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Nowicka P, Ek A, Jurca-Simina IE, Bouzas C, Argelich E, Nordin K, García S, Vasquez Barquero MY, Hoffer U, Reijs Richards H, Tur JA, Chirita-Emandi A, Eli K. Explaining the complex impact of the Covid-19 pandemic on children with overweight and obesity: a comparative ecological analysis of parents' perceptions in three countries. BMC Public Health 2022; 22:1000. [PMID: 35581642 PMCID: PMC9113066 DOI: 10.1186/s12889-022-13351-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 05/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Covid-19 pandemic has changed children's eating and physical activity behaviours. These changes have been positive for some households and negative for others, revealing health inequalities that have ramifications for childhood obesity. This study investigates the pandemic's impact on families of children aged 2-6 years with overweight or obesity. METHODS Drawing on interviews conducted as part of a randomised controlled trial (RCT) for childhood obesity, thematic analysis was used to examine how parents of pre-schoolers perceived changes in their eating, screentime and physical activity behaviours between the first and second waves of Covid-19. Parents (n = 70, representing 68 families) were interviewed twice during a period of 6 months in three countries with markedly different pandemic policies - Sweden, Romania, and Spain. The analysis is informed by Bronfenbrenner's ecological systems theory, which embeds home- and school-based influences within societal and policy contexts. RESULTS The findings show that, although all participants were recruited from an RCT for families of children with excess weight, they reported different responses to the pandemic's second wave, with some children engaging in healthier eating and physical activity, and others engaging in comfort eating and a more sedentary lifestyle. Differences in children's obesity-related behaviours were closely related to differences in parents' practices, which were, in turn, linked to their emotional and social wellbeing. Notably, across all sites, parents' feeding and physical activity facilitation practices, as well as their emotional and social wellbeing, were embedded in household resilience. In resilient households, where parents had secure housing and employment, they were better able to adapt to the challenges posed by the pandemic, whereas parents who experienced household insecurity found it more difficult to cope. CONCLUSIONS As the Covid-19 pandemic is turning into a long-term public health challenge, studies that address household resilience are crucial for developing effective prevention and treatment responses to childhood obesity.
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Affiliation(s)
- P Nowicka
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden. .,Department of Food Studies, Nutrition and Dietetics, University of Uppsala, Uppsala, Sweden.
| | - A Ek
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - I E Jurca-Simina
- Department of Microscopic Morphology Genetics Discipline, Center of Genomic Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - C Bouzas
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain
| | - E Argelich
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain
| | - K Nordin
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - S García
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain
| | - M Y Vasquez Barquero
- Department of Food Studies, Nutrition and Dietetics, University of Uppsala, Uppsala, Sweden
| | - U Hoffer
- Department of Food Studies, Nutrition and Dietetics, University of Uppsala, Uppsala, Sweden
| | - H Reijs Richards
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - J A Tur
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain
| | - A Chirita-Emandi
- Department of Microscopic Morphology Genetics Discipline, Center of Genomic Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - K Eli
- Department of Food Studies, Nutrition and Dietetics, University of Uppsala, Uppsala, Sweden.,School of Anthropology and Museum Ethnography, University of Oxford, Oxford, UK.,Warwick Medical School, University of Warwick, Coventry, UK
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2
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Duncanson K, Shrewsbury V, Burrows T, Chai LK, Ashton L, Taylor R, Gow M, Ho M, Ells L, Stewart L, Garnett S, Jensen ME, Nowicka P, Littlewood R, Demaio A, Coyle DH, Walker JL, Collins CE. Impact of weight management nutrition interventions on dietary outcomes in children and adolescents with overweight or obesity: a systematic review with meta‐analysis. J Hum Nutr Diet 2020; 34:147-177. [DOI: 10.1111/jhn.12831] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/28/2020] [Accepted: 10/02/2020] [Indexed: 12/19/2022]
