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Muja H, Vasil S, Toçi D, Clemens T, Brand H, Burazeri G. Ability to Maintain and Improve Health and Socio-Demographic Correlates among Children in Albania. Zdr Varst 2024; 63:113-122. [PMID: 38881632 PMCID: PMC11178029 DOI: 10.2478/sjph-2024-0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 04/23/2024] [Indexed: 06/18/2024] Open
Abstract
Objective Our aim was to assess the level and socio-demographic correlates of the ability to maintain health among children in Albania, a post-communist country in the Western Balkans. Methods A cross-sectional study was conducted in Albania in September 2022. The study population consisted of a nationwide representative sample of 7,831 schoolchildren (≈54% girls) aged 12-15 years. A structured self-administered and anonymous questionnaire inquired about the children's attitudes toward health promotion (ability to maintain and improve health) and a range of key dimensions on knowledge and practices regarding healthcare services. Socio-demographic data were also collected. Binary logistic regression was used to assess the socio-demographic correlates of children's ability to maintain health. Results Overall, about 71% of schoolchildren exhibited the best attitudes toward health promotion (ability to maintain and improve health). In the multivariable adjusted logistic regression models, poorer attitudes toward health promotion (ability to maintain and improve health) were significantly related to older age (OR=1.2, 95% CI=1.0-1.3), middle/low maternal education (OR=1.2, 95%CI=1.1-1.3), poor/very poor economic situation (OR=1.5, 95%CI=1.2-1.8), lack of appropriate knowledge about rights to healthcare (OR=1.3, 95% CI=1.1-1.5), lack of knowledge about obtaining healthcare services (OR=1.7, 95%CI=1.4-2.2), and lack of consultations/visits with health professionals excluding vaccinations (OR=1.2, 95%CI=1.1-1.4). Conclusions Almost 1/3rd of Albanian schoolchildren included in this study did not exhibit the best attitudes toward health promotion (ability to maintain and improve health). The best attitudes were related to a higher socioeconomic level and adequate knowledge and practices regarding healthcare services. There is thus a need to increase health literacy levels among children in order to ultimately induce sustainable healthy behavioural/lifestyle practices.
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Affiliation(s)
- Herion Muja
- Department of International Health, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Institute of Public Health, Tirana, Albania
| | - Suela Vasil
- "Schools for Health", a project of the Swiss Development and Cooperation (SDC) Agency, Tirana, Albania
- Faculty of Natural Sciences, University of Tirana, Tirana, Albania
| | | | - Timo Clemens
- Department of International Health, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Helmut Brand
- Department of International Health, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Genc Burazeri
- Department of International Health, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Faculty of Medicine, University of Medicine, Tirana, Albania
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Ling J, Suriyawong W, Robbins LB, Zhang N, Kerver JM. FirstStep2Health: A cluster randomised trial to promote healthy behaviours and prevent obesity amongst low-income preschoolers. Pediatr Obes 2024; 19:e13122. [PMID: 38622494 PMCID: PMC11156553 DOI: 10.1111/ijpo.13122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 03/04/2024] [Accepted: 03/26/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVE To evaluate the preliminary effects of a theory-based, multi-component intervention on improving healthy lifestyle behaviours and preventing obesity amongst low-income preschoolers. METHODS A cluster randomised controlled trial was conducted at 10 daycare centres. The 16-week FirstStep2Health intervention, grounded in the Actor-Partner Interdependence Model and the Social Cognitive Theory, included five components: a Facebook-based parent programme, three virtual parent meetings, three weekly motivational text messages, parent-child learning via weekly child letters and daycare centre-based child programme. RESULTS A total of 95 preschoolers (53 intervention and 42 control) participated. Preschoolers' mean age was 49.27 months, with 57.9% being female, 12.6% being Hispanic and 40% being African American. The intervention significantly decreased intervention preschoolers' fat intake (B = -33.76, p = 0.047) and % body fat (B = -1.18, p = 0.036) compared to the control. During year 2, there were significant intervention effects on increasing skin carotenoids (B = 87.06, p = 0.035). Although not statistically significant, the intervention showed positive effects on increasing preschoolers' fruit/vegetable intake; and decreasing screen time, body mass index z-score and proportion of overweight/obesity. CONCLUSIONS Even with some potential limitations (small sample size, measurement concerns and confounding with Coronavirus Disease 2019 pandemic), the study's results support the preliminary efficacy of the FirstStep2Health intervention in preventing obesity amongst low-income racially diverse preschoolers.
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Affiliation(s)
- Jiying Ling
- Michigan State University College of Nursing, East Lansing, Michigan, USA
| | - Wachira Suriyawong
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan, USA
| | - Lorraine B Robbins
- Michigan State University College of Nursing, East Lansing, Michigan, USA
| | - Nanhua Zhang
- Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
| | - Jean M Kerver
- Division of Biostatistics & Epidemiology, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Krijger A, Schiphof-Godart L, Lanting C, Elstgeest L, Raat H, Joosten K. A lifestyle screening tool for young children in the community: needs and wishes of parents and youth healthcare professionals. BMC Health Serv Res 2024; 24:584. [PMID: 38702743 PMCID: PMC11069244 DOI: 10.1186/s12913-024-10997-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 04/16/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Youth healthcare has an important role in promoting a healthy lifestyle in young children in order to prevent lifestyle-related health problems. To aid youth healthcare in this task, a new lifestyle screening tool will be developed. The aim of this study was to explore how youth healthcare professionals (YHCP) could best support parents in improving their children's lifestyle using a new lifestyle screening tool for young children. METHODS We conducted four and seven focus groups among parents (N = 25) and YHCP (N = 25), respectively. Two main topics were addressed: the experiences with current practice of youth healthcare regarding lifestyle in young children, and the requirements for the lifestyle screening tool to be developed. The focus groups were recorded, transcribed verbatim and analysed using an inductive approach. RESULTS Both parents and YHCP indicated that young children's lifestyles are often discussed during youth healthcare appointments. While parents felt that this discussion could be more in-depth, YHCP mainly needed clues to continue the discussion. According to parents and YHCP, a new lifestyle screening tool for young children should be easy to use, take little time and provide courses of action. Moreover, it should be attractive to complete and align with the family concerned. CONCLUSIONS According to parents and YHCP, a new lifestyle screening tool for young children could be useful to discuss specific lifestyle topics in more detail and to provide targeted advice.
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Affiliation(s)
- Anne Krijger
- Department of Neonatal and Paediatric Intensive Care, Division of Paediatric Intensive Care, Erasmus MC - Sophia Children's Hospital, PO box 2060, Rotterdam, 3000 CB, the Netherlands
- Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Lieke Schiphof-Godart
- Department of Medical Informatics, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Caren Lanting
- Netherlands Organisation for Applied Scientific Research TNO, unit Healthy Living, Child Health expertise group, Leiden, the Netherlands
| | - Liset Elstgeest
- Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
- Reinier Academy, Reinier de Graaf Hospital, Delft, the Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Koen Joosten
- Department of Neonatal and Paediatric Intensive Care, Division of Paediatric Intensive Care, Erasmus MC - Sophia Children's Hospital, PO box 2060, Rotterdam, 3000 CB, the Netherlands.
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4
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Johnson LG, Cho H, Lawrence SM, Keenan GM. Early childhood (1-5 years) obesity prevention: A systematic review of family-based multicomponent behavioral interventions. Prev Med 2024; 181:107918. [PMID: 38417469 DOI: 10.1016/j.ypmed.2024.107918] [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: 09/01/2023] [Revised: 02/06/2024] [Accepted: 02/23/2024] [Indexed: 03/01/2024]
Abstract
INTRODUCTION Globally 38.9 million children under age 5 have overweight or obesity, leading to type 2 diabetes, cardiovascular complications, depression, and poor educational outcomes. Obesity is difficult to reverse and lifestyle behaviors (healthy or unhealthy) can persist from 1.5 years of age. Targeting caregivers to help address modifiable behaviors may offer a viable solution. OBJECTIVE Evaluate the impact of multicomponent family interventions on weight-based outcomes in early childhood and explore related secondary behavior outcomes. METHODS Four databases were searched (1/2017-6/2022) for randomized controlled trials (RCTs) of obesity-prevention interventions for children (1-5 years). Eligible studies included an objectively measured weight-based outcome, family interventions targeting the caregiver or family, and interventions including at least two behavioral components of nutrition, physical activity, or sleep. RESULTS Eleven interventions were identified consisting of four delivery modes: self-guided (n = 3), face-to-face group instruction (n = 3), face-to-face home visits (n = 2), and multiple levels of influence (n = 3). The reviewed studies reported almost no significant effects on child weight-based outcomes. Only two studies (one was an underpowered pilot study) resulted in significant positive child weight-management outcomes. Seven of the interventions significantly improved children's dietary intake. CONCLUSION Except for one, the reviewed studies reported that family based interventions had no significant effects on child weight-based outcomes. Future studies of this type should include measurements of age and sex-based body mass index (BMI) and trajectories, and also examine other important benefits to the children and families.
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Affiliation(s)
- Lisa G Johnson
- College of Nursing, University of Florida College of Nursing, 1225 Center Dr, Gainesville, FL 32610, United States.
| | - Hwayoung Cho
- College of Nursing, University of Florida College of Nursing, 1225 Center Dr, Gainesville, FL 32610, United States
| | - Samantha M Lawrence
- College of Nursing, University of Florida College of Nursing, 1225 Center Dr, Gainesville, FL 32610, United States
| | - Gail M Keenan
- College of Nursing, University of Florida College of Nursing, 1225 Center Dr, Gainesville, FL 32610, United States
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Poinsot R, Richonnet C, Vieux F. Nutritional impact of no-added sugar fruit puree consumption at different eating occasions: a modelling study on French children. Public Health Nutr 2024; 27:e103. [PMID: 38529770 PMCID: PMC11010159 DOI: 10.1017/s1368980024000739] [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: 07/25/2023] [Revised: 01/24/2024] [Accepted: 03/12/2024] [Indexed: 03/27/2024]
Abstract
OBJECTIVE The recommended level of five fruits and vegetables per day is reached by a minority of French children. No-added sugars fruit puree (NASFP) can be consumed as a complement of fresh fruit to meet the recommendation for fruits and vegetables. The objective was to simulate the nutritional impact of an increase in consumption of NASFP among French children, together with a reduction in sweetened foods. DESIGN The study was conducted on French children aged 1-17 years. The simulation consisted in introducing NASFP on four different eating occasions (breakfast, lunch, snack and dinner) to reach one serving and removing the same serving of sweetened foods. Intakes in nutrients to favour, nutrients to limit and prevalence of adequacy to nutritional requirements were compared between observed and simulated diets in the whole sample and in five different age groups. SETTING France. PARTICIPANTS Children from 1 to 17 years of age in the last available French representative dietary survey (INCA3). RESULTS Simulated diets were more nutrient-dense thanks to increases in nutrients to favour from NASFP (especially fibres, iodine, Se, and vitamin A and C) associated with reductions in energy and nutrients to limit (especially free sugars) coming from sweetened foods. Prevalence of adequacy increased from 2 to 14·5 points for fibres and from 4·5 to 12 points for free sugars according to age group and eating occasion. CONCLUSION Promoting NASFP in replacement of sweetened products is a promising strategy to improve the nutritional quality of French children's diet through a better adherence to national guidelines.
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Affiliation(s)
- Romane Poinsot
- MS-Nutrition, Faculté de Medecine la Timone, 27 boulevard Jean
Moulin, Marseille, France
| | | | - Florent Vieux
- MS-Nutrition, Faculté de Medecine la Timone, 27 boulevard Jean
Moulin, Marseille, France
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Vepsäläinen H, Korkalo L, Skaffari E, Abdollahi AM, Pajulahti R, Lehto R, Engberg E, Leppänen MH, Lehto E, Ray C, Roos E, Erkkola M. How energy balance-related behaviours, temperament, stress and overweight associate: a cross-sectional study of Finnish preschoolers. Public Health Nutr 2024; 27:e93. [PMID: 38433593 DOI: 10.1017/s1368980024000612] [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] [Indexed: 03/05/2024]
Abstract
OBJECTIVE This study aimed to (1) examine the clustering of energy balance-related behaviours (EBRB) and (2) investigate whether EBRB clusters, temperament and hair cortisol concentration (HCC) associate with overweight. DESIGN We assessed food consumption using food records, screen time (ST) using sedentary behaviour diaries, sleep consistency and temperament (negative affectivity, surgency, effortful control) using questionnaires and HCC using hair samples. Accelerometers were used to assess physical activity (PA) intensities, sleep duration and sleep efficiency. Researchers measured each child's weight and height. We used finite mixture models to identify EBRB clusters and multilevel logistic regression models to examine the associations between EBRB clusters, temperament, HCC and overweight. SETTING The cross-sectional DAGIS survey, data collected in 2015-2016. PARTICIPANTS Finnish 3-6-year-olds (n 864) recruited through preschools. RESULTS One-third of the participants were categorised into the cluster labelled 'Unhealthy diet, excessive screen time', characterised by unhealthy dietary choices (e.g. greater consumption of high-fat, high-sugar dairy products) and longer ST. Two-thirds were categorised into the second cluster, labelled 'Healthy diet, moderate screen time'. PA and sleep were irrelevant for clustering. Higher negative affectivity and lower effortful control associated with the 'Unhealthy diet, excessive screen time' cluster. EBRB clusters and HCC did not associate with overweight, but surgency was positively associated with overweight (OR = 1·63, 95 % CI 1·17, 2·25). CONCLUSIONS Of the EBRB, food consumption and ST seem to associate. As temperament associates with EBRB clusters and overweight, tailored support acknowledging the child's temperament could be profitable in maintaining a healthy weight.
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Affiliation(s)
- Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Liisa Korkalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Essi Skaffari
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Anna M Abdollahi
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Riikka Pajulahti
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | | | - Elina Engberg
- Folkhälsan Research Center, Helsinki, Finland
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | | | - Elviira Lehto
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Carola Ray
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Eva Roos
- Folkhälsan Research Center, Helsinki, Finland
- Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland
- Department of Food Studies, Nutrition and Dietetics, University of Uppsala, Uppsala, Sweden
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
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Segre G, Clavenna A, Roberti E, Scarpellini F, Cartabia M, Pandolfini C, Tessarollo V, Costantino I, Bonati M. Pediatrician and parental evaluation of child neurodevelopment at 2 years of age. BMC Pediatr 2024; 24:137. [PMID: 38388376 PMCID: PMC10882900 DOI: 10.1186/s12887-024-04616-2] [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: 05/09/2023] [Accepted: 02/02/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The early identification of infants with a risk for neurodevelopmental disorders in the first few years of life is essential for better developmental outcomes. Screenings should be carried out by combining the family pediatricians' and parents' perspectives, the two fundamental sources of information on children's health. The present study has three aims: (a) to test the feasibility of parent-report instruments to detect warning signs in their children's development; (b) to ascertain whether there is an agreement between the family pediatricians' (FP) clinical judgments of warning signs and the parental perceptions; (c) to determine whether there is a link between parents' distress and child development. METHODS Within the NASCITA birth cohort, in addition to the family pediatrician's clinical evaluation with routine tools, the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) was completed by parents to assess the child's language, social skills, behavior, and sensory areas. Parents were also asked to complete the Parenting Stress Index, Short Form (PSI-SF) to verify the magnitude of stress in the parent-child system. Univariate and multivariate analyses were performed to evaluate the association between child and parental characteristics and the presence of warning signs. RESULTS The follow-up assessment was completed for 435 infants: 69 (15.8%) presented warning signs: 43 in the pediatrician's assessment and 36 in the M-CHAT-R (10 in both). A total of 16 children (14 with warning signs) received a diagnosis after a specialist evaluation. Being male (OR 2.46, 95%CI: 1.23-4.91) and having sleep disorders (OR 2.43, 95% CI 1.17-5.04) was associated with a greater likelihood of warning signs in the multivariate analysis, while reading aloud was a protective factor (not exposed versus exposed (OR = 3.14; 95% CI 1.60-6.17). For 73 children (18.4%), at least one parent tested positive for PSI-SF. An increased prevalence of parental distress was observed in children with warning signs (OR 2.36, 95% CI 1.27-4.37). CONCLUSIONS Integrating physician and parental perspectives during well-child visits and in clinical practice appears feasible and can improve the identification of children at risk of developmental disorders.
