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Wu X, Yu Y, He H, Yu X, Guo D, Zhu W. Individual and family factors correlated with children's fruit consumption. Front Public Health 2024; 12:1399704. [PMID: 38737855 PMCID: PMC11082377 DOI: 10.3389/fpubh.2024.1399704] [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: 03/12/2024] [Accepted: 04/16/2024] [Indexed: 05/14/2024] Open
Abstract
Background Fruits are essential for health, yet their consumption in children is inadequate, with unclear influencing factors. Methods A cross-sectional study was conducted among students in grades 3-12 in Beijing, China, from September 2020 to June 2021. Fruit consumption in children was surveyed using a self-administered food frequency questionnaire. Additionally, children's food and nutrition literacy and family food environments were assessed using the "Food and Nutrition Literacy Questionnaire for Chinese School-age Children" and the "Family Food Environment Questionnaire for Chinese School-age Children," respectively. Results Out of 10,000 participating children, 62.5% consumed fruit daily, with a lower frequency among boys (59.3%) compared to girls (65.8%), and among senior students (48.6%) compared to junior (63.6%) and primary students (71.2%). Fruit consumption was positively associated with other healthy foods (vegetables, whole grains, etc.) and negatively with unhealthy foods (sugared soft drinks). Children with higher food and nutrition literacy consumed fruits daily more frequently (82.4% vs. 59.9%, ORs = 2.438, 95%CI: 2.072-2.868). A significant positive correlation was found between children's fruit consumption and a healthy family food environment (66.4% vs. 50.2%, OR = 1.507, 95%CI: 1.363-1.667). Conclusion The results indicate that individual food and nutrition literacy and family food environment are key positive predictors of children's fruit consumption. Future interventions should focus on educating children and encouraging parents to foster supportive family environments.
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Affiliation(s)
- Xiangyi Wu
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Yingjie Yu
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Hairong He
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Xiaohui Yu
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Dandan Guo
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Wenli Zhu
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
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Choedon T, Brennan E, Joe W, Lelijveld N, Huse O, Zorbas C, Backholer K, Murira Z, Wrottesley SV, Sethi V. Nutritional status of school-age children (5-19 years) in South Asia: A scoping review. MATERNAL & CHILD NUTRITION 2024; 20:e13607. [PMID: 38095279 PMCID: PMC10981491 DOI: 10.1111/mcn.13607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 04/01/2024]
Abstract
Information on malnutrition for school-age children and adolescents (5-19 years) in South Asia is fragmented and inconsistent, which limits the prioritization of nutrition policies, programmes and research for this age group. This scoping review aimed to synthesize existing evidence on the burden of malnutrition for children and adolescents aged 5-19 years in South Asia, and on interventions to improve their nutritional status. Cochrane Library, EMBASE, Medline and Google Scholar were systematically searched for articles published between January 2016 and November 2022. Eligible studies reported the prevalence of undernutrition, overweight/obesity, micronutrient deficiencies and unhealthy dietary intakes, and interventions that aimed to address these in South Asia. In total, 296 articles met our inclusion criteria. Evidence revealed widespread, yet heterogeneous, prevalence of undernutrition among South Asian children and adolescents: thinness (1.9%-88.8%), wasting (3%-48%), underweight (9.5%-84.4%) and stunting (3.7%-71.7%). A triple burden of malnutrition was evident: the prevalence of overweight and obesity ranged from 0.2% to 73% and 0% to 38% (with rapidly rising trends), respectively, alongside persistent micronutrient deficiencies. Diets often failed to meet nutritional requirements and high levels of fast-food consumption were reported. Education, fortification, supplementation and school feeding programmes demonstrated beneficial effects on nutritional status. Comprehensive and regular monitoring of all forms of malnutrition among children and adolescents, across all countries in South Asia is required. Further, more large-scale intervention research is needed to ensure policy and programmes effectively target and address malnutrition among children and adolescents in South Asia.