Affiliation(s)
- K. Duncanson
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
| | - V. Shrewsbury
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
| | - T. Burrows
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
| | - L. K. Chai
- Health and Wellbeing Queensland Queensland Government Milton QLD Australia
- Centre for Children’s Health Research Institute of Health and Biomedical Innovation Exercise and Nutrition Queensland University of Technology South Brisbane QLD Australia
| | - L. Ashton
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
| | - R. Taylor
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
| | - M. Gow
- Institute of Endocrinology and Diabetes The Children’s Hospital at Westmead Westmead NSW Australia
- Children’s Hospital at Westmead Clinical School The University of Sydney Westmead NSW Australia
| | - M. Ho
- School of Nursing The University of Hong Kong Pokfulam Hong Kong
| | - L. Ells
- School of Clinical and Applied Sciences Leeds Beckett University Leeds UK
- Teesside Centre for Evidence Informed Practice: a Joanna Briggs Institute Centre of Excellence Middlesbrough UK
| | - L. Stewart
- Appletree Healthy Lifestyle Consultancy Perth UK
| | - S. Garnett
- Institute of Endocrinology and Diabetes The Children’s Hospital at Westmead Westmead NSW Australia
- Children’s Hospital at Westmead Clinical School The University of Sydney Westmead NSW Australia
| | - M. E. Jensen
- Priority Research Centre Grow Up Well and Faculty of Health and Medicine The University of Newcastle Callaghan NSW Australia
| | - P. Nowicka
- Department of Food Studies, Nutrition and Dietetics Uppsala University Uppsala Sweden
| | - R. Littlewood
- Health and Wellbeing Queensland Queensland Government Milton QLD Australia
- School of Human Movement and Nutrition Sciences The University of Queensland St Lucia QLD Australia
| | - A. Demaio
- Victorian Health Promotion Foundation Carlton South VIC Australia
| | - D. H. Coyle
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
- The George Institute for Global Health University of New South Wales Sydney NSW Australia
| | - J. L. Walker
- School of Human Movement and Nutrition Sciences The University of Queensland St Lucia QLD Australia
| | - C. E. Collins
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
- The University of Newcastle Centre for Evidence Based Healthcare Informing Research (CEBHIR): a Joanna Briggs Institute Centre of Excellence Callaghan NSW Australia
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Cano-Lamadrid M, Hernández F, Nowicka P, Carbonell-Barrachina A, Wojdyło A. Formulation and storage effects on pomegranate smoothie phenolic composition, antioxidant capacity and color. Lebensm Wiss Technol 2018. [DOI: 10.1016/j.lwt.2018.05.047] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Taylor JH, Xu Y, Li F, Shaw M, Dziura J, Caprio S, Tamborlane WV, Nowicka P, Savoye M. Psychosocial predictors and moderators of weight management programme outcomes in ethnically diverse obese youth. Pediatr Obes 2017; 12:453-461. [PMID: 27384496 PMCID: PMC5568975 DOI: 10.1111/ijpo.12165] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 05/01/2016] [Accepted: 05/08/2016] [Indexed: 02/01/2023]
Abstract
BACKGROUND An important area of research in childhood obesity is the identification of factors that predict or moderate the responses to obesity intervention programmes, yet few studies have examined the impact of self-esteem and family functioning on obesity treatment outcomes. OBJECTIVES We sought to determine whether baseline self-esteem and family functioning predicted or moderated childhood obesity intervention outcomes at 6 months. METHODS From 2009 to 2011, seventy-five 10-16 year old, racially/ethnically diverse obese youths with abnormal glucose tolerance were randomized to 6 months of an intensive family-based obesity lifestyle intervention (Bright Bodies) or routine outpatient Clinic Care. We examined youth self-concept, parent-rated family functioning and 6-month outcomes (youths' glucose tolerance, weight, body mass index and percent fat). We set the significance threshold as P ≤ 0.05 for moderator and predictor analyzes. RESULTS Having poor family functioning and self-concept scores indicating high anxiety and low self-esteem at baseline predicted poor 6-month outcomes overall (Bright Bodies and Clinic Care groups combined). Additionally, baseline self-esteem and family functioning moderated treatment effects such that Bright Bodies outperformed Clinic Care in youths with low self-esteem and poorly functioning families, whereas youths with high self-esteem and high-functioning families did similarly well with either intervention. DISCUSSION Our findings suggest intensive family-based lifestyle programmes are particularly beneficial for youth with low self-esteem and poorly functioning families.