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Affiliation(s)
- Giulia Segre
- Laboratory of Epidemiology of Developing Age, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, Milan, 20156, Italy
| | - Antonio Clavenna
- Laboratory of Epidemiology of Developing Age, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, Milan, 20156, Italy
| | - Elisa Roberti
- Laboratory of Epidemiology of Developing Age, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, Milan, 20156, Italy
| | - Francesca Scarpellini
- Laboratory of Epidemiology of Developing Age, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, Milan, 20156, Italy
- Centro Psicodiagnostico Italiano, Milan, Italy
| | - Massimo Cartabia
- Laboratory of Epidemiology of Developing Age, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, Milan, 20156, Italy
| | - Chiara Pandolfini
- Laboratory of Epidemiology of Developing Age, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, Milan, 20156, Italy
| | - Valeria Tessarollo
- Child Neuropsychiatry Unit, Department of Health Sciences, San Paolo Hospital, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy
| | - Ilaria Costantino
- Child Neuropsychiatry Unit, Department of Health Sciences, San Paolo Hospital, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy
| | - Maurizio Bonati
- Laboratory of Epidemiology of Developing Age, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, Milan, 20156, Italy.
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Raudeniece J, Vanags E, Justamente I, Skara D, Fredriksen PM, Brownlee I, Reihmane D. Relations between the levels of moderate to vigorous physical activity, BMI, dietary habits, cognitive functions and attention problems in 8 to 9 years old pupils: network analysis (PACH Study). BMC Public Health 2024; 24:544. [PMID: 38383413 PMCID: PMC10882845 DOI: 10.1186/s12889-024-18055-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 02/09/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Physical activity (PA) and dietary habits (DH) play a crucial role on quality of life and health outcomes from various aspects. METHODS This study aims to investigate the relations between recommended daily levels of moderate to vigorous physical activity (MVPA) in 8 to 9 year old pupils, and their body mass index (BMI), DH, cognitive functions and attention problem scores by network analysis. Study participants were split into two groups based on their MVPA levels on weekdays. RESULTS Our findings suggest that children who reach recommended MVPA levels consume more vegetables and fruits, eat breakfast more frequently, have better motor speed and lower impulsivity score. CONCLUSIONS The number of interlinkages between various parameters in network structure for children who do not reach recommended MVPA levels is greater and more intense, highlighting the differences between the groups and suggesting that different interventions and approaches to improve/change lifestyle habits might be used.
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Affiliation(s)
- Jelena Raudeniece
- Department of Human and Animal Physiology, Faculty of Biology, University of Latvia, Jelgavas Street 1, Riga, LV-1004, Latvia
- Department of Human Physiology and Biochemistry, Riga Stradiņš University, Dzirciema Street 16, Riga, LV-1007, Latvia
| | - Edmunds Vanags
- Department of Psychology, Faculty of Education, Psychology and Art, University of Latvia, Jelgavas Street 1, Riga, LV-1004, Latvia
| | - Ilze Justamente
- Department of Human and Animal Physiology, Faculty of Biology, University of Latvia, Jelgavas Street 1, Riga, LV-1004, Latvia
- Department of Human Physiology and Biochemistry, Riga Stradiņš University, Dzirciema Street 16, Riga, LV-1007, Latvia
| | - Dana Skara
- Department of Psychology, Faculty of Education, Psychology and Art, University of Latvia, Jelgavas Street 1, Riga, LV-1004, Latvia
| | - Per Morten Fredriksen
- Department of Biotechology, Faculty of Applied Ecology, Agricultural Sciences and Biotechnology, Inland Norway University of Applied Sciences, 2318, Hamar, Norway
| | - Iain Brownlee
- Department of Applied Sciences, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK
| | - Dace Reihmane
- Department of Human and Animal Physiology, Faculty of Biology, University of Latvia, Jelgavas Street 1, Riga, LV-1004, Latvia.
- Department of Human Physiology and Biochemistry, Riga Stradiņš University, Dzirciema Street 16, Riga, LV-1007, Latvia.
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9
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Olejua P, McLain AC, Inak N, Dowda M, Pate RR. Clustering Patterns of 24-Hour Physical Activity in Children 6-36 Months Old. Pediatr Exerc Sci 2024:1-8. [PMID: 38307017 DOI: 10.1123/pes.2023-0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 11/15/2023] [Accepted: 11/27/2023] [Indexed: 02/04/2024]
Abstract
PURPOSE To determine 24-hour physical activity (PA) clusters in children 6-36 months of age, factors associated with the clusters, and their agreement across time. METHOD A longitudinal study followed 150 infants from South Carolina up to 36 months of age. Measures included 24-hour PA and demographic data. Functional clustering was used to obtain the clusters. The association between cluster membership and infant/parent characteristics was examined by Kruskal-Wallis and chi-squared tests. Concordance was measured with the kappa coefficient and percent agreement. RESULTS At each follow-up, 3 clusters were optimal, identified as late activity (cluster 1), high activity (cluster 2), and medium activity (cluster 3). The defining feature of the late activity cluster was that their physical activity (PA) activity was shifted to later in the day versus children in clusters 2 and 3. At 6 months, the clusters were associated with race (<0.001), crawling (0.043), other children in the household (0.043), and mother's education (0.004); at 12 months with race (0.029), childcare (<0.001), and education (<0.001); and at 36 months with other children in the household (0.019). Clusters showed moderate agreement (kappa = .41 [.25 to .57], agreement = 61% [49% to 72%]) between 6 and 12 months and, at 36 months, showed no agreement with either 6 or 12 months. CONCLUSION Twenty-four-hour PA can be clustered into medium, high, and late PA. Further research is needed into the consequences of late sleeping in children at this age. Clusters are associated with household and childcare factors, and cluster membership is dynamic across time.
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Affiliation(s)
- Peter Olejua
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC,USA
| | - Alexander C McLain
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC,USA
| | - Nabila Inak
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC,USA
| | - Marsha Dowda
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC,USA
| | - Russell R Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC,USA
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10
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Park E, Jang M, Jung MS, Dlamini NS. Meta-synthesis of qualitative studies to explore fathers' perspectives of their influence on children's obesity-related health behaviors. BMC Nurs 2024; 23:78. [PMID: 38291434 PMCID: PMC10826084 DOI: 10.1186/s12912-024-01728-z] [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] [Received: 03/08/2023] [Accepted: 01/10/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND In nursing research and practice, there is a paucity of information about how fathers perceive their role in shaping their children's health behaviors. Most studies on the parental factors affecting children's health behaviors have focused on the role of mothers. However, recent studies showed that fathers' health behaviors can influence those of their children. Therefore, the aim of this study was to synthesize existing qualitative studies to explore fathers' perspectives regarding how they influence children's obesity-related health behaviors. METHODS We conducted a descriptive meta-synthesis. To retrieve relevant articles, we used databases including PubMed, CINAHL, and Web of Science. Only qualitative studies published in English-language peer-reviewed journals, targeting fathers of children aged 2-18 years, and focusing on fathers' perspectives were included. All the quotes collected from the studies were reviewed and coded, and thematic analysis was used to derive themes. RESULTS Article screening and review yielded a total of 13 qualitative studies, from which the following themes emerged: (1) fathers' parenting practices and role-modeling behaviors, (2) fathers' roles in their relationships with their family members, and (3) fathers' resource-seeking behaviors and contributions to their home food environment. Fathers were aware that their parenting practices and role-modeling behaviors could influence their children's health behaviors. Furthermore, fathers recognized the importance of their relationships with family members, which was reflected in their family roles; that is, whether they took responsibility for childcare and household work, whether their parenting practices were similar to those of their spouses, and whether they involved their children in their activities. Fathers also reported their resource-seeking behaviors as well as their contribution to the home food environment, which affected their children's health behaviors. CONCLUSION Fathers' perspectives on their influence on children's health behaviors reveal their unique paternal role in influencing children's health behaviors. Fathers' perspectives could be incorporated into future nursing research to examine the relationship between fathers' roles and children's health behaviors to develop better health intervention programs.
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Affiliation(s)
- Eunyoung Park
- College of Nursing, Chungnam National University, Munhwa-ro 266, Jung-gu, Daejeon, 35015, South Korea
| | - Myoungock Jang
- College of Nursing, Chungnam National University, Munhwa-ro 266, Jung-gu, Daejeon, 35015, South Korea.
| | - Mi Sook Jung
- College of Nursing, Chungnam National University, Munhwa-ro 266, Jung-gu, Daejeon, 35015, South Korea
| | - Nondumiso Satiso Dlamini
- College of Nursing, Chungnam National University, Munhwa-ro 266, Jung-gu, Daejeon, 35015, South Korea
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Chia A, Toh JY, Natarajan P, Cai S, Ong YY, Descarpentrie A, Lioret S, Bernard JY, Müller-Riemenschneider F, Godfrey KM, Tan KH, Chong YS, Eriksson JG, Chong MFF. Trajectories of lifestyle patterns from 2 to 8 years of age and cardiometabolic risk in children: the GUSTO study. Int J Behav Nutr Phys Act 2024; 21:9. [PMID: 38279175 PMCID: PMC10811908 DOI: 10.1186/s12966-024-01564-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/19/2024] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND Tracking combinations of lifestyle behaviours during childhood ("lifestyle pattern trajectories") can identify subgroups of children that might benefit from lifestyle interventions aiming to improve health outcomes later in life. However, studies on the critical transition period from early to middle childhood are limited. We aimed to describe lifestyle patterns trajectories in children from 2 to 8 years of age and evaluated their associations with cardiometabolic risk markers at age 8 years in a multi-ethnic Asian cohort. METHODS Twelve lifestyle behaviours related to child's diet, physical activity, screen use, and sleep were ascertained using questionnaires at ages 2, 5, and 8 years. Age-specific lifestyle patterns were derived using principal component analysis and trajectories were determined using group-based multi-trajectory modelling. Child cardiometabolic risk markers were assessed at age 8 years, and associations with trajectories examined using multiple regression, adjusted for confounders. RESULTS Among 546 children, two lifestyle patterns "healthy" and "unhealthy" were observed at ages 2, 5, and 8 years separately. Three trajectory groups from 2 to 8 years were identified: consistently healthy (11%), consistently unhealthy (18%), and mixed pattern (71%). Children in the consistently unhealthy group (vs. mixed pattern) had increased odds of pre-hypertension (OR = 2.96 [95% CI 1.18-7.41]) and higher levels of diastolic blood pressure (β = 1.91 [0.27-3.55] mmHg), homeostasis model assessment of insulin resistance (β = 0.43 [0.13-0.74]), triglycerides (β = 0.11 [0.00-0.22] mmol/L), and metabolic syndrome score (β = 0.85 [0.20-1.49]), but not with BMI z-score or any anthropometric measurements. The consistently healthy group showed no differences in cardiometabolic outcomes compared to the mixed pattern group. CONCLUSION Three distinct lifestyle pattern trajectories were identified from early to middle childhood. Children in the consistently unhealthy lifestyle group did not have a raised BMI but was associated with several elevated cardiometabolic risk markers. These findings suggest the potential benefits of initiating holistic lifestyle interventions to improve children's health and well-being from an early age. TRIAL REGISTRATION Trial registration number: NCT01174875. Name of registry: ClinicalTrials.gov. URL of registry: https://classic. CLINICALTRIALS gov/ct2/show/NCT01174875 . Date of registration: August 4, 2010. Date of enrolment of the first participant to the trial: June 2009.
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Affiliation(s)
- Airu Chia
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building, 12 Science Drive 2, #12 - 01, Singapore, 117549, Singapore.
| | - Jia Ying Toh
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Padmapriya Natarajan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building, 12 Science Drive 2, #12 - 01, Singapore, 117549, Singapore
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Shirong Cai
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yi Ying Ong
- Department of Social and Behavioural Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Alexandra Descarpentrie
- Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, INRAE, Paris, F-75004, France
| | - Sandrine Lioret
- Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, INRAE, Paris, F-75004, France
| | - Jonathan Y Bernard
- Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, INRAE, Paris, F-75004, France
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building, 12 Science Drive 2, #12 - 01, Singapore, 117549, Singapore
- Digital Health Center, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Kok Hian Tan
- Duke-NUS Medical School, Singapore, Singapore
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Centre, Helsinki, Finland
| | - Mary F-F Chong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building, 12 Science Drive 2, #12 - 01, Singapore, 117549, Singapore
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
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12
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Vasileva F, Font-Lladó R, Carreras-Badosa G, Roman-Viñas B, Cadellans-Arróniz A, López-Bermejo A, Prats-Puig A. Salivary cardiac-enriched FHL2-interacting protein is associated with higher diastolic-to-systolic-blood pressure ratio, sedentary time and center of pressure displacement in healthy 7-9 years old school-children. Front Endocrinol (Lausanne) 2024; 15:1292653. [PMID: 38304464 PMCID: PMC10830845 DOI: 10.3389/fendo.2024.1292653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/04/2024] [Indexed: 02/03/2024] Open
Abstract
Introduction Cardiac-enriched FHL2-interacting protein (CEFIP) is a recently identified protein, first found in the z-disc of striated muscles, and related to cardiovascular diseases. Our objectives are: 1) to quantify CEFIP in saliva in healthy 7-9 years old school-children; and 2) to assess the associations of salivary CEFIP concentration and blood pressure, physical (in)activity and physical fitness in these children. Methods A total of 72 children (7.6 ± 0.3 years) were included in the study, recruited in primary schools in Girona (Spain). A sandwich enzyme-linked immunosorbent assay was used (abx506878; Abbexa, United Kingdom) to quantify CEFIP in saliva. Anthropometric evaluation was performed [body mass, height and body mass index (BMI)]. Systolic and diastolic blood pressure were measured by means of an electronic oscillometer and the diastolic-to-systolic blood pressure ratio (D/S BP ratio) was calculated. Physical (in)activity [sedentary time and time spent in physical activity (PA)] were assessed by means of a triaxial Actigraph GT3X accelerometer (Actigraph, Pensacola, FL, USA) that children were instructed to wear for 24h during 7 conssecutive days. Finally, physical fitness (speed and agility, explosive power of legs, handgrip strength, flexibility and balance) were assessed through validated and standardized testing batteries. Results CEFIP was easily detected and measured in all saliva samples (mean concentration: 0.6 ± 0.2 pg/ml). Salivary CEFIP was positively associated with D/S BP ratio (r=0.305, p=0.010) and sedentary time (r=0.317, p=0.012), but negatively associated with PA in 7-9 years old school-children (r=-0.350, p=0.002). Furthermore, salivary CEFIP was related to lower level of balance i.e., higher center of pressure (CoP) displacement in these children (r=0.411, p<0.001). The associations of salivary CEFIP with D/S BP ratio (Beta=0.349, p=0.004), sedentary time (Beta=0.354, p=0.009) and CoP displacement (Beta=0.401, p=0.001), were maintained significant after adjustment for potential confounding variables such as age, gender and BMI in linear regression analyses. Conclusion CEFIP can be easily assessed in saliva as a promising biomarker associated with cardiovascular health in 7-9 years old school-children. Interestingly, higher salivary CEFIP concentration was related to higher D/S BP ratio, more sedentary time and higher CoP displacement i.e., lower level of balance in these children.
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Affiliation(s)
- Fidanka Vasileva
- Pediatric Endocrinology Research Group, Girona Institute for Biomedical Research, Girona, Spain
- University School of Health and Sport, University of Girona, Girona, Spain
| | - Raquel Font-Lladó
- University School of Health and Sport, University of Girona, Girona, Spain
- Research Group of Culture and Education, Institute of Educational Research, University of Girona, Girona, Spain
| | - Gemma Carreras-Badosa
- Pediatric Endocrinology Research Group, Girona Institute for Biomedical Research, Girona, Spain
| | - Blanca Roman-Viñas
- University School of Health and Sport, University of Girona, Girona, Spain
- Department of Physical Activity and Sport Sciences, Blanquerna-Universitat Ramon Llull, Barcelona, Spain
| | - Aïda Cadellans-Arróniz
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, International University of Catalonia, Barcelona, Spain
| | - Abel López-Bermejo
- Pediatric Endocrinology Research Group, Girona Institute for Biomedical Research, Girona, Spain
- Department of Medical Sciences, University of Girona, Girona, Spain
- Pediatric Endocrinology, Dr. Josep Trueta Hospital, Girona, Spain
| | - Anna Prats-Puig
- University School of Health and Sport, University of Girona, Girona, Spain
- Research Group of Clinical Anatomy, Embryology and Neuroscience, Department of Medical Sciences, University of Girona, Girona, Spain
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Bransby L, Rosenich E, Maruff P, Lim YY. How Modifiable Are Modifiable Dementia Risk Factors? A Framework for Considering the Modifiability of Dementia Risk Factors. J Prev Alzheimers Dis 2024; 11:22-37. [PMID: 38230714 PMCID: PMC10995020 DOI: 10.14283/jpad.2023.119] [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: 06/13/2023] [Accepted: 08/06/2023] [Indexed: 01/18/2024]
Abstract
Many risk factors for dementia, identified from observational studies, are potentially modifiable. This raises the possibility that targeting key modifiable dementia risk factors may reduce the prevalence of dementia, which has led to the development of dementia risk reduction and prevention strategies, such as intervention trials or dementia prevention guidelines. However, what has rarely been considered in the studies that inform these strategies is the extent to which modifiable dementia risk factors can (1) be identified by individuals, and (2) be readily modified by individuals. Characteristics of modifiable dementia risk factors such as readiness of identification and targeting, as well as when they should be targeted, can influence the design, or success of strategies for reducing dementia risk. This review aims to develop a framework for classifying the degree of modifiability of dementia risk factors for research studies. The extent to which these modifiable dementia risk factors could be modified by an individual seeking to reduce their dementia risk is determined, as well as the resources that might be needed for both risk factor identification and modification, and whether modification may be optimal in early-life (aged <45 years), midlife (aged 45-65 years) or late-life (aged >65 years). Finally, barriers that could influence the ability of an individual to engage in risk factor modification and, ultimately, dementia risk reduction are discussed.
