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Lowe SA, Hunter S, Patte KA, Leatherdale ST, Pabayo R. Exploring the longitudinal associations between census division income inequality and BMI trajectories among Canadian adolescent: Is gender an effect modifier? SSM Popul Health 2023; 24:101519. [PMID: 37808229 PMCID: PMC10550757 DOI: 10.1016/j.ssmph.2023.101519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 09/20/2023] [Accepted: 09/20/2023] [Indexed: 10/10/2023] Open
Abstract
Background Income inequality is a structural determinant of health linked to increased risk of overweight and obesity, although its links to the health of adolescent populations are not well understood. This study investigated the longitudinal associations between census-division-level (CD) income inequality and BMI trajectories among Canadian adolescents, and determine if these associations vary by gender. Methods Study data are from the Cannabis use, Obesity, Mental health, Physical Activity, Alcohol use, Smoking, and Sedentary behaviour (COMPASS) cohort of adolescents attending secondary schools in Canada. Our sample included 14,675 adolescents who were followed up across three waves of the COMPASS study (2016-2017, 2017-2018, and 2018-2019) and linked to 30 CDs. Measures of income inequality and other area-level covariates were derived and linked to COMPASS participants using data from the 2016 Canadian Census. We utilized multilevel mixed-effects linear regression modelling to quantify the associations between income inequality and BMI and test for effect modification by gender. Sensitivity analyses were run excluding those with BMI scores in the range considered overweight or obesity at baseline. Results Higher CD income inequality was significantly associated with higher z-transformed BMI scores (β = 0.11, 95% CI = 0.034 to 0.19). The interaction term between income inequality and time was not statistically significant, indicating that this association remained constant over time. Once stratified by gender, the association between inequality and BMI became stronger for males (β = 0.14, 95% CI = 0.060 to 0.022) and attenuated for females (β = 0.063, 95% CI = -0.047 to 0.17). Conclusion Attending schools in CDs with higher income inequality was associated with higher BMI scores among male but not female adolescents. Further work is needed to investigate this discrepancy and identify the structural mechanisms that mediate the relationship between inequality and adolescent health.
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Affiliation(s)
- Samuel A.J. Lowe
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Stephen Hunter
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Karen A. Patte
- Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
| | | | - Roman Pabayo
- School of Public Health, University of Alberta, Edmonton, AB, Canada
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2
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Wende ME, Meyer MRU, Abildso CG, Davis K, Kaczynski AT. Urban-rural disparities in childhood obesogenic environments in the United States: Application of differing rural definitions. J Rural Health 2023; 39:121-135. [PMID: 35635492 PMCID: PMC10084162 DOI: 10.1111/jrh.12677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Research is needed that identifies environmental resource disparities and applies multiple rural definitions. Therefore, this study aims to examine urban-rural differences in food and physical activity (PA) environment resource availability by applying several commonly used rural definitions. We also examine differences in resource availability within urban-rural categories that are typically aggregated. METHODS Six food environment variables (access to grocery/superstores, farmers' markets, fast food, full-service restaurants, convenience stores, and breastfeeding-friendly facilities) and 4 PA environment variables (access to exercise opportunities and schools, walkability, and violent crimes) were included in the childhood obesogenic environment index (COEI). Total COEI, PA environment, and food environment index scores were generated by calculating the average percentile for related variables. US Department of Agriculture Urban Influence Codes, Office of Management and Budget codes, Rural-Urban Continuum Codes, Census Bureau Population Estimates for percent rural, and Rural Urban Commuting Area Codes were used. One-way ANOVA was used to detect urban-rural differences. RESULTS The greatest urban-rural disparities in COEI (F=310.2, P<.0001) and PA environment (F=562.5, P<.0001) were seen using RUCC codes. For food environments, the greatest urban-rural disparities were seen using Census Bureau percent rural categories (food: F=24.9, P<.0001). Comparing remote rural categories, differences were seen for food environments (F=3.1, P=.0270) and PA environments (F=10.2, P<.0001). Comparing metro-adjacent rural categories, differences were seen for PA environment (F=4.7, P=.0090). CONCLUSION Findings inform future research on urban and rural environments by outlining major differences between urban-rural classifications in identifying disparities in access to health-promoting resources.
