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Bodepudi S, Hinds M, Northam K, Reilly-Harrington NA, Stanford FC. Barriers to Care for Pediatric Patients with Obesity. Life (Basel) 2024; 14:884. [PMID: 39063637 PMCID: PMC11277597 DOI: 10.3390/life14070884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 06/21/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
This review article emphasizes the challenges pediatric patients face during obesity treatment. Prior research has been compartmentalized, acknowledging that stigma, the ability to implement lifestyle changes, social health determinants, and healthcare accessibility are considerable impediments for obese children. These issues emerge at various levels, including the individual or family, the community and school, and even national policy. This suggests the need for a more comprehensive, team-based approach to tackle pediatric obesity. Understanding these barriers is the first step toward creating effective strategies and solutions to overcome these challenges.
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Affiliation(s)
- Sreevidya Bodepudi
- MGH Weight Center, Massachusetts General Hospital, Boston, MA 02114, USA; (K.N.); (N.A.R.-H.)
- Harvard Medical School, Boston, MA 02115, USA
| | | | - Kayla Northam
- MGH Weight Center, Massachusetts General Hospital, Boston, MA 02114, USA; (K.N.); (N.A.R.-H.)
| | - Noreen A. Reilly-Harrington
- MGH Weight Center, Massachusetts General Hospital, Boston, MA 02114, USA; (K.N.); (N.A.R.-H.)
- Harvard Medical School, Boston, MA 02115, USA
| | - Fatima Cody Stanford
- Harvard Medical School, Boston, MA 02115, USA
- MGH Weight Center, Massachusetts General Hospital, Department of Medicine-Division of Endocrinology-Neuroendocrine, Department of Pediatrics-Division of Endocrinology, Nutrition Obesity Research Center at Harvard (NORCH), Boston, MA 02114, USA
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Goel A, Reddy S, Goel P. Causes, Consequences, and Preventive Strategies for Childhood Obesity: A Narrative Review. Cureus 2024; 16:e64985. [PMID: 39161504 PMCID: PMC11332093 DOI: 10.7759/cureus.64985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2024] [Indexed: 08/21/2024] Open
Abstract
Childhood obesity is a complex public health challenge with profound implications for both physical and psychological well-being. A significant portion of the global population struggles with obesity. Sedentary lifestyles, increased consumption of ultra-processed foods, and socioeconomic disparities are major contributors. The COVID-19 pandemic has further exacerbated these issues, leading to a surge in obesity rates among children. The consequences of childhood obesity extend beyond immediate health issues like type 2 diabetes and cardiovascular diseases; obese children are at higher risk for psychological problems such as depression, anxiety, and low self-esteem, which can persist into adulthood. These health challenges also impose substantial economic burdens due to increased healthcare costs and reduced productivity. This paper synthesizes findings from various articles to provide an overview of the causes, consequences, and preventive strategies related to childhood obesity. It highlights the varied nature of obesity, including genetic, environmental, and lifestyle factors, and discusses the profound impact on physical health, socioemotional skills, and mental health. Additionally, it examines the global challenge of childhood obesity, particularly in developing nations, and emphasizes the importance of preventive measures, family and parental behaviors, and effective policy interventions.
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Affiliation(s)
- Ashish Goel
- Department of Cardiology, Fayth Clinic, Mumbai, IND
| | - Spoorti Reddy
- Department of General Medicine, Jan Sewa Hospital, Tantia University, Sri Ganganagar, IND
| | - Paula Goel
- Department of Pediatrics, Fayth Clinic, Mumbai, IND
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Thorén A, Filipsson T, Englund E, Sandström O, Janson A, Silfverdal SA. Significant effects of childhood obesity treatment with a web-based component in a randomised controlled study (Web-COP). Acta Paediatr 2024; 113:276-285. [PMID: 37837210 DOI: 10.1111/apa.17000] [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: 05/16/2022] [Revised: 09/29/2023] [Accepted: 10/04/2023] [Indexed: 10/15/2023]
Abstract
AIM We evaluated the effect on body mass index standard deviation score (BMI-SDS) of a combined treatment (Web-COP) for children with obesity, including a web-based component targeting their parents. METHODS This randomised controlled trial recruited children 5-12 years of age with obesity (International Obesity Task Force BMI [IOTF-BMI] ≥30 kg/m2 ) from school health care and outpatient paediatric clinics in in Northern Sweden from 1 June 2019 to 21 June 2020. The children were randomised to Web-COP, an intervention with group sessions and a 12-week web-based component, or standard care. The primary outcome was the change in IOTF BMI-SDS after 6 months. RESULTS In total, 75 children (33 girls), mean age 9.5 years, were randomised, and 65/75 (87%) children and their parents completed the study, 35/39 (90%) in the Web-COP intervention and 30/36 (83%) in the standard care group. BMI-SDS at 6 months was changed from 3.08 to 2.81 in the intervention group compared to an increase from 3.07 to 3.16 in the standard care group, representing a significant difference between groups (p < 0.001). In the intervention group, 14/30 (47%) reduced their BMI-SDS ≥0.25, compared to none in the standard care group. CONCLUSION The parent-focused intervention significantly improved BMI-SDS in children with obesity as compared to children in standard care.
