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Lavie CJ, Neeland IJ, Ortega FB. Intervention in School-Aged Children to Prevent Progression of Obesity and Cardiometabolic Disease: A Paradigm Shift Indeed. J Am Coll Cardiol 2024; 84:509-511. [PMID: 39084825 DOI: 10.1016/j.jacc.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 06/03/2024] [Indexed: 08/02/2024]
Affiliation(s)
- Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, Louisiana, USA.
| | - Ian J Neeland
- Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Case Western University School of Medicine, Cleveland, Ohio, USA
| | - Francisco B Ortega
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain; Center for Biomedical Network Research: Physiopathology of Obesity and Nutrition (CIBEROBN), Granada, Spain; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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2
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López-Gil JF, Victoria-Montesinos D, García-Hermoso A. Effects of lifestyle-based interventions to improve Mediterranean diet adherence among the young population: a meta-analysis of randomized controlled trials. Nutr Rev 2024; 82:849-860. [PMID: 37672008 DOI: 10.1093/nutrit/nuad107] [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] [Indexed: 09/07/2023] Open
Abstract
CONTEXT Despite the large number of studies published to date, the effect of lifestyle-based interventions on improving adherence to the Mediterranean diet (MedDiet) in young people has not been meta-analyzed. OBJECTIVE The aim of the present systematic review and meta-analysis was two-fold: (1) to determine the pooled intervention effects of lifestyle-based interventions on improving adherence to the MedDiet in a young population aged 3 years-18 years and (2) to examine the potential factors related to those intervention effects. DATA SOURCES A systematic search of the MEDLINE (via PubMed), Scopus, Cochrane Library, and Web of Science databases was performed from their inception until June 15, 2023. DATA EXTRACTION Different meta-analyses were independently performed to observe the effect of lifestyle-based interventions on adherence to the MedDiet (according to the Mediterranean Diet Quality Index in children and adolescents [KIDMED]). DATA ANALYSIS Compared with the control group, the intervention group showed a small increase in KIDMED score (d = .27; 95% confidence interval [CI], .11 to .43; P < .001; I2 = 89.7%). Similarly, participants in the lifestyle-based intervention groups had a 14% higher probability of achieving optimal adherence to the MedDiet (risk difference = .14; 95% CI, .02 to .26; P = .023; I2 = 96.8%). Greater improvements in achieving optimal adherence to the MedDiet were found in interventions delivered out of school (risk difference = .24, 95% CI, .04 to .44; I2 = 88.4%), those aimed at parents or at both children and parents (risk difference = .20, 95% CI, .07 to .34; I2 = 98.2%), and those including only participants with overweight/obesity (risk difference = .34, 95% CI, .15 to .52; I2 = .0%). CONCLUSION Healthy lifestyle-based interventions seem to be effective in increasing adherence to the MedDiet and in achieving optimal adherence to this dietary pattern among children and adolescents. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD2022369409.
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Affiliation(s)
- José Francisco López-Gil
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona (Navarra), Spain
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston (Massachusetts), USA
- One Health Research Group, Universidad de Las Américas, Quito, Ecuador
| | | | - Antonio García-Hermoso
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona (Navarra), Spain
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3
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Lydecker JA, Winschel J, Gilbert K, Cotter EW. School absenteeism and impairment associated with weight bullying. J Adolesc 2023; 95:1478-1487. [PMID: 37487590 PMCID: PMC10731314 DOI: 10.1002/jad.12220] [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: 10/03/2022] [Revised: 07/07/2023] [Accepted: 07/10/2023] [Indexed: 07/26/2023]
Abstract
INTRODUCTION Many children experience weight-based bullying (WB), when individuals are treated poorly or demeaned because of weight. WB has negative mental and physical health consequences. The current study examined how children's experiences of different forms of WB (verbal, social, physical, cyber) were associated with impaired functioning in school, social life, and family life. METHODS Data were collected in Spring 2021. Participants (N = 224) were parents of a school-aged child and lived in the United States. Sixty percent of parents were mothers and 72% of parents self-identified as White. They completed surveys regarding weight, eating, and bullying. RESULTS Social and cyber WB were associated with clinically significant impairment for both children and parents. Children who experienced social and physical WB were more likely to skip school, whereas physical and cyber WB were associated with skipping a particular class. All forms of bullying were associated with skipping gym class. Social and cyber WB were associated with isolating. Cyber WB was associated with all disordered eating behaviors. In addition, physical WB was associated with binge eating, social WB was associated with purging, and verbal WB was associated with secretive eating. DISCUSSION Victims of WB experience impairment in school, social life, and family life, absenteeism, and disordered eating. It is essential to develop approaches to address WB in its various forms to identify strategies for reducing and preventing WB across various levels of influence, including peer groups, schools, and families.
