Psychosocial, Eating Behavior, and Lifestyle Factors Influencing Overweight and Obesity in Adolescents

The effect of Internet use on adolescent nutritional outcomes: evidence from China

BACKGROUND

The increasing prevalence of adolescent overweight and obesity poses significant public health challenges, particularly in China. With the rapid adoption of the Internet, adolescents' lifestyles, including dietary habits and physical activity levels, have undergone substantial changes. However, the causal relationship between Internet use and adolescent nutritional outcomes, especially in transitional economies, remains underexplored.

METHODS

This study employs longitudinal data from the China Health and Nutrition Survey (CHNS) and China Family Panel Studies (CFPS) to investigate the impact of Internet use on adolescents' BMI-for-age z-scores and overweight status. An endogenous switching regression (ESR) model addresses potential self-selection bias. Heterogeneity analyses examine urban-rural and gender differences, while mechanism analyses identify dietary pathways influencing outcomes.

RESULTS

Internet use increases BMI-for-age z-scores and the likelihood of being overweight among adolescents, with more intensive Internet use further amplifying these effects. These effects hold across urban and rural areas as well as for both boys and girls, though the magnitude may vary. Mechanism analyses suggest that Internet use enhances protein intake while also leading to higher consumption of fast food and soft drinks.

CONCLUSION

Internet use increases BMI-for-age z-scores and overweight risks among adolescents, reinforcing the need for targeted interventions to mitigate its negative health impacts. Policies promoting healthier online behaviors and better access to nutritional education are essential to ensuring that adolescents develop healthy lifestyle habits in the digital age. Addressing these challenges can help policymakers develop equitable health strategies for adolescents in transitional economies.

Insights into youth nutritional status in Serbia: assessing prevalence and trend in the context of social determinants

BACKGROUND

The study aimed to assess the prevalence and distribution of different levels of nutritional status among young people, to examine its association with social determinants of health, and to analyse its trend over time.

METHOD

The research was a secondary analysis of the data from four national health surveys of the Serbian population. The research sample included 11,243 respondents, aged 15 to 29, both genders. A multivariate logistic regression model was applied to examine the association between socio-demographic characteristics, lifestyle, health status, and the level of respondents' nutritional status. The trend analysis of the levels of nutritional status by the research years was done using multiple linear regression in adjusted models.

RESULTS

A total of 63.3% of respondents had body mass index (BMI) in the normal weight range, 11.7% were underweight, 18.5% were pre-obese, and 6.2% were obese. The average BMI of the study participants was 23.01 ± 6.01. The female respondents were more frequently underweight, and the male respondents were pre-obese and obese. Different factors were associated with different nutritional status levels - for underweight: female gender (OR: 5.29), age 15-19 (OR: 0.06), being married/ in a relationship (OR: 0.69), living in Belgrade region (OR: 1.35), presence of chronic diseases (OR: 0.56), consumption of psychoactive substances (OR:0.56) and non-smoking (OR: 0.70); for pre-obesity: female gender (OR: 0.38), ages 15-19 (OR:0.36) and 20-24 (OR:0.65), being married/ in a relationship (OR: 1.39), having high wealth index (OR:1.30) and non-smoking status (OR:1.32); for obesity: female gender (OR: 0.36), ages 15-19 (OR:0.35) and 20-24 (OR:0.51), being married/ in a relationship (OR:2.31) and primary education level (OR:2.17). The trend analysis of nutritional status level in the research period showed an increase in the average value of the BMI of the respondents in the entire sample, as well as the prevalence of obesity, while the prevalence of underweight and pre-obesity decreased.

CONCLUSION

The research provided insight into the specific factors associated with and trends of levels of nutritional status of the young, leading to the conclusion that preventive and interventional public health programs and strategies must be fully adapted to their specific needs.