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Affiliation(s)
- Annelie Thorén
- Department of Clinical Sciences, Paediatrics, Umeå University, Umeå, Sweden
- Department of Paediatrics, Sollefteå hospital, Sollefteå, Sweden
| | - Tobias Filipsson
- Department of Paediatrics, Örnsköldsvik hospital, Örnsköldsvik, Sweden
| | - Erling Englund
- Department of Research and Development, Västernorrland County Council, Sundsvall, Sweden
| | - Olof Sandström
- Department of Clinical Sciences, Paediatrics, Umeå University, Umeå, Sweden
| | - Annika Janson
- National Childhood Obesity Centre, Karolinska University Hospital, Stockholm, Sweden
- Department of Women's and Children's Health, Division of Paediatric Endocrinology, Karolinska Institutet, Stockholm, Sweden
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Umekar S, Joshi A. Obesity and Preventive Intervention Among Children: A Narrative Review. Cureus 2024; 16:e54520. [PMID: 38516445 PMCID: PMC10955407 DOI: 10.7759/cureus.54520] [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: 02/08/2024] [Accepted: 02/20/2024] [Indexed: 03/23/2024] Open
Abstract
Childhood obesity has become a major public health concern around the world, with a rise in prevalence over the last few decades. This abstract provides an overview of pediatric obesity, including its causes, implications, and potential treatments. Childhood obesity is caused by a complex combination of environmental, genetic, and behavioral variables. A child's likelihood of developing obesity is influenced by factors, such as socioeconomic status, family dynamics, and cultural norms. Childhood obesity leads to extensive repercussions, elevating the risk of chronic conditions, such as diabetes, cardiovascular diseases, and mental health challenges. Furthermore, children dealing with obesity often face social stigmatization, diminished self-esteem, and academic struggles. Efforts to prevent and manage childhood obesity should employ a comprehensive and multi-tiered approach. This involves enacting policies geared toward enhancing nutrition in schools and communities, advocating for increased physical activity (PA), and curbing sedentary behaviors.
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Affiliation(s)
- Sayali Umekar
- School of Epidermology and Public Health, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Abhishek Joshi
- Community Medicine, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Bozkurt O, Kocaadam-Bozkurt B, Koçyiğit E. Evaluation of the Relationships Among Mindful Eating, Environmental Beliefs, Adherence to the Mediterranean Diet, and Obesity in Children. Turk Arch Pediatr 2024; 59:98-105. [PMID: 38454267 PMCID: PMC10837568 DOI: 10.5152/turkarchpediatr.2024.23173] [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: 08/09/2023] [Accepted: 10/21/2023] [Indexed: 03/09/2024]
Abstract
OBJECTIVE This study aimed to evaluate the relationship between adherence to the Mediterranean diet (MD), mindful eating, environmental beliefs, and obesity in children. MATERIALS AND METHODS The study included 318 children (50.6% male, 49.4% female, 10.0 ± 0.73 years old). Data were obtained using survey and a face-to-face interview method. The questionnaire includes general information, anthropometric measurements, the New Ecological Paradigm Scale for Children (NEP), the Mediterranean Diet Quality Index for children and adolescents (KIDMED), and the Mindful Eating Questionnaire for Children. RESULTS According to the KIDMED classification, 52.5% of the children were in the group that needs improvement, 35.2% were in the low diet quality group, and 12.3% were in the optimal MD group. The Mindless score was higher in overweight/obese children compared to the normal body mass index (BMI) group (P < .05). Awareness, NEP, and KIDMED scores were the lowest in overweight/obese children (P < .05). In regression analysis, the father's age, KIDMED, and Awareness scores related to NEP scores positively (R2 : 0.545, P < .001). Also, children's body mass index-related KIDMED scores negatively, and awareness and NEP scores related KIDMED scores positively (R2 : 0.276, P < .001). CONCLUSION Our results show that higher adherence to the MD is associated with higher environmental beliefs. Children with higher mindful eating have higher environmental beliefs and adherence to the MD, and these scores are lower in obese children. Therefore, raising generations that adopt sustainable diet models and have high environmental awareness is necessary. This research provides significant findings for future clinical studies on children's body weight maintenance and sustainability. Cite this article as: Bozkurt O, Kocaadam-Bozkurt B, Koçyiğit E. Evaluation of the relationships among mindful eating, environmental beliefs, adherence to the mediterranean diet, and obesity in children. Turk Arch Pediatr. 2024;59(1):98-105.
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Affiliation(s)
- Osman Bozkurt
- Department of Nutrition and Dietetics, Erzurum Technical University Faculty of Health Sciences, Erzurum, Turkey
| | - Betül Kocaadam-Bozkurt
- Department of Nutrition and Dietetics, Erzurum Technical University Faculty of Health Sciences, Erzurum, Turkey
| | - Emine Koçyiğit
- Department of Nutrition and Dietetics, Ordu University Faculty of Health Sciences, Ordu, Turkey
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Desmet M, Fillon A, Thivel D, Tanghe A, Braet C. Attrition rate and predictors of a monitoring mHealth application in adolescents with obesity. Pediatr Obes 2023; 18:e13071. [PMID: 37680003 DOI: 10.1111/ijpo.13071] [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: 12/08/2022] [Revised: 06/14/2023] [Accepted: 07/10/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Integrating mobile health (mHealth) into paediatric obesity treatment can provide opportunities for more personalized and lifetime treatment. However, high attrition rates pose a significant challenge. The current study attempts to better understand attrition by exploring (1) attrition rates of a monitoring mHealth application for usage over 14 days and (2) testing predictors of attrition in adolescents with obesity. METHODS Participants were 69 adolescents between 12 and 16 years old who engaged in a multidisciplinary obesity treatment centre (either outpatient or inpatient) in two countries (Belgium and France). To assess the attrition rates, frequency distributions were used. To test the predictors of attrition, zero-inflated negative binomial regression was performed. RESULTS Attrition rates were high, in the outpatient group, more than half of the participants (53.3%) used the app for only 0-7 days. In the inpatient group, this percentage was 24.1%. Only deficits in initiating (a component of executive functions) were a negative predictor of attrition, indicating that deficits in initiating lead to lower attrition rates. CONCLUSIONS This study provides evidence for high attrition rates in mHealth interventions for adolescents with obesity and was the first to investigate psychological predictors of attrition to an mHealth monitoring tool in adolescents with obesity in treatment. Findings regarding predictors of attrition should be approached with caution due to the small sample size.
