1
|
Family socioeconomic status and childhood adiposity in Europe - A scoping review. Prev Med 2022; 160:107095. [PMID: 35594926 DOI: 10.1016/j.ypmed.2022.107095] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/28/2022] [Accepted: 05/13/2022] [Indexed: 11/23/2022]
Abstract
Childhood obesity is a considerable public health problem worldwide. In Europe, lower parental socioeconomic status (SES) relates to higher childhood adiposity. This scoping review strives to discover, which SES indicators are the most commonly used and meaningful determinants of childhood adiposity (greater level of continuous adiposity indicator, e.g. body mass index z-score, or overweight or obesity categorized by established definitions). The review focused on studies about European general populations from the 21st century (January 2000-April 2021) considering children and adolescents aged 0-17 years. PubMed and reference lists of articles were searched in February-April 2021. Total of 53 studies with 121 association analyses between different SES indicators and adiposity indicators, were identified and reviewed. Different SES indicators were grouped to 25 indicators and further to six indicator groups. The most used indicator was mother's education (n of association analyses = 24) and the most used indicator group was parental education (n of association analyses = 51). Of all association analyses, 55% were inverse, 36% were non-significant, and 8% were positive. Composite SES (80%), parental education (69%) and parental occupation (64%) indicators showed most frequently inverse associations with obesity measures (i.e. lower parental SES associating with higher adiposity), while parental income (50% inverse; 50% non-significant) and property and affluence (42% inverse; 50% nonsignificant) indicators showed approximately even number of inverse and non-significant associations. Instead, majority of parental employment (60%) indicators, showed non-significant associations and 33% showed positive associations (i.e. higher parental SES associating with higher adiposity). Despite some variation in percentages, majority of the associations were inverse in each age group and with different outcome categorizations. In girls and in boys, non-significant associations predominated. It seems that children with parents of higher SES have lower likelihood of adiposity in Europe. Parents' employment appears to differ from other SES indicators, so that having an employed parent(s) does not associate with lower likelihood of adiposity. Positive associations seem to occur more frequently in poorer countries. Criteria for uniform childhood SES and adiposity measures should be established and used in studies in order to be able to produce comparable results across countries.
Collapse
|
2
|
Prevalence of overweight, obesity, and early adiposity rebound in nursery school children in southeastern France. Arch Pediatr 2022; 29:388-394. [PMID: 35523635 DOI: 10.1016/j.arcped.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 12/27/2021] [Accepted: 03/26/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND The aim of the present study was to assess the prevalence of overweight, obesity, and early adiposity rebound in nursery school children aged 3.5-4.5 years and to evaluate associations with deprivation. METHODS A cross-sectional study was conducted in the Bouches-du-Rhône department in southeastern France. Data for all nursery school children aged 3.5-4.5 years were collected during systematic medical examinations. The prevalence of overweight and obesity was determined using French, International Obesity Task Force (IOTF), and World Health Organization reference values. A French ecological deprivation index was used to assess associations with deprivation. RESULTS Among 19,295 children included in the study, the prevalence of overweight (IOTF-25 < BMI < IOTF-30) was 9.1% and the prevalence of obesity (BMI > IOTF-30) was 2.6%. Children attending nursery schools in the most disadvantaged areas were 4.3 times more likely to be affected by obesity than those from schools in the most advantaged areas (OR: 4.32; 95% CI: 2.98-6.25, p < 0.001), after adjusting for gender, age group, and school status. Early adiposity rebound was observed in 2131 of 9872 children (21.6%). CONCLUSION Programs to prevent childhood overweight and obesity in France should be intensified and take account of major persistent social inequalities. Medical practitioners should learn to systematically assess BMI curve dynamics and early adiposity rebound.
Collapse
|
3
|
Exposure of French Children and Adolescents to Advertising for Foods High in Fat, Sugar or Salt. Nutrients 2021; 13:nu13113741. [PMID: 34835996 PMCID: PMC8624500 DOI: 10.3390/nu13113741] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/12/2021] [Accepted: 10/20/2021] [Indexed: 01/22/2023] Open
Abstract
Food marketing of products high in fat, sugar and salt (HFSS), including television advertising, is one of the environmental factors considered as a contributor to the obesity epidemic. The main objective of this study was to quantify the exposure of French children and adolescents to television advertisements for HFSS products. TV food advertisements broadcast in 2018 were categorized according to the Nutri-Score of the advertised products. These advertisements, identified according to the days and times of broadcast, were cross-referenced with audience data for 4- to 12-year-olds and 13- to 17-year-olds. More than 50% of food advertisements seen on television by children and adolescents concerned HFSS products, identified as classified as Nutri-Score D and E. In addition, half of advertisements for D and E Nutri-Score products were seen by children and adolescents in the evening during peak viewing hours, when more than 20% of both age groups watched television. On the other hand, during the same viewing hours, the percentage of children and adolescents who watched youth programs, the only programs subject to an advertising ban, was very low (<2%). These results show that the relevance of regulating advertising at times when the television audience of children and adolescents is the highest and not targeted at youth programs, in order to reduce their exposure to advertising for products of low nutritional quality.
Collapse
|
4
|
Time trends of overweight and obesity among schoolchildren in Kuwait over a 13-year period (2007-2019): repeated cross-sectional study. Public Health Nutr 2021; 24:5318-5328. [PMID: 34342262 DOI: 10.1017/s1368980021003177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES This study aimed to examine age-specific trends in the prevalence of overweight and obesity in schoolchildren in Kuwait over a 13-year period (2007 to 2019) using the WHO, the Centers for Disease Control and Prevention (CDC) and the International Obesity Taskforce (IOTF) definitions. DESIGN Using cross-sectional approach, Kuwait Nutrition Surveillance System (KNSS) objectively measured weight and height of schoolchildren over a 13-year period. Log-binomial regression models were used to examine age-specific trends of obesity and overweight over the study period. SETTING Public primary, middle and high schools in all provinces of Kuwait. PARTICIPANTS Schoolchildren aged 5-19 years (n 172 603). RESULTS According to the WHO definition, the prevalence of overweight and obesity in schoolchildren, respectively, increased from 17·73 % and 21·37 % in 2007 to 20·19 % and 28·39 % in 2019 (Pfor trend < 0·001). There is evidence that the obesity in females (but not males) has levelled off in the period 2014-2019 according to the three definitions of obesity, which is corroborated by a similar trend in the mean of BMI-for-age Z-score. CONCLUSION The prevalence of obesity and overweight in schoolchildren in Kuwait has risen over the last 13 years and trends are similar across all definitions. Obesity is no longer increasing at the same pace and there is evidence that the prevalence of obesity in females has plateaued. The current level of childhood overweight and obesity is too high and requires community-based and school-based interventions.
Collapse
|
5
|
Measurement of screen time among young children aged 0-6 years: A systematic review. Obes Rev 2021; 22:e13260. [PMID: 33960616 PMCID: PMC8365769 DOI: 10.1111/obr.13260] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/24/2021] [Accepted: 03/30/2021] [Indexed: 12/16/2022]
Abstract
The impact of screen-based devices on children's health and development cannot be properly understood without valid and reliable tools that measure screen time within the evolving digital landscape. This review aimed to summarize characteristics of measurement tools used to assess screen time in young children; evaluate reporting of psychometric properties; and examine time trends related to measurement and reporting of screen time. A systematic review of articles published in English across three databases from January 2009 to April 2020 was undertaken using PROSPERO protocol (registration: CRD42019132599) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included articles measured screen time as outcome, exposure, or confounder in children 0-6 years. The search identified 35,868 records, 1035 full-text articles were screened for eligibility, and 622 met inclusion criteria. Most measures (60%) consisted of one to three items and assessed duration of screen time on a usual day. Few measures assessed content (11%) or coviewing (7%). Only 40% of articles provided a citation for the measure, and only 69 (11%) reported psychometric properties-reliability n = 58, validity n = 19, reliability and validity n = 8. Between 2009 and 2019, the number of published articles increased from 28 to 71. From 2015, there was a notable increase in the proportion of articles published each year that assessed exposure to mobile devices in addition to television. The increasing number of published articles reflects increasing interest in screen time exposure among young children. Measures of screen time have generally evolved to reflect children's contemporary digital landscape; however, the psychometric properties of measurement tools are rarely reported. There is a need for improved measures and reporting to capture the complexity of children's screen time exposures.
