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Paciência I, Cavaleiro Rufo J, Mendes F, Farraia M, Cunha P, Silva D, Delgado L, Padrão P, Moreira P, Moreira A. A cross-sectional study of the impact of school neighbourhood on children obesity and body composition. Eur J Pediatr 2021; 180:535-545. [PMID: 32910211 DOI: 10.1007/s00431-020-03798-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 08/24/2020] [Accepted: 08/31/2020] [Indexed: 11/26/2022]
Abstract
Schools' neighbourhoods provide an important environmental context that may influence the risk of obesity among children. The aim of this study was to assess the effect of neighbourhood surrounding schools on obesity and body composition in schoolchildren. Data on 845 children aged 7 to 12 years old from 20 primary schools were considered. Anthropometric measurements and bioelectrical impedance analysis were performed to assess body mass index (BMI) and characterize body composition. Land use characteristics were quantified within a 500-m buffer zone around schools. Mixed-effect models measured the effects of school neighbourhood on obesity and body composition. The results showed a tendency between green urban areas around schools and lower values of BMI and better body composition parameters compared with built areas, being BMI z-scores CDC, and body fat percentage significantly higher in-built than in green urban areas (β = 0.48, 95% CI 0.05; 0.90, and β = 2.56, 95% CI 0.39; 4.73, respectively).Conclusion: Our findings suggest that the school neighbourhood has an effect on BMI and body fat percentage in schoolchildren. These results may contribute to the creation of healthier cities and help reduce health expenses by focusing on prevention programmes towards the expansion of green spaces. What is Known: • Living in greener areas has been associated with healthy weight outcomes and to the lower impact of obesogenic urban environments. • The school environment may be especially important for youth health outcomes. What is New: • Neighbourhoods around schools may affect child health, specifically the development of obesity. • The presence of urban green areas around school may promote a framework of lifestyle or behaviours conducive to achieving a healthy weight.
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Affiliation(s)
- Inês Paciência
- Serviço de Imunologia Básica e Clínica, Departamento de Patologia, Faculdade de Medicina, da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.
| | - João Cavaleiro Rufo
- Serviço de Imunologia Básica e Clínica, Departamento de Patologia, Faculdade de Medicina, da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Francisca Mendes
- Serviço de Imunologia Básica e Clínica, Departamento de Patologia, Faculdade de Medicina, da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Mariana Farraia
- Serviço de Imunologia Básica e Clínica, Departamento de Patologia, Faculdade de Medicina, da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Pedro Cunha
- Faculdade de Ciências da Nutrição e Alimentação, da Universidade do Porto, Porto, Portugal
| | - Diana Silva
- Serviço de Imunologia Básica e Clínica, Departamento de Patologia, Faculdade de Medicina, da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
- Serviço de Imunoalergologia, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Luís Delgado
- Serviço de Imunologia Básica e Clínica, Departamento de Patologia, Faculdade de Medicina, da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
- Serviço de Imunoalergologia, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Patrícia Padrão
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Faculdade de Ciências da Nutrição e Alimentação, da Universidade do Porto, Porto, Portugal
| | - Pedro Moreira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Faculdade de Ciências da Nutrição e Alimentação, da Universidade do Porto, Porto, Portugal
| | - André Moreira
- Serviço de Imunologia Básica e Clínica, Departamento de Patologia, Faculdade de Medicina, da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Faculdade de Ciências da Nutrição e Alimentação, da Universidade do Porto, Porto, Portugal
- Serviço de Imunoalergologia, Centro Hospitalar Universitário São João, Porto, Portugal
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Macek P, Terek-Derszniak M, Biskup M, Krol H, Smok-Kalwat J, Gozdz S, Zak M. Assessment of Age-Induced Changes in Body Fat Percentage and BMI Aided by Bayesian Modelling: A Cross-Sectional Cohort Study in Middle-Aged and Older Adults. Clin Interv Aging 2020; 15:2301-2311. [PMID: 33335389 PMCID: PMC7737547 DOI: 10.2147/cia.s277171] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 11/10/2020] [Indexed: 12/25/2022] Open
Abstract
Background Loss of fat-free mass (FFM) and gain in body fat (BF) are the key disability risk factors, also instrumental in perpetuating already existing functional disorders. Obesity construed in terms of body mass index (BMI) values, in view of undesirable gain in BF, is a risk factor for cardio-metabolic disorders. Both detrimental processes clearly evidence a scope of involutionary changes characteristic of an aging population, also standing for one of its greatest burdens. Purpose The present study aimed to assess the changes in body composition (BC), in conjunction with the relationship between BF% and BMI, for defining overweight and obesity status in middle-aged and older adults, against the select indicator variables under study. Materials and Methods The study involved 4799 individuals (33.7% men), PONS Project participants, aged 43-64 years. BF% was measured with the aid of bioelectrical impedance analysis (BIA) method. Age-induced changes in BC were determined against BF%, fat mass (FM), FFM, BMI, fat mass index (FMI), and fat-free mass index (FFMI). The relationship between BF% and BMI was established with the aid of Bayesian regression models, adjusted for gender and age. Results In both genders, BF% increased with age at a similar annual rate. The reduction of FFM was noted mainly in men, which in conjunction with BF% gain ensured BMI stability. The increase in BF% in women with stable FFM affected an increase in BMI. Regardless of the BMI threshold, the anticipated (predicted) BF% increased with age in both genders. Conclusion Monitoring of BC is of particular importance in older adults, in view of appreciably better characteristics of both the short- and long-term health predictors, as well as overall potential for developing specifically targeted, effective health interventions.