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Affiliation(s)
- Maurane Desmet
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Alicia Fillon
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), EA 3533, Clermont Auvergne University, Clermont-Ferrand, France
- National Observatory for Physical Activity and Sedentary behaviors (ONAPS), Clermont-Ferrand, France
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), EA 3533, Clermont Auvergne University, Clermont-Ferrand, France
- National Observatory for Physical Activity and Sedentary behaviors (ONAPS), Clermont-Ferrand, France
| | | | - Caroline Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
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Zandvakili I, Pulaski M, Pickett-Blakely O. A phenotypic approach to obesity treatment. Nutr Clin Pract 2023; 38:959-975. [PMID: 37277855 DOI: 10.1002/ncp.11013] [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: 11/30/2022] [Revised: 03/23/2023] [Accepted: 04/16/2023] [Indexed: 06/07/2023] Open
Abstract
Obesity is a chronic disease that increases morbidity and mortality and adversely affects quality of life. The rapid rise of obesity has outpaced the development and deployment of effective therapeutic interventions, thereby creating a global health crisis. The presentation, complications, and response to obesity treatments vary, yet lifestyle modification, which is the foundational therapeutic intervention for obesity, is often "one size fits all." The concept of personalized medicine uses genetic and phenotypic information as a guide for disease prevention, diagnosis, and treatment and has been successfully applied in diseases such as cancer, but not in obesity. As we gain insight into the pathophysiologic mechanisms of obesity and its phenotypic expression, specific pathways can be targeted to yield a greater, more sustained therapeutic impact in an individual patient with obesity. A phenotype-based pharmacologic treatment approach utilizing objective measures to classify patients into predominant obesity mechanism groups resulted in greater weight loss (compared with a non-phenotype-based approach) in a recent study by Acosta and colleagues. In this review, we discuss the application of lifestyle modifications, behavior therapy and pharmacotherapy using the obesity phenotype-based approach as a framework.
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Affiliation(s)
- Inuk Zandvakili
- Division of Digestive Diseases, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Division of Gastroenterology and Hepatology, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Marya Pulaski
- Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Octavia Pickett-Blakely
- Division of Gastroenterology and Hepatology, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Zeldman J, Salloum RG, Mobley AR. Implementing Successful Early Childhood Obesity Prevention Interventions: The Need for Family-Based Effectiveness-Implementation Hybrid Studies. J Acad Nutr Diet 2023; 123:1409-1416. [PMID: 37247755 DOI: 10.1016/j.jand.2023.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/19/2023] [Accepted: 05/24/2023] [Indexed: 05/31/2023]
Affiliation(s)
- Jamie Zeldman
- Department of Health Education and Behavior, University of Florida, Gainesville, Florida
| | - Ramzi G Salloum
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida
| | - Amy R Mobley
- Department of Health Education and Behavior, University of Florida, Gainesville, Florida.
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Son D, Lee M. Gene regulation of RMR-related DNAJC6 on adipogenesis and mitochondria function in 3T3-L1 preadipocytes. Biochem Biophys Res Commun 2023; 672:1-9. [PMID: 37331165 DOI: 10.1016/j.bbrc.2023.06.037] [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: 05/26/2023] [Revised: 06/06/2023] [Accepted: 06/11/2023] [Indexed: 06/20/2023]
Abstract
In the pilot GWAS of children obesity, DNAJC6 gene was found as a regulator for resting metabolic rate (RMR) and obesity in children aged 8-9 years. To investigate whether DNAJC6 gene regulated obesity and energy metabolism, the physiological mechanisms during adipogenesis of 3T3-L1 preadipocytes were confirmed after DNAJC6 gene was overexpressed or inhibited. Overexpressing DNAJC6 gene maintained a 3T3-L1 preadipocyte status during cell differentiation (MTT, ORO, DAPI/BODIPY). It suppressed adipogenesis and adipokine production (leptin, adiponectin), insulin signaling with IRS-GLUT4 system (RT-PCR, Western blotting), and mitochondrial function (Mito Stress Test). DNAJC6 overexpressed cells inhibited mTOR expression, but maintained LC3 expression at a high level, indicating that autophagy occurred and energy was obtained. However, when DNAJC6 gene was inhibited, fat synthesis factor was highly expressed during differentiation (PPARr, C/EBPa, aP2, etc) and the intracellular stress level increased accordingly, which affected the reduction of reserve respiratory capacity during mitochondrial respiration. Our study confirmed gene regulation of DNAJC6, overexpression or inhibition, affects adipogenesis with energy metabolism and mitochondrial functions. This basic data can be used for clinic obesity studies to control an energy imbalance.
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Affiliation(s)
- Dajeong Son
- Department of Food & Nutrition, Sungshin Women's University, Seoul, 01133, Republic of Korea; Research Institute of Obesity Science, Sungshin Women's University, Seoul, 01133, Republic of Korea
| | - Myougsook Lee
- Department of Food & Nutrition, Sungshin Women's University, Seoul, 01133, Republic of Korea; Research Institute of Obesity Science, Sungshin Women's University, Seoul, 01133, Republic of Korea.