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Affiliation(s)
- Marilyn E Wende
- Deparment of Public Health, Robbins School of Health and Human Sciences, Baylor University, Waco, Texas, USA
| | - M Renée Umstattd Meyer
- Deparment of Public Health, Robbins School of Health and Human Sciences, Baylor University, Waco, Texas, USA
| | - Christiaan G Abildso
- Department of Social and Behavioral Health Sciences, School of Public Health, West Virginia University, Morgantown, West Virginia, USA
| | - Kara Davis
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Andrew T Kaczynski
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
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3
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Prince SA, Lancione S, Lang JJ, Amankwah N, de Groh M, Jaramillo Garcia A, Merucci K, Geneau R. Examining the state, quality and strength of the evidence in the research on built environments and physical activity among children and youth: An overview of reviews from high income countries. Health Place 2022; 76:102828. [PMID: 35700605 DOI: 10.1016/j.healthplace.2022.102828] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 05/13/2022] [Accepted: 05/16/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND Built environments have shown to be associated with health, with physical activity (PA) considered one of the critical pathways for achieving benefits. Navigating available evidence on the built environment and PA is challenging given the number of reviews. OBJECTIVE Examine the current state and quality of research looking at associations between built environments and total PA and domains of PA (i.e., leisure/recreation, transportation, school) among children and youth (1-18 years). METHODS We systematically searched the grey literature and six bibliographic databases from January 2000 to May 2020. Review quality was assessed using the AMSTAR2. Results by age group were synthesized using narrative syntheses and harvest plots, and certainty of the evidence was assessed using a modified GRADE approach. RESULTS This overview included 65 reviews. Most reviews were of very low-to-low quality. High certainty was found for positive associations between transportation PA and walking/cycling/active transportation (AT) infrastructure. There was high certainty for positive associations between streets/play streets and total PA, alongside lower certainty for transportation and leisure PA. Very low-to-moderate certainty supports schoolyards designed to promote PA were positively associated with total PA, but mixed for school PA (except children). Less consistent positive associations were found for forests/trees, greenspace/open space, recreation facilities, street lighting, traffic safety, population/residential density, proximity/access to destinations, neighbourhood characteristics, and home environments. There is very low-to-moderate certainty for negative associations between greater distance to school and traffic volume and domains of PA. Generally, null or mixed associations were observed for aesthetics, parks, AT comfort infrastructure, land-use mix, street connectivity, urban/rural status, and public transit. DISCUSSION There remains a need for high quality systematic reviews and studies to evaluate the effects of environmental changes across the pediatric age spectrum and using a PA domain approach. Given the global physical inactivity crisis the built environment remains and important means to promote PA among children/youth.
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Affiliation(s)
- Stephanie A Prince
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
| | - Samantha Lancione
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Justin J Lang
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada; School of Mathematics and Statistics, Faculty of Science, Carleton University, Ottawa, Canada
| | - Nana Amankwah
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Canada
| | - Margaret de Groh
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Canada
| | | | | | - Robert Geneau
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Canada
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4
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Wende ME, Stowe EW, Eberth JM, McLain AC, Liese AD, Breneman CB, Josey MJ, Hughey SM, Kaczynski AT. Spatial clustering patterns and regional variations for food and physical activity environments across the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2021; 31:976-990. [PMID: 31964175 DOI: 10.1080/09603123.2020.1713304] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 01/06/2020] [Indexed: 06/10/2023]
Abstract
This study examined spatial patterns of obesogenic environments for US counties. We mapped the geographic dispersion of food and physical activity (PA) environments, assessed spatial clustering, and identified food and PA environment differences across U.S. regions and rurality categories. Substantial low food score clusters were located in the South and high score clusters in the Midwest and West. Low PA score clusters were located in the South and high score clusters in the Northeast and Midwest (p < .0001). For region, the South had significantly lower food and PA environment scores. For rurality, rural counties had significantly higher food environment scores and metropolitan counties had significantly higher PA environment scores (p < .0001). This study highlights geographic clustering and disparities in food and PA access nationwide. State and region-wide environmental inequalities may be targeted using structural interventions and policy initiatives to improve food and PA access.