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Affiliation(s)
- Janet A. Lydecker
- Department of Psychiatry, Yale University School of
Medicine, New Haven, CT, USA
| | - Julia Winschel
- Department of Psychiatry, Yale University School of
Medicine, New Haven, CT, USA
- School of Public Health, Yale University, New Haven, CT,
USA
| | - Kelsey Gilbert
- Department of Psychiatry, Yale University School of
Medicine, New Haven, CT, USA
- Department of Psychology, University of Hartford, Hartford,
CT, USA
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Plummer RS, Alter Z, Lee RM, Gordon AR, Cory H, Brion-Meisels G, Reiner J, Topping K, Kenney EL. "It's Not the Stereotypical 80s Movie Bullying": A Qualitative Study on the High School Environment, Body Image, and Weight Stigma. THE JOURNAL OF SCHOOL HEALTH 2022; 92:1165-1176. [PMID: 35702896 PMCID: PMC10137145 DOI: 10.1111/josh.13203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/09/2022] [Accepted: 04/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Schools are crucial for preventing negative health outcomes in youth and are an ideal setting to address weight stigma and poor body image. The current study sought to examine and describe the nature of weight stigma and body image in adolescents, ascertain aspects of the school environment that affect body image, and identify recommendations for schools. METHODS We conducted 24 semi-structured interviews with students at 2 high schools in 2020. Qualitative data were analyzed using inductive coding and an immersion/crystallization approach. RESULTS Students did not report weight discrimination or harmful body image messaging from teachers or administrators. Physical education (PE) class and dress codes were 2 instances where covert weight stigma appeared. The most common forms of peer weight stigma reported were weight-based teasing and self-directed appearance critiques. Students recommended that schools eliminate dress codes, diversify PE activities, address body image issues in school, and be cognizant of teasing within friend groups. CONCLUSIONS Weight stigma presents itself in unique ways in high school settings. Schools can play a role in reducing experiences of weight stigma and negative body image. Weight-related teasing within friend groups was common and may not be captured in traditional assessments of bullying. More nuanced survey instruments may be needed.
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Affiliation(s)
- Rachel S. Plummer
- Department of Nutrition, Harvard T. H. Chan School of Public Health, 665 Huntington Ave, Boston, MA, 02115
| | - Zanny Alter
- Harvard Graduate School of Education, 13 Appian Way, Cambridge, MA, 02138
| | - Rebekka M. Lee
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115
| | - Allegra R. Gordon
- Department of Community Health Sciences, Boston University School of Public Health, 715AlbanySt, Boston, MA, 02118; Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, 300 Longwood Ave, Boston, MA, 02115
| | - Hannah Cory
- Department of Nutrition, Harvard T. H. Chan School of Public Health, 665 Huntington Ave, Boston, MA, 02115
| | | | - Jennifer Reiner
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115
| | - Kimm Topping
- Harvard Graduate School of Education, 13 AppianWay, Cambridge, MA, 02138
| | - Erica L. Kenney
- Department of Nutrition, Harvard T. H. Chan School of Public Health, 665 Huntington Ave, Boston, MA, 02115; Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115
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Siegel L, Asada Y, Lin S, Fitzgibbon ML, Kong A. Perceived factors that influence adoption, implementation and sustainability of an evidence-based intervention promoting healthful eating and physical activity in childcare centers in an urban area in the United States serving children from low-income, racially/ethnically diverse families. FRONTIERS IN HEALTH SERVICES 2022; 2:980827. [PMID: 36925814 PMCID: PMC10012626 DOI: 10.3389/frhs.2022.980827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022]
Abstract
