1
|
Hermeling L, Steinacker JM, Kobel S. Beyond correlates: the social gradient in childhood overweight. Arch Public Health 2024; 82:3. [PMID: 38195594 PMCID: PMC10775653 DOI: 10.1186/s13690-023-01232-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/20/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Health (in)equity has a high priority on research and policy agendas. Even though it is known that inequalities in overweight prevalence accumulate with age and are already existent among children below the age of six, research on this topic is scarce. In this young age group, parents play an important role in preventing overweight and associated adverse consequences. This study examines the magnitude of parental misclassification of child weight status and its correlates, focussing on the factors that determine social status and equity. METHODS Preschool children's weight and height was measured objectively. Parents gave information on their socioeconomic background. Family education was dichotomised into tertiary and non-tertiary educational level, according to CASMIN. Binary logistic regression, adjusted for parental BMI, was applied to detect odds of childhood overweight. RESULTS Data on family educational level and anthropometrics were available from 643 children (4.5 ± 0.82 years, 52.7% male) and their parents of which 46.5% (n = 299) had a tertiary educational background. The groups (tertiary vs. non-tertiary educational level) differ significantly in overweight prevalence (3.7% vs. 11.9%, p ≤ 0.001). Odds of overweight were two times higher in children with non-tertiary educational background (OR: 2.123, CI: 1.010-4.461, p < 0.05), adjusted for parental BMI. CONCLUSION Children from families with low educational background have an elevated risk of overweight, already at a very young age. Education in general (not explicitly health education) seems to play a tremendous role in the prevention of overweight and obesity and should therefore be implied in policies enhancing health equity. TRIAL REGISTRATION DRKS-ID: DRKS00010089.
Collapse
Affiliation(s)
- Lina Hermeling
- Division of Sports- and Rehabilitation Medicine, Centre of Medicine, Ulm University Hospital, Ulm, Germany
| | - Jürgen M Steinacker
- Division of Sports- and Rehabilitation Medicine, Centre of Medicine, Ulm University Hospital, Ulm, Germany
| | - Susanne Kobel
- Division of Sports- and Rehabilitation Medicine, Centre of Medicine, Ulm University Hospital, Ulm, Germany.
| |
Collapse
|
2
|
Jackson JK, Grady A, Lecathelinais C, Fielding A, Yoong SL. Parent-reported compared with researcher-measured child height and weight: impact on body mass index classification in Australian pre-school aged children. Health Promot J Austr 2023; 34:742-749. [PMID: 36734513 PMCID: PMC10946955 DOI: 10.1002/hpja.702] [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: 07/29/2022] [Revised: 01/25/2023] [Accepted: 02/01/2023] [Indexed: 02/04/2023] Open
Abstract
ISSUE ADDRESSED Parent-reported data may provide a practical and cheap way for estimating young children's weight status. This study aims to compare the validity and reliability of parent-reported height and weight to researcher-measured data for pre-school aged children (aged 2-6 years). METHODS This was a nested study within a cluster randomised controlled trial (October 2016-April 2017), conducted within 32 Early Childhood Education and Care (ECEC) services across New South Wales, Australia. Parents of children reported on demographics and child height and weight via a survey. For the same child, height and weight data were objectively collected by trained research staff at the service. We calculated mean differences, intra-class correlations, Bland-Altman plots, percentage agreement and Cohen's kappa coefficient (>0.8 = "excellent"; 0.61-0.8 = "good"; 0.41-0.60 = "moderate"; 0.21 and 0.4 = "fair [weak]"; <0.2 = "poor"). RESULTS Overall, 89 children were included (mean age: 4.7 years; 59.5% female). The mean difference between parent-reported and researcher-measured data were small (BMI z-score: mean difference -0.01 [95% CI: -0.45 to 0.44]). There was "fair/weak" agreement between parent-categorised child BMI compared with researcher-measured data (Cohen's Kappa 0.24 [95% CI: 0.06 to 0.42]). Agreement was poor (Cohen's kappa <0.2) for female children, when reported by fathers or by parents with a BMI > 25 kg/m2 . CONCLUSION There was "fair/weak" agreement between parent-reported and measured estimates of child weight status. SO WHAT?: Parent's report of weight and height may be a weak indicator of adiposity at the level of individuals however it may be useful for aggregate estimates.
Collapse
Affiliation(s)
- Jacklyn Kay Jackson
- Priority Research Centre for Health BehaviourCollege of Health, Medicine and Wellbeing, University of NewcastleCallaghanNSWAustralia
- Hunter Medical Research Institute (HMRI)New Lambton HeightsNSWAustralia
- Hunter New England Population Health Unit, Hunter New England Local Health DistrictWallsendNSWAustralia
| | - Alice Grady
- Priority Research Centre for Health BehaviourCollege of Health, Medicine and Wellbeing, University of NewcastleCallaghanNSWAustralia
- Hunter Medical Research Institute (HMRI)New Lambton HeightsNSWAustralia
- Hunter New England Population Health Unit, Hunter New England Local Health DistrictWallsendNSWAustralia
| | - Christophe Lecathelinais
- Priority Research Centre for Health BehaviourCollege of Health, Medicine and Wellbeing, University of NewcastleCallaghanNSWAustralia
- Hunter Medical Research Institute (HMRI)New Lambton HeightsNSWAustralia
- Hunter New England Population Health Unit, Hunter New England Local Health DistrictWallsendNSWAustralia
| | - Alison Fielding
- Priority Research Centre for Health BehaviourCollege of Health, Medicine and Wellbeing, University of NewcastleCallaghanNSWAustralia
- NSW & ACT Research and Evaluation Unit, GP Synergy, Regional Training Organisation (RTO)Mayfield WestNSWAustralia
| | - Sze Lin Yoong
- Priority Research Centre for Health BehaviourCollege of Health, Medicine and Wellbeing, University of NewcastleCallaghanNSWAustralia
- Hunter Medical Research Institute (HMRI)New Lambton HeightsNSWAustralia
- Hunter New England Population Health Unit, Hunter New England Local Health DistrictWallsendNSWAustralia
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Deakin UniversityGeelongVictoriaAustralia
| |
Collapse
|
3
|
Household income and maternal education in early childhood and risk of overweight and obesity in late childhood: Findings from seven birth cohort studies in six high-income countries. Int J Obes (Lond) 2022; 46:1703-1711. [PMID: 35821522 PMCID: PMC9395266 DOI: 10.1038/s41366-022-01171-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 06/13/2022] [Accepted: 06/13/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES This study analysed the relationship between early childhood socioeconomic status (SES) measured by maternal education and household income and the subsequent development of childhood overweight and obesity. SUBJECTS/METHODS Data from seven population-representative prospective child cohorts in six high-income countries: United Kingdom, Australia, the Netherlands, Canada (one national cohort and one from the province of Quebec), USA, Sweden. Children were included at birth or within the first 2 years of life. Pooled estimates relate to a total of N = 26,565 included children. Overweight and obesity were defined using International Obesity Task Force (IOTF) cut-offs and measured in late childhood (8-11 years). Risk ratios (RRs) and pooled risk estimates were adjusted for potential confounders (maternal age, ethnicity, child sex). Slope Indexes of Inequality (SII) were estimated to quantify absolute inequality for maternal education and household income. RESULTS Prevalence ranged from 15.0% overweight and 2.4% obese in the Swedish cohort to 37.6% overweight and 15.8% obese in the US cohort. Overall, across cohorts, social gradients were observed for risk of obesity for both low maternal education (pooled RR: 2.99, 95% CI: 2.07, 4.31) and low household income (pooled RR: 2.69, 95% CI: 1.68, 4.30); between-cohort heterogeneity ranged from negligible to moderate (p: 0.300 to < 0.001). The association between RRs of obesity by income was lowest in Sweden than in other cohorts. CONCLUSIONS There was a social gradient by maternal education on the risk of childhood obesity in all included cohorts. The SES associations measured by income were more heterogeneous and differed between Sweden versus the other national cohorts; these findings may be attributable to policy differences, including preschool policies, maternity leave, a ban on advertising to children, and universal free school meals.
Collapse
|
4
|
Ruiter ELM, Fransen GAJ, Kleinjan M, van der Velden K, Molleman GRM, Engels RCME. The degree of consistency of applying parental dietary and sedentary behavior rules as indicators for overweight in children: a cross-sectional study. BMC Public Health 2022; 22:348. [PMID: 35180872 PMCID: PMC8855353 DOI: 10.1186/s12889-022-12742-8] [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: 06/25/2021] [Accepted: 01/31/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Review studies increasingly emphasize the importance of the role of parenting in interventions for preventing overweight in children. The aim of this study was to examine typologies regarding how consistently parents apply energy-balance related behavior rules, and the association between these typologies and socio-demographic characteristics, energy balance-related behaviors among school age children, and the prevalence of being overweight. METHODS For this cross-sectional study, we had access to a database managed by a Municipal Health Service Department in the Netherlands. In total, 4,865 parents with children 4-12 years of age participated in this survey and completed a standardized questionnaire. Parents classified their consistency of applying rules as "strict", "indulgent", or "no rules". Typologies were identified using latent class analyses. We used regression analyses to examine how the typologies differed with respect to the covariates socio-demographic characteristics, children's energy balance-related behaviors, and weight status. RESULTS We identified four stable, distinct parental typologies with respect to applying dietary and sedentary behavior rules. Overall, we found that parents who apply "overall strict EBRB rules" had the highest level of education and that their children practiced healthier behaviors compared to the children of parents in the other three classes. In addition, we found that parents who apply "indulgent dietary rules and no sedentary rules" had the lowest level of education and the highest percentage of non-Caucasians; in addition, their children 8-12 years of age had the highest likelihood of being overweight compared to children of parents with "no dietary rules". CONCLUSIONS Parents' consistency in applying rules regarding dietary and sedentary behaviors was associated with parents' level of education and ethnic background, as well as with children's dietary and sedentary behaviors and their likelihood of becoming overweight. Our results may contribute to helping make healthcare professionals aware that children of parents who do not apply sedentary behavior rules are more likely to become overweight, as well as the importance of encouraging parents to apply strict dietary and sedentary behavior rules. These results can serve as a starting point for developing effective strategies to prevent overweight among children.