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Affiliation(s)
- J H Taylor
- Yale Child Study Center, New Haven, CT, USA
- Yale Department of Psychiatry, New Haven, CT, USA
| | - Y Xu
- Yale School of Public Health, New Haven, CT, USA
| | - F Li
- Yale School of Public Health, New Haven, CT, USA
| | - M Shaw
- Yale Pediatric Endocrinology, New Haven, CT, USA
| | - J Dziura
- Yale School of Public Health, New Haven, CT, USA
| | - S Caprio
- Yale Pediatric Endocrinology, New Haven, CT, USA
| | | | - P Nowicka
- Department of Food, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
- Division of Pediatrics, Department of Clinical Science Intervention and Technology, Karolinska Institute, Stockholm, Sweden
| | - M Savoye
- Yale Pediatric Endocrinology, New Haven, CT, USA
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5
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Somaraki M, Eli K, Sorjonen K, Flodmark CE, Marcus C, Faith MS, Osowski CP, Ek A, Nowicka P. Perceived child eating behaviours and maternal migrant Background. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Somaraki
- Department of Food, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - K Eli
- Department of Food, Nutrition and Dietetics, Uppsala University, Oxford, UK
| | - K Sorjonen
- Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
| | - CE Flodmark
- Childhood Obesity Unit, Skåne University Hospital, Malmö, Sweden
| | - C Marcus
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - MS Faith
- Department of Counseling, School, and Educational Psychology, University of Buffalo, Buffalo, NY, United States
| | - C Persson Osowski
- Department of Food, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - A Ek
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - P Nowicka
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
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6
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Ulijaszek SJ, Pentecost M, Marcus C, Karpe F, Frühbeck G, Nowicka P. Inequality and childhood overweight and obesity: a commentary. Pediatr Obes 2017; 12:195-202. [PMID: 26990034 DOI: 10.1111/ijpo.12128] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 02/17/2016] [Indexed: 02/02/2023]
Abstract
Statements on childhood overweight and obesity (COO) have focused on different avenues for prevention and treatment, critical stages of the life cycle, including pregnancy and lactation, individual, family, school and community-based interventions, multidisciplinary family programmes and multicomponent interventions. This commentary is concerned with the less-addressed relationship between COO and inequality. It describes current global patterns of inequality and COO and the ways in which those inequalities are linked to COO at micro-level, meso-level and macro-level. It then describes current programmatic approaches for COO inequality, preventive and medical, and considers important pitfalls in the framing of the problem of COO and inequality. It ends with describing how childhood and adolescent overweight and obesity prevention and treatment programmes might be formulated within broader socio-political frameworks to influence outcomes.
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Affiliation(s)
- S J Ulijaszek
- School of Anthropology, University of Oxford, Oxford, UK
| | - M Pentecost
- School of Anthropology, University of Oxford, Oxford, UK
| | - C Marcus
- Karolinska Institutet, Stockholm, Sweden
| | - F Karpe
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - G Frühbeck
- Department of Endocrinology and Nutrition, Clinica Universidad de Navarra, CIBEROBN, IdiSNA, Pamplona, Spain
| | - P Nowicka
- Karolinska Institutet, Stockholm, Sweden.,Department of Food, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
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Lindberg L, Ek A, Nyman J, Marcus C, Ulijaszek S, Nowicka P. Low grandparental social support combined with low parental socioeconomic status is closely associated with obesity in preschool-aged children: a pilot study. Pediatr Obes 2016; 11:313-6. [PMID: 26097148 DOI: 10.1111/ijpo.12049] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 04/14/2015] [Accepted: 05/20/2015] [Indexed: 11/30/2022]
Abstract
While the influence of parental socioeconomic status (SES) on children's weight status is well known, the impact of other family-related aspects such as parental and grandparental social support is less understood. This study investigates the importance of parents' SES and social support (functional and structural) for weight status in a clinical sample of preschoolers 4-6 years old with obesity (n = 39, 56% girls; 73% of parents were overweight/obese, 50% were of non-Swedish origin). Linear regression analyses, simple and multiple, were performed on SES and social support with child BMI SDS (body mass index standard deviation score) as the dependent variable. The results show that parents' income and low emotional support from paternal grandparents were significantly associated with more severe obesity. The association between parental income and the child's BMI SDS was stronger among parents who had low emotional support from their own parents. In conclusion, grandparental social support may be protective against childhood obesity.
