1
|
Assari S, Cobb S, Najand B, Zare H, Sonnega A. Race, Educational Attainment, and Sustained High Body Mass Index over 24 Years of Follow-up in Middle-Aged and Older Adults. J Racial Ethn Health Disparities 2024; 11:1097-1105. [PMID: 37129782 PMCID: PMC10933141 DOI: 10.1007/s40615-023-01589-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/25/2023] [Accepted: 03/31/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Educational attainment has been linked to reduced risk of health problems such as obesity, but research suggests that this effect may be weaker for non-Hispanic Black individuals compared to non-Hispanic White individuals, a pattern known as minorities' diminished returns (MDRs). OBJECTIVES This study is aimed at examining the differential association between educational attainment and sustained high body mass index (BMI) among non-Hispanic Black and non-Hispanic White middle-aged and older adults in the USA. METHODS Using data from the Health and Retirement Study (HRS) spanning 1992-2016, we analyzed a national sample of 35,110 individuals, including 7766 non-Hispanic Black and 27,344 non-Hispanic White individuals. We used logistic regression models to examine the relationship between educational attainment, race, and sustained high BMI, while controlling for age, sex, and marital status at baseline. RESULTS Approximately 30.6% of the sample (n = 10,727) had sustained high BMI, while 69.4% (n = 24,383) had sustained low BMI over the period of follow-up. Higher levels of educational attainment were associated with a lower risk of sustained high BMI. We also found, however, that the protective effects of education against sustained high BMI were weaker for non-Hispanic Blacks compared to non-Hispanic Whites. CONCLUSION Our findings suggest that the protective effects of educational attainment against sustained high BMI may be more robust for non-Hispanic Whites than for non-Hispanic Blacks. Further research should explore whether these results are found in other racial and ethnic minorities and whether potential life history experiences may contribute to these disparities.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.
- Marginalization-Related-Diminished Returns (MDRs) Center, Los Angeles, CA, USA.
- School of Nursing, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.
| | - Sharon Cobb
- School of Nursing, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Babak Najand
- Marginalization-Related-Diminished Returns (MDRs) Center, Los Angeles, CA, USA
| | - Hossein Zare
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
- School of Business, University of Maryland Global Campus (UMGC), Adelphi, MD, 20774, USA
| | - Amanda Sonnega
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
2
|
Olsen NJ, Østergaard JN, Bjerregaard LG, Høy TV, Kierkegaard L, Michaelsen KF, Sørensen TIA, Grønbaek MK, Bruun JM, Heitmann BL. A literature review of evidence for primary prevention of overweight and obesity in healthy weight children and adolescents: A report produced by a working group of the Danish Council on Health and Disease Prevention. Obes Rev 2024; 25:e13641. [PMID: 37871966 DOI: 10.1111/obr.13641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 08/18/2023] [Accepted: 09/09/2023] [Indexed: 10/25/2023]
Abstract
Primary prevention targets development of overweight in individuals with healthy weight and is a great challenge. This paper summarizes the main findings of a working group of the Danish Council on Health and Disease Prevention that reviewed the literature on primary prevention of overweight and obesity among children and adolescents. The results were presented in a Danish report, in which a 2019 Cochrane review on childhood obesity prevention was complemented by searches in PubMed to include all relevant subsequent studies published from January 2018 until March 2020. In this paper, the review was updated until June 2023. Numerous childhood overweight prevention interventions have been developed during the past decades, primarily targeting diet and/or physical activity. Several of these interventions showed positive effects on diet and physical activity level but did not show effects on risk of developing overweight. The evidence foundation is inconsistent as four out of five interventions did not show positive effects. Previously observed intervention effects may not reflect excessive weight gain prevention among children with healthy weight but rather bodyweight reduction among those with overweight or obesity. We do not have sufficient knowledge about how to prevent children with healthy weight from developing overweight, and creative solutions are urgently needed.
Collapse
Affiliation(s)
- Nanna J Olsen
- Research Unit for Dietary Studies, the Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Jane N Østergaard
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Lise G Bjerregaard
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Teresa V Høy
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Lene Kierkegaard
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Kim F Michaelsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Thorkild I A Sørensen
- Department of Public Health and Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Morten K Grønbaek
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Jens M Bruun
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Danish National Center for Obesity, Aarhus, Denmark
| | - Berit L Heitmann
- Research Unit for Dietary Studies, the Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
- The Boden Group, Faculty of Medicine and Health, Sydney University, Sydney, New South Wales, Australia
- Section of General Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
3
|
Do family characteristics contribute to a socioeconomic gradient in overweight in early childhood? - Single mediation analyses of data on preschool children of Germany. Prev Med Rep 2023; 33:102178. [PMID: 37008454 PMCID: PMC10060745 DOI: 10.1016/j.pmedr.2023.102178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/31/2023] [Accepted: 03/14/2023] [Indexed: 03/19/2023] Open
Abstract
Children's overweight is strongly associated with family socioeconomic position (SEP) and family characteristics (FC). There is limited research on the extent to which FC account for a socioeconomic gradient in childhood overweight. This study examined whether FC explain SEP differences in the prevalence of overweight. The study used baseline data of preschool-aged children from the German 'PReschool INtervention Study'. The sample (n = 872, 48% girls) was recruited at kindergartens in Baden-Württemberg, Germany. Data included children's measured weight status and parents' reports on socioeconomic indicators (e.g., school education, vocational education, income) and FC. Variables represent main determinants of overweight (nutrition: sweets consumption in front of TV, soft drink consumption, regular breakfast, child sets table; physical activity: outdoor sports; parental role model). In single mediation analyses indirect effects of SEP on overweight were analysed (OR[95%CI]). Preschool girls and boys with low parental education had higher odds for overweight than children with high parental education. Among boys, low levels of parental education contributed to the odds of overweight via indirect effects by both factors 'sweets consumption in front of TV' (OR = 1.31[1.05-1.59]) and 'no sports' (OR = 1.14[1.01-1.38]). Among girls, FC measured did not explain SEP differences in overweight. Family nutrition and parental/family physical activity contribute to inequalities in overweight among preschool boys, but not girls. Research is needed to identify FC that explain inequalities in overweight for both.
Collapse
|
4
|
Alrouh H, van Bergen E, de Zeeuw E, Dolan C, Boomsma DI. Intergenerational transmission of body mass index and associations with educational attainment. BMC Public Health 2022; 22:890. [PMID: 35509009 PMCID: PMC9069759 DOI: 10.1186/s12889-022-13270-1] [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: 11/03/2021] [Accepted: 03/28/2022] [Indexed: 11/29/2022] Open
Abstract
Background Individual differences in educational attainment (EA) and physical health, as indexed by body mass index (BMI), are correlated within persons and across generations. The present aim was to assess these associations while controlling for parental transmission. Methods We analyzed BMI and EA obtained for 8,866 families from the Netherlands. Data were available for 19,132 persons, including 6,901 parents (mean age 54) and 12,234 of their adult offspring (mean age 32). We employed structural equation modeling to simultaneously model the direct and indirect transmission of BMI and EA from parents to offspring, spousal correlations, and the residual within-person BMI-EA association and tested for gender differences in the transmission parameters. Results We found moderate intergeneration transmission for BMI (standardized beta ~ .20) and EA (~ .22), and substantial spousal correlations for BMI (.23) and EA (.51). Cross-trait parent to offspring transmission was weak. The strength of transmission was largely independent of parent or offspring gender. Negative within person EA-BMI correlations were observed for all family members (fathers, -0.102; mothers, -0.147; sons, -0.154; daughters, -0.173). About 60% of the EA-BMI correlation in offspring persisted after taking into account the intergeneration transmission. Conclusions The intergenerational transmission for BMI and EA is mainly predictive within traits. Significant spousal and within person correlations in the parental generation are responsible for the effect of parental EA on offspring BMI. Offspring EA and BMI are further correlated beyond parental influences. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13270-1.
