Physical activity, smoking, and obesity among Canadian school youth. Comparison between urban and rural schools

Prevalence and Associated Risk Factors of Childhood Obesity in the Eastern Province of Saudi Arabia

Introduction Overweight and obesity are defined as excessive fat accumulation that poses a risk to well-being. In children, a BMI of the 85th percentile to less than the 95th percentile is considered overweight, and the 95th percentile or greater is considered obese. Aim This study aimed to measure the prevalence of childhood obesity in a population of six to 16 years of age and its associated risk factors. Participants and methods This is a cross-sectional study conducted among children aged between six and 16 years old who live in the Eastern province of Saudi Arabia. The data collector in each school distributed envelopes containing an informed consent form and a survey to collect data on the demographics and socioeconomic status to all students. All students whose parents signed the informed consent would undergo measurement of growth parameters which ultimately determined the BMI. Results Six hundred eighty-eight children agreed to participate. The prevalence of overweight and obesity was 15.3% (overweight 10.2%, obese 5.1%). Children who eat four or more meals per day were 29.5% while only 10% were regularly exercising for more than two hours a day. Independent risk factors of obesity and overweight were eating four or more meals per day. Spending more than an hour a day on physical activity was a protective factor against being overweight and obese. Conclusion Increased daily food consumption was the most frequent risk factor for obesity. Physical activity was the protective factor against obesity in children and adolescents. Further intervention measures must be implemented to reduce the prevalence of overweight and obesity. A healthy lifestyle based on effective dietary education and physical activity promotion is required to prevent overweight and obesity among youth.

Association between density and proximity of tobacco retail outlets with smoking: A systematic review of youth studies

BACKGROUND

Reducing the retail availability of tobacco has been proposed as a component of tobacco endgame, yet it is not known whether retail availability has a direct impact on smoking behaviours. A narrative review and a meta-analysis have been undertaken to examine the density and proximity of tobacco retail outlets, but were limited in scope, exposure and outcome variables. The aim of this current study was to undertake a systematic review of the international literature on the density and proximity of tobacco retail outlets to homes, schools and communities and their association with smoking behaviours among youth.

METHODS

We reviewed and critically appraised the evidence documenting the association between density or proximity of tobacco retail outlets and smoking behaviours among school-age youth (18 and under), between 1 January 1990 and 21 October 2019. We reviewed original quantitative research that examined the associations of tobacco retail outlet density and proximity with individual smoking status or population-level smoking prevalence; initiation of smoking; frequency of tobacco use; sales to minors; purchasing by minors; susceptibility to smoking among non-smokers; perceived prevalence of smoking, and quitting behaviours.

FINDINGS

Thirty-five peer-reviewed papers met the inclusion criteria. This review provided evidence of a relationship between density of tobacco retail outlets and smoking behaviours, particularly for the density near youths' home. A study using activity spaces also found a significant positive association between exposure to tobacco retail outlets and daily tobacco use. The review did not provide evidence of an association between the proximity of tobacco retail outlets to homes or schools and smoking behaviours among youth.

CONCLUSIONS

The existing evidence supports a positive association between tobacco retail outlet density and smoking behaviours among youth, particularly for the density near youths' home. This review provides evidence for the development and implementation of policies to reduce the density of tobacco retail outlets to reduce smoking prevalence among youth.

Predictors of current tobacco smoking by adolescents in Nigeria: Interaction between school location and socioeconomic status

INTRODUCTION

Tobacco smoking is the largest preventable cause of global mortality, with its prevalence increasing in Sub-Saharan Africa, particularly among adolescents. We sought to determine the factors associated with tobacco smoking among Nigerian school adolescents and investigate the interaction between school location and socioeconomic status (SES).

METHODS

Using a cross-sectional study design, 4332 eighth to tenth grade students in rural and urban secondary schools in Enugu State, Nigeria, were selected by stratified two-stage cluster sampling. We collected data using a modified Global Youth Tobacco Survey (GYTS) Core Questionnaire. Outcome measures were current smoking of cigarettes and other smoked tobacco. Multilevel mixed effects logistic regression models were used to determine factors associated with current tobacco smoking and were considered statistically significant at p<0.05.

RESULTS

Prevalences of current smoking of cigarettes and other smoked tobacco were 13.3% (95% CI: 11.3-15.7) and 5.8% (95% CI: 4.6-7.2), respectively. Possession of higher weekly allowance, exposure to secondhand smoke or tobacco advertisements, having smoking parents, friends or classmates who smoke, and sale of cigarettes near school, were positively associated with current smoking of tobacco. Female sex, having both parents employed and being exposed to tobacco teaching in school were negatively associated with current cigarette smoking while increasing age and high father's SES were negatively associated with current smoking of other tobacco products. There was an interaction between school location and father's SES in the association with cigarette smoking. The higher odds of smoking in rural versus urban schools were much higher for students with fathers of high SES compared to low SES. In rural schools, high SES was associated with higher odds of smoking, but in urban schools low SES was associated with higher odds of smoking. CONCLUSIONS Environmental factors are associated with adolescent tobacco smoking. Tobacco control programs should use targeted strategies that vary depending on the local context.

Secular trends in weight, stature, and body mass index in Nova Scotia, Canada

OBJECTIVES

The present study aims to investigate the secular trends of weight, stature, and BMI values in a Nova Scotian sample from 1946 to 1999, with particular focus on how these trends may relate to nutrition and the evolving obesity epidemic.

METHODS

Data were collected from investigative (autopsy) records of 1645 individuals (1287 males, 358 females) of European descent at the Nova Scotia Medical Examiner Service. Secular trends were evaluated by linear regression of weight, stature, and BMI with respect to the year of birth. Further analysis of this sample was based on five time periods (birth cohorts), in order to determine whether dramatic shifts in diet and nutrition affected weight, stature, and BMI.

RESULTS

Overall, the results of this study demonstrate positive secular trends in weight, stature, and BMI from 1946 to 1999 in the Nova Scotian sample. Subsequent analysis among different time periods shows a secular increase in the weight of Nova Scotian males from 1946 to 1979, and a subsequent decrease in weight in after 1980. For Nova Scotian females, the results show a secular increase in weight from 1946 to 1989, and a subsequent decrease in weight after 1990. Such secular increases in weight coincide with the global nutrition transition, while recent decreasing median weight values may reflect economic growth and urbanization in Nova Scotia.

CONCLUSIONS

Overall, the results of the present study indicate that temporal trends in nutrition may have contributed to positive secular changes in weight, stature, and BMI in Nova Scotia, Canada between 1946 and 1999.

Developing a coordinated Canadian post-secondary surveillance system: a Delphi survey to identify measurement priorities for the Canadian Campus Wellbeing Survey (CCWS)

Background

Interventions that promote health and wellbeing among young adults are needed. Such interventions, however, require measurement tools that support intervention planning, monitoring and evaluation. The primary purpose of this study is to describe the process in developing a framework for a Canadian post-secondary health surveillance tool known as the Canadian Campus Wellbeing Survey (CCWS).

Methods

Nineteen health service providers or mental health experts from 5 Canadian provinces participated in a 3-round Delphi survey by email and an in-person roundtable meeting to identify wellbeing and health behavior measurement priorities and indicators for the CCWS.