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Affiliation(s)
| | | | - William Joe
- Institute of Economic Growth (IEG)DelhiIndia
| | | | - Oliver Huse
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of HealthDeakin UniversityGeelongVictoriaAustralia
| | - Christina Zorbas
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of HealthDeakin UniversityGeelongVictoriaAustralia
| | - Kathryn Backholer
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of HealthDeakin UniversityGeelongVictoriaAustralia
| | | | | | - Vani Sethi
- UNICEF South Asia Regional OfficeKathmanduNepal
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Rivera-Ochoa M, López-Gil JF, Brazo-Sayavera J, Pantoja-Arévalo L, González-Gross M, Vizmanos-Lamotte B, Guadalupe-Grau A. Clustering Health Behaviors in Mexican Adolescents: The HELENA-MEX Study. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024; 95:281-288. [PMID: 37369131 DOI: 10.1080/02701367.2023.2195458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 03/13/2023] [Indexed: 06/29/2023]
Abstract
Purpose: The prevalence of excess weight within the adolescent population is rapidly increasing in Mexico, especially in areas with lower socioeconomic status. The present study aimed to identify lifestyle clustered patterns in adolescents and analyze the associations among these clusters and body composition. Method: A final sample of n=259 participants (13 to 17 years old, 58.7% girls), residents in rural and urban areas, were included. Hierarchical and k-means clusters analyses included moderate to vigorous physical activity (MVPA), cardiorespiratory fitness (CRF), handgrip strength, screen time, sleep time, and diet. The associations between cluster membership and body composition were analyzed through general linear models (ANCOVA), including sex, age, place of residence, and socioeconomic status as covariates. Results: Three different clusters were identified: Cluster 1, [Unhealthy] (low values in all lifestyle patterns), Cluster 2, [Low Physical Fitness] (low values in CRF and handgrip strength) and Cluster 3, [High Physical Activity and CRF] (highest values in CRF, handgrip strength and MVPA). Clusters 2 and 3 showed high values in screen time and industrialized food consumption. There were no differences in sleep between the 3 Clusters. ANCOVA analysis revealed that participants belonging to Cluster 3 showed significantly lower adiposity and a higher Fat Free Mass compared with the other two clusters (p < 0.05). Conclusion: Our findings suggest that a lifestyle characterized by high levels of physical activity and physical fitness and low consumption of industrialized food may be protective against the problem of obesity, which could be helpful to develop interventions to reduce excess weight in Mexican adolescents.
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Affiliation(s)
| | - José F López-Gil
- Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA
- Harvard University T.H. Chan School of Public Health
- Universidad de Las Américas
| | | | | | | | | | - Amelia Guadalupe-Grau
- Universidad Politécnica de Madrid
- Instituto de Salud Carlos III, ISCIII
- Universidad Castilla-La Mancha
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Shawon MSR, Rouf RR, Jahan E, Hossain FB, Mahmood S, Gupta RD, Islam MI, Al Kibria GM, Islam S. The burden of psychological distress and unhealthy dietary behaviours among 222,401 school-going adolescents from 61 countries. Sci Rep 2023; 13:21894. [PMID: 38082022 PMCID: PMC10713667 DOI: 10.1038/s41598-023-49500-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 12/08/2023] [Indexed: 12/18/2023] Open
Abstract
We aimed to calculate the sex-specific prevalence of psychological distress and unhealthy eating habits among adolescents across countries and regions, and to explore their potential associations. We used data from the Global School-Based Health Survey (GSHS) for 61 countries. Psychological distress was defined based on the existence of ≥ 2 factors from the following: loneliness, anxiety, suicide ideation, suicide planning, and suicide attempt. Four unhealthy dietary behaviours were examined: inadequate fruit intake, inadequate vegetable intake, daily consumption of soft drinks, and weekly fast-food consumption. We used random-effects meta-analysis to estimate the overall and regional pooled prevalence. Mixed-effect multilevel logistic regressions were used to estimate adjusted odds ratios (aORs) of unhealthy dietary behaviours in relation to psychological distress. Among 222,401 school-going adolescents (53.3% girls), the prevalence of psychological distress was 17.9%, with girls reporting higher than boys (20.8% vs. 14.9%). Adolescents in the African region reported the highest prevalence (22.5%), while those in the South-East Asia region reported the lowest (11.3%). The prevalence of inadequate fruit intake, inadequate vegetable intake, daily soft drink consumption, and weekly fast-food consumption was 37.0%, 28.5%, 50.0%, and 57.4% respectively. Psychological distress was associated with inadequate fruit intake (pooled aOR = 1.19, 95% CI 1.17-1.23), inadequate vegetable intake (pooled OR = 1.19, 1.16-1.22), daily consumption of soft drinks (pooled aOR = 1.14, 1.12-1.17), and weekly consumption of fast food (pooled aOR = 1.12, 1.09-1.15). Our findings indicate a substantial variance in the burden of psychological distress and unhealthy dietary behaviours across different regions. Adolescents experiencing psychological distress were more likely to have unhealthy dietary habits.