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Affiliation(s)
- Marilyn E Wende
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, USA
| | - Ellen W Stowe
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, USA
| | - Jan M Eberth
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, USA
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - Alexander C McLain
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, USA
| | - Angela D Liese
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, USA
| | - Charity B Breneman
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - Michele J Josey
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, USA
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - S Morgan Hughey
- Department of Health and Human Performance, College of Charleston, Charleston, USA
| | - Andrew T Kaczynski
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, USA
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, USA
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5
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Wende ME, Alhasan DM, Hallum SH, Stowe EW, Eberth JM, Liese AD, Breneman CB, McLain AC, Kaczynski AT. Incongruency of youth food and physical activity environments in the United States: Variations by region, rurality, and income. Prev Med 2021; 148:106594. [PMID: 33932474 DOI: 10.1016/j.ypmed.2021.106594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 03/04/2021] [Accepted: 04/25/2021] [Indexed: 02/08/2023]
Abstract
Local environments are increasingly the focus of health behavior research and practice to reduce gaps between fruit/vegetable intake, physical activity (PA), and related guidelines. This study examined the congruency between youth food and PA environments and differences by region, rurality, and income across the United States. Food and PA environment data were obtained for all U.S. counties (N = 3142) using publicly available, secondary sources. Relationships between the food and PA environment tertiles was represented using five categories: 1) congruent-low (county falls in both the low food and PA tertiles), 2) congruent-high (county falls in both the high food and PA tertiles), 3) incongruent-food high/PA low (county falls in high food and low PA tertiles), 4) incongruent-food low/PA high (county falls in low food and high PA tertiles), and 5) intermediate food or PA (county falls in the intermediate tertile for food and/or PA). Results showed disparities in food and PA environment congruency according to region, rurality, and income (p < .0001 for each). Nearly 25% of counties had incongruent food and PA environments, with food high/PA low counties mostly in rural and low-income areas, and food low/PA high counties mostly in metropolitan and high-income areas. Approximately 8.7% of counties were considered congruent-high and were mostly located in the Northeast, metropolitan, and high-income areas. Congruent-low counties made up 10.0% of counties and were mostly in the South, rural, and low-income areas. National and regional disparities in environmental obesity determinants were identified that can inform targeted public health interventions.
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Affiliation(s)
- Marilyn E Wende
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, United States.