Introduction Early childcare centers offer optimal settings to provide healthy built environments where preschool age children spend a majority of their week. Many evidence-based interventions (EBIs) promoting healthful eating and physical activity for early childcare settings exist, but there is a limited understanding of how best to support adoption, implementation and sustainability in community settings. This study examined how early childcare teachers and administrators from Chicago-area childcare centers serving children from low-income, racially/ethnically diverse communities viewed an EBI called Hip to Health (H3), and the factors they perceived as relevant for EBI adoption, implementation, and sustainability. Methods A multiple methods study including key informant interviews and a brief survey was conducted. Key informant interviews with teachers and administrators from childcare centers located in Chicago, IL were completed between December 2020 and May 2021. An interview guide and coding guide based on the Consolidated Framework for Implementation Research (CFIR) was developed. Interview transcripts were team coded in MAXQDA Qualitative Data Analysis software. Thematic analysis was used to identify findings specific to adoption, implementation, and sustainability. Participants were also asked to respond to survey measures about the acceptability, feasibility, and appropriateness of H3. Results Overall, teachers (n = 20) and administrators (n = 16) agreed that H3 was acceptable, appropriate, and feasible. Low start-up costs, ease-of-use, adaptability, trialability, compatibility, and leadership engagement were important to EBI adoption. Timely and flexible training was critical to implementation. Participants noted sustainability was tied to low ongoing costs, access to ongoing support, and positive observable benefits for children and positive feedback from parents. Conclusions These findings suggest that EBIs suitable for adoption, implementation, and sustainment in childcare centers serving racially/ethnically diverse, low-income families should be adaptable, easy to use, and low-cost (initial and ongoing). There is also some evidence from these findings of the heterogeneity that exists among childcare centers serving low-income families in that smaller, less resourced centers are often less aware of EBIs, and the preparation needed to implement EBIs. Future research should examine how to better support EBI dissemination and implementation to these settings.
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Affiliation(s)
- Leilah Siegel
- 4-H Youth Development, University of Illinois Extension, St. Charles, IL, United States
| | - Yuka Asada
- Community Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, IL, United States
| | - Shuhao Lin
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, United States
| | - Marian L. Fitzgibbon
- Institute for Health Research and Policy, University of Illinois Chicago, Chicago, IL, United States
| | - Angela Kong
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois Chicago, College of Pharmacy, Chicago, IL, United States
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Matthan NR, Barger K, Wylie-Rosett J, Xue X, Groisman-Perelstein AE, Diamantis PM, Ginsberg M, Mossavar-Rahmani Y, Lichtenstein AH. Spillover Effects of a Family-Based Childhood Weight-Management Intervention on Parental Nutrient Biomarkers and Cardiometabolic Risk Factors. Curr Dev Nutr 2022; 6:nzab152. [PMID: 35155982 PMCID: PMC8826936 DOI: 10.1093/cdn/nzab152] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 12/14/2021] [Accepted: 12/17/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Parental involvement has been shown to favorably affect childhood weight-management interventions, but whether these interventions influence parental diet and cardiometabolic health outcomes is unclear. OBJECTIVES The aim was to evaluate whether a 1-y family-based childhood weight-management intervention altered parental nutrient biomarker concentrations and cardiometabolic risk factors (CMRFs). METHODS Secondary analysis from a randomized-controlled, parallel-arm clinical trial (NCT00851201). Families were recruited from a largely Hispanic population and assigned to either standard care (SC; American Academy of Pediatrics overweight/obesity recommendations) or SC + enhanced program (SC+EP; targeted diet/physical activity strategies, skill building, and monthly support sessions). Nutrient biomarkers (plasma carotenoids and fat-soluble vitamins, RBC fatty acid profiles) and CMRFs (BMI, blood pressure, glucose, insulin, lipid profile, inflammatory and endothelial dysfunction markers, adipokines) were measured in archived samples collected from parents of participating children at baseline and end of the 1-y intervention. RESULTS Parents in both groups (SC = 106 and SC+EP = 99) had significant reductions in trans fatty acid (-14%) and increases in MUFA (2%), PUFA n-6 (ɷ-6) (2%), PUFA n-3 (7%), and β-carotene (20%) concentrations, indicative of lower partially hydrogenated fat and higher vegetable oil, fish, and fruit/vegetable intake, respectively. Significant reductions in high-sensitivity C-reactive protein (hsCRP; -21%) TNF-α (-19%), IL-6 (-19%), and triglycerides (-6%) were also observed in both groups. An additional significant improvement in serum insulin concentrations (-6%) was observed in the SC+EP parents. However, no major reductions in BMI or blood pressure and significant unfavorable trajectories in LDL-cholesterol and endothelial dysfunction markers [P-selectin, soluble intercellular adhesion molecule (sICAM), thrombomodulin] were observed. Higher carotenoid, MUFA, and PUFA (n-6 and n-3) and lower SFA and trans fatty acid concentrations were associated with improvements in circulating glucose and lipid measures, inflammatory markers, and adipokines. CONCLUSIONS The benefits of a family-based childhood weight-management intervention can spill over to parents, resulting in apparent healthier dietary shifts that are associated with modest improvements in some CMRFs.
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Affiliation(s)
- Nirupa R Matthan
- Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Kathryn Barger
- Biostatistics and Data Management Core Unit, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Judith Wylie-Rosett
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Xiaonan Xue
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Pamela M Diamantis
- Department of Pediatrics, Albert Einstein College of Medicine, Jacobi Medical Center, Bronx, NY, USA
| | - Mindy Ginsberg
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Alice H Lichtenstein
- Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
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School-based obesity interventions in the metropolitan area of Rio De Janeiro, Brazil: pooled analysis from five randomised studies. Br J Nutr 2021; 126:1373-1379. [PMID: 33441203 DOI: 10.1017/s0007114521000076] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
School-based studies, despite the large number of studies conducted, have reported inconclusive results on obesity prevention. The sample size is a major constraint in such studies by requiring large samples. This pooled analysis overcomes this problem by analysing 5926 students (mean age 11·5 years) from five randomised school-based interventions. These studies focused on encouraging students to change their drinking and eating habits, and physical activities over the one school year, with monthly 1-h sessions in the classroom; culinary class aimed at developing cooking skills to increase healthy eating and attempts to family engagement. Pooled intention-to-treat analysis using linear mixed models accounted for school clusters. Control and intervention groups were balanced at baseline. The overall result was a non-significant change in BMI after one school year of positive changes in behaviours associated with obesity. Estimated mean BMI changed from 19·02 to 19·22 kg/m2 in the control group and from 19·08 to 19·32 kg/m2 in the intervention group (P value of change over time = 0·09). Subgroup analyses among those overweight or with obesity at baseline also did not show differences between intervention and control groups. The percentage of fat measured by bioimpedance indicated a small reduction in the control compared with intervention (P = 0·05). This large pooled analysis showed no effect on obesity measures, although promising results were observed about modifying behaviours associated with obesity.
