Unhealthy eating habits and participation in organized leisure-time activities in Czech adolescents

Fast food and anxiety symptoms of Chinese multi-ethnic adolescents: The moderating role of regulatory emotional self-efficacy

BACKGROUND

Although previous studies demonstrated an association between fast food intake and anxiety symptoms in adolescents, this relationship has not been studied in Chinese multi-ethnic adolescents. The purpose of this study is to investigate the aforementioned association and the potential moderating effect of regulatory emotional self-efficacy (RESE) among Chinese multi-ethnic adolescents.

METHODS

A cluster random sampling of 8500 middle school students from 11 counties in Yunnan province was conducted. The Depression Anxiety Stress Scale-21 was utilized to assess anxiety symptoms, while the food frequency questionnaire was employed to gather data on eating behaviors. The association between fast food intake, RESE, and anxiety symptoms was analyzed using generalized linear models. The moderating effect of RESE on the association between fast food intake and anxiety symptoms was examined using structural equation models.

RESULTS

The positive rate of anxiety symptoms in middle school students was 48.5 % (4120/8500). The positive rate of depressive symptoms in females (53.3 %, 2301/4316) was higher than that in males (43.5 %, 1819/4184). Chinese fast food intake (males vs females: β = 0.26, 95%CI:0.14-0.39; β = 0.16, 95%CI:0.02-0.29), expressing positive affect (β = -0.04, 95%CI:-0.07-0.01; β = -0.06, 95%CI:-0.10-0.03) and managing anger/irritation affect (β = -0.11, 95%CI:-0.14-0.08; β = -0.16, 95%CI:-0.19-0.12) was associated with anxiety symptoms in males and females (all P < 0.05). Takeaway fast food intake (β = 0.19, 95%CI:0.02-0.35) and managing despondency/distress affect (β = -0.08, 95%CI:-0.12-0.04, P < 0.001) was associated with anxiety symptoms in females (all P < 0.05). RESE significantly inversely moderated the association between fast food intake and anxiety symptoms (all participants: β = -0.11; males: β = - 0.08; females: β = - 0.14; all P < 0.01).

LIMITATIONS

Association observed in the cross-sectional study is uncertain and need to be confirmed in cohort studies.

CONCLUSION

Our findings suggest that fast food intake may be associated with an increased risk of anxiety symptoms among Chinese multi-ethnic adolescents, while good RESE can potentially mitigate this risk.

Prevalence of the Patterns of Unhealthy Diet in the School and University Students of Iran: A Systematic Review and Meta-Analysis

Introduction

The present study was conducted to investigate the pooled prevalence rate of the different patterns of unhealthy diet among the school and university students of Iran.

Methods

In this systematic review, the type of the main question was regarding prevalence and the effect measure was prevalence rate reported along with 95% confidence interval (CI). Data bases including PubMed, Scopus, and Web of Science as well as Google Scholar and Persian resources were used. The Newcastle-Ottawa scale (NOS) checklist was used for quality assessment of studies.

Results

The extracted types of unhealthy diet in the present systematic review were "breakfast skipper," "fast food," "hydrogenated oils consumption," "salty snacks," "sweetened beverages," "breakfast skipper," "dinner skipper," "launch skipper," and "sweets." The range of pooled prevalence for different types was 0.06-0.75. The data of 16,321 subjects included in six studies were analyzed. The pooled prevalence of unhealthy diet was 0.28 (95% CI: 0.23-0.33, I 2 > 99%) overall, 0.25 (95% CI: 0.20-0.31, I 2 > 99%) in school students and 0.37 (95% CI: 0.12-0.62, I 2 > 99%) in university students. The most prevalent pattern was breakfast skipping 0.39 (95% CI: 0.28-0.50) followed by consumption of sweetened beverages 0.31 (95% CI: 0.20-0.43). The pooled prevalence range among the patterns was 0.06-0.75 (random effects for all).

Conclusion

The pooled prevalence was 28% for unhealthy diet among the Iranian students (6% to 75% in different patterns). Although there was uncertainty regarding the pooled evidence, the whole of the mentioned range was clinically important for health policymakers. Decisions should be made on the basis of the patterns.