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Wirnitzer KC, Motevalli M, Cocca A, Tanous DR, Wirnitzer G, Wagner KH, Schätzer M, Drenowatz C, Ruedl G, Kirschner W. Health behavior of Austrian tertiary students focusing on diet type linked to sports and exercise-first glimpse of results from the "sustainably healthy-from science 2 high school and university" study. Front Public Health 2023; 11:1129004. [PMID: 37533531 PMCID: PMC10392833 DOI: 10.3389/fpubh.2023.1129004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 06/13/2023] [Indexed: 08/04/2023] Open
Abstract
Background There is a strong association between lifestyle behavior and health status. While young adulthood is a critical period for adopting and stabilizing lifelong healthy behavior, university life is independently associated with psychological stressors that may further affect health and well-being. Objective The present multidisciplinary study aimed to examine the health behavior of Austrian college and university students, differentiated based on diet types (vegan, vegetarian, and omnivorous) and physical activity (PA) habits. Methods Following a cross-sectional study design, a total number of 6,148 students (65.3% females; 66.1% bachelor students, 67.0% from urban areas; mean age: 24.8 years) from 52 Austrian college/universities participated in an online survey and provided data on sociodemographic characteristics, dietary patterns, PA habits, and other lifestyle behavior characteristics, including alcohol intake and smoking. Results Across the total sample, 74.0% had a normal weight (BMI = 18.5-25.0 kg/m2), while the prevalence of overweight/obesity (BMI ≥ 30.0 kg/m2) was lower in females than males and more in rural than urban students (p < 0.01). The general prevalence of vegetarian and vegan diets was 22.8 and 6.0%, respectively, with a predominance of females, graduates, and urban students compared to their peers (p < 0.01). The majority of students (79.3%) had a regular engagement in sport/exercise, with a predominance of vegetarian or vegan students compared to omnivores (p < 0.01). Vegans and vegetarians had a lower alcohol intake (p < 0.01) but no differences in smoking habits (p > 0.05) compared to omnivores. Students engaging in sport/exercise had a lower smoking rate and higher intake of fruits, vegetables, and fluids compared to inactive students (p < 0.01). Conclusion The present findings suggest that diet type and PA habits of college/university students have an impact on other health behaviors, highlighting the interconnected nature of lifestyle habits and health behavior.
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Affiliation(s)
- Katharina C. Wirnitzer
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
- Research Center Medical Humanities, University of Innsbruck, Innsbruck, Austria
| | - Mohamad Motevalli
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Armando Cocca
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Derrick R. Tanous
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | | | - Karl-Heinz Wagner
- Department of Nutritional Sciences and Research Platform Active Ageing, University of Vienna, Vienna, Austria
| | - Manuel Schätzer
- Special Institute for Preventive Cardiology and Nutrition (SIPCAN), Elsbethen, Austria
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Teacher Education Upper Austria, Linz, Austria
| | - Gerhard Ruedl
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Werner Kirschner
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
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Wirnitzer KC, Motevalli M, Tanous DR, Wirnitzer G, Wagner KH, Schätzer M, Drenowatz C, Cocca A, Ruedl G, Kirschner W. A glimpse of academic staff health behavior on diet type and physical activity at Austrian universities: first findings from the "Sustainably Healthy - From Science 2 Highschool & University" study. Front Public Health 2023; 11:1194602. [PMID: 37483946 PMCID: PMC10359429 DOI: 10.3389/fpubh.2023.1194602] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/24/2023] [Indexed: 07/25/2023] Open
Abstract
Background The association between lifestyle and health status highlights the importance of assessing health-related behavior in different populations. This multidisciplinary study aimed to examine the health behavior of academic staff of Austrian colleges and universities, with a specific focus on diet types (vegan, vegetarian, omnivorous) and physical activity (PA) reports. Methods Following a cross-sectional study design incorporating an online survey, a sample of 1,041 academics from 52 institutes (mean age: 46.4 years) provided data on sociodemographic characteristics, dietary patterns, PA behavior, and other lifestyle behaviors (smoking, alcohol intake, etc.). Results The prevalence of vegetarian and vegan diets was 13.2 and 2.0%, respectively, and 33.2% of participants had excess body weight (BMI ≥ 25). The majority of participants (88.5%) reported regularly engaging in leisure-time PA, but 18.6% were active members of sports clubs. No difference between females and males was observed in diet type and the type of sport participation (p > 0.05). Participants with a mixed diet had a higher BMI than vegetarians and vegans (p < 0.05). Leisure-time PA participation was associated with more frequent fruit and vegetable intake (p < 0.05). The prevalence of smoking and alcohol intake was 13.1 and 73.5%, respectively, without any difference between dietary or sports participation subgroups (p > 0.05). Conclusion The present study provides an overview of the social trends in vegan and vegetarian diets linked to health behaviors in tertiary educational settings. Findings can be used by health scientists, decision-makers, and multipliers in health and education to improve public health.