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Affiliation(s)
- L Bransby
- Lisa Bransby, Turner Institute for Brain and Mental Health, 18 Innovation Walk, Clayton, VIC 3800, Australia;
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Wright EC, van Oort B, Bjøntegaard MM, Carlsen MH, Andersen LF. Environmental and nutritional assessment of young children's diets in Norway: comparing the current diet with national dietary guidelines and the EAT-Lancet reference diet. Eur J Nutr 2023; 62:3383-3396. [PMID: 37653070 PMCID: PMC10611869 DOI: 10.1007/s00394-023-03243-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/21/2023] [Indexed: 09/02/2023]
Abstract
PURPOSE Introducing healthy and sustainable diets early in life can promote lifelong healthy dietary patterns with a low environmental impact. Therefore, we aimed to estimate the environmental and nutritional consequences of a dietary change for 2-year-old children in Norway towards healthier dietary patterns. METHODS Environmental impacts of the current habitual diet among 2-year-olds (n = 1413) were estimated for six impact categories and compared with scenario diets based on the Norwegian food-based dietary guidelines (FBDG) and the EAT-Lancet Commission reference diet. Last, we evaluated the nutritional adequacy of the diets against the Norwegian nutrition recommendations for children aged 2-5 years. The current diet was assessed by an FFQ. RESULTS Environmental impacts of the current habitual diet were up to two times higher than those of the scenario diets. Compared with the current diet, impacts from the FBDG scenario diet were reduced by 35% for water use and 18% for terrestrial acidification, whereas impacts from the EAT-Lancet scenario diet were reduced by 51% for water use, 57% for terrestrial acidification, 36% for global warming potential and 27% for freshwater eutrophication. Milk and dairy products were the main contributors to environmental impacts in both the current diet and the FBDG scenario diet. The scenario diets were nutritionally adequate and improved the dietary quality among Norwegian 2-year-olds. CONCLUSION Compared to current diets among young children, more plant-based dietary patterns in line with national FBDG or the EAT-Lancet Commission reference diet can improve the nutritional adequacy of diets and simultaneously reduce environmental impacts.
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Affiliation(s)
| | - Bob van Oort
- CICERO Center for International Climate Research, Oslo, Norway
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15
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Descarpentrie A, Calas L, Cornet M, Heude B, Charles MA, Avraam D, Brescianini S, Cadman T, Elhakeem A, Fernández-Barrés S, Harris JR, Inskip H, Julvez J, Llop S, Margetaki K, Maritano S, Nader JLT, Roumeliotaki T, Salika T, Subiza-Pérez M, Vafeiadi M, Vrijheid M, Wright J, Yang T, Dargent-Molina P, Lioret S. Lifestyle patterns in European preschoolers: Associations with socio-demographic factors and body mass index. Pediatr Obes 2023; 18:e13079. [PMID: 37795656 DOI: 10.1111/ijpo.13079] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/30/2023] [Accepted: 09/16/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Energy balance-related behaviours (EBRBs), that is, dietary intake, screen, outdoor play and sleep, tend to combine into 'lifestyle patterns', with potential synergistic influences on health. To date, studies addressing this theme mainly focused on school children and rarely accounted for sleep, with a cross-country perspective. OBJECTIVES We aimed at comparing lifestyle patterns among preschool-aged children across Europe, their associations with socio-demographic factors and their links with body mass index (BMI). METHODS Harmonized data on 2-5-year-olds participating in nine European birth cohorts from the EU Child Cohort Network were used (EBRBs, socio-demographics and anthropometrics). Principal component analysis and multivariable linear and logistic regressions were performed. RESULTS The most consistent pattern identified across cohorts was defined by at least three of the following EBRBs: discretionary consumption, high screen time, low outdoor play time and low sleep duration. Consistently, children from low-income households and born to mothers with low education level had higher scores on this pattern compared to their socioeconomically advantaged counterparts. Furthermore, it was associated with higher BMI z-scores in the Spanish and Italian cohorts (β = 0.06, 95% CI = [0.02; 0.10], both studies). CONCLUSION These findings may be valuable in informing early multi-behavioural interventions aimed at reducing social inequalities in health at a European scale.
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Affiliation(s)
- Alexandra Descarpentrie
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Lucinda Calas
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Maxime Cornet
- Télécom-Paris, Département SES, Institut Polytechnique de Paris, Palaiseau Cedex, France
| | - Barbara Heude
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Marie-Aline Charles
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Demetris Avraam
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Sonia Brescianini
- Centre of Behavioral Science and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Tim Cadman
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ahmed Elhakeem
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sílvia Fernández-Barrés
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Jennifer R Harris
- Centre for Fertility and Health, The Norwegian Institute of Public Health, Oslo, Norway
| | - Hazel Inskip
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Jordi Julvez
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Clinical and Epidemiological Neuroscience Group (NeuroÈpia), Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Sabrina Llop
- CIBER Epidemiologa y Salud Pública (CIBERESP), Madrid, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de Valencia, Valencia, Spain
| | - Katerina Margetaki
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Silvia Maritano
- Cancer Epidemiology Unit-Department of Medical Sciences, University of Turin, Turin, Italy
- University School for Advanced Studies IUSS Pavia, Pavia PV, Italy
| | - Johanna Lucia Thorbjornsrud Nader
- Department of Genetics and Bioinformatics, Division of Health Data and Digitalization, Norwegian Institute of Public Health, Oslo, Norway
| | - Theano Roumeliotaki
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Theodosia Salika
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Mikel Subiza-Pérez
- CIBER Epidemiologa y Salud Pública (CIBERESP), Madrid, Spain
- Department of Clinical and Health Psychology and Research Methods, University of the Basque Country UPV/EHU, Donostia-San Sebastián, Spain
- Group of Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, Donostia-San Sebastián, Spain
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Marina Vafeiadi
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Martine Vrijheid
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- CIBER Epidemiologa y Salud Pública (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Tiffany Yang
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Patricia Dargent-Molina
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Sandrine Lioret
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
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Krijger A, Schiphof-Godart L, Elstgeest L, van Rossum C, Verkaik-Kloosterman J, Steenbergen E, Ter Borg S, Lanting C, van Drongelen K, Engelse O, Kindermann A, Detmar S, Frenkel C, Raat H, Joosten K. Development and evaluation study of FLY-Kids: a new lifestyle screening tool for young children. Eur J Pediatr 2023; 182:4749-4757. [PMID: 37580556 PMCID: PMC10587277 DOI: 10.1007/s00431-023-05126-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/09/2023] [Accepted: 07/18/2023] [Indexed: 08/16/2023]
Abstract
Evaluating, discussing, and advising on young children's lifestyles may contribute to timely modification of unhealthy behaviour and prevention of adverse health consequences. We aimed to develop and evaluate a new lifestyle screening tool for children aged 1-3 years. The lifestyle screening tool "FLY-Kids" was developed using data from lifestyle behaviour patterns of Dutch toddlers, age-specific lifestyle recommendations, target group analyses, and a Delphi process. Through 10 items, FLY-Kids generates a dashboard with an overview of the child's lifestyle that can be used as conversation aid. FLY-Kids was completed by parents of children aged 1-3 years attending a regular youth healthcare appointment. Youth healthcare professionals (YHCP) then used the FLY-Kids dashboard to discuss lifestyle with the parents and provided tailored advice. Parents as well as YHCP evaluated the tool after use. Descriptive and correlation statistics were used to determine the usability, feasibility, and preliminary effect of FLY-Kids. Parents (N = 201) scored an average of 3.2 (out of 9, SD 1.6) unfavourable lifestyle behaviours in their children, while 3.0% complied with all recommendations. Most unfavourable behaviours were reported in unhealthy food intake and electronic screen time behaviour. Parents and YHCP regarded FLY-Kids as usable and feasible. The number of items identified by FLY-Kids as requiring attention was associated with the number of items discussed during the appointment (r = 0.47, p < 0.001). Conclusion: FLY-Kids can be used to identify unhealthy lifestyle behaviour in young children and guide the conversation about lifestyle in preventive healthcare settings. End-users rated FLY-Kids as helpful and user-friendly. What is Known: • A healthy lifestyle is important for optimal growth, development and overall health of young children (1-3 years). • Evaluating, discussing and advising on young children's lifestyles may contribute to timely modification of unhealthy behaviour and prevention of adverse health consequences. What is New: • The new lifestyle screening tool FLY-Kids generates a dashboard with an overview of young children's lifestyle that can be used as conversation aid between parents and youth healthcare professionals. • As parents and youth healthcare professionals rated FLY-Kids as helpful and user-friendly, and the number of items identified by FLY-Kids as requiring attention was associated with the number of items discussed during the appointment, FLY-Kids can be considered guiding the lifestyle discussion in preventive healthcare settings.
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Affiliation(s)
- Anne Krijger
- Department of Pediatrics and Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, PO Box 2060, 3000 CB, Rotterdam, The Netherlands
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Lieke Schiphof-Godart
- Department of Medical Informatics, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Liset Elstgeest
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Reinier Academy, Reinier de Graaf Hospital, Delft, The Netherlands
| | - Caroline van Rossum
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | | | - Elly Steenbergen
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Sovianne Ter Borg
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Caren Lanting
- Netherlands Organisation for Applied Scientific Research TNO, Unit Healthy Living, Child Health Expertise Group, Leiden, The Netherlands
| | | | - Ondine Engelse
- Dutch Knowledge Centre for Youth Health, Utrecht, The Netherlands
| | - Angelika Kindermann
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Amsterdam, The Netherlands
| | - Symone Detmar
- Netherlands Organisation for Applied Scientific Research TNO, Unit Healthy Living, Child Health Expertise Group, Leiden, The Netherlands
| | - Carolien Frenkel
- Association of Dutch Infant and Dietetic Foods Industries, The Hague, The Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Koen Joosten
- Department of Pediatrics and Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, PO Box 2060, 3000 CB, Rotterdam, The Netherlands.
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van Meijeren-van Lunteren A, You Y, Raat H, Wolvius E, Kragt L. Caries Preventive Interventions and Oral Health Inequalities: A Scoping Review. JDR Clin Trans Res 2023; 8:311-325. [PMID: 35912710 PMCID: PMC10504820 DOI: 10.1177/23800844221109116] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Dental caries remains one of the most prevalent but preventable diseases among children worldwide and especially affects children with a lower socioeconomic status or ethnic minority background. It is important that all groups of children are reached by preventive interventions to reduce oral health inequalities. So far, it is unknown whether children from different social and ethnic groups benefit equally from potentially effective oral health interventions. OBJECTIVES This scoping review aimed to identify European public health interventions that report their effect on dental caries across different social groups. METHODS Four databases were searched for studies evaluating the effect of oral health interventions on dental caries among children from 0 to 12 y, and studies were included when results were presented by children of different social groups separately. RESULTS A total of 14 studies were included, representing 4 different countries: 3 randomized and 11 nonrandomized studies. Most studies were performed at schools. Six studies showed results indicative of a reduction in oral health inequalities, 4 studies showed results that potentially widen oral health inequalities, and 5 studies showed results that were indicative of no impact on oral health inequalities. Interventions that contain early approaches, with a high frequency, approaching multiple levels of influence, and including at least the broader organizational or public policy level, may have the potential to reduce oral health inequalities among children from birth to young adolescence. CONCLUSION We recommend researchers to perform high-quality intervention studies and to evaluate the effectiveness of oral health intervention always in different socioeconomic or ethnic groups separately, to better understand their contribution toward oral health (in)equalities. KNOWLEDGE TRANSFER STATEMENT This review offers insight in the differential effects that oral health interventions might have across different social groups. Its results can be used to develop interventions that might reduce oral health inequalities among children. Also, we recommend future researchers to always evaluate the effects of any preventive oral health measure in different social groups separately.
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Affiliation(s)
- A.W. van Meijeren-van Lunteren
- The Generation R Study Group, Erasmus University Medical Centre, CA Rotterdam, the Netherlands
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, CA Rotterdam, the Netherlands
| | - Y. You
- The Generation R Study Group, Erasmus University Medical Centre, CA Rotterdam, the Netherlands
- Department of Public Health, Erasmus University Medical Centre, CA Rotterdam, the Netherlands
| | - H. Raat
- The Generation R Study Group, Erasmus University Medical Centre, CA Rotterdam, the Netherlands
- Department of Public Health, Erasmus University Medical Centre, CA Rotterdam, the Netherlands
| | - E.B. Wolvius
- The Generation R Study Group, Erasmus University Medical Centre, CA Rotterdam, the Netherlands
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, CA Rotterdam, the Netherlands
| | - L. Kragt
- The Generation R Study Group, Erasmus University Medical Centre, CA Rotterdam, the Netherlands
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, CA Rotterdam, the Netherlands
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18
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D’Souza NJ, Downing K, Zheng M, Abbott G, Lioret S, Campbell KJ, Hesketh KD. Cross-sectional and prospective associations between behavioural patterns and adiposity in school-aged children. Public Health Nutr 2023; 26:1840-1849. [PMID: 37271724 PMCID: PMC10478049 DOI: 10.1017/s136898002300112x] [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: 05/25/2022] [Revised: 04/27/2023] [Accepted: 05/23/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Behavioural patterns are important in understanding the synergistic effect of multiple health behaviours on childhood adiposity. Most previous evidence assessing associations between patterns and adiposity were cross-sectional and investigated two or three behaviour domains within patterns. This study aimed to identify behavioural patterns comprising four behaviour domains and investigate associations with adiposity risk in children. DESIGN Parent-report and accelerometry data were used to capture daily dietary, physical activity, sedentary behaviour and sleep data. Variables were standardised and included in the latent profile analysis to derive behavioural patterns. Trained researchers measured children's height, weight and waist circumference using standardised protocols. Associations of patterns and adiposity measures were tested using multiple linear regression. SETTING Melbourne, Australia. PARTICIPANTS A total of 337 children followed up at 6-8 years (T2) and 9-11 years (T3). RESULTS Three patterns derived at 6-8 years were broadly identified to be healthy, unhealthy and mixed patterns. Patterns at 9-11 years were dissimilar except for the unhealthy pattern. Individual behaviours characterising the patterns varied over time. No significant cross-sectional or prospective associations were observed with adiposity at both time points; however, children displaying the unhealthy pattern had higher adiposity measures than other patterns. CONCLUSION Three non-identical patterns were identified at 6-8 and 9-11 years. The individual behaviours that characterised patterns (dominant behaviours) at both ages are possible drivers of the patterns obtained and could explain the lack of associations with adiposity. Identifying individual behaviour pattern drivers and strategic intervention are key to maintain and prevent the decline of healthy patterns.
