Predictors of Obesity in a US Sample of High School Adolescents With and Without Disabilities

Comparative Health Behaviour of Young People with Disabilities in Hungary: A Cross-Sectional Study

The health status of Hungary's population is unfavorable, with significant differences in health indicators not only compared to the EU15 but also to the Visegrad countries. Unfavorable health indicators can be disproportionate and particularly affect vulnerable groups, such as people with disabilities. In this study, we set out to compare the health behavior of disabled youth and youth with typical development in Hungary. We also aimed to compare the health behavior of adolescents in the Visegrad countries. The eating habits of both groups of young people we examined are unfavorable. Adolescents with disabilities experience a significantly higher rate of school stress than children with typical development in Hungary. The prevalence of somatic complaints and parameters of poor mental well-being are significantly higher in Hungary than in the other Visegrad countries. The results indicate that additional interventions are needed in Hungary and that differentiated, professional health promotion is needed for young people with disabilities. The researchers recommend extending the study to disabled adolescents living in Visegrad countries, on the basis of which an injury-specific health promotion methodology could be developed with international interprofessional cooperation.

Global Prevalence of Adolescent Use of Nonprescription Weight-Loss Products: A Systematic Review and Meta-Analysis

Importance

Use of nonprescribed weight-loss products in adolescents is a public health concern that is associated with negative physical and psychological consequences. However, the prevalence of nonprescribed weight-loss product use in adolescents is unknown.

Objective

To determine the global prevalence of nonprescription weight-loss product use in children and adolescents.

Data Sources

Four databases, including MEDLINE, PsycINFO, CINAHL (Cumulative Index of Nursing and Allied Health), and EMBASE, were searched for quantitative studies that reported prevalence data on use of nonprescription weight-loss products with no restrictions on publication date. The search was performed December 1, 2020, and updated March 6, 2023.

Study Selection

Studies were included in the meta-analysis if they reported the prevalence of weight-loss product use, were published in English, and included individuals 18 years or younger.

Data Extraction and Synthesis

Data extraction was completed by 2 independent reviewers. Data analysis determined the overall pooled proportion of weight-loss product use in total and during the past week, past 30 days, past year, or lifetime. Inverse variance heterogeneity effect models were used.

Main Outcomes and Measures

The main outcome measure was the prevalence of nonprescription weight-loss product use in adolescents for all included studies and over the past week, past month, past year, or lifetime. Subgroup analysis included separation of groups by sex, specific weight-loss product types, geographical location, and study publication time.

Results

A total of 90 articles (604 552 unique participants) were included in the meta-analysis. Of these, 50 studies (56%) were from North America. The reported prevalence of weight-loss product use in adolescents was 5.5% (96% CI, 5.5%-5.6%) overall. When identifying use of weight-loss products in the general population, prevalence was 2.0% (95% CI, 1.9%-2.1%) in the past week, 4.4% (95% CI, 4.3%-4.5%) in the past month, 6.2% (95% CI, 6.1%-6.3%) in the past year, and 8.9% (95% CI, 8.6%-9.2%) in their lifetime. Use of weight-loss products was higher among girls than boys.

Conclusions and Relevance

This meta-analysis found that use of weight-loss products occurs at high levels in adolescents, especially girls. These findings suggest that, given the ineffectiveness of these products for weight loss coupled with their harmful long-term health consequences, interventions are required to reduce use of weight-loss products in this group.

Eating Disorders in Youth with Chronic Health Conditions: Clinical Strategies for Early Recognition and Prevention

Youth with chronic health conditions face an elevated risk of eating disorders and disordered eating behaviors. Contributors to this phenomenon may include the unique threats faced by this vulnerable population to their body image, their relationships with food and eating, and their mental health and self-esteem. However, youth with chronic health conditions may also experience more severe medical complications and mortality from eating disorder behaviors because of the additional risks conveyed by their underlying conditions. In this review, clinical strategies are provided to support youth with chronic health conditions through early recognition of eating disorder behaviors and prompt referral to treatment, which is important for a better prognosis. Suggestions are also given to mitigate their risk of developing eating disorders by proactively addressing risk factors and offering thoughtful anticipatory guidance that promotes a positive relationship with food and eating.

Factors Related to High-School Students’ Odds of Having Overweight or Obesity

This study used data the Youth Risk Behavior Surveillance System ( N = 7,088) to examine factors associated with the odds of overweight/obesity. Overweight/obese was defined as a body mass index ≥85th percentile, based on age- and sex-specific growth charts. Participants were categorized into meeting/not meeting guidelines for: sleep, moderate-to-vigorous PA (MVPA), muscle strengthening PA, screen time, breakfast eating, fruit and vegetable consumption, and soda and milk consumption. Logistic regression analyses determined whether meeting guidelines for each health behavior was associated with the odds of students having overweight/obesity in the total group and stratified by sex. Meeting MVPA guidelines was the only behavior associated with having a lower odds of overweight/obesity in both sexes. For females, meeting recommendations for breakfast eating and strength training were also associated with lower odds of having overweight/obesity, whereas for boys, getting the recommended amount of sleep was associated with having lower odds of overweight/obesity. Interventions to reduce the prevalence of overweight/obesity in youth should be implemented inside and outside of the school environment and should include components addressing physical activity, diet, and sleep. Such interventions should address barriers to healthy behaviors that are unique to adolescents already affected by overweight/obesity.

