence of overweight/obesity between the years 2002 and 2014 were evident for both adolescent boys (18.3%(2002)-24.8%(2014)) and girls (8.3%(2002)-11.9%(2014)). Compared to 2002, in 2014 significant decreases (p < 0.001) in meeting MVPA recommendations were observed among boys (32.2%(2002)-25.6%(2014)) and girls (23.2%(2002)-19.2%(2014)). Moreover, in boys we observed significant increases (p < 0.001) in excessive ST on weekdays (75.1%(2002)-88.8%(2014)), as well as on weekends (78.3%(2002)-91.9%(2014)) between the years 2002 and 2014. Increases in overweight/obesity with concomitant decreases in PA provide evidence in support of the current and upcoming efforts of government and commercial organizations in implementing interventions aimed at reducing excessive body weight among Czech adolescents.
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Su TT, Sim PY, Nahar AM, Majid HA, Murray LJ, Cantwell MM, Al-Sadat N, Jalaludin MY. Association between self-reported physical activity and indicators of body composition in Malaysian adolescents. Prev Med 2014; 67:100-5. [PMID: 25016043 DOI: 10.1016/j.ypmed.2014.07.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 06/27/2014] [Accepted: 07/01/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Obesity and lack of physical activity are fast becoming a concern among Malaysian adolescents. OBJECTIVE This study aims to assess physical activity levels among Malaysian adolescents and investigate the association between physical activity levels and body composition such as body mass index (BMI), waist circumference (WC) and percentage of body fat. SUBJECTS AND METHODS 1361 school-going 13 year old multi-ethnic adolescents from population representative samples in Malaysia were involved in our study. Self-reported physical activity levels were assessed using the validated Malay version of the Physical Activity Questionnaire for Older Children (PAQ-C). Height, weight, body fat composition and waist circumference (WC) were measured. Data collection period was from March to May 2012. RESULTS 10.8% of the males and 7.4% of the females were obese according to the International Obesity Task Force standards. A majority of the adolescents (63.9%) were physically inactive. There is a weak but significant correlation between physical activity scores and the indicators of obesity. The adjusted coefficient for body fatness was relatively more closely correlated to physical activity scores followed by waist circumference and lastly BMI. CONCLUSION This study demonstrates that high physical activity scores were associated with the decreased precursor risk factors of obesity.
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Affiliation(s)
- Tin Tin Su
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Malaysia.
| | - Pei Ying Sim
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Malaysia
| | - Azmi Mohamed Nahar
- Department of Sports Medicine, Faculty of Medicine, University of Malaya, Malaysia
| | - Hazreen Abd Majid
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Malaysia
| | - Liam J Murray
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University of Belfast, Belfast, UK
| | - Marie M Cantwell
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University of Belfast, Belfast, UK
| | - Nabilla Al-Sadat
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Malaysia
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Sigmundová D, Sigmund E, Vokáčová J, Kopková J. Parent-child associations in pedometer-determined physical activity and sedentary behaviour on weekdays and weekends in random samples of families in the Czech Republic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:7163-81. [PMID: 25026084 PMCID: PMC4113867 DOI: 10.3390/ijerph110707163] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 07/06/2014] [Accepted: 07/08/2014] [Indexed: 12/01/2022]
Abstract
This study investigates whether more physically active parents bring up more physically active children and whether parents’ level of physical activity helps children achieve step count recommendations on weekdays and weekends. The participants (388 parents aged 35–45 and their 485 children aged 9–12) were randomly recruited from 21 Czech government-funded primary schools. The participants recorded pedometer step counts for seven days (≥10 h a day) during April–May and September–October of 2013. Logistic regression (Enter method) was used to examine the achievement of the international recommendations of 11,000 steps/day for girls and 13,000 steps/day for boys. The children of fathers and mothers who met the weekend recommendation of 10,000 steps were 5.48 (95% confidence interval: 1.65; 18.19; p < 0.01) and 3.60 times, respectively (95% confidence interval: 1.21; 10.74; p < 0.05) more likely to achieve the international weekend recommendation than the children of less active parents. The children of mothers who reached the weekday pedometer-based step count recommendation were 4.94 times (95% confidence interval: 1.45; 16.82; p < 0.05) more likely to fulfil the step count recommendation on weekdays than the children of less active mothers.
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Affiliation(s)
- Dagmar Sigmundová
- Center for Kinanthropology Research, Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University in Olomouc, Tr. Miru 115, Olomouc 77111, Czech Republic.
| | - Erik Sigmund
- Center for Kinanthropology Research, Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University in Olomouc, Tr. Miru 115, Olomouc 77111, Czech Republic.
| | - Jana Vokáčová
- Department of Social Sciences in Kinanthropology, Faculty of Physical Culture, Palacký University in Olomouc, Tr. Miru 115, Olomouc 77111, Czech Republic.
| | - Jaroslava Kopková
- Center for Kinanthropology Research, Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University in Olomouc, Tr. Miru 115, Olomouc 77111, Czech Republic.
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Does participation in physical education reduce sedentary behaviour in school and throughout the day among normal-weight and overweight-to-obese Czech children aged 9-11 years? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:1076-93. [PMID: 24441509 PMCID: PMC3924493 DOI: 10.3390/ijerph110101076] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 01/07/2014] [Accepted: 01/08/2014] [Indexed: 11/19/2022]
Abstract
Participation of 9 to 11-year-old children in physical education lessons (PEL) contributes to a significantly higher duration of moderate-to-vigorous physical activity (MVPA) during the school day and, in overweight/obese girls and normal-weight boys, to an increase in overall daily MVPA as shown by previous research. However, it is not known whether this increase in MVPA is at the expense of light physical activity (LPA) or sedentary behaviour (SED). SED, LPA, and MVPA were assessed in 338 schoolchildren aged 9–11 years (50.3% girls; 29.6% overweight/obese) over two school days (with and without a PEL) using a triaxial accelerometer during various segments of the school day. SED, LPA, and MVPA were quantified based on the duration of the activity (minutes). Participation in PEL led to significantly higher school MVPA in the overweight/obese and normal-weight girls and boys (p < 0.005) compared to MVPA of those children on the school day without PEL. Participation in PEL led to a significantly higher overall daily MVPA duration compared to that during the day without PEL for the overweight/obese girls (p < 0.05), normal-weight girls (p < 0.05) and boys (p < 0.005). Participation in PEL contributed not only to significantly higher LPA in the normal-weight girls and boys (p < 0.01) during the school day but also reduced school-time SED in the overweight/obese children (p < 0.01) and normal-weight girls (p < 0.005). Moreover, participation in PEL significantly reduced the overall daily SED in the normal-weight children and overweight/obese boys (p < 0.05). Adding one PEL to the daily school routine appears to be a promising strategy for effectively reducing SED in children.
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