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Affiliation(s)
- Ninoshka J D’Souza
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood3125, VIC, Australia
| | - Katherine Downing
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood3125, VIC, Australia
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood3125, VIC, Australia
| | - Gavin Abbott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood3125, VIC, Australia
| | - Sandrine Lioret
- Research Center in Epidemiology and Biostatistics (CRESS), Université de Paris, INSERM, INRAE, 75004Paris, France
| | - Karen J Campbell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood3125, VIC, Australia
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood3125, VIC, Australia
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19
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Alosaimi N, Sherar LB, Griffiths P, Pearson N. Clustering of diet, physical activity and sedentary behaviour and related physical and mental health outcomes: a systematic review. BMC Public Health 2023; 23:1572. [PMID: 37596591 PMCID: PMC10436445 DOI: 10.1186/s12889-023-16372-6] [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: 05/11/2023] [Accepted: 07/24/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Physical activity (PA), sedentary behaviour (SB) and diet play an important role in the physical and mental health of young people. Understanding how these behaviours cluster, and the impact of clusters on health is important for the development of public health interventions. This review examines the prevalence of clusters of PA, sedentary time, and dietary behaviours, and how clusters relate to physical and mental health indicators among children, adolescents and young adults. METHODS Electronic (PubMed, Web of Science and Scopus) and manual searches were conducted for articles that were (i) observational studies including children, adolescents and/or young adults aged 5-24 years, (ii) examined the 'patterning', 'clustering', or 'co-existence' of each of PA, dietary behaviour and SB, and (iii) published in English up to and including July 2022. In addition to information on clustering, data on physical and mental health outcomes were extracted where reported. Included studies were assessed using the Cochrane risk of bias for observational studies. A narrative synthesis was conducted due to high heterogeneity. This review was registered with PROSPERO (CRD42021230976). RESULTS Forty-nine cross-sectional studies and four prospective cohort studies from eighteen countries reporting data from 778,415 individual participants were included. A broad range of clusters (n = 172) were found (healthy, unhealthy, and mixed). Mixed clusters were common (n = 98), and clusters of high diet quality, low PA and high SB were more prevalent in girls, while mixed clusters of high PA, high SB and low diet quality were more prevalent in boys. Unhealthy clusters comprising low moderate to vigorous PA, low consumption of fruits and vegetables, and high screen time were prevalent, particularly in those from lower socioeconomic status families. Compared to those with healthy behavioural clusters, those with unhealthy and mixed clusters had a higher adiposity, higher risk of cardiovascular disease, poorer mental health scores, and lower cardiorespiratory fitness. CONCLUSIONS PA, SB and diet cluster in healthy, unhealthy and mixed patterns in young people that differ across sociodemographic characteristics. Unhealthy clusters are associated with poorer health outcomes. Intervention strategies targeting un-clustering multiple unhealthy behaviours should be developed and evaluated for their impact on health outcomes.
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Affiliation(s)
- Noura Alosaimi
- School of Sport, Exercise & Health Sciences, Loughborough University, Epinal Way, Loughborough, LE11 3TU, Leicestershire, UK.
| | - Lauren B Sherar
- School of Sport, Exercise & Health Sciences, Loughborough University, Epinal Way, Loughborough, LE11 3TU, Leicestershire, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK
| | - Paula Griffiths
- School of Sport, Exercise & Health Sciences, Loughborough University, Epinal Way, Loughborough, LE11 3TU, Leicestershire, UK
| | - Natalie Pearson
- School of Sport, Exercise & Health Sciences, Loughborough University, Epinal Way, Loughborough, LE11 3TU, Leicestershire, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK
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20
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Jonsson KR, Corell M, Löfstedt P, Adjei NK. The clustering of multiple health and lifestyle behaviors among Swedish adolescents: a person-oriented analysis. Front Public Health 2023; 11:1178353. [PMID: 37538263 PMCID: PMC10394625 DOI: 10.3389/fpubh.2023.1178353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 06/16/2023] [Indexed: 08/05/2023] Open
Abstract
Background Knowledge of the distribution, prevalence, and clustering of multiple health and lifestyle related behaviors (HLBs) among adolescents can inform the development of effective health-promoting policies and interventions. We assessed the clustering of multiple HLBs among 11, 13 and 15-year-old Swedish adolescents and examined the socioeconomic and demographic correlates for the identified clusters. Methods We used data from the 2017/2018 Swedish Health Behaviour in School-aged children (HBSC) study to conduct sex and age-stratified latent class analysis (LCA). The LCA was based on five HLBs: eating behavior and habits (EBH), physical activity (PA), tobacco usage (TU), alcohol consumption (AC) and sleeping habits and patterns (SHPs). Multinomial logistic regression models were used to assess the associations between the identified clusters and the socioeconomic and demographic characteristics of adolescents and their parents. Results Health behaviors varied by sex and age. Four distinct clusters were identified based on sex: cluster 1 (Mixed eating behaviors and habits, physical activity and low alcohol consumption), cluster 2 (Healthy lifestyle behaviors), cluster 3 (Unhealthy lifestyle behaviors), and cluster 4 (Breakfast, low alcohol consumption and tobacco usage). In the age-stratified analyzes, three clusters were identified: cluster 1 (Unhealthy lifestyle behaviors), cluster 2 (Moderately healthy lifestyle behaviors) and cluster 3 (Healthy lifestyle behaviors). The multinomial analysis showed that sex, age, family situation and perceived family wealth were strong predictors of health behaviors. Unhealthy behaviors were most commonly associated with socioeconomic disadvantage, having a migrant background, and living in reconstructed families or single-parent households. Conclusion Health behaviors vary significantly based on socioeconomic and demographic circumstances. Targeted policies and intervention programs are necessary to improve HLBs among vulnerable and at-risk adolescents.
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Affiliation(s)
- Kenisha Russell Jonsson
- School of Public Health and Community Medicine, Institute of Medicine, Gothenburg University, Göteborg, Sweden
| | - Maria Corell
- School of Public Health and Community Medicine, Institute of Medicine, Gothenburg University, Göteborg, Sweden
| | - Petra Löfstedt
- School of Public Health and Community Medicine, Institute of Medicine, Gothenburg University, Göteborg, Sweden
| | - Nicholas Kofi Adjei
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
- Leibniz Institute for Prevention Research and Epidemiology–BIPS, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
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21
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Fanelli Kuczmarski M, Beydoun MA, Georgescu MF, Noren Hooten N, Mode NA, Evans MK, Zonderman AB. Diet Quality Trajectories over Adulthood in a Biracial Urban Sample from the Healthy Aging in Neighborhoods of Diversity across the Life Span Study. Nutrients 2023; 15:3099. [PMID: 37513517 PMCID: PMC10383268 DOI: 10.3390/nu15143099] [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] [Received: 06/07/2023] [Revised: 07/07/2023] [Accepted: 07/08/2023] [Indexed: 07/30/2023] Open
Abstract
Limited investigation has been done on diet quality trajectories over adulthood. The main study objectives were to determine the diet quality group trajectories (GTs) over time and to detect changes in a socio-economically and racially diverse middle-aged cohort. Data from three waves of the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study were used to determine diet quality with group-based trajectory modeling (GBTM). Three quality indices-the Healthy Eating Index (HEI), the Dietary Inflammatory Index (DII), and the Mean Adequacy Ratio (MAR)-were explored. The rate of change in quality over time was determined by mixed-effects regression analysis. Three diet quality GTs, low, middle, and high quality, were identified for each index and confirmed with spaghetti plots. Within each GT, only small changes in diet quality scores were observed, with improvements for the HEI and DII indices and a slight decline in MAR scores. Weighted kappa values revealed that the DII had better agreement with the HEI-2010 and MAR indices compared with the agreement between the HEI-2010 and MAR. Bayesian estimates revealed that the annualized rate of change in diet quality per person across the GTs was similar. There was minimal change in diet quality over time, regardless of the diet quality index used.
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Affiliation(s)
- Marie Fanelli Kuczmarski
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Baltimore, MD 21224, USA
| | - May A Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Baltimore, MD 21224, USA
| | - Michael F Georgescu
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Baltimore, MD 21224, USA
| | - Nicole Noren Hooten
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Baltimore, MD 21224, USA
| | - Nicolle A Mode
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Baltimore, MD 21224, USA
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Baltimore, MD 21224, USA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Baltimore, MD 21224, USA
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22
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Hasan F, Nguyen AV, Reynolds AR, You W, Zoellner J, Nguyen AJ, Swift D, Kranz S. Preschool- and childcare center-based interventions to increase fruit and vegetable intake in preschool children in the United States: a systematic review of effectiveness and behavior change techniques. Int J Behav Nutr Phys Act 2023; 20:66. [PMID: 37268953 DOI: 10.1186/s12966-023-01472-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/27/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Fruit and vegetable (FV) consumption in children in the United States (US) is very low. Adequate FV consumption is required for proper development during childhood, and dietary habits are established during preschool-age and tend to persist into adulthood. As most U.S. preschool-aged children attend childcare or preschool, this may be an opportune time and setting to conduct interventions to improve FV intake. These interventions should be based in theory and use behavior change techniques (BCTs) to explain mechanisms for expected change. To date, no published reviews have examined the effectiveness of childcare- or preschool-based FV interventions in preschoolers and their use of theoretical frameworks and BCTs. METHODS This systematic review was completed adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria were randomized controlled trials (RCTs) published between 2012 and 2022 of interventions to improve diet or FV intake in preschoolers (aged 2-5 years) in childcare or preschool-settings. A search of four databases was conducted between in September 2022 using search terms pertaining to the study's primary aim (FV consumption), age group (preschool-aged), settings (US childcare or preschool settings), and study design (RCT). Additional criteria were objective measures of FV consumption or skin carotenoids, as a proxy for FV intake. Included studies were narratively synthesized based on intervention type, measured effect, and use of theory and BCTs. RESULTS The search resulted in six studies that reported on nine interventions. Overall, six interventions increased FV intake, of which five used nutrition education and one manipulated the feeding environment. Among the three interventions with no measured effect, two manipulated the feeding environment and one used peer modeling. Effective studies used at least three BCTs, though no pattern was observed between use of theory or BCTs and intervention effect. CONCLUSIONS While several studies have shown promising results, the limited number of studies identified in this review highlights key gaps in this field: there is a need for studies to test FV interventions in US childcare settings that use objective measures of FV intake, directly compare intervention components and BCTs, are theory-based, and assess long-term behavior change.
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Affiliation(s)
- Faten Hasan
- Department of Kinesiology, University of Virginia, Charlottesville, VA, 22903, USA
| | - Andy V Nguyen
- Department of Human Services, University of Virginia, Charlottesville, VA, 22903, USA
| | - Amaya R Reynolds
- Department of Human Services, University of Virginia, Charlottesville, VA, 22903, USA
| | - Wen You
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, 22903, USA
| | - Jamie Zoellner
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, 22903, USA
| | - Amanda J Nguyen
- Department of Human Services, University of Virginia, Charlottesville, VA, 22903, USA
| | - Damon Swift
- Department of Kinesiology, University of Virginia, Charlottesville, VA, 22903, USA
| | - Sibylle Kranz
- Department of Kinesiology, University of Virginia, Charlottesville, VA, 22903, USA.
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23
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Slimi O, Marsigliante S, Ciardo V, Bahloul M, Selmi O, Jebabli N, Muscella A. The effects of adapted physical education sessions on the empathy of female students with overweight. Front Psychol 2023; 14:1170446. [PMID: 37325765 PMCID: PMC10264700 DOI: 10.3389/fpsyg.2023.1170446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/04/2023] [Indexed: 06/17/2023] Open
Abstract
The global prevalence of childhood and adolescent overweight and obesity increases rapidly. Physical activity plays a major role in the prevention of obesity. The present study aimed to analyze the effect of adapted basketball sessions according to the empathic capacity of adolescent girls with overweight. Forty-two girls with overweight (age: 16.09 ± 0.85; years; height: 1.64 ± 0.67 m: weight: 73.02 ± 0.61 kg; BMI: 27.15 ± 1.37) volunteered to participate in the study and were randomly assigned to the experimental group (EG, n = 21) and control group (CG, n = 21). EG was submitted to a basketball intervention adapted to students with obesity while the CG performed classic basketball exercises for 7 weeks. Each week girls had 2 basketball teaching-learning sessions, lasting 50 min. The participants' empathy was assessed before and after the intervention using the Favre CEC. The results showed that adaptation intervention was associated with a significant emotional contagion decrease (Δ% = 0.466) and splitting with emotions (Δ% = 0.375), and with an empathy increase (Δ% = 1.387), in EG compared to CG. No significant difference was assessed in the empathy CG, before and after the intervention. This study demonstrated that adapted physical education classes could be an effective strategy to improve empathetic skills and inclusion of overweight girls as well as a means to prevent obesity.
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Affiliation(s)
- Oumayma Slimi
- Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Santo Marsigliante
- Department of Biological and Environmental Sciences and Technologies (Di.S.Te.B.A.), University of Salento, Lecce, Italy
| | - Vito Ciardo
- Department of Biological and Environmental Science and Technologies, University of Salento, Lecce, Italy
| | - Mourad Bahloul
- Higher Institute of Education and Continuing Training, Virtual University of Tunis, Tunis, Tunisia
- Higher Institute of Business Administration of Sfax, University of Sfax, Sfax, Tunisia
| | - Okba Selmi
- Higher Institute of Sports and Physical Education of Kef, University of Jendouba, Kef, Tunisia
| | - Nidhal Jebabli
- Higher Institute of Sports and Physical Education of Kef, University of Jendouba, Kef, Tunisia
| | - Antonella Muscella
- Department of Biological and Environmental Sciences and Technologies (Di.S.Te.B.A.), University of Salento, Lecce, Italy
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24
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Kim L, Duh-Leong C, Nagpal N, Ortiz R, Katzow MW, Russ S, Halfon N. Supporting early childhood routines to promote cardiovascular health across the life course. Curr Probl Pediatr Adolesc Health Care 2023; 53:101434. [PMID: 37821292 PMCID: PMC10842608 DOI: 10.1016/j.cppeds.2023.101434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
Optimal cardiovascular health is an essential component of human health and well-being across the life course. Heart healthy practices around diet, physical activity, and sleep early in childhood have the potential to greatly improve lifespan and quality (Mehta et al., 2020). Early childhood routines, defined as functional practices that are predictable and repeatable, predict positive growth and development across the lifecourse (Fiese et al., 2002; Ferretti and Bub, 2017; Spagnola and Fiese, 2007). The American Heart Association has identified key heart healthy routines, such as daily regular activities including diet, physical activity, and sleep that promote cardiovascular health (Lloyd-Jones et al., 2022). Integrating the strength-based relational aspects of routines with the acquisition of cardiovascular health development capabilities allows children to establish their own optimal cardiovascular health trajectory early on. A systematic life course approach to supporting heart healthy routines in early childhood would inform clinical, research, and policy strategies to promote long-term cardiovascular health, and contribute to reducing inequalities in cardiovascular outcomes.
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Affiliation(s)
- Leah Kim
- NYU Grossman School of Medicine, 550 First Avenue, New York, NY 10016, USA.
| | - Carol Duh-Leong
- Division of General Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, USA
| | - Nikita Nagpal
- Division of General Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, USA
| | - Robin Ortiz
- Division of General Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, USA; Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA; Institute for Excellence in Health Equity, NYU Langone Health, New York, NY, USA
| | - Michelle W Katzow
- Department of Pediatrics, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA; Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Shirley Russ
- Center for Healthier Children, Families, and Communities, University of California, Los Angeles, CA, USA; Department of Pediatrics, Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Neal Halfon
- Center for Healthier Children, Families, and Communities, University of California, Los Angeles, CA, USA; Department of Pediatrics, Geffen School of Medicine, University of California, Los Angeles, CA, USA; Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA; Department of Public Policy, UCLA Luskin School of Public Affairs, Los Angeles, CA, USA
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25
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Kucab MD, Keown-Stoneman CDG, Birken CS, Perlman M, Maguire JL. Centre-based childcare in early childhood and growth in later childhood: a prospective cohort study. Int J Obes (Lond) 2023:10.1038/s41366-023-01316-2. [PMID: 37106078 DOI: 10.1038/s41366-023-01316-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 04/14/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND Attending government-regulated centre-based childcare may influence important health behaviours including dietary quality, physical activity and routines related to child growth. However, the relationship between centre-based childcare and childhood obesity remains unclear. OBJECTIVES The primary objective was to evaluate the association between centre-based childcare attendance in early childhood and body mass index z-score (zBMI) in later childhood. Secondary objectives included exploring whether family income, child sex, or non-centre-based setting modified these relationships. METHODS A prospective cohort study of children aged 1 to 10 years who participated in the TARGet Kids! cohort was conducted. Linear mixed-effect modelling was used to evaluate the relationship between centre-based childcare attendance (in hours/week) compared to non-centre-based childcare between 1-4 years of age and zBMI between 4 and 10 years of age. Generalised estimating equation modelling was used to explore weight status categories. Models were adjusted for confounders and effect modification was explored. RESULTS A total of 3503 children were included. Children who attended centre-based childcare full-time (40 h/week) had 0.11 (95% CI: -0.19, -0.03; p = 0.01) lower zBMI at 4 and 7 years of age and lower odds of overweight and obesity at 4 years (OR 0.78; 95% CI: 0.62, 0.97; p = 0.03), but no evidence of an association was found at 10 years of age. Children from families with income < $50,000CDN who attended centre-based childcare full-time had 0.32 (95% CI: -0.50, -0.14; p = 0.001) lower zBMI and lower odds of overweight and obesity (OR 0.52; 95% CI: 0.28, 0.99; p = 0.05) at 10 years of age. CONCLUSIONS Attending centre-based childcare in early childhood was associated with a lower zBMI and odds of overweight and obesity in later childhood. These associations were stronger for children from lower income families. Centre-based childcare may be an early intervention for the prevention of childhood obesity. CLINICAL TRIAL Clinical Trial Registry Number: NCT01869530 (clinicaltrials.gov).