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Affiliation(s)
- Katharina C. Wirnitzer
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
- Research Center Medical Humanities, University of Innsbruck, Innsbruck, Austria
| | - Mohamad Motevalli
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Derrick R. Tanous
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | | | - Karl-Heinz Wagner
- Department of Nutritional Sciences and Research Platform Active Ageing, University of Vienna, Vienna, Austria
| | - Manuel Schätzer
- Special Institute for Preventive Cardiology and Nutrition – SIPCAN, Elsbethen, Austria
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Teacher Education Upper Austria, Linz, Austria
| | - Armando Cocca
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Gerhard Ruedl
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Werner Kirschner
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
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Arshad A, Shaheen F, Safdar W, Tariq MR, Navid MT, Qazi AS, Awan MA, Sajid MW, Garti HK. A PRECEDE-PROCEED model-based educational intervention to promote healthy eating habits in middle school girls. Food Sci Nutr 2023; 11:1318-1327. [PMID: 36911841 PMCID: PMC10002990 DOI: 10.1002/fsn3.3167] [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: 01/08/2022] [Revised: 11/13/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022] Open
Abstract
The present study was designed to develop Nutrition Education Program (NEP) based on PRECEDE-PROCEED model (PPM) to address healthy eating behavior among middle school girls aged between 4 and 12 years. For this, middle school girls from grade 1 to 8 (n = 900) were consulted for their eating behaviors, followed by the analysis of their health problems. From 15 different schools of three large cities (Faisalabad, Lahore, and Rawalpindi) of Pakistan, students were divided into two groups: control group (n = 30) and intervention group (n = 30) from each school. The data were collected through interview-based questionnaires according to the phases of PRECEDE Model and evaluated based on PROCEED model. Implementation of NEP was carried out through lectures. Lessons were prepared to enhance student's awareness about nutritious food and healthy lifestyle through educational pamphlets and influenced their attitude towards selection of food choices from My-Plate. Results showed that NEP was quite successful for long-term results. A significant increase in total caloric intake was observed after 8 weeks of NEP intervention (1694 ± 217 Kcal) as compared to before intervention (1329 ± 318 Kcal). Similarly, carbohydrate, protein, and fat content was also increased in daily diet. Conclusively, NEP based on PPM has great impact on healthy lifestyle of middle school girls. Significant difference was observed in score of health variables before and after NEP intervention.
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Affiliation(s)
- Asma Arshad
- Quaid-e-Azam Medical College Bahawalpur Pakistan
| | | | - Waseem Safdar
- Department of Biological Sciences National University of Medical Sciences, The Mall Rawalpindi Pakistan
| | - Muhammad R Tariq
- Department of Food Sciences, Faculty of Agricultural Sciences University of the Punjab Lahore Pakistan
| | - Muhammad T Navid
- Department of Biological Sciences National University of Medical Sciences, The Mall Rawalpindi Pakistan
| | - Asma S Qazi
- Department of Biological Sciences National University of Medical Sciences, The Mall Rawalpindi Pakistan
| | | | - Muhammad W Sajid
- Department of Biosciences, Faculty of Sciences COMSATS University Islamabad-Sahiwal Campus Sahiwal Pakistan
| | - Humphrey K Garti
- Department of Nutritional Sciences School of Allied Health Sciences, University for Development Studies Ghana Tamale Ghana
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Wirnitzer KC, Motevalli M, Tanous DR, Wirnitzer G, Wagner KH, Cocca A, Schätzer M, Kirschner W, Drenowatz C, Ruedl G. Study Protocol of "Sustainably Healthy-From Science 2 Highschool & University"-Prevalence of Mixed, Vegetarian, and Vegan Diets Linked to Sports & Exercise among Austrian Tertiary Students and Lecturers/Academic Staff. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15313. [PMID: 36430039 PMCID: PMC9690980 DOI: 10.3390/ijerph192215313] [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: 10/21/2022] [Revised: 11/14/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
Healthy lifestyle is the major indicator of individual and public health especially in target populations (e.g., during emerging adulthood). Evidence indicates that unhealthy lifestyle behaviors are strongly associated with the increasing prevalence of chronic diseases. The dual approach of sustainable health (i.e., physical exercise tied to a healthy diet) is an effective lifestyle strategy to control and manage health-related disorders, including overweight/obesity. Based on the evidence on plant-based diets regarding health and considering the growing prevalence of vegans and vegetarians worldwide, limited data exist on the health-related behaviors of those who follow plant-based vs. mixed diets in young adulthood. This multidisciplinary study is the first to examine the association between diet type (mixed, vegetarian, and vegan diets) and various health-related behaviors (primarily physical activity, sport, & exercise) among college/university students and lecturers/academic staff in Austria nationwide. Following a cross-sectional study design and using online questionnaires, 4510 tertiary students and 1043 lecturers/academic staff provided data on sociodemographic characteristics, dietary patterns, physical exercise habits, and other lifestyle behaviors (sleep, alcohol intake, smoking, etc.) along with information on health status and quality of life. While the data will be analyzed based on differentiated sociodemographic and health-related categories, the influence of the COVID-19 pandemic on lifestyle behaviors will also be evaluated. As a study protocol, this article represents comprehensive details of the design, purposes, and associated analytical measures of the present study within the tertiary educational context.
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Affiliation(s)
- Katharina C. Wirnitzer
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, 6010 Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
- Research Center Medical Humanities, Leopold-Franzens University of Innsbruck, 6020 Innsbruck, Austria
| | - Mohamad Motevalli
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, 6010 Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
| | - Derrick R. Tanous
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, 6010 Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
| | | | - Karl-Heinz Wagner
- Department of Nutritional Sciences and Research Platform Active Ageing, University of Vienna, 1090 Vienna, Austria
| | - Armando Cocca
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
| | - Manuel Schätzer
- Special Institute for Preventive Cardiology and Nutrition—SIPCAN, 5061 Elsbethen, Austria
| | - Werner Kirschner
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Teacher Education Upper Austria, 4020 Linz, Austria
| | - Gerhard Ruedl
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
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14
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Wirnitzer KC, Tanous DR, Motevalli M, Göbel G, Wirnitzer G, Drenowatz C, Ruedl G, Cocca A, Kirschner W. Study protocol of "From Science 2 School"-prevalence of sports and physical exercise linked to omnivorous, vegetarian and vegan, diets among Austrian secondary schools. Front Sports Act Living 2022; 4:967915. [PMID: 36249320 PMCID: PMC9554638 DOI: 10.3389/fspor.2022.967915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
The increasing prevalence of unhealthy lifestyle choices contribute to almost all chronic conditions negatively affecting individual and public health. As the most beneficial preventative solution, a healthy lifestyle focusing on the dual approach of physical activity (PA) and a healthful diet is highly recommended. Considering the growing number of people interested in sustainable, plant-based diets, it seems crucial to analyze lifestyle behaviors with a special focus on diet type to delve deeper into the unenthusiastic health status among young populations. Therefore, this multidisciplinary study aims to survey and scale health behaviors with a special focus on the prevalence of traditional and vegetarian diets in connection with PA levels among Austrian pupils (10-19 years), teachers and principals in secondary education levels I and II. Following a cross-sectional design, sociodemographic and school-related data along with a complete profile of lifestyle behaviors, including detailed information regarding diet, PA, sports & exercise, and other health-related behaviors, were collected using online-based questionnaires. A total number of 8,845 children/adolescents (~1.2% of the eligible 771,525 Austrian secondary school pupils) and 1,350 adults (~1.5% of total eligible 89,243 Austrian teachers/principals) participated in the study. As this is the first investigation to explore the prevalence of veganism/vegetarianism amongst a large group of pupils, the present study will add an important contribution to overcome the lack of knowledge on PA, sports & exercise linked to healthy alternative diets. With a sustainable healthy lifestyle, a healthy transition from childhood to adulthood occurs, which can result in growing healthier functioning generations at all social levels. As a study protocol, the present article is intended to present comprehensive details of the study design, objectives, and the associated analytical procedures of the "From Science 2 School" study.