Collapse
|
6
|
Influence of the Growth and Development Check (GDC) on Overweight/Obesity of Children under-5 Years in China: A Propensity Score Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1203. [PMID: 33572858 PMCID: PMC7908242 DOI: 10.3390/ijerph18031203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/11/2021] [Accepted: 01/26/2021] [Indexed: 11/23/2022]
Abstract
To improve health and reduce the rapidly increasing prevalence of overweight and obesity in children, the Chinese government has formulated childcare standards, with the Growth and Development Check (GDC) as the main content. However, few studies have evaluated the impact of the GDC on lowering the risk of childhood overweight and obesity. Using the 2014 China Family Dynamics Survey and propensity score matching (PSM), this article examined the impact of the GDC on overweight/obesity in children aged 5 years and younger. The results revealed that the mean Body Mass Index (BMI) was 17.80 kg/m2, and the prevalence of overweight/obesity was 24.62% in children. Children whose parents were aware of the GDC had a lower BMI and a lower risk of overweight/obesity than those whose parents were not aware of it. Children who engaged in the GDC in the last 12 months had a lower BMI and a lower chance of overweight/obesity than those not engaged.
Collapse
|
7
|
Prevalence of obesity in children enrolled in private and public primary schools. Clin Nutr ESPEN 2020; 40:115-120. [PMID: 33183523 DOI: 10.1016/j.clnesp.2020.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 10/05/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Obesity is a growing scourge in Africa. More and more children are exposed to it. This study was designed to assess obesity in children enrolled in private and public primary schools in three communes in the health district of Abidjan, in the south of Côte d'Ivoire. METHODS This study involved 1251 children enrolled in six schools due to two schools per municipality (Cocody, Yopougon and Treichville) including 587 boys and 664 girls aged 5-15 years. Children were recruited from private and public primary schools. Anthropometric parameters (Weight, Height, waist circumference, Body mass index) and blood pressure were measured. Data on eating habits were collected using a questionnaire. RESULTS Overall, 1251 children were enrolled, or 592 and 659 children in private and public primary schools, respectively. The majority of the children (54.2% [678/1251]) were of normal weight. However, 35.5%, 7.8% and 2.4% of the children were, respectively, underweight, overweight and obese. Overweight including obesity was 10.2%. Overweight and abdominal obesity were common among girls compared to boys (χ2 = 0.113, P = 0.001). The low obesity rate (2.4%) observed in our study is probably due to the fact that children are very active. The prevalence of hypertension in overweight people, including obese, was 20.3%. Systolic and diastolic blood pressure was influenced by both BMI and gender with higher systolic (χ2 = 0.142, P = 0.001) and diastolic (χ2 = 0.135, P = 0.001) blood pressure observed in girls. CONCLUSION Our study points out that in addition to a sedentary lifestyle; obesity is also linked to the socio-economic status and daily diet of children. We recommend introducing and operationalizing sports activity in the education system in order to reduce the frequency of obesity and its corollary of metabolic diseases among children.
Collapse
|
8
|
Time spent watching television impacts on body mass index in youth with obesity, but only in those with shortest sleep duration. J Paediatr Child Health 2020; 56:721-726. [PMID: 31821651 DOI: 10.1111/jpc.14711] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 05/09/2019] [Accepted: 11/14/2019] [Indexed: 12/16/2022]
Abstract
AIM To determine the interplay between sleep and sedentary behaviours on body mass index (BMI) in children with obesity. METHODS Cross-sectional study of 343 children with obesity aged 4-17 years, from a tertiary care weight management clinic in Melbourne, Victoria, Australia. Multifaceted data relating to activity and sleep from child and parent questionnaires analysed with anthropometric data collected during routine clinical care. Associations between sleep duration and activity measures were examined via regression models with adjustment for potential confounders. RESULTS Higher BMI was associated with more hours spent watching television (P = 0.04), as well as less reported enjoyment of physical activity (P = 0.005) and less time spent in organised sport activity (P = 0.005). Higher BMI was also associated with higher levels of obstructive sleep apnoea (P = 0.002). Less time in bed was associated with higher levels of BMI (P = 0.03) but analysis by sex revealed this association to only hold for males. In the whole group, a significant television and sleep interaction was seen, such that increasing television watching was associated with higher BMI, but only in those with shortest sleep duration. CONCLUSIONS Both poor sleep and increasing screen time (including television viewing, smart-phone use, internet use or video-gaming) appear to impact BMI in children with obesity, with a particular detrimental effect of television viewing in those who sleep less. Efforts to improve sleep time and quality in children may minimise negative effects of screen time on increasing BMI and should be included in public health strategies to combat obesity in childhood.
Collapse
|
9
|
Significant Decrease in Childhood Obesity and Waist Circumference over 15 Years in Switzerland: A Repeated Cross-Sectional Study. Nutrients 2019; 11:nu11081922. [PMID: 31443303 PMCID: PMC6722927 DOI: 10.3390/nu11081922] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 08/08/2019] [Accepted: 08/09/2019] [Indexed: 11/19/2022] Open
Abstract
Despite a global increase in childhood obesity over the past decades, several countries, including Switzerland, have recently reported stabilizing trends. Using national data from school-aged children in Switzerland over the past 16 years, our study aim was to assess changes in the prevalence of overweight and obesity, central adiposity and predictors of obesity related to lifestyle and parental factors. Nationally representative samples of children aged 6–12 years were studied in 2002 (n = 2493), 2007 (n = 2218), 2012 (n = 2963), and 2017/18 (n = 2279). Height and weight, waist circumference, and multiple skinfold thicknesses were measured. Potential risk factors for overweight and obesity were determined using a self-administered questionnaire in 2017/18, collecting data on diet, physical activity, and parental factors. Prevalence (95% CI) of overweight (incl. obesity) and obesity in 2017/18 was 15.9% (14.4–17.4) and 5.3% (4.5–6.3), respectively. Binary logistic regression revealed a small but significant decrease in the prevalence of overweight (including obesity) since 2002 (OR (95% CI) = 0.988 (0.978–0.997)), while the change in obesity alone was not significant. The most important risk factors for childhood overweight/obesity in 2017/18 were low parental education, non-Swiss origin of the parents, low physical activity of the child, and male sex. In conclusion, we have shown a small but significant declining trend in the childhood overweight/obesity prevalence over the past 15 years in Switzerland. Based on the risk factor analysis, preventive action in schoolchildren might be most effective in boys, migrant populations, and families with lower education, and should emphasize physical activity.
Collapse
|
10
|
Prevalence of Overweight and Obesity among European Preschool Children: A Systematic Review and Meta-Regression by Food Group Consumption. Nutrients 2019; 11:nu11071698. [PMID: 31340602 PMCID: PMC6682909 DOI: 10.3390/nu11071698] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 07/18/2019] [Accepted: 07/18/2019] [Indexed: 12/13/2022] Open
Abstract
The aim of this review was to estimate the prevalence of overweight and obesity among European children aged 2–7 years from 2006 to 2016 and to analyze these estimations by gender, country, and food group consumption. We searched CINAHL, EMBASE, MEDLINE, and Web of Science databases from their inception until 27 February 2019 including cross-sectional studies and baseline measurements of cohort studies with overweight and obesity defined according to the International Obesity Task Force criteria. Both the inverse-variance fixed-effects method and the DerSimonian and Laird random effects method were used to determinate pooled prevalence estimates and their respective 95% confidence intervals (CIs). A total of 32 studies (n = 197,755 children) with data from 27 European countries were included. Overall, the pooled prevalence estimates of overweight/obesity in European children (aged 2–7 years) during the period 2006–2016 was 17.9% (95% CI: 15.8–20.0), and the pooled prevalence estimate of obesity was 5.3% (95% CI: 4.5–6.1). Southern European countries showed the highest prevalence of excess weight. Additional measures to address the obesity epidemic in early life should be established, especially in European countries where the prevalence of excess weight is very high.
Collapse
|
11
|
Food and beverage intakes according to physical activity levels in European children: the IDEFICS (Identification and prevention of Dietary and lifestyle induced health EFfects In Children and infantS) study. Public Health Nutr 2018; 21:1717-1725. [PMID: 29457580 PMCID: PMC11109026 DOI: 10.1017/s1368980018000046] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 11/23/2017] [Accepted: 01/02/2018] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Physical activity (PA) levels and dietary habits are considered some of the most important factors associated with obesity. The present study aimed to examine the association between PA level and food and beverage consumption in European children (2-10 years old).Design/Setting/SubjectsA sample of 7229 children (49·0 % girls) from eight European countries participating in the IDEFICS (Identification and prevention of Dietary and lifestyle induced health EFfects In Children and infantS) study was included. Moderate-to-vigorous PA (MVPA) was assessed objectively with accelerometers. FFQ was used to register dietary habits. ANCOVA and binary logistic regression were applied. RESULTS Boys who spent less time in MVPA reported lower consumption of vegetables, fruits, cereals, yoghurt, milk, bread, pasta, candies and sugar-sweetened beverages (SSB) than boys who spent more time in MVPA (P<0·05). Moreover, boys who spent less time in MVPA were more likely to consume fast foods and water than those in the highest MVPA tertile (P<0·05). Girls who spent less time in MVPA reported lower consumption frequencies of vegetables, pasta, bread, yoghurt, candies, jam/honey and SSB than girls in the highest MVPA tertile (P<0·05). Also, girls in the lowest MVPA tertile were more likely to consume fast foods and water than those with high levels of MVPA (P<0·05). CONCLUSIONS Food intake among European children varied with different levels of daily MVPA. Low time spent in MVPA was associated with lowest consumption of both high- and low-energy-dense foods and high fast-food consumption.