Changes in Body Mass Index during the COVID-19 Pandemic among Indonesian Adolescents: The Role of Sex, Urban Area, Baseline BMI, and Appetitive Traits

INTRODUCTION

Little is known about how the COVID-19 situation affected weight development among Indonesian adolescents. This longitudinal study examined whether, and for whom, the COVID-19 situation affected weight outcomes over time among adolescents from private schools and higher socio-economic positions in Indonesia, where being overweight is a rather prevalent characteristic. This study specifically examined whether appetitive traits (i.e., emotional overeating, food responsiveness) as well as baseline zBMI, sex, and urban area could explain changes in zBMI.

METHODS

At baseline, 411 adolescents from 5 private schools in Indonesia (53.3% males, Mage = 12.02 years, SD = 0.45) filled out questionnaires on appetitive traits and background characteristics. In addition, their height and weight were measured. Of these, 336 adolescents (81.8%) also participated at follow-up. At follow-up, height and weight were measured or reported. We used linear regression to analyze the association between predictors and interactions with zBMI.

RESULTS

The results showed a significant decrease in zBMI over time, with a lower average zBMI during COVID-19 compared to before COVID-19. Female adolescents and adolescents with higher baseline zBMI values particularly tended to show this zBMI decreasing pattern. We did not find statistically significant main effects of baseline emotional overeating, food responsiveness, and urban area or any interactions.

CONCLUSIONS

Indonesian adolescents appeared to decrease in terms of zBMI during COVID-19, particularly females and adolescents with higher pre-COVID-19 zBMI. Our findings suggest that (culturally-specific) contextual changes (i.e., less exposure to the Indonesian food environment at schools and more exposure to the home environment) might have a beneficial impact in terms of preventing overweight among Indonesian adolescents, particularly among those being more vulnerable (i.e., having higher baseline zBMI).

Effects of family life cycle events on individual Body Mass Index trajectories: Evidence from China

PURPOSE

Body mass index (BMI) is an important predictor of one's physiological health. China is a family-centric nation compared to Western societies and has already entered an aged society. Exploring the characteristics and patterns of BMI changes during household events in China provides critical insights into the biological and social determinants of health, which can help enhance the scientific validity of health promotion measures and contribute to the realization of healthy aging goals in China.

METHODS

Using data from the China Health and Nutrition Survey (CHNS) from 1993 to 2015, this article utilizes two-level growth curve models with piecewise spline specifications for age to examine the effects of family life cycle events on BMI trajectories for age groups and gender differences.

RESULTS

Compared to continuing status, experiencing transition in an individual's family life cycle could lead to more fluctuating variations in their BMI trajectories, generally, there is a faster increase in BMI during youth and a faster decline during old age. As for gender heterogeneity, males are more affected by divorce, widowhood, and empty nest, whereas females' BMI changes are influenced by entering/maintaining marriage and parenthood.

CONCLUSIONS

A long-term perspective has revealed the significance of family events on BMI throughout the life course. Future research should focus on the nutrition and health of specific populations, especially elderly individuals in vulnerable groups.

Emerging Perspectives on the Set of Conditions That Lead to the Emergence of Metabolic Syndrome

Metabolic syndrome, as a medical condition, presents multifactorial complexity that is characterized by the resulting damage from genetic, environmental, and lifestyle factors (presence or absence of physical activity, food choices). Thus, metabolic syndrome qualifies unequivocally as a medical condition in which there are, simultaneously, several independent metabolic risk factors, namely, abdominal obesity, high triglyceride level, low HDL cholesterol level, arterial hypertension, and high glycemic level. Although age, sex, socio-economic status, and the precise definition of metabolic syndrome all influence the prevalence and risk of developing the condition, clinical and epidemiological studies clearly show that central obesity, as measured by an increased abdominal circumference, is the main risk factor. Thus, due to the growing global incidence of obesity, there has been an increase in the incidence of metabolic syndrome. Starting with obesity, all other metabolic risk factors are influenced: for example, as a result of insulin resistance with hyperglycemia, diabetes is linked to an increased risk of cardiovascular disease due to increased abdominal circumference. Through this review, we aimed to highlight the latest research studies and dietary nutritional interventions useful in the prevention of this disease but also implementation strategies for primary prevention among the healthy population.