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Buru K, Emeto TI, Malau-Aduli AEO, Malau-Aduli BS. Australian School Stakeholders' Perceived Strategies for Preventing Adolescent Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9387. [PMID: 34501977 PMCID: PMC8430679 DOI: 10.3390/ijerph18179387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/01/2021] [Accepted: 09/03/2021] [Indexed: 11/16/2022]
Abstract
Adolescent obesity is a complex multifactorial disease with a combination of environmental, behavioral, psychosocial, biological, cultural and genetic determinants. It remains a global public health issue that presents a major challenge to chronic disease prevention and health into adulthood. Schools have a rich opportunity to improve youth health and tackle obesity, yet they face barriers in fulfilling this function. This study investigated school stakeholders' beliefs and perceptions of the barriers and enablers currently experienced by schools, as well as their recommendations towards preventing adolescent obesity. A sequential explanatory mixed-methods study design was utilised with surveys administered for the quantitative phase and individual interviews for the qualitative phase. Descriptive statistics and inductive thematic analyses were utilised for the survey and interview data, respectively. Triangulation of findings from the quantitative and qualitative phases aided in the better understanding and integration of the overall results. In total, 60 school stakeholders (52 subject teachers, 3 senior teachers and 5 heads of department) from both independent and public high schools in Queensland, Australia responded to the survey, while 14 respondents participated in the interviews. The main perceived causes of obesity were poor eating habits and sedentary lifestyle. Highlighted barriers were busy timetables, shortage of trained staff and funding, lack of robustness in the introduction and implementation of school interventions and insufficient motivation of learners to participate in obesity prevention programs. Enabling factors included parental support, easy access to fitness equipment during recess, supportive government policies, provision of healthier school tuck shop menu options and elimination of sugary drinks from vending machines. A model for the prevention of adolescent obesity was developed based on participants' perceptions. Tripartite collaboration between the school, government and parents was perceived as fundamental to preventing adolescent obesity. Strategies targeting nutrition, physical activity and overall health, including parental education on health, formal health talks in schools by health professionals and better-targeted advertisement encouraging healthy lifestyle choices, were identified as essential for improved adolescent health outcomes.
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Affiliation(s)
- Kakale Buru
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia
| | - Theophilus I Emeto
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
| | - Aduli E O Malau-Aduli
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
| | - Bunmi S Malau-Aduli
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia
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Rieder J, Moon JY, Joels J, Shankar V, Meissner P, Johnson-Knox E, Frohlich B, Davies S, Wylie-Rosett J. Trends in health behavior and weight outcomes following enhanced afterschool programming participation. BMC Public Health 2021; 21:672. [PMID: 33827501 PMCID: PMC8028223 DOI: 10.1186/s12889-021-10700-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 03/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The United States needs to increase access to effective obesity prevention and treatment programming for impoverished youth at risk for health disparities. Although recommended, schools have difficulty consistently implement evidence-based obesity programing. We report on the effectiveness of adding structured nutrition education and minimum physical activity (PA) requirements to standard middle school after-school programming. METHODS Using a longitudinal pre-post study design, we evaluated program effectiveness at one year on target behaviors on students recruited during three consecutive school years (2016-2018). We used generalized linear (or logistic) mixed-effects modeling to determine: 1) impact on healthy weight and target healthy behavior attainment, and 2) whether target behavior improvement and weight change were associated with after-school program attendance. The seven target behaviors relate to eating healthy, physical activity, and sleep. RESULTS Over the three years, a total of 76 students enrolled and completed one year of programming (62% Hispanic, 46% girls, 72% with BMI > 85th %ile, 49% with BMI > 95th %ile). Of students with BMI > 85th %ile, 44% maintained or decreased BMI Z-score. There were improvements (non-significant) in BMI Z-score and the adoption of four healthy eating behaviors: fruit, vegetables, sugar-free beverages, and unhealthy snack food. Students with higher after-school attendance (> 75%) had greater improvements (non-significant) in composite behavior scores, BMI Z-score, and in most target behaviors (5/7) than students with lower after-school attendance (< 75%). Sleep improvements were significantly associated with BMI Z-score decrease (Beta = - 0.05, 95% CI (- 0.1,-0.003), p = 0.038.) CONCLUSIONS: Enhancement of existing after-school programming with structured nutrition education and minimum physical activity requirements demonstrates positive improvements in several health behaviors and weight outcomes. Adopting enhanced after-school programming increases access to health activities and may bring us closer to solving obesity in at-risk youth in impoverished communities. TRIAL REGISTRATION ClinicalTrials.gov identifier (NCT number): NCT03565744 . Registered 21 June 2018 - Retrospectively registered.