Results

The final CCWS framework consisted of 9 core sections: mental health assets, student experience, mental health deficits, health service utilization/help seeking, physical health/health behaviors, academic achievement, substance use, nutrition, and sexual health behavior. Panelists generally agreed on a set of indicators, and reached consensus for at least one indicator per core section.

Conclusion

This CCWS framework is the first step in developing a common surveillance mechanism tailored to the Canadian postsecondary context. Future work will include online consultation with health service providers from a broader range of post-secondary institutions, an in-person meeting with research and measurement experts to finalize survey items, and formative testing. The CCWS will play a valuable role in developing population health initiatives targeting the increasing number of young Canadians attending postsecondary institutions.

Trends in the ease of cigarette purchase among Korean adolescents: evidence from the Korea youth risk behavior web-based survey 2005-2016

Background

According to the Juvenile Protection Act in Korea, no one is allowed to sell, rent, or distribute tobacco products to adolescents. Furthermore, the Framework Convention on Tobacco Control Article 16 prohibits the sale of tobacco products to minors. In this study, we investigated the trends in and associated factors of the ease of cigarette purchase among Korean adolescents from 2005 to 2016.

Methods

The analyses were based on the data of the Korea Youth Risk Behavior Web-based Survey. We estimated the trends in the ease of cigarette purchase from 2005 to 2016 and evaluated associated factors. Ease of cigarette purchase was defined as the proportion of adolescents who were able to purchase cigarettes from among those who had tried to purchase cigarettes in the past 30 days.

Results

The ease of cigarette purchase began decreasing since 2008 (81.3%) compared to 2005 (83.9%). It decreased to 76.5% in 2013 and further decreased to 71.4% in 2016. The ease of cigarette purchase increased for adolescents who were in higher grades, smoked larger amounts of cigarettes per day, lived in metropolitan cities, had problematic drinking in the past year, and had close friends who smoked. It decreased in adolescents who had current smokers among their family members.

Conclusions

Although the proportion of adolescents who were able to purchase cigarettes significantly decreased starting in 2008, more than 70% of Korean adolescents can still purchase cigarettes. Enforcement of the Juvenile Protection Act must be strengthened in order to prevent cigarette use among adolescents.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-6151-9) contains supplementary material, which is available to authorized users.

The relationship between physical activity and diet, and overweight and obesity, in young people

BACKGROUND

Childhood obesity has a worldwide association with serious health problems and complications that increase the risk of illness and death.

AIM

To identify and assess the factors contributing to overweight and obesity among school students in north Jordan.

METHOD

A descriptive cross-sectional study involving 1,554 students was conducted between October 2014 and February 2015.

RESULTS

More than two thirds (70%) of participants were normal weight (5th percentile-<85th percentile), while 12% were overweight and 13% were obese. The prevalence of obesity was high (20%) among those eating snacks three times per day. The prevalence of overweight was high (12%) among those who followed no regular physical activity programme.

CONCLUSION

Collaboration is required between policymakers, healthcare professionals, business and community leaders, schools and local organisations to create suitable environments that support healthy lifestyles for children and young people.

Disparities in tobacco use by adolescents in southeast, Nigeria using Global Youth Tobacco Survey (GYTS) approach

BACKGROUND

Tobacco use during adolescence is a substantial problem and adolescents are at higher risk of addiction and prolonged use. To reduce the burden of tobacco-related morbidity and mortality, monitoring of adolescent tobacco use is imperative. We aimed to determine the prevalence of tobacco use among adolescents in urban and rural secondary schools in Enugu State, southeast Nigeria.

METHODS

A cross-sectional study of 4332 adolescents in 8th to 10th grades in 25 urban and 24 rural secondary schools in Enugu, Nigeria was done using Global Youth Tobacco Survey (GYTS) methodology. Students were asked about previous and current tobacco use, smoking cessation, and susceptibility to smoking initiation among non-smokers. Geographical, age and sex prevalence differences were examined. Analyses were performed for all adolescents (10-19 years) and for a subset of students, 13-15 years of age for comparison with previous GYTS surveys. All analyses were weighted to account for the complex survey design and for differential non-response at school, class and student levels.

RESULTS

About 28.9% of students reported ever smoking cigarettes; 19.4% reported current tobacco use among all adolescents (13.3, 5.8 and 7.8% for cigarettes, other smoked tobacco, and smokeless tobacco, respectively) while 18.6% reported current tobacco use among 13-15 year olds (12.6, 5.2 and 7.5% for cigarettes, other smoked tobacco and smokeless tobacco respectively). Prevalence of all types of tobacco use was higher in rural schools (vs. urban schools), and among boys (vs. girls). Susceptibility to smoking initiation among non-smokers was 9.3% (95% CI: 8.1-10.7) among all adolescents, and 9% (95% CI: 7.6-10.7) among 13-15 year olds. About 88.1% of all adolescent smokers desired to quit and 57.9% of them had never received help to quit smoking.

CONCLUSIONS

Nearly one in every five school-going adolescents currently uses at least one type of tobacco in Enugu State, southeast Nigeria. Prevalence of tobacco use is higher in rural schools and among boys in this setting. Most adolescent current smokers desire to quit and need smoking cessation support.

The shelf space and strategic placement of healthy and discretionary foods in urban, urban-fringe and rural/non-metropolitan Australian supermarkets

Objective

Supermarkets are a key influence on eating behaviours, but it is unknown if the promotion of food within stores varies on a geographic gradient from urban, to urban-fringe and non-metropolitan areas. The present study aimed to assess the shelf space and strategic placement of healthy and discretionary foods in each of urban, urban-fringe and non-metropolitan Australian supermarkets.

Design/Setting

In-store audits were conducted in stores from one of the two major Australian supermarket chains in urban (n19), urban-fringe (n20) and non-metropolitan (n26) areas of Victoria. These audits examined selected food items (crisps/chips, chocolate, confectionery, soft drinks/sodas, fruits and vegetables) and measured the shelf space and the proportion of end-of-aisle and cash register displays containing these products. Store size was measured as the sum of aisle length. Differences in the supermarket food environment with respect to location were assessed, before and after adjustment for neighbourhood socio-economic position.

Results

The strategic placement of discretionary foods was commonly observed in all supermarkets. Adjusting for store size (larger in urban-fringe and rural areas), urban stores had greater shelf space devoted to fruits and vegetables, and less checkouts with soft drinks, than urban-fringe and rural/non-metropolitan areas. Differences remained following adjustment for neighbourhood socio-economic position. No clear pattern was observed for end-of-aisle displays, or the placement of chocolate and confectionery at checkouts.

Conclusions

The shelf space of healthy and discretionary foods in urban-fringe and rural stores parallels the prevalence of overweight and obesity in these areas. Interventions in urban-fringe and rural stores targeting the shelf space of healthy foods and the placement of soft drinks at key displays may be useful obesity prevention initiatives.