Collapse
|
12
|
Measuring adolescents’ weight socioeconomic gradient using parental socioeconomic position. Eur J Public Health 2018; 28:1097-1102. [DOI: 10.1093/eurpub/cky064] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
13
|
Breaking Habits: The Effect of the French Vending Machine Ban on School Snacking and Sugar Intakes. JOURNAL OF POLICY ANALYSIS AND MANAGEMENT : [THE JOURNAL OF THE ASSOCIATION FOR PUBLIC POLICY ANALYSIS AND MANAGEMENT] 2018; 37:88-111. [PMID: 29320810 DOI: 10.1002/pam.22032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This paper estimates the effect of the 2005 vending machine ban in French secondary schools on nutrient intakes and on the frequency of morning snacking at school. Using data before and after the ban, and exploiting the discontinuity associated with the age-dependent exposure to the ban, we specify a difference-in-differences regression discontinuity design. Since the relationship between age-at-interview and school level is not precise, we introduce fuzziness in the model. We find that the ban has generated a 10-gram reduction in sugar intakes from morning snacks at school, and a significant reduction in the frequency of these morning snacks. However, we find no evidence that the intervention affects total daily intakes, and our results are suggestive of compensation effects.
Collapse
|
14
|
The effect of early feeding practices on growth indices and obesity at preschool children from four European countries and UK schoolchildren and adolescents. Eur J Pediatr 2017; 176:1181-1192. [PMID: 28711955 DOI: 10.1007/s00431-017-2961-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 05/29/2017] [Accepted: 06/30/2017] [Indexed: 10/19/2022]
Abstract
UNLABELLED Not only healthy growth but also childhood obesity partly originate from early life. The current work aimed to examine the association of feeding practices during infancy with growth and adiposity indices in preschool children from four European countries and in UK schoolchildren and adolescents. Existing data from four European birth cohorts (ALSPAC-UK, EDEN-France, EuroPrevall-Greece and Generation XXI-Portugal) were used. Anthropometrics and body composition indices were collected. Parallel multivariate regression analyses were performed to examine the research hypothesis. Overall, the analyses showed that breastfeeding and timing of complementary feeding were not consistently associated with height z-score, overweight/obesity, and body fat mass in children or adolescents. However, breastfeeding duration for less than 6 months was associated with lower height z-scores in 5-year-old French children (P < 0.001) but with higher height z-scores in 4-year-old UK children (P = 0.006). Furthermore, introduction of complementary foods earlier than 4 months of age was positively associated with fat mass levels in 5-year-old French children (P = 0.026). CONCLUSION Early feeding practices, i.e., any breastfeeding duration and age of introduction of complementary foods, do not appear to be consistently associated with height z-score, overweight/obesity, and body fat mass in preschool children from four European countries and in UK schoolchildren and adolescents. What is known? • Healthy growth and childhood obesity partly originate from early life. What is new? • Breastfeeding duration less than 6 months was associated with lower height z-scores in 5-year-old French children, while the opposite was observed in 4-year-old British children. • Introduction of complementary foods earlier than 4 months was positively associated with fat mass levels in 5-year-old French children, but not in the other three countries. • Early feeding practices did not appear to be consistently associated with growth and adiposity indices, and as such, no clear influence can be observed.
Collapse
|
15
|
Urban-Rural Disparities in Energy Intake and Contribution of Fat and Animal Source Foods in Chinese Children Aged 4-17 Years. Nutrients 2017; 9:nu9050526. [PMID: 28531133 PMCID: PMC5452256 DOI: 10.3390/nu9050526] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 05/09/2017] [Accepted: 05/16/2017] [Indexed: 12/24/2022] Open
Abstract
Objective: Excessive energy intake and poor food choices are major health concerns associated with overweight and obesity risk. This study aims to explore disparities in energy intake and the contributions from fat and animal source foods among Chinese school-aged children and adolescents in different communities based on urbanization levels. Design: Three consecutive 24 h recalls were used to assess dietary intake. Subjects’ height and weight were measured using standard equipment. Standardized questionnaires were used to collect household demographic and socioeconomic characteristics by trained interviewers. Setting: The 2011 China Health and Nutrition Survey is part of an ongoing longitudinal household survey across 228 communities in nine provinces and three mega-cities in China. Subjects consisted of children aged 4–17 years (n = 1866; 968 boys and 898 girls). Results: The estimated average energy intake was 1604 kcal/day (1706 kcal/day for boys and 1493 kcal/day for girls). Proportions of energy from fat and animal source foods were 36.8% and 19.8% respectively and did not differ by gender. Total energy intake showed no significant disparity, but the proportion of energy from fat and animal source foods increased with increasing urbanization levels and increasing household income level. The largest difference in consumption percentages between children in rural areas and those in highly urban areas was for milk and dairy products (14.8% versus 74.4%) and the smallest difference was seen in percent consuming meat and meat products (83.1% versus 97.1%). Conclusions: Results of this study highlight the need for developing and implementing community-specific strategies to improve Chinese children’s diet quality.
Collapse
|
16
|
A contemporary description of French newborns’ growth using the Efemeris cohort. Arch Pediatr 2017; 24:424-431. [PMID: 28343882 DOI: 10.1016/j.arcped.2017.02.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 12/06/2016] [Accepted: 02/10/2017] [Indexed: 11/18/2022]
|
17
|
Évaluation de la qualité de l’alimentation d’adolescents algériens par le score d’adéquation aux recommandations nutritionnelles du PNNS (France). NUTR CLIN METAB 2017. [DOI: 10.1016/j.nupar.2016.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
18
|
Overweight and Obesity in Children under 5 Years: Surveillance Opportunities and Challenges for the WHO European Region. Front Public Health 2017; 5:58. [PMID: 28451584 PMCID: PMC5389968 DOI: 10.3389/fpubh.2017.00058] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 03/03/2017] [Indexed: 01/19/2023] Open
Abstract
Background Many children who have overweight or obesity before puberty can develop obesity in early adulthood, which is associated with increased morbidity and mortality. The preschool years (ages 0–5) represents a point of opportunity for children to be active, develop healthy eating habits, and maintain healthy growth. Surveillance of childhood overweight and obesity in this age group can help inform future policies and interventions. Objective To review and report available prevalence data in WHO European Region Member States and determine how many countries can accurately report on rates of overweight and obesity in children under 5 years. Methods We conducted a rapid review of studies reporting on overweight and obesity prevalence in children ages 0–5 in the WHO European region member states from 1998 to 2015. Results Currently, 35 of the 53 member states have data providing prevalence rates for overweight and obesity for children under 5 years. There was little consistency in study methods, impacting comparability across countries. The prevalence of overweight and obesity in children under 5 years ranges from 1 to 28.6% across member states. Conclusion Although measuring overweight and obesity in this age group may be challenging, there is an opportunity to leverage existing surveillance resources in the WHO European Region.
Collapse
|
19
|
Socio-economic disparities in the diet of French children and adolescents: a multidimensional issue. Public Health Nutr 2016; 20:870-882. [PMID: 27846923 DOI: 10.1017/s1368980016002895] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The present research aimed to study the multidimensionality of the link between dietary intake and socio-economic position (SEP) in a representative sample of French children and adolescents, using a variety of SEP indicators. DESIGN Data from the second French national food consumption survey (INCA2) were used. Information on food consumption was collected using a 7d food record and SEP data (occupation, education, income, household wealth indices) using questionnaires. Multivariable linear regression analyses were performed separately in children and adolescents to assess the relationships between dietary components (food groups and macronutrients) and each dimension of SEP. SETTING The INCA2 survey, France. SUBJECTS A representative sample of French children (3-10 years of age; n 574) and adolescents (11-17 years of age; n 881). RESULTS Compared with children from a higher SEP, those from a lower SEP had lower intakes of fruit and vegetables, yoghurts and confectionery and higher intakes of starchy foods, meat, milk, sugar-sweetened beverages and pizzas/sandwiches. Similar results were observed in adolescents for fruit and vegetables, yoghurts and sugar-sweetened beverages. Adolescents also had lower intakes of cakes/pastries and higher intakes of processed meat and dairy desserts. Neither energy nor protein intake was associated with SEP. Adolescents from a lower SEP had higher carbohydrate and lower lipid intakes. Overall, these findings were consistent across the various dimensions of SEP, but the gradient was steeper depending on the caregiver's educational level. CONCLUSIONS This research highlights the need for specific messages to help poorly educated families adopt good eating habits.