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Affiliation(s)
- Katharina C. Wirnitzer
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, Leopold-Franzens University Innsbruck, Innsbruck, Austria
- Research Center Medical Humanities, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - Derrick R. Tanous
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - Mohamad Motevalli
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - Georg Göbel
- Department of Medical Statistics, Informatics and Health Economics, Medical University Innsbruck, Innsbruck, Austria
| | | | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Teacher Education Upper Austria, Linz, Austria
| | - Gerhard Ruedl
- Department of Sport Science, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - Armando Cocca
- Department of Sport Science, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - Werner Kirschner
- Department of Sport Science, Leopold-Franzens University Innsbruck, Innsbruck, Austria
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15
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Khatamnejad M, Akhlaghi M. Maternal-child overweight relationship, assessment of maternal perception of child weight status and feeding behaviours. Nutr Health 2022:2601060221124734. [PMID: 36071603 DOI: 10.1177/02601060221124734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Parents play a key role in constructing children' behaviours. We studies maternal-child overweight relationship and compared maternal perception of child weight status and feeding behaviours between groups of normal-weight and overweight children. METHODS The cross-sectional study was conducted on 192 girls aged 10-13 years and their mothers. They were divided to two groups of overweight (n = 94) and normal-weight (n = 98) children. Anthropometric characteristics were measured for children and mothers. Logistic regression analysis was used to examine the association between child overweight and tertiles of maternal body mass index (BMI). Maternal perception of child's weight status and her engagement in promoting child's healthy behaviours was assessed. RESULTS BMI and waist circumference was significantly higher in children (P < 0.001) and mothers (P < 0.01) of overweight compared to normal-weight group. There was a significant relationship between children's overweight and tertiles of maternal BMI, which remained significant after adjusting for potential confounders. Mothers of overweight children were more concerned for their child's overeating and overweight, and for compelling the child to diet to maintain a desirable weight (P < 0.001). In contrast, mothers of normal-weight children restricted sugar-sweetened drinks (P = 0.008), offered fruit and vegetables (P = 0.035), and helped their children to get enough physical activity (P = 0.022) and night sleep (P = 0.001) more than mothers in other group. CONCLUSIONS This study showed a strong relationship between children and mothers' overweight. Despite being more concerned about their child weight status, mothers of overweight children reported behaviours which were less encouraging the children for healthy eating and lifestyle than mothers of normal-weight children.
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Affiliation(s)
- Mozhgan Khatamnejad
- Department of Community Nutrition, School of Nutrition and Food Sciences, 48435Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoumeh Akhlaghi
- Department of Community Nutrition, School of Nutrition and Food Sciences, 48435Shiraz University of Medical Sciences, Shiraz, Iran
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16
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Androutsos O, Charmandari E. Determinants, Screening, Prevention and Management of Obesity in Youth: New Evidence and Horizons. Nutrients 2022; 14:nu14163280. [PMID: 36014786 PMCID: PMC9414778 DOI: 10.3390/nu14163280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 08/09/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
- Odysseas Androutsos
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece
- Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
- Correspondence: ; Tel.: +30-213-2013384
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17
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Siroma TK, Machate DJ, Zorgetto-Pinheiro VA, Figueiredo PS, Marcelino G, Hiane PA, Bogo D, Pott A, Cury ERJ, Guimarães RDCA, Vilela MLB, Ferreira RDS, do Nascimento VA. Polyphenols and ω-3 PUFAs: Beneficial Outcomes to Obesity and Its Related Metabolic Diseases. Front Nutr 2022; 8:781622. [PMID: 35111795 PMCID: PMC8802753 DOI: 10.3389/fnut.2021.781622] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 11/29/2021] [Indexed: 01/02/2023] Open
Abstract
Obesity is associated with the leading causes of death in the worldwide. On the other hand, the intake of vegetables, fruits and fish is related to the reduction of obesity and other metabolic syndromes. This review aims to highlight the role of ingestion of polyphenols and omega-3 polyunsaturated fatty acids (ω-3 PUFAs) in reducing obesity and related metabolic diseases (RMDs). The consumption of vegetables, fish and by-products rich in polyphenols and α-linolenic acid (ALA), as well as oils rich in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are associated with a decrease in obesity and its RMDs in consumers. Furthermore, we discussed the adequate amount of extracts, powder, polyphenols, ω-3 PUFAs administrated in animal models and human subjects, and the relevant outcomes obtained. Thus, we appeal to the research institutions and departments of the Ministries of Health in each country to develop a food education joint project to help schools, businesses and families with the aim of reducing obesity and other metabolic diseases.