Factors Associated With Current Smoking Among Off-Reserve First Nations and Métis Youth: Results From the 2012 Aboriginal Peoples Survey

First Nations and Métis, two of Canada's constitutionally recognized Indigenous groups, suffer from poorer overall health than non-Indigenous Canadians. Current smoking, a known predictor of chronic health conditions, is close to twice as prevalent among Indigenous youth as it is among non-Indigenous Canadian youth. However, little population-level research has examined the correlates of current smoking among this population. Guided by a health framework centered on Indigenous-specific determinants, we used data from the 2012 Aboriginal Peoples Survey to examine the correlates of current smoking among First Nations and Métis youth aged 15-17 years living outside of First Nations reserves. Using binary logistic regression, we investigated how culturally specific factors, namely knowledge of an Indigenous language, participation in traditional activities, and family members' attendance at residential schools, were correlated with current smoking. We also considered demographic, geographic, socioeconomic and health-related correlates. Overall, an estimated 20.6% of First Nations and Métis youth reported current smoking. We found no significant associations between culturally specific activities and current smoking in the multivariate analyses, although those who spoke an Indigenous language were more likely to smoke. Those who participated in sports more often were less likely to smoke, and respondents who reported heavy drinking and who were from families with lower income were more likely to smoke. Gender, body mass index, urban/rural geography and regional geography, and mother's highest level of education were not significantly correlated with smoking. The results of our study support prior research that has found a disturbingly high prevalence of current smoking among Indigenous youth, compared to their non-Indigenous counterparts. Our results highlight the importance of considering sports participation, co-occurring health-risk behaviours and socioeconomic factors when developing interventions aimed at reducing the prevalence of smoking among First Nations and Métis youth.

Actual Body Weight and the Parent's Perspective of Child's Body Weight among Rural Canadian Children

The prevalence of being overweight during childhood continues to increase in the USA and Canada and children living in rural areas are more at risk than their urban counterparts. The objectives of this study were to evaluate how well the parent’s perception of their child’s weight status correlated with objectively measured weight status among a group of rural children and to identify predictors of inaccurate parental perceptions of child’s weight status. Participants were children from the Saskatchewan Rural Health Study conducted in 2010. Self-administered questionnaires were distributed through rural schools to parents of children in grades one to eight. Parents reported their child’s height and weight and rated their child’s weight status (underweight, just about the right weight, or overweight). Standardized body mass index (BMI) categories were calculated for clinically measured height and weight and for parental report of height and weight for 584 children. Logistic regression analysis was performed to identify predictors of misclassification of the parent’s perception of child’s weight status adjusting for potential confounders. Clinically measured overweight was much higher (26.5%) compared to parental perceived overweight (7.9%). The misclassification of the child’s BMI was more likely to occur if the child was a boy (odds ratio (OR) = 1.58) or non-Caucasian (OR = 2.03). Overweight was high in this group of rural children and parental perception of weight status underestimated the actual weight status of overweight school-age children. Parental reporting of child weight status has implications for public health policy and prevention strategies. Future research should focus on assessing longitudinal effects of parental misperceptions of child’s weight status.

Adherence to Canadian physical activity and sedentary behaviour guidelines among children 2 to 13 years of age

Active living is relevant for healthy child development and disease prevention. In 2011-2012 new Canadian Physical Activity and Sedentary Behaviour Guidelines were developed for children under four and 5-17 years of age. This cross-sectional study assessed children's adherence to the national guidelines, using a large sample of Alberta children ages 2-4 and 5-13 years in 2013. The proportions of children achieving the average daily duration of physical activity and screen time recommended were determined, and child and parental predictors of non-achievement were identified. Participants were 631 parent and child dyads. Data were collected by parental reports of physical activity and screen time during weekdays, and analysed using univariate and multivariate techniques (p < 0.05). Logistic regression models were used to examine factors associated with children's non-achievement of physical activity and screen time recommendations while adjusting for covariates. Sixty-two percent of children aged 2-4 and 26% of children aged 5-13 did not meet physical activity time recommendations, and 64% of children aged 2-4 and 23% of children aged 5-13 exceeded the maximum screen time recommendation. Several associations between parental age and education with non-achievement were observed but associations were not consistent across age groups or behaviours. Among preschoolers, those with middle-age parents were more likely to not achieve physical activity recommendations. Evidence of high non-achievement of the recommendations among children 2-4 years highlights the need for increased programming targeting preschool children. Further research is required to identify modifiable risk factors that may inform future health promotion efforts.

Physical Activity and Sedentary Screen Time in Obese and Overweight Children Living in Different Environments

AIM

To assess the relationship of children's physical activity and sedentary screen time with overweight and obesity in children living in different environments (town and city) in Lithuania.

METHODS

An analysis of anthropometric data from 532 children living in town and city areas was performed. A youth physical activity questionnaire (YPAQ) was conducted to evaluate physical activity and sedentary screen time.

RESULTS

The prevalence of overweight and obesity among the children was 25.5% in the town and 18.6% in the city. Children living in the town on average engaged 9.3 min/day less in moderate to vigorous physical activity (p=0.050) and had 33.2 MET-min/day lower energy expenditure than children living in the city. Sedentary screen time was extremely high on weekends in both town and city children.

CONCLUSIONS

A higher prevalence of overweight and obesity and a lower amount of moderate-to-vigorous physical activity was found in children living in the town compared to children living in the city.

Built environment interventions aimed at improving physical activity levels in rural Ontario health units: a descriptive qualitative study

BACKGROUND

Few studies to date have explored the relationship between the built environment and physical activity specifically in rural settings. The Ontario Public Health Standards policies mandate that health units in Ontario address the built environment; however, it is unclear how public health practitioners are integrating the built environment into public health interventions aimed at improving physical activity in chronic disease prevention programs.

METHODS

This descriptive qualitative study explored interventions that have or are being implemented which address the built environment specifically related to physical activity in rural Ontario health units, and the impact of these interventions. Data were collected through twelve in-depth semi-structured interviews with rural public health practitioners and managers representing 12 of 13 health units serving rural communities. Key themes were identified using qualitative content analysis.

RESULTS

Themes that emerged regarding the types of interventions that health units are employing included: Engagement with policy work at a municipal level; building and working with community partners, committees and coalitions; gathering and providing evidence; developing and implementing programs; and social marketing and awareness raising. Evaluation of interventions to date has been limited.

CONCLUSIONS

Public health interventions, and their evaluations, are complex. Health units who serve large rural populations in Ontario are engaging in numerous activities to address physical activity levels. There is a need to further evaluate the impact of these interventions on population health.

Urban and Rural Fitness Level: Comparison between Italian and Croatian Students

The goal of this study was to investigate the differences in physical fitness in relation to urban or rural living environment and between two countries: Italy and Croatia. Over 14,000 students were tested during physical education (PE) lessons. Croatian students were taller and heavier than Italian students, with women achieving better results in flexibility. Urban students were fitter in abdominal strength than rural students. Age seemed to be the major factor influencing the performance. This study's results indicate a trend: urban students performed “indoor” tests better than rural students; the opposite may be true for rural students. Living environment, socio-economic-status, or cultural correlation differences could be decreased during school experiences. Thus, PE programs could train all people toward an adequate, age-based fitness level.

Relations between the school physical environment and school social capital with student physical activity levels

Background

The physical and social environments at schools are related to students’ moderate-to-vigorous physical activity (MVPA) levels. The purpose of this study was to explore the interactive effects of the school physical environment and school social capital on the MVPA of students while at school.