Collapse
Affiliation(s)
- Hekmat Alrouh
- Department of Biological Psychology, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7-9, Room MF-H557, 1081 BT, Amsterdam, The Netherlands. .,Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
| | - Elsje van Bergen
- Department of Biological Psychology, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7-9, Room MF-H557, 1081 BT, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, Netherlands.,Research Institute LEARN!, VrijeUniversiteit Amsterdam, Amsterdam, Netherlands
| | - Eveline de Zeeuw
- Department of Biological Psychology, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7-9, Room MF-H557, 1081 BT, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Conor Dolan
- Department of Biological Psychology, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7-9, Room MF-H557, 1081 BT, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Dorret I Boomsma
- Department of Biological Psychology, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7-9, Room MF-H557, 1081 BT, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, Netherlands.,Amsterdam Reproduction & Development Research Institute, Amsterdam, Netherlands
| |
Collapse
|
5
|
Blond K, Carslake D, Gjærde LK, Vistisen D, Sørensen TIA, Smith GD, Baker JL. Instrumental variable analysis using offspring BMI in childhood as an indicator of parental BMI in relation to mortality. Sci Rep 2021; 11:22408. [PMID: 34789785 PMCID: PMC8599489 DOI: 10.1038/s41598-021-01352-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 10/19/2021] [Indexed: 01/11/2023] Open
Abstract
Childhood BMI shows associations with adult mortality, but these may be influenced by effects of ill health in childhood on BMI and later mortality. To avoid this, we used offspring childhood BMI as an instrumental variable (IV) for own BMI in relation to mortality and compared it with conventional associations of own childhood BMI and own mortality. We included 36,097 parent–offspring pairs with measured heights and weights from the Copenhagen School Health Records Register and register-based information on death. Hazard ratios (HR) were estimated using adjusted Cox regression models. For all-cause mortality, per zBMI at age 7 the conventional HR = 1.07 (95%CI: 1.04–1.09) in women and 1.02 (95%CI: 0.92–1.14) in men, whereas the IV HR = 1.23 (95%CI: 1.15–1.32) in women and 1.05 (95%CI: 0.94–1.17) in men. Per zBMI at age 13, the conventional HR = 1.11 (95%CI: 1.08–1.15) in women and 1.03 (95%CI: 0.99–1.06) in men, whereas the IV HR = 1.30 (95%CI: 1.19–1.42) in women and 1.15 (95%CI: 1.04–1.29) in men. Only conventional models showed indications of J-shaped associations. Our IV analyses suggest that there is a causal relationship between BMI and mortality that is positive at both high and low BMI values.
Collapse
Affiliation(s)
- Kim Blond
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
| | - David Carslake
- Medical Research Council (MRC) Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Line Klingen Gjærde
- Children's Hospital Copenhagen and Juliane Marie Centre, Rigshospitalet, The Capital Region, Copenhagen, Denmark
| | | | - Thorkild I A Sørensen
- Medical Research Council (MRC) Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Department of Public Health, Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - George Davey Smith
- Medical Research Council (MRC) Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jennifer L Baker
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark.
| |
Collapse
|
6
|
Three-Year Intervention Effects on Food and Beverage Intake-Results from the Quasi-Experimental Copenhagen School Child Intervention Study (CoSCIS). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910543. [PMID: 34639843 PMCID: PMC8507748 DOI: 10.3390/ijerph181910543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/27/2021] [Accepted: 10/04/2021] [Indexed: 11/23/2022]
Abstract
The diet of Danish children is often not in accordance with dietary guidelines. We aimed to evaluate changes in the intake of selected foods and beverages during a multi-component school-based physical activity intervention, and to investigate if changes were modified by socioeconomic status (SES). The study included 307 children (intervention group: 184; comparison group: 123) with information on dietary intake pre- and post-intervention as well as on SES. Linear regression models were conducted to assess the effect of the intervention on changes in dietary factors. Children from the intervention group increased their intake of whole-grain bread during the intervention (group means: 6.1 g/d (95% CI: 2.2 to 10.0) vs. 0.3 g/d (95% CI: −3.1 to 3.7) in the comparison group, p = 0.04). A significant interaction between SES and group allocation was observed to change in fruit intake (p = 0.01). Among children from low SES families, only those from the comparison group decreased their fruit intake (group means: −40.0 g/d (95% CI: −56.0 to −23.9) vs. 9.3 g/d (95% CI: −16.1 to 94) in the intervention group, p = 0.006). The present study found no convincing effect of introducing a multi-component intervention on dietary intake except a small beneficial effect on whole-grain bread consumption. However, beneficial intervention effects in fruit intake were found particularly among children from low SES families.
Collapse
|
7
|
Mozzillo E, Zito E, Calcaterra V, Corciulo N, Di Pietro M, Di Sessa A, Franceschi R, Licenziati MR, Maltoni G, Morino G, Predieri B, Street ME, Trifirò G, Gallè F, Franzese A, Valerio G. Poor Health Related Quality of Life and Unhealthy Lifestyle Habits in Weight-Loss Treatment-Seeking Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179355. [PMID: 34501945 PMCID: PMC8431705 DOI: 10.3390/ijerph18179355] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/19/2021] [Accepted: 08/19/2021] [Indexed: 12/17/2022]
Abstract
Obesity is associated with unhealthy lifestyle behaviors and poor Health Related Quality of Life (HRQOL). The cumulative effect of lifestyle behaviors on HRQOL has been demonstrated in chronically ill adolescents, but not in adolescents with obesity. The present study aimed to assess the association between HRQOL and adherence to the Mediterranean Diet (MD) and/or low levels of physical activity (PA) in a large sample of outpatient adolescents with overweight or obesity seeking weight loss treatment. Four-hundred-twenty participants were enrolled from 10 Italian outpatient clinics. The demographics and anthropometric features, KIDMED scores, and exercise levels of the participants were collected, together with parental features. The HRQOL was assessed by the Pediatric Quality of Life Inventory (PedsQL™), Adolescents Version 4.0. PedsQL total score and functioning subscales were lower in adolescents who reported one or two unhealthy habits. Compared with the high/intermediate groups, the risk of low HRQOL was twice as high for each unit increase in BMI SDS, while the percentage was reduced by 12.2% for every unit increase in the KIDMED score and by 32.3% for each hour increase of exercise. The clustering of these two unhealthy behaviors conferred a 120% higher risk of low HRQOL. Similarly, adolescents displaying better diet quality and/or a physically more active lifestyle have better physical and psychological functioning. Further studies are needed to disclose whether these characteristics may be predictive of better adherence to weight loss treatment.