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Affiliation(s)
- Jessica Rieder
- Division of Adolescent Medicine, Department of Pediatrics, Children’s Hospital at Montefiore, 3415 Bainbridge Avenue, Bronx, NY USA
| | - Jee-Young Moon
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Jack and Pearl Resnick Campus, 1300 Morris Park Avenue, Bronx, NY 10461 USA
| | - Joanna Joels
- Division of Adolescent Medicine, Department of Pediatrics, Children’s Hospital at Montefiore, 3415 Bainbridge Avenue, Bronx, NY USA
| | - Viswanathan Shankar
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Jack and Pearl Resnick Campus, 1300 Morris Park Avenue, Bronx, NY 10461 USA
| | - Paul Meissner
- Care Management Organization, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467 USA
| | - Elicia Johnson-Knox
- Division of Adolescent Medicine, Department of Pediatrics, Children’s Hospital at Montefiore, 3415 Bainbridge Avenue, Bronx, NY USA
| | - Bailey Frohlich
- Division of Adolescent Medicine, Department of Pediatrics, Children’s Hospital at Montefiore, 3415 Bainbridge Avenue, Bronx, NY USA
| | - Shelby Davies
- Division of Adolescent Medicine, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104 USA
| | - Judy Wylie-Rosett
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Jack and Pearl Resnick Campus, 1300 Morris Park Avenue, Bronx, NY 10461 USA
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Di Figlia-Peck S, Feinstein R, Fisher M. Treatment of children and adolescents who are overweight or obese. Curr Probl Pediatr Adolesc Health Care 2020; 50:100871. [PMID: 33097417 PMCID: PMC7576185 DOI: 10.1016/j.cppeds.2020.100871] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Stephanie Di Figlia-Peck
- Division of Adolescent Medicine, Cohen Children's Medical Center, Northwell Health, 410 Lakeville Road, Suite 108, New Hyde Park, NY 11042, United States; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States.
| | - Ronald Feinstein
- Division of Adolescent Medicine, Cohen Children's Medical Center, Northwell Health, 410 Lakeville Road, Suite 108, New Hyde Park, NY 11042, United States; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Martin Fisher
- Division of Adolescent Medicine, Cohen Children's Medical Center, Northwell Health, 410 Lakeville Road, Suite 108, New Hyde Park, NY 11042, United States; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
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Cocca A, Carbajal Baca JE, Hernández Cruz G, Cocca M. Does A Multiple-Sport Intervention Based on the TGfU Pedagogical Model for Physical Education Increase Physical Fitness in Primary School Children? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155532. [PMID: 32751812 PMCID: PMC7432696 DOI: 10.3390/ijerph17155532] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 12/18/2022]
Abstract
Teaching Games for Understanding (TGfU) is one of the pedagogical models used for increasing health through physical education (PE), being associated with several psychological benefits. However, only few studies have studied the effect of TGfU on physical fitness. This study aims at assessing the changes in students' physical fitness after a six-month TGfU-based program with primary school children. A total of eight schools from the state of Sonora (Mexico) were randomly distributed into experimental (EG) and control group (CG). The final sample consisted of 188 pupils (100 boys, 88 girls; age = 10.22 ± 0.76 years) from the 5th and 6th grade. Employing a quasi-experimental design, physical fitness was assessed by means of the Eurofit test battery. At post-test, EG obtained significantly higher scores than CG in flexibility, abdominals, speed (p < 0.001), handgrip (p = 0.002), low-limb power (p = 0.032), and cardiorespiratory fitness (p = 0.048). Our findings suggest that TGfU can be a valid alternative to traditional methodologies not only when the aim of a PE unit is to stimulate the cognitive domain, but also for the development of physical fitness attributes that may help pupils develop in a comprehensive manner.
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Affiliation(s)
- Armando Cocca
- Department of Sport Science, University of Innsbruck, Fürstenweg 185, 6020 Innsbruck, Austria
- Correspondence:
| | - Jovanny Edmundo Carbajal Baca
- Degree in Sport Training, State University of Sonora, Boulevard Rosales 189, Colonia Centro, 83079 Hermosillo, Mexico;
| | - Germán Hernández Cruz
- School of Sport Organization, Autonomous University of Nuevo Leon, Ciudad Universitaria s/n, 66455 San Nicolás de los Garza, Mexico; (G.H.C.); (M.C.)
| | - Michaela Cocca
- School of Sport Organization, Autonomous University of Nuevo Leon, Ciudad Universitaria s/n, 66455 San Nicolás de los Garza, Mexico; (G.H.C.); (M.C.)