Methods

Data from 18,875 grade 6–10 students from 331 schools who participated in the 2009/10 Canadian Health Behaviour in School-Aged Children survey were analyzed using multi-level regression. Students answered questions on the amount of time they spend in MVPA at school and on their school’s social capital. Administrator reports were used to create a physical activity related physical environment score.

Results

The school physical environment score was positively associated with student MVPA at school (β = 0.040, p < .005). The association between the school social capital and MVPA was also positive (β = 0.074, p < .001). The difference in physical environments equated to about 20 minutes/week of MVPA for students attending schools with the lowest number of physical environment features and about 40 minutes/week for students attending schools with the lowest school social capital scores by comparison to students attending schools with the highest scores.

Conclusions

The findings suggest that school social capital may be a more important factor in increasing students MVPA than the school physical environment. The results of this study may help inform interventions aimed at increasing student physical activity levels.

The rural and the rotund? A critical interpretation of food deserts and rural adolescent obesity in the Canadian context

Resting on the notion that rural spaces are "food deserts," rural adolescents are increasingly regarded as a "problem population" in Western obesity narratives. Using qualitative data gleaned from interviews with 51 teenage participants from rural areas across Canada, this paper focuses on the ways in which obesity is constructed as a rural disease in the Canadian context, demonstrating in particular how discourses of food deserts and related rural obesity rely on classist imaginings of obesity as a working-class embodiment. The paper will further question the understanding of the rural as a food desert, showing the ways in which rural teens acquire fresh, healthy foods in part through an informal economy of food growing and sharing.

The community-based healthy-lifestyle intervention for rural preschools (CHIRP) study: design and methods

The CHIRP study is a two-arm, pilot randomized controlled trial assessing the effectiveness of a behavioral family weight management intervention in an important and at-risk population, overweight young children, 3 to 6 years of age, and their parents from underserved rural counties. Participants will include 96 parent-child dyads living in rural counties in north central Florida. Families will be randomized to one of two conditions: (a) behavioral family based intervention or (b) a waitlist control. Child and parent participants will be assessed at baseline (month 0), post-treatment (month 4), and follow-up (month 10). Assessments and intervention sessions will be held at the Cooperative Extension office in each participating rural county. The primary outcome measure is change in child body mass index (BMI) z-score. Additional key outcome measures include child dietary intake, physical activity, and parent BMI. This study is unique because (1) it is one of the few randomized controlled trails examining a behavioral family intervention to address healthy habits and improved weight status in young overweight and obese children, (2) addresses health promotion in rural settings, and (3) examines intervention delivery in real world community settings through the Cooperative Extension Service offices. If successful, this research has potential implications for medically underserved rural communities and preventative health services for young children and their families.

Obesity, diet, and activity in relation to asthma and wheeze among rural dwelling children and adolescents

AIMS AND OBJECTIVES

We investigated associations between weight status, activity level, and diet with asthma or wheeze as well as the interrelationship between these factors.

METHODS

We conducted a case-control study of 6-18-year olds from 2005 to 2007. Cases (n = 87) were subjects reporting episodes or breathing medication use along with doctor-diagnosed asthma or wheeze in the past 12 months. Controls were randomly selected (n = 208) and without asthma or wheeze. Data regarding health outcomes, diet, and activity were obtained from questionnaire. Objectively measured height and weight were collected.

RESULTS

In the adjusted analysis, there was a trend (P = 0.07) towards an increased risk of asthma or wheeze associated with high fast food and/or pop consumption. Among cases, a significantly lower proportion (66%) classified as overweight participated in hard exercise in ≥9 of the past 14 days compared to those who were not overweight (86%). This pattern was not seen among controls (76% participating in hard exercise versus 78%, resp.). However, based on perceived weight status by the parent, the patterns were similar regardless of case-control status.

CONCLUSIONS

Overweight status may negatively impact activity level among those with asthma or wheeze. Efforts should be made to encourage healthy food choices, and activity programming must consider the needs of overweight children with asthma.

Physical activity, energy intake, and obesity prevalence among urban and rural schoolchildren aged 11–12 years in Japan

The prevalence of childhood overweight and obesity has been shown to differ among regions, including rural–urban regional differences within nations. This study obtained simultaneous accelerometry-derived physical activity, 24 h activity, and food records to clarify the potential contributing factors to rural–urban differences in childhood overweight and obesity in Japan. Sixth-grade children (n = 227, 11–12 years old) from two urban elementary schools in Kyoto and four rural elementary schools in Tohoku participated in the study. The children were instructed to wear a pedometer that included a uniaxial accelerometer and, assisted by their parents, keep minute-by-minute 24 h activity and food records. For 12 children, the total energy expenditure was measured by the doubly labeled water method that was used to correct the Lifecorder-predicted activity energy expenditure and physical activity level. The overweight and obesity prevalence was significantly higher in rural than in urban children. The number of steps per day, activity energy expenditure, physical activity level, and duration of walking to school were significantly lower in rural than in urban children. In contrast, the reported energy intake did not differ significantly between the regions. The physical activity and duration of the walk to school were significantly correlated with body mass index. Rural children had a higher prevalence of overweight and obesity, and this may be at least partly caused by lower physical activity, especially less time spent walking to school, than urban children.

Geography influences dietary intake, physical activity and weight status of adolescents

Purpose. The purpose of this study was to assess rural and urban differences in the dietary intakes, physical activity levels and weight status of a large sample of Canadian youth in both 2005 and 2008. Materials and Methods. A cross-sectional study of rural and urban adolescents (n = 10, 023) in Alberta was conducted in both 2005 and 2008 using a web-based survey. Results. There was an overall positive change in nutrient intakes between 2005 and 2008; however, rural residents generally had a poorer nutrient profile than urban residents (P < .001). They consumed less fibre and a greater percent energy from saturated fat. The mean physical activity scores increased among rural youth between 2005 and 2008 (P < .001), while remaining unchanged among urban youth. Residence was significantly related to weight status in 2005 (P = .017), but not in 2008. Conclusion. Although there were small improvements in nutrient intakes from 2005 to 2008, several differences in the lifestyle behaviours of adolescents living in rural and urban areas were found. The results of this study emphasize the importance of making policy and program recommendations to support healthy lifestyle behaviours within the context of the environments in which adolescents live.

Urban-rural differences in asthma prevalence among young people in Canada: the roles of health behaviors and obesity

BACKGROUND

Asthma prevalence has been reported to be lower in rural regions, but the reasons for this are not known.

OBJECTIVE

To confirm the existence of an urban-rural geographic gradient in asthma prevalence among Canadian youths and to evaluate whether this gradient was mediated by health behaviors.

METHODS

Cross-sectional data from 4,726 Canadian youth (grades 6-10) were collected during the 2001-02 Health Behaviour in School-Aged Children survey. Geographic region was categorized as metro (urbanized), non-metro but adjacent to metro, and rural. Asthma was defined via self-report of doctors' diagnoses and at least 1 of: (1) asthma symptoms or (2) a health care visit for asthma in the past year. Health behaviors (diet and physical activity) as well as obesity were also assessed.