Collapse
|
20
|
Parental response to a letter reporting child overweight measured as part of a routine national programme in England: results from interviews with parents. BMC Public Health 2016; 16:846. [PMID: 27544538 PMCID: PMC4992560 DOI: 10.1186/s12889-016-3481-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 08/11/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rising rates of childhood obesity have become a pressing issue in public health, threatening both the mental and physical well-being of children. Attempts to address this problem are multifaceted, and in England include the National Child Measurement Programme (NCMP) which assesses weight status in English primary school children in reception class (aged 4-5) and in year 6 (aged 10-11), with results being sent out to parents. However the effectiveness and impact of this routine parental feedback has yet to be fully understood. This paper reports one component of a mixed methods study undertaken in North East England, examining the impact of the feedback letters on parents' understanding and feelings about their child's weight status and whether or not this seemed likely to lead to behaviour change. METHODS One-to-one semi-structured interviews (n = 16) were conducted with a sample of parents/guardians after they had received their child's weight results letter. Eight parents/guardians were sub-sampled from the group whose child had been indicated to be overweight or obese and eight were from the group whose child had been indicated to be of ideal weight status. Interviews were conducted until data saturation was reached for both groups. RESULTS The reactions of parents/guardians whose children were identified as being overweight followed a sequence of behaviours ranging from shock, disgust with the programme, through denial and self-blame to acceptance, worry and intention to seek help. On the other hand, the reaction of parents/guardians whose children were identified as being ideal weight ranged from relief, pleasure and happiness through affirmation and self-congratulation to 'othering'. CONCLUSIONS Whilst overweight and obesity is often portrayed as a medical condition, parents/guardians see it as deeply rooted in their social lives and not in health terms. Parents believe that the causes of overeating and lack of exercise relate closely to the obesogenic environment, particularly the complex social and cultural milieu and time pressures within which this sample of people live. Associating this problem in feedback letters with dangerous diseases like cancer, and advising parents to visit GPs to resolve child weight issues was perceived as inappropriate by the parents, and caused controversy and anger. Given the likelihood that the NCMP will continue as a monitoring device, it is evident that the management of the process needs to be reviewed, with particular attention being paid to the feedback process. Local health authorities will need to manage parental expectations and ensure linkage with appropriately commissioned remedial weight management interventions.
Collapse
|
21
|
Prospective associations between energy balance-related behaviors at 2 years of age and subsequent adiposity: the EDEN mother-child cohort. Int J Obes (Lond) 2016; 41:38-45. [PMID: 27528250 DOI: 10.1038/ijo.2016.138] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 06/01/2016] [Accepted: 07/23/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND/OBJECTIVES Sedentary behavior, physical activity and dietary behavior are formed early during childhood and tend to remain relatively stable into later life. No longitudinal studies have assessed the independent influence of these three energy balance-related behaviors during toddlerhood on later adiposity. We aimed to analyze the associations between TV/DVD watching time, outdoor play time and dietary patterns at the age of 2 years and child adiposity at the age of 5 years, in boys and girls separately. SUBJECTS/METHODS This study included 883 children from the French EDEN mother-child cohort. TV/DVD watching time, outdoor play time and dietary intakes were reported by parents in questionnaires when the child was aged 2 years. Two dietary patterns, labeled 'Guidelines' and 'Processed, fast foods', were identified in a previous study. The percentage of body fat (%BF) based on bioelectrical impedance analysis and body mass index were measured at the age of 5 years. RESULTS In boys, TV/DVD watching time at the age of 2 years was positively associated with %BF at the age of 5 years (β=0.50 (95% confidence interval: 0.001, 1.00) for those boys with ⩾60 min per day of TV/DVD watching time vs those with ⩽15 min per day, P-value for trend 0.05). In girls, outdoor play was inversely associated with %BF (β=-0.96 (95% confidence interval: -1.60, -0.32) for those in the highest tertile of outdoor play time vs those in the lowest tertile, P=0.001). Overall, at the age of 2 years, dietary patterns were associated with both TV/DVD watching time and outdoor play time, but no significant and independent association was observed between dietary patterns and later adiposity. CONCLUSION This study shows longitudinal and gender-differentiated relations between both TV/DVD watching time and outdoor play time in toddlerhood and later adiposity, whereas evidence for a relation between dietary patterns and subsequent fat development was less conclusive. Early childhood-by the age of 2 years-should be targeted as a critical time for promoting healthy energy balance-related behaviors.
Collapse
|
22
|
Administration of Antibiotics to Children Before Age 2 Years Increases Risk for Childhood Obesity. Gastroenterology 2016; 151:120-129.e5. [PMID: 27003602 PMCID: PMC4924569 DOI: 10.1053/j.gastro.2016.03.006] [Citation(s) in RCA: 115] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 03/08/2016] [Accepted: 03/13/2016] [Indexed: 12/02/2022]
Abstract
BACKGROUND & AIMS Childhood obesity is increasing and is associated with adult obesity. Antibiotics have been used to promote weight gain in livestock for several decades. Antibiotics are commonly prescribed for children, but it is not clear how exposure to antibiotics early in life affects risk for obesity. We performed a population-based cohort study to assess the association between antibiotic exposure before age 2 years and obesity at age 4 years. METHODS We performed a retrospective cohort study of 21,714 children in The Health Improvement Network-a population-representative dataset of >10 million individuals derived from electronic medical records from 1995 through 2013 in the United Kingdom. Eligible subjects were registered within 3 months of birth with complete follow-up and height and weight were recorded within 12 months of their 4th birthday. Antibiotic exposure was assessed before age 2 years, and classified based on anti-anaerobic activity. The primary outcome was obesity at age 4 years. We performed logistic regression analyses, adjusting for maternal and sibling obesity, maternal diabetes, mode of delivery, socioeconomic status, year and country of birth, and urban dwelling. RESULTS In the cohort, 1306 of the children (6.4%) were obese at 4 years of age. Antibiotic exposure was associated with an increased risk of obesity at 4 years (odds ratio [OR] = 1.21; 95% confidence interval [CI]: 1.07-1.38). ORs increased with repeated exposures: for 1-2 prescriptions, OR = 1.07 (95% CI, 0.91-1.23); for 3-5 prescriptions, OR = 1.41 (95% CI, 1.20-1.65); and for 6 or more prescriptions, OR = 1.47 (95% CI, 1.19-1.82). Antifungal agents were not associated with obesity (OR = 0.81; 95% CI, 0.59-1.11). CONCLUSIONS Administration of 3 or more courses of antibiotics before children reach an age of 2 years is associated with an increased risk of early childhood obesity.
Collapse
|
23
|
Dietary patterns in the French adult population: a study from the second French national cross-sectional dietary survey (INCA2) (2006-2007). Br J Nutr 2016; 116:300-15. [PMID: 27189191 PMCID: PMC4910537 DOI: 10.1017/s0007114516001549] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 02/20/2016] [Accepted: 03/21/2016] [Indexed: 11/17/2022]
Abstract
Identification and characterisation of dietary patterns are needed to define public health policies to promote better food behaviours. The aim of this study was to identify the major dietary patterns in the French adult population and to determine their main demographic, socio-economic, nutritional and environmental characteristics. Dietary patterns were defined from food consumption data collected in the second French national cross-sectional dietary survey (2006-2007). Non-negative-matrix factorisation method, followed by a cluster analysis, was implemented to derive the dietary patterns. Logistic regressions were then used to determine their main demographic and socio-economic characteristics. Finally, nutritional profiles and contaminant exposure levels of dietary patterns were compared using ANOVA. Seven dietary patterns, with specific food consumption behaviours, were identified: 'Small eater', 'Health conscious', 'Mediterranean', 'Sweet and processed', 'Traditional', 'Snacker' and 'Basic consumer'. For instance, the Health-conscious pattern was characterised by a high consumption of low-fat and light products. Individuals belonging to this pattern were likely to be older and to have a better nutritional profile than the overall population, but were more exposed to many contaminants. Conversely, individuals of Snacker pattern were likely to be younger, consumed more highly processed foods, had a nutrient-poor profile but were exposed to a limited number of food contaminants. The study identified main dietary patterns in the French adult population with distinct food behaviours and specific demographic, socio-economic, nutritional and environmental features. Paradoxically, for better dietary patterns, potential health risks cannot be ruled out. Therefore, this study demonstrated the need to conduct a risk-benefit analysis to define efficient public health policies regarding diet.