| | - Dana M Alhasan
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, United States
| | - Shirelle H Hallum
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, United States
| | - Ellen W Stowe
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, United States
| | - Jan M Eberth
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, United States; Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, United States
| | - Angela D Liese
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, United States
| | - Charity B Breneman
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, United States
| | - Alexander C McLain
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, United States
| | - Andrew T Kaczynski
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, United States; Prevention Research Center, Arnold School of Public Health, University of South Carolina, United States
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Cairo SMC, Teixeira CSS, da Silva TO, da Silva EKP, Martins PC, Bezerra VM, de Medeiros DS. Overweight in Rural Quilombola and Non-quilombola Adolescents From the Northeast of Brazil. Front Nutr 2021; 7:593929. [PMID: 33634159 PMCID: PMC7900433 DOI: 10.3389/fnut.2020.593929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 12/29/2020] [Indexed: 11/26/2022] Open
Abstract
Introduction: Overweight is an emerging problem among children and adolescents that leads to the development of several morbidities and health risks. Overweight occurs differently in different populations, especially in vulnerable groups like the rural and quilombola communities (an African-descendant population). This study aimed to estimate the prevalence of overweight and to investigate the possible associated factors in rural adolescents living in both quilombola and non-quilombola communities in Northeast Brazil. Methods: This study is a population-based cross-sectional study with a household approach carried out in 2015 with 390 adolescents (age 10–19 years) living in rural quilombola and non-quilombola communities. The nutritional status was gauged using z-scores calculated for body mass index (BMI) and varies with gender and age. Prevalence ratios (PRs) and 95% confidence intervals (95% CIs) were used to establish associations between the results and explained variables. The multivariate analysis followed a model with a hierarchical entry of covariables controlled by gender and age. Results: The study showed that 18.5% of rural adolescents were overweight, of which 17.9% were quilombolas and 19.0% were non-quilombolas. A significant difference in overweight between the samples was not found. In the multivariate-adjusted model, age ≥16 years (PR: 0.51; 95% CI: 0.28–0.95), the habit of having regular breakfast (PR: 0.58; 95% CI: 0.35–0.98), and process of attending school (PR: 0.35; 95% CI: 0.17–0.71) were associated with a lower prevalence of overweight. Stationary screen time, in contrast, was associated with a higher prevalence (PR: 1.61; 95% CI: 1.05–2.46). The process of attending school was associated with a lower prevalence of overweight (PR: 0.26; 95% CI: 0.09–0.69), even for the quilombolas. Conclusions: A low prevalence of overweight was identified in rural adolescents. Overweight was significantly associated with the habit of having regular breakfast, older age, stationary screen time, and the process of attending school. The results reveal that school is a potential space for health promotion interventions, specifically in the most vulnerable rural regions, such as the quilombola communities. Besides, the study emphasizes the importance of adopting a healthy lifestyle early in life, including cultivating the habit of having regular breakfast and reducing stationary screen time.
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Affiliation(s)
- Stefanie M C Cairo
- Program of Post-Graduation in Collective Health, Multidisciplinary Institute of Health, Federal University of Bahia, Vitória da Conquista, Brazil
| | - Camila S S Teixeira
- Program of Post-Graduation in Public Health, Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - Tainan O da Silva
- Program of Post-Graduation in Collective Health, Multidisciplinary Institute of Health, Federal University of Bahia, Vitória da Conquista, Brazil
| | - Etna K P da Silva
- Program of Post-Graduation in Public Health, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Poliana C Martins
- Program of Post-Graduation in Collective Health, Multidisciplinary Institute of Health, Federal University of Bahia, Vitória da Conquista, Brazil
| | - Vanessa M Bezerra
- Program of Post-Graduation in Collective Health, Multidisciplinary Institute of Health, Federal University of Bahia, Vitória da Conquista, Brazil
| | - Danielle S de Medeiros
- Program of Post-Graduation in Collective Health, Multidisciplinary Institute of Health, Federal University of Bahia, Vitória da Conquista, Brazil
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7
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Kaczynski AT, Eberth JM, Stowe EW, Wende ME, Liese AD, McLain AC, Breneman CB, Josey MJ. Development of a national childhood obesogenic environment index in the United States: differences by region and rurality. Int J Behav Nutr Phys Act 2020; 17:83. [PMID: 32615998 PMCID: PMC7330993 DOI: 10.1186/s12966-020-00984-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 06/10/2020] [Indexed: 11/24/2022] Open