The effect of health literacy on health behaviors in a sample of Turkish adolescents

PURPOSE

Health literacy is a strong factor in the health outcomes and behaviors of adolescents. This study was conducted to examine the health literacy levels of adolescents, their health behaviors, and the effect of health literacy on health behaviors.

DESIGN AND METHODS

This cross-sectional study was conducted with a total of 649 adolescents between the ages of 14 and 18. Data were collected using the Adolescent Lifestyle Profile II (ALP-R2) and the Health Literacy Scale for School-Age Children (HLSAC). A multiple regression analysis was conducted to determine the effects of health literacy on health behaviors and the factors associated with health behaviors.

RESULTS

The mean total ALP-R2 score of the participants was 114.35 ± 17.48, and their mean HLSAC score was 28.95 ± 5.79. Among the participants, 26% had low health literacy, 61.9% had moderate health literacy, and 12% had high health literacy. The regression analysis revealed that the health literacy levels of the participants significantly predicted all dimensions of health behaviors and total health behaviors (p < 0.001). The health literacy levels of the participants, the community where the adolescent lived, their participation in social activities, family relationships, friend relationships, and health perceptions significantly predicted their total health behaviors (R2 = 0.347; p < 0.001).

CONCLUSIONS

The health literacy levels and health behaviors of adolescents were found to be moderate, and their health behaviors increased as their levels of health literacy increased. The results showed that the health literacy and health behaviors of adolescents need to be improved.

IMPLICATIONS FOR PRACTICE

Nurses should provide training to increase the healthy lifestyle behaviors and health literacy of adolescents.

School health programs of physical education and/or diet among pupils of primary and secondary school levels I and II linked to body mass index: A systematic review protocol within the project From Science 2 School

The most common causes of death in Western countries today are preventable diseases mainly attributed to daily behavior. It has been well documented that genetics are influential but not the deciding factor for developing non-communicable diseases. Ideally, the public should be educated to perform methods of optimal health and wellbeing independently, meaning that individuals should be in control of their health without relying on others. As behavior is known to be consistent over time, good or poor health behavior will track from childhood into adulthood. Physical activity and diet are permanently linked to the individual's state of health, and when properly balanced, the effects on personal health summate, resulting in greater benefits from this dual-approach for public health. The objective is to highlight the different approaches (physical intervention, nutritional intervention, and dual-approach of diet and exercise) and identify effective interventions for sustainable body weight and healthy body mass index in school children. A systematic review will be conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. The review will assess school-based diet and exercise interventions on children in primary and secondary school levels I and II. Overweight and obesity develop as a result of a prolonged imbalance in the energy balance model, with both physical activity and diet being influential in the fluctuation of body weight. A dual-approach including physical activity and diet could therefore be a very promising method to promote sustainable healthy body weight in school children.

Adiposity Metabolic Consequences for Adolescent Bone Health

Infancy and adolescence are crucial periods for bone health, since they are characterized by intense physical growth and bone development. The unsatisfactory acquisition of bone mass in this phase has consequences in adult life and increases the risk of developing bone diseases at more advanced ages. Nutrient deficiencies, especially calcium and vitamin D, associated with a sedentary lifestyle; lack of sun exposure; and epigenetic aspects represent some of the main risk factors for poor bone quality. In addition, recent studies relate childhood obesity to impaired bone health; however, studies on the adiposity effects on bone health are scarce and inconclusive. Another gap concerns the implications of obesity on child sexual maturity, which can jeopardize their genetic potential bone mass and increase fracture risk. Therefore, we reviewed the analyzed factors related to bone health and their association with obesity and metabolic syndrome in adolescents. We concluded that obesity (specifically, accumulated visceral fat) harms bones in the infant-juvenile phase, thereby increasing osteopenia/osteoporosis in adults and the elderly. Thus, it becomes evident that forming and maintaining healthy eating habits is necessary during infancy and adolescence to reduce the risk of fractures caused by bone-metabolic diseases in adulthood and to promote healthy ageing.