RESULTS

Asthma prevalence was lowest in rural regions (metro = 17.7%, non-metro-adjacent = 15.6%, rural = 14.8%). A lower risk of asthma was associated with rural region (adjusted odds ratio [OR] = 0.76, 95% CI = 0.61-0.95) and living in non-metro-adjacent regions (adjusted OR = 0.81, 95% CI = 0.65-1.01). Health behaviors and obesity status did not mediate the association between geographic region and asthma. Being overweight or obese, having a high physical activity level, and exposure to passive smoking independently elevated the risk of asthma, whereas increased consumption of whole milk or vegetables were each protective.

CONCLUSIONS

Although asthma prevalence among youth was lower in rural areas, this association was not mediated by health behaviors or obesity. Other exposures, likely environmental, are the logical mechanisms through which rural geographic status is related to lower asthma prevalence.

Contrasting physical activity patterns in children and adolescents living in differing environments in the UK

Aims: There is evidence for lower physical activity (PA) in rural adults; it is important to evaluate how the environment influences the PA of children and adolescents. Methods: We compared the PA of 6485 English 10—15.9 year olds according to two systems for classifying the immediate environment. System one compared urban and rural areas. System two compared urban, town and fringe, and rural areas. Analyses were carried out separately for children (<13 years) and adolescents (>13 years). Results: Rural children were more active than those from urban areas (OR 1.38, 95% CI 1.15—1.66) as were adolescents (OR 1.30, 95% CI 1.11—1.51). Using trilateral division, children were more active if they lived in town and fringe (OR 1.32, 95% CI 1.03—1.67) or rural (OR 1.45, 95% CI 1.14—1.84) areas compared with urban areas. Adolescents from town and fringe areas were more active than urban dwellers (OR 1.50, 95% CI 1.24—1.81). Rural adolescents’ PA did not differ from urban dwellers’. Conclusions: Rural environments support PA in children but not that of adolescents. Town and fringe areas with mixed elements of rural and urban land use appear to facilitate and sustain PA in both children and adolescents.

A pilot study of the impact of bovine spongiform encephalopathy on the futures of rural youth and Canadian farming

There is an abundance of literature examining the economic impact of Canada's bovine spongiform encephalopathy (BSE) outbreak, but few studies examined the impact of such a crisis on health at the individual, family, or community levels. In particular, rural youth represent an under-researched population despite being at risk for a unique set of social and health concerns. In this pilot study, our objectives were to explore how rural youth responded to Canada's BSE crisis and how they perceived themselves, their families, and their communities to have been impacted. Seven youths (n = 7), recruited from within a university setting using a snowball sampling method, were interviewed. They represent a segment of rural, agriculturally based youth who are resilient due to good parental support. Although they reported high stress in their families during the immediate crisis in 2003, they did not report lasting high levels of stress or negative health effects due to BSE. They did report a decline in rural community health, identifying a reduction in community activities and in the participation of families in community activities. Participants identified elements that discourage youth from pursuing farming as a career and expressed concern for the future of family farming. The results are discussed in terms of the ability of agriculturally based youth to make the transition to adulthood. The implications have importance for future research and policy that addresses the structural supports for choice making, the long-term success for rural youth in transitioning to adult status, and the future of agriculture.

A latent profile analysis of neighborhood recreation environments in relation to adolescent physical activity, sedentary time, and obesity

OBJECTIVEV: This study examined whether multivariate profiles of the neighborhood recreation environment were associated with adolescent physical activity, sedentary time, and obesity.

DESIGN

Residential addresses of 871 adolescents in San Diego County (53% female, mean age = 12.8 years) were geocoded to create 1-mile network buffers.

MEASURES

Geographic information systems calculated neighborhood environmental variables. Accelerometers (worn 3-7 days) estimated daily moderate to vigorous physical activity (MVPA) and sedentary time. Height and weight were directly measured.

RESULTS

Latent profile analysis, using 7 environmental variables, resulted in 3 neighborhood profiles characterized as "open space" (OS), "residential with cul-de-sacs" (RWC), and "housing & facility dense" (HFD). These were named Adolescent Recreation Environment Accessibility (AREA) profiles. Multiple regression models stratified by gender tested associations between the AREA profiles and outcomes. Boys were less sedentary in the OS and RWC neighborhoods (7 hours per day) compared with the HFD neighborhoods (8 hours per day) (P < .01), and boys were more likely to be obese in the HFD neighborhoods (55%) compared with the OS group (24%) (P < .05). Girls in the RWC neighborhoods had lower MVPA levels (70 minutes per day) and were more likely to be obese (31%) than those in the OS neighborhoods (79 minutes per day MVPA, 21% obese) (Ps < .05). No differences were found for boys' MVPA or girls' sedentary time by the AREA profiles.

CONCLUSIONS

These findings highlight the complex relationships among environmental factors, activity levels, and obesity.nn.

Geographic differences in childhood overweight, physical activity, nutrition and neighbourhood facilities: implications for prevention

BACKGROUND

Childhood overweight is a major public health concern. Whereas various studies have documented higher prevalence rates in rural areas compared to urban areas, little is known about what is causing these differences. We sought to identify the factors underlying the overweight differentials by examining physical activity and nutrition behaviours as well as neighbourhood characteristics of urban areas, towns and rural areas across Alberta.

METHODS

In 2008, we surveyed 3,421 grade five students and their parents from 148 randomly selected schools. Students completed the Harvard Food Frequency Questionnaire, questions on physical activities, and had their height and weight measured. Parents completed questions on socioeconomic background, child's lifestyle, and neighbourhood perception. We applied multilevel regression methods to quantify the geographic differentials in physical activity, nutrition and neighbourhood facilities.

RESULTS

The prevalence of overweight was 28.5% among Albertan grade five students, with 6.7% being obese. Among students attending schools in towns and rural areas, the prevalence of overweight (obesity) was 29.8% (7.9%) and 30.6% (8.0%), respectively. Compared with students attending urban schools, those attending schools in towns and rural areas reported more physical activity despite perceiving less access to playgrounds/parks and recreational programs (p < 0.01). These latter students further reported poorer diets and purchasing more energy-dense foods and snacks at their schools (p < 0.01).

CONCLUSION

Our findings confirmed the existence of geographic differentials in overweight and its underlying causes. The study urges more promotion of healthy eating and active living, particularly in towns and rural areas to reduce geographic inequalities in health.

The meaning of health in rural children: a mixed methods approach

Gaining an understanding of the meaning of health in children may provide insight into factors that contribute to effective programs aimed at preventing diseases such as childhood obesity. A mixed methods design was used to explore the meaning of health of rural Saskatchewan children. A health questionnaire and Body Mass Index scores were collected from 99 children (Grades 1 to 7). A focused ethnographic approach was used to explore the meaning of health in a subset of 20 children (9 to 12 years old). Regardless of weight status, children described their meaning of health as Knowing Stuff, Having a Working Body, and Feeling Happy and suggested that Feeling Happy was most meaningful. The rural environment appeared to provide a sense of safety, security, and freedom. The researcher discovered the value children placed on the psychosocial dimension of health and provided insights into aspects that may foster healthy behaviors in this population.