Collapse
|
24
|
Childhood overweight in Berlin: intra-urban differences and underlying influencing factors. Int J Health Geogr 2016; 15:12. [PMID: 27001085 PMCID: PMC4802651 DOI: 10.1186/s12942-016-0041-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 03/09/2016] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND In recent years, childhood overweight and obesity have become an increasing and challenging phenomenon in Western cities. A lot of studies have focused on the analysis of factors such as individual dispositions and nutrition balances, among others. However, little is known about the intra-urban spatial patterns of childhood overweight and its associations with influencing factors that stretch from an individual to a neighbourhood level. The aim of this paper is to analyse the spatial patterns of childhood obesity in Berlin, and also to explore and test for associations with a complex set of risk factors at the individual, household and neighbourhood levels. METHODS We use data from a survey of 5-6 year-olds that includes health status, height, and weight, as well as several socioeconomic and other risk variables. In addition, we use a set of neighbourhood variables, such as distance, and density measures of parks or fast food restaurants. Our outcome variable is the percentage of children of 5-6 years who were reported overweight or obese in 2012. The aggregated data is available for 60 areas in Berlin. We first analyse the outcome and risk factor data descriptively, and subsequently apply a set of regression analyses to test for associations between reported overweight and obesity, and also individual, household and neighbourhood characteristics. RESULTS Our analysis returned a distinct spatial distribution of childhood overweight in Berlin with highest shares in the city centre. Moreover, we were able to identify significant effects regarding the social index, and the percentage of non-German children being obese or overweight; additionally, we identified fast food restaurant density as a possible influencing factor. For the other variables, including the neighbourhood variables, we could not identify a significant association on this aggregated level of analysis. CONCLUSIONS Our findings confirm the results of earlier studies, in which the social status and percentage of non-German children is very important in terms of the association with childhood overweight and obesity. Unlike many studies conducted in North America, this study did not reveal an influence of neighbourhood variables. We argue that European urban structures differ from North American structures and highlight the need for a more detailed analysis of the association between the neighbourhood environment and the physical activity of children in urban setting.
Collapse
|
25
|
Trends in child and adolescent obesity prevalence in economically advanced countries according to socioeconomic position: a systematic review. Obes Rev 2016; 17:276-95. [PMID: 26693831 DOI: 10.1111/obr.12360] [Citation(s) in RCA: 172] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 10/29/2015] [Accepted: 10/30/2015] [Indexed: 11/29/2022]
Abstract
Recent obesity trends in children and adolescents suggest a plateau. However, it is unclear whether such trends have been experienced across socioeconomic groups. We analysed whether recent trends in child and adolescent overweight and obesity differ by socioeconomic position (SEP) across economically advanced countries. Eligible studies reported overweight and obesity prevalence in children and/or adolescents (2-18 years), for at least two time points since 1990, stratified by SEP. Socioeconomic differences in trends in child and adolescent overweight and obesity over time were analysed. Differences in trends between SEP groups were observed across a majority of studies. Over half the studies indicated increasing prevalence among low SEP children and adolescents compared to a third of studies among children and adolescents with a high SEP. Around half the studies indicated widening socioeconomic inequalities in overweight and obesity. Since 2000 a majority of studies demonstrated no change or a decrease in prevalence among both high and low SEP groups. However around 40% of studies indicated widening of socioeconomic inequalities post-2000. While our study provides grounds for optimism, socioeconomic inequalities in overweight and obesity continue to widen. These findings highlight the need for greater consideration of different population groups when implementing obesity interventions.
Collapse
|
26
|
|
27
|
Trends in childhood obesity and central adiposity between 1998-2001 and 2010-2012 according to household income and urbanity in Korea. BMC Public Health 2016; 16:18. [PMID: 26744297 PMCID: PMC4705619 DOI: 10.1186/s12889-015-2616-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 12/15/2015] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND This study examined trends in body mass index (BMI), waist circumference (WC), and childhood overweight and obesity prevalence between 1998-2001 and 2010-2012 according to household income and urbanity among nationally representative Korean children and adolescents aged 10-19. METHODS The repeated cross-sectional data from Korean National Health and Nutrition Examination Surveys in 1998-2001 and 2010-2012 were used. Gender specific trends in age-adjusted means of WC and BMI by household equivalized income and urbanity were compared between years. The age-standardized prevalence of childhood overweight and obesity was calculated using three international criteria (International Obesity Task Force, World Health Organization, US Centers for Disease Control and Prevention) and a Korean national reference standard. RESULTS Among boys, overall BMI and overweight prevalence increased between 1998-2001 and 2010-2012, while overall WC decreased. Clear gender differences were found in the relationship of childhood obesity metrics with household income and urbanity and the time trends of those relationships. Positive relationships between these parameters were found for boys while negative relationships appeared for girls. In addition, compared with the childhood obesity prevalence among boys in rural areas, the prevalence among boys in urban areas were slightly lower in 1998-2001 but became greater in 2010-2012. CONCLUSIONS This study revealed gender difference in the association of childhood obesity with household income and urbanity and its time trends. The long-term gender-specific monitoring of socioeconomic and urban-rural differences in childhood obesity measures is warranted in South Korea.
Collapse
|
28
|
Socioeconomic position and childhood-adolescent weight status in rich countries: a systematic review, 1990-2013. BMC Pediatr 2015; 15:129. [PMID: 26391227 PMCID: PMC4578240 DOI: 10.1186/s12887-015-0443-3] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 09/04/2015] [Indexed: 01/09/2023] Open
Abstract
Background Childhood obesity is a major problem in rich countries due to its high prevalence and its harmful health consequences. An exploratory analysis conducted in the PubMed database highlighted that the number of papers published on the relationship between socioeconomic position (SEP) and childhood-adolescent weight status had risen substantially with respect to an earlier review which had covered the period 1990–2005. Methods To describe the findings on the relationship between SEP and childhood-adolescent weight status in papers published in rich countries from 1990 through 2013, studies were identified in the following databases: PubMed; Web of Knowledge (WOK); PsycINFO; Global Health; and Embase. We included observational studies from the 27 richest OECD countries, which covered study populations aged 0 to 21 years, and used parental education, income and/or occupation as family SEP indicators. A total of 158 papers met the inclusion criteria and reported 134 bivariable and 90 multivariable analyses. Results Examination of the results yielded by the bivariable analyses showed that 60.4 % of studies found an inverse relationship, 18.7 % of studies did not found relationship, and 20.9 % of studies found a relationship that varied depending on another variable, such as age, sex or ethnic group; the corresponding percentages in the multivariable analyses were 51.1, 20.0 and 27.8 %, respectively. Furthermore, 1.1 % found a positive relationship. Conclusion The relationship between SEP and childhood-adolescent weight status in rich countries is predominantly inverse and the positive relationship almost has disappeared. The SEP indicator that yields the highest proportion of inverse relationships is parents’ education. The proportion of inverse relationships is higher when the weight status is reported by parents instead using objective measurements. Electronic supplementary material The online version of this article (doi:10.1186/s12887-015-0443-3) contains supplementary material, which is available to authorized users.
Collapse
|
29
|
Abstract
A range of important early-life predictors of later obesity have been identified. Children of lower socioeconomic position (SEP) have a steeper weight gain trajectory from birth with a strong socioeconomic gradient in child and adult obesity prevalence. An assessment of the association between SEP and the early-life predictors of obesity has been lacking. The review involved a two-stage process: Part 1, using previously published systematic reviews, we developed a list of the potentially modifiable determinants of obesity observable in the pre-natal, peri-natal or post-natal (pre-school) periods; and part 2, conducting a literature review of evidence for socioeconomic patterning in the determinants identified in part 1. Strong evidence was found for an inverse relationship between SEP and (1) pre-natal risk factors (pre-pregnancy maternal body mass index (BMI), diabetes and pre-pregnancy diet), (2) antenatal/peri natal risk factors (smoking during pregnancy and low birth weight) and (3) early-life nutrition (including breastfeeding initiation and duration, early introduction of solids, maternal and infant diet quality, and some aspects of the home food environment), and television viewing in young children. Less strong evidence (because of a lack of studies for some factors) was found for paternal BMI, maternal weight gain during pregnancy, child sleep duration, high birth weight and lack of physical activity in young children. A strong socioeconomic gradient exists for the majority of the early-life predictors of obesity suggesting that the die is cast very early in life (even pre-conception). Lifestyle interventions targeting disadvantaged women at or before child-bearing age may therefore be particularly important in reducing inequality. Given the likely challenges of reaching this target population, it may be that during pregnancy and their child's early years are more feasible windows for engagement.