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Lessard LM, Juvonen J. Weight Stigma in the School Setting: The Role of Inclusive Weight Climate-A Commentary. THE JOURNAL OF SCHOOL HEALTH 2020; 90:507-510. [PMID: 32367520 DOI: 10.1111/josh.12898] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 01/28/2020] [Accepted: 01/31/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Leah M Lessard
- University of Connecticut, Rudd Center for Food Policy & Obesity, One Constitution Plaza, Suite 600, Hartford, CT, 06103, USA
| | - Jaana Juvonen
- University of California, Los Angeles, Department of Psychology, 502 Portola Plaza, Los Angeles, CA, 90095, USA
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Pahlavani M, Ramalingam L, Miller EK, Davis H, Scoggin S, Moustaid-Moussa N. Discordant Dose-Dependent Metabolic Effects of Eicosapentanoic Acid in Diet-Induced Obese Mice. Nutrients 2020; 12:E1342. [PMID: 32397139 PMCID: PMC7284763 DOI: 10.3390/nu12051342] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/01/2020] [Accepted: 05/02/2020] [Indexed: 02/07/2023] Open
Abstract
Obesity is a widespread epidemic that increases the risk for several metabolic diseases. Despite several beneficial health effects of eicosapentaenoic acid (C20:5n-3, EPA), previous studies have used very high doses of EPA. In this study, dose-dependent effects of EPA on metabolic outcomes were determined in diet-induced obese mice. We used B6 male mice, fed high-fat diet (HF, 45% kcal fat) or HF diet supplemented with 9, 18, and 36 g/kg of EPA-enriched fish oil for 14 weeks. We conducted metabolic phenotyping during the feeding period, and harvested tissues and blood at termination. Only mice fed 36 g/kg of EPA significantly (p < 0.05) lowered body weight, fat content and epididymal fat pad weight, compared to HF. Both 18 and 36 g/kg doses of EPA significantly increased glucose clearance and insulin sensitivity, compared to HF or 9 g/kg of EPA. Locomotor activity was significantly increased with both 18 and 36 g/kg doses of EPA. Interestingly, all doses of EPA compared to HF, significantly increased energy expenditure and oxygen consumption and significantly reduced serum insulin, leptin, and triglycerides levels. These results demonstrate weight- and adiposity-independent metabolic benefits of EPA, at doses comparable to those currently used to treat hypertriglyceridemia.
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Affiliation(s)
| | | | | | | | | | - Naima Moustaid-Moussa
- Department of Nutritional Sciences, and Obesity Research Institute, Texas Tech University, Lubbock, TX 79409, USA; (M.P.); (L.R.); (E.K.M.); (H.D.); (S.S.)