Investigation of the relationships between mindfulness, emotional eating, weight control self-efficacy, and obesity in adolescents

PURPOSE

This research was conducted to examine the relationships between mindfulness, emotional eating, weight control self-efficacy, and obesity in adolescents.

DESIGN AND METHODS

The research was conducted with 198 adolescents aged 13-18 years in three high schools in the central county of a province in Türkiye. Data were collected using a sociodemographic information form, the Mindful Attention Awareness Scale-Adolescents, the Emotional Eating Scale for Children and Adolescents, and the Weight-Efficacy Lifestyle Questionnaire for Adolescents-Short Form. In this study, adolescents' height and weight were measured to determine the effects of the study variables on their body mass indexes (BMIs).

RESULTS

The variables were analyzed according to BMI. The mean age of the adolescents participating in the research was 15.25 ± 1.01 years; 52% were female, and 85% were ninth-grade high school students. Their mean height was 170.33 ± 8.59 cm, and their mean weight was 62.24 ± 12.84 kg. The adolescents' BMI was found to have a low-level, significant negative correlation with their mindfulness, a low-level, significant positive correlation with their emotional eating, and a low-level significant negative correlation with their weight control self-efficacy. Adolescents' mindfulness, emotional eating, and weight control self-efficacy scores significantly predicted their BMI and explained 14.1% of the variance in their BMI levels.

CONCLUSIONS

Mindfulness, emotional eating, and weight control self-efficacy in adolescents have a facilitating effect on the management of obesity.

IMPLICATIONS TO PRACTICE

Multidimensional programs should be developed that take into account the interaction of parents, children, and the environment, which will pave the way for the development of healthy nutrition behaviors and contribute to the prevention of obesity.

Behavioural and environmental risk factors associated with primary schoolchildren's overweight and obesity in urban Indonesia

OBJECTIVES

To aid the design of nutrition interventions in low- and middle-income countries undergoing a nutrition transition, this study examined behavioural and environmental risk factors associated with childhood overweight and obesity in urban Indonesia.

DESIGN

Body height and weight of children were measured to determine BMI-for-age Z-scores and childhood overweight and obesity status. A self-administered parental survey measured socio-economic background, children's diet, physical activity, screen time and parental practices. Logistic and quantile regression models were used to assess the association between risk factors and the BMI-for-age Z-score distribution.

SETTING

Public primary schools in Central Jakarta, sampled at random.

PARTICIPANTS

Children (n 1674) aged 6-13 years from 18 public primary schools.

RESULTS

Among the children, 31·0 % were overweight or obese. The prevalence of obesity was higher in boys (21·0 %) than in girls (12·0 %). Male sex and height (aOR = 1·67; 95 % CI 1·30, 2·14 and aOR = 1·16; 95 % CI 1·14, 1·18, respectively) increased the odds of being overweight or obese, while the odds reduced with every year of age (aOR = 0·43; 95 % CI 0·37, 0·50). Maternal education was positively associated with children's BMI at the median of the Z-score distribution (P = 0·026). Dietary and physical activity risk scores were not associated with children's BMI at any quantile. The obesogenic home food environment score was significantly and positively associated with the BMI-for-age Z-score at the 75th and 90th percentiles (P = 0·022 and 0·023, respectively).

CONCLUSIONS

This study illustrated the demographic, behavioural and environmental risk factors for overweight and obesity among primary schoolchildren in a middle-income country. To foster healthy behaviours in primary schoolchildren, parents need to ensure a positive home food environment. Future sex-responsive interventions should involve both parents and children, promote healthy diets and physical activity and improve food environments in homes and schools.

Investigation of obesity, eating behaviors and physical activity levels living in rural and urban areas during the covid-19 pandemic era: a study of Turkish adolescent

Background

The purpose of this study was to determine the eating behaviors, obesity and physical activity status of children of similar ages living in rural and urban areas and to examine these relationships during the coronavirus disease (COVID-19) pandemic process.