Collapse
|
30
|
Primordial Influence of Post-operative Compliance on Weight Loss After Adolescent Laparoscopic Adjustable Gastric Banding. Obes Surg 2015; 26:98-104. [PMID: 26058753 DOI: 10.1007/s11695-015-1725-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
31
|
Abstract
Objective The aim of the present study was to examine the prevalence and time trends in childhood overweight including obesity and obesity among Tuscan children from 2002 to 2012. Design Cross-sectional study at five time points (Tuscan Nutritional Surveillance Surveys conducted in the years of 2002, 2006, 2008, 2010 and 2012). Trained personnel directly measured the height and weight of the subjects. BMI was assessed by means of the International Obesity Task Force (IOTF) and WHO cut-offs. Setting Representative sample of children in the Tuscany region (Italy). Subjects Children (n 7183) aged between 7·5 and 9·5 years (3711 boys and 3472 girls). Results With respect to the estimation of the absolute prevalence level of childhood overweight, a discrepancy was observed between the two criteria. In all surveys, more boys than girls were overweight (including obesity). Trend analysis showed a significant decrease in the prevalence of overweight including obesity and obesity in Tuscan children from 2002 to 2012 (32·0 % v. 25·8 %, P<0·001 on using IOTF criteria and 37·7 % v. 34·3 %, P<0·001 on using WHO criteria for overweight including obesity; and 10·0 % v. 6·7 %, P<0·001 on using IOTF criteria and 12·5 % v. 11·3 %, P=0·035 on using WHO criteria for obesity). Conclusions The present study is the first report from an Italian region showing a significant decrease in childhood obesity and overweight in the last 10 years. This reduction is probably a result of regional and local actions that have taken place in many sectors of society. However, efforts should be made to lower the prevalence of childhood obesity and overweight further.
Collapse
|
32
|
Weight disorders and anthropometric indices according to socioeconomic status of living place in Iranian children and adolescents: The CASPIAN-IV study. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2015; 20:440-53. [PMID: 26487872 PMCID: PMC4590198 DOI: 10.4103/1735-1995.163960] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 04/07/2015] [Accepted: 05/26/2015] [Indexed: 01/10/2023]
Abstract
BACKGROUND Excess weight in children and adolescents is a multi-factorial phenomenon and associated with earlier risk of obesity-related diseases. This study aims to assess the prevalence of weight disorders and the mean values of anthropometric indices according to regional, socioeconomic, and urban-rural variations among Iranian children and adolescents. MATERIALS AND METHODS This nationwide study was performed in 2011-2012 among a representative multi-stage cluster sample of 14,880 Iranian students aged 6-8 years. The World Health Organization (WHO) reference curves were used to define weight disorders. Abdominal obesity was defined as the waist-to-height ratio (WHtR) of more than 0.5. Iran was classified into four regions according to the socioeconomic status (SES). RESULTS The mean (95% confidence interval) of body mass index (BMI), waist circumference (WC), and hip circumference (HC) was 18.8 (18.7, 18.9) kg/m(2), 67.0 (66.7, 67.3) cm, and 80.8 (80.3, 81.2) cm, respectively. The prevalence of underweight was 12.2%. A total of 9.7%, 11.9%, and 19.1% of students overweight, obese, and abdominally obese, respectively. The highest mean of BMI, WC, wrist circumference, HC, and WHtR were related to the second high SES (North-northeast) area (19.2 [18.8, 19.5], 68.3 [67.3, 69.4], 14.8 [14.7, 15.0], 82.6 [81.1, 84.0], and 0.464 [0.460, 0.468]). In contrast, the lowest SES (Southeast) region had the lowest mean of these anthropometric indices (17.6 [17.1, 18.2], 63.2 [61.7, 64.8], 14.5 [14.2, 14.8], 76.9 [74.9, 79.0], and 0.439 [0.434, 0.444]). CONCLUSION We found considerable differences in the prevalence of anthropometric measures throughout the country by SES of the region. Health policy making and implementing health strategies should consider SES of regions.
Collapse
|
33
|
Dietary patterns of French adults: associations with demographic, socio-economic and behavioural factors. J Hum Nutr Diet 2015; 29:241-54. [DOI: 10.1111/jhn.12315] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
34
|
Regional Disparities in Sedentary Behaviors and Meal Frequency in Iranian Adolescents: The CASPIAN-III Study. IRANIAN JOURNAL OF PEDIATRICS 2015. [PMID: 26195993 PMCID: PMC4505997 DOI: 10.5812/ijp.182] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The prevalence of obesity is increasing among Iranian youngsters like other developing countries. OBJECTIVES This study was conducted to assess regional disparities in sedentary behaviors and meal frequency in Iranian adolescents. PATIENTS AND METHODS In this national survey, 5682 students aged 10 - 18 years from urban and rural districts of 27 provinces of Iran were selected via stratified multi-stage sampling method. The country was classified into four sub-national regions, based on criteria of the combination of geography and socioeconomic status (SES). Mean of meal frequency and physical activity levels as well as prevalence of omitting meals and sedentary behavior were compared across regions with different SES after stratifying with sex and age group. RESULTS Meal frequency in lower socio-economic regions was significantly higher than two other regions in 10 - 13 and 10 - 18 years old groups (P trend < 0.001). However, the mean of working hours with computer was linearly increased with increasing the SES in studied regions (P trend < 0.001), whereas the corresponding figure was not significant for the mean of watching TV (P trend > 0.05). Frequency of adolescents omitting their meals was higher in higher SES regions especially in West Iran (P < 0.001) in 10 - 13 years old age group. Having personal computer and working with it more than two hours per day mainly was observed in central Iran which ranked as the highest SES group. CONCLUSIONS Efforts to ensure Iranian youth meet healthy food habits and screen time guidelines include limiting access to screen technologies and encouraging parents to monitor their own screen time is required.
Collapse
|
35
|
Risk factors for overweight and obesity in Swiss primary school children: results from a representative national survey. Eur J Nutr 2015; 55:621-629. [PMID: 25796625 DOI: 10.1007/s00394-015-0882-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 03/11/2015] [Indexed: 12/16/2022]
Abstract
PURPOSE Obesity is a global epidemic affecting around 10 % of 5- to 17-year olds. With the causes for obesity being multifactorial, a better understanding of the influencing factors is essential for effective treatment and prevention programs. The aim of this study was therefore to identify specific risk factors for overweight and obesity in children in Switzerland. METHODS A nationally representative sample of children aged 6-12 years was recruited (n = 2724). Height and weight were measured to calculate BMI (kg/m(2)). In addition, a questionnaire was distributed to all children asking about their physical activity, media consumption, and dietary habits as well as some parental factors. RESULTS The prevalence of overweight and obesity in boys was 11.8 and 7.5 %, respectively, and in girls, it was 11.9 and 5.7 %. In univariate analyses, a number of parental, dietary, and activity factors were shown to be associated with BMI category. Based on a multinomial logistic regression, parent nationality and media consumption were the most important factors predicting obesity in boys, while in girls it was parental education, nationality, and physical activity. CONCLUSION We have demonstrated that parental nationality and education play an important role in the development of childhood obesity, together with media consumption and physical activity. However, risk factors are also different according to child gender. Thus, an important target group for the treatment and prevention of childhood obesity in Switzerland are immigrant families, and the problem needs to be tackled differently in boys and girls as their risk factors are not the same.
Collapse
|
36
|
Body-weight perception and related preoccupations in a large national sample of adolescents. Pediatr Obes 2015; 10:15-22. [PMID: 24453118 DOI: 10.1111/j.2047-6310.2013.00211.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 09/24/2013] [Accepted: 10/28/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This study aimed to investigate the association between body-weight (BW) perception, weight preoccupation and behaviour, including weight control practices and compulsive over-eating episodes, across gender and actual BW classes. DESIGN This study used a cross-sectional observational study. PARTICIPANTS A large, nationally representative sample of 6404 ninth-grade French adolescents was randomly selected from schools throughout France. METHODS Weight and height were measured, and BW preoccupation, BW control practices and compulsive over-eating were self-reported using standardized questionnaires. RESULTS Nearly one-third of adolescents misperceived their BW. Misperception was more frequent among girls than boys (42.2% vs. 27.3%, P < 0.01). Underestimation of BW among overweight adolescents, like BW overestimation among underweight adolescents, was associated with less preoccupation with weight and fewer weight control practices than accurate perception of BW. Normal weight adolescents who overestimated their BW were more likely to declare weight preoccupations (ORa = 8.66 [6.67-11.25]), dieting (ORa = 4.81 [3.68-6.27]) and recurrent compulsive over-eating episodes (ORa = 2.36 [1.72-3.23]) compared with their counterparts who correctly estimated their BW. CONCLUSION Our study underlines the role of these associations in each category of actual BW (underweight, normal weight and overweight) in a large national sample.
