All eUpdates are produced by Knowledge Services, NHS Lanarkshire Submit your literature search request to: [email protected]Child Healthy Weight February 2018 1. Barstad,Lisa Ha, Júlíusson,Pétur B., Johnson,Line Kristin, Hertel,Jens Kristoffer, Lekhal,Samira and Hjelmesæth,Jøran. Gender-related differences in cardiometabolic risk factors and lifestyle behaviors in treatment-seeking adolescents with severe obesity. BMC Pediatr. 2018 18 1-8 Background: Obesity during adolescence is associated with cardiovascular mortality in adulthood. The adverse obesity-related cardiometabolic risk profile is already observed in adolescence. We aimed to examine possible gender differences in cardiometabolic risk factors and lifestyle behaviors among adolescents with severe obesity, hypothesizing that boys would have both a higher prevalence of the metabolic syndrome as well as less healthy lifestyle behaviors than girls.Methods: Cross-sectional study of treatment-seeking adolescents with severe obesity who attended the Morbid Obesity Centre at Vestfold Hospital Trust and who were consecutively enrolled in the Vestfold Register of Obese Children between September 2009 and September 2015. A total of 313 adolescents aged 12 to 18 years were recruited, whereof 268 subjects (49% boys) completed a food and activity frequency questionnaire and were included in the analysis.Results: Mean (SD) age, BMI and BMI SDS were 15 (1.6) years, 38.6 (5.9) kg/m2 and 3.5 (0.6). Levels of LDL cholesterol, fasting insulin and glucose and diastolic blood pressure (DBP) did not differ between genders. Compared to girls, boys had significantly higher triglycerides (p = 0.037) and systolic blood pressure (SBP) (p = 0.003), as well as lower HDL cholesterol (p = 0.002). The metabolic syndrome was present in 27% of the boys and 19% of the girls (p = 0.140), and the prevalence of high DBP, dyslipidemia and dysglycemia also did not differ significantly between genders. The prevalence of high SBP was higher in boys than in girls (19% vs. 9%, p = 0.021). Gender was associated with a number of lifestyle habits, as a larger proportions of boys had higher screen time (p = 0.032), more regular breakfast eating (p = 0.023), higher intake of sugar sweetened soda (p = 0.036), and lower intake of vegetables than girls (p = 0.011). By contrast, physical activity level and intake of fruit and berries did not differ between genders.Conclusions: Male treatment-seeking adolescents with severe obesity had a more unfavorable set of metabolic and behavioral risk factors for cardiovascular disease than girls. Our results indicate that lifestyle behavioral markers should be thoroughly assessed in both genders, and possible gender-related differences in risk profile should be taken into account in future treatment programs.
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All eUpdates are produced by Knowledge Services, NHS Lanarkshire
1. Barstad,Lisa Ha, Júlíusson,Pétur B., Johnson,Line Kristin, Hertel,Jens Kristoffer, Lekhal,Samira and Hjelmesæth,Jøran. Gender-related differences in cardiometabolic risk factors and lifestyle behaviors in treatment-seeking adolescents with severe obesity. BMC Pediatr. 2018 18 1-8 Background: Obesity during adolescence is associated with cardiovascular mortality in adulthood. The adverse obesity-related cardiometabolic risk profile is already observed in adolescence. We aimed to examine possible gender differences in cardiometabolic risk factors and lifestyle behaviors among adolescents with severe obesity, hypothesizing that boys would have both a higher prevalence of the metabolic syndrome as well as less healthy lifestyle behaviors than girls.Methods: Cross-sectional study of treatment-seeking adolescents with severe obesity who attended the Morbid Obesity Centre at Vestfold Hospital Trust and who were consecutively enrolled in the Vestfold Register of Obese Children between September 2009 and September 2015. A total of 313 adolescents aged 12 to 18 years were recruited, whereof 268 subjects (49% boys) completed a food and activity frequency questionnaire and were included in the analysis.Results: Mean (SD) age, BMI and BMI SDS were 15 (1.6) years, 38.6 (5.9) kg/m2 and 3.5 (0.6). Levels of LDL cholesterol, fasting insulin and glucose and diastolic blood pressure (DBP) did not differ between genders. Compared to girls, boys had significantly higher triglycerides (p = 0.037) and systolic blood pressure (SBP) (p = 0.003), as well as lower HDL cholesterol (p = 0.002). The metabolic syndrome was present in 27% of the boys and 19% of the girls (p = 0.140), and the prevalence of high DBP, dyslipidemia and dysglycemia also did not differ significantly between genders. The prevalence of high SBP was higher in boys than in girls (19% vs. 9%, p = 0.021). Gender was associated with a number of lifestyle habits, as a larger proportions of boys had higher screen time (p = 0.032), more regular breakfast eating (p = 0.023), higher intake of sugar sweetened soda (p = 0.036), and lower intake of vegetables than girls (p = 0.011). By contrast, physical activity level and intake of fruit and berries did not differ between genders.Conclusions: Male treatment-seeking adolescents with severe obesity had a more unfavorable set of metabolic and behavioral risk factors for cardiovascular disease than girls. Our results indicate that lifestyle behavioral markers should be thoroughly assessed in both genders, and possible gender-related differences in risk profile should be taken into account in future treatment programs.