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Affiliation(s)
- Md Shajedur Rahman Shawon
- Centre for Big Data Research in Health, University of New South Wales, Level 2, AGSM Building (G27), Sydney, NSW, 2052, Australia.
| | | | - Esrat Jahan
- Department of Health Systems and Populations, Macquarie University, Sydney, Australia
| | | | | | - Rajat Das Gupta
- Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - Md Irteja Islam
- School of Public Health, University of Sydney, Sydney, Australia
| | | | - Shariful Islam
- Institute for Physical Activity and Nutrition (IPAN), Faculty of Health, Deakin University, Perth, Australia
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Farello G, D’Andrea M, Quarta A, Grossi A, Pompili D, Altobelli E, Stagi S, Balsano C. Children and Adolescents Dietary Habits and Lifestyle Changes during COVID-19 Lockdown in Italy. Nutrients 2022; 14:nu14102135. [PMID: 35631277 PMCID: PMC9147105 DOI: 10.3390/nu14102135] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/10/2022] [Accepted: 05/16/2022] [Indexed: 12/14/2022] Open
Abstract
Background: We evaluated the changes in lifestyle during the COVID-19 pandemic lockdown in a sample of children and adolescents in order to assess any increase in risk factors for the onset of cardiovascular diseases in later ages. Methods: We conducted a cross-sectional study involving 965 parents who completed an online survey about dietary habits and lifestyle during the first lockdown in Italy (from 9 March 2020 to 18 May 2020) and compared their findings with the period before the pandemic. The inclusion criteria were parents (or caregivers) with Italian residency and with children aged between 5 and 18 years. Results: We identified 563 adolescents and 402 children. The mean age was 12.28 years (SD 3.754). The pandemic was associated with an increase in the consumption of high-calorie snack foods. The total amount of food in homes during lockdown compared with before the pandemic increased 50%. Relating to the parent-perceived child weight status, more parents reported obesity in their children after lockdown (+0.6% in the 5–11 age group and +0.2% in the 12–18 age group). We reported a reduction of physical activity, an increase of sedentary lifestyle and sleep habits changes. Conclusion: The COVID-19 pandemic was associated with changes in the lifestyles of children and adolescents; this could cause an increase in the incidence of obesity and of cardiovascular and metabolic diseases in adulthood.
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Affiliation(s)
- Giovanni Farello
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.D.); (A.Q.); (D.P.); (E.A.)