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Affiliation(s)
- Michaela D Kucab
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Paediatrics, St. Michael's Hospital, Toronto, ON, Canada
| | - Charles D G Keown-Stoneman
- Applied Health Research Centre, Unity Health Toronto, Toronto, ON, Canada
- Biostatistics Division, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Catherine S Birken
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada
- Division of Paediatric Medicine, Hospital for Sick Children, Toronto, ON, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Department of Nutritional Sciences, Joannah and Brian Lawson Centre for Child Nutrition, University of Toronto, Toronto, ON, Canada
| | - Michal Perlman
- Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, ON, Canada
| | - Jonathon L Maguire
- Department of Paediatrics, St. Michael's Hospital, Toronto, ON, Canada.
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada.
- Department of Nutritional Sciences, Joannah and Brian Lawson Centre for Child Nutrition, University of Toronto, Toronto, ON, Canada.
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
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26
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Krijger A, Steenbergen E, Schiphof-Godart L, van Rossum C, Verkaik-Kloosterman J, Elstgeest L, Ter Borg S, Raat H, Joosten K. Clusters of lifestyle behaviours and their associations with socio-demographic characteristics in Dutch toddlers. Eur J Nutr 2023; 62:1143-1151. [PMID: 36434406 PMCID: PMC10030397 DOI: 10.1007/s00394-022-03056-x] [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: 06/08/2022] [Accepted: 11/10/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE This study aimed to identify clusters of lifestyle behaviours in toddlers and assess associations with socio-demographic characteristics. METHODS We used data from the Dutch National Food Consumption Survey 2012-2016 and included 646 children aged 1-3 years. Based on 24-h dietary recalls and a questionnaire, a two-step cluster analysis was conducted to identify clusters in the intake of fruit, vegetables, sugar-sweetened beverages and unhealthy snacks, physical activity and screen time. Logistic regression models assessed associations between socio-demographic characteristics and cluster allocation. RESULTS Three clusters emerged from the data. The 'relatively healthy cluster' demonstrated a high intake of fruit and vegetables, low sugar-sweetened beverage and unhealthy snack intake and low screen time. The 'active snacking cluster' was characterised by high unhealthy snack intake and high physical activity, and the 'sedentary sweet beverage cluster' by high intake of sugar-sweetened beverages and high screen time. Children aged 1 year were most likely to be allocated to the 'relatively healthy cluster'. Compared to children of parents with a high education level, children of parents with a low or middle education level were less likely to be in the 'relatively healthy cluster', but more likely to be in the 'sedentary sweet beverage cluster'. CONCLUSION Clusters of lifestyle behaviours can be distinguished already in children aged 1-3 years. To promote healthy lifestyle behaviour, efforts may focus on maintaining healthy behaviour in 1-year-olds and more on switching towards healthy behaviour in 2- and 3-year-olds.
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Affiliation(s)
- Anne Krijger
- Department of Pediatrics and Pediatric Surgery, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands.
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
| | - Elly Steenbergen
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Lieke Schiphof-Godart
- Department of Medical Informatics, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Caroline van Rossum
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | - Liset Elstgeest
- Department of Pediatrics and Pediatric Surgery, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands
- Reinier Academy, Reinier de Graaf Hospital, Delft, The Netherlands
| | - Sovianne Ter Borg
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Koen Joosten
- Department of Pediatrics and Pediatric Surgery, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands
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Lafave LMZ. Is the online 'creating healthy eating and active environments survey' (CHEERS) tool reliable for early childhood educators in Alberta, Canada: a randomized crossover trial. Arch Public Health 2023; 81:22. [PMID: 36782334 PMCID: PMC9926852 DOI: 10.1186/s13690-023-01036-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 02/06/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND The creating healthy eating and active environments survey (CHEERS) is an audit tool used to assess the nutrition and physical activity environment in early childhood education and care (ECEC) centres. Availability of the tool has been limited to paper-based versions. Digital health initiatives offer improved reach and immediacy of support for community-based clients through novel technology products. In order to provide increased access to the CHEERS tool, an online version was developed. The objective of this study was to assess the reliability of an online version of CHEERS. METHODS Utilizing a randomized crossover design, ECEC educators completed either a paper-based or online-based survey and then the opposite mode with a two to three-week interval. The intraclass correlation coefficient (ICC, with 95% confidence interval) was used to determine the reliability between test and retest. Absolute index of reliability in the original measurement was assessed through the standard error of measurement (SEM = SD × √1-ICC). The smallest amount of change not due to inherent variation was assessed by determining minimal detectable change at the 95% confidence level (MDC95 = SEM × 1.96 ×√2; MDC95% = MDC95/mean ×100). RESULTS Test-retest reliability was good to excellent for the online-based CHEERS total score (ICC = 0.86) and for each of the four subscales: food served (ICC = 0.82), healthy eating environment (ICC = 0.76), program planning (ICC = 0.76), and physical activity environment (ICC = 0.79). The SEM, MDC95, and MDC95% for the CHEERS overall score were 0.79, 2.19, and 9.6%, respectively. CONCLUSIONS The results of this study demonstrate that the online-based and paper-based versions of the CHEERS audit tool share comparable accuracy. The CHEERS tool can be reliably implemented in an online environment and this provides users an alternative means to complete the centre-based health assessment. The advantage of the online-based version includes user accessibility and the potential to develop a feedback response for participants using digitally collected data.
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Affiliation(s)
- Lynne M. Z. Lafave
- grid.411852.b0000 0000 9943 9777Department of Health and Physical Education, Mount Royal University, Calgary, AB T3E 6K6 Canada
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Mehta P, Li Q, Stahl M, Uusitalo U, Lindfors K, Butterworth MD, Kurppa K, Virtanen S, Koletzko S, Aronsson C, Hagopian WA, Rewers MJ, Toppari J, Ziegler AG, Akolkar B, Krischer JP, Agardh D, Liu E. Gluten-free diet adherence in children with screening-detected celiac disease using a prospective birth cohort study. PLoS One 2023; 18:e0275123. [PMID: 36730234 PMCID: PMC9894423 DOI: 10.1371/journal.pone.0275123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/10/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Celiac disease has an increasing incidence worldwide and is treated with lifelong adherence to a gluten-free diet. We aimed to describe gluten-free diet adherence rates in children with screening-identified celiac disease, determine adherence-related factors, and compare adherence to food records in a multinational prospective birth cohort study. METHODS Children in The Environmental Determinants of Diabetes in the Young study with celiac disease were included. Subjects had at least annual measurement of adherence (parent-report) and completed 3-day food records. Descriptive statistics, t-tests, Kruskal-Wallis tests and multivariable logistic and linear regression were employed. RESULTS Two hundred ninety (73%) and 199 (67%) of subjects were always adherent to a gluten-free diet at 2 and 5 years post celiac disease diagnosis respectively. The percentage of children with variable adherence increased from 1% at 2 years to 15% at 5 years. Children with a first-degree relative with celiac disease were more likely to be adherent to the gluten-free diet. Gluten intake on food records could not differentiate adherent from nonadherent subjects. Adherent children from the United States had more gluten intake based on food records than European children (P < .001 and P = .007 at 2 and 5 years respectively). CONCLUSION Approximately three-quarters of children with screening-identified celiac disease remain strictly adherent to a gluten-free diet over time. There are no identifiable features associated with adherence aside from having a first-degree relative with celiac disease. Despite good parent-reported adherence, children from the United States have more gluten intake when assessed by food records. Studies on markers of gluten-free diet adherence, sources of gluten exposure (particularly in the United States), and effects of adherence on mucosal healing are needed.
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Affiliation(s)
- Pooja Mehta
- Department of Pediatrics, Children’s Hospital Colorado, University of Colorado, Aurora, CO, United States of America
| | - Qian Li
- Health Informatics Institute, University of South Florida, Tampa, FL, United States of America
| | - Marisa Stahl
- Department of Pediatrics, Children’s Hospital Colorado, University of Colorado, Aurora, CO, United States of America
| | - Ulla Uusitalo
- Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, FL, United States of America
| | - Katri Lindfors
- Celiac Disease Research Center, Tampere University, Tampere, Finland
| | - Martha D. Butterworth
- Health Informatics Institute, University of South Florida, Tampa, FL, United States of America
| | - Kalle Kurppa
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland
- Department of Pediatrics, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Suvi Virtanen
- National Institute for Health and Welfare, University of Helsinki, Helsinki, Finland
| | - Sibylle Koletzko
- Department of Pediatrics, Dr. von Hauner Children’s Hospital, LMU Klinikum, University of Munich, Munich, Germany
- Department of Pediatrics, University of Warmia and Mazury, Olsztyn, Poland
| | - Carin Aronsson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | | | - Marian J. Rewers
- Barbara Davis Center for Childhood Diabetes, University of Colorado, Aurora, CO, United States of America
| | - Jorma Toppari
- Department of Pediatrics, Turku University Hospital, Turku, Finland
- Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, University of Turku, Turku, Finland
| | - Anette-G. Ziegler
- Institute of Diabetes Research, Helmholtz Zentrum München, Klinikum rechts der Isar, Technische Universität München, Forschergruppe Diabetes e.V., Neuherberg, Germany
| | - Beena Akolkar
- National Institute of Diabetes & Digestive & Kidney Diseases, Bethesda, MD, United States of America
| | - Jeffrey P. Krischer
- Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, FL, United States of America
| | - Daniel Agardh
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Edwin Liu
- Department of Pediatrics, Children’s Hospital Colorado, University of Colorado, Aurora, CO, United States of America
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Dai J, Yang J, Fan H, Wu Y, Wu H, Wang Y, Tung TH, Wang L, Zhang M. Eating order and childhood obesity among preschoolers in China: A cross-sectional study. Front Pediatr 2023; 11:1139743. [PMID: 36969294 PMCID: PMC10030843 DOI: 10.3389/fped.2023.1139743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 02/21/2023] [Indexed: 03/29/2023] Open
Abstract
Background Early childhood is a critical period for dietary education and development of good eating habits. However, few studies have investigated the effect of eating order in children and childhood obesity in real-world settings. Objective To examine whether the order in which meats/fish or vegetables are consumed affects the risk of obesity in preschoolers. Methods We conducted a population-based cross-sectional study using a self-administered online survey on the lifestyle and health behaviors of preschoolers in Taizhou, China. A total of 3,200 parents were invited to take part in the survey, and 2,049 of them completed the questionnaire. Children were classified as having a normal weight, overweight, or obesity using the definitions provided by the International Obesity Task Force, and z-scores for body mass index were calculated. We divided the children's eating order at the beginning of the meal into two groups: "vegetables before meats/fish" or "meats/fish before vegetables". We analyzed the relationship between what was consumed first at a meal and the overweight status of each child. Results No difference in body mass index was observed between the children eating meats/fish-first and the children eating vegetables-first during a meal. Children with parents who were affected by obesity were more likely to eat vegetables first. Among children of mothers with obesity, body mass index was significantly higher in the meats/fish-first group than that in the vegetable-first group (2.891 vs. 0.845, P = 0.007). In children whose mothers were affected by obesity, those that ate meats/fish first had a 12.21 times higher risk of being overweight compared with those that ate vegetables first (95% CI:1.22-121.74, P = 0.033). Conclusion Our findings suggest eating vegetables or meats/fish at the start of a meal does not affect weight status in preschoolers.
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Affiliation(s)
- Jin Dai
- Department of Pediatrics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou Enze Medical Center (Group) Enze Hospital, Taizhou, China
| | - Jingyun Yang
- Department of Pediatrics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Hailing Fan
- Department of Pediatrics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Yixin Wu
- Department of Pediatrics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Huilan Wu
- Department of Pediatrics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Yun Wang
- Department of Pediatrics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Tao-Hsin Tung
- Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Lizhen Wang
- Department of Pediatrics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou Enze Medical Center (Group) Enze Hospital, Taizhou, China
- Department of Pediatrics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
- Correspondence: Meixian Zhang Lizhen Wang
| | - Meixian Zhang
- Department of Pediatrics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
- Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
- Correspondence: Meixian Zhang Lizhen Wang
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Skouteris H, Green R, Chung A, Bergmeier H, Amir LH, Baidwan SK, Chater A, Chamberlain C, Emond R, Gibbons K, Gooey M, Hatzikiriakidis K, Haycraft E, Hills AP, Higgins DJ, Hooper O, Hunter S, Kappelides P, Kleve S, Krakouer J, Lumeng JC, Manios Y, Mansoor A, Marmot M, Mâsse LC, Matvienko‐Sikar K, Mchiza ZJ, Meyer C, Moschonis G, Munro ER, O'Connor TM, O'Neil A, Quarmby T, Sandford R, Schneiderman JU, Sherriff S, Simkiss D, Spence A, Sturgiss E, Vicary D, Wickes R, Wolfenden L, Story M, Black MM. Nurturing children's development through healthy eating and active living: Time for policies to support effective interventions in the context of responsive emotional support and early learning. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e6719-e6729. [PMID: 36401560 PMCID: PMC10946933 DOI: 10.1111/hsc.14106] [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: 07/20/2022] [Revised: 10/19/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
Fostering the growth, development, health, and wellbeing of children is a global priority. The early childhood period presents a critical window to influence lifelong trajectories, however urgent multisectoral action is needed to ensure that families are adequately supported to nurture their children's growth and development. With a shared vision to give every child the best start in life, thus helping them reach their full developmental potential, we have formed the International Healthy Eating Active Living Matters (HEALing Matters) Alliance. Together, we form a global network of academics and practitioners working across child health and development, and who are dedicated to improving health equity for children and their families. Our goal is to ensure that all families are free from structural inequality and oppression and are empowered to nurture their children's growth and development through healthy eating and physical activity within the context of responsive emotional support, safety and security, and opportunities for early learning. To date, there have been disparate approaches to promoting these objectives across the health, community service, and education sectors. The crucial importance of our collective work is to bring these priorities for early childhood together through multisectoral interventions, and in so doing tackle head on siloed approaches. In this Policy paper, we draw upon extensive research and call for collective action to promote equity and foster positive developmental trajectories for all children. We call for the delivery of evidence-based programs, policies, and services that are co-designed to meet the needs of all children and families and address structural and systemic inequalities. Moving beyond the "what" is needed to foster the best start to life for all children, we provide recommendations of "how" we can do this. Such collective impact will facilitate intergenerational progression that builds human capital in future generations.