Collapse
Affiliation(s)
- Enza Mozzillo
- Department of Translational Medical Science, Section of Pediatrics, Regional Center of Pediatric Diabetes, University of Naples Federico II, 80131 Naples, Italy; (E.M.); (A.F.)
| | - Eugenio Zito
- Department of Social Sciences, University of Naples Federico II, 80138 Naples, Italy;
| | - Valeria Calcaterra
- Pediatrics and Adolescentology Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy;
- Department of Pediatrics, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
| | - Nicola Corciulo
- Unit of Auxology and Pediatric Endocrinology, Sacred Heart of Jesus Hospital, Gallipoli, 73014 Lecce, Italy;
| | | | - Anna Di Sessa
- Department of Woman, Child, and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | | | - Maria Rosaria Licenziati
- Obesity and Endocrine Disease Unit, Department of Neurosciences, Santobono-Pausilipon Children’s Hospital, 80129 Naples, Italy;
| | - Giulio Maltoni
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Giuseppe Morino
- Research Unit for Multifactorial Diseases, Bambino Gesù Children’s Hospital, 00165 Rome, Italy;
| | - Barbara Predieri
- Department of Medical and Surgical Sciences of the Mother, Children and Adults—Pediatric Unit University of Modena and Reggio Emilia, 41124 Modena, Italy;
| | - Maria Elisabeth Street
- Department of Mother and Child, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Giuliana Trifirò
- Endocrinology and Metabolism Division, IRCCS Policlinico San Donato, 20097 Milan, Italy;
| | - Francesca Gallè
- Department of Movement Sciences and Wellbeing, Parthenope University of Naples, 80133 Naples, Italy;
| | - Adriana Franzese
- Department of Translational Medical Science, Section of Pediatrics, Regional Center of Pediatric Diabetes, University of Naples Federico II, 80131 Naples, Italy; (E.M.); (A.F.)
| | - Giuliana Valerio
- Department of Movement Sciences and Wellbeing, Parthenope University of Naples, 80133 Naples, Italy;
- Correspondence:
| |
Collapse
|
8
|
Body weight trends in adolescents of Central Italy across 13 years: social, behavioural, and psychological correlates. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01627-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Abstract
Aim
The study aimed to determine trends in the prevalence of underweight, overweight, obesity and their putative risk factors in different cohorts from a representative population of adolescents in Central Italy.
Subject and methods
After random sampling, five cohorts of adolescents attending public high schools – aged 14 to 18 years – were evaluated from 2005 to 2018 (n: 25,174). Collected information included self-reported body mass index (BMI), descriptors of family environment, eating behaviour, physical activity, screen use, bullying victimisation, sexual behaviour (age at first intercourse, number of partners) and perceived psychological distress. For these data, between-cohort prevalence differences were used to esteem prevalence variations across time. In the 2018 cohort, the association between these factors and body weight was evaluated through multinomial regressions with sex-specific crude relative risk ratios for different BMI categories.
Results
An increased prevalence of overweight was observed for both boys and girls. The study outlined a transition towards higher parental education and unemployment, reduced soft drinks consumption and higher psychological distress. Sex-specific changes were observed for physical and sexual activity, and a rising percentage of girls reported being bullied and distressing family relationships. Parental education and employment, together with physical activity, confirmed to be protective factors against pathological weight. The latter clustered with reduced soft drinks consumption, bullying victimisation, early sexual activity, worse family relationships and higher distress.
Conclusion
An increased prevalence of both overweight and underweight was observed across time. Economic factors associated with unemployment and changes in behavioural patterns may have contributed to this trend.
Collapse
|
9
|
Rodrigues D, Costa D, Gama A, Machado-Rodrigues AM, Nogueira H, Silva MRG, Rosado-Marques V, Padez C. Socioeconomic inequalities in the prevalence of overweight and obesity among Portuguese preschool-aged children: Changes from 2009 to 2016. Am J Hum Biol 2021; 34:e23582. [PMID: 33634924 DOI: 10.1002/ajhb.23582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 02/01/2021] [Accepted: 02/09/2021] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES We evaluated, for the first time in Portugal, the prevalence of overweight and obesity according to parental education in a population of preschool-aged Portuguese children in 2009/2010 and 2016/2017. METHODS Anthropometric data were collected in public and private preschools (n = 1996 in 2009/2010; n = 2077 in 2016/2017). Body mass index was calculated and weight status categories were based on the International Obesity Task Force cutoff points. Parental education level was self-reported. RESULTS Prevalence of overweight (17.1%-14.1%; p < 0.001) and obesity (6.6%-3.9%, p < 0.001) was lower in 2016/2017 than in 2009/2010, with higher rates being found in the north of the country. Parental education was significantly associated with childhood overweight and obesity and inequalities between low- and high-education increased between the two periods. CONCLUSIONS While a decrease in childhood overweight and obesity were positive findings, the prevalence is still high and shows pronounced socioeconomic differences. Policies for obesity prevention need to be inclusive and tackle inequalities, with interventions tailored to suit local contexts.
Collapse
Affiliation(s)
- Daniela Rodrigues
- Research Centre for Anthropology and Health, University of Coimbra, Coimbra, Portugal.,Department of Life Sciences, University of Portugal, Coimbra, Portugal
| | - Diogo Costa
- Research Centre for Anthropology and Health, University of Coimbra, Coimbra, Portugal
| | - Augusta Gama
- Research Centre for Anthropology and Health, University of Coimbra, Coimbra, Portugal.,Department of Animal Biology, Faculty of Sciences of the University of Lisbon, Lisbon, Portugal
| | - Aristides M Machado-Rodrigues
- Research Centre for Anthropology and Health, University of Coimbra, Coimbra, Portugal.,High School of Education, Polytechnic Institute of Viseu, Viseu, Portugal
| | - Helena Nogueira
- Research Centre for Anthropology and Health, University of Coimbra, Coimbra, Portugal
| | - Maria-Raquel G Silva
- Research Centre for Anthropology and Health, University of Coimbra, Coimbra, Portugal.,Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal
| | - Vítor Rosado-Marques
- Research Centre for Anthropology and Health, University of Coimbra, Coimbra, Portugal.,Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Cristina Padez
- Research Centre for Anthropology and Health, University of Coimbra, Coimbra, Portugal.,Department of Life Sciences, University of Portugal, Coimbra, Portugal
| |
Collapse
|
10
|
Knaappila N, Marttunen M, Fröjd S, Lindberg N, Kaltiala R. Changes in cannabis use according to socioeconomic status among Finnish adolescents from 2000 to 2015. J Cannabis Res 2020; 2:44. [PMID: 33526131 PMCID: PMC7819333 DOI: 10.1186/s42238-020-00052-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 11/13/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Despite reduced sanctions and more permissive attitudes toward cannabis use in the USA and Europe, the prevalences of adolescent cannabis use have remained rather stable in the twenty-first century. However, whether trends in adolescent cannabis use differ between socioeconomic groups is not known. The aim of this study was to examine trends in cannabis use according to socioeconomic status among Finnish adolescents from 2000 to 2015. METHODS A population-based school survey was conducted biennially among 14-16-year-old Finns between 2000 and 2015 (n = 761,278). Distributions for any and frequent cannabis use over time according to socioeconomic adversities were calculated using crosstabs and chi-square test. Associations between any and frequent cannabis use, time, and socioeconomic adversities were studied using binomial logistic regression results shown by odds ratios with 95% confidence intervals. RESULTS At the overall level, the prevalences of lifetime and frequent cannabis use varied only slightly between 2000 and 2015. Cannabis use was associated with socioeconomic adversities (parental unemployment in the past year, low parental education, and not living with both parents). The differences in any and frequent cannabis use between socioeconomic groups increased significantly over the study period. CONCLUSIONS Although the overall changes in the prevalence of adolescent cannabis use were modest, cannabis use increased markedly among adolescents with the most socioeconomic adversities. Socioeconomic adversities should be considered in the prevention of adolescent cannabis use.