The effect of leisure boredom and A1C level on diabetes eating problems in adolescents with type 1 diabetes

PURPOSE

Eating out of boredom, the changes in daily routine, physical inactivity and longer exposure to screens have made glycemic control difficult at home during the COVID-19 pandemic among adolescents with Type 1 Diabetes Mellitus. Adolescents with diabetes are at higher risk of developing eating problems than are their healthy peers. The aim of this study is to examine the effects of leisure time boredom and A1C level on eating problems in adolescents with Type 1 Diabetes Mellitus.

DESIGN AND METHODS

A descriptive, correlational, and cross-sectional design was used in this study. The study was conducted in Turkey, with the participation of 173 adolescents diagnosed with Type 1 Diabetes Mellitus. Convenience sampling was used to recruit patients from pediatric endocrinology outpatient clinics of hospitals.

RESULTS

It was determined that the diabetes eating problems of adolescents with Type 1 Diabetes were mostly affected by the level of leisure time and A1C, respectively. In the overall model, 58% (F = 4119.701, p < .001) of the factors affecting diabetes eating problems could be explained by the level of leisure boredom and A1C level.

CONCLUSION

It has been found that the adolescents with diabetes with high A1C levels and who cannot use their leisure time and have boredom are more at risk in terms of diabetes eating problems.

PRACTICE IMPLICATIONS

It should be determined how the adolescents with diabetes spend their lesiure time by diabetes health care team, which should be supported to develop leisure time skills. Effective use of leisure time and strategies to cope with boredom should also be included in diabetes education.

Urban Forest Health Intervention Program to promote physical activity, healthy eating, self-efficacy and life satisfaction: impact on Israeli at-risk youth

The aim of this study was to evaluate an urban forest intervention program effect on physical activity, healthy eating habits, self-efficacy and life satisfaction (LS) among Israeli at-risk youth. The quasi-experimental study ran from September 2016 to June 2017; participants were randomly selected. There were 76 total study participants: 53 in the intervention and 23 in the control group. Participants ranged in age from 15 to 18 years. Questionnaires were administered to intervention and control groups before and after the intervention. Univariate and multivariable analyses evaluated the intervention effect. Repeated measures analyses of covariance were calculated to assess change in group differences. An increase was found in measures of physical activity in the intervention group (p < 0.001), while no change was noted in the control group. Healthy eating increased in both groups (p = 0.007), with no significant difference between them (p = 0.165). Unhealthy eating decreased significantly in the intervention group (p = 0.002) and increased in the control group (p = 0.007). Self-efficacy increased in the intervention group (p < 0.001), while no change was noted in the control group (p = 0.353). Likewise, LS increased in the intervention group (p < 0.001), while no change was found in the control group (p = 0.657). Findings indicate that the intervention was efficacious in increasing physical activity, healthy eating habits, self-efficacy, and LS. The effectiveness of this intervention among larger samples is warranted in future prospective studies.

Extracurricular Sports Participation and Sedentary Behavior in Association with Dietary Habits and Obesity Risk in Children and Adolescents and the Role of Family Structure: a Literature Review

PURPOSE OF REVIEW

Childhood obesity is considered a major problem in the modern world, associated with many health issues in youth. This review aimed the association between extracurricular sports participation, sedentary time/screen time, and "obesogenic" and "non-obesogenic" dietary habits among youth and to explore the role of family structure on the adoption of sedentary behaviors by children.

RECENT FINDINGS

Increased participation in extracurricular sports was associated with a healthier dietary pattern, containing more "non-obesogenic" food choices. Opposite results were indicated by sedentary activities. Increased time in watching TV, computer/electronic games, and other screen devices was positively associated with unhealthy dietary patterns. Overall, extracurricular activities influence the quality of food choices, which may prevent or promote childhood obesity; thus, sport-related activities should be promoted through public health policies. The role of the family structure is contradictory.