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Affiliation(s)
- L Lindberg
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - A Ek
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - J Nyman
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - C Marcus
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - S Ulijaszek
- Unit for Biocultural Variation and Obesity, Institute of Social and Cultural Anthropology, University of Oxford, Oxford, UK
| | - P Nowicka
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Unit for Biocultural Variation and Obesity, Institute of Social and Cultural Anthropology, University of Oxford, Oxford, UK
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8
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Lindberg L, Ek A, Nyman J, Marcus C, Ulijaszek S, Nowicka P. Low parental economic capital and low grandparental social support are closely associated with obesity in preschool-aged children. Preliminary findings. Appetite 2015. [DOI: 10.1016/j.appet.2014.12.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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9
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Ek A, Sorjonen K, Marcus C, Nowicka P. Overeating and physical inactivity in preschool-aged children challenge parents and their confidence. Results from the Lifestyle Behaviour Checklist and the Child Feeding Questionnaire. Appetite 2015. [DOI: 10.1016/j.appet.2014.12.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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10
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Svensson V, Johansson E, Ek A, Forssén M, Ekbom K, Nowicka P, Ekstedt M, Hagströmer M, Marcus C. Effects of one year obesity prevention on relative weight and dietary intake in toddlers with overweight or obese parents. Early STOPP, a randomized controlled intervention. Appetite 2015. [DOI: 10.1016/j.appet.2014.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Nyman J, Ek A, Marcus C, Nowicka P. Comparing different treatment approaches to childhood obesity in preschoolers. Preliminary results of the More and Less study, a randomized controlled trial. Appetite 2015. [DOI: 10.1016/j.appet.2014.12.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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12
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Svensson V, Ek A, Forssén M, Ekbom K, Cao Y, Ebrahim M, Johansson E, Nero H, Hagströmer M, Ekstedt M, Nowicka P, Marcus C. Infant growth is associated with parental education but not with parental adiposity - Early Stockholm Obesity Prevention Project. Acta Paediatr 2014; 103:418-25. [PMID: 24387055 DOI: 10.1111/apa.12551] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 12/23/2013] [Accepted: 01/02/2014] [Indexed: 12/24/2022]
Abstract
AIM To explore the simultaneous impact of parental adiposity and education level on infant growth from birth to 12 months, adjusting for known early-life risk factors for subsequent childhood obesity. METHODS Baseline data for 197 one-year-old children and their parents, participating in a longitudinal obesity intervention, were used. Obesity risk groups, high/low, were defined based on parental body mass index (n = 144/53) and parental education (n = 57/139). Observational data on infant growth between 0 and 12 months were collected. The children's relative weight (body mass index standard deviation score) at 3, 6 and 12 months and rapid weight gain 0-6 months were analysed in regression models, with obesity risk as primary exposure variables, adjusting for gestational weight gain, birth weight, short exclusive breastfeeding and maternal smoking. RESULTS Relative weight at 3, 6 and 12 months was associated with low parental education but not with parental adiposity. No significant associations were observed with rapid weight gain. None of the early-life factors could explain the association with parental education. CONCLUSION Low parental education level is independently associated with infant growth, whereas parental obesity does not contribute to a higher weight or to rapid weight gain during the first year.