Lessons learned from a blended telephone/e-health platform for caregivers in promoting physical activity and nutrition in children with a mobility disability

BACKGROUND

Children with physical disabilities report higher rates of sedentary lifestyle and unhealthy dietary patterns than non-disabled peers. These behaviors can increase comorbidities, caregiver burden, and healthcare costs. Innovative interventions are needed to assist caregivers of children with physical disabilities improve health behaviors.

OBJECTIVE

/Hypothesis: The purpose of this pilot study was to test the usability and preliminary efficacy of an e-health and telecoaching intervention compared to telecoaching alone.

METHODS

Parent/child dyads (n = 65) were randomized into either the e-health and telephone group (e-HT) or the telephone only group (TO). All participants received regular calls from a telecoach, and the e-HT group received access to a website with personalized weekly goals for diet and physical activity, and access to resources to meet these goals. At the conclusion of the intervention, participants in the e-HT group were asked to complete a semi-structured interview to discuss the usability of the e-health platform.

RESULTS

Fifty of the 65 randomized dyads (77%) completed all baseline measures and had at least one intervention call. Forty families (80% of those that started the intervention) completed the study (50% spina bifida, 24% mobility limitation, diagnosis not reported). Age of the children ranged from 6 to 17 years old. Both groups had high adherence to scheduled phone calls (e-HT (n = 17): 81%, TO (n = 23): 86%); however no significant differences in dietary intake or physical activity were seen within or between groups. Primary themes to emerge from qualitative interviewers were: the platform should target children rather than parents, parents valued the calls more than the website, and schools need to be involved in interventions.

CONCLUSIONS

E-health interventions are a promising way to promote healthy behaviors in children with physical disability, but technology must be balanced with ease of use for parents while also engaging the child.

Obesity Among High School Students in the United States: Risk Factors and Their Population Attributable Fraction

Introduction

The prevalence of obesity among children and adolescents in the United States is high. The aim of this study was to assess the association between modifiable risk factors and obesity and to estimate the population attributable fractions (PAFs) of modifiable risk factors among high school students in the United States.

Methods

For this retrospective study, we used a nationally representative sample of 15,624 students who participated in the 2015 Youth Risk Behavior Survey (YRBS). Obesity was defined as body mass index at or above the 95th percentile, based on sex- and age-specific data from the Centers for Disease Control and Prevention. We examined unhealthy dietary behaviors, physical inactivity, and other modifiable risk factors (tobacco use, alcohol consumption, and sleep). We used multivariable logistic regression, accounting for the complex survey design of YRBS, to assess the association between risk factors and obesity and to calculate PAFs. Confidence intervals of PAFs were estimated by using the jackknife repeated replication method.

Results

Among all students included in the study, 13.9% were classified as obese. Not being on a sports team (odds ratio [OR], 1.61; 95% confidence interval [CI], 1.31–1.98), current tobacco use (OR, 1.42; 95% CI, 1.14–1.77), and watching television for 3 hours or more per day (OR, 1.38; 95% CI, 1.09–1.76) were significantly correlated with obesity. The combined PAF for all modifiable risk factors was 34.80% (95% CI, 32.09%–37.51%). The single modifiable risk factor with the largest PAF was not participating on a sports team (PAF, 16.57%; 95% CI, 15.30%–17.84%).

Conclusion

Findings about PAFs help demonstrate the importance of promoting physical activity, healthy diet, and other healthy lifestyles in reducing obesity among high school students in the United States.

2017 Dutch Report Card+: Results From the First Physical Activity Report Card Plus for Dutch Youth With a Chronic Disease or Disability

Background: The Dutch Active Healthy Kids (AHK) Report Card⁺ (RC⁺) consolidates and translates research and assesses how the Netherlands is being responsible in providing physical activity (PA) opportunities for youth (< 18 years) with a chronic disease or disability. The aim of this article is to summarize the results of the Dutch RC⁺. Methods: Nine indicators were graded using the AHK Global Alliance RC development process, which includes a synthesis of best available research, surveillance, policy and practice findings, and expert consensus. Two additional indicators were included: weight status and sleep. Results: Grades assigned were: Overall Physical Activity, D; Organized Sports Participation, B-; Active Play, C-; Active Transportation, A-; Sedentary Behavior, C; Sleep C; For Weight Status, Family and Peers, School, Community and Built Environment, Government Strategies, and Investments all INC. Conclusions: The youth with disabilities spend a large part of the day sedentary, since only 26% of them met the PA norm for healthy physical activity. Potential avenues to improve overall physical activity are changing behaviors regarding sitting, screen time, and active play. The Netherlands is on track regarding PA opportunities for youth with disabilities, however they are currently not able to participate unlimited in sports and exercise.