Collapse
Affiliation(s)
- Noora Knaappila
- Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland
| | - Mauri Marttunen
- Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, PO Box 22, FI-00014 Helsinki, Finland
| | - Sari Fröjd
- Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland
| | - Nina Lindberg
- Department of Adolescent Psychiatry, Helsinki University Central Hospital, PO Box 590, 00029 HUS, Helsinki, Finland
| | - Riittakerttu Kaltiala
- Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland
- Vanha Vaasa Hospital, Vierinkiventie 1, 65380 Vaasa, Finland
- Department of Adolescent Psychiatry, Tampere University Hospital, 33380 Pitkäniemi, Finland
| |
Collapse
|
11
|
Rasmussen M, Damsgaard MT, Morgen CS, Kierkegaard L, Toftager M, Rosenwein SV, Krølner RF, Due P, Holstein BE. Trends in social inequality in overweight and obesity among adolescents in Denmark 1998-2018. Int J Public Health 2020; 65:607-616. [PMID: 32076738 DOI: 10.1007/s00038-020-01342-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 01/16/2020] [Accepted: 02/12/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES The aim was to analyze trends in overweight and obesity in relation to socioeconomic position among Danish adolescents in the 20-year period 1998-2018. METHODS The study used data on self-reported height and weight and parents' occupational social class (OSC) from 11-, 13- and 15-year-old schoolchildren in 1998, 2002, 2006, 2010, 2014 and 2018, n = 22,177. The analyses included absolute social inequality in overweight/obesity (prevalence difference between low and high OSC) and relative social inequality (OR for overweight/obesity). RESULTS In the total sample, the prevalence of overweight and obesity was 9.7% and 1.4%, respectively, with significantly higher prevalence in low than high OSC. There were significantly increasing trends in both overweight and obesity 1998-2018 in low OSC and no significant increase in high OSC. The OR for overweight was 1.59 (1.42-1.74) in middle and 2.16 (1.89-2.46) in low OSC, OR for obesity 1.74 (1.29-2.34) in middle and 2.97 (2.15-4.11) in low OSC. Associations were not modified by survey year. CONCLUSIONS There was a persistent absolute and relative social inequality in overweight and obesity 1998-2018 among Danish adolescents.
Collapse
Affiliation(s)
- Mette Rasmussen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark
| | - Mogens Trab Damsgaard
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark
| | - Camilla Schmidt Morgen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark
| | - Lene Kierkegaard
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark
| | - Mette Toftager
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark
| | - Stine Vork Rosenwein
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark
| | - Rikke Fredenslund Krølner
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark
| | - Pernille Due
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark
| | - Bjørn Evald Holstein
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark.
| |
Collapse
|
12
|
Assari S, Boyce S, Bazargan M, Mincy R, Caldwell CH. Unequal Protective Effects of Parental Educational Attainment on the Body Mass Index of Black and White Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3641. [PMID: 31569829 PMCID: PMC6801712 DOI: 10.3390/ijerph16193641] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/17/2019] [Accepted: 09/19/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Parental educational attainment is shown to be protective against health problems; the Minorities' Diminished Returns theory, however, posits that these protective effects tend to be smaller for socially marginalized groups particularly blacks than whites. AIMS To explore racial differences in the effect of parental educational attainment on body mass index (BMI) in a national sample of US adolescents. METHODS In this cross-sectional study, we used baseline data of 10,701 (8678 white and 2023 black) 12-17 years old adolescents in the Population Assessment of Tobacco and Health (PATH; 2013). Parental educational attainment was the predictor. Youth BMI (based on self-reported weight and height) was the dependent variable. Age, gender, ethnicity, and family structure were covariates. Race was the focal moderator. RESULTS Overall, higher parental educational attainment was associated with lower youth BMI. Race, however, moderated the effect of parental educational attainment on BMI, suggesting that the protective effect of parental educational attainment on BMI is significantly smaller for black than white youth. CONCLUSIONS In the United States, race alters the health gains that are expected to follow parental educational attainment. While white youth who are from highly educated families are fit, black youth have high BMI at all levels of parental educational attainment. This means, while the most socially privileged group, whites, gain the most health from their parental education, blacks, the least privileged group, gain the least. Economic, social, public, and health policymakers should be aware that health disparities are not all due to lower socioeconomic status (SES) of the disadvantaged group but also diminished returns of SES resources for them. Black-white health disparities exist across all high socioeconomic status (SES) levels.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
| | - Shanika Boyce
- Department of Pediatrics, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
- Department of Family Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA.
| | - Ron Mincy
- Center for Research on Fathers, Children, and Family Well-Being, Columbia University, New York, NY 10027-5927, USA.
- Columbia Population Research Center (CPRC), Columbia University, New York, NY 10027-5927, USA.
- Columbia University School of Social Work, Columbia University, New York, NY 10027-5927, USA.
| | - Cleopatra H Caldwell
- Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA.
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA.
| |
Collapse
|
13
|
Assari S, Bazargan M, Caldwell C. Parental Educational Attainment and Chronic Medical Conditions among American Youth; Minorities' Diminished Returns. CHILDREN-BASEL 2019; 6:children6090096. [PMID: 31454956 PMCID: PMC6770143 DOI: 10.3390/children6090096] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 08/13/2019] [Accepted: 08/22/2019] [Indexed: 11/30/2022]
Abstract
Background: Parental educational attainment is protective against chronic medical conditions (CMCs). According to the minorities’ diminished returns (MDRs) theory, however, the health effects of socioeconomic status (SES) indicators are smaller for socially marginalized groups such as racial and ethnic minorities rather than Whites. Aims: To explore racial and ethnic differences in the effect of parental educational attainment on CMCs in a nationally representative sample of American youth. Methods: In this cross-sectional study, we used baseline data of 10,701 12–17 years old youth in the Population Assessment of Tobacco and Health (PATH; 2013). Parental educational attainment was the independent variable. The dependent variable was the number of CMCs in youth. Age, gender, and family structure were covariates. Race and ethnicity were the focal moderators. Linear and multinomial regression were applied to analyze the data. Results: Overall, higher parental educational attainment was associated with a lower number of CMCs. Race and ethnicity, however, showed significant interactions with parental educational attainment on a number of CMCs as well as 2+ CMCs, suggesting that the effect of parenting educational attainment on CMCs is significantly smaller for Black and Hispanic than White youth. Conclusions: In the United States, race and ethnicity alter the health gains that are expected to follow parental educational attainment. While White youth who are from highly educated families are most healthy, Black and Hispanic youth from highly educated families remain at higher risk for CMCs. That means, while the most socially privileged group, Whites, gain the most health from their parental education, Blacks and Hispanics, the least privileged groups, gain the least. The result is a disproportionately high number of CMCs in middle-class Blacks and Hispanics. Economic, social, public, and health policy makers should be aware that health disparities are not all due to lower SES of the disadvantaged group but also diminished returns of SES resources for them. Youth physical health disparities due to race and ethnicity exist across all SES levels.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
- Department of Family Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Cleopatra Caldwell
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA
| |
Collapse
|
14
|
Antibiotic use during pregnancy and childhood overweight: A population-based nationwide cohort study. Sci Rep 2019; 9:11528. [PMID: 31395930 PMCID: PMC6687733 DOI: 10.1038/s41598-019-48065-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 07/09/2019] [Indexed: 12/25/2022] Open
Abstract
Studies in mice suggest that early life represents a critical time window, where antibiotics may exert profound and lasting effects on the gut microbiota and metabolism. We aimed to test the hypothesis that prenatal antibiotic exposure is associated with increased risk of childhood overweight in a population-based cohort study. We linked 43,365 mother-child dyads from a nationwide cohort of pregnant women and their offspring to the Danish National Prescription Registry. Linear and logistic regression models were used to examine associations between prenatal exposure to antibiotics and BMI z-score and overweight (including obesity) at age seven and 11 years. Prenatal antibiotic exposure and childhood overweight were both associated with high pre-pregnancy BMI, maternal diabetes, multi-parity, smoking, low socioeconomic status, high paternal BMI, and short duration of breastfeeding. After adjustment for confounders, no associations were observed between prenatal antibiotic exposure and odds of overweight at age seven and 11 years. Whereas no association was observed between broad-spectrum antibiotics and overweight at age 11 years, exposure to broad-spectrum antibiotics was associated with higher odds of overweight at age seven years with an odds ratio of 1.27 (95% CI, 1.05–1.53) for ampicillin and an odds ratio of 1.56 (95% CI, 1.23–1.97) for amoxicillin. As we did not account for underlying infections, the observed associations with early childhood overweight could be explained by confounding by indication. In conclusion, our population-based study suggests that prenatal exposure to narrow-spectrum antibiotics is not associated with overweight in offspring. Exposure to some broad-spectrum antibiotics may increase the odds of overweight in early childhood, but the association does not persist in later childhood.