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Affiliation(s)
- Thais Keiko Siroma
- Graduate Program in Health and Development in the Central-West Region, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - David Johane Machate
- Spectroscopy and Bioinformatics Applied Biodiversity and Health - GEBABS, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
- Graduate Program in Materials Science, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | | | - Priscila Silva Figueiredo
- Graduate Program in Health and Development in the Central-West Region, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - Gabriela Marcelino
- Graduate Program in Health and Development in the Central-West Region, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - Priscila Aiko Hiane
- Graduate Program in Health and Development in the Central-West Region, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - Danielle Bogo
- Graduate Program in Health and Development in the Central-West Region, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - Arnildo Pott
- Graduate Program in Biotechnology and Biodiversity in the Central-West Region, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - Elenir Rose Jardim Cury
- Graduate Program in Health and Development in the Central-West Region, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | | | | | | | - Valter Aragão do Nascimento
- Graduate Program in Health and Development in the Central-West Region, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
- Spectroscopy and Bioinformatics Applied Biodiversity and Health - GEBABS, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
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18
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Health Behaviors of Austrian Secondary Level Pupils at a Glance: First Results of the From Science 2 School Study Focusing on Sports Linked to Mixed, Vegetarian, and Vegan Diets. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312782. [PMID: 34886508 PMCID: PMC8657632 DOI: 10.3390/ijerph182312782] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/26/2021] [Accepted: 11/27/2021] [Indexed: 01/06/2023]
Abstract
Attaining healthy behaviors is essential at any life stage, particularly childhood, due to the strong link between children’s lifestyle and the subsequent adult state of health. This multidisciplinary study aimed to assess lifestyle behaviors of Austrian pupils of secondary schools I and II, with a specific focus on PA habits and diet types based on a large sample. In total, 8845 children/adolescents participated in the short standardized online survey on relevant health-related aspects nationwide. Valid and complete data was provided by 8799 pupils, including 1.14% of the eligible 771,525; 63% girls, 76% having a normal body weight, 70% attending secondary schools II, and more pupils/students living in rural vs. urban areas (3:1 ratio). Across the total sample, 11.8% were considered overweight/obese with a higher prevalence of overweight/obesity in boys than girls (15.5% vs. 9.6%) and urban vs. rural participants (13.9% vs. 10.8%; p < 0.05). The majority of participants (84.5%) reported a mixed diet, while 7.2% and 8.5% reported a vegan and vegetarian diet, respectively. Vegans reported a lesser alcohol intake (p < 0.05) compared to non-vegan pupils (no difference in dietary subgroups for smoking). Although overall PA and dietary behaviors suggest an appropriate health status among Austrian youth, attention should be focused on policies to increase healthy lifestyle habits at best through a dual approach to health permanently combining regular PA, sports, and exercise with a healthy diet, which would contribute to matching the current recommendations for improving individual and public health.
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Baranowski T, Thompson D, Hughes SO, O’Connor TM. Precision Food Parenting: A Proposed Conceptual Model and Research Agenda. Nutrients 2021; 13:3650. [PMID: 34684651 PMCID: PMC8538596 DOI: 10.3390/nu13103650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/11/2021] [Accepted: 10/15/2021] [Indexed: 12/11/2022] Open
Abstract
Precision medicine, nutrition and behavioral interventions are attempting to move beyond the specification of therapies applied to groups, since some people benefit, some do not and some are harmed by the same therapy. Instead, precision therapies are attempting to employ diverse sets of data to individualize or tailor interventions to optimize the benefits for the receiving individuals. The benefits to be achieved are mostly in the distant future, but the research needs to start now. While precision pediatric nutrition will combine diverse demographic, behavioral and biological variables to specify the optimal foods a child should eat to optimize health, precision food parenting will combine diverse parent and child psychosocial and related variables to identify the optimal parenting practices to help a specific child accept and consume the precision nutrition specified foods. This paper presents a conceptual overview and hypothetical model of factors we believe are needed to operationalize precision food parenting and a proposed research agenda to better understand the many specified relationships, how they change over the age of the child, and how to operationalize them to encourage food parenting practices most likely to be effective at promoting healthy child food choices.
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Affiliation(s)
- Tom Baranowski
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St., Houston, TX 77030, USA; (D.T.); (S.O.H.); (T.M.O.)