Abstract
Background Diverse environmental factors are associated with physical activity (PA) and healthy eating (HE) among youth. However, no study has created a comprehensive obesogenic environment index for children that can be applied at a large geographic scale. The purpose of this study was to describe the development of a childhood obesogenic environment index (COEI) at the county level across the United States. Methods A comprehensive search of review articles (n = 20) and input from experts (n = 12) were used to identify community-level variables associated with youth PA, HE, or overweight/obesity for potential inclusion in the index. Based on strength of associations in the literature, expert ratings, expertise of team members, and data source availability, 10 key variables were identified – six related to HE (# per 1000 residents for grocery/superstores, farmers markets, fast food restaurants, full-service restaurants, and convenience stores; as well as percentage of births at baby (breastfeeding)-friendly facilities) and four related to PA (percentage of population living close to exercise opportunities, percentage of population < 1 mile from a school, a composite walkability index, and number of violent crimes per 1000 residents). Data for each variable for all counties in the U.S. (n = 3142) were collected from publicly available sources. For each variable, all counties were ranked and assigned percentiles ranging from 0 to 100. Positive environmental variables (e.g., grocery stores, exercise opportunities) were reverse scored such that higher values for all variables indicated a more obesogenic environment. Finally, for each county, a total obesogenic environment index score was generated by calculating the average percentile for all 10 variables. Results The average COEI percentile ranged from 24.5–81.0 (M = 50.02,s.d. = 9.01) across US counties and was depicted spatially on a choropleth map. Obesogenic counties were more prevalent (F = 130.43,p < .0001) in the South region of the U.S. (M = 53.0,s.d. = 8.3) compared to the Northeast (M = 43.2,s.d. = 6.9), Midwest (M = 48.1,s.d. = 8.5), and West (M = 48.4,s.d. = 9.8). When examined by rurality, there were also significant differences (F = 175.86,p < .0001) between metropolitan (M = 46.5,s.d. = 8.4), micropolitan (M = 50.3,s.d. = 8.1), and rural counties (M = 52.9,s.d. = 8.8) across the U.S. Conclusion The COEI can be applied to benchmark obesogenic environments and identify geographic disparities and intervention targets. Future research can examine associations with obesity and other health outcomes.
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Affiliation(s)
- Andrew T Kaczynski
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA. .,Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
| | - Jan M Eberth
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.,Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Ellen W Stowe
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Marilyn E Wende
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Angela D Liese
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Alexander C McLain
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Charity B Breneman
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Michele J Josey
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.,Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
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8
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Gunther C, Reicks M, Banna J, Suzuki A, Topham G, Richards R, Jones B, Lora K, Anderson AK, da Silva V, Penicka C, Hopkins LC, Cluskey M, Hongu N, Monroe-Lord L, Wong SS. Food Parenting Practices That Influence Early Adolescents' Food Choices During Independent Eating Occasions. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:993-1002. [PMID: 31221526 DOI: 10.1016/j.jneb.2019.05.597] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 05/03/2019] [Accepted: 05/16/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To identify practices that parents use to influence early adolescents' food choices during independent eating occasions (iEOs) from parent and child perspectives. DESIGN In-depth interviews. PARTICIPANTS Low-income parents (n = 49) and early adolescent children (aged 10-13 years; n = 44) from 10 US states and the District of Columbia. PHENOMENON OF INTEREST Parent and child perspectives on parenting practices that influence food choices during iEOs. ANALYSIS Audio-recorded interviews transcribed verbatim, NVivo coding, and directed content analysis. RESULTS Parents reported setting rules and expectations and managing availability or accessibility as the most common practices used to influence iEOs. Other practices included teaching, pressuring to eat, monitoring, and modeling. Children reported that their parents had rules about what they could or could not eat during iEOs and that they used specific strategies (eg, call or text) to monitor their iEOs. CONCLUSIONS AND IMPLICATIONS Additional studies are needed to confirm findings from this exploratory study. Future cross-sectional and longitudinal studies could determine whether and to what extent food parenting practices identified in the current study are associated with healthy dietary intake during iEOs, as well as potential racial and ethnic differences.