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Affiliation(s)
- Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive MedicineMonash UniversityVictoriaMelbourneAustralia
- Warwick Business SchoolUniversity of WarwickCoventryUK
| | - Rachael Green
- Health and Social Care Unit, School of Public Health and Preventive MedicineMonash UniversityVictoriaMelbourneAustralia
| | - Alexandra Chung
- Health and Social Care Unit, School of Public Health and Preventive MedicineMonash UniversityVictoriaMelbourneAustralia
| | - Heidi Bergmeier
- Health and Social Care Unit, School of Public Health and Preventive MedicineMonash UniversityVictoriaMelbourneAustralia
| | - Lisa H. Amir
- Judith Lumley Centre, School of Nursing and MidwiferyLa Trobe UniversityVictoriaBundooraAustralia
| | | | - Angel Marie Chater
- Centre for Health, Wellbeing and Behaviour ChangeUniversity of BedfordshireLutonUK
| | - Catherine Chamberlain
- Judith Lumley Centre, School of Nursing and MidwiferyLa Trobe UniversityVictoriaBundooraAustralia
- Centre for Health EquityThe University of MelbourneVictoriaMelbourneAustralia
- Ngangk Yira Research Centre for Aboriginal Health and Social EquityMurdoch UniversityMurdochAustralia
- The Lowitja InstituteCollingwoodVictoriaAustralia
| | | | - Kay Gibbons
- Institute for Health & SportVictoria UniversityVictoriaMelbourneAustralia
| | - Michelle Gooey
- Health and Social Care Unit, School of Public Health and Preventive MedicineMonash UniversityVictoriaMelbourneAustralia
| | - Kostas Hatzikiriakidis
- Health and Social Care Unit, School of Public Health and Preventive MedicineMonash UniversityVictoriaMelbourneAustralia
| | - Emma Haycraft
- School of Sport, Exercise and Health SciencesLoughborough UniversityLoughboroughUK
| | - Andrew P. Hills
- School of Health SciencesUniversity of TasmaniaTasmaniaLauncestonAustralia
| | | | - Oliver Hooper
- School of Sport, Exercise and Health SciencesLoughborough UniversityLoughboroughUK
| | | | - Pam Kappelides
- Department of ManagementLa Trobe UniversityVictoriaBundooraAustralia
| | - Sue Kleve
- Department of Nutrition, Dietetics and Food, School of Clinical SciencesMonash UniversityVictoriaClaytonAustralia
| | - Jacynta Krakouer
- Health and Social Care Unit, School of Public Health and Preventive MedicineMonash UniversityVictoriaMelbourneAustralia
| | | | - Yannis Manios
- Department of Nutrition and DieteticsHarokopio University of AthensAthensGreece
- Institute of Agri‐food and Life SciencesHellenic Mediterranean University Research CentreHeraklionGreece
| | - Athar Mansoor
- The Hong Kong University of Science and TechnologyHong KongHong Kong
| | | | - Louise C. Mâsse
- BC Children's Hospital Research Institute/School of Population and Public HealthUniversity of British ColumbiaBritish ColumbiaVancouverCanada
| | | | - Zandile June‐Rose Mchiza
- Non‐communicable Disease Research Unit, South African Medical Research Council & School of Public Health, Faculty of Community and Health SciencesUniversity of the Western CapeBellvilleSouth Africa
| | - Caroline Meyer
- Executive Office, Warwick Medical SchoolUniversity of WarwickCoventryUK
| | - George Moschonis
- Department of Food, Nutrition and Dietetics, School of Allied Health, Human Services and SportLa Trobe UniversityVictoriaBundooraAustralia
| | - Emily R. Munro
- Tilda Goldberg Centre for Social Work and Social CareUniversity of BedfordshireLutonUK
| | - Teresia Margareta O'Connor
- USDA/ARS Children's Nutrition Research Center, Department of PediatricsBaylor College of MedicineTexasHoustonUSA
| | - Adrienne O'Neil
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of MedicineDeakin UniversityVictoriaGeelongAustralia
| | | | - Rachel Sandford
- School of Sport, Exercise and Health SciencesLoughborough UniversityLoughboroughUK
| | - Janet U. Schneiderman
- Department of Nursing, Suzanne Dworak‐Peck School of Social WorkUniversity of Southern CaliforniaCaliforniaLos AngelesUSA
| | | | - Doug Simkiss
- Executive Office, Warwick Medical SchoolUniversity of WarwickCoventryUK
- Birmingham Community Healthcare NHS Foundation TrustBirminghamUK
- Aston UniversityBirminghamUK
| | - Alison Spence
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition SciencesDeakin UniversityGeelongVictoriaAustralia
| | - Elizabeth Sturgiss
- School of Primary and Allied Health CareMonash UniversityFrankstonVictoriaAustralia
| | | | - Rebecca Wickes
- Griffith Criminology InstituteGriffith UniversityBrisbaneQueenslandAustralia
| | - Luke Wolfenden
- School of Medicine and Public Health, College of Health, Medicine and WellbeingThe University of NewcastleCallaghanNew South WalesAustralia
| | - Mary Story
- Duke Global Health InstituteDurhamNorth CarolinaUSA
| | - Maureen M. Black
- School of MedicineUniversity of MarylandCollege ParkMarylandUSA
- Research Triangle Institute InternationalResearch Triangle ParkNorth CarolinaUSA
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Specht IO, Larsen SC, Rohde JF, Østergaard JN, Heitmann BL. Comparison of Motor Difficulties Measured in the First Year of School among Children Who Attended Rural Outdoor or Urban Conventional Kindergartens. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14158. [PMID: 36361035 PMCID: PMC9653742 DOI: 10.3390/ijerph192114158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/26/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Kindergartens can potentially contribute substantially to the daily level of physical activity and development of motor skills and might be an ideal setting for improving these as a public health initiative. We aimed to examine whether children from rural outdoor kindergartens had a lower risk of motor difficulties than children from urban conventional kindergartens. METHODS Motor test results were measured during the first school year by school health nurses using a six-item test of gross- and fine motor skills (jumping, handle a writing tool, cutting with a scissor following a line, one-leg stand on each leg, throwing and grabbing). Register-based information was available on potential confounding factors. RESULTS We included 901 children from outdoor kindergartens and 993 from conventional kindergartens with a mean (SD) age of 6.5 years (0.4). The children from the two types of kindergarten differed according to demographic information, with outdoor kindergarten children more often being from more affluent families (long maternal education level: 47.5% vs. 31.0%, p < 0.0001) and fewer girls attending the outdoor kindergartens (42.7% vs. 49.5%, p = 0.003). In the adjusted models, we found no evidence of differences in the risk of motor difficulties between children attending either type of kindergarten (OR: 0.95, 95%CI: 0.71; 1.27, p = 0.72). CONCLUSION Our results do not support outdoor kindergartens as a potential intervention to improve motor abilities among children. Randomized controlled trials are needed to confirm these findings.
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Affiliation(s)
- Ina Olmer Specht
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, 2000 Frederiksberg, Denmark
| | - Sofus Christian Larsen
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, 2000 Frederiksberg, Denmark
| | - Jeanett Friis Rohde
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, 2000 Frederiksberg, Denmark
| | - Jane Nautrup Østergaard
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Central Denmark Region, 8200 Aarhus, Denmark
| | - Berit Lilienthal Heitmann
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, 2000 Frederiksberg, Denmark
- The Boden Group, Faculty of Medicine and Health, Sydney University, Sydney, NSW 2006, Australia
- Section for General Practice, Department of Public Health, University of Copenhagen, 1165 Copenhagen, Denmark
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Mahmood L, Moreno LA, Flores-Barrantes P, Mavrogianni C, Schwarz P, Makrilakis K, Liatis S, Cardon G, Willems R, Rurik I, Radó S, Tankova T, Iotova V, Usheva N, Manios Y, Gonzalez-Gil EM. Parental food consumption and diet quality and its association with children's food consumption in families at high risk of type 2 diabetes: the Feel4Diabetes-study. Public Health Nutr 2022; 25:1-12. [PMID: 36217747 PMCID: PMC9991723 DOI: 10.1017/s1368980022002245] [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: 12/03/2021] [Revised: 08/19/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine the parental food consumption and diet quality and its associations with children's consumption in families at high risk for developing type 2 diabetes mellitus across Europe. Also, to compare food frequency consumption among parents and children from high-risk families to the European Dietary guidelines/recommendations. DESIGN Cross-sectional study using Feel4diabetes FFQ. SETTING Families completed FFQ and anthropometric measures were obtained. Linear regression analyses were applied to investigate the relations between parental food consumption and diet quality and their children's food consumption after consideration of potential confounders. PARTICIPANTS 2095 European families (74·6 % mothers, 50·9 % girls). The participants included parent and one child, aged 6-8 years. RESULTS Parental food consumption was significantly associated with children's intake from the same food groups among boys and girls. Most parents and children showed under-consumption of healthy foods according to the European Dietary Guidelines. Parental diet quality was positively associated with children's intake of 'fruit' (boys: β = 0·233, P < 0·001; girls: β = 0·134, P < 0·05) and 'vegetables' (boys: β = 0·177, P < 0·01; girls: β = 0·234, P < 0·001) and inversely associated with their 'snacks' consumption (boys: β = -0·143, P < 0·05; girls: β = -0·186, P < 0·01). CONCLUSION The present study suggests an association between parental food consumption and diet quality and children's food intake. More in-depth studies and lifestyle interventions that include both parents and children are therefore recommended for future research.
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Affiliation(s)
- Lubna Mahmood
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza50009, Spain
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza50009, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Paloma Flores-Barrantes
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza50009, Spain
| | - Christina Mavrogianni
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Peter Schwarz
- Department of Medicine III, Technical University of Dresden, Dresden, Germany
| | - Konstantinos Makrilakis
- Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Stavros Liatis
- Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Gent, Belgium
| | - Ruben Willems
- Department of Public Health and Primary Care, Ghent University, Gent, Belgium
| | - Imre Rurik
- Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Sándorné Radó
- Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Tsvetalina Tankova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Violeta Iotova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Natalya Usheva
- Department of Social Medicine and Health Care Organization, Medical University of Varna, Varna, Bulgaria
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
- Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - Esther M Gonzalez-Gil
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza50009, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Biochemistry and Molecular Biology II, Instituto de Nutrición y Tecnología de los Alimentos, Center of Biomedical Research (CIBM), Universidad de Granada, Granada, Spain
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Jahnel T, Dassow HH, Gerhardus A, Schüz B. The digital rainbow: Digital determinants of health inequities. Digit Health 2022; 8:20552076221129093. [PMID: 36204706 PMCID: PMC9530552 DOI: 10.1177/20552076221129093] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 09/09/2022] [Indexed: 12/04/2022] Open
Abstract
The widely used socioecological rainbow model from Dahlgren and Whitehead specifies determinants of health inequity on multiple hierarchical levels and suggests that these determinants may interact both within and between levels. At the time of its inception, digital determinants only played a minor role in tackling inequities in public health and were therefore not specifically considered. This has dramatically changed: From today's perspective, health inequities increasingly depend on digital determinants. In this article, we suggest adapting the Dahlgren-Whitehead model to reflect these developments. We propose a model that allows formulating testable hypotheses, interpreting research findings, and developing policy implications against the background of the global spread of digital technologies. This may facilitate the development of a new line of research and logic models for public health interventions in the digital age. Using the COVID-19 pandemic as a case study, we illustrate how the digitization of all aspects of life affects the different levels of determinants of health inequities in the Dahlgren-Whitehead model. In doing so, we deliberately argue for not introducing a separate digital sphere in its own right, but for understanding digitization as a phenomenon that permeates all levels of determinants of health inequities. As a result, we present a digital rainbow model that integrates Dahlgren and Whitehead's 1991 model with digital environments to identify current health promotion and research issues without changing the rainbow model's initial structure.
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Affiliation(s)
- Tina Jahnel
- Institute for Public Health and Nursing, Research, Health Services Research University of Bremen, Bremen, Germany,Leibniz ScienceCampus Digital Public Health Bremen, Bremen, Germany
| | - Hans-Henrik Dassow
- Leibniz ScienceCampus Digital Public Health Bremen, Bremen, Germany,Institute for Philosophy, University of Bremen, Bremen, Germany
| | - Ansgar Gerhardus
- Institute for Public Health and Nursing, Research, Health Services Research University of Bremen, Bremen, Germany,Leibniz ScienceCampus Digital Public Health Bremen, Bremen, Germany
| | - Benjamin Schüz
- Leibniz ScienceCampus Digital Public Health Bremen, Bremen, Germany,Institute for Public Health and Nursing Research, Prevention and Health
Promotion, University of Bremen, Bremen, Germany,Benjamin Schüz, Institut für Public Health und
Pflegeforschung, Universität Bremen, Grazer Str. 4, 28359 Bremen, Germany.
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Chawłowska E, Staszewski R, Zawiejska A, Giernaś B, Domaradzki J. Actions Speak Louder Than Words: Health Behaviours and the Literacy of Future Healthcare Professionals. Healthcare (Basel) 2022; 10:1723. [DOI: https:/doi.org/10.3390/healthcare10091723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2023] Open
Abstract
Our everyday behaviours in life can positively and negatively impact our health, thus cumulatively shaping our lifestyles as more or less healthy. These behaviours are often determined by our knowledge, literacy, motivations and socioeconomic backgrounds. The authors aimed to assess health behaviours and explore variables that may affect persons studying to become future healthcare professionals in Poland. This study was conducted with a group of 275 undergraduate students attending the Poznan University of Medical Sciences representing six different majors of study. We used self-reported, cross-sectional survey conducted through the use of a questionnaire that consisted of one standardised scale (Juczyński’s Health Behaviour Inventory) as well as a self-developed health literacy measure. The students showed average to high levels of health-promoting behaviours (mean HBI = 82.04 ± 11.26). Medium to strong associations were found between these behaviours and high scores on the health literacy scale (p = 0.001, r = 0.45 between total scores of the two scales). Dietetics students and female respondents scored significantly better on both scales, which suggests that their self-reported behaviours and health literacy were higher than those of other participants. Exhibiting health-protective behaviours and high health literacy is likely to result in the better individual health of our respondents, but, more importantly, will also influence their future professions. As members of the healthcare workforce they will be responsible for the health of the population and it is crucial for them not only to provide care, education, and guidance, but also to act as role-models for their patients and society.
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Chawłowska E, Staszewski R, Zawiejska A, Giernaś B, Domaradzki J. Actions Speak Louder Than Words: Health Behaviours and the Literacy of Future Healthcare Professionals. Healthcare (Basel) 2022; 10:healthcare10091723. [PMID: 36141335 PMCID: PMC9498724 DOI: 10.3390/healthcare10091723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 08/31/2022] [Accepted: 09/05/2022] [Indexed: 11/16/2022] Open
Abstract
Our everyday behaviours in life can positively and negatively impact our health, thus cumulatively shaping our lifestyles as more or less healthy. These behaviours are often determined by our knowledge, literacy, motivations and socioeconomic backgrounds. The authors aimed to assess health behaviours and explore variables that may affect persons studying to become future healthcare professionals in Poland. This study was conducted with a group of 275 undergraduate students attending the Poznan University of Medical Sciences representing six different majors of study. We used self-reported, cross-sectional survey conducted through the use of a questionnaire that consisted of one standardised scale (Juczyński’s Health Behaviour Inventory) as well as a self-developed health literacy measure. The students showed average to high levels of health-promoting behaviours (mean HBI = 82.04 ± 11.26). Medium to strong associations were found between these behaviours and high scores on the health literacy scale (p = 0.001, r = 0.45 between total scores of the two scales). Dietetics students and female respondents scored significantly better on both scales, which suggests that their self-reported behaviours and health literacy were higher than those of other participants. Exhibiting health-protective behaviours and high health literacy is likely to result in the better individual health of our respondents, but, more importantly, will also influence their future professions. As members of the healthcare workforce they will be responsible for the health of the population and it is crucial for them not only to provide care, education, and guidance, but also to act as role-models for their patients and society.
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Affiliation(s)
- Ewelina Chawłowska
- Laboratory of International Health, Department of Preventive Medicine, Poznan University of Medical Sciences, 60-781 Poznań, Poland
- Correspondence: ; Tel.: +48-607-323-211; Fax: +48-618-546-575
| | - Rafał Staszewski
- Department of Hypertension, Angiology and Internal Diseases, Poznan University of Medical Sciences, 61-848 Poznań, Poland
| | - Agnieszka Zawiejska
- Department of Medical Simulation, Poznan University of Medical Sciences, 60-806 Poznań, Poland
| | - Bogusz Giernaś
- Laboratory of International Health, Department of Preventive Medicine, Poznan University of Medical Sciences, 60-781 Poznań, Poland
| | - Jan Domaradzki
- Department of Social Sciences and Humanities, Poznan University of Medical Sciences, 60-806 Poznań, Poland
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Khalsa AS, Copeland KA, Kharofa RY, Geraghty SR, Dewitt TG, Woo JG. The Longitudinal Relation between Infant Feeding Styles and Growth Trajectories among Families from Low-Income Households. J Nutr 2022; 152:2015-2022. [PMID: 35641195 DOI: 10.1093/jn/nxac123] [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: 03/01/2022] [Revised: 04/11/2022] [Accepted: 05/24/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Parental feeding styles, including the emotional environment parents create to modify a child's eating behaviors, have been associated with measures of adiposity in cross-sectional studies. The longitudinal relation between parental feeding styles in early infancy and adiposity in later infancy/toddlerhood are scant and have shown mixed results, particularly in families from low-income households. OBJECTIVES This study examined the relation between parental feeding styles and infant BMI z-score trajectories between 6 and 18 mo in families from low-income households. METHODS Parent-infant dyads were recruited during the infant's 6-, 9-, or 12-mo well-child visit. Feeding styles were assessed using the Infant Feeding Style Questionnaire (IFSQ). Infant anthropometrics from birth through 18 mo were extracted from the electronic medical record. BMI z-score slopes were estimated for each infant between 0-6 mo and 6-18 mo. Associations between feeding styles and BMI z-score slopes were examined using mixed models controlling for demographic, clinical, and feeding covariates. RESULTS The final analytic sample included 198 dyads (69% Black; median infant age: 9.0 mo; IQR: 6.8-10.3 mo). The predominant parent feeding styles included the following: laissez-faire (30%), restrictive (28%), responsive (23%), and pressuring (19%). In adjusted models, the predominant feeding style at enrollment was associated with the BMI z-score slope between 6 and 18 mo, with the responsive feeding style exhibiting a steeper increase in BMI z-score than other feeding styles. Infant feeding style was not associated with BMI z-score slope between birth and 6 mo of age. Infants of parents who exhibited restrictive feeding styles were more likely to have a BMI ≥85th percentile at their last measurement. CONCLUSIONS The predominant parent feeding style during infancy in a low-income population was associated with infant BMI z-score between 6 and 18 mo of age, but not earlier. Further studies are needed to better understand how predictive factors collectively contribute to BMI increase in the first 2 y.