Collapse
|
37
|
The relationship between school lunch attendance and the food intakes of French schoolchildren aged 3-17 years. Public Health Nutr 2015; 18:1647-57. [PMID: 25634126 DOI: 10.1017/s1368980014002900] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Recently, school meal composition regulations have been implemented in France in order to improve the nutritional status of children. The present study investigated the link between school lunch attendance and the food intakes of schoolchildren aged 3-17 years. DESIGN Second French cross-sectional dietary survey (2006-2007). Eating frequencies were assessed for twenty-four food groups with a 7 d food record. Eating locations were recorded for main meals. Food group intakes at weekday lunches were compared for the school canteen and for other locations. The children's overall dietary intake was compared based on school lunch attendance. SETTING Mainland France. SUBJECTS Schoolchildren aged 3-17 years (n 1068). RESULTS Lunchtime food intake differed between the school canteen and other locations. Some intakes at school canteens were more in accordance with the regulations (more fruit and vegetables, fish and dairy products, and less sandwiches, soft drinks, chocolate and confectionery), whereas others highlighted needs for improvement (more sweet biscuits and pastries, ice cream and dairy desserts, pizzas and salty pastries). Many of these differences were also observed in the children's overall diet: children regularly attending school lunches ate more mashed fruit, fish and sweet biscuits or pastries, and less sandwiches and soft drinks. The link between school lunch attendance and overall diet was less pronounced in secondary-school children. CONCLUSIONS School canteen attendance is associated with both potentially beneficial and deleterious differences in the lunchtime and overall diets of French children. These findings are important to consider when setting national regulations for school meal composition.
Collapse
|
38
|
Opportunities for intervention strategies for weight management: global actions on fluid intake patterns. Obes Facts 2015; 8:54-76. [PMID: 25765164 PMCID: PMC5644897 DOI: 10.1159/000375103] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 11/20/2014] [Indexed: 12/12/2022] Open
Abstract
Water is an essential nutrient for all physiological functions and particularly important for thermoregulation. About 60% of our body weight is made of water. Under standard conditions (18-20 °C and moderate activity), water balance is regulated within 0.2 % of body weight over a 24-hour period. Water requirement varies between individuals and according to environmental conditions. Concerning considerations related to obesity, the health impact of fluid intake is commonly overlooked. Fluid intake advices are missing in most of food pyramids offered to the public, and water requirements and hydration challenges remain often neglected. The purpose of this paper is to emphasize and discuss the role of water consumption in the context of other important public health measures for weight management. Attention will be focused on fluid intake patterns and hydration-related questions in the context of global interventions and/or physical activity programs settled in weight management protocols.
Collapse
|
39
|
Anthropometric variables, lifestyle and sports in school-age children: Comparison between the cities of Bologna and Crotone. HOMO-JOURNAL OF COMPARATIVE HUMAN BIOLOGY 2014; 65:499-508. [DOI: 10.1016/j.jchb.2014.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 03/11/2014] [Accepted: 05/14/2014] [Indexed: 11/27/2022]
|
40
|
Overweight and obesity in Portuguese children: prevalence and correlates. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:11398-417. [PMID: 25372884 PMCID: PMC4245619 DOI: 10.3390/ijerph111111398] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 10/22/2014] [Accepted: 10/27/2014] [Indexed: 12/18/2022]
Abstract
There are widespread differences in overweight/obesity prevalence in children, and understanding the reasons for this is very important. The present study aims: (I) to conduct a meta-analysis on overweight/obesity prevalence in Portuguese children; (II) to identify differences in biological and behavioural characteristics between normal-weight and overweight/obese children; and (III) to investigate the importance of individual- and school-level correlates of variation in children's BMI using multilevel modelling. A search was done for all published papers including Portuguese children during the last decade; further, 686 Portuguese children (9-11 years old) were sampled and their BMI, family income, maturity offset, nutritional habits, physical activity, sedentariness, sleep time, and school environment information were collected. Results showed a stabilization of overweight/obesity during the last decade, 30.6% (95%CI: 0.287-0.34) for boys, 28.4% (95%CI: 0.23-0.35) for girls, and 30.3% (95%CI: 0.27-0.34) for boys and girls together. Differences between weight groups were only found in individual-level biological traits. The multilevel analysis did not identify significant contributions of school-level variables to children's BMI variation. In conclusion, no increase was found in the prevalence of overweight/obesity among Portuguese children since 2000. Normal-weight and overweight/obese children only differ in individual-level characteristics, and school context variables were not related to variation in BMI.
Collapse
|
41
|
School meal programs and their potential to operate as school-based obesity prevention and nutrition interventions: case studies from France and Japan. CRITICAL PUBLIC HEALTH 2014. [DOI: 10.1080/09581596.2014.957654] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
42
|
Overweight and obesity in primary school: native children versus migrant children. J Public Health (Oxf) 2014. [DOI: 10.1007/s10389-014-0637-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
|
43
|
Evidence of inbreeding depression on height, weight, and body mass index: A population-based child cohort study. Am J Hum Biol 2014; 26:784-95. [DOI: 10.1002/ajhb.22599] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 07/17/2014] [Accepted: 07/17/2014] [Indexed: 12/11/2022] Open
|
44
|
A break in the obesity epidemic? Explained by biases or misinterpretation of the data? Int J Obes (Lond) 2014; 39:189-98. [PMID: 24909829 DOI: 10.1038/ijo.2014.98] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 03/14/2014] [Accepted: 04/01/2014] [Indexed: 12/24/2022]
Abstract
Recent epidemiologic papers are presenting prevalence data suggesting breaks and decreases in obesity rates. However, before concluding that the obesity epidemic is not increasing anymore, the validity of the presented data should be discussed more thoroughly. We had a closer look into the literature presented in recent reviews to address the major potential biases and distortions, and to develop insights about how to interpret the presented suggestions for a potential break in the obesity epidemic. Decreasing participation rates, the use of reported rather than measured data and small sample sizes, or lack of representativeness, did not seem to explain presented breaks in the obesity epidemic. Further, available evidence does not suggest that stabilization of obesity rates is seen in higher socioeconomic groups only, or that urbanization could explain a potential break in the obesity epidemic. However, follow-ups of short duration may, in part, explain the apparent break or decrease in the obesity epidemic. On the other hand, a single focus on body mass index (BMI) ⩾25 or ⩾30 kg m(-)(2) is likely to mask a real increase in the obesity epidemic. And, in both children and adults, trends in waist circumferences were generally suggesting an increase, and were stronger than those reported for trends in BMI. Studies concluding that there is a recent break in the obesity epidemic need to be interpreted with caution. Reported studies presenting a break were mostly of short duration. Further, focusing on trends in waist circumference rather than BMI leads to a less optimistic conclusion: the public health problem of obesity is still increasing.
Collapse
|
45
|
Trends in child and adolescent obesity prevalence according to socioeconomic position: protocol for a systematic review. Syst Rev 2014; 3:52. [PMID: 24887511 PMCID: PMC4038826 DOI: 10.1186/2046-4053-3-52] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 05/06/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Obesity is a significant public health issue and is socially patterned, with greater prevalence of obesity observed in the most socioeconomically disadvantaged groups. Recent evidence suggests that the prevalence of childhood obesity is levelling off in some countries. However, this may not be the case across all socioeconomic strata. The aim of this review is to examine whether trends in child and adolescent obesity prevalence since 1990 differ according to socioeconomic position in developed countries. METHODS An electronic search will be conducted via Ovid Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, Scopus and Cochrane Collaboration to identify articles that report trends in obesity prevalence in children and adolescents according to socioeconomic position. We will also search grey literature databases including the Virtual Library for Public Health and the System for Information on Grey Literature, as well as websites from relevant organisations. Articles that report on a series of cross sectional studies; describe one or more measure of obesity with data recorded at two or more time points since 1990; and report trends by at least one indicator of socioeconomic position will be included. Quality of included studies will be evaluated according to criteria that consider both internal and external validity. Descriptive analysis will be performed to examine trends since 1990 in childhood obesity prevalence according to socioeconomic position. DISCUSSION The review will provide a picture of change over time in developed countries of childhood obesity prevalence across socioeconomic strata and identify whether changes in childhood obesity prevalence are experienced equally across socioeconomic groups. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42014007625.