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Narayanan N, Nagpal N, Zieve H, Vyas A, Tatum J, Ramos M, McCarter R, Lucas CT, Mietus-Snyder M. A School-Based Intervention Using Health Mentors to Address Childhood Obesity by Strengthening School Wellness Policy. Prev Chronic Dis 2019; 16:E154. [PMID: 31753082 PMCID: PMC6880918 DOI: 10.5888/pcd16.190054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
PURPOSE AND OBJECTIVES The objective of our study was to strengthen wellness policy in Title 1 schools by implementing a mentored behavior-change model that extends the continuum of care from academic to community settings and mobilizes existing public resources in accordance with US Preventive Services Task Force screening guidelines for childhood obesity management. INTERVENTION APPROACH Team Kid POWER! (KiPOW!) health mentors (students and trainees in medical and health-related fields) in 2 geographically and demographically distinct school districts, the District of Columbia and Orange County, California, delivered standardized health curricular modules to fifth grade classrooms, modeled healthy eating behaviors during school lunchtime, and engaged in active play at recess. EVALUATION METHODS Initial interventions in the the District of Columbia and Orange County delivered 10 sessions in which all participants received the intervention. Two subsequent interventions in Orange County, for 5 weeks (Lite) and 10 weeks (Full), included controls. Pre-post measurements of body mass index (BMI) and blood pressure were documented in all participants. A mixed linear regression model, which included a random effect for each school, estimated differences between Full and Lite interventions compared with controls, adjusting for site, sex, and baseline status of the dependent variable. RESULTS KiPOW! Full, but not KiPOW! Lite, was associated with a modest reduction in BMI percentile compared with control (KiPOW! Full, P = .04; KiPOW! Lite, P = .41), especially in Orange County (P < .001). Systolic blood pressure improved in Full (P < .046) more than in Lite interventions (P = .11), and diastolic blood pressure improved in both Full (P = .02) and Lite (P = .03) interventions. Annual renewal of the school and volunteer commitment needed to maintain KiPOW! was found to be sustainable. IMPLICATIONS FOR PUBLIC HEALTH KiPOW! is a generalizable academic-community partnership promoting face-to-face contact between students and trusted health mentors to reinforce school wellness policies and foster youth confidence in decision-making about nutrition- and activity-related behaviors to achieve reduced BMI percentile and lowered blood pressure.
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Affiliation(s)
- Nisha Narayanan
- Division of Pediatric Emergency Medicine, New York University Langone Medical Center, New York, New York
| | - Nikita Nagpal
- Department of General Pediatrics, New York University School of Medicine, Bellview Hospital Center, New York, New York
| | - Hillary Zieve
- Department of Pediatrics, Children's Hospital of Orange County, Irvine, California
| | - Aashay Vyas
- Department of General Pediatrics, Valley Children's Healthcare, Irvine, California
| | - Jonathan Tatum
- Department of General Pediatrics, Cincinnati Children's Medical Center, Cincinnati, Ohio
| | - Margarita Ramos
- Department of General Pediatrics, Children's National Hospital, Washington, District of Columbia
| | - Robert McCarter
- Division of Biostatistics and Study Methodology, Children's National Hospital, Washington, District of Columbia
| | - Candice Taylor Lucas
- Department of Pediatrics, University of California, Irvine School of Medicine, Irvine, California
- Pediatric Exercise and Genomics Research Center (PERC), University of California, Irvine School of Medicine, Irvine, California
| | - Michele Mietus-Snyder
- Center for Translational Research, Children's National Hospital, Washington, District of Columbia
- Division of Pediatric Cardiology, Children's National Hospital, Washington, District of Columbia
- George Washington University School of Medicine, Center for Translational Research, Children's National Hospital, 111 Michigan Ave NW, Washington, DC 20010.
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Lessard LM, Juvonen J. Body weight and academic achievement: The role of weight diversity in urban middle schools. ACTA ACUST UNITED AC 2019; 34:253-260. [PMID: 30883159 DOI: 10.1037/spq0000317] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The current study was designed to examine one possible weight stigma-reduction mechanism: school-level weight diversity. It was hypothesized that greater weight diversity among same-sex peers at school would attenuate the negative association between weight and academic achievement. Across 26 urban public middle schools, 5,991 sixth-grade students (52% girls) were included: 12% African American/Black, 14% East/Southeast Asian, 30% Latino, 21% White, and 23% from other specific ethnic groups. Weight diversity was estimated as the likelihood that two randomly selected students would be from different weight categories, using Simpson's index. Standardized achievement test scores and grade point average (GPA) were used to assess academic achievement. Consistent with our contextual moderator hypothesis, high levels of weight diversity at school served a protective function. The negative association between body mass index (BMI) and achievement test scores, as well as GPA (girls only) was nonsignificant at schools with high levels of weight diversity. The study results offer a potential explanation for inconsistent findings regarding body weight and achievement, and a novel methodological approach to capture weight diversity in ways that provide new insights for school-based interventions. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Leah M Lessard
- Department of Psychology, University of California, Los Angeles
| | - Jaana Juvonen
- Department of Psychology, University of California, Los Angeles
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