Collapse
Affiliation(s)
- Emilie L M Ruiter
- Integrated Health Policy, Primary and Community Care, Academic Collaborative Center AMPHI, Radboud University Medical Center, ELG 117, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands.
| | - Gerdine A J Fransen
- Integrated Health Policy, Primary and Community Care, Academic Collaborative Center AMPHI, Radboud University Medical Center, ELG 117, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - Marloes Kleinjan
- Trimbos Institute, P.O. Box 725, 3500 AS, Utrecht, the Netherlands.,Interdisciplinary Social Science, University Utrecht, P.O. Box 80.140, 3508 TC, Utrecht, the Netherlands
| | - Koos van der Velden
- Academic Collaborative Centre AMPHI, Primary and Community Care, Radboud University Medical Centre, ELG 117, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - Gerard R M Molleman
- Integrated Health Policy, Primary and Community Care, Academic Collaborative Center AMPHI, Radboud University Medical Center, ELG 117, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - Rutger C M E Engels
- Department of Psychology, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, the Netherlands
| |
Collapse
|
5
|
Haddad EN, Kojaoghlanian T, Comstock SS. Moving Toward Remote, Parent-Reported Measurements in Pediatric Anthropometrics for Research and Practice. Front Pediatr 2022; 10:838815. [PMID: 35350270 PMCID: PMC8957848 DOI: 10.3389/fped.2022.838815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Eliot N Haddad
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, United States
| | - Tsoline Kojaoghlanian
- Department of Pediatrics, Maimonides Children's Hospital, Brooklyn, NY, United States
| | - Sarah S Comstock
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, United States
| |
Collapse
|
6
|
Biener AI, Cawley J, Meyerhoefer C. The medical care costs of obesity and severe obesity in youth: An instrumental variables approach. HEALTH ECONOMICS 2020; 29:624-639. [PMID: 32090412 DOI: 10.1002/hec.4007] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 01/09/2020] [Accepted: 01/14/2020] [Indexed: 06/10/2023]
Abstract
This paper is the first to use the method of instrumental variables to estimate the impact of obesity and severe obesity in youth. on U.S. medical care costs. We examine data from the Medical Expenditure Panel Survey for 2001-2015 and instrument for child BMI using the BMI of the child's biological mother. Instrumental variables estimates indicate that obesity in youth raises annual medical care costs by $907 (in 2015 dollars) or 92%, which is considerably higher than previous estimates of the association of youth obesity with medical costs. We find that obesity in youth significantly raises costs in all major categories of medical care: outpatient doctor visits, inpatient hospital stays, and prescription drugs. The costs of youth obesity are borne almost entirely by third-party payers, which is consistent with substantial externalities of youth obesity, which in turn represents an economic rationale for government intervention.
Collapse
Affiliation(s)
- Adam I Biener
- Department of Economics, Lafayette College, Easton, Pennsylvania, USA
| | - John Cawley
- Department of Policy Analysis and Management and Department of Economics, Cornell University, New York, USA
| | - Chad Meyerhoefer
- College of Business and Economics, Lehigh University, Bethlehem, Pennsylvania, USA
| |
Collapse
|
7
|
Andersson White P, Ludvigsson J, Jones MP, Faresjo T. Inequalities in cardiovascular risks among Swedish adolescents (ABIS): a prospective cohort study. BMJ Open 2020; 10:e030613. [PMID: 32086351 PMCID: PMC7044991 DOI: 10.1136/bmjopen-2019-030613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To investigate if socioeconomic status (SES) is predictive of cardiovascular risk factors among Swedish adolescents. Identify the most important SES variable for the development of each cardiovascular risk factor. Investigate at what age SES inequality in overweight and obesity occurs. DESIGN Longitudinal follow-up of a prospective birth cohort. SETTING All Babies in Southeast Sweden (ABIS) study includes data from children born between October 1997 and October 1999 in five counties of south east Sweden. PARTICIPANTS A regional ABIS-study subsample from three major cities of the region n=298 adolescents aged 16-18 years, and prospective data from the whole ABIS cohort for overweight and obesity status at the ages 2, 5, 8 and 12 years (n=2998-7925). OUTCOME MEASURES Blood pressure above the hypertension limit, overweight/obesity according to the International Obesity Task Force definition, low high-density lipoproteins (HDL) or borderline-high low-density lipoproteins according to National Cholesterol Education Program expert panel on cholesterol levels in children. RESULTS For three out of four cardiovascular risk outcomes (elevated blood pressure, low HDL and overweight/obesity), there were increased risk in one or more of the low SES groups (p<0.05). The best predictor was parental occupational class (Swedish socioeconomic classification index) for elevated blood pressure (area under the receiver operating characteristic (ROC) curve 0.623), maternal educational level for overweight (area under the ROC curve 0.641) and blue-collar city of residence for low HDL (area under the ROC curve 0.641). SES-related differences in overweight/obesity were found at age 2, 5 and 12 and for obesity at age 2, 5, 8 and 12 years (all p<0.05). CONCLUSIONS Even in a welfare state like Sweden, SES inequalities in cardiovascular risks are evident already in childhood and adolescence. Intervention programmes to reduce cardiovascular risk based on social inequality should start early in life.
Collapse
Affiliation(s)
- Pär Andersson White
- Department of Medicine and Health, Linköping University, Linköping, Sweden
- Crown Princess Victoria Children's Hospital, Linköping University Hospital, Linkoping, Sweden
| | - Johnny Ludvigsson
- Crown Princess Victoria Children's Hospital and Div. of Pediatrics, Dept. of Clinical and Experimental Medicine, Linkopings universitet, Linkoping, Sweden
| | - Michael P Jones
- Psychology Department, Macquarie University, Sydney, New South Wales, Australia
| | - Tomas Faresjo
- Department of Medicine and Health, Linköping University, Linköping, Sweden
| |
Collapse
|
8
|
Ruiter ELM, Saat JJEH, Molleman GRM, Fransen GAJ, van der Velden K, van Jaarsveld CHM, Engels RCME, Assendelft WJJ. Parents' underestimation of their child's weight status. Moderating factors and change over time: A cross-sectional study. PLoS One 2020; 15:e0227761. [PMID: 31945129 PMCID: PMC6964904 DOI: 10.1371/journal.pone.0227761] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 12/28/2019] [Indexed: 01/01/2023] Open
Abstract
Background Parents’ underestimation of their child’s weight status can hinder active participation in overweight prevention programs. We examined the level of agreement between the parents’ perception of their child’s weight status and the child’s actual weight status, moderating factors, and change over time. Methods This cross-sectional study used data collected in 2009 (n = 8105), 2013 (n = 8844) and 2017 (n = 11,022) from a community-based survey conducted among parents of children age 2–12 years in the Netherlands. Parents classified their perception of their child’s weight status on a 5-point Likert scale. In 2009 and 2013, the child’s BMI was calculated from self-reported data by parents. The level of agreement between the parent’s perception of the weight status and the actual weight status was examined using Cohen’s kappa. The role of demographic factors on parents’ perception were examined using logistic regression. Results In 2009, 2013 and 2017, 6%, 6% and 5% of the parents, respectively, classified their child as heavy/extremely heavy. In 2009 and 2013, 64.7% and 61.0% of parents, respectively, underestimated the weight status of their overweight child. This was even higher among parents of obese children. Overall, the agreement between the parents’ perception and the actual weight status improved from 2009 (kappa = 0.38) to 2013 (kappa = 0.43) (p<0.05), but remained unsatisfactory. The parents’ underestimation of their child’s overweight/obesity status was associated with the child’s age in 2009 and 2013 (2–7 years; OR: 0.18), the child’s gender in 2009 (male; OR: 0.55), and the parents’ education level in 2009 (middle and high education; OR: 0.56 and 0.44 respectively). Conclusions Parents’ underestimation of their child’s weight status remains alarmingly high, particularly among parents of young, obese children. This underestimation is a barrier to preventing childhood overweight/obesity. Healthcare professionals should take this underestimation into consideration and should actively encourage parents to take steps to prevent overweight/obesity in their children.