Collapse
|
15
|
Knaappila N, Marttunen M, Fröjd S, Lindberg N, Kaltiala-Heino R. Changes in delinquency according to socioeconomic status among Finnish adolescents from 2000 to 2015. Scand J Child Adolesc Psychiatr Psychol 2019; 7:52-59. [PMID: 33520768 PMCID: PMC7709941 DOI: 10.21307/sjcapp-2019-008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background: Scientific literature suggests that the prevalence of delinquency amongst adolescents has decreased internationally in past decades. However, whether this change is consistent across all socioeconomic groups has not yet been studied. Objective: The aim of this study was to examine changes in delinquency amongst Finnish adolescents according to socioeconomic status between 2000 and 2015. Method: A population-based school survey was conducted biennially amongst 14-16-year-old Finns between 2000 and 2015 (n = 761,278). Distributions for delinquency and socioeconomic adversities (low parental education, not living with both parents and parental unemployment in the past year) were calculated using crosstabs. Associations between delinquency, time, and socioeconomic adversities were studied using binomial logistic regression results shown by odds ratios with 95 % confidence intervals. Results: Delinquency was positively associated with all three socioeconomic adversities studied and cumulative socioeconomic adversity. Although the prevalence of delinquency varied only slightly between 2000 and 2015 in the overall population, it increased significantly amongst adolescents with most socioeconomic adversities. Conclusions: The findings indicate that socioeconomic differences in delinquency have increased amongst Finnish adolescents in past decades. Delinquency prevention and intervention programs should take socioeconomic adversities into account.
Collapse
Affiliation(s)
- Noora Knaappila
- University of Helsinki and Helsinki University Hospital, Adolescent Psychiatry, Helsinki, Finland
| | - Mauri Marttunen
- University of Helsinki and Helsinki University Hospital, Adolescent Psychiatry, Helsinki, Finland
| | - Sari Fröjd
- University of Tampere, Faculty of Medicine and Life Sciences, Tampere, Finland
| | - Nina Lindberg
- Helsinki University Central Hospital, Dep. of Adolescent Psychiatry, Helsinki, Finland
| | - Riittakerttu Kaltiala-Heino
- University of Tampere, Faculty of Medicine and Life Sciences, Tampere, Finland.,Vanha Vaasa Hospital, Vaasa Finland.,Tampere University Hospital, Dep. of Adolescent Psychiatry, Pitkäniemi, Finland
| |
Collapse
|
16
|
Lauria L, Spinelli A, Buoncristiano M, Nardone P. Decline of childhood overweight and obesity in Italy from 2008 to 2016: results from 5 rounds of the population-based surveillance system. BMC Public Health 2019; 19:618. [PMID: 31113403 PMCID: PMC6528349 DOI: 10.1186/s12889-019-6946-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 05/07/2019] [Indexed: 01/11/2023] Open
Abstract
Background Given the effects of childhood obesity on future health, and the lack of information of its prevalence in Italy, a national surveillance system was implemented in 2007. It is OKkio alla SALUTE, part of the WHO/Europe Childhood Obesity Surveillance Initiative (COSI). This study reports the 2008–2016 trends by sex, area of residence and socio-demographic characteristics in the prevalence of overweight and obesity in primary school children (8–9 years). Methods In each round of the surveillance held in 2008, 2010, 2012, 2014 and 2016, a nationally representative sample of about 45,000 children, was weighed and measured with standard equipment and methods by trained personnel. Children were classified as normal weight, overweight or obese using World Obesity Federation (WOF) (formerly the International Obesity Task Force (IOTF)) and WHO cut-offs. Children’s sex, area of residence and mothers’ education and citizenship, were obtained using self-reported questionnaires and were assessed using multivariate logistic regression models. Results Between 2008 and 2016, the overall prevalence of obesity dropped from 12.0 to 9.3% (WOF-IOTF) and from 21.2 to 17.0% (WHO), while the overall prevalence of overweight (including obesity) from 35.2 to 30.6% (WOF-IOTF) and from 44.4 to 39.4% (WHO). Reduction in the prevalence of overweight and obesity was greater in boys (− 14.5%, p for trend< 0.001; and − 24.7%, p = 0.001) compared to girls (− 11.1%, p < 0.001; and − 19.2%, p = 0.034). Decreasing trends were observed in overweight prevalences within children resident in the center and in the south. Decreasing trends in obesity prevalences were observed among boys resident in the north and in the south, and among girls resident in the center. Decreasing trends were observed in overweight prevalences within socio–demographic characteristics, except among children with low educated and foreign mothers; and in obesity prevalences for children with medium educated mothers, and girls with Italian mothers. Conclusions From 2008 to 2016 a decrease of childhood overweight and obesity was observed in Italy. However, as these prevalences are still among the highest in Europe, there is need to continue their monitoring and implement more interventions to promote healthy lifestyles. More effort should be focused on children belonging to low social classes.
Collapse
Affiliation(s)
- Laura Lauria
- National Centre for Disease Prevention and Health Promotion, National Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy.
| | - Angela Spinelli
- National Centre for Disease Prevention and Health Promotion, National Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy
| | - Marta Buoncristiano
- National Centre for Disease Prevention and Health Promotion, National Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy
| | - Paola Nardone
- National Centre for Disease Prevention and Health Promotion, National Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy
| |
Collapse
|
17
|
Geographic and socioeconomic diversity of food and nutrient intakes: a comparison of four European countries. Eur J Nutr 2018; 58:1475-1493. [PMID: 29594476 PMCID: PMC6561990 DOI: 10.1007/s00394-018-1673-6] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 03/22/2018] [Indexed: 01/11/2023]
Abstract
Purpose Public health policies and actions increasingly acknowledge the climate burden of food consumption. The aim of this study is to describe dietary intakes across four European countries, as baseline for further research towards healthier and environmentally-friendlier diets for Europe. Methods Individual-level dietary intake data in adults were obtained from nationally-representative surveys from Denmark and France using a 7-day diet record, Italy using a 3-day diet record, and Czech Republic using two replicates of a 24-h recall. Energy-standardised food and nutrient intakes were calculated for each subject from the mean of two randomly selected days. Results There was clear geographical variability, with a between-country range for mean fruit intake from 118 to 199 g/day, for vegetables from 95 to 239 g/day, for fish from 12 to 45 g/day, for dairy from 129 to 302 g/day, for sweet beverages from 48 to 224 ml/day, and for alcohol from 8 to 15 g/day, with higher intakes in Italy for fruit, vegetables and fish, and in Denmark for dairy, sweet beverages and alcohol. In all countries, intakes were low for legumes (< 20 g/day), and nuts and seeds (< 5 g/day), but high for red and processed meat (> 80 g/day). Within countries, food intakes also varied by socio-economic factors such as age, gender, and educational level, but less pronounced by anthropometric factors such as overweight status. For nutrients, intakes were low for dietary fibre (15.8–19.4 g/day) and vitamin D (2.4–3.0 µg/day) in all countries, for potassium (2288–2938 mg/day) and magnesium (268–285 mg/day) except in Denmark, for vitamin E in Denmark (6.7 mg/day), and for folate in Czech Republic (212 µg/day). Conclusions There is considerable variation in food and nutrient intakes across Europe, not only between, but also within countries. Individual-level dietary data provide insight into the heterogeneity of dietary habits beyond per capita food supply data, and this is crucial to balancing healthy and environmentally-friendly diets for European citizens. Electronic supplementary material The online version of this article (10.1007/s00394-018-1673-6) contains supplementary material, which is available to authorized users.