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Affiliation(s)
- Amrik Singh Khalsa
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.,Division of Primary Care Pediatrics and Center for Child Health Equity and Outcomes Research, Nationwide Children's Hospital, Columbus, OH.,Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH
| | - Kristen A Copeland
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Roohi Y Kharofa
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.,Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Sheela R Geraghty
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Thomas G Dewitt
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Jessica G Woo
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.,Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
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Cascaes AM, Silva NRJD, Fernandez MDS, Bomfim RA, Vaz JDS. Ultra-processed food consumption and dental caries in children and adolescents: a systematic review and meta-analysis. Br J Nutr 2022; 129:1-10. [PMID: 35894293 DOI: 10.1017/s0007114522002409] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This study summarised the association between ultra-processed food (UPF) consumption and dental caries in children and adolescents through a systematic review and meta-analysis. The search of PubMed, Cochrane, Web of Science and Scopus databases using the 'PECOS' strategy retrieved 1462 eligible articles. Only studies with humans aged ≤ 19 years; that assessed groups of any UPF or specific UPF items; that measured dental caries as the decayed, filled and missing surfaces or teeth indexes, based on the WHO criteria; cross-sectional, case-control, cohort and all types of interventions that examined the adjusted association between UPF consumption and dental caries were included. All studies received qualitative evaluation. Meta-analysis using random-effects models combined multivariable-adjusted OR for case-control and cross-sectional studies and risk ratio (RR) for longitudinal studies of the highest v. lowest category of UPF consumption. Forty-two studies were included in the qualitative synthesis and twenty-seven in the meta-analysis. The pooled RR was 1·71 (95 % CI 1·31, 2·24), and the pooled OR was 1·55 (95 % CI 1·37, 1·75). The highest OR was found among participants who had dental caries prevalence >70 % (OR = 3·67, 95 % CI 2·16, 6·23). Better evidence quality was found among cohort studies that evaluated children <6 years old. The findings suggest that higher UPF consumption is associated with greater dental caries in children and adolescents. Public health efforts to reduce UPF consumption are needed to improve the oral health of children and adolescents.
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Affiliation(s)
- Andreia Morales Cascaes
- Federal University of Santa Catarina, Department of Public Health, Graduate Program in Public Health, Graduate Program in Dentistry, Florianópolis, SC, Brazil
| | | | | | - Rafael Aiello Bomfim
- Federal University of Mato Grosso do Sul, School of Dentistry, Graduate Program in Dentistry, Campo Grande, MS, Brazil
| | - Juliana Dos Santos Vaz
- Federal University of Pelotas, Faculty of Nutrition, Graduate Program in Nutrition and Foods, Pelotas, RS, Brazil
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Swindle T, Rutledge JM, Zhang D, Martin J, Johnson SL, Selig JP, Yates AM, Gaulden DT, Curran GM. De-Implementation of Detrimental Feeding Practices in Childcare: Mixed Methods Evaluation of Community Partner Selected Strategies. Nutrients 2022; 14:nu14142861. [PMID: 35889818 PMCID: PMC9319894 DOI: 10.3390/nu14142861] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/05/2022] [Accepted: 07/11/2022] [Indexed: 02/05/2023] Open
Abstract
This pilot evaluated strategies to decrease detrimental feeding practices in early care and education, which are hypothesized to compete with evidence-based feeding and obesity prevention practices. This study made two key comparisons: (1) a between-site comparison of sites receiving (a) no implementation or de-implementation strategies (i.e., Basic Support; B), (b) implementation strategies only (i.e., Enhanced Support; E), and (c) implementation and de-implementation strategies (i.e., De-implementation + Enhanced Support; D + E) and (2) a within-site pre-post comparison among sites with D + E. At nutrition lessons, the D + E group had more Positive Comments (Hedege’s g = 0.60) and higher Role Model fidelity (Hedege’s g = 1.34) compared to the E group. At meals, assistant teachers in the D + E group had higher Positive Comments than in the B group (g = 0.72). For within-group comparisons, the D + E group decreased Negative Comments (t(19) = 2.842, p = 0.01), increased Positive Comments (t(20) = 2.314, p = 0.031), and improved use of the program mascot at nutrition lessons (t(21) = 3.899, p = 0.001). At meals, lead teachers’ Negative Comments decreased (t(22) = 2.73, p = 0.01). Qualitative data identified strengths and opportunities for iteration. Despite a COVID interruption, mid-point comparisons and qualitative feedback suggest promise of the de-implementation strategy package.
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Affiliation(s)
- Taren Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; (D.Z.); (J.M.); (D.T.G.)
- Correspondence:
| | - Julie M. Rutledge
- College of Applied and Natural Sciences, School of Human Ecology, Louisiana Tech University, Ruston, LA 71272, USA; (J.M.R.); (A.M.Y.)
| | - Dong Zhang
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; (D.Z.); (J.M.); (D.T.G.)
| | - Janna Martin
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; (D.Z.); (J.M.); (D.T.G.)
| | - Susan L. Johnson
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
| | - James P. Selig
- College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;
| | - Amy M. Yates
- College of Applied and Natural Sciences, School of Human Ecology, Louisiana Tech University, Ruston, LA 71272, USA; (J.M.R.); (A.M.Y.)
| | - Daphne T. Gaulden
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; (D.Z.); (J.M.); (D.T.G.)
| | - Geoffrey M. Curran
- Department of Pharmacy Practice and Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;
- Central Arkansas Veterans Healthcare System, Little Rock, AR 72205, USA
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Khalsa AS, Weber ZA, Zvara BJ, Keim SA, Andridge R, Anderson SE. Factors associated with parenting stress in parents of 18-month-old children: Parenting stress in parents of toddlers. Child Care Health Dev 2022; 48:521-530. [PMID: 34978103 PMCID: PMC9203946 DOI: 10.1111/cch.12954] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 12/01/2021] [Accepted: 12/20/2021] [Indexed: 01/26/2023]
Abstract
AIM Parenting stress is associated with less optimal outcomes for children. Risk factors contributing to parenting stress in healthy toddlers have received little empirical attention. This study sought to determine the factors that are associated with parenting stress in parents of 18-month-old children. METHODS We analysed cross-sectional survey data from a prospective cohort study focused on parent-child mealtime interactions. Families with an 18-month-old child were recruited in Columbus, Ohio, USA, between December 2017 and May 2019. Adjusted stepwise linear regression models estimated associations between child factors (e.g., temperament), parental factors (e.g., depressive symptoms), quality of romantic relationship factors (e.g., adult attachment style) and home environment factors (e.g., household income) and parenting stress (Parental Distress subscale of the Parenting Stress Index-4 Short Form). RESULTS The 299 children included 129 (43%) females. Parents were on average 30.6 (SD 6.1) years old and included a diverse racial/ethnic cohort. Mean Parental Distress score was 24.3 (SD 6.8; score range 12-60). Higher Parental Distress scores were associated with greater parental depressive symptoms (B = 5.1 [95% CI: 2.4, 7.7]) and avoidant (B = 2.8 [95% CI: 0.9, 4.6]) attachment style. Other child, parental and home environment factors did not demonstrate statistically significant relationships with parental distress in the final model. CONCLUSION Our findings align with recommendations for paediatric providers to screen for parenting stress and mental health.
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Affiliation(s)
- Amrik Singh Khalsa
- Division of Primary Care Pediatrics, Center for Child Health Equity and Outcomes Research, Nationwide Children’s Hospital 700 Children’s Drive Columbus, OH 43205,Department of Pediatrics, College of Medicine, The Ohio State University 370 W. 9th Ave. Columbus, OH 43210
| | - Zachary A. Weber
- Division of Epidemiology, College of Public Health, The Ohio State University 1841 Neil Ave. Columbus, OH 43210
| | - Bharathi J. Zvara
- Department of Maternal and Child Health, Gillings School of Global Public Health, The University of North Carolina 421C Rosenau Hall, Chapel Hill, NC 27599
| | - Sarah A. Keim
- Department of Pediatrics, College of Medicine, The Ohio State University 370 W. 9th Ave. Columbus, OH 43210,Division of Epidemiology, College of Public Health, The Ohio State University 1841 Neil Ave. Columbus, OH 43210,Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children’s Hospital 700 Children’s Drive Columbus, OH 43205
| | - Rebecca Andridge
- Division of Biostatistics, College of Public Health, The Ohio State University 1841 Neil Ave, Columbus, OH 43210
| | - Sarah E. Anderson
- Division of Epidemiology, College of Public Health, The Ohio State University 1841 Neil Ave. Columbus, OH 43210
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Henström M, Duncanson K, Collins CE, Ashton LM, Davidson E, Ball R. Online reach and engagement of a child nutrition peer-education program (PICNIC): insights from social media and web analytics. BMC Public Health 2022; 22:836. [PMID: 35473610 PMCID: PMC9041288 DOI: 10.1186/s12889-022-13252-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Parents frequently seek parental advice online and on social media; thus, these channels should be better utilized in child health interventions. The Parents in Child Nutrition Informing Community (PICNIC) program aims to facilitate peer-to-peer sharing of evidence-based child feeding information and support parents within their social networks. The present study aimed to explore web and social media analytics to evaluate reach and user engagement with the PICNIC online components. METHODS Online user activity data from the PICNIC Facebook closed group and public Page were collected through Facebook Insights, and program-specific website traffic data through Google Analytics. Analytics data from Nov-2019 to April-2021 was evaluated through visualisation and summary statistics to obtain insights into program growth and current reach in Australia, compare demographics of audience reached through the online channels, and explore parents' use and engagement in PICNIC content. RESULTS Results showed steady program growth in the 18 months of recruitment; participant numbers grew from 102 to 261 peer educators while the Facebook Page audience increased threefold, totalling 1615 followers. Intervention posts shared on Facebook (4-5 posts/week) typically reached only a portion of PICNIC Page followers each week, but also reached a wider audience through their friends. Throughout the evaluated period, Facebook users actively engaged in PICNIC posts, although the level of engagement varied considerably from post to post. Furthermore, results from this study suggest the strategy of directing potentially interested parents from social media to the website for program sign-up was successful. Finally, the explored data gave insights into users' availability, demographics and engagement, which will be used to inform refinement of the PICNIC website and social media strategies. CONCLUSIONS Our findings confirm the benefits of using a peer education approach and existing social network channels to disseminate evidence-based child feeding information to parents. This study also demonstrates the usefulness of web and social media analytics to be used as part of a continuous evaluation for gaining insight to inform further development and improvement of program strategies. TRIAL REGISTRATION The PICNIC project was retrospectively submitted for registration with the Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12622000230752 (09/02/2022).
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Affiliation(s)
- Maria Henström
- Department of Biosciences and Nutrition, Karolinska Institutet, 141 83, Huddinge, Sweden. .,School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia.
| | - Kerith Duncanson
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Clare E Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Lee M Ashton
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, 2308, Australia.,School of Education, College of Human and Social Futures, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Emma Davidson
- Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
| | - Richard Ball
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia.,Mid North Coast Local Health District, Port Macquarie, NSW, 2444, Australia
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Ortegon-Sanchez A, Vaughan L, Christie N, McEachan RRC. Shaping Pathways to Child Health: A Systematic Review of Street-Scale Interventions in City Streets. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5227. [PMID: 35564621 PMCID: PMC9105466 DOI: 10.3390/ijerph19095227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/13/2022] [Accepted: 04/20/2022] [Indexed: 12/01/2022]
Abstract
Street-level built environment factors, for example, walking infrastructure, building density, availability of public transport, and proliferation of fast-food outlets can impact on health by influencing our ability to engage in healthy behaviour. Unhealthy environments are often clustered in deprived areas, thus interventions to improve the built environments may improve health and reduce inequalities. The aim of this review was to identify whether street-level built environment interventions can improve children's health in high income countries. A secondary aim was to describe key built environment elements targeted in interventions and research gaps. A systematic review of published literature was conducted by a multi-disciplinary team. Ten intervention papers were included. Physical activity or play was the only health outcome assessed. Most interventions described temporary changes including closure of streets to traffic (N = 6), which were mainly located in deprived neighbourhoods, or the addition of technology to 'gamify' active travel to school (N = 2). Two studies reported permanent changes to street design. There was limited evidence that closing streets to traffic was associated with increases in activity or play and inconclusive evidence with changes to street design and using technology to gamify active travel. Our ability to draw conclusions was hampered by inadequate study designs. Description of interventions was poor. Rigorous evaluation of built environment interventions remains challenging. We recommend a multi-disciplinary approach to evaluation, explicit reporting of built environment indicators targeted in interventions and offer solutions to others working in this area.
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Affiliation(s)
- Adriana Ortegon-Sanchez
- Centre for Transport Studies, Department of Civil, Environmental and Geomatic Engineering, UCL, London WC1E 6BT, UK;
| | - Laura Vaughan
- Space Syntax Laboratory, The Bartlett School of Architecture, UCL, London WC1E 6BT, UK;
| | - Nicola Christie
- Centre for Transport Studies, Department of Civil, Environmental and Geomatic Engineering, UCL, London WC1E 6BT, UK;
| | - Rosemary R. C. McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford BD9 6RJ, UK
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Mekonnen T, Brantsæter AL, Andersen LF, Lien N, Arah OA, Gebremariam MK, Papadopoulou E. Mediators of differences by parental education in weight-related outcomes in childhood and adolescence in Norway. Sci Rep 2022; 12:5671. [PMID: 35383270 PMCID: PMC8983661 DOI: 10.1038/s41598-022-09987-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 03/31/2022] [Indexed: 11/30/2022] Open
Abstract
Studies exploring mediators of socioeconomic inequalities in excess weight gain in early-life and subsequent overweight/obesity (OW/OB) among youth are limited. Thus, this study examined the mediating role of prenatal and early postnatal factors and child energy balance-related behaviours (EBRB) in the effects of parental education on (i) excess weight gain from birth to 2 years and (ii) OW/OB at 5, 8 and 14 years. The Norwegian Mother, Father and Child Cohort Study was used to include participants at the ages of 2 (n = 59,597), 5 (n = 27,134), 8 (n = 28,285) and 14 (n = 11,278) years. Causal mediation analyses using the inverse odds weighting approach were conducted. Children of low-educated parents had a higher conditional excess weight gain at 2 years compared to children of high-educated parents (total effect, RRTE = 1.06; 95% CI 1.01, 1.10). The joint mediation effects of the prenatal and early postnatal factors explained most of the total effect of low education on conditional excess weight gain at 2 years. Children of low-educated parents had a higher risk of OW/OB at 5, 8 and 14 years compared to children of high-educated parents. The mediators jointly explained 63.7%, 67% and 88.9% of the total effect of parental education on OW/OB among 5, 8 and 14 year-old-children, respectively. Of the total mediated effects at 5, 8 and 14 years, the prenatal and early postnatal mediators explained 59.2%, 61.7% and 73.7%, whereas the child EBRB explained 10.3%, 15.8.0%% and 34.8%. The mediators included were found to have a considerable mediating effect in the associations explored, in particular the prenatal and early postnatal factors. If truly causal, the findings could indicate potential targets for interventions to tackle socioeconomic inequalities in OW/OB from birth to adolescence.
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Affiliation(s)
- Teferi Mekonnen
- Department of Nutrition, Faculty of Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
| | - Anne-Lise Brantsæter
- Division for Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Lene F Andersen
- Department of Nutrition, Faculty of Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Nanna Lien
- Department of Nutrition, Faculty of Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Onyebuchi A Arah
- Department of Epidemiology and Department of Statistics, University of California, Los Angeles (UCLA), Los Angeles, USA
- Research Unit for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Mekdes K Gebremariam
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Eleni Papadopoulou
- Global Health Cluster, Division of Health Service, Norwegian Institute of Public Health, Oslo, Norway
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Chia A, Descarpentrie A, Cheong RN, Toh JY, Natarajan P, Sugianto R, Cai S, Saldanha-Gomes C, Dargent-Molina P, de Lauzon-Guillain B, Plancoulaine S, Lança C, Saw SM, Godfrey KM, Shek LP, Tan KH, Charles MA, Chong YS, Heude B, Eriksson JG, Müller-Riemenschneider F, Lioret S, Chong MFF, Bernard JY. Family-focused contextual factors associated with lifestyle patterns in young children from two mother-offspring cohorts: GUSTO and EDEN. Int J Behav Nutr Phys Act 2022; 19:26. [PMID: 35292047 PMCID: PMC8922741 DOI: 10.1186/s12966-022-01266-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 02/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Integrated patterns of energy balance-related behaviours of preschool children in Asia are sparse, with few comparative analyses. PURPOSE Using cohorts in Singapore (GUSTO) and France (EDEN), we characterized lifestyle patterns of children and investigated their associations with family-focused contextual factors. METHODS Ten behavioural variables related to child's diet, walking, outdoor play and screen time were ascertained by parental questionnaires at age 5-6 years. Using principal component analysis, sex-specific lifestyle patterns were derived independently for 630 GUSTO and 989 EDEN children. Contextual variables were organised into distal (family socio-economics, demographics), intermediate (parental health, lifestyle habits) and proximal (parent-child interaction factors) levels of influence and analysed with hierarchical linear regression. RESULTS Three broadly similar lifestyle patterns were identified in both cohorts: "discretionary consumption and high screen time", "fruit, vegetables, and low screen time" and "high outdoor playtime and walking". The latter two patterns showed small differences between cohorts and sexes. The "discretionary consumption and high screen time" pattern was consistently similar in both cohorts; distal associated factors were lower maternal education (EDEN boys), no younger siblings (GUSTO boys) and Malay/Indian ethnicity (GUSTO), while intermediate and proximal associated factors in both cohorts and sexes were poor maternal diets during pregnancy, parents allowing high child control over food intake, snacking between meals and having television on while eating. CONCLUSIONS Three similar lifestyle patterns were observed among preschool children in Singapore and France. There were more common associated proximal factors than distal ones. Cohort specific family-focused contextual factors likely reflect differences in social and cultural settings. Findings will aid development of strategies to improve child health.
