Trends in childhood obesity in Japan: A nationwide observational study from 2012 to 2021

Investigating the association between parental educational status and offspring obesity risk using the Japan Environment and Children's Study

BACKGROUND

Previous studies have demonstrated an inverse relationship between socioeconomic status and childhood obesity in affluent nations, with parental education as a key factor. However, the meaning of socioeconomic indicators may vary by race and country, and research on this topic in Asian countries is limited.

OBJECTIVES

We investigated the association between parents' educational status and childhood obesity in Japan.

METHODS

We utilized data from Japan's birth cohort, recruiting participants from 2011 to 2014, and included 49 564 children. Parental educational status was categorized into four groups: both parents with lower education (LM-LF), mothers with higher education and fathers with lower education (HM-LF), mothers with lower education and fathers with higher education (LM-HF), and both parents with higher education (HM-HF). Multivariable logistic regression analyzed the association between parental education and overweight/obesity among 4-year-old children.

RESULTS

Of the participants, 17.9%, 16.9%, 16.2% and 15.4% were overweight/obese; and 5.5%, 4.6%, 4.4% and 3.8% were obese in LM-LF, HM-LF, LM-HF and HM-HF groups, respectively. When the reference group was defined as children born to parents with HM-HF, the adjusted odds ratios for overweight/obesity in LM-LF, HM-LF and LM-HF were 1.13 (95% confidence intervals [CI]: 1.06-1.21), 1.08 (95% CI: 1.01-1.15) and 1.03 (95% CI: 0.95-1.12); and those for obesity were 1.34 (95% CI: 1.20-1.50), 1.16 (95% CI: 1.04-1.31) and 1.11 (95% CI: 0.96-1.28), respectively.

CONCLUSIONS

Lower educational status in both parents was associated with overweight/obesity among 4-year-old children in Japan. Public policies might target parents with lower education to prevent childhood obesity.

Impact of Lifestyle Changes on Body Weight Gain During Nationwide Lockdown Due to COVID-19 Pandemic

Background: During the coronavirus disease 2019 (COVID-19) pandemic, people in Japan were urged to stay at home as much as possible, and this resulted in significant changes in lifestyle behavior. The new lifestyle included factors affecting both energy intake and energy consumption, and it is now thought that weight gain during the lockdown was the result of complex effects. The aim of this study was to determine the relationships among lifestyle habits, laboratory data, and body weight gain during the lockdown using medical check-up data. Methods: A total of 3789 individuals who had undergone consecutive medical check-ups during the period from 2018 to 2020 were included in this study. Participants whose body weight had increased by 5% or more were divided into two groups: a before-lockdown group (participants who had gained weight between 2018 and 2019) and an after-lockdown group (participants who had gained weight between 2019 and 2020). Physical measurements, laboratory data, and answers to six questions about lifestyle habits, for which information was obtained from the records from medical check-ups, were compared in the two groups. Results: There was no significant difference between the distribution of weight changes in 2018-2019 before the lockdown and the distribution of weight changes in 2019-2020 after the lockdown. The before-lockdown and after-lockdown groups both included about 7% of the total participants (279 and 273 participants, respectively). Diastolic blood pressure and levels of AST, ALT, and LDL-C were significantly higher in the after-lockdown group than in the before-lockdown group. The percentages of participants with alcohol consumption and exercise habits were significantly higher in the after-lockdown group than in the before-lockdown group, and an analysis by gender showed that the differences were significant for women but not for men. Conclusions: The distributions of weight changes before and during the COVID-19 pandemic were similar. Exercise habits and alcohol consumption might have been unique factors causing weight gain during the COVID-19 pandemic, particularly in women. Our findings suggest that the impact of behavioral restrictions and lifestyle changes during a pandemic may be different in men and women.

Neighborhood Socioeconomic Deprivation and Gender Disparities in Children with Excessive Body Weight in a Southern European Municipality

BACKGROUND/OBJECTIVES

Previous research has indicated that gender differences exist in the relationship between neighborhood socioeconomic (SE) deprivation and childhood excessive body weight. However, none of these studies were conducted in a metropolitan area of southern Europe. This study aims to investigate whether the association between neighborhood SE deprivation and childhood excessive body weight in the capital of the Porto Metropolitan Area is influenced by gender.

METHODS

The sample comprised 832 children (434 girls) aged between 3 and 10 years. Weight and height measurements were taken objectively, and body mass index (BMI) was calculated. The International Obesity Task Force cutoffs were used to identify the children with excessive body weight. Neighborhood SE deprivation was measured using the 2011 Portuguese version of the European Deprivation Index. Logistic regression models were applied for data analysis.

RESULTS

Overall, 27.8% of the participating children had excessive body weight. The prevalence of excessive body weight was higher in the neighborhoods characterized by high SE deprivation compared to those with low SE deprivation (34.4% vs. 23.1%). In a multivariable analysis, the girls living in high SE deprivation neighborhoods had a 90% higher risk of excessive body weight compared to the girls in low SE deprivation neighborhoods (OR = 1.90; 95% CI: 1.05-3.44; p = 0.035). No significant association was observed between neighborhood SE deprivation and body weight in the boys.

CONCLUSIONS

The findings indicate that neighborhood SE deprivation substantially increases the risk of excessive body weight, particularly among girls. Therefore, prevention and intervention strategies aimed at addressing excessive body weight gain should specifically target the populations and areas that are at a higher risk.