Collapse
|
18
|
Geiker NRW, Astrup A, Hjorth MF, Sjödin A, Pijls L, Markus CR. Does stress influence sleep patterns, food intake, weight gain, abdominal obesity and weight loss interventions and vice versa? Obes Rev 2018; 19:81-97. [PMID: 28849612 DOI: 10.1111/obr.12603] [Citation(s) in RCA: 127] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 07/06/2017] [Accepted: 07/22/2017] [Indexed: 12/29/2022]
Abstract
Decades of research have reported only weak associations between the intakes of specific foods or drinks and weight gain and obesity. Randomized controlled dietary intervention trials have only shown very modest effects of changes in nutrient intake and diet composition on body weight in obese subjects. This review summarizes the scientific evidence on the role mental stress (either in or not in association with impaired sleep) may play in poor sleep, enhanced appetite, cravings and decreased motivation for physical activity. All these factors contribute to weight gain and obesity, possibly via decreasing the efficacy of weight loss interventions. We also review evidence for the role that lifestyle and stress management may play in achieving weight loss in stress-vulnerable individuals with overweight.
Collapse
Affiliation(s)
- N R W Geiker
- Clinical Nutrition Research Unit, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark
| | - A Astrup
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - M F Hjorth
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - A Sjödin
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - L Pijls
- Loekintofood-gcv/scs, Brussels, Belgium
| | - C Rob Markus
- Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
19
|
Furthner D, Ehrenmüller M, Biebl A, Lanzersdorfer R, Halmerbauer G, Auer-Hackenberg L, Schmitt K. Gender differences and the role of parental education, school types and migration on the body mass index of 2930 Austrian school children : A cross-sectional study. Wien Klin Wochenschr 2017; 129:786-792. [PMID: 28831568 DOI: 10.1007/s00508-017-1247-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 07/20/2017] [Indexed: 01/04/2023]
Abstract
BACKGROUND Austria faces increasing numbers of childhood overweight and obesity. Despite increasing numbers of studies, associations between parental body mass index (BMI) and education and the school type on overweight/obesity in students have not been reported. The objective of this study was to evaluate the influence of these parameters on the genesis of overweight/obesity in a large cohort representative of youth in Upper Austrian. METHODS A cross-sectional analysis of data from 2930 children and adolescents aged 10, 14 or 17 years from 11 different state school types was conducted. Students and their parents completed a questionnaire and heights and weights were measured. RESULTS Of the students 16.9% fulfilled the criteria for overweight and 5.6% for obesity, with the highest rates in the 10-year-olds (19.6% and 5.8%, respectively). While no gender differences were present in the youngest age group, the body mass index (BMI) during adolescence remained higher in boys but decreased significantly in girls. Male gender remained a risk factor through all calculations. Boys were overrepresented in schools with lower education levels and more often had BMIs ≥ 85th and ≥95th percentile. Higher parental education levels and lower parental BMIs were associated with lower BMIs of their offspring. Migration was an additional association factor for BMIs ≥ 85th percentile. CONCLUSION Low parental education levels, higher parental BMIs and migration background were associated with overweight and obesity in 10-year-olds. In adolescence, male gender and higher parental BMIs remained risk factors.
Collapse
Affiliation(s)
- Dieter Furthner
- Med Campus IV, Kepler University Hospital Linz, Krankenhausstraße 26-30, 4020, Linz, Austria
| | - Margit Ehrenmüller
- University of Applied Sciences Steyr, Wehrgrabengasse 1, 4400, Steyr, Austria
| | - Ariane Biebl
- Med Campus IV, Kepler University Hospital Linz, Krankenhausstraße 26-30, 4020, Linz, Austria
| | - Roland Lanzersdorfer
- Med Campus IV, Kepler University Hospital Linz, Krankenhausstraße 26-30, 4020, Linz, Austria
| | - Gerhard Halmerbauer
- University of Applied Sciences Steyr, Wehrgrabengasse 1, 4400, Steyr, Austria
| | - Lorenz Auer-Hackenberg
- Med Campus IV, Kepler University Hospital Linz, Krankenhausstraße 26-30, 4020, Linz, Austria
| | - Klaus Schmitt
- Med Campus IV, Kepler University Hospital Linz, Krankenhausstraße 26-30, 4020, Linz, Austria.
| |
Collapse
|
20
|
Jones RE, Jewell J, Saksena R, Ramos Salas X, Breda J. 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
Affiliation(s)
- Rebecca E Jones
- Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, USA
| | - Jo Jewell
- Department of Nutrition, Physical Activity, and Obesity, European Region of World Health Organization, Copenhagen, Denmark
| | | | - Ximena Ramos Salas
- Department of Nutrition, Physical Activity, and Obesity, European Region of World Health Organization, Copenhagen, Denmark.,School of Public Health, University of Alberta, Edmonton, Canada
| | - João Breda
- Department of Nutrition, Physical Activity, and Obesity, European Region of World Health Organization, Copenhagen, Denmark
| |
Collapse
|
21
|
Ditlevsen K, Nielsen A. Setting limits in uneasy times – healthy diets in underprivileged families. INTERNATIONAL JOURNAL OF MIGRATION HEALTH AND SOCIAL CARE 2016. [DOI: 10.1108/ijmhsc-07-2015-0023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to provide knowledge on barriers to preventive action on early childhood overweight in non-western migrant families. It investigates the underlying understandings of the parental role in relation to weight control present in health-care professionals and in families.
Design/methodology/approach
The study is based on qualitative interviews with parents who are engaged in interventions aimed at helping them and their children to adopt a healthier life style, and on interviews with health-care professionals.
Findings
This study shows that the participating parents, all low SES and living under different forms of insecurity, perceived their parental task for the present as creating well-being for their children, and they were, therefore, reluctant to enforce dietary changes. The health-care professionals, in contrast, considered the need for change through a perspective on future risks.
Research limitations/implications
The results are based on a rather small sample and the link between insecurity, family dynamics and health practice needs further research.
Originality/value
The participating parents represented a group that is rarely included in scientific research and the study, therefore, contributes valuable knowledge on health behavior in ethnic minority families. The empirical analysis provides new insights for health professionals regarding the suitability of the universal model of parental feeding styles. It illuminates the implications of implicitly applying this model in health interventions which involve vulnerable categories of parents such as refugees to western societies.