Collapse
Affiliation(s)
- Emilie L. M. Ruiter
- Academic Collaborative Center AMPHI, Integrated Health Policy, Department of Primary and Community Care, ELG, Radboud university medical center, HB Nijmegen, the Netherlands
- * E-mail:
| | - Jenneke J. E. H. Saat
- Academic Collaborative Center AMPHI, Integrated Health Policy, Department of Primary and Community Care, ELG, Radboud university medical center, HB Nijmegen, the Netherlands
| | - Gerard R. M. Molleman
- Academic Collaborative Center AMPHI, Integrated Health Policy, Department of Primary and Community Care, ELG, Radboud university medical center, HB Nijmegen, the Netherlands
| | - Gerdine A. J. Fransen
- Academic Collaborative Center AMPHI, Integrated Health Policy, Department of Primary and Community Care, ELG, Radboud university medical center, HB Nijmegen, the Netherlands
| | - Koos van der Velden
- Academic Collaborative Center AMPHI, Integrated Health Policy, Department of Primary and Community Care, ELG, Radboud university medical center, HB Nijmegen, the Netherlands
| | | | | | | |
Collapse
|
9
|
Kowalkowska J, Wadolowska L, Hamulka J, Wojtas N, Czlapka-Matyasik M, Kozirok W, Bronkowska M, Sadowska J, Naliwajko S, Dziaduch I, Koronowicz A, Piasna-Slupecka E, Czeczelewska E, Czeczelewski J, Kostecka M, Dlugosz A, Loboda D, Jeruszka-Bielak M. Reproducibility of a Short-Form, Multicomponent Dietary Questionnaire to Assess Food Frequency Consumption, Nutrition Knowledge, and Lifestyle (SF-FFQ4PolishChildren) in Polish Children and Adolescents. Nutrients 2019; 11:nu11122929. [PMID: 31816859 PMCID: PMC6950380 DOI: 10.3390/nu11122929] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 11/20/2019] [Indexed: 02/08/2023] Open
Abstract
The aim of the study was to assess the reproducibility of a short-form, multicomponent dietary questionnaire (SF-FFQ4PolishChildren) in Polish children and adolescents. The study involved 437 children (6–10 years old) and 630 adolescents (11–15 years old) from rural and urban areas of Poland. The self-administered questionnaire was related to nutrition knowledge, dietary habits, active/sedentary lifestyle, self-reported weight and height, and socioeconomic data. The questionnaire was completed with a two-week interval—twice by parents for their children (test and retest for children), twice by adolescents themselves (adolescent’s test and retest) and once by adolescents’ parents (parent’s test). The strength of agreement measured using the kappa statistic was interpreted as follows: 0–0.20 slight, 0.21–0.40 fair, 0.41–0.60 moderate, 0.61–0.80 good, and 0.81–1.00 excellent. Regarding the frequency of consumption of food items and meals, kappa statistics were 0.46–0.81 (the lowest: fruit/mixed fruit and vegetable juices; the highest: Energy drinks) in test–retest for children, 0.30–0.54 (fruit/mixed fruit and vegetable juices; breakfast, respectively) in adolescent’s test–retest, 0.27–0.56 (the lowest: Sweets, fruit, dairy products; the highest: Breakfast) in adolescent’s test and parent’s test. Lower kappa statistics were found for more frequently consumed foods (juices, fruit, vegetables), higher kappa statistics were found for rarely consumed foods (energy drinks, fast food). Across study groups, kappa statistics for diet quality scores were 0.31–0.55 (pro-healthy diet index, pHDI) and 0.26–0.45 (non-healthy diet index, nHDI), for active/sedentary lifestyle items they were 0.31–0.72, for components of the Family Affluence Scale (FAS) they were 0.55–0.93, for BMI categories (based on self-reported weight and height) they were 0.64–0.67, for the nutrition knowledge (NK) of adolescents the kappa was 0.36, for the nutrition knowledge of children’s parents it was 0.62. The Spearman’s correlations for diet quality scores were 0.52–0.76 (pHDI) and 0.53–0.83 (nHDI), for screen time score they were 0.45–0.78, for physical activity score they were 0.51–0.77, for the FAS score they were 0.90–0.93, and for the NK score they were 0.68–0.80. The questionnaire can be recommended to evaluate dietary and lifestyle behaviors among children and adolescents.
Collapse
Affiliation(s)
- Joanna Kowalkowska
- Department of Human Nutrition, Faculty of Food Sciences, University of Warmia and Mazury in Olsztyn, Sloneczna 45F, 10-718 Olsztyn, Poland; (L.W.); (N.W.)
- Correspondence: ; Tel.: +48-89-524-5517
| | - Lidia Wadolowska
- Department of Human Nutrition, Faculty of Food Sciences, University of Warmia and Mazury in Olsztyn, Sloneczna 45F, 10-718 Olsztyn, Poland; (L.W.); (N.W.)
| | - Jadwiga Hamulka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Science—SGGW, Nowoursynowska 159C, 02-776 Warsaw, Poland; (J.H.); (M.J.-B.)
| | - Natalia Wojtas
- Department of Human Nutrition, Faculty of Food Sciences, University of Warmia and Mazury in Olsztyn, Sloneczna 45F, 10-718 Olsztyn, Poland; (L.W.); (N.W.)
| | - Magdalena Czlapka-Matyasik
- Institute of Human Nutrition and Dietetics, Poznań University of Life Sciences, 31 Wojska Polskiego St., 60-624 Poznań, Poland;
| | - Witold Kozirok
- Department of Commodity and Quality Management, Faculty of Entrepreneurship and Quality Science, Gdynia Maritime University, 81-87 Morska Street, 81-225 Gdynia, Poland;
| | - Monika Bronkowska
- Department of Human Nutrition, Faculty of Biotechnology and Food Science, Wrocław University of Environmental and Life Sciences, Chełmońskiego 37, 51-630 Wroclaw, Poland;
| | - Joanna Sadowska
- Department of Human Nutrition Physiology, Faculty of Food Sciences and Fisheries, West Pomeranian University of Technology in Szczecin, Papieża Pawła VI 3, 71-459 Szczecin, Poland; (J.S.); (I.D.)
| | - Sylwia Naliwajko
- Department of Bromatology, Faculty of Pharmacy with the Division of Laboratory Medicine, Medical University of Bialystok, Mickiewicza 2D, 15-222 Bialystok, Poland;
| | - Izabela Dziaduch
- Department of Human Nutrition Physiology, Faculty of Food Sciences and Fisheries, West Pomeranian University of Technology in Szczecin, Papieża Pawła VI 3, 71-459 Szczecin, Poland; (J.S.); (I.D.)
| | - Aneta Koronowicz
- Department of Human Nutrition, Faculty of Food Technology, University of Agriculture in Krakow, Balicka 122, 30-149 Krakow, Poland; (A.K.); (E.P.-S.)
| | - Ewelina Piasna-Slupecka
- Department of Human Nutrition, Faculty of Food Technology, University of Agriculture in Krakow, Balicka 122, 30-149 Krakow, Poland; (A.K.); (E.P.-S.)
| | - Ewa Czeczelewska
- Department of Nursing, Faculty of Health Sciences, Collegium Mazovia Innovative Higher School in Siedlce, Sokolowska 161, 08-110 Siedlce, Poland;
| | - Jan Czeczelewski
- Human Nutrition Laboratory, Faculty of Physical Education and Sport in Biala Podlaska, Jozef Pilsudski University of Physical Education, Warsaw, Akademicka 2, 21-500 Biala Podlaska, Poland;
| | - Malgorzata Kostecka
- Department of Chemistry, Faculty of Food Science and Biotechnology, University of Life Sciences, 15 Akademicka Street, 20-950 Lublin, Poland;
| | - Anna Dlugosz
- Faculty of Chemical Technology and Engineering, University of Technology and Life Sciences in Bydgoszcz, Seminaryjna 3, 85-326 Bydgoszcz, Poland;
| | - Dorota Loboda
- Institute of Health, University of Economy in Bydgoszcz, Garbary 2, 85-229 Bydgoszcz, Poland;
| | - Marta Jeruszka-Bielak
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Science—SGGW, Nowoursynowska 159C, 02-776 Warsaw, Poland; (J.H.); (M.J.-B.)
| |
Collapse
|
10
|
Esdaile E, Hernandez E, Moores CJ, Vidgen HA. Enrolment of families with overweight children into a program aimed at reducing childhood obesity with and without a weight criterion: a natural experiment. BMC Public Health 2019; 19:756. [PMID: 31200674 PMCID: PMC6570944 DOI: 10.1186/s12889-019-6894-y] [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: 12/20/2018] [Accepted: 04/25/2019] [Indexed: 11/10/2022] Open
Abstract
Background Difficulties engaging families with overweight children to enrol into programs aimed at reducing childhood obesity have been well documented. During the implementation of the Parenting, Eating and Activity for Child Health Program (PEACH™) over a large geographical area (Queensland (QLD), Australia), a natural experiment developed. This experiment provided an opportunity to observe if there was a difference in enrolment for families with overweight children with a weight criterion (referred to as the period with a Targeted Eligibility Criterion (TEC)) compared to when a weight criterion was removed (the period referred to as Universal Eligibility Criterion (UEC)). We also examined the eligibility criterion’s relationship with attendance, parental concern about their child’s weight, estimation of overweight and obesity from parent-reported data. Methods A secondary analysis of baseline data from 926 overweight/obese children from 817 families enrolled in PEACH™ QLD was performed. Analyses were adjusted to control for the presence of clustered data. Bivariate statistics were performed using Pearson chi-square test with the second-order Rao-Scott correction, and Mann–Whitney U-test for non-parametric continuous variables. Generalized Estimating Equations (GEE) explored the association between weight status-based eligibility criteria and enrolment of overweight children. GEE were adjusted for sex, age and socioeconomic index and stratified for weight category. Results Compared to obese children, overweight children were almost twice as likely to be enrolled when the program did not have weight status-based eligibility criteria (during UEC period) (OR = 1.90 (CI 95% 1.35–2.68, p < 0.001)). Parents of overweight children enrolled during the UEC period were more likely to regard their child’s weight as less of a concern than during the TEC period (UEC 67% vs. TEC 45%, p = 0.036). Children whose parent-reported data underestimated their weight category were more likely to be enrolled while the program did not have weight-related eligibility criteria OR = 2.27 (CI 1.38–3.70, p < 0.01). Program session attendance did not appear to be impacted by the changes in eligibility criteria. Conclusions The omission of weight criteria for healthy lifestyle programs is a consideration for health professionals and decision-makers alike when encouraging the enrolment of children who are overweight into healthy lifestyle programs. Trial registration ACTRN12617000315314. Retrospectively registered 28 February 2017. Electronic supplementary material The online version of this article (10.1186/s12889-019-6894-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Emma Esdaile
- School of Exercise & Nutrition Sciences, Faculty of Health, Queensland University of Technology, Level 4, A Wing, O Block, Kelvin Grove, Brisbane, Queensland, Qld 4059, Australia.