Cardiorespiratory fitness of asthmatic children and validation of predicted aerobic capacity

INTRODUCTION

Predicted aerobic capacity (PAC) was estimated by submaximal exercise test and compared with monitored aerobic capacity (MAC) measured by laboratory conditions [maximal oxygen uptake (VO(2peak))] in 18 children and adolescents, 10 asthmatics and 8 matched controls.

OBJECTIVES

To compare aerobic capacity between asthmatic children and controls, to estimate the agreement between PAC and MAC and observe for trend of PAC.

MATERIALS AND METHODS

The design was prospective, 4 years (PAC) and cross-sectional (MAC and VO(2peak)). Non-parametric Wilcoxon rank sums were applied for statistical evaluation; the method of Bland and Altman estimated the agreement between PAC and MAC; P < 0.05.

RESULTS

PAC at baseline and follow-up, and MAC at follow-up, showed significant differences between groups (P < 0.05), and the mean difference between PAC and MAC at follow-up was -1.0 mLO(2)/min/kg [non-significant (ns)], indicating that PAC had a bias towards underestimation as compared with MAC. Limits of agreement, mean difference [+/-2 standard deviations (SD)], ranged from -8.5 to 6.5 mLO(2)/min/kg, indicating good agreement between the two measurements. No trend of PAC was observed (ns). Physical activity level and subjective health showed no differences between groups, or level and categories, respectively.

CONCLUSION

The asthmatic participants presented with lower aerobic capacity than controls in both PAC and MAC; therefore, results confirmed the validity of the PAC method. Data warrant exploration by large-scale paediatric asthma epidemiology.

Physical activity levels of children living in different built environments

OBJECTIVE

To review the available literature assessing differences in physical activity levels of children living in different built environments classified according to land use within developed countries.

METHODS

A systematic review of published literature up to March 2009. Online searches of five databases yielded 18 studies which met inclusion criteria. Studies provided data on n=129446, 5-18 years old (n=117544 from the United States).

RESULTS

From 13 assessments of differences in physical activity between rural and urban children one showed that rural children were significantly more active than urban children. In studies where the built environment was sub-divided further, suburban and small town children showed the highest levels of physical activity, followed by rural, then urban children. Differences in types of physical activity undertaken were evident, showing that rural children spent more time outdoors, involved in unstructured play compared with urban children. These findings were mainly restricted to children <13 years old.

CONCLUSIONS

The literature does not show major differences in the physical activity levels between children from rural or urban areas. Where studied, the suburban built environment appears most conducive to promoting physical activity. Further research should use at least a trilateral division of the built environment and should also account for socioeconomic status, racial factors and seasonal effects.

What is a healthy body weight? Perspectives of overweight youth

PURPOSE

A qualitative assessment was completed of overweight/obese youths' perceptions of the meaning of "healthy body weight," barriers and facilitators to healthy body weight attainment, and what would effectively enhance and support their healthy body weight behaviours.

METHODS

This qualitative study targeted a sample of overweight and obese youth, aged 14 to 16 years. An experienced interviewer conducted 11 in-depth interviews. Interviews were audio-recorded and transcribed verbatim. Three qualitative researchers conducted independent and simultaneous inductive content analysis to facilitate confirmability. Data trustworthiness was supported via member checking, peer debriefing, and reflexive journalling.

RESULTS

Most participants characterized healthy body weight as a combination of healthy eating and regular physical activity. Some included a psychological dimension in the definition. Perceived facilitators of a healthy body weight included family support, access to nutritious food at home, physical activity encouragement, and a physical activity environment at school. Perceived barriers included lack of family support, a poor nutrition environment, an unsupportive school environment, time, self-esteem, and bullying. Participants identified preferences for an intervention that would include opportunities for unstructured coeducational recreational activities, coeducational nutrition education sessions, and a gender-specific discussion forum.

CONCLUSIONS

Participants provided a wealth of information to form the foundation of future youth-focused efficacious healthy body weight interventions.

Body satisfaction and body weight: gender differences and sociodemographic determinants

Background

Given the documented links between body satisfaction, weight-related behaviors, and weight change in adolescents, we sought to examine the prevalence of poor body satisfaction in prepubescent girls and boys and its associations with body weight, socioeconomic factors, and rural residence.

Methods

We obtained data from 4254 girls and boys participating in a population-based survey of grade five students in the province of Nova Scotia, Canada. We examined gender specific associations between the prevalence of poor body satisfaction and body mass index (BMI) with generalized additive models and applied multilevel logistic regression methods to estimate associations of body satisfaction with BMI, rural residence, parental education and income, and neighborhood household income.

Results

We observed a linear increase in poor body satisfaction with increasing BMI in girls. Among boys, however, we found a U-shape association where boys with low BMI and those with high BMI reported higher levels of poor body satisfaction. We also found that poor body satisfaction was more prevalent among girls whose parents had lower educational attainment and among those who reside in rural areas.

Conclusion

Insight into the unique relationships between body satisfaction and BMI experienced by prepubescent children, males, and populations diverse in parental education and geographic location may help to inform public health initiatives designed to improve weight-related behaviors and reduce overweight in children.

Changing prevalence of obesity in a rural community between 1977 and 2003: a multiple cross-sectional study

OBJECTIVE

To determine the changes in the prevalence of obesity in a rural community between 1977 and 2003.

STUDY DESIGN

A multiple cross-sectional study.

METHODS

The analysis was based on data from four cross-sectional surveys of adults aged 25-59 years, conducted in the town of Humboldt, Saskatchewan in 1977, 1983, 1993 and 2003. People with a body mass index (BMI) > or =30 kg/m(2) were considered to be obese.

RESULTS

Average body weight increased by 8 kg for both men and women during the study period. The increase in BMI was greater in adults aged 25-39 years compared with older age groups. The prevalence of obesity increased from 24% in 1977 to 38% in 2003 for men, and from 16% to 32% for women. The change was more pronounced from 1993 to 2003 than from 1977 to 1993, especially among younger adults. Standardized to the 2003 study population by sex, age and smoking status, the prevalence of obesity was 16.8% in 1977, 22.7% in 1983, 24.7% in 1993 and 34.5% in 2003, and was much higher than the Canadian national average (16% in 2003).

CONCLUSION

There was a dramatic increase in the prevalence of obesity in rural adults, and this was greater in younger adults. Changes in cigarette smoking did not explain the increase. There is an urgent need to identify and implement effective interventions to slow if not reverse the trend, particularly in rural populations.

Elevated blood pressure in relation to overweight and obesity among children in a rural Canadian community

OBJECTIVE

Childhood overweight and obesity may result in premature onset of cardiovascular risk factors such as hypertension. Rural populations in North America may be at increased risk for overweight. We evaluated whether overweight and obesity were associated with prehypertension and hypertension in a well-characterized population of children in rural Canada.

METHODS

The study population for this cross-sectional study was composed of children (aged 4-17 years) who were participants of the Walkerton Health Study (Canada) in 2004. Prehypertension and hypertension were defined on the basis of percentiles from the average of 3 blood pressure measures taken on a single occasion. Percentiles for BMI and blood pressure were calculated by using the 2000 Centers for Disease Control and Prevention growth charts. Multinomial logistic regression was used to evaluate the odds for prehypertension and hypertension resulting from overweight and obesity.