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Affiliation(s)
- Carolyn Gunther
- Department of Human Sciences, Human Nutrition Program, The Ohio State University, Columbus, OH.
| | - Marla Reicks
- Department of Food Science and Nutrition, University of Minnesota, St. Paul, MN
| | - Jinan Banna
- Department of Human Nutrition, Food, and Animal Sciences, University of Hawaii at Manoa, Manoa, HI
| | - Asuka Suzuki
- Department of Human Nutrition, Food, and Animal Sciences, University of Hawaii at Manoa, Manoa, HI
| | - Glade Topham
- School of Family Studies and Human Services, Kansas State University, Manhattan, KS
| | - Rickelle Richards
- Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, UT
| | - Blake Jones
- Department of Psychology, Brigham Young University, Provo, UT
| | - Karina Lora
- Department of Exercise and Nutrition Sciences, George Washington University, Washington, DC
| | | | - Vanessa da Silva
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ
| | - Christine Penicka
- Department of Human Sciences, Human Nutrition Program, The Ohio State University, Columbus, OH
| | - Laura C Hopkins
- Department of Human Sciences, Human Nutrition Program, The Ohio State University, Columbus, OH
| | - Mary Cluskey
- School of Biological and Population Health Sciences Nutrition, Oregon State University, Corvallis, OR
| | - Nobuko Hongu
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ
| | - Lillie Monroe-Lord
- Department of Center for Nutrition, Diet, and Health, University of the District of Columbia, Washington, DC
| | - Siew Sun Wong
- School of Biological and Population Health Sciences Nutrition, Oregon State University, Corvallis, OR
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9
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Gray HL, Buro AW, Barrera Ikan J, Wang W, Stern M. School-level factors associated with obesity: A systematic review of longitudinal studies. Obes Rev 2019; 20:1016-1032. [PMID: 31013544 DOI: 10.1111/obr.12852] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 02/16/2019] [Accepted: 02/25/2019] [Indexed: 01/27/2023]
Abstract
Although school has been an important intervention venue for obesity prevention, the role of school-level factors in obesity development or prevention has not been well-documented. This study aimed to systematically examine the current evidence on school-level factors associated with obesity outcomes in longitudinal studies. The literature search was performed in PubMed, EMBASE, CINHAL, and PsycINFO. Peer-reviewed articles using longitudinal study designs and published in English from 1991 to 2018 were eligible. Twelve articles met eligibility criteria for final systematic review. Nine studies reported significant long-term associations between school-level factors and obesity outcomes. Higher parental education, longer minutes of recess, meeting recommended recess and physical education time, higher socio-economic status, suburban compared with rural area, higher parental involvement in school, and healthful school food environment were significantly associated with lower rates of obesity or obesity trajectory. However, due to the small number of studies and heterogeneity of measures and variables used in their analytic models, the overall level of evidence from this review suggests the importance of further, systematic study. Empirically rigorous research is needed to identify additional aspects of the school context and environment that may contribute to the risk of obesity throughout the life course.
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Affiliation(s)
- Heewon L Gray
- College of Public Health, University of South Florida, Tampa, Florida
| | - Acadia W Buro
- College of Public Health, University of South Florida, Tampa, Florida
| | | | - Wei Wang
- College of Public Health, University of South Florida, Tampa, Florida.,Centre for Addiction and Mental Health, Ontario, Canada
| | - Marilyn Stern
- Department of Child & Family Studies, College of Behavioral & Community Sciences, University of South Florida, Tampa, Florida
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Case Reports: Multifaceted Experiences Treating Youth with Severe Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16060927. [PMID: 30875836 PMCID: PMC6466372 DOI: 10.3390/ijerph16060927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 02/27/2019] [Accepted: 03/06/2019] [Indexed: 12/20/2022]
Abstract
The management of youth with severe obesity is strongly impacted by social determinants of health and family dynamics. We present case studies of three patients seen in our tertiary care obesity treatment clinic as examples of the challenges faced by these patients and their families, as well as by the medical team. We discuss how these cases illustrate potential barriers to care, the role of child protective services, and we reflect upon lessons learned through the care of these patients. These cases highlight the need for comprehensive care in the management of youth with severe obesity, which can include: visits to multiple medical specialists, and mental and behavioral health providers; school accommodations; linkage to community resources; and, potentially, child protective services involvement. Through the care of these youth, our medical team gained more experience with using anti-obesity medications and meal replacements. The care of these youth also heightened our appreciation for the integral role of mental health services and community-based resources in the management of youth with severe obesity.