| | - Emely Hernandez
- School of Exercise & Nutrition Sciences, Faculty of Health, Queensland University of Technology, Level 4, A Wing, O Block, Kelvin Grove, Brisbane, Queensland, Qld 4059, Australia
| | - Carly Jane Moores
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, South Australia, 5001, Australia
| | - Helen Anna Vidgen
- School of Exercise & Nutrition Sciences, Faculty of Health, Queensland University of Technology, Level 4, A Wing, O Block, Kelvin Grove, Brisbane, Queensland, Qld 4059, Australia
| |
Collapse
|
11
|
The impact of positive contextual factors on the association between adverse family experiences and obesity in a National Survey of Children. Prev Med 2018; 116:81-86. [PMID: 30218722 DOI: 10.1016/j.ypmed.2018.09.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 08/20/2018] [Accepted: 09/11/2018] [Indexed: 01/08/2023]
Abstract
Adverse family experiences (AFEs) are associated with childhood obesity. We evaluated whether certain positive contextual factors reduce the risk of obesity and overweight among children exposed to AFEs in a nationally representative sample. Using data derived from the National Survey of Children's Health 2011-12 (N = 43,864), we calculated the distribution of positive contextual factors (very good/excellent maternal mental health, neighborhood and school safety, and child resilience) and AFEs across weight status. The AFEs composite score was modeled as a categorical measure (0 or ≥1 AFEs). Positive contextual factors, AFEs and their interactions were evaluated in weighted, adjusted, multinomial logistic regression models predicting the odds of overweight and obesity. Children exposed to lack of very good/excellent maternal mental health and at least one AFE were at risk for overweight (OR = 1.43; 95% CI: 1.16, 1.76) and obesity (OR = 1.53; 95% CI: 1.22, 1.93). Unsafe school or neighborhood environment and exposure to 1 or more AFEs was. associated with overweight (OR = 1.32; 95% CI: 1.08, 1.61) and obesity (OR = 1.66; 95% CI: 1.34, 2.05). Lack of child resilience and exposure to 1 or more AFEs was associated with an increased risk of obesity (OR = 1.45; 95% CI: 1.17, 1.90) and overweight (OR = 1.29; 95% CI: 1.06, 1.57). These odds of obesity and overweight all decreased when positive contextual factors were present. Among children exposed to AFEs, overweight and obesity risk is reduced with positive contextual factors. Optimizing the early childhood environment can impact obesity risk.
Collapse
|
12
|
Maternal glycemic index and glycemic load in pregnancy and offspring metabolic health in childhood and adolescence-a cohort study of 68,471 mother-offspring dyads from the Danish National Birth Cohort. Eur J Clin Nutr 2018; 73:1049-1062. [PMID: 30250133 DOI: 10.1038/s41430-018-0316-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 07/27/2018] [Accepted: 08/17/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND High glycemic index (GI) and glycemic load (GL) as indicators of carbohydrate quality and quantity have been found to increase risk of metabolic outcomes in adults. Whether carbohydrate quality may influence metabolic programming already in early life is unknown. We examined the association of maternal GI and GL with offspring body mass index (BMI) in the first 7 years of life among 68,471 mother-offspring dyads from the Danish National Birth Cohort (DNBC). In a sub-cohort of offspring with clinical data (n = 1234) that included 608 dyads exposed to gestational diabetes mellitus (GDM), we also examined the relation to metabolic health at 9-16 years. METHODS Maternal GI and GL were quantified using a mid-pregnancy food frequency questionnaire. We used birth weight and length to calculate offspring's ponderal index. Age- and sex-specific BMI z scores at 5 mo, 12 mo, and 7 y were standardized against WHO reference data. In the clinical cohort, we quantified body composition, HOMA-IR, and HOMA-B. We used multivariable mixed linear and Poisson regression to model the associations. RESULTS Median (IQR) of GI and GL were 83 (63-111) and 241 (180-333) g/day, respectively. We found that GI (Q4 vs. Q1:1.09, 95%CI: 1.03, 1.15) and GL (Q4 vs. Q1:1.10, 95%CI: 1.05, 1.16) modestly increased the relative risk of large-for gestational age (LGA). In the clinical sub-cohort, we observed a potential increase in offspring HOMA-IR, adiposity, and metabolic syndrome z score with higher maternal GI and GI. These associations were stronger among the GDM-exposed offspring, but the CI included the null value. CONCLUSION We found associations of GI and GL in pregnancy with offspring LGA. Potential long-term benefits to offspring exposed to GDM need to be confirmed in larger, well-powered studies.
Collapse
|
13
|
He J, Fan X. How Accurate Is Using Parent-Reported Height and Weight for Screening Children and Adolescents for Overweight and Obesity? Meta-Analyses at Both Population and Individual Levels. Child Obes 2018; 14:302-315. [PMID: 29969281 DOI: 10.1089/chi.2018.0062] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To explore the accuracy of using parent-reported data for screening children and adolescents with overweight and/or obesity at both population and individual levels by quantitatively synthesizing previous inconsistent findings in the research literature. METHOD PubMed, Web of Science, and EBSCOhost were searched up to December 2017. A study was included if it explored the accuracy of using parent-reported data (i.e., BMI based on parent-reported height and weight; BMIpr) relative to directly measured data (i.e., BMI based on measured height and weight; BMIm) for screening children and adolescents with overweight and/or obesity. RESULTS Fourteen studies were identified for the meta-analysis at population level. Using a random-effects model, the use of BMIpr overestimated the prevalence of overweight and obesity among children and adolescents compared with BMIm, with prevalence ratio = 1.118 (95% confidence interval [CI]: 1.027-1.216). Thirteen studies were included in the meta-analysis at individual level. The use of BMIpr for screening children and adolescents with overweight and/or obesity showed a pooled sensitivity of 0.713 (95% CI: 0.700-0.726) and a pooled specificity of 0.918 (95% CI: 0.915-0.922). Moreover, subgroup analyses and meta-regressions showed that its accuracy at both levels differed by certain conditions. CONCLUSION Based on the results of the current two meta-analyses, the use of BMIpr was not accurate at either population level or individual level. However, considering that its accuracy varied by certain conditions, future researchers using BMIpr may consider these findings to achieve a more accurate screening of overweight and obesity among children and adolescents.
Collapse
Affiliation(s)
- Jinbo He
- 1 Educational Science Research Institute, Hunan University , Hunan, China
| | - Xitao Fan
- 2 School of Humanities and Social Science, Chinese University of Hong Kong (Shenzhen) , Guangdong, China
| |
Collapse
|
14
|
Gregori D, Hochdorn A, Azzolina D, Berchialla P, Lorenzoni G. Does Love Really Make Mothers Blind? A Large Transcontinental Study on Mothers' Awareness About Their Children's Weight. Obesity (Silver Spring) 2018; 26:1211-1224. [PMID: 29932519 DOI: 10.1002/oby.22214] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 04/23/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The aim of this study was to assess maternal misperception rates (perception as normal or underweight of a child with overweight or obesity) and their role in affecting the chance of implementing actions to change children's weight. METHODS Obesogeneicity of Gadgets Marketed with Snacks (OBEY-AD) is an international study investigating factors promoting childhood overweight and obesity in 10 countries, in which 2,720 child-mother dyads have been enrolled. Mothers' perception of their children's weight was assessed using a projective test. Children's weight status was measured according to the anthropometric standards established by the World Health Organization. RESULTS Mothers classified 89% of children with overweight and 52% of children with obesity as normal weight. The odds ratio of mothers' misperception was significantly higher for higher parental BMI, higher children's International Brand Awareness Inventory score, and high family socioeconomic status. Children with overweight and/or obesity who were perceived as normal weight by their mothers were less likely to be referred to specific health care services. CONCLUSIONS Most children with overweight and/or obesity were perceived as normal weight by their mothers. Such lack of concern regarding a severe disease might interfere with the effectiveness of prevention programs. Considering the contextual factors that frame the etiological causes of a disease may help in finding effective and enduring solutions to target childhood obesity.
Collapse
Affiliation(s)
- Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy
| | - Alexander Hochdorn
- Department of Social, Work and Organisational Psychology, University of Brasília, Brasília, Brazil
| | - Danila Azzolina
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy
| | - Paola Berchialla
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy
| | | |
Collapse
|
15
|
Brettschneider AK, Schienkiewitz A, Schmidt S, Ellert U, Kurth BM. Updated prevalence rates of overweight and obesity in 4- to 10-year-old children in Germany. Results from the telephone-based KiGGS Wave 1 after correction for bias in parental reports. Eur J Pediatr 2017; 176:547-551. [PMID: 28132095 DOI: 10.1007/s00431-017-2861-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 01/15/2017] [Accepted: 01/18/2017] [Indexed: 11/27/2022]
Abstract
UNLABELLED The nationwide 'German Health Interview and Examination Survey for Children and Adolescents' (KiGGS), conducted in 2003-2006, showed an increase in the prevalence rates of overweight and obesity compared to the early 1990s, indicating the need for regular monitoring. Recently, a follow-up-KiGGS Wave 1 (2009-2012)-was carried out as a telephone-based survey, providing parent-reported height and weight from 5155 children aged 4-10 years. Since parental reports lead to a bias in prevalence rates of weight status, a correction is needed. From a subsample of KiGGS Wave 1 participants, measurements for height and weight were collected in a physical examination. In order to correct prevalence rates derived from parent reports, weight status categories based on parent-reported and measured height and weight were used to estimate a correction formula according to an established procedure. The corrected prevalence rates derived from KiGGS Wave 1 for overweight, including obesity, in children aged 4-10 years in Germany showed that stagnation is reached compared to the KiGGS baseline study (2003-2006). CONCLUSION The rates for overweight, including obesity, in Germany have levelled off. However, they still remain at a high level, indicating a need for further public health action. What is Known: • In the last decades, prevalence of overweight and obesity has risen. Now a days, the prevalence seems to be stagnating. • In Germany, prevalence estimates of overweight and obesity are only available from regional or non-representative studies. What is New: • This article gives an update for prevalence rates of overweight and obesity amongst children aged 4-10 years in Germany based on a nationwide and representative sample. • Results show that stagnation in prevalence rates for overweight in children in Germany is reached.