From secondary school to university: associations between sport participation and total and domain-specific sedentary behaviours in Spanish students

Effective ways to reduce sedentary behaviour in adolescents are needed to mitigate the risk of chronic disease and poor mental health. Organised sport participation is the most practiced physical activity during adolescence. However, the influence sport participation has on sedentary behaviours remains unclear. This study investigated the associations between sport participation, total and domain-specific sedentary behaviour and physical activity during the transition from secondary school to university. A 3-year longitudinal survey followed Spanish secondary school students (n = 113) to their first year of university. Generalized linear models, adjusted by gender and year, assessed the relationships between sport participation, total and domain-specific sedentary behaviour and physical activity. Compared with non-sport participants, teenagers who played individual sports from baseline during secondary school spent significantly less total time sitting (- 110.5 min/day at weekends), watching television (- 18.7 min/day at weekends) or using the computer for leisure (- 37.4 min/day weekdays). Those who played team sports from baseline at secondary school spent less time sitting (- 126.4 min/day at weekends) or socialising (- 37 min/day at weekends)Conclusion: From secondary school to university, sport participation-based interventions might be an effective strategy to reduce sitting time spent on some domain-specific behaviours. Promoting sports could reduce the rise of sedentary behaviour during adolescence, a stage where sedentary behaviour evolves. What is Known: • Sitting too much and for too long is an important risk factor during adolescence. • Replacing adolescent's sedentary time with moderate-to-vigorous physical activity has been associated with a better quality of life. What is New: • Playing sport is associated with spending less time in total SB on the transition from high school to college. • Not all SB domains are linked to sport participation with associations differing from whether participants played individual or team sports.

The Clustering of Low Diet Quality, Low Physical Fitness, and Unhealthy Sleep Pattern and Its Association with Changes in Cardiometabolic Risk Factors in Children

The clustering of diet quality, physical activity, and sleep and its association with cardiometabolic risk (CMR) factors remains to be explored. We included 5315 children aged 6–13 years in the analysis. CMR score (CMRS) was computed by summing Z-scores of waist circumference, an average of systolic and diastolic blood pressure, fasting glucose, high-density lipoprotein cholesterol (multiplying by −1), and triglycerides. Low diet quality and low cardiorespiratory fitness (CRF) were more likely to be seen in a pair, but low diet quality was less likely to be clustered with unhealthy sleep patterns. Low diet quality, low CRF, and unhealthy sleep pattern was associated with a 0.63, 0.53, and 0.25 standard deviation (SD) higher increase in CMRS, respectively. Compared to children with no unhealthy factor (−0.79 SD), those with ≥1 unhealthy factor had a higher increase (−0.20 to 0.59 SD) in CMRS. A low diet quality-unhealthy sleep pattern resulted in the highest increase in CMRS, blood pressure, and triglycerides. A low diet quality–low CRF-unhealthy sleep pattern resulted in the highest increase in fatness and fasting glucose. Unhealthy factor cluster patterns are complex; however, their positive associations with changes in CMR factors are consistently significant in children. Some specific patterns are more harmful than others for cardiometabolic health.

Time-trends and correlates of obesity in Czech adolescents in relation to family socioeconomic status over a 16-year study period (2002-2018)

Background

The main objective of the study is to analyse the changes in the prevalence of obesity among Czech adolescents between 2002 and 2018 with regard to the socioeconomic status (SES) of adolescents’ families and to find SES-separated correlates of adolescents’ obesity in 2018.

Methods

A nationally representative sample of 29,879 adolescents (49.6% of them boys) aged 10.5–16.5 years was drawn from the Health Behaviour in School-aged Children cross-sectional, self-reported questionnaire surveys conducted in 2002, 2006, 2010, 2014, and 2018 in Czechia. Chi-square (χ²) tests were performed to assess the changes in the prevalence of obesity in both genders and all SES categories of adolescents between 2002 and 2018, and SES category-related differences in the prevalence of obesity in 2018 separately for boys and girls. A series of multiple stepwise logistic regression (backward elimination) analyses were used to reveal obesity correlates separately for SES categories of adolescents.