RESULTS

Of 675 children (98.7% white), 122 (18.1%) were overweight and 77 (11.4%) were obese. Prehypertension and hypertension were detected in 51 (7.6%) and 50 (7.4%), respectively. After adjustment for family history of hypertension and kidney disease, obesity was associated with both prehypertension and hypertension. Overweight was associated with hypertension but not prehypertension. These associations were observed across the genders and children aged <13 and >or=13 years, except that overweight was not associated with hypertension among girls.

CONCLUSIONS

In this population of children who lived in a rural community in Canada, overweight and obesity were strongly associated with elevated blood pressure. Whether blood pressure normalizes with improvements in diet, physical activity, and environment is an area for additional study.

A framework for addressing the global obesity epidemic locally: the Child Health Ecological Surveillance System (CHESS)

Childhood obesity has reached epidemic levels in the developed world. Recent research and commentary suggest that an ecological approach is required to address childhood obesity, given the multidimensional nature of the problem. We propose a Canadian prototype, the Child Health Ecological Surveillance System, for a regional health authority to address the growing obesity epidemic. This prototype could potentially be used in other jurisdictions to address other child health issues. We present 8 guiding principles for the development and implementation of a regional framework for action.

Gender differences in growth and nutrition in a sample of rural ontario schoolchildren

This paper reports findings of a cross-sectional study of the growth and nutrition of children living in rural Ontario, Canada. The objectives of the research were threefold: (1) to obtain data on obesity prevalence and nutrient intake in a sample of rural Canadian schoolchildren, (2) to compare findings with rural and national-level data on obesity prevalence and nutrient intake, and (3) to provide data to school board and public health agencies planning and implementing nutrition policy and programs to this population. Measures of height and weight were obtained for 504 children ages 7-13 years. Height for age and body mass index scores were calculated and compared with 2000 data from the Centers for Disease Control (Kuczmarski et al. [2002]: Vital Health Stat 246:1-190). Weekday 24-h dietary recall was conducted on a subsample of 352 children and the results compared with Canada's Food Guide (Health Canada,1997) and dietary reference data from the US Institute of Medicine (2000). Prevalence of overweight and obesity were high in this sample, with 17.7% of children classified as overweight and 10.9% of children classified as obese. Fifteen percent of boys were classified as obese, compared to 6.8% of girls. Boys consumed significantly more servings from the grain and meat food groups than girls. While mean daily intake of fiber and micronutrients was significantly low for both boys and girls, there were significant gender differences in nutrient intake, with boys consuming greater energy, protein, carbohydrate, calcium, iron, phosphorus, and sodium than girls. A number of limitations are discussed, in particular issues arising from the use of Dietary Reference Intakes.

Prevalence of overweight and obesity among school-aged children in urban, rural and mountain areas of the Veneto Region, Italy

OBJECTIVE

To define the prevalence of overweight and obesity among school-aged children resident in mountain areas, rural areas and urban areas.

DESIGN, SETTING AND SUBJECTS

The sample (n = 12832; 50.7% boys) included 9- and 11-year-old children of the Veneto Region of north-east Italy. Overweight and obesity status were determined using the International Obesity Task Force cut-off points for body mass index. The prevalence of overweight and obese subjects was calculated with a confidence interval of 95%. The Mantel-Haenszel method was used to compare the combined prevalence of overweight and obesity among children resident in mountain areas, rural areas and urban areas.

RESULTS

Among boys the prevalence of overweight was 21.06%, while obesity prevalence was 5.92%; among girls overweight prevalence was 21.30%, while obesity prevalence was 5.15%. The prevalence was higher among 11-year-old boys (odds ratio (OR) = 1.19; 95% confidence interval (CI): 1.06-1.33) and 9-year-old girls (OR = 1.13; 95% CI: 1.01-1.26). Children resident in rural areas presented a higher risk of overweight and obesity compared with children resident in mountain areas (Mantel-Haenszel OR = 1.27; 95% CI: 1.13-1.42; chi2 = 17.55; P < 0.0001) and in urban areas (Mantel-Haenszel OR = 1.18; 95% CI: 1.07-1.31; chi2 = 10.39; P < 0.001).

CONCLUSIONS

A relevant prevalence of overweight and obesity was found; the excess weight concerns one child in four. There are differences linked to different geographical areas that must be further investigated.

Physical activity patterns and sedentary behaviors of children from urban and rural areas of Cyprus

BACKGROUND

A sedentary lifestyle among children is becoming increasingly common and has been linked to future risk of degenerative diseases. Urban residence has been suggested to be a contributing factor to a less active lifestyle; however, not all available studies support this link. In the present study we examined the physical activity patterns and sedentary behaviours of children living in urban and rural areas of Cyprus, where major demographic shifts have occurred the last decades.

METHODS

We studied 1140 children (531 boys; 609 girls), aged 10-12 years, registered in 24 selected elementary public schools from five urban and rural districts of Cyprus. Children completed a semi-quantitative physical activity questionnaire regarding frequency and duration of everyday physical and sedentary activities. Weight and height of the children, as well as demographic and socioeconomic information was collected from children and their guardians.

RESULTS

Rural children reported being slightly more active after school and occupied weekly with outdoors chores compared to urban children, who on the other hand reported engaging in sports on a weekly basis more than their rural peers (all p < 0.10). However, the average weekly time spent by urban and rural children on vigorous (8.6 +/- 4.7 and 9.1 +/- 4.8 h/w, respectively; p = 0.193) or moderate-to-vigorous (14.9 +/- 7.6 and 15.2 +/- 7.6 h/w, respectively; p = 0.612) activities, as well as total screen time, were not different. The distribution of children with regards to most other physical activity and inactivity pursuits was similar between urban and rural areas.

CONCLUSION

We found no substantial differences in the physical activity habits and sedentary behaviours among children living in urban and rural areas of Cyprus. Hence public health awareness directed to enhance physical activity and decrease sedentary lifestyle among youngsters should focus equally to urban and rural children.

Differences in the correlates of physical activity between urban and rural Canadian youth

BACKGROUND

Despite the benefits of physical activity (PA), a significant proportion of youth remains inactive. Studies assessing differences in the correlates of PA among urban and rural youth are scarce, and such investigations can help identify subgroups of the population that may need to be targeted for special intervention programs. The purpose of this study was to assess differences in the correlates of PA between Canadian urban and rural youth.

METHODS

The sample consisted of 1398 adolescents from 4 urban schools and 1290 adolescents from 4 rural schools. Mean age of the participants was 15.6 +/- 1.3 years. Hierarchical regression analyses were used to examine the association between self-reported PA and a number of demographic, psychological, behavioral, and social correlates.

RESULTS

Common correlates between the 2 locations included gender (with girls being less active than boys) perceptions of athletic/physical ability, self-efficacy, interest in organized group activities, use of recreation time, and friends' and siblings' frequency of participation in PA. Active commuting to school and taking a physical education class were unique correlates of PA at the multivariate level in urban and rural students, respectively. Variance explained in PA ranged from 43% for urban school students to 38% for rural school students.