Collapse
Affiliation(s)
- Anna-Kristin Brettschneider
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, 12101, Berlin, Germany.
| | - Anja Schienkiewitz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, 12101, Berlin, Germany
| | - Steffen Schmidt
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany
| | - Ute Ellert
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, 12101, Berlin, Germany
| | - Bärbel-Maria Kurth
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, 12101, Berlin, Germany
| |
Collapse
|
16
|
Dobranowski K, Lloyd M, Côté P, Balogh R. Validity of proxy-reported height and weight to derive body mass index in adults participating in Special Olympics. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 31 Suppl 1:136-143. [PMID: 28205295 DOI: 10.1111/jar.12332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Overweight and obesity are common in adults with intellectual disabilities, which complicates their health. To meet their health needs, individuals with intellectual disability frequently rely on proxies to answer questions on their behalf. In the general population, the use of proxy-reported height and weight to compute body mass index (BMI) has been validated, but not among adults with intellectual disability. The objective of this study was to determine the accuracy of proxy-reported height, weight and derived BMI among adults with intellectual disability. METHODS Proxies were asked to report height and weight on behalf of adults with intellectual disability who participate in Special Olympics Ontario; their answers were compared to measured height and weight. RESULTS Proxies reported height and weight accurately; the sensitivity of proxy reports for classifying individuals with intellectual disability as overweight and/or obese was 84.6%. CONCLUSION Proxy reports may be useful when direct measurements of individuals with intellectual disability are not available.
Collapse
Affiliation(s)
| | - Meghann Lloyd
- University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Pierre Côté
- University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Robert Balogh
- University of Ontario Institute of Technology, Oshawa, ON, Canada
| |
Collapse
|
17
|
Hoffmann S, Warschburger P. Weight, shape, and muscularity concerns in male and female adolescents: Predictors of change and influences on eating concern. Int J Eat Disord 2017; 50:139-147. [PMID: 27739586 DOI: 10.1002/eat.22635] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 09/15/2016] [Accepted: 09/15/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the impact of age and weight status on adolescents' body dissatisfaction and its change over 20 months in a gender-comparing design. The influence of body image concern on eating concern was also investigated. METHOD In a prospective study, 675 male and female adolescents aged 12-16 were assessed using self-report questionnaires on weight, shape, muscularity, and eating concerns. Height and weight measurements were taken by trained personnel. Data were analyzed using structural equation modeling. RESULTS Analyses of latent means revealed more pronounced weight/shape concern in females than males and more pronounced muscularity concern in males than females. Weight/shape concern increased in females over time, whereas muscularity concern remained stable in both genders. Baseline levels of weight/shape concern could be predicted by age and weight status in females and by weight status in males. The only predictor of change in weight/shape concern was weight status in males. Baseline levels of muscularity concern could be predicted by age in females and by weight status in males. Similar effects were found for changes in muscularity concern in both genders. Increases in weight/shape and muscularity concern were associated with more pronounced eating concern. DISCUSSION The results confirm gender differences in distinctive facets of body image concern and its prediction. The relevance of increase in body image concern in adolescents is underlined by its association with eating concern in both genders. Further explanatory variables for change in body dissatisfaction should be examined in future studies. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:139-147).
Collapse
Affiliation(s)
- Svenja Hoffmann
- Department of Psychology, University of Potsdam, Karl-Liebknecht-Straße 24/25, Potsdam, 14476, Germany
| | - Petra Warschburger
- Department of Psychology, University of Potsdam, Karl-Liebknecht-Straße 24/25, Potsdam, 14476, Germany
| |
Collapse
|
18
|
Hochdorn A, Faleiros VP, Camargo BV, Bousfield AB, Wachelke JF, Quintão IP, Azzolina D, Gregori D. Obese children are thin in parents' eyes: A psychologically, socially, or culturally driven bias? J Health Psychol 2016; 23:114-126. [PMID: 27821680 DOI: 10.1177/1359105316676328] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Although obesity presents a serious health problem in children, parents often underestimate their children's overweight and obesity status. Therefore, scientific literature was systematically screened through PubMed and PsycINFO to demonstrate the psychological, social, and cultural processes that underlie this evaluation bias. A total of 37 papers that focused on research conducted in different geopolitical contexts were taken into account. Furthermore, a lexicometric analysis of the papers' conclusions was performed. The findings showed that education plays a key role in promoting parents' awareness and their realistic recognition of their children's weight. Accordingly, adequate educational support for parents should be implemented in all healthcare policies addressing childhood obesity.
Collapse
|
19
|
McDonald SW, Ginez HK, Vinturache AE, Tough SC. Maternal perceptions of underweight and overweight for 6-8 years olds from a Canadian cohort: reporting weights, concerns and conversations with healthcare providers. BMJ Open 2016; 6:e012094. [PMID: 27798005 PMCID: PMC5073603 DOI: 10.1136/bmjopen-2016-012094] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES The majority of mothers do not correctly identify their child's weight status. The reasons for the misperception are not well understood. This study's objective was to describe maternal perceptions of their child's body mass index (BMI) and maternal report of weight concerns raised by a health professional. DESIGN Prospective, community-based cohort. PARTICIPANTS Data were collected in 2010 from 450 mothers previously included in a longitudinal birth cohort. Mothers of children aged 6-8 years reported their child's anthropometric measures and were surveyed concerning their opinion about their child's weight. They were also asked if a healthcare provider raised any concerns regarding their child's body weight. Child BMI was categorised according to the WHO Growth Charts adapted for Canada. Descriptive statistics and bivariate analyses were used to evaluate mothers' ability to correctly identify their children's body habitus. RESULTS 74% of children had a healthy BMI, 10% were underweight, 9% were overweight and 7% were obese. 80%, 89% and 62% of mothers with underweight, overweight and obese children, respectively, believed that their child was at the right weight. The proportion of mothers who recalled a health professional raising concerns about their child being underweight, overweight, and obese was low (12.5%). CONCLUSIONS The majority of mothers with children at unhealthy weights misclassified and normalised their child's weight status, and they did not recall a health professional raising concerns regarding their child's weight. The highest rates of child body weight misclassification occurred in overweight children. This suggests that there are missed opportunities for healthcare professionals to improve knowledge exchange and early interventions to assist parents to recognise and support healthy weights for their children.
Collapse
Affiliation(s)
- Sheila W McDonald
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Population, Public, and Aboriginal Health, Alberta Health Services, Calgary, Alberta, Canada
| | - Heather K Ginez
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Angela E Vinturache
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Suzanne C Tough
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
20
|
de Munter JS, Friedl A, Lind S, Kark M, Carlberg M, Andersson N, Georgellis A, Rasmussen F. Stability in the prevalence of Swedish children who were overweight or obese in 2003 and 2011. Acta Paediatr 2016; 105:1173-80. [PMID: 26833765 DOI: 10.1111/apa.13351] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 10/05/2015] [Accepted: 01/27/2016] [Indexed: 11/29/2022]
Abstract
AIM We aimed to explore the prevalence and determinants of overweight including obesity among children in Sweden in 2003 and 2011. METHODS Two population-based cross-sectional surveys included 7728 and 12 882 12-year-old children in Sweden, and 1198 and 2699 eight-year-old children in Stockholm County, in 2003 and 2011. Weighted prevalence of overweight including obesity and multivariate-adjusted relative risks (RRs) with 95% confidence intervals (CIs) was calculated. RESULTS In 2011, the overweight prevalence was lower for 12-year-old girls than boys (RR=0.84, CI=0.77-0.92), lower for girls and boys with a higher rather than a lower educated mother (for example, RRgirls =0.76, CI=0.65-0.88), but higher for girls and boys in smaller rather than main cities (RRgirls =1.52, CI=1.28-1.82). There was no difference in overweight prevalence between 2003 and 2011 among the 12-year-old children. However, eight-year-old girls had a lower overweight prevalence in 2011 than in 2003 (RR=0.76, CI=0.59-0.97). The strongest decrease in overweight was among eight-year-old girls with mothers with lower levels of education (RR=0.63, CI=0.47-0.86). CONCLUSION The prevalence of overweight including obesity was stable among Swedish children between 2003 and 2011. Gradients in the determinants of overweight persisted. There was some evidence of a less steep socio-economic gradient in overweight in eight-year-old girls over time.