Results

Across the quadrennial surveys from 2002 to 2018, we observed a clear increase in the prevalence of obesity in all SES categories of adolescents, which was most striking (p < 0.05) in adolescents with low SES (boys: + 7.5% points (p.p.); girls + 2.4 p.p.). When all the survey cycles were compared, the highest prevalence of obesity was evident in the low-SES adolescents in 2018, both in girls (5.1%) and boys (12.0%). Regardless of the adolescent SES category, the lower odds of obesity were significantly (p < 0.05) associated with regular vigorous physical activity (PA), participation in organized sport, and daily consumption of sweets. In addition, at least 60 min of moderate-to-vigorous PA significantly reduced the odds of obesity in adolescents of low and high SES categories.

Conclusions

An unreasonable increase in the prevalence of obesity in adolescents with low SES highlights the need to prevent obesity in adolescents with a low-SES background. Additionally, significantly higher odds of obesity in 11- and 13-year-old adolescents from low-SES families, compared with their peers aged 15, indicated an expectable rise in obesity in older low-SES adolescents in the near future.

Changes in Sedentary and Active Lifestyle, Diet Quality and Body Composition Nine Months after an Education Program in Polish Students Aged 11⁻12 Years: Report from the ABC of Healthy Eating Study

The sustainability of education focused on improving the dietary and lifestyle behaviours of teenagers has not been extensively studied. The aim of this study was to determine the sustainability of diet-related and lifestyle-related school-based education on sedentary and active lifestyle, diet quality and body composition of Polish pre-teenagers in a medium-term follow-up study. An education-based intervention study was carried out on 464 students aged 11⁻12 years (educated/control group: 319/145). Anthropometric measurements were taken and body mass index (BMI) and waist-to-height ratios (WHtR) were calculated, both at the baseline and after nine months. Dietary data from a short-form food frequency questionnaire (SF-FFQ4PolishChildren) were collected. Two measures of lifestyle (screen time, physical activity) and two diet quality scores (pro-healthy, pHDI, and non-healthy, nHDI) were established. After nine months, in the educated group (vs. control) a significantly higher increase was found in nutrition knowledge score (mean difference of the change: 1.8 points) with a significantly higher decrease in physical activity (mean difference of the change: -0.20 points), nHDI (-2.3% points), the z-WHtR (-0.18 SD), and the z-waist circumference (-0.13 SD). Logistic regression modelling with an adjustment for confounders revealed that after nine months in the educated group (referent: control), the chance of adherence to a nutrition knowledge score of at least the median was over 2 times higher, and that of the nHDI category of at least the median was significantly lower (by 35%). In conclusion, diet-related and lifestyle-related school-based education from an almost one-year perspective can reduce central adiposity in pre-teenagers, despite a decrease in physical activity and the tendency to increase screen time. Central adiposity reduction can be attributed to the improvement of nutrition knowledge in pre-teenagers subjected to the provided education and to stopping the increase in unhealthy dietary habits.

Association of Sports Participation and Diet with Motor Competence in Austrian Middle School Students

Physical activity and diet are important contributors to overall health and development in adolescents. There remains, however, limited research on the combined association of sports participation and dietary pattern on motor competence, which is crucial for an active lifestyle during and beyond adolescence. The present study, therefore, examined the association between sports participation, dietary pattern, and motor competence in 165 middle school students (55% male) between 11 and 14 years of age. Body weight and height were measured, and motor competence was determined via the German motor test during regular Physical Education (PE). Further, participants completed a food frequency questionnaire and reported their engagement in club sports. Of the total sample 20% were overweight/obese and 49% reported participation in club sports, with no differences between boys and girls. Interaction effects of sports participation and dietary pattern on motor competence were limited, but sports participation and healthy diet were independently associated with higher motor performance. Healthy dietary choices, along with participation in club sports, therefore, should be promoted in adolescents in order to facilitate motor development. As adolescence is a crucial time for the establishment of lifelong behaviors, such efforts could facilitate a healthy lifestyle throughout adulthood.