- Correspondence: ; Tel.: +39-862434731
| | - Marianna D’Andrea
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.D.); (A.Q.); (D.P.); (E.A.)
| | - Alessia Quarta
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.D.); (A.Q.); (D.P.); (E.A.)
| | - Armando Grossi
- Department of Pediatrics-Endocrinology, Bambino Gesù Children’s Research Hospital, 00165 Rome, Italy;
| | - Davide Pompili
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.D.); (A.Q.); (D.P.); (E.A.)
| | - Emma Altobelli
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.D.); (A.Q.); (D.P.); (E.A.)
| | - Stefano Stagi
- Department of Health Sciences, University of Florence, Anna Meyer Children’s University Hospital, 50100 Florence, Italy;
| | - Clara Balsano
- Department of Life, Health & Environmental Sciences, School of Emergency and Urgency Medicine, University of L’Aquila, 67100 L’Aquila, Italy;
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Zhang R, Yu X, Yu Y, Guo D, He H, Zhao Y, Zhu W. Family Food Environments and Their Association with Primary and Secondary Students' Food Consumption in Beijing, China: A Cross-Sectional Study. Nutrients 2022; 14:nu14091970. [PMID: 35565937 PMCID: PMC9105134 DOI: 10.3390/nu14091970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 02/05/2023] Open
Abstract
Family is the most fundamental and proximal context for children, and children’s eating behavior occurs mostly in the home or together with family members. With this study, we aimed to evaluate the distribution of family food environment dimensions and their relationship with healthy and unhealthy food consumption in primary and secondary students in order to provide evidence in the Chinese context and explore environmental solutions for improved child nutrition. Multi-stage stratified cluster sampling was used to conduct a cross-sectional survey among students in Beijing, China, from September 2020 to June 2021. Family food environment (FFE) was measured by the validated Family Food Environment Questionnaire for Chinese School-age Children, which was self-administered by the children’s caregivers. The students were asked to answer questions about food consumption frequencies in the past 7 days. Binary logistic regression models were used to investigate the relationships between food consumption frequency and FFE, and odds ratios (ORs) with 95% confidence intervals (CI) were computed for independent variables. Among the study population, 9686 students in grades 3−12 and their caregivers completed the survey. The mean score of FFE was 65.7 (±8.4) out of a total possible score of 100, with 76.6% of students categorized as relatively healthier according to their FFE score (≥ 60). Compared with the reference group, students in primary schools and those cared for principally by parents were more likely to be in a healthy FFE category (p < 0.05). Daily consumption of fruits and vegetables was reported by 62.6% and 71.6% of students, respectively, and weekly sugared soft drink consumption was reported by 70.9% of the students. Students with a healthier FFE score (≥60) were more likely to consume fruits (OR = 1.578, 95% CI: 1.428~1.744) and vegetables (OR = 1.402, 95% CI: 1.263~1.556) but less likely to consume sugared soft drinks (OR = 0.592, 95% CI: 0.526~0.667). Family food availability (β = 0.137), caregivers’ nutritional literacy (β = 0.093), meal practices (β = 0.079) and food rules (β = 0.050) were positively correlated with food consumption behavior (p < 0.05). The students with healthier FFE scores (OR = 1.130, 95% CI: 1.014~1.258) and whose caregiver was obese (OR = 2.278, 95% CI: 1.973~2.631) were more likely to be overweight. The family food environment plays an important role in shaping food consumption in children. Provision of healthy foods instead of unhealthy foods, positive meal practices and food rules, and nutrition education for parents can promote healthy eating in children.
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Affiliation(s)
- Rong Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China;
- Key Laboratory of Reproductive Health, China’s Ministry of Health, Beijing 100191, China
| | - Xiaohui Yu
- Beijing Center for Disease Prevention and Control, Beijing 100013, China; (X.Y.); (Y.Y.); (D.G.); (H.H.)
| | - Yingjie Yu
- Beijing Center for Disease Prevention and Control, Beijing 100013, China; (X.Y.); (Y.Y.); (D.G.); (H.H.)
| | - Dandan Guo
- Beijing Center for Disease Prevention and Control, Beijing 100013, China; (X.Y.); (Y.Y.); (D.G.); (H.H.)
| | - Hairong He
- Beijing Center for Disease Prevention and Control, Beijing 100013, China; (X.Y.); (Y.Y.); (D.G.); (H.H.)
| | - Yao Zhao
- Beijing Center for Disease Prevention and Control, Beijing 100013, China; (X.Y.); (Y.Y.); (D.G.); (H.H.)