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Affiliation(s)
- Pawel Macek
- Institute of Health Sciences, Collegium Medicum, The Jan Kochanowski University, Kielce, Poland.,Department of Epidemiology and Cancer Control, Holycross Cancer Centre, Kielce, Poland
| | | | - Malgorzata Biskup
- Institute of Health Sciences, Collegium Medicum, The Jan Kochanowski University, Kielce, Poland.,Department of Rehabilitation, Holycross Cancer Centre, Kielce, Poland
| | - Halina Krol
- Institute of Health Sciences, Collegium Medicum, The Jan Kochanowski University, Kielce, Poland.,Research and Education Department, Holycross Cancer Centre, Kielce, Poland
| | | | - Stanislaw Gozdz
- Institute of Health Sciences, Collegium Medicum, The Jan Kochanowski University, Kielce, Poland.,Clinical Oncology Clinic, Holycross Cancer Centre, Kielce, Poland
| | - Marek Zak
- Institute of Health Sciences, Collegium Medicum, The Jan Kochanowski University, Kielce, Poland
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Masukume G, Khashan AS, Morton SMB, Baker PN, Kenny LC, McCarthy FP. Caesarean section delivery and childhood obesity in a British longitudinal cohort study. PLoS One 2019; 14:e0223856. [PMID: 31665164 PMCID: PMC6821069 DOI: 10.1371/journal.pone.0223856] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 09/29/2019] [Indexed: 01/08/2023] Open
Abstract
Background Several studies reported an association between Caesarean section (CS) birth and childhood obesity. However, there are several limitations in the current literature. These include an inability to distinguish between planned and emergency CS, small study sample sizes and not adjusting for pre-pregnancy body-mass-index (BMI). We examined the association between CS delivery and childhood obesity using the United Kingdom Millennium Cohort Study (MCS). Methods Mother-infant pairs were recruited into the MCS. Use of sampling weights ensured the sample was representative of the population. The exposure was categorised as normal vaginal delivery (VD) [reference], assisted VD, planned CS and emergency CS. Childhood obesity prevalence, at age three, five, seven, eleven and fourteen years was calculated using the International Obesity Taskforce criteria. Mixed-effects linear regression models were fitted with associations adjusted for several potential confounders like maternal age, pre-pregnancy BMI, education and infant macrosomia. Linear regression models were fitted evaluating body fat percentage (BF%), at age seven and fourteen years. Results Of the 18,116 infants, 3872 (21.4%) were delivered by CS; 9.2% by planned CS. Obesity prevalence was 5.4%, 5.7%, 6.5%, 7.1% and 7.6% at age three, five, seven, eleven and fourteen years respectively. The mixed-effects linear regression model showed no association between planned (adjusted mean difference = 0.00; [95% confidence interval (CI) -0.10; 0.10], p-value = 0.97) or emergency CS (adjusted mean difference = 0.08; [95% CI -0.01; 0.17], p-value = 0.09) and child BMI. At age seven years, there was no association between planned CS and BF% (adjusted mean difference = 0.13; [95% CI -0.23; 0.49]); there was no association at age fourteen years. Conclusions Infants born by planned CS did not have a significantly higher BMI or BF% compared to those born by normal VD. This may suggest that the association, described in the literature, could be due to the indications/reasons for CS birth or residual confounding.