Method

The research was conducted using the scanning model. The research group consists of children living in rural and urban areas in Turkey. The sample of the study consists of a total of 733 adolescent participants, 351 females (47.9%) and 382 males (52.1%). After anthropometric measurements were made, the Physical Activity Questionnaire for older children and the Yale Food Addiction Scale for children 2.0 were used to determine the food addiction and physical activity status of children during the COVID19 pandemic process. Since the groups were homogeneously distributed, independent samples t-test and Pearson correlation test were used.

Result

In terms of food addiction and physical activity levels, children living in the urban have higher scores than children living in rural areas. In addition, children living in the urban were taller and have higher body mass values than those in rural areas. In terms of physical activity level and food addiction levels, while girls living in the urban had higher activity levels than those living in rural areas, no statistically significant difference was found between the physical activity levels of boys. When evaluated in terms of general and gender, it was determined that children living in rural areas were overweight and obese at a higher rate. Obese children had higher levels of food addiction and lower physical activity levels than non-obese children.

Conclusion

In order to prevent childhood obesity, the level of food addiction should be reduced as well as increasing the level of physical activity. This study is limited in terms of cross-sectional evaluation. Future research can experimentally reveal how much obesity is reduced by methods such as exercise and diet interventions.

Sense and Manner of WASH and Their Coalition With Disease and Nutritional Status of Under-five Children in Rural Bangladesh: A Cross-Sectional Study

This study aimed to assess the knowledge and practice of caregivers and their relationship to the disease and nutritional status of children under 5 years of age in rural areas of Sylhet, Bangladesh. A total of 110 households with at least a child aged 6 to 59 months were selected by simple random method from 10 rural communities of three Upazila of Sylhet from September 2019 to February 2020. Descriptive statistics were used to assess the "Water Access, Sanitation, and Hygiene" (WASH) knowledge and practice, and multivariate chi-square analyses were performed to assess associations among diseases and nutritional status with WASH following a structured questionnaire. The study found a significant association between WASH with childhood disease and nutritional status, and 65% of children were found to be in a diseased state and 35% of children were found in a no exposure of disease state within the last 6 months. The findings sketched that mother with poor WASH knowledge and practice was at greater risk for disease outbreaks, disease frequency, and duration. The highest incidence of diarrhea was 17% in children aged 12 to 23 months. A significant effect of WASH was also found in children's nutritional status, which was reflected in the ratio of stunted, underweight, and wasted children. Integrated convergent work focusing on providing clean water within the household, stopping open defecation, promoting handwashing, behavior change, and poverty alleviation is needed to improve the situation. Health, nutrition, and livelihood programs should be uninterrupted, and mothers or caregivers should be encouraged to participate in these programs.

The Prevalence of Overweight Status among Early Adolescents from Private Schools in Indonesia: Sex-Specific Patterns Determined by School Urbanization Level

(1) Background: Few studies have investigated (demographic) correlates of (prevalent) overweight rates among early adolescents, especially from higher socioeconomic positions (SEP) in developing countries, such as Indonesia. The current study aims to fill this gap. (2) Methods: Participants included 411 adolescents from five private schools in Indonesia. Adolescents’ weight and height were measured, and adolescents completed questionnaires on demographic factors (i.e., sex, school area, ethnicity, pocket money) and previous year dieting. (3) Results: Results showed that more than one-third of the sample was overweight, with higher rates among adolescent males (47%) than females (24%). Moreover, adolescents attending schools in urban areas (compared with suburban areas), and those reporting past dieting (compared with those reporting no dieting) had higher overweight rates. Ethnicity and the amount of pocket money were not related to overweight status. Finally, a clear sex-specific interaction was found involving school area, showing that males in urban areas had a significantly higher risk to be overweight, whereas this did not apply to females. (4) Conclusions: males from urban area private schools in Indonesia may be an important target group for future preventive overweight interventions.