- Correspondence: (Y.Z.); (W.Z.); Tel.: +86-1368-158-3701 (Y.Z.); +86-10-8280-1575 (W.Z.)
| | - Wenli Zhu
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China;
- Key Laboratory of Reproductive Health, China’s Ministry of Health, Beijing 100191, China
- Correspondence: (Y.Z.); (W.Z.); Tel.: +86-1368-158-3701 (Y.Z.); +86-10-8280-1575 (W.Z.)
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Fan H, Zhang X. Recent trends in overweight and obesity in adolescents aged 12 to 15 years across 21 countries. Pediatr Obes 2022; 17:e12839. [PMID: 34355535 DOI: 10.1111/ijpo.12839] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 07/21/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND There is limited information on recent country-specific trends in the prevalence of overweight and obesity in adolescents. OBJECTIVE We aimed to identify country-specific trends in overweight and obesity in a study of 137 995 adolescents aged 12 to 15 years from 21 countries based on Global School-Based Student Health Surveys from 2005 to 2017. METHODS The World Health Organization criteria were used to define paediatric overweight and obesity. The weighted country-specific prevalence of and trends in overweight and obesity across the survey years were evaluated. Random- or fixed-effect meta-analyses were used to calculate pooled trends across 21 countries. RESULTS A significant upward trend was observed in the prevalence of overweight and obesity in 10 countries, whereas a significant downward trend was observed in 2 countries (ps < 0.05). The pooled prevalence of overweight and obesity in the first and last surveys was 24.8% and 27.7%, respectively. A significant upward pooled trend was observed in the prevalence of overweight and obesity across 21 countries (odds ratios [95% confidence intervals]: 1.22 [1.11, 1.35]). An increasing trend in the prevalence of overweight and obesity was specifically observed in high-, upper-middle- and lower-middle-income countries. CONCLUSION This study confirms a significant upward trend in the prevalence of overweight and obesity in 12- to 15-year-old adolescents, thus emphasizing the urgent need for interventions to mitigate overweight and obesity in this demographic.
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Affiliation(s)
- Hui Fan
- Department of Preventive Medicine, North Sichuan Medical College, Nanchong, China
| | - Xingyu Zhang
- Thomas E.Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
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Moitra P, Madan J, Verma P. Independent and combined influences of physical activity, screen time, and sleep quality on adiposity indicators in Indian adolescents. BMC Public Health 2021; 21:2093. [PMID: 34781921 PMCID: PMC8591930 DOI: 10.1186/s12889-021-12183-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/09/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Inadequate physical activity (PA), excess screen time (ST), and sub-optimal sleep quality tend to co-occur during adolescence. Yet, little is known about the associations of these behaviors as a cluster with adiposity indicators in Indian adolescents. This study aimed to evaluate the independent and combined influences of PA, ST, and sleep quality on body mass index (BMI) and waist to height ratio (WHtR) in 10-15 years old adolescents in Mumbai, India. A secondary aim was to explore if these influences vary between sexes. METHODS Cross-sectional study. Adolescents (n = 772, mean age 13.2 (1.4) years) reported frequency and duration of moderate to vigorous PA (MVPA) and time spent using screens on a previously validated instrument. Sleep quality was estimated using the Pittsburg Sleep Quality Index (PSQI). Weight, height, and waist circumference were measured. Mixed effect logistic regression analyses were performed to explore associations between adiposity indicators (BMI z scores > +1SD and WHtR > 0.5) and unhealthy behaviors (PA < 60 min/d, ST > 120 min/d and PSQI scores > 5), stratified by sex. RESULTS The combined prevalence of overweight and obesity was 38.3%. Overall, 62.0 and 85.0% reported MVPA< 60 min/d and ST > 120 min/d respectively. Girls reported higher ST (218.21 (69.01) min/d) as compared to boys (165.3 (101.22) min/d, p < 0.001). Clustering of low PA and excess ST was observed in 69.2% and of all three unhealthy behaviors in 18.8%. Among girls, MVPA < 60 min/d (OR = 1.78, 95% CI 1.54-1.92, p < 0.001) and PSQI scores > 5 (OR = 2.01, 95% CI 1.78-2.25, p < 0.001) predicted increased BMI. The odds of overweight/obesity were 2.10 times higher in boys reporting low PA and 4.13 times higher in those with low PA+ ST > 120 min/d. Clustering of all three unhealthy behaviors increased prevalence of obesity in both sexes. CONCLUSIONS The results indicated a co-existence of multiple unhealthy lifestyle factors of obesity and that clustering of these behaviors can further aggravate obesity risk as compared to their independent effects. Integrated interventions that leverage the cumulative benefits of being active, less sedentary and sufficient sleep are warranted to facilitate greater improvements in obesity risk behaviors.