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Affiliation(s)
- Gwinyai Masukume
- INFANT Research Centre, Cork, Ireland
- Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
| | - Ali S. Khashan
- INFANT Research Centre, Cork, Ireland
- School of Public Health, Western Gateway Building, University College Cork, Cork, Ireland
| | - Susan M. B. Morton
- Centre for Longitudinal Research–He Ara ki Mua, University of Auckland, Auckland, New Zealand
| | - Philip N. Baker
- College of Life Sciences, University of Leicester, Leicester, England, United Kingdom
| | - Louise C. Kenny
- Department of Women’s and Children’s Health, Institute of Translational Medicine, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, England, United Kingdom
| | - Fergus P. McCarthy
- INFANT Research Centre, Cork, Ireland
- Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
- Department of Women and Children’s Health, School of Life Course Sciences, King’s College London, London, England, United Kingdom
- * E-mail:
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Physical Activity Level Using Doubly-Labeled Water in Relation to Body Composition and Physical Fitness in Preschoolers. ACTA ACUST UNITED AC 2018; 55:medicina55010002. [PMID: 30591687 PMCID: PMC6359212 DOI: 10.3390/medicina55010002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 12/09/2018] [Accepted: 12/20/2018] [Indexed: 11/30/2022]
Abstract
Background and objectives: There is a lack of studies investigating associations of physical activity level (PAL) and activity energy expenditure (AEE) using the doubly-labeled water (DLW) method with body composition and physical fitness in young children. Thus, we aimed to examine cross-sectional associations of PAL and AEE with body composition indices and physical fitness components in Swedish preschool children. Materials and methods: PAL was calculated as total energy expenditure measured using DLW divided by the predicted basal metabolic rate in 40 children aged 5.5 (standard deviation 0.2) years. AEE was calculated as total energy expenditure minus basal metabolic rate and the thermic effect of food, and divided by fat-free mass. Body composition was assessed using the 3-component model by combining measurements based on isotope dilution and air-displacement plethysmography. Physical fitness (muscular strength, motor fitness, and cardiorespiratory fitness) was evaluated using the PREFIT test battery. Multiple linear regression models were conducted. Results: PAL and AEE were negatively associated with body mass index, percent body fat, and fat mass index (PAL: standardized β −0.35, −0.41, and −0.45, all p < 0.036; AEE: standardized β −0.44, −0.44, and −0.47, all p < 0.006, respectively). Furthermore, PAL and AEE were positively associated with the standing long jump test (PAL: standardized β 0.37, p = 0.017; AEE: standardized β 0.38, p = 0.014). There were no statistically significant associations found regarding PAL or AEE with fat-free mass index or any other physical fitness test. Conclusions: Greater PAL and AEE at the age 5.5 were significantly associated with body fatness and improved lower-body muscular strength. Therefore, increasing physical activity, and thus energy expenditure, at young ages may be beneficial for preventing overweight/obesity. However, further studies with larger sample sizes are needed to confirm the results.
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The paediatric option for BodPod to assess body composition in preschool children: what fat-free mass density values should be used? Br J Nutr 2018; 120:797-802. [PMID: 30132437 DOI: 10.1017/s0007114518002064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Air displacement plethysmography utilises a two-component model to assess body composition, which relies on assumptions regarding the density of fat-free mass (FFM). To date, there is no evidence as to whether Lohman's or Wells et al.'s FFM density values are more accurate in young children. Therefore, the aims of this study were to compare total body fat percentage (TBF%) assessed using the BodPod with both Lohman's and Wells et al.'s FFM density values with TBF% from the three-component (3C) model in forty healthy Swedish children aged 5·5 years. Average TBF% calculated using Lohman's FFM density values underestimated TBF% in comparison with the corresponding value assessed using the 3C model (22·2 (sd 5·7) and 25·1 (sd 5·5) %, respectively; P<0·001). No statistically significant difference was observed between TBF% assessed using Wells et al.'s FFM density values and the 3C model (24·9 (sd 5·5) and 25·1 (sd 5·5) %, respectively; P=0·614). The Bland and Altman plots for TBF% using both Lohman's and Wells et al.'s FFM density values did not show any bias across the range of body fatness (Lohman: r 0·056, P=0·733 and Wells et al.: r -0·006, P=0·970). These results indicate that Wells et al.'s FFM density values should be used when assessing body composition with the paediatric option for BodPod in 5-year-old children. However, future studies are needed to confirm these results in other populations, including a wider age range of children.