Collapse
|
22
|
Abstract
Previous studies have shown that mean BMI and prevalences of overweight/obesity and obesity have increased over the last decades in the Nordic countries, despite highly regulated societies with a focus on obesity prevention. We review recent overweight/obesity and obesity prevention initiatives within four of the five Nordic countries: Sweden, Denmark, Finland, and Iceland. Moreover, we analyze the current situation based on monitoring data on BMI collected in 2011 and 2014, and obtain overall estimates of overweight/obesity and obesity prevalences for the Nordic Region. Data analysis shows that obesity in adults has increased from 2011 to 2014, while no significant changes were found for children. No significant increases were found for mean BMI and overweight/obesity prevalence. Obesity prevention initiatives among the Nordic countries are highly similar although minor differences are present, which is rooted in transnational Nordic cooperation and comparable societal structures.
Collapse
Affiliation(s)
- Anders Stockmarr
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Richard Petersens Plads, Building 324, DK-2800, Kongens Lyngby, Denmark.
| | - Tatjana Hejgaard
- Danish Health Authority, Islands Brygge 67, DK-2300, København S, Denmark
| | - Jeppe Matthiessen
- National Food Institute, Technical University of Denmark, Mørkhøj Bygade 19 Building C, DK-2860, Søborg, Denmark
| |
Collapse
|
23
|
Fismen AS, Smith ORF, Torsheim T, Rasmussen M, Pedersen Pagh T, Augustine L, Ojala K, Samdal O. Trends in Food Habits and Their Relation to Socioeconomic Status among Nordic Adolescents 2001/2002-2009/2010. PLoS One 2016; 11:e0148541. [PMID: 26859568 PMCID: PMC4747535 DOI: 10.1371/journal.pone.0148541] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 01/19/2016] [Indexed: 11/24/2022] Open
Abstract
Background In the Nordic countries, substantial policy and intervention efforts have been made to increase adolescents' consumption of fruit and vegetables and to reduce their intake of sweets and soft drinks. Some initiatives have been formulated in a Nordic collaboration and implemented at national level. In recent years, social inequalities in food habits have been attracted particular governmental interest and several initiatives addressing the socioeconomic gradient in food habits have been highlighted. However, few internationally published studies have evaluated how trends in adolescents' food habits develop in the context of Nordic nutrition policy, or have compared differences between the Nordic countries. Methods The study was based on Danish, Finnish, Norwegian and Swedish cross-sectional data from the international Health Behaviour in School-Aged Children (HBSC) study, collected via three nationally representative and comparable questionnaire surveys in 2001/2002, 2005/2006 and 2009/2010. Food habits were identified by students' consumption of fruit, vegetables, sweets and sugar sweetened soft drink. Socioeconomic status (SES) was measured with the Family Affluence Scale (FAS). Multilevel logistic regression was used to analyze the data. Results Trends in fruit consumption developed differently across countries, characterized by an increase in Denmark and Norway and more stable trends in Sweden and Finland. Vegetable consumption increased particularly in Denmark and to a lesser extent in Norway, whereas Sweden and Finland displayed stable trends. Decreased trends were observed for sweet and soft drink consumption and were similar in Norway, Sweden and Finland. Sweet consumption decreased across all survey years, whereas soft drink consumption decreased between 2001/2002–2005/2006 and was stable thereafter. Denmark displayed an increase between 2001/2002–2005/2006 followed by a similar decrease between 2005/2006–2009/2010 for both sweet and soft drink consumption. Socioeconomic inequalities in fruit and vegetable consumption were observed in all countries, with no cross-country differences, and no changes over time. Small but not significant cross-country variation was identified for SES inequalities in sweet consumption. Reduced SES inequalities were observed in Sweden between 2005/2006 and 2009/2010. SES was not associated with soft drink consumption in this study population, with the exception of Denmark for the survey year 2009/2010. Conclusion Different trends resulted in increased country differences in food habits during the time of observations. In survey year 2009/2010, Danish students reported a higher intake of fruit and vegetable consumption than their counterparts in the other Nordic countries. Finnish students reported the lowest frequency of sweets and soft drink consumption. Despite the positive dietary trends documented in the present study, the majority of Nordic adolescents are far from meeting national dietary recommendations. Our findings underline the need for more comprehensive initiatives targeting young people's food habits as well as a more deliberate and focused action to close gaps in social inequalities that affect food choices.
Collapse
Affiliation(s)
- Anne-Siri Fismen
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
- * E-mail:
| | | | - Torbjørn Torsheim
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Mette Rasmussen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Trine Pedersen Pagh
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Lilly Augustine
- School of Education and Environment, Kristianstad University, Kristianstad, Sweden
| | - Kristiina Ojala
- Research Centre for Health Promotion, University of Jyväskylä, Jyväskylä, Finland
| | - Oddrun Samdal
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| |
Collapse
|
24
|
Ditlevsen K, Reventlow S, Nielsen A. From policy to reality: early overweight, structural barriers, and the allocation of responsibility in the Danish health care system. CRITICAL PUBLIC HEALTH 2015. [DOI: 10.1080/09581596.2015.1123810] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
25
|
Martínez-Vizcaíno V, Solera-Martínez M, Cavero-Redondo I, García-Prieto JC, Arias-Palencia N, Notario-Pacheco B, Martínez-Andrés M, Mota J, Sánchez-López M. Association between parental socioeconomic status with underweight and obesity in children from two Spanish birth cohorts: a changing relationship. BMC Public Health 2015; 15:1276. [PMID: 26695508 PMCID: PMC4687138 DOI: 10.1186/s12889-015-2569-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 12/03/2015] [Indexed: 12/01/2022] Open
Abstract
Background Our objective was twofold: to estimate the prevalence of underweight, overweight, and obesity in two birth cohorts (1999–2000 and 2007–2008) from Castilla-La Mancha, Spain; and to examine the association between parental socioeconomic status (SES) and weight status in these two cohorts. Methods Cross-sectional analysis of baseline measurements was utilised in two cluster randomised trials. Using population-based samples of children from Castilla-La Mancha, Spain, 1158 children with a mean age of 9.5 years, born in the years 1999–2000 and 1588 children with a mean age of 5.3 years born in the years 2007–2008 participated. Children were classified according to the body mass index cut-offs proposed by the International Obesity Task Force criteria. An index of SES was calculated using questions regarding parental education and occupation levels. Results Prevalence of underweight was higher in the 2007–2008 birth cohort (20.5 %, 95 % CI: 18.5, 22.5) than in the 1999–2000 birth cohort (8.1 %, 95 % CI: 6.5, 9.7), and the overweight/obesity prevalence was 20.4 % (95 % CI: 18.4, 22.5) and 35.5 % (95 % CI: 32.7, 38.3) respectively. In the lower SES stratum, in the 2007–2008 birth cohort, the prevalence of underweight and overweight/obesity was 36.7 % (95 % CI: 22.2, 51.2) and 16.3 % (95 % CI: 4.9, 27.7) respectively, and 22.2 % (95 % CI: 2.8, 60.0) and 55.5 % (95 % CI: 21.2, 86.3) in the 1999–2000 cohort. The ratio between underweight:overweight/obesity showed higher values for all SES categories in 2007–2008 cohort, but particularly in the lower SES group (0.4 in the 1999–2000 cohort and 2.2 in the 2007–2008 cohort). Conclusion Underweight prevalence was lower in the cohort of children born in 1999–2000, and the prevalence of overweight and obesity was lower in the cohort of children born in 2007–2008. Furthermore, while in the 1999–2000 children’s cohort underweight was more frequent amongst children from high SES families and overweight/obesity was more frequent in children from low SES families, in the 2008–2009 children’s cohort the opposite was true. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2569-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha: Health and Social Research Center, Cuenca, Castilla-La Mancha, España. .,Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile.
| | - Montserrat Solera-Martínez
- Universidad de Castilla-La Mancha: Health and Social Research Center, Cuenca, Castilla-La Mancha, España.