CONCLUSIONS

Although more similarities than discrepancies were found in the correlates of PA between the 2 geographical locations, findings from this study strengthen the policies that argue for a coordinated multisector approach to the promotion of PA in youth, which include the family, school, and community.

Far from ideal: weight perception, weight control, and associated risky behaviour of adolescent girls in Nova Scotia

OBJECTIVE

To examine the prevalence of weight-related concerns, unhealthy weight-control behaviour, and associated risky behaviour among adolescent girls, and to ascertain whether these girls had discussed a healthy weight with their physicians.

DESIGN

Anonymous, self-report, cross-sectional survey.

SETTING

Four high schools in rural Nova Scotia.

PARTICIPANTS

Adolescent girls in grades 10 to 12.

MAIN OUTCOME MEASURES

Weight perception, prevalence of weight-control behaviour, associations between weight perception and risky behaviour, associations between disordered eating behaviour and other risky behaviour.

RESULTS

Overall response rate was 76%. Half the 1133 participants saw themselves as not being the "right" weight; 60% were trying to lose weight. During the past 30 days, 16% of the girls were attempting to control or lose weight and had engaged in disordered eating behaviour. In univariate analysis, perception of being either overweight or underweight was significantly associated with suicidal thoughts, suicide planning, and risk of depression. In multivariate analysis, positive associations were found between disordered eating behaviour and suicidal thoughts (odds ratio [OR] 4.2, 95% confidence interval [CI] 2.6 to 6.7), suicide planning (OR 2.9, 95% CI 1.7 to 4.7), suicide attempts (OR 3.4, 95% CI 1.8 to 6.6), and ever having had vaginal intercourse (OR 1.6, 95% CI 1.1 to 2.5). Only 22% of respondents had spoken with a doctor about a healthy weight.

CONCLUSION

Weight concerns are prevalent among adolescent girls in Nova Scotia. Many of them, especially those who see themselves as overweight or underweight, engage in unhealthy weight-control methods. Perceived underweight and overweight and disordered eating behaviour have strong associations with depression and self-harming behaviour. Few participants had discussed a healthy weight with a physician. Health professionals should be aware of the associations between weight perception and disordered eating behaviour and other risky behaviour.

Obesity rates among rural Ontario schoolchildren

BACKGROUND

The majority of existing studies of obesity risk among Canadian children come from urban populations. The purpose of this study is to assess the prevalence of obesity in a sample of rural Ontario children.

METHODS

Measures of height and weight were obtained for 504 children attending seven public elementary schools in Grey and Bruce Counties, a predominantly rural area of Southern Ontario. Body mass index (BMI, or weight/height2) scores were calculated and compared with reference data from the Centers for Disease Control.

RESULTS

Rates of overweight and obesity were high in this sample, with 17.7% of children classified as overweight and 10.9% classified as obese. There was a significantly high prevalence of overweight for both boys (17.8%) and girls (17.5%) (Chi-square = 75.70, p < 0.001). However there was a significant gender difference in obesity prevalence: 15.0% of boys were obese, compared with 6.8% of girls (Mann-Whitney U = 29133.0, p > 0.05).

CONCLUSION

Findings indicate that among rural children--particularly boys--risk of overweight and obesity are at least as high as in their urban Canadian counterparts. There appear to be fewer girls than boys at the extreme high end of the distribution of BMI, which may indicate differences in the growth environment of rural boys and girls.

Obesity rates among rural Ontario schoolchildren

BACKGROUND

The majority of existing studies of obesity risk among Canadian children come from urban populations. The purpose of this study is to assess the prevalence of obesity in a sample of rural Ontario children.

METHODS

Measures of height and weight were obtained for 504 children attending seven public elementary schools in Grey and Bruce Counties, a predominantly rural area of Southern Ontario. Body mass index (BMI, or weight/height2) scores were calculated and compared with reference data from the Centers for Disease Control.

RESULTS

Rates of overweight and obesity were high in this sample, with 17.7% of children classified as overweight and 10.9% classified as obese. There was a significantly high prevalence of overweight for both boys (17.8%) and girls (17.5%) (Chi-square = 75.70, p < 0.001). However there was a significant gender difference in obesity prevalence: 15.0% of boys were obese, compared with 6.8% of girls (Mann-Whitney U = 29133.0, p > 0.05).

CONCLUSION

Findings indicate that among rural children--particularly boys--risk of overweight and obesity are at least as high as in their urban Canadian counterparts. There appear to be fewer girls than boys at the extreme high end of the distribution of BMI, which may indicate differences in the growth environment of rural boys and girls.

Urban-rural disparities in smoking behaviour in Germany

Background

It is currently not clear whether individuals living in metropolitan areas differ from individuals living in rural and urban areas with respect to smoking behaviours. Therefore, we sought to explore the relation between residential area and smoking behaviours in Germany.

Methods

We used a nationwide German census representative for the general population of Germany. A number of 181,324 subjects aged 10 years or older were included. Information on the average daily usage of cigarettes that have or had been smoked formerly or currently was available in subjects who have ever smoked. A daily consumption of more than 20 cigarettes was considered heavy smoking. Logistic regression analyses were performed sex-stratified and adjusted for relevant confounders.

Results

Analyses revealed inhabitants of metropolitan areas to be more likely current smokers than inhabitants of rural areas (odds ratio 1.56, 95%-confidence interval 1.51; 1.62). Among current and former smokers those who lived in urban communities had also increased odds for being heavy smokers than those who lived in rural communities.

Conclusion

We conclude that living in an urban and particularly living in a metropolitan area is a determinant of both smoking and severity of current smoking. Tobacco control programs should recognize the difference in living conditions between rural and urban areas.

Conquering Childhood Inactivity: Is the Answer in the Past?

PURPOSE

The primary purpose of this study was to compare the health-related physical fitness and physical activity behaviors of Old Order Mennonite children to both rural and urban-dwelling children living a contemporary Canadian lifestyle.

METHODS

A cross-sectional study design was used to compare the physical fitness and physical activity characteristics of three groups of children between the ages of 8-13 yr. A total of 124 Old Order Mennonite children (OOM) from Ontario, Canada, were compared with contemporary living children from urban (USK, N = 110) and rural (RSK, N = 165) Saskatchewan, Canada. Fitness was assessed using measures of height, weight, triceps skinfold, grip strength, push-ups, partial curl-ups, and aerobic fitness. Physical activity levels were directly measured for seven consecutive days using a MTI Actigraph accelerometer model 7164.

RESULTS

After controlling for maturational age, analyses revealed that OOM children had a smaller triceps skinfold than USK children (P < 0.01), a greater aerobic fitness score than RSK children (P < 0.05), and greater grip strength than both RSK and USK children (P < 0.001). The OOM children also accumulated more minutes of MVPA per day than RSK or USK groups (P < 0.001).

CONCLUSION

This research demonstrates that OOM children tend to be leaner, stronger and more active than urban and rural dwelling children living a contemporary Canadian lifestyle despite having no physical education, no institutionalized sport, and low socioeconomic status. These findings support the notion that that contemporary living may facilitate a decline in fitness and physical activity among some Canadian children.