2. Buscemi,Silvio, Marventano,Stefano, Castellano,Sabrina, et al. Role of anthropometric factors, self-perception, and diet on weight misperception among young adolescents: a cross-sectional study. Eat.Weight Disord. 2018 23 1 107-115 Purpose: Adolescence overweight and obesity have increased considerably, and the misperception of their weight status could reduce the efficiency of intervention programs. The aim of this study was to evaluate the prevalence rate of misperception and to assess the relationship between weight perception and anthropometric parameters, self-perception, physical activity, and adherence to the Mediterranean diet.Methods: A total of 1643 young adolescents (11-16 years old) were surveyed in a cross-sectional investigation during two scholastic years (period October-May of 2012-2013 and 2013-2014) in 15 secondary schools of Sicily, southern Italy. Data on demographic information, anthropometric characteristics (bioelectrical impedance), physical activity level, The Children and Youth Physical Self-Perception Profile, weight perception, and dietary habits (KIDMED) were collected.Results: Misperception was found in the 27.6 % of the young adolescents, and boys were more likely to underestimate their weight status, while girls had a high percentage of overestimation. The strong association with weight misperception was with socioeconomic status, waist circumference, physical activities, and physical self-worth. Moreover, a good adherence to the Mediterranean diet was inversely associated with both overestimation and underestimation in both boys and girls.Conclusion: These findings highlight that almost one-third of the participants had a weight misperception that was associated with several anthropometric, social, and lifestyle factors. Future intervention to prevent overweight and obesity should consider not only gender-specific differences, but also parental SES, perception, and satisfaction of body weight status.
3. Canterberry,Melanie, Francois,Samantha, van Hattum,Taslim, Rudov,Lindsey and Carton,Thomas W. School Lunch Consumption Among 3 Food Service Providers in New Orleans. J.Sch.Health. 2018 88 2 93-100 ABSTRACT: BACKGROUND: Louisiana has one of the highest rates of overweight and obese children in the United States. The Healthy School Food Collaborative (HSFC) was created to allow New Orleans's schools to select their own healthy school Food Service Provider (FSP) with requirements for higher nutritional standards than traditional options. The
goal of this cross‐sectional study was to examine whether HSFC membership was associated with lunch consumption rates in elementary school children. METHODS:
An 8‐week plate waste study examining 18,070 trays of food among fourth and fifth graders was conducted. Participants included 7 schools and the 3 FSPs (2 HSFC
and 1 non‐HSFC member) that serviced them. Mixed models analysis examined whether consumption rates of food items differed among FSPs. RESULTS: On average, students consumed 307 cal during lunch. Analyses showed significant differences in consumption rates of entrée, vegetables, fruit, and milk between the 3 FSPs (p < .01). The highest consumption rate was among entrées at 65%. One
HSFC provider had consumption levels consistent with the non‐HSFC FSP. CONCLUSIONS: Overall, students consumed less than 60% of the US Department of Agriculture recommended calories for school lunch. While overall caloric
consumption was higher among the non‐HSFC schools, interventions to increase lunch consumption across all schools are needed.