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Is BMI a relevant marker of fat mass in 4 year old children? Results from the MINISTOP trial. Eur J Clin Nutr 2018; 72:1561-1566. [DOI: 10.1038/s41430-018-0133-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 12/06/2017] [Accepted: 02/09/2018] [Indexed: 11/08/2022]
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Leppänen MH, Henriksson P, Delisle Nyström C, Henriksson H, Ortega FB, Pomeroy J, Ruiz JR, Cadenas-Sanchez C, Löf M. Longitudinal Physical Activity, Body Composition, and Physical Fitness in Preschoolers. Med Sci Sports Exerc 2018; 49:2078-2085. [PMID: 28538260 DOI: 10.1249/mss.0000000000001313] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to investigate longitudinal associations of objectively measured physical activity (PA) and sedentary behavior (SB) with body composition and physical fitness at a 12-month follow-up in healthy Swedish 4-yr-old children. METHODS The data from the population-based MINISTOP trial were collected between 2014 and 2016, and this study included the 138 children who were in the control group. PA and SB were assessed using the wrist-worn ActiGraph (wGT3x-BT) accelerometer during seven 24-h periods and, subsequently, defined as SB, light-intensity PA, moderate-intensity PA, vigorous-intensity PA (VPA), and moderate-to-vigorous PA (MVPA). Body composition was measured using air-displacement plethysmography and physical fitness (cardiorespiratory fitness, lower and upper muscular strength as well as motor fitness) by the PREFIT fitness battery. Linear regression and isotemporal substitution models were applied. RESULTS Greater VPA and MVPA at the age of 4.5 yr were associated with higher fat-free mass index (FFMI) at 5.5 yr (P < 0.001 and P = 0.044, respectively). Furthermore, greater VPA and MVPA at the age of 4.5 yr were associated with higher scores for cardiorespiratory fitness, lower body muscular strength, and motor fitness at 12-month follow-up (P = 0.001 to P = 0.031). Substituting 5 min·d of SB, light-intensity PA, or moderate-intensity PA for VPA at the age of 4.5 yr were associated with higher FFMI, and with greater upper and lower muscular strength at 12-month follow-up (P < 0.001 to P = 0.046). CONCLUSION Higher VPA and MVPA at the age of 4.5 yr were significantly associated with higher FFMI and better physical fitness at 12-month follow-up. Our results indicate that promoting high-intensity PA at young ages may have long-term beneficial effects on childhood body composition and physical fitness, in particular muscular strength.
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Affiliation(s)
- Marja H Leppänen
- 1Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, FINLAND; 2Department of Clinical and Experimental Medicine, Faculty of Health Science, Linkoping University, Linkoping, SWEDEN; 3Promoting Fitness and Health through Physical Activity Research Group (PROFITH), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, SPAIN; 4Department of Biosciences and Nutrition, Karolinska Institutet, NOVUM, Huddinge, SWEDEN; and 5Marshfield Clinic Research Foundation, Marshfield, WI
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Validation of an Online Food Frequency Questionnaire against Doubly Labelled Water and 24 h Dietary Recalls in Pre-School Children. Nutrients 2017; 9:nu9010066. [PMID: 28098765 PMCID: PMC5295110 DOI: 10.3390/nu9010066] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 12/22/2016] [Accepted: 01/11/2017] [Indexed: 11/26/2022] Open
Abstract
The development of easy-to-use and accurate methods to assess the intake of energy, foods and nutrients in pre-school children is needed. KidMeal-Q is an online food frequency questionnaire developed for the LifeGene prospective cohort study in Sweden. The aims of this study were to compare: (i) energy intake (EI) obtained using KidMeal-Q to total energy expenditure (TEE) measured via doubly labelled water and (ii) the intake of certain foods measured using KidMeal-Q to intakes acquired by means of 24 h dietary recalls in 38 children aged 5.5 years. The mean EI calculated using KidMeal-Q was statistically different (p < 0.001) from TEE (4670 ± 1430 kJ/24 h and 6070 ± 690 kJ/24 h, respectively). Significant correlations were observed for vegetables, fruit juice and candy between KidMeal-Q and 24 h dietary recalls. Only sweetened beverage consumption was significantly different in mean intake (p < 0.001), as measured by KidMeal-Q and 24 h dietary recalls. In conclusion, KidMeal-Q had a relatively short answering time and comparative validity to other food frequency questionnaires. However, its accuracy needs to be improved before it can be used in studies in pre-school children.
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