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha: Health and Social Research Center, Cuenca, Castilla-La Mancha, España.
| | - Jorge Cañete García-Prieto
- Universidad de Castilla-La Mancha: Health and Social Research Center, Cuenca, Castilla-La Mancha, España.
| | - Natalia Arias-Palencia
- Universidad de Castilla-La Mancha: Health and Social Research Center, Cuenca, Castilla-La Mancha, España.
| | - Blanca Notario-Pacheco
- Universidad de Castilla-La Mancha: Health and Social Research Center, Cuenca, Castilla-La Mancha, España.
| | - Maria Martínez-Andrés
- Universidad de Castilla-La Mancha: Health and Social Research Center, Cuenca, Castilla-La Mancha, España.
| | - Jorge Mota
- Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal.
| | - Mairena Sánchez-López
- Universidad de Castilla-La Mancha: Health and Social Research Center, Cuenca, Castilla-La Mancha, España. .,Universidad de Castilla-La Mancha: School of Education, Ciudad Real, Castilla-La Mancha, España.
| | | |
Collapse
|
26
|
Bergh IH, Skare Ø, Aase A, Klepp KI, Lien N. Weight development from age 13 to 30 years and adolescent socioeconomic status: The Norwegian Longitudinal Health Behaviour study. Int J Public Health 2015; 61:465-73. [PMID: 26446084 PMCID: PMC4909804 DOI: 10.1007/s00038-015-0748-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 09/15/2015] [Accepted: 09/24/2015] [Indexed: 02/02/2023] Open
Abstract
Objectives To describe the weight development and model change in body mass index (BMI), and to examine the association of adolescent socioeconomic status (SES) with change in BMI distribution in a cohort followed from adolescence through adulthood. Methods Participants (n = 924) from western Norway were surveyed seven times from age 13 to 30 (1990–2007). BMI was based on self-reported height and weight. Quantile regression analyses were used to model change in weight development and to investigate associations between SES (measured by parental education) and change in BMI distribution. The analyses were adjusted for curvilinearity in BMI development, gender and relevant health behaviours. Results Body mass index increased over time with the greatest increase in the 90th percentile. No significant associations between change in BMI and SES were observed at any of the percentiles (10th, 25th, 50th, 75th or 90th). Conclusions Those in the upper BMI percentile gained more weight than those in the lower percentiles indicating that these might need targeted interventions. Further investigation of the association of change in BMI and SES with better quality data might be warranted.
Collapse
Affiliation(s)
- Ingunn Holden Bergh
- Department of Nutrition, Faculty of Medicine, University of Oslo, P.O. Box 1046, Blindern, 0316, Oslo, Norway
| | - Øivind Skare
- Department of Nutrition, Faculty of Medicine, University of Oslo, P.O. Box 1046, Blindern, 0316, Oslo, Norway
| | - Annalena Aase
- Department of Nutrition, Faculty of Medicine, University of Oslo, P.O. Box 1046, Blindern, 0316, Oslo, Norway
| | - Knut-Inge Klepp
- Department of Nutrition, Faculty of Medicine, University of Oslo, P.O. Box 1046, Blindern, 0316, Oslo, Norway
| | - Nanna Lien
- Department of Nutrition, Faculty of Medicine, University of Oslo, P.O. Box 1046, Blindern, 0316, Oslo, Norway.
| |
Collapse
|
27
|
Matthiessen J, Stockmarr A, Fagt S, Knudsen VK, Biltoft-Jensen A. Danish children born to parents with lower levels of education are more likely to become overweight. Acta Paediatr 2014; 103:1083-8. [PMID: 24948460 DOI: 10.1111/apa.12722] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 04/07/2014] [Accepted: 06/16/2014] [Indexed: 12/16/2022]
Abstract
AIM Little is known about whether the socio-economic status of parents is linked to their children becoming overweight. This study examined the association between parents' educational level and overweight Danish children in a nationally representative sample. METHODS Body mass index was calculated for a random sample of 512 children aged from four to 14 from the Danish National Survey of Diet and Physical Activity 2005-2008. Their parents provided weight and height data during an interview, together with details of their own educational level. Children were classified as overweight/obese in accordance with the International Obesity Task Force. Frequency estimates of prevalence and logistic regression models were used to correlate childhood overweight/obesity with the mothers' and fathers' educational levels as the main outcome measures. RESULTS Danish mothers tended to be more highly educated than fathers and their educational level was inversely associated with their child being overweight, especially if it was a boy. However, the highest educational level of the parents was the only significant educational variable, suggesting that education was associated with overweight children irrespective of the gender of the parent. CONCLUSION Public health initiatives should target parents with low educational levels to prevent, and reduce, social inequality in overweight children.
Collapse
Affiliation(s)
- Jeppe Matthiessen
- Division of Nutrition; National Food Institute; Technical University of Denmark; Søborg Denmark
| | - Anders Stockmarr
- Department of Applied Mathematics and Computer Science; Technical University of Denmark; Lyngby Denmark
| | - Sisse Fagt
- Division of Nutrition; National Food Institute; Technical University of Denmark; Søborg Denmark
| | | | - Anja Biltoft-Jensen
- Division of Nutrition; National Food Institute; Technical University of Denmark; Søborg Denmark
| |
Collapse
|
28
|
Fismen AS, Smith ORF, Torsheim T, Samdal O. A school based study of time trends in food habits and their relation to socio-economic status among Norwegian adolescents, 2001-2009. Int J Behav Nutr Phys Act 2014; 11:115. [PMID: 25252935 PMCID: PMC4177592 DOI: 10.1186/s12966-014-0115-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 09/05/2014] [Indexed: 01/11/2023] Open
Abstract
Background In recent years, adolescents’ food habits have become a major source of concern, and substantial policy and intervention efforts have been made to influence adolescents to consume more fruit and vegetables and less sweets and soft drink. Particular attention has been devoted to the social gradient in food habits, aiming to reduce dietary inequality. However, few internationally published studies have evaluated trends in teenagers’ food habits, or investigated how dietary inequalities develop. Methods We used Norwegian cross-sectional data from the international Health Behaviour in School-Aged Children (HBSC) study, collected via three nationally representative and comparable questionnaire surveys in 2001, 2005 and 2009. Food habits were identified by students’ consumption of fruit, vegetables, sweets and sugar rich soft drink. Socio-economic status (SES) was measured with the Family Affluence Scale (FAS). Multilevel logistic regression was used to analyze the data. Results The analyses indicated an overall positive trend in food habits among adolescents in Norway. Students were more likely to consume fruit (OR 1.76, CI 1.61-1.92) and vegetables (OR 1.51, CI 1.37-1.66) daily in 2005 as compared to 2001, and were less likely to consume sweets (OR 0.58, CI 0.51-0.66 resp. OR 0.77, CI 0.67-0.90) and soft drink (OR 0.55, CI 0.49-0.62 resp. OR 0.84, CI 0.73-0.96) daily when comparing, respectively, 2005 with 2001 and 2009 with 2005. Across all survey years, students with higher SES were more likely to eat fruit (OR 1.47, CI 1.32-1.65) and vegetables (OR 1.40, CI 1.24-1.58) daily than did students with lower SES. Our analyses indicated that the socio-economic differences were stable in the period 2002 - 2010, with uniform improvement in fruit and vegetable consumption across all SES levels. No significant associations between SES and intake of sweets and sugar-added soft drink were found. Conclusion The study identifies an overall improvement in diet among adolescents over a period characterized by onset of as well as ongoing initiatives targeting young people’s food habits. However, the observed socio-economic gradient in fruit and vegetable consumption remained unchanged.
Collapse
|