Collapse
Affiliation(s)
- Jeroen S. de Munter
- Child and Adolescent Public Health Epidemiology; Department of Public Health Sciences; Karolinska Institutet; Stockholm Sweden
| | - Andrea Friedl
- Child and Adolescent Health Unit; Centre for Epidemiology and Community Medicine; Stockholm County Council; Stockholm Sweden
| | - Simon Lind
- Child and Adolescent Public Health Epidemiology; Department of Public Health Sciences; Karolinska Institutet; Stockholm Sweden
| | - Malin Kark
- Public Health Agency of Sweden; Stockholm Sweden
| | - Magdalena Carlberg
- Child and Adolescent Health Unit; Centre for Epidemiology and Community Medicine; Stockholm County Council; Stockholm Sweden
| | - Niklas Andersson
- Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
| | - Antonis Georgellis
- Unit of Environmental Medicine; Centre for Occupational and Environmental Medicine; Stockholm County Council; Stockholm Sweden
| | - Finn Rasmussen
- Child and Adolescent Public Health Epidemiology; Department of Public Health Sciences; Karolinska Institutet; Stockholm Sweden
- Child and Adolescent Health Unit; Centre for Epidemiology and Community Medicine; Stockholm County Council; Stockholm Sweden
| |
Collapse
|
21
|
Lynch BA, Agunwamba A, Wilson PM, Kumar S, Jacobson RM, Phelan S, Cristiani V, Fan C, Finney Rutten LJ. Adverse family experiences and obesity in children and adolescents in the United States. Prev Med 2016; 90:148-54. [PMID: 27377335 DOI: 10.1016/j.ypmed.2016.06.035] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 05/27/2016] [Accepted: 06/27/2016] [Indexed: 10/21/2022]
Abstract
While exposure to adverse family experiences (AFEs), subset of adverse childhood experiences (ACEs), has been associated with childhood obesity, less is known about the impact of exposures to each type of AFE. Using 2011-2012 National Survey of Children's Health data, we evaluated associations between exposure to individual AFEs and overweight/obesity status in children 10years or older, adjusting for socio-demographic factors. Caregivers reported their child's height, weight, and exposure to nine AFEs; body mass index (BMI) was classified by Center for Disease Control and Prevention's (CDC) guidelines. At Mayo Clinic, we calculated frequencies and weighted estimates of socio-demographic factors and AFEs. Unadjusted and adjusted weighted multinomial logistic regression models were employed to assess the independent associations of each AFE and the different AFE composite scores with BMI category. Exposure to two or more AFEs was independently associated with increased odds of overweight (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.13, 1.56) and obese (OR, 1.45; 95% CI, 1.21, 1.73) status after adjustment for age, household income, parents' education-level, race and sex. Death of parent (OR, 1.59; 95% CI, 1.18, 2.15) and hardship due to family income (OR, 1.26; 95% CI, 1.06, 1.50) were independently associated with obesity status with adjustment for other AFEs and socio-demographic factors. Our results suggest that, in addition to cumulative exposure to AFEs, exposure to certain childhood experiences are more strongly associated with childhood obesity than others. Death of parent and hardship due to family income are individual AFEs, which are strongly predictive of obesity.
Collapse
Affiliation(s)
- Brian A Lynch
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | - Amenah Agunwamba
- Department of Health Sciences Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | - Patrick M Wilson
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | - Seema Kumar
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | - Robert M Jacobson
- Department of Pediatric and Adolescent Medicine, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | - Sean Phelan
- Department of Health Sciences Research, Division of HealthCare Policy and Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | - Valeria Cristiani
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | - Chun Fan
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | - Lila J Finney Rutten
- Division of Epidemiology, Department of Health Sciences Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| |
Collapse
|
22
|
Brault MC, Turcotte O, Aimé A, Côté M, Bégin C. Body Mass Index Accuracy in Preadolescents: Can We Trust Self-Report or Should We Seek Parent Report? J Pediatr 2015; 167:366-71. [PMID: 25982141 DOI: 10.1016/j.jpeds.2015.04.043] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 03/12/2015] [Accepted: 04/15/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To assess the accuracy of self- and parent-report of weight, height, and body mass index (BMI) in children between 8 and 12 years of age and to determine whether self- or parent-report should be preferred for preadolescents' subjective measures. STUDY DESIGN Through at-home questionnaires, 875 preadolescent children (44% boys; 56% girls) and their parents (N = 821) were asked to report the children's weight and height. Objective weight and height were measured at school by trained interviewers. RESULTS Correlations between objective, self-reported, and parent-reported measures were strong for weight, height, and BMI, but children and parents generally underestimated the children's weight by about 1 kg, their height by less than 1 cm, and their BMI by less than 0.25 kg/m(2). The magnitude of the underestimation varied by age, sex, and BMI category, with older children, girls, and children in the overweight and obese BMI categories underestimating their weight to a greater extent. Weight estimates provided by girls' parents tended to be lower than the real values more often than those of boys' parents. CONCLUSIONS Children and parents are likely to misreport children's weight, height, and BMI. For most youths aged 8 years of age and older, self-report appears as accurate as parent-report and could, therefore, be used interchangeably.
Collapse
Affiliation(s)
- Marie-Christine Brault
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Québec, Canada.
| | | | - Annie Aimé
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Québec, Canada
| | - Marilou Côté
- School of Psychology, Université Laval, Québec, Canada
| | | |
Collapse
|
23
|
Abstract
In singletons, asthma may be associated with shorter height and delayed growth during adolescence. Yet, these studies do not account for heritability of asthma, puberty/menarche, and height. We aimed to study the association between asthma and puberty in boys and menarche in girls, and height, in a cohort of twins and subsequently in same-sex twin pairs discordant for asthma. From a Swedish twin cohort, parent- and self-reported data on asthma, puberty/menarche, and height were collected. Pubertal staging was established via the Petersen index. Logistic and linear regression was used to estimate associations between asthma and puberty/menarche and height, respectively. For within-pair analyses in twins discordant for asthma, conditional logistic and linear regression were used. Data on 2,658 (49.1% boys) twins were included. Among boys, asthma prevalence was 8.2% at 8-9 years and 10.2% at 13-14 years. Corresponding numbers for girls were 4.2% and 4.9%, respectively. In the entire cohort, no statistically significant associations were found between current asthma and puberty/menarche. Boys with asthma were shorter than boys without asthma at 8-9 years (on average, 1.86 [0.17-3.56] cm, p = .03) and at 13-14 years (on average, 2.94 [0.98-4.91] cm, p = .003) but not at 19-20 years. No such associations were found for girls. Within same-sex twin pairs discordant for asthma, no statistically significant associations were found for either sex. Twin boys, but not girls, with asthma were shorter than those without asthma. Non-statistically significant estimates from within-pair analyses suggest the association is partly confounded by genetic or familial environmental factors.
Collapse
|
24
|
Gordon NP, Mellor RG. Accuracy of parent-reported information for estimating prevalence of overweight and obesity in a race-ethnically diverse pediatric clinic population aged 3 to 12. BMC Pediatr 2015; 15:5. [PMID: 25886135 PMCID: PMC4341231 DOI: 10.1186/s12887-015-0320-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 01/22/2015] [Indexed: 11/21/2022] Open
Abstract
Background There is conflicting evidence about the accuracy of estimates of childhood obesity based on parent-reported data. We assessed accuracy of child height, weight, and overweight/obesity classification in a pediatric clinic population based on parent data to learn whether accuracy differs by child age and race/ethnicity. Methods Parents of patients ages 3–12 (n = 1,119) completed a waiting room questionnaire that asked about their child’s height and weight. Child’s height and weight was then measured and entered into the electronic health record (EHR) by clinic staff. The child’s EHR and questionnaire data were subsequently linked. Accuracy of parent-reported height, weight, overweight/obesity classification, and parent perception of child’s weight status were assessed using EHR data as the gold standard. Statistics were calculated for the full sample, two age groups (3–5, 6–12), and four racial/ethnic groups (nonHispanic White, Black, Latino, Asian). Results A parent-reported height was available for 59.1% of the children, weight for 75.6%, and weight classification for 53.0%. Data availability differed by race/ethnicity but not age group. Parent-reported height was accurate for 49.2% of children and weight for 58.2%. Latino children were less likely than nonHispanic Whites to have accurate height and weight data, and weight data were less accurate for 6–12 year than 3–5 year olds. Concordance of parent- and EHR-based classifications of the child as overweight/obese and obese was approximately 80% for all subgroups, with kappa statistics indicating moderate agreement. Parent-reported data significantly overestimated prevalence of overweight/obesity (50.2% vs. 35.2%) and obesity (32.1% vs. 19.4%) in the full sample and across all age and racial/ethnic subgroups. However, the percentages of parents who perceived their child to be overweight or very overweight greatly underestimated actual prevalence of overweight/obesity and obesity. Missing data did not bias parent-based overweight/obesity estimates and was not associated with child’s EHR weight classification or parental perception of child’s weight. Conclusions While the majority of parents of overweight or obese children tend to be unaware that their child is overweight, use of parent-reported height and weight data for young children and pre-teens will likely result in overestimates of prevalence of youth overweight and obesity. Electronic supplementary material The online version of this article (doi:10.1186/s12887-015-0320-0) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Nancy P Gordon
- Division of Research, Kaiser Permanente Medical Care Program, 2000 Broadway, Oakland, CA, 94611, USA.
| | - R Grant Mellor
- Department of Pediatrics, Kaiser Permanente Northern California Central Valley Area, Stockton, CA, USA.
| |
Collapse
|
25
|
Validity of parentally reported versus measured weight, length and waist in 7- to 9-year-old children for use in follow-up studies. Eur J Pediatr 2014; 173:921-8. [PMID: 24497184 DOI: 10.1007/s00431-014-2274-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 12/19/2013] [Accepted: 01/22/2014] [Indexed: 10/25/2022]
Abstract
UNLABELLED The aim of this prospective cohort study was to assess the validity of parentally reported anthropometric data compared to measured data in 7- to 9-year-old Flemish children especially for use in follow-up studies. The subjects were 116 Flemish children of a birth cohort recruited in the first Flemish Environment and Health Study (2002-2003). Data about anthropometric measures (waist circumference (WC), weight and length) were obtained by a postal parentally reported questionnaire and during a home visit. Our study showed that parents tend to overreport their child's WC and underreport the BMI, especially in children with large WC and high BMI. The median difference between measured and parentally reported WC was 1.6% of the median measured WC; for BMI, the median difference was 2.8% of the median measured BMI. Both for WC and BMI, we observed a good agreement between parentally reported values and measured values to classify children in the highest 10 and 20% of the study population. When classifying the children in 'overweight' and 'not overweight', there were less misclassifications when parentally reported WC was used compared to parentally reported BMI. CONCLUSIONS Although there is a high agreement between parentally reported and measured WC, the parentally reported data must be used with reserve. Moreover, this study is the first to suggest that WC is a better indicator compared to BMI when parentally reported values are used to classify children.