Changes in weight distribution and trends in obesity among children and adolescents in East Asia: Insights from NCD-RisC data

Pediatric obesity is a serious global health challenge. In East Asia, rapid socioeconomic changes have increased obesity rates. This study examines weight distribution and obesity trends in East Asian children using WHO criteria. Data from the Non-Communicable Disease Risk Factor Collaboration was used to analyze weight categories (thinness, normal weight, overweight, and obesity) among children aged 5 to 19 in China, Japan, South Korea, and Taiwan. Data were collected through probabilistic sampling and national surveys and classified using WHO BMI standards. Age standardized prevalence rate enabled cross-country comparisons for boys and girls from 2010 to 2022. Statistical methods included arithmetic statistics, linear regression, and time series analysis using the ARIMA model, with SAS 9.4 and SPSS for analysis. Significant trends were found (p for trend < 0.05). Taiwan and South Korea showed increased thinness, while China and Japan showed decreases. Normal weight prevalence declined, notably among South Korean boys. Overweight and obesity rates rose, especially among South Korean boys and Chinese girls. Japan's rates remained stable, while Taiwan showed minor fluctuations. Boys had higher overweight and obesity rates than girls in all countries. The highest rates were among children aged 10 to 11 years. East Asia, particularly South Korea and China, has seen rising obesity rates. Increasing thinness in South Korea and Taiwan also requires attention. The decline in healthy-weight children is concerning. Interventions should target children before ages 10 to 11. Urgent, tailored public health interventions are needed.

Early versus late-onset of weight struggles among patients with obesity: Data from the ACTION-IO study

Background and Aim

The prevalence of obesity is increasing and people with obesity (PwO) continue to struggle with their weight. We aimed to describe the experiences of people who struggled with their weight at an early age (EAO) or at a later age (LAO), their discussions with their healthcare practitioners (HCPs) and episodes of depression and anxiety.

Methods

We gathered information from 1,000 adults PwO, categorized them into EAO and LAO and analyzed their responses regarding weight loss attempts, discussions with their HCP, perceptions about obesity and episodes of depression/anxiety.

Results

Mean age was 36.6 years old, and 73.0% were AAO. EAO had significantly fewer weight loss attempts and had fewer interactions with their HCP. EAO reported less HCP support for weight management, were less motivated to lose weight, and experienced more episodes of anxiety/depression. Significant association between greater obesity class with longer duration of weight problems, and depression and anxiety. EAO PwOs were less likely to discuss weight problems with their HCP.

Conclusion

It is fundamental that HCPs recognize and address weight issues in PwO who are at risk of obesity in adulthood as early as adolescence. They should also take the lead in addressing these psychophysiological concerns by involving the parents in the decision-making process and facilitating shared planning. These may enhance their motivation to lose weight, boost self-confidence, and reduce the complications of obesity.

Factorial validation of the children's eating behavior questionnaire and the association between the eating behaviors assessed and BMI Z score in Chinese preschoolers aged 2-5 years

OBJECTIVE

This study aimed to evaluate the validity and reliability of the Children's Eating Behavior Questionnaire (CEBQ) among Chinese preschool children aged 2-5 years. Additionally, we investigated the associations between eating behaviors assessed by the CEBQ and body mass index (BMI).

METHODS

A cross-sectional study was conducted with a sample of Chinese preschool children aged 2 to 5 years (n = 11,780). The CEBQ was employed to assess participants' eating behaviors, and factor analysis of the CEBQ was conducted; sex and age differences in eating behaviors were examined. Correlations between children's BMI z scores and eating behaviors were analyzed via linear regression analysis controlling for age; sex; ethnicity; maternal age, education level, ethnicity and BMI; paternal age, education level, ethnicity and BMI.

RESULTS

The factor analysis confirmed the eight-factor structure of the CEBQ, which explained 67.57% of the total variance. Two items were excluded owing to low factor loadings. The subscales showed satisfactory internal reliability (Cronbach's alpha range: 0.76-0.90). Significant sex and age differences were observed for several CEBQ subscales, and BMI z scores were found to be associated with various eating behavior subscales.

CONCLUSIONS

This study's findings support the validity and reliability of the CEBQ for assessing eating behaviors among Chinese preschool children, and children's eating behaviors might be affected by age and sex. Furthermore, BMI was found to be associated with specific eating behaviors. Understanding these associations can inform interventions that promote healthy eating habits in this population.

Occult endocrine disorders newly diagnosed in patients with post-COVID-19 symptoms

Determination of long COVID requires ruling out alternative diagnoses, but there has been no report on the features of alternative diagnoses. This study was a single-center retrospective study of outpatients who visited our clinic between February 2021 and June 2023 that was carried out to determine the characteristics of alternative diagnoses in patients with post-COVID-19 symptoms. In a total of 731 patients, 50 patients (6.8%) were newly diagnosed with 52 diseases requiring medical intervention, and 16 (32%) of those 50 patients (2.2% of the total) were considered to have priority for treatment of the newly diagnosed disorders over long COVID treatment. The proportion of patients with a new diagnosis increased with advance of age, with 15.7% of the patients aged 60 years or older having a new diagnosis. Endocrine and metabolic diseases and hematological and respiratory diseases were the most common, being detected in eight patients (16%) each. Although 35 of the 52 diseases (67%) were related to their symptoms, endocrine and metabolic diseases were the least associated with specific symptoms. Other disorders that require attention were found especially in elderly patients with symptomatic long COVID. Thus, appropriate assessment and differentiation from alternative diagnoses are necessary for managing long COVID.