4. da,Silva Julio, Tauil Paladino,Roberto, Reis Hausen,Lucas, et al. Relationship of the Physical Activity and Percentage of Fat of Schoolars. REV ENFERMAGEM UFPE. 2018 12 2 481-488 Objective: to identify the level of Physical Activity and Percentage of Body Fat of schoolchildren. Method: cross-sectional quantitative study of 640 schoolchildren (Age: 10 ° 1 years; Body Mass, 37.25 ° 13.90 kg; Stature, 1.45 ° 0.08 m; BMI, 17.50 ° 5.04 kg/m²). The NAF by PAQ-C, % GC by the skinfold method and the BMI. Results: there were significant differences (p <0.01, d = 0.37) in the PAQ-C score between the sexes, with superiority in the male values; (p <0.0001, d = 6.7) and in the CG distribution by gender (p <0.0001, d = 0.28). Conclusion: obesity rates among schoolchildren (43% and 53.10%, female and male, respectively) were identified at the same time as this population shows that they are active or moderately physically active (67.07% and 67.56%, male and female, respectively); however, no association was identified between Physical Activity Level and Body Fat Percentage. These results corroborate the general findings of the literature that demonstrate that PAL is not a determinant factor for the Percentage of Body Fat.
5. Dumuid,Dorothea, Olds,T., Lewis,L. K., et al. The adiposity of children is
associated with their lifestyle behaviours: a cluster analysis of school‐aged children from 12 nations. PEDIATR OBESITY. 2018 13 2 111-119 Summary: Background: The relationship between children's adiposity and lifestyle behaviour patterns is an area of growing interest. Objectives: The objectives of this study are to identify clusters of children based on lifestyle behaviours and compare children's adiposity
among clusters. Methods: Cross‐sectional data from the International Study of Childhood Obesity, Lifestyle and the Environment were used. Participants: the
participants were children (9–11 years) from 12 nations (n = 5710). Measures: 24‐h accelerometry and self‐reported diet and screen time were clustering input variables. Objectively measured adiposity indicators were waist‐to‐height ratio, percent body fat
and body mass index z‐scores. Analysis: sex‐stratified analyses were performed on the global sample and repeated on a site‐wise basis. Cluster analysis (using isometric log ratios for compositional data) was used to identify common lifestyle behaviour patterns. Site representation and adiposity were compared across clusters using linear models. Results: Four clusters emerged: (1) Junk Food Screenies, (2)
Actives, (3) Sitters and (4) All‐Rounders. Countries were represented differently among clusters. Chinese children were over‐represented in Sitters and Colombian children in Actives. Adiposity varied across clusters, being highest in Sitters and lowest in Actives. Conclusions: Children from different sites clustered into groups of similar lifestyle behaviours. Cluster membership was linked with differing adiposity. Findings support the implementation of activity interventions in all countries, targeting both physical activity and sedentary time.
6. Hardy,Louise L., Bell,Jane, Bauman,Adrian and Mihrshahi,Seema. Association
between adolescents’ consumption of total and different types of sugar‐sweetened beverages with oral health impacts and weight status. AUST NZ J PUBLIC HEALTH. 2018 42 1 22-26 Abstract: Objective: To examine the associations between
adolescents’ intake of sugar‐sweetened beverages (SSBs) with oral health impacts
(OHI) and weight status. Methods: Cross‐sectional health survey with anthropometry and self‐report OHI (toothache and avoiding some foods because of oral problems) and SSB intake (fruit juice, flavoured water, soft, diet, sports and energy drinks)
collected in 2015. Results: A total of 3,671 adolescents participated (50% girls; mean age 13.2 years ±1.7). Drinking ≥1cup/day of SSBs was consistently associated with higher odds of OHI compared with drinking <1cup/day: diet soft drinks (AOR, 5.21 95%CI 2.67, 10.18); sports drinks (AOR 3.60 95%CI 1.93, 6.73); flavoured water (AOR 3.07 95%CI 1.55, 6.06); and energy drinks (AOR 2.14 95%CI 1.44, 3.19). Daily SSB intake was not consistently associated with weight status. The odds of overweight/obesity (AOR 1.27 95%CI 1.01, 1.59) and obesity (AOR 1.61 95%CI 1.01, 2.57) were higher for energy drink consumption, compared with not drinking energy drinks; and the odds of abdominal obesity were twice as high among adolescents who drank ≥1cup/day of sports drinks, compared with <1cup/day intake. Conclusions: Daily consumption of SSBs is prevalent among adolescents and is consistently associated with higher odds of OHI. The most popular SSBs among adolescents were energy drinks. Different types of SSB were differentially associated with OHI and weight status. Implications for public health: Different types of SSBs were differentially associated with OHI and weight status in adolescents. Diet soft drinks and new generation SSBs such as energy and sport drinks and flavoured water had a greater impact on adolescents’ OHI compared with soft drinks and fruit juice.