Collapse
|
26
|
Jwa SC, Fujiwara T, Kondo N. Latent protective effects of breastfeeding on late childhood overweight and obesity: a nationwide prospective study. Obesity (Silver Spring) 2014; 22:1527-37. [PMID: 24591416 DOI: 10.1002/oby.20735] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 02/28/2014] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To investigate the latent effect of breastfeeding on overweight and obesity in late childhood. METHODS Data on breastfeeding and child anthropometric measurements were collected annually from a nation-wide population-based prospective cohort study in Japan (21,425 boys and 20,147 girls). Breastfeeding status (exclusiveness and duration) was assessed when the child was 6 months old. Mixed effects models were used to evaluate trajectories of body mass index (BMI), together with overweight and obesity status, from 1.5 to 8 years of age. RESULTS Mixed-fed boys and exclusively breastfed boys showed lower BMI as the main effect, as well as a slower increase of inclination in BMI as interaction term between feeding type and age, than exclusively formula-fed boys. Breastfed boys had lower BMI at the ages of 7 and 8, in comparison with exclusively formula fed boys (P = 0.002 and P < 0.001, respectively). A similar association was found for girls, although the main effect of feeding type was not statistically significant. The analysis of breastfeeding duration had similar results. CONCLUSIONS Breastfeeding, even if partial or for short duration, has a latent protective effect against overweight and obesity in late childhood, especially for boys.
Collapse
Affiliation(s)
- Seung Chik Jwa
- Department of Social Medicine, National Research Institute for Child Health and Development, National Center for Child Health and Development, Tokyo, Japan
| | | | | |
Collapse
|
27
|
Helton JJ, Liechty JM. Obesity prevalence among youth investigated for maltreatment in the United States. CHILD ABUSE & NEGLECT 2014; 38:768-775. [PMID: 24035366 DOI: 10.1016/j.chiabu.2013.08.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 08/09/2013] [Accepted: 08/16/2013] [Indexed: 06/02/2023]
Abstract
The objective of this study is to determine the prevalence and correlates of obesity among youth investigated for maltreatment in the United States. Participants were drawn from the National Survey of Child and Adolescent Well-Being II, a national probability study of 5,873 children aged birth to 17 years under investigation for maltreatment in 2008. From child weight reported by caregivers, we estimated obesity (weight-for-age ≥95th percentile) prevalence among children aged 2 through 17 (n=2,948). Sex-specific logistic regression models by developmental age were used to identify obesity risk factors, including child age, race/ethnicity, and maltreatment type. Obesity prevalence was 25.4% and was higher among boys than girls (30.0% vs. 20.8%). African American adolescent boys had a lower risk for obesity than white boys (OR=0.28, 95% CI [0.08, 0.94]). Compared with girls aged 2-5 with a neglect allegation, girls with a sexual abuse allegation were at greater risk for obesity (OR=3.54, 95% CI [1.01, 12.41]). Compared with adolescent boys with a neglect allegation, boys with a physical abuse allegation had a lower risk for obesity (OR=0.24, 95% CI [0.06, 0.99]). Adolescent girls with a prior family history of investigation were at greater risk for obesity than those without a history of investigation (OR=3.97, 95% CI [1.58, 10.02]). Youth investigated for maltreatment have high obesity rates compared with national peers. Opportunities to modify and evaluate related child welfare policies and health care practices should be pursued.
Collapse
Affiliation(s)
- Jesse J Helton
- School of Social Work and Children and Family Research Center, University of Illinois, Urbana, IL, USA
| | - Janet M Liechty
- School of Social Work and College of Medicine, University of Illinois, Urbana, IL, USA
| |
Collapse
|
28
|
Psychosocial determinants of quality of life in parents of obese children seeking inpatient treatment. Qual Life Res 2014; 23:1985-95. [DOI: 10.1007/s11136-014-0659-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2014] [Indexed: 11/25/2022]
|
29
|
Matthiessen J, Stockmarr A, Biltoft-Jensen A, Fagt S, Zhang H, Groth MV. Trends in overweight and obesity in Danish children and adolescents: 2000-2008--exploring changes according to parental education. Scand J Public Health 2014; 42:385-92. [PMID: 24516062 DOI: 10.1177/1403494813520356] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS To examine the hypotheses that an overall levelling off in the prevalence of overweight and obesity during the period 2000-2008 has occurred, and that increasing social inequality in overweight and obesity exists in a nationally representative sample of Danish children and adolescents. METHODS The population comprised a random sample of 1849 children aged 4-14 years who participated in the Danish National Survey of Diet and Physical Activity in 2000-2002, 2003-2004 and 2005-2008. Parental education was chosen as an indicator of children's socioeconomic status. Body mass index (BMI) was calculated from parent-reported weight and height. Subjects were classified as overweight and obese according to the International Obesity Task Force age- and gender-specific BMI cut-off values. Crude prevalence estimates and logistic regression models were used to analyse trends in overweight and obesity as the main outcome measures. RESULTS An increase was found in the crude prevalence of overweight (including obesity) in boys (12.8-21.7%, p = 0.0006), but not in girls (17.6-15.9%, p = 0.56), between 2000-2002 and 2005-2008. The prevalence of overweight increased significantly in boys of parents with low educational level only. A strong inverse social gradient in overweight and obesity was documented for boys and girls during the whole survey period. CONCLUSIONS The present study showed an increase in the prevalence of overweight in Danish boys, but not in girls. This increase was due to increasing social inequality in overweight among boys. Public health initiatives aimed at preventing and reducing overweight and obesity should consider gender difference and especially target boys with parents of low educational level.
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
| | - Anja Biltoft-Jensen
- Division of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - Sisse Fagt
- Division of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - Hao Zhang
- Department of Applied Mathematics and Computer Science, Technical University of Denmark,. Lyngby, Denmark
| | - Margit Velsing Groth
- Division of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| |
Collapse
|
30
|
Huybrechts I, Beirlaen C, De Vriendt T, Slimani N, Pisa PT, Schouppe E, De Coene A, De Bacquer D, De Henauw S, Himes JH. Validity of instruction leaflets for parents to measure their child's weight and height at home: results obtained from a randomised controlled trial. BMJ Open 2014; 4:e003768. [PMID: 24508849 PMCID: PMC3918984 DOI: 10.1136/bmjopen-2013-003768] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To compare the validity of parent-reported height, weight and body mass index (BMI) values of children (aged 4-10 years), when measured at home by means of newly developed instruction leaflets in comparison with simple estimated parental reports. DESIGN Randomised controlled trial with control and intervention group using simple randomisation. SETTING Belgian children and their parents recruited via schools (multistage cluster sampling design). PARTICIPANTS 164 Belgian children (53% male; participation rate 62%). INTERVENTION Parents completed a questionnaire including questions about the height and weight of their child. Parents in the intervention group received instruction leaflets to measure their child's weight and height. Classes were randomly allocated to the intervention and control groups. Nurses measured height and weight following standardised procedures up to 2 weeks after parental reports. OUTCOME MEASURES Weight, height and BMI category of the child were derived from the index measurements and the parental reports. RESULTS Mean parent-reported weight was slightly more underestimated in the intervention group than in the control group relative to the index weights. However, for all three parameters (weight, height and BMI), correlations between parental reports and nurse measurements were higher in the intervention group. Sensitivity for underweight and overweight/obesity was respectively, 75% and 60% in the intervention group, and 67% and 43% in the control group. Weighed κ for classifying children in the correct BMI category was 0.30 in the control group and was 0.51 in the intervention group. CONCLUSIONS Although mean parent-reported weight was slightly more underestimated in the intervention than in the control group, correlations were higher and there was considerably less misclassification into valid BMI categories for the intervention group. This pattern suggests that most of the parental deviations from the index measurements were probably due to random errors of measurement and that diagnostic measures could improve by encouraging parents to measure their children's weight and height at home by means of instruction leaflets.
Collapse
Affiliation(s)
- Inge Huybrechts
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | | | - Tineke De Vriendt
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Research Foundation Flanders, Brussels, Belgium
| | - Nadia Slimani
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Pedro T Pisa
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Elien Schouppe
- KaHo Sint-Lieven, Gebroeders Desmetstraat 1, Ghent, Belgium
| | - Anja De Coene
- Flemish Community Education, Centre for Pupils Counselling (CLB), Ghent, Belgium
| | - Dirk De Bacquer
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Stefaan De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Department of Nutrition and Dietetics, University College Ghent, Ghent, Belgium
| | - John H Himes
- Division of Epidemiology and Community, Health University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| |
Collapse
|
31
|
Yorkin M, Spaccarotella K, Martin-Biggers J, Quick V, Byrd-Bredbenner C. Accuracy and consistency of weights provided by home bathroom scales. BMC Public Health 2013; 13:1194. [PMID: 24341761 PMCID: PMC3890563 DOI: 10.1186/1471-2458-13-1194] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2013] [Accepted: 11/22/2013] [Indexed: 11/10/2022] Open
Abstract
Background Self-reported body weight is often used for calculation of Body Mass Index because it is easy to collect. Little is known about sources of error introduced by using bathroom scales to measure weight at home. The objective of this study was to evaluate the accuracy and consistency of digital versus dial-type bathroom scales commonly used for self-reported weight. Methods Participants brought functioning bathroom scales (n = 18 dial-type, n = 43 digital-type) to a central location. Trained researchers assessed accuracy and consistency using certified calibration weights at 10 kg, 25 kg, 50 kg, 75 kg, 100 kg, and 110 kg. Data also were collected on frequency of calibration, age and floor surface beneath the scale. Results All participants reported using their scale on hard surface flooring. Before calibration, all digital scales displayed 0, but dial scales displayed a mean absolute initial weight of 0.95 (1.9 SD) kg. Digital scales accurately weighed test loads whereas dial-type scale weights differed significantly (p < 0.05). Imprecision of dial scales was significantly greater than that of digital scales at all weights (p < 0.05). Accuracy and precision did not vary by scale age. Conclusions Digital home bathroom scales provide sufficiently accurate and consistent weights for public health research. Reminders to zero scales before each use may further improve accuracy of self-reported weight.