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Affiliation(s)
- V Svensson
- Division of Pediatrics; Department of Clinical Science, Intervention and Technology; Karolinska Institutet; Stockholm Sweden
| | - A Ek
- Division of Pediatrics; Department of Clinical Science, Intervention and Technology; Karolinska Institutet; Stockholm Sweden
| | - M Forssén
- Division of Pediatrics; Department of Clinical Science, Intervention and Technology; Karolinska Institutet; Stockholm Sweden
| | - K Ekbom
- Division of Pediatrics; Department of Clinical Science, Intervention and Technology; Karolinska Institutet; Stockholm Sweden
| | - Y Cao
- Division of Pediatrics; Department of Clinical Science, Intervention and Technology; Karolinska Institutet; Stockholm Sweden
| | - M Ebrahim
- Division of Pediatrics; Department of Clinical Science, Intervention and Technology; Karolinska Institutet; Stockholm Sweden
| | - E Johansson
- Division of Pediatrics; Department of Clinical Science, Intervention and Technology; Karolinska Institutet; Stockholm Sweden
| | - H Nero
- Division of Physiotherapy; Department of Neurobiology, Care Sciences and Society; Karolinska Institutet; Stockholm Sweden
| | - M Hagströmer
- Division of Physiotherapy; Department of Neurobiology, Care Sciences and Society; Karolinska Institutet; Stockholm Sweden
| | - M Ekstedt
- Division of Patient Safety; School of Technology and Health; Royal Institute of Technology; Stockholm Sweden
| | - P Nowicka
- Division of Pediatrics; Department of Clinical Science, Intervention and Technology; Karolinska Institutet; Stockholm Sweden
| | - C Marcus
- Division of Pediatrics; Department of Clinical Science, Intervention and Technology; Karolinska Institutet; Stockholm Sweden
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Abstract
AIM To study self-esteem in clinical sample of obese children and adolescents. METHODS Obese children and adolescents aged 8-19 years (n = 107, mean age 13.2 years, mean BMI 32.5 [range 22.3-50.6], mean BMI z-score 3.22 [range 2.19-4.79]; 50 boys and 57 girls) were referred for treatment of primary obesity. Self-esteem was measured with a validated psychological test with five subscales: physical characteristics, talents and skills, psychological well-being, relations with the family and relations with others. A linear mixed effect model used the factors gender and adolescence group, and the continuous covariates: BMI z-scores, and BMI for the parents as fixed effects and subjects as random effects. RESULTS Age and gender, but neither the child's BMI z-score nor the BMI of the parents were significant covariates. Self-esteem decreased (p < 0.01) with age on the global scale as well as on the subscales, and was below the normal level in higher ages in both genders. Girls had significantly lower self-esteem on the global scale (p = 0.04) and on the two subscales physical characteristics (p < 0.01) and psychological well-being (p < 0.01). CONCLUSION Self-esteem is lower in girls and decreases with age. In treatment settings special attention should be paid to adolescent girls.
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Affiliation(s)
- P Nowicka
- Childhood Obesity Unit, University Hospital Malmö, Malmö, Sweden.
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Abstract
Changes in physical activity with the aim of increasing energy expenditure are usually an important component of childhood obesity treatment. Physical activity also has several other aspects that are positive for the obese child's health, such as improving the metabolic profile and psychological well being. The aim of this paper is to give a short review of what we know about physical activity in paediatric obesity treatment. In addition, practical recommendations will be presented which a health care provider can suggest to obese children and their families with a special focus on daily activity, participation in physical education classes and sports, sedentary behaviours, active commuting to school and how to get family and friends involved in supporting the child.
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Affiliation(s)
- P Nowicka
- Childhood Obesity Unit, University Hospital Malmö, Sweden.
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15
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Nowicka P. Landscaping for the future. Hosp Dev 1984; 12:22. [PMID: 10268625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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