7. Ievers-Landis,Carolyn, Olayinka,Oluwatomisin, Burant,Christopher and Moore,Shirley. Predictors of Weight-Related Quality of Life in Adolescents Who Are Overweight or Obese. J.Dev.Behav.Pediatr. 2018 39 2 126-135 Objective: Weight-related quality of life (WRQOL) is a type of health-related QOL that may serve as a patient-reported outcome of the potential burden of overweight. The present study uses structural equation modeling path analysis methods to examine body mass index (BMI) and other potential predictors of WRQOL components among adolescents who were overweight/obese from predominantly low-income, urban households.Methods: Baseline data were obtained from 360 participants (10-13 year olds; 57.8% female; 76.7% black; average BMI of 27.12) and their parents/legal guardians from a randomized, controlled, treatment trial. Youth completed measures of WRQOL, depressive symptoms, and family/friend social support for healthy eating. Parents completed measures of demographics and child social problems.Results: The initial model included BMI, gender, parent education, family/friend social support for healthy eating, child social problems, body esteem and social life WRQOL, and depressive symptoms. The final model fit the data well (χ = 27.738; df = 16; p = .034). Higher BMI was indirectly related to lower social life and body esteem WRQOL through greater social problems. Physical comfort and family relations WRQOL were unrelated to BMI and were not included. Lower social life and body esteem related to more depressive symptoms. Family/friend discouragement for healthy eating was associated with lower body esteem; also, family discouragement was related to lower social life.Conclusion: Body mass index may not directly relate to WRQOL but may be associated through other factors, including child social problems. Interventions should screen for and treat mood and social problems and address family/friend support for healthy eating.
8. Kim,YoonMyung. Effects of Exercise Training Alone on Depot-Specific Body Fat Stores in Youth: Review of Recent Literature. PEDIATR EXERC SCI. 2018 30 1 60-70 The prevalence of childhood obesity has increased at an alarming rate. The increased obesity rate in pediatrics parallels the increased risks for developing
metabolic abnormalities, such as insulin resistance, type 2 diabetes, and nonalcoholic fatty liver disease. In particular, the strong relationship between obesity and such health consequences is well explained by the excessive accumulation of depot-specific body adiposity, such as visceral adipose tissue, intrahepatic lipid content, intermuscular adipose tissue, and/or intramyocellular lipid content. Limited evidence suggests that both aerobic and resistance exercise alone, independent of weight loss, can be an effective therapeutic strategy for improving risk markers of metabolic abnormalities as well as inducing positive changes in depot-specific body adiposity in obese children and adolescents. However, the independent role of exercise alone (without calorie restriction) in body fat distribution is still unclear, and the results are less conclusive in pediatrics. In this brief review, the effects of aerobic and resistance exercise on depot-specific body adiposity changes in children and adolescents are discussed. Order.
9. Krishnan,Mohanraj, Shelling,Andrew N., Wall,Clare R., et al. Gene-by-Activity Interactions on Obesity Traits of 6-Year-Old New Zealand European Children: A Children of SCOPE Study. PEDIATR EXERC SCI. 2018 30 1 71-82 Purpose: The decline of physical activity in children is considered an important determinant to explain the rising rates of obesity. However, this risk may be augmented in children who are genetically susceptible to increased weight gain. We hypothesized that a sedentary lifestyle and moderate activity will interact with genetic loci, resulting in differential effects in relation to obesity risk. Methods: We recruited 643 European children born to participants in the New Zealand-based Screening for Pregnancy Endpoints (SCOPE) study. Seventy gene variants were evaluated by the Sequenom assay. Interaction analyses were performed between the genetic variants and the activity type derived from actigraphy, in relation to percentage body fat. Results: We found a statistically significant association between increased proportions of sedentary activitywith increased percentage body fat scores (P = .012). The OLFM4-9568856 (P = .01) and GNPDA2-rs10938397 (P = .044) gene variants showed genotype differences with proportions of sedentary activity. Similarly, the OLFM4-9568856 (P = .021), CLOCK-rs4864548 (P = .029), and LEPR-1045895 (P = .047) showed genotype differences with proportions of moderate activity. We found evidence for unadjusted gene-by-activity interactions of SPACA3/SPRASArs16967845, PFKP-rs6602024, and SH2B1-rs7498665 on percentage body fat scores. Conclusions: These findings indicate a differential effect of physical activity in relation to obesity risk, suggesting that children genetically predisposed to increased weight gain may benefit from higher levels of moderate activity. Order.