Collapse
Affiliation(s)
| | | | - Jennifer Martin-Biggers
- Department of Nutritional Sciences, Rutgers, The State University of New Jersey, 26 Nichol Avenue, Davison Hall, 08901, New Brunswick, NJ, USA.
| | | | | |
Collapse
|
32
|
Relationship between sleep duration and dietary intake in 4- to 14-year-old Danish children. J Nutr Sci 2013; 2:e38. [PMID: 25191588 PMCID: PMC4153308 DOI: 10.1017/jns.2013.23] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 07/12/2013] [Accepted: 07/17/2013] [Indexed: 11/07/2022] Open
Abstract
A negative association between sleep duration and BMI has been observed in children. However, knowledge about the association between sleep duration and diet is limited. The objective was to examine the association between sleep duration and intake of foods and nutrients in children. In the present cross-sectional study, dietary intake and sleep duration were recorded by the parents for seven consecutive days in a food and sleep record in a representative sample of 802 4- to 14-year-old children. No sex differences were found regarding age and sleep duration. Sleep duration was negatively correlated to age (ρ = -0·68; P < 0·001) and BMI (ρ = -0·41; P < 0·001). In multiple linear regression analyses, sleep duration was not associated with energy intake (b = -0·015; P = 0·20), but there was a trend towards a positive association with intake of dietary fibre (b = 0·006; P = 0·05) and vegetables (b = 0·011; P = 0·05), and a negative association with intake of poultry (b = -0·002; P = 0·02), and a trend towards a negative association with intake of liquid 'discretionary calories' (b = -0·01; P = 0·05). Furthermore, in a comparison of dietary intake between age-dependent tertiles of sleep duration, only intake of liquid 'discretionary calories' was significantly lower in long sleepers than in short and medium sleepers (P = 0·03). In conclusion, sleep duration was not associated with energy intake and the proposal that children with short sleep duration have less healthy eating habits than children with longer sleep duration was only weakly supported by the present findings.
Collapse
|
33
|
Foty RG, Nelligan K, To T, Stieb DM, Dell SD. Children with Asthma Are Less Likely to Walk to School. PEDIATRIC ALLERGY IMMUNOLOGY AND PULMONOLOGY 2013. [DOI: 10.1089/ped.2012.0203] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Richard G. Foty
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kathleen Nelligan
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Teresa To
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | | | - Sharon D. Dell
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Division of Respiratory Medicine, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| |
Collapse
|
34
|
Amigo I, Busto R, Peña-Suárez E, Pena E, Fernández C. [Prevalence of overweight and obesity in 9 and 10 year-old children in the Principality of Asturias: evaluation bias by parents]. An Pediatr (Barc) 2013; 79:307-11. [PMID: 23726686 DOI: 10.1016/j.anpedi.2013.04.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Revised: 03/19/2013] [Accepted: 04/16/2013] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION Overweight and obesity in children is a very important issue in the field of health. The aim of this study was to determine the prevalence of overweight and obesity in pre-adolescent children aged 9 to 10 years old in the Principality of Asturias, and to assess the reliability of the measurements of weight and height reported by parents. MATERIAL AND METHOD A sample of 291 subjects, 142 girls and 149 boys were chosen at random from the network of schools in the Principality of Asturias. They were weighed and measured individually at the school. All participants brought the signed consent of their parents, which also contained the anthropometric measurements of they made of their children. RESULTS The results showed that 28.17% of children aged 9 and 10 years old in the Principality of Asturias were overweight and 15.80% obese. This means that 44% of the sample had some degree of overweight. Data reported by parents underestimated the weight of both the boys and girls by an average of 2.07kg. CONCLUSIONS The high percentage of excess weight observed is due to the categorisation system used (IOFT) and the age of the sample. The results call into question the research with data indirectly recorded data.
Collapse
Affiliation(s)
- I Amigo
- Departamento de Psicología, Universidad de Oviedo, Oviedo, España.
| | | | | | | | | |
Collapse
|
35
|
Reuter CP, Burgos LT, Camargo MD, Possuelo LG, Reckziegel MB, Reuter ÉM, Meinhardt FP, Burgos MS. Prevalence of obesity and cardiovascular risk among children and adolescents in the municipality of Santa Cruz do Sul, Rio Grande do Sul. SAO PAULO MED J 2013; 131:323-30. [PMID: 24310801 PMCID: PMC10876324 DOI: 10.1590/1516-3180.2013.1315518] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 01/07/2013] [Indexed: 01/07/2023] Open
Abstract
CONTEXT AND OBJECTIVE Studies have demonstrated that metabolic complications from child obesity, although silent, increase the risk of development of cardiovascular diseases in adulthood. The present paper sought to describe the prevalence of overweight/obesity and analyze the possible relationship between obesity and other cardiovascular risk factors among children and adolescents. DESIGN AND SETTING Cross-sectional study, conducted in a university. METHODS The study included 564 children and adolescents, aged 8 to 17 years. Body mass index and waist circumference were used to evaluate obesity. Other cardiovascular risk factors were evaluated, like systolic and diastolic blood pressure, glycemia, triglycerides and total cholesterol. Descriptive analysis was used for sample characterization, the chi-square test for categorical variables and Pearson's linear correlation for evaluating the relationship between obesity indicators and other cardiovascular risk factors. RESULTS High prevalence of overweight/obesity was found among the schoolchildren (25.3% among the boys and 25.6% among the girls), along with abdominal obesity (19.0%). The overweight/obese schoolchildren presented higher percentages for the pressure and biochemical indicators, compared with underweight and normal-weight schoolchildren. Body mass index and waist circumference showed a weak correlation with the variables of age and systolic and diastolic blood pressure (P < 0.001), but there was no correlation between these obesity indices and biochemical variables. CONCLUSION The high prevalence of overweight/obesity and its relationship with other cardiovascular risk factors demonstrate that it is necessary to develop intervention and prevention strategies from childhood onwards, in order to avoid development of chronic-degenerative diseases in adulthood.
Collapse
Affiliation(s)
- Cézane Priscila Reuter
- BSc. Pharmacist. Master Degree in Health Promotion, Universidade de Santa Cruz do Sul (UNISC), Santa Cruz do Sul.
| | - Leandro Tibiriçá Burgos
- Doctoral studentin Human Movement Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Marcelo Dias Camargo
- MSc. Professor, Department of Physical Education and Health, Universidade de Santa Cruz do Sul (UNISC), Santa Cruz do Sul, Rio Grande do Sul, Brazil.
| | - Lia Gonçalves Possuelo
- MSc. Doctoral Student in Health Sciences, Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul/Hospital de Clínicas de Porto Alegre (UFRGS/HCPA).
| | - Miriam Beatris Reckziegel
- Doctoral studentin Human Movement Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Éboni Marília Reuter
- Physical Educator, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Francielle Pasqualotti Meinhardt
- PhD. Professor, Department of Biology and Pharmacy and Postgraduate Course (Stricto Sensu) on Health Promotion, Universidade de Santa Cruz do Sul (UNISC), Santa Cruz do Sul, Rio Grande do Sul, Brazil.
| | - Miria Suzana Burgos
- BSc. Physiotherapist. Master's Student in Health Promotion, Universidade de Santa Cruz do Sul (UNISC), Santa Cruz do Sul, Rio Grande do Sul, Brazil.
| |
Collapse
|
36
|
Segna D, Widhalm H, Pandey MP, Zehetmayer S, Dietrich S, Widhalm K. Impact of mother tongue and gender on overweight, obesity and extreme obesity in 24,989 Viennese children/adolescents (2-16 years). Wien Klin Wochenschr 2012. [PMID: 23179432 DOI: 10.1007/s00508-012-0277-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The present survey aims at determining the prevalence of extreme obesity (defined as a body mass index (BMI) ≥ 99.5th percentile) for the first time in Austria and at investigating the relationship between weight status and mother tongue in a representative Viennese sample of 24,989 children and adolescents (2-16 years) with a percentage of approximately 46 % of migration background.Directly measured anthropometric data on body weight and height were collected and BMI was calculated. Prevalence of overweight, obesity and extreme obesity was determined for every subgroup according to mother tongue using the German national reference criteria by Kromeyer-Hauschild et al.In this sample, 2.1 % of all children and adolescents had to be classified as being extremely obese. More boys (2.3 %) than girls (1.9 %) suffered from extreme obesity (p = 0.048). Total 1.7 % of children and adolescents with German as their native language, 2.5 % of Turkish native speakers and 2.9 % of children and adolescents with another mother tongue were extremely obese (p ≤ 0.001). The highest prevalence of overweight or obesity was found in Turkish-native-speaking children and adolescents (p ≤ 0.001), whereas the lowest one was found in German-native-speaking children and adolescents (p ≤ 0.001).This large study clearly shows that extreme obesity is a common disease and largely neglected. Apparently, another native language than German, as an indicator for a migration background, may be associated with a substantially higher probability for the development of extreme obesity in Vienna, Austria. Thus, effective preventive measures to overcome obesity are urgently needed.
Collapse
Affiliation(s)
- Daniel Segna
- Division of Nutrition and Metabolism, Department of Pediatrics, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | | | | | | | | | | |
Collapse
|