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20
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Rigamonti AE, Caroli D, Grugni G, Cella SG, Sartorio A. Frequent Medical Supervision Increases the Effectiveness of a Longitudinal Multidisciplinary Body Weight Reduction Program: A Real-World Experience in a Population of Children and Adolescents with Obesity. Nutrients 2021; 13:nu13103362. [PMID: 34684362 PMCID: PMC8539124 DOI: 10.3390/nu13103362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 09/23/2021] [Accepted: 09/23/2021] [Indexed: 12/11/2022] Open
Abstract
Regular medical supervision represents a fundamental component of the clinical management of obesity. In fact, when frequently supplied it reduces the risk of failure associated with any body weight reduction program (BWRP), resulting in body weight gain. The aim of the present study was to establish the potential beneficial effects of increasing medical supervision on weight loss and other auxometric and cardiometabolic parameters in a population of children and adolescents with obesity (n = 158; F/M = 94/64; age range 9.7-17.3 years; body mass index, BMI = 37.8 ± 6.9 kg/m2), followed up for one year in a real-world setting, after and before a 3-week in-hospital BWRP. Weight loss was significantly associated with medical supervision and changes in several auxometric and cardiometabolic parameters such as fat mass, fat-free mass, waist and hip circumferences, total and LDL cholesterols, triglycerides, glucose, insulin, HOMA-IR, systolic blood pressure and IDF criteria for the diagnosis of metabolic syndrome. As expected, weight loss and, congruently, medical supervision, were significantly higher in responsive and stable subjects than in those belonging to the non-responsive group and in responsive subjects than those belonging to the stable group. While weight loss was significantly higher in subjects having class 2 and 3 obesity than those belonging to class 1 obesity group, medical supervision was significantly higher in subjects having class 3 than those having class 1 obesity. Weight loss was significantly higher in subjects suffering from metabolic syndrome than those without; nevertheless, no significant difference was found in medical supervision between these groups. Finally, sex was associated with no differences in weight loss and medical supervision. In conclusion, based on the results of a real-world experience, frequent medical supervision increases the weight loss associated with a longitudinal multidisciplinary BWRP, with a parallel improvement of a set of auxometric and cardiometabolic parameters. Prospectively, incentivising regular medical supervision should reduce the risk of BWRP failure and body weight gain, thus contributing to counteract the detrimental transition from simple obesity to metabolic syndrome in pediatric patients.
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Affiliation(s)
- Antonello E. Rigamonti
- Department of Clinical Sciences and Community Health, University of Milan, 20129 Milan, Italy;
- Correspondence: ; Tel.: +39-02-503-17013; Fax: +39-02-503-17011
| | - Diana Caroli
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, IRCCS, 28824 Verbania, Italy; (D.C.); (G.G.); (A.S.)
| | - Graziano Grugni
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, IRCCS, 28824 Verbania, Italy; (D.C.); (G.G.); (A.S.)
- Division of Auxology and Metabolic Diseases, Istituto Auxologico Italiano, IRCCS, 28824 Verbania, Italy
| | - Silvano G. Cella
- Department of Clinical Sciences and Community Health, University of Milan, 20129 Milan, Italy;
| | - Alessandro Sartorio
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, IRCCS, 28824 Verbania, Italy; (D.C.); (G.G.); (A.S.)
- Division of Auxology and Metabolic Diseases, Istituto Auxologico Italiano, IRCCS, 28824 Verbania, Italy
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21
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Epigenetic Alterations in Pediatric Sleep Apnea. Int J Mol Sci 2021; 22:ijms22179523. [PMID: 34502428 PMCID: PMC8430725 DOI: 10.3390/ijms22179523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/24/2021] [Accepted: 08/30/2021] [Indexed: 12/03/2022] Open
Abstract
Pediatric obstructive sleep apnea has significant negative effects on health and behavior in childhood including depression, failure to thrive, neurocognitive impairment, and behavioral issues. It is strongly associated with an increased risk for chronic adult disease such as obesity and diabetes, accelerated atherosclerosis, and endothelial dysfunction. Accumulating evidence suggests that adult-onset non-communicable diseases may originate from early life through a process by which an insult applied at a critical developmental window causes long-term effects on the structure or function of an organism. In recent years, there has been increased interest in the role of epigenetic mechanisms in the pathogenesis of adult disease susceptibility. Epigenetic mechanisms that influence adaptive variability include histone modifications, non-coding RNAs, and DNA methylation. This review will highlight what is currently known about the phenotypic associations of epigenetic modifications in pediatric obstructive sleep apnea and will emphasize the importance of epigenetic changes as both modulators of chronic disease and potential therapeutic targets.
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22
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Nevill AM, Reuter CP, Brand C, Gaya AR, Mota J, Renner JDP, Duncan MJ. BMI Fails to Reflect the Developmental Changes in Body Fatness between Boys and Girls during Adolescence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157833. [PMID: 34360126 PMCID: PMC8345620 DOI: 10.3390/ijerph18157833] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/16/2021] [Accepted: 07/18/2021] [Indexed: 02/06/2023]
Abstract
Body mass index (BMI) is thought to reflect excess adiposity in both youth and adults alike. However, the association between BMI and fatness varies, especially as children grow into adults. Thus, the present study sought to address this issue by characterizing how BMI reflects age and sex differences in body fatness in 7-16-year-old children. METHODS This cross-sectional study was conducted with 2150 children and adolescents, aged 7 to 16 years from the city of Santa Cruz do Sul, Brazil. BMI (kg/m2), and percentage body fat, using tricipital and subscapular folds, were assessed. For statistical analysis, ANOVA and ANCOVA were used. RESULTS When considered in isolation, there was no significant interaction in the age-by-sex differences in BMI (p = 0.69). However, when we controlled for percent body fatness, the analysis revealed considerable age-by-sex differences in BMI (p < 0.001). CONCLUSION For the same body fat (%), there are no differences in BMI in children <10 years.
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Affiliation(s)
- Alan M. Nevill
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Walsall WS1 3BD, UK;
| | - Cézane Priscila Reuter
- Graduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul 96816-501, Brazil; (C.P.R.); (C.B.); (J.D.P.R.)
| | - Caroline Brand
- Graduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul 96816-501, Brazil; (C.P.R.); (C.B.); (J.D.P.R.)
| | - Anelise Reis Gaya
- School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre 90040-060, Brazil;
| | - Jorge Mota
- Faculty of Sport, University of Porto, 4099-002 Porto, Portugal;
| | - Jane Dagmar Pollo Renner
- Graduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul 96816-501, Brazil; (C.P.R.); (C.B.); (J.D.P.R.)
| | - Michael J. Duncan
- Sport, Exercise and Life Sciences Research Centre, Coventry University, Coventry CV1 5FB, UK
- Correspondence: ; Tel.: +44-24768-87688
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