10. Ling,Jiying, Stommel,Manfred and Choi,Seung Hee. Attempts to Lose Weight Among US Children: Importance of Weight Perceptions from Self, Parents, and Health Professionals. OBESITY (19307381). 2018 26 2 N.PAG-N.PAG Objective: The objective of this study was to investigate how perceptions of weight by children themselves, parents, and health professionals influence children's persistent attempts to lose weight.Methods: The sample included 4,914 children aged 8 to 15 years from the 2005 to 2014 National Health and Nutrition Examination Survey (representing 20.7 million children). Data were analyzed using logistic regression models.Results: About 34.2% never made an effort to lose weight, whereas 28.2% made persistent attempts to lose weight. Children's persistent attempts to lose
weight were highly related to their own BMI percentile. Children's self-perceptions of overweight increased the odds of persistent attempts to lose weight more than sevenfold. Health professionals' perceptions that children were overweight increased the odds of persistent attempts to lose weight almost threefold. However, parents' perceptions of children as overweight had a relatively small though significant influence on children's attempts to lose weight.Conclusions: As perceptions of children's weight status play big roles in children's attempts to lose weight, interventions focusing on increasing accuracy of perceptions may help promote healthy weight loss efforts. Although parents are key agents in controlling their children's weight gain, especially among minority school-aged children, the study findings also emphasize the greater importance of health professionals on children's attempts to lose weight across different racial/ethnic groups.
11. Mameli,C., Brunetti,D., Colombo,V., et al. Combined use of a wristband and a smartphone to reduce body weight in obese children: randomized controlled trial. PEDIATR OBESITY. 2018 13 2 81-87 Summary: Background: Technological instruments may help control paediatric obesity. Objective: We tested whether a personalized programme based on the energy expenditure obtained from a wristband (WB) and the energy intake obtained from a smartphone application (APP) is superior to a standard approach at promoting weight loss. Methods: We performed a randomized controlled trial in obese children aged 10–17 years. The experimental
(EXP) and control (CTR) groups were given a low‐energy diet and a prescription for physical activity. The EXP group was equipped with a WB and an APP and given personalized feedback every 7 days. The main outcome was weight loss at
3 months. Results: The mean (standard deviation) z‐score of body mass index at the enrollment was 2.20 (0.47) in the EXP (n = 16 out of 23) and 2.09 (0.34) in the CTR group (n = 14 out of 20) of children who completed the trial. The mean (95%CI) difference in weight loss at 3 months was 0.07 kg (95%CI: 2.81 to 2.96) for EXP vs. the CTR. Conclusion: A personalized lifestyle programme based on a WB and an APP was not superior to a standard lifestyle programme at promoting weight loss in obese children.
12. Mejia,de Grubb, Salemi,Jason L., Gonzalez,Sandra J., et al. Parenting style and perceptions of children's weight among US Hispanics: a qualitative analysis. HEALTH PROMOT INT. 2018 33 1 132-139 Parental perceptions of their children's weight status may limit their willingness to participate in or acknowledge the importance of early interventions to prevent childhood obesity. This study aimed to examine potential differences in Hispanic mothers' and fathers' perceptions of childhood obesity, lifestyle behaviors and communication preferences to inform the development of culturally appropriate childhood obesity interventions. A qualitative study using focus groups was conducted. Groups (one for mothers and one for fathers) were composed of Hispanic parents (n = 12) with at least one girl and one boy (≤10 years old) who were patients at a pediatric clinic in Tennessee, USA. Thirteen major themes clustered into four categories were observed: (i) perceptions of childhood obesity/children's weight; (ii) parenting strategies related to children's dietary behaviors/physical activity; (iii) perceptions of what parents can do to prevent childhood obesity and (iv) parental suggestions for partnering with child care providers to address childhood obesity. Mothers appeared to be more concerned than fathers about their children's weight. Fathers expressed more concern about the
girls' weight than boys'. Mothers were more likely than fathers to congratulate their children more often for healthy eating and physical activity. Parents collectively expressed a desire for child care providers (e.g. caregivers, teachers, medical professionals and food assistance programs coordinators) to have a caring attitude about their children, which might