Collapse
|
46
|
Correction of body-mass index using body-shape perception and socioeconomic status in adolescent self-report surveys. PLoS One 2014; 9:e96768. [PMID: 24844229 PMCID: PMC4028195 DOI: 10.1371/journal.pone.0096768] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 04/11/2014] [Indexed: 11/29/2022] Open
Abstract
Objectives To propose a simple correction of body-mass index (BMI) based on self-reported weight and height (reported BMI) using gender, body shape perception and socioeconomic status in an adolescent population. Methods 341 boys and girls aged 17–18 years were randomly selected from a representative sample of 2165 French adolescents living in Paris surveyed in 2010. After an anonymous self-administered pen-and-paper questionnaire asking for height, weight, body shape perception (feeling too thin, about the right weight or too fat) and socioeconomic status, subjects were measured and weighed. BMI categories were computed according to Cole’s cut-offs. Reported BMIs were corrected using linear regressions and ROC analyses and checked with cross-validation and multiple imputations to handle missing values. Agreement between actual and corrected BMI values was estimated with Kappa indexes and Intraclass correlation coefficients (ICC). Results On average, BMIs were underreported, especially among girls. Kappa indexes between actual and reported BMI were low, especially for girls: 0.56 95%CI = [0.42–0.70] for boys and 0.45 95%CI = [0.30–0.60] for girls. The regression of reported BMI by gender and body shape perception gave the most balanced results for both genders: the Kappa and ICC obtained were 0.63 95%CI = [0.50–0.76] and 0.67, 95%CI = [0.58–0.74] for boys; 0.65 95%CI = [0.52–0.78] and 0.74, 95%CI = [0.66–0.81] for girls. The regression of reported BMI by gender and socioeconomic status led to similar corrections while the ROC analyses were inaccurate. Conclusions Using body shape perception, or socioeconomic status and gender is a promising way of correcting BMI in self-administered questionnaires, especially for girls.
Collapse
|
47
|
A socio-ecological approach promoting physical activity and limiting sedentary behavior in adolescence showed weight benefits maintained 2.5 years after intervention cessation. Int J Obes (Lond) 2014; 38:936-43. [PMID: 24509504 PMCID: PMC4088336 DOI: 10.1038/ijo.2014.23] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 01/21/2014] [Accepted: 01/24/2014] [Indexed: 01/17/2023]
Abstract
Background: Obesity in youth remains a major public health issue. Yet no effective long-term preventive strategy exists. We previously showed that a school-based socio-ecological approach targeting behavior and social/environmental influences on physical activity (PA) prevented 4-year excessive weight gain in 12-year olds. In this study, we investigated if this efficacy persists 30 months after intervention cessation. Methods and Findings: The program targeted students, family, school and the living environment to promote/support PA and prevent sedentary behavior (SB). A total of 732 students from eight randomized middle schools completed the 4-year trial. At the 30-month post-trial follow-up, body mass index (BMI), fat mass index (FMI), leisure PA (LPA), home/school/workplace active commuting, TV/video time (TVT), and attitudes toward PA were measured in 531 adolescents. The beneficial effects of the intervention on the excess BMI increase (+0.01 vs +0.34 kg m−2 in the intervention and control groups, respectively) and on the overweight incidence in initially non-overweight students (4.3% vs 8.6% odds ratio=0.48 (95% confidence interval: 0.23–1.01)) were maintained at the post-trial follow-up. LPA was not maintained at the level achieved during the trial. However, we still observed a prevention of the age-related decrease of the adolescents' percentage reporting regular LPA (−14.4% vs −26.5%) and a higher intention to exercise in the intervention group. The intervention promoted lower TVT (−14.0 vs +13.6 min per day) and higher active commuting changes (+11.7% vs −4.8%). Trends in higher BMI reduction in students with high initial TVT and in the least wealthy group were noted. TVT changes throughout the follow-up predicted excess BMI and FMI changes. Conclusions: Long-term multilevel approach targeting PA and SB prevents excessive weight gain up to 30 months after intervention cessation. The efficacy may be higher in the most sedentary and least wealthy adolescents. Healthy PA-related behavior inducing long-lasting weight effects can be promoted in youth providing that an ecological approach is introduced in the prevention strategy.
Collapse
|
48
|
Trends in the prevalence of childhood overweight and obesity according to socioeconomic status: Spain, 1987-2007. Eur J Clin Nutr 2013; 68:209-14. [PMID: 24346475 DOI: 10.1038/ejcn.2013.255] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 09/30/2013] [Accepted: 10/28/2013] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES To ascertain trends in the prevalence of overweight and obesity among Spanish children and adolescents according to the socioeconomic status of the family household and area of residence across the period 1987-2007. SUBJECTS/METHODS For study purposes, data were drawn from the 1987, 1995, 1997, 2001 and 2007 Spanish National Health Surveys. Overweight and obesity were estimated on the basis of body mass index. The following indicators of socioeconomic status were used: educational level of primary household earner and per capita income of province of residence. The statistical significance of the trend in the prevalence of overweight and obesity was assessed for each category of socioeconomic status. The χ2 test for trend was used in the case of educational level and a linear regression in the case of per capita income of province of residence. RESULTS Although the prevalence of overweight and obesity had levelled off among boys and girls aged 5 to 9 years, it nevertheless showed a significant upward trend among those aged 10 to 15 years from families whose primary household earner had a lower educational level. The prevalence of overweight among boys in this last group was 13.1% in 1987 and 31.5% in 2007. From 1997 onwards, the prevalence of overweight and obesity among boys and girls aged 10 to 15 years increased in both the richest and the remaining provinces, although the magnitude of this increase was greater in the latter. Specifically, in these provinces the prevalence increased from 18 to 28.9% over the period of study. CONCLUSIONS The prevalence of overweight and obesity in the childhood population in Spain has stabilised, except among adolescents, whether from lower-income families or lower-income areas, among whom a rising trend is in evidence.
Collapse
|
49
|
Overweight and obesity prevalence and trends in children and adolescents in Cyprus 2000-2010. Obes Res Clin Pract 2013; 8:e426-34. [PMID: 25263832 DOI: 10.1016/j.orcp.2013.11.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 11/12/2013] [Accepted: 11/14/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To estimate the prevalence of overweight and obesity in 2010 and examine prevalence trends between 2000 and 2010 among school-aged children and adolescents in Cyprus. METHODS A representative cross-sectional study was undertaken in 2010. Anthropometric data were taken using standard methods from 3090 children. The IOTF cut-offs were used to define overweight and obese participants, and prevalence was compared with a previous representative study performed in 2000. Prevalences with 95% confidence intervals (95% CI) were calculated and logistic regression models were used to estimate 10-year trends. RESULTS The overall prevalence of obesity was higher in 2010 (8.1% [95%CI: 7.1, 9.1]) compared to 2000 (5.9% [95%CI: 5.0, 6.8]), p=0.002. The overall prevalence of overweight was also higher in 2010 (20.1% [95%CI: 18.7, 21.5]) compared to 2000 (16.5% [95%CI: 15.0, 18.0]), p<0.001. The prevalence of obesity increased at a greater rate in school-aged boys (p=0.017), and in rural areas (p=0.001). In rural areas, high maternal education background is associated with a decreased odds for obesity; odds ratio 0.35 (95% CI: 0.17, 0.69), p=0.003. CONCLUSIONS The prevalence of obesity and overweight in children and adolescents in Cyprus has increased substantially over a decade, mainly in rural areas and in school-aged boys.
Collapse
|
50
|
Pomegranate seed oil prevents bone loss in a mice model of osteoporosis, through osteoblastic stimulation, osteoclastic inhibition and decreased inflammatory status. J Nutr Biochem 2013; 24:1840-8. [PMID: 23953990 DOI: 10.1016/j.jnutbio.2013.04.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Revised: 04/09/2013] [Accepted: 04/15/2013] [Indexed: 11/19/2022]
Abstract
In the current context of longer life expectancy, the prevalence of osteoporosis is increasingly important. This is why development of new strategies of prevention is highly suitable. Pomegranate seed oil (PSO) and its major component, punicic acid (a conjugated linolenic acid), have potent anti-inflammatory and anti-oxidative properties both in vitro and in vivo, two processes strongly involved in osteoporosis establishment. In this study, we demonstrated that PSO consumption (5% of the diet) improved significantly bone mineral density (240.24±11.85 vs. 203.04±34.19 mg/cm(3)) and prevented trabecular microarchitecture impairment in ovariectomized (OVX) mice C57BL/6J, compared to OVX control animals. Those findings are associated with transcriptional changes in bone tissue, suggesting involvement of both osteoclastogenesis inhibition and osteoblastogenesis improvement. In addition, thanks to an ex vivo experiment, we provided evidence that serum from mice fed PSO (5% by gavage) had the ability to significantly down-regulate the expression of specific osteoclast differentiation markers and RANK-RANKL downstream signaling targets in osteoclast-like cells (RAW264.7) (RANK: negative 0.49-fold vs. control conditions). Moreover, in osteoblast-like cells (MC3T3-E1), it elicited significant increase in alkaline phosphatase activity (+159% at day 7), matrix mineralization (+271% on day 21) and transcriptional levels of major osteoblast lineage markers involving the Wnt/β-catenin signaling pathways. Our data also reveal that PSO inhibited pro-inflammatory factors expression while stimulating anti-inflammatory ones. These results demonstrate that PSO is highly relevant regarding osteoporosis. Indeed, it offers promising alternatives in the design of new strategies in nutritional management of age-related bone complications.
Collapse
|