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Top food sources of percentage of energy, nutrients to limit and total gram amount consumed among US adolescents: National Health and Nutrition Examination Survey 2011–2014. Public Health Nutr 2018; 22:661-671. [DOI: 10.1017/s1368980018002884] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveTo identify most commonly consumed foods by adolescents contributing to percentage of total energy, added sugars, SFA, Na and total gram intake per day.DesignData from the National Health and Nutrition Examination Survey (NHANES) 2011–2014.SettingNHANES is a cross-sectional study nationally representative of the US population.ParticipantsOne 24 h dietary recall was used to assess dietary intake of 3156 adolescents aged 10–19 years. What We Eat in America food category classification system was used for all foods consumed. Food sources of energy, added sugars, SFA, Na and total gram amount consumed were sample-weighted and ranked based on percentage contribution to intake of total amount.ResultsThree-highest ranked food subgroup sources of total energy consumed were: sugar-sweetened beverages (SSB; 7·8 %); sweet bakery products (6·9 %); mixed dishes – pizza (6·6 %). Highest ranked food sources of total gram amount consumed were: plain water (33·1 %); SSB (15·8 %); milk (7·2 %). Three highest ranked food sources of total Na were: mixed dishes – pizza (8·7 %); mixed dishes – Mexican (6·7 %); cured meats/poultry (6·6 %). Three highest ranked food sources of SFA were: mixed dishes – pizza (9·1 %); sweet bakery products (8·3 %); mixed dishes – Mexican (7·9 %). Three highest ranked food sources of added sugars were: SSB (42·1 %); sweet bakery products (12·1 %); coffee and tea (7·6 %).ConclusionsIdentifying current food sources of percentage energy, nutrients to limit and total gram amount consumed among US adolescents is critical for designing strategies to help them meet nutrient recommendations within energy needs.
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Staiano AE, Beyl RA, Hsia DS, Katzmarzyk PT, Newton RL. A 12-week randomized controlled pilot study of dance exergaming in a group: Influence on psychosocial factors in adolescent girls. CYBERPSYCHOLOGY 2018; 12:3. [PMID: 31367239 PMCID: PMC6669081 DOI: 10.5817/cp2018-2-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Dance exergaming, which involves playing an interactive video game that requires the player to make upper and lower body movements by dancing to music, may provide a social physical activity experience that positively impacts psychosocial health. The objective of this randomized controlled study was to examine the effects of group-based dance exergaming on adolescent girls' psychosocial health including enjoyment, subjective health, perceived peer support, and health-related quality of life. Forty-one adolescents with overweight/obesity were randomly assigned to a 12-week dance exergaming intervention or to a control group. Peer support, subjective health, and health-related quality of life (HRQOL) were assessed pre- and post-intervention, and intervention participants rated enjoyment after each exergaming session. Repeated measures analysis of covariance models controlling for age and baseline body mass index were used to examine condition differences. Results indicated that subjective health improved in the exergaming condition more than control (p = .02). Ratings of peer conflict after the intervention were significantly different by condition (p = .01), with peer conflict stabilizing in the exergaming group and worsening in the control group. There was no difference by condition for HRQOL. Enjoyment remained high throughout the intervention. In summary, group exergaming improved subjective health, stabilized peer conflict, and provided an enjoyable physical activity experience for overweight adolescent girls.
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Affiliation(s)
- Amanda E Staiano
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Robbie A Beyl
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Daniel S Hsia
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | | | - Robert L Newton
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
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