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Affiliation(s)
- Airu Chia
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Alexandra Descarpentrie
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), Inserm, INRAE, F-75004, Paris, France
| | - Rene N Cheong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Jia Ying Toh
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Padmapriya Natarajan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ray Sugianto
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Shirong Cai
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Cécilia Saldanha-Gomes
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), Inserm, INRAE, F-75004, Paris, France
| | - Patricia Dargent-Molina
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), Inserm, INRAE, F-75004, Paris, France
| | - Blandine de Lauzon-Guillain
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), Inserm, INRAE, F-75004, Paris, France
| | - Sabine Plancoulaine
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), Inserm, INRAE, F-75004, Paris, France
| | - Carla Lança
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Seang Mei Saw
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Lynette P Shek
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kok Hian Tan
- Duke-NUS Medical School, Singapore, Singapore
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Marie-Aline Charles
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), Inserm, INRAE, F-75004, Paris, France
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Barbara Heude
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), Inserm, INRAE, F-75004, Paris, France
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Centre, Helsinki, Finland
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Sandrine Lioret
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), Inserm, INRAE, F-75004, Paris, France.
| | - Mary F-F Chong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Jonathan Y Bernard
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), Inserm, INRAE, F-75004, Paris, France
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
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Zheng M, Hesketh KD, McNaughton SA, Salmon J, Crawford D, Cameron AJ, Lioret S, Campbell KJ. Quantifying the overall impact of an early childhood multi-behavioural lifestyle intervention. Pediatr Obes 2022; 17:e12861. [PMID: 34658152 DOI: 10.1111/ijpo.12861] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/10/2021] [Accepted: 10/04/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The overall impact of interventions targeting multiple behaviours remains largely unexplored. OBJECTIVES This study adopted an integrative lifestyle pattern analysis approach to assess the overall effectiveness of an early childhood intervention on change across multiple behaviours. METHODS The Melbourne INFANT program was a 15-month cluster-randomized controlled trial involving 4-month-old infants and their parents at baseline in 2008 (n = 542). The intervention included six education sessions helping parents to promote a healthy diet, physical activity and limit sedentary behaviour in their infants. Participants were followed-up twice post-intervention, at ages 3.6 (2011) and 5 years (2013), to assess sustained effects of the intervention. Previous principal component analyses identified two lifestyle patterns from dietary intake, outdoor time and television viewing time. Random effect linear regression models were conducted to assess the impact of the intervention on lifestyle patterns. RESULTS The intervention group had a lower 'Discretionary consumption and TV' lifestyle pattern score than the control group at all time points with adjusted mean difference: -0.29, 95% CI -0.49, -0.09, p = 0.004 post-intervention at age 1.5 years; -0.29, 95% CI -0.54, -0.04, p = 0.02 at the first follow-up (age 3.6 years); and -0.21, 95% CI -0.43, 0.01, p = 0.06 at the second follow-up (age 5.0 years). No evidence of between-group differences was found for the 'Fruit, vegetables and outdoor' lifestyle pattern score. CONCLUSION This early childhood intervention designed to promote change in more than one obesity-related behaviour was effective in improving correlated unhealthy lifestyle behaviours. Lifestyle pattern analysis is a useful and interpretable approach for evaluating multi-behavioural interventions.
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Affiliation(s)
- Miaobing Zheng
- School of Exercise and Nutrition Sciences, Deakin University, Institute for Physical Activity and Nutrition Research, Geelong, Victoria, Australia
| | - Kylie D Hesketh
- School of Exercise and Nutrition Sciences, Deakin University, Institute for Physical Activity and Nutrition Research, Geelong, Victoria, Australia
| | - Sarah A McNaughton
- School of Exercise and Nutrition Sciences, Deakin University, Institute for Physical Activity and Nutrition Research, Geelong, Victoria, Australia
| | - Jo Salmon
- School of Exercise and Nutrition Sciences, Deakin University, Institute for Physical Activity and Nutrition Research, Geelong, Victoria, Australia
| | - David Crawford
- School of Exercise and Nutrition Sciences, Deakin University, Institute for Physical Activity and Nutrition Research, Geelong, Victoria, Australia
| | - Adrian J Cameron
- Global Obesity Centre (GLOBE), Deakin University, Institute for Health Transformation, Geelong, Victoria, Australia
| | - Sandrine Lioret
- INSERM, INRAE, Université de Paris, Research Center in Epidemiology and Biostatistics (CRESS), Paris, France
| | - Karen J Campbell
- School of Exercise and Nutrition Sciences, Deakin University, Institute for Physical Activity and Nutrition Research, Geelong, Victoria, Australia
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Associations of preschoolers' dietary patterns with eating behaviors and parental feeding practices at a 12-month follow-up of obesity treatment. Appetite 2022; 168:105724. [PMID: 34606942 DOI: 10.1016/j.appet.2021.105724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 09/13/2021] [Accepted: 09/28/2021] [Indexed: 11/20/2022]
Abstract
Although dietary patterns are key to the management of childhood obesity, they are rarely assessed and thus poorly understood. This study examines preschoolers' dietary patterns and correlates 12 months after the start of obesity treatment (n = 99, mean age 5.2 years, 52% girls). A food frequency questionnaire (FFQ), the Child Eating Behavior Questionnaire (CEBQ), Child Feeding Questionnaire (CFQ) and Lifestyle Behavior Checklist (LBC) were answered by parents to assess children's food intake, eating behaviors, parental feeding practices, and obesity-related behaviors, respectively. Principal component analysis identified dietary patterns based on FFQ data. Through multiple linear regressions we examined correlations between a healthy (HD) and a less healthy (LHD) dietary pattern and mean scores of the CEBQ, CFQ, LBC scales as well as BMI z-scores. The reported intake of items in the LHD decreased after treatment while no differences were found for the HD. Children's eating behaviors, in particular food fussiness, showed consistent associations with diet (b = -0.39, 95% CI -0.63, -0.14 for HD and b = 0.41, 95% CI 0.15, 0.66 for LHD). Feeding practices and obesity-related behaviours were weakly associated with the dietary patterns (HD and Monitoring: b = 0.36, 95% CI 0.09, 0.62; LHD and Screen time b = 0.08, 95% CI 0.01, 0.15). Among the measured variables, eating behaviors had the largest impact on children's dietary patterns. The LHD was associated with a higher BMI z-score but no associations were found between changes in LHD intake and changes in BMI z-scores. Our findings suggest that decreasing food fussiness in children with obesity is key to positive dietary changes. Assessment of children's eating behaviors can help tailor dietary advice and provide support for families of children with obesity.
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Lafave LMZ, Webster AD, McConnell C, Van Wyk N, Lafave MR. The Impact of COVID-19 on Eating Environments and Activity in Early Childhood Education and Care in Alberta, Canada: A Cross-Sectional Study. Nutrients 2021; 13:4247. [PMID: 34959799 PMCID: PMC8706784 DOI: 10.3390/nu13124247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 11/23/2021] [Accepted: 11/25/2021] [Indexed: 11/24/2022] Open
Abstract
Early childhood education and care (ECEC) environments influence children's early development and habits that track across a lifespan. The purpose of this study was to explore the impact of COVID-19 government-mandated guidelines on physical activity (PA) and eating environments in ECEC settings. This cross-sectional study involved the recruitment of 19 ECEC centers pre-COVID (2019) and 15 ECEC centers during COVID (2020) in Alberta, Canada (n = 34 ECEC centers; n = 83 educators; n = 361 preschoolers). Educators completed the CHEERS (Creating Healthy Eating and activity Environments Survey) and MEQ (Mindful Eating Questionnaire) self-audit tools while GT3X+ ActiGraph accelerometers measured preschooler PA. The CHEERS healthy eating environment subscale was greater during COVID-19 (5.97 ± 0.52; 5.80 ± 0.62; p = 0.02) and the overall score positively correlated with the MEQ score (r = 0.20; p = 0.002). Preschoolers exhibited greater hourly step counts (800 ± 189; 649 ± 185), moderate-to-vigorous PA (MVPA) (9.3 ± 3.0 min/h; 7.9 ± 3.2 min/h) and lower sedentary times (42.4 ± 3.9 min/h; 44.1 ± 4.9 min/h) during COVID-19 compared to pre-COVID, respectively (p < 0.05). These findings suggest the eating environment and indices of child physical activity were better in 2020, which could possibly be attributed to a change in government-mandated COVID-19 guideline policy.
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Affiliation(s)
- Lynne M. Z. Lafave
- Department of Health and Physical Education, Mount Royal University, Calgary, AB T3E 6K6, Canada; (A.D.W.); (C.M.); (N.V.W.); (M.R.L.)
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Al-Alawy K, Gaafar R, Moonesar IA, Muhsineh S. The nexus of Sugar-Sweetened Beverages: Insights on demographics, enablers and barriers. PUBLIC HEALTH IN PRACTICE 2021; 2:100189. [PMID: 36101613 PMCID: PMC9461627 DOI: 10.1016/j.puhip.2021.100189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/31/2021] [Accepted: 09/06/2021] [Indexed: 11/29/2022] Open
Abstract
Objectives The study objectives were to a) explore the association between household income and nationality and Sugar-Sweetened Beverage (SSB) enablers and barriers, and b) inform public health policy and health promotion. Study design A Cross-sectional Study in the UAE. Methods Nationally representative population survey was used to capture demographic and SSB behaviour data. Results We recruited 7500 participants into the study and received 1290 responses (17.2% participation rate). We report statistically significant associations between household income, nationality, and enablers and barriers. In some instances, similar enablers and barriers were reported by household income and nationality. Conclusions There are several associations between household income, nationality and SSB enablers, and barriers. These associations should be considered for future public health policy and health promotion decision-making to reduce SSB consumption. In addition, further research is needed to explore how other demographic factors (modifying variables) are associated with SSB enablers and barriers. They are statistically significant associations between household income, nationality and SSB enablers, and barriers; For SSB enablers, participants agreed that SSB is readily available when they go out, and the label and packaging does not suggest SSB is harmful to health. Participants had neutral viewpoints on SSB affordability and availability at home, ease of access through mobile platforms and lack of healthier alternatives suggesting more work is needed to sway participants to disagree or strongly disagree on these aspects; For SSB barriers, participants agreed that they worry about their health if they drink SSB, know about SSB that prevents them from drinking SSB, and were happy with the sugar-free alternatives. There were several areas where participants expressed a neutral viewpoint, e.g. there are no good deals/promotions to buy SSB, SSB is not available when they go out, they do not like the taste of SSB, SSB makes them sick, the label and packaging of SSB tells them it is harmful to their health, and they always have cheaper or free alternatives suggesting more work needed to sway participants to agree or strongly agre; and Household income and nationality can influence SSB enablers and barriers in different ways, and in some instances, presents a nexus.
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Family Socioecological Correlates of Lifestyle Patterns in Early Childhood: A Cross-Sectional Study from the EDEN Mother-Child Cohort. Nutrients 2021; 13:nu13113803. [PMID: 34836060 PMCID: PMC8623755 DOI: 10.3390/nu13113803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/24/2021] [Accepted: 10/25/2021] [Indexed: 11/19/2022] Open
Abstract
Energy balance-related behaviors (EBRBs), i.e., diet, sedentary behavior, physical activity, and sleep, combine into lifestyle patterns, which we aim to identify in French preschoolers and analyze their family correlates within the framework of a comprehensive socioecological model. Parental questionnaires provided information about family characteristics and children’s EBRBs for 978 5-year-olds of the EDEN cohort. We used principal component analysis to derive lifestyle patterns from EBRBs and hierarchical multivariable linear regressions to assess their associations with family socio-demographics, parent health/behaviors, and parent-child interactions. Analyses were stratified by sex. Of the three lifestyle patterns identified (unhealthy, healthy, and mixed), the mixed pattern differed the most between sexes. Lower parental education, suboptimal maternal diet, TV during meals, and later bedtime were associated with higher adherence to unhealthy patterns. Children cognitively stimulated at home and boys of mothers not employed adhered more to the healthy pattern. Older siblings (for girls) and higher engagement of parents in leisure-time physical activity (for boys) were related to greater adherence to mixed patterns. The identification of various correlates from multiple socioecological levels suggests that tackling the potentially synergistic effect of lifestyle patterns on health requires addressing processes relevant to the parent-child dimension and structural barriers parents may encounter.
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How to Support Child Healthcare Nurses in Sweden to Promote Healthy Lifestyle Behaviors from the Start of Life. CHILDREN-BASEL 2021; 8:children8080696. [PMID: 34438588 PMCID: PMC8392879 DOI: 10.3390/children8080696] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/07/2021] [Accepted: 08/09/2021] [Indexed: 11/24/2022]
Abstract
Child healthcare (CHC) nurses have a key role in promoting and supporting healthy lifestyle behaviors from a young age. Thus, this study aims to investigate the perspectives of CHC nurses regarding discussing food introduction, physical activity/active play, and screen time with parents; explore facilitators and barriers influencing the discussion of healthy lifestyle behaviors with parents; and explore the perspectives of CHC nurses regarding a complementary program to promote healthy lifestyle behaviors from the start of life. A total of fifteen nurses participated in semi-structured interviews, which were recorded, transcribed verbatim, and analyzed using thematic analysis. There were four themes that were generated: parental needs; facilitators and barriers; parental groups; and future working methods. This study found that CHC nurses have seen an increase in the need for support among today’s parents. Time, the need to tailor information, and confidence to address sensitive topics were perceived as the largest barriers during daily work for the nurses. Furthermore, large variations in parental groups were found. Finally, the CHC nurses displayed a willingness and openness to change and develop current working methods using digital solutions. These solutions could possibly ease the workload and at the same time, support parents to create healthy lifestyle behaviors from the start of their child’s life.
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Byrne R, Terranova CO, Trost SG. Measurement of screen time among young children aged 0-6 years: A systematic review. Obes Rev 2021; 22:e13260. [PMID: 33960616 PMCID: PMC8365769 DOI: 10.1111/obr.13260] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/24/2021] [Accepted: 03/30/2021] [Indexed: 12/16/2022]
Abstract
The impact of screen-based devices on children's health and development cannot be properly understood without valid and reliable tools that measure screen time within the evolving digital landscape. This review aimed to summarize characteristics of measurement tools used to assess screen time in young children; evaluate reporting of psychometric properties; and examine time trends related to measurement and reporting of screen time. A systematic review of articles published in English across three databases from January 2009 to April 2020 was undertaken using PROSPERO protocol (registration: CRD42019132599) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included articles measured screen time as outcome, exposure, or confounder in children 0-6 years. The search identified 35,868 records, 1035 full-text articles were screened for eligibility, and 622 met inclusion criteria. Most measures (60%) consisted of one to three items and assessed duration of screen time on a usual day. Few measures assessed content (11%) or coviewing (7%). Only 40% of articles provided a citation for the measure, and only 69 (11%) reported psychometric properties-reliability n = 58, validity n = 19, reliability and validity n = 8. Between 2009 and 2019, the number of published articles increased from 28 to 71. From 2015, there was a notable increase in the proportion of articles published each year that assessed exposure to mobile devices in addition to television. The increasing number of published articles reflects increasing interest in screen time exposure among young children. Measures of screen time have generally evolved to reflect children's contemporary digital landscape; however, the psychometric properties of measurement tools are rarely reported. There is a need for improved measures and reporting to capture the complexity of children's screen time exposures.
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Affiliation(s)
- Rebecca Byrne
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
| | - Caroline O. Terranova
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
| | - Stewart G. Trost
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
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