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Affiliation(s)
- Panchali Moitra
- Department of Food, Nutrition & Dietetics, Sir Vithaldas Thackersey College of Home Science (Autonomous), SNDT Women’s University, Santacruz West, Mumbai, Maharashtra 400049 India
| | - Jagmeet Madan
- Department of Food, Nutrition & Dietetics, Sir Vithaldas Thackersey College of Home Science (Autonomous), SNDT Women’s University, Santacruz West, Mumbai, Maharashtra 400049 India
| | - Preeti Verma
- Department of Special Education, Department of Interdisciplinary Studies, SNDT Women’s University, Santacruz West, Mumbai, Maharashtra 400049 India
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Fan H, Zhang X. Prevalence of and Trends in the Co-Existence of Obesogenic Behaviors in Adolescents From 15 Countries. Front Pediatr 2021; 9:664828. [PMID: 33968860 PMCID: PMC8100235 DOI: 10.3389/fped.2021.664828] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 03/26/2021] [Indexed: 12/22/2022] Open
Abstract
Background: The global epidemic of pediatric obesity is well-known, but data on co-existence of obesogenic behaviors are limited. We aim to report the prevalence of and trends in the co-existence of obesogenic behaviors in adolescents from 15 countries. Methods: This study was based on the Global School-based Student Health Survey 2003-2017 and included 121,963 adolescents aged 12-15 years from 15 countries where at least 2 cross-sectional surveys were conducted. We used sampling weights and calculated the country-level prevalence of and trends in the co-existence of obesogenic behaviors (low fruit and vegetable intake, anxiety-induced insomnia, no physical activity, and sedentary behavior) during survey years. Pooled prevalence and trend estimates were calculated with random-effects models. Results: Pooled prevalence of exposure ≥ 1, ≥2, and ≥3 obesogenic behaviors was 88.2, 44.9, and 9.8% in the first survey and 88.4, 46.4, and 10.2% in the last survey, respectively. Plateauing, increasing, and decreasing trends in the co-existence of obesogenic behaviors were observed in different countries. Specifically, we identified a plateauing pooled trend in the exposure ≥ 1, ≥2, and ≥3 obesogenic behaviors [odds ratios (95% confidence intervals): 1.03 (0.93, 1.14), 1.05 (0.97, 1.13), and 1.06 (0.95, 1.18), respectively]. Conclusion: Trends in the prevalence of the co-existence of obesogenic behaviors varied significantly across different countries, but the prevalence remained high in most countries. These findings suggest the need for behavioral interventions to mitigate obesogenic behaviors in adolescents for overweight and obesity prevention.
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Affiliation(s)
- Hui Fan
- Department of Preventive Medicine, North Sichuan Medical College, Nanchong, China
| | - Xingyu Zhang
- Applied Biostatistics Laboratory, University of Michigan School of Nursing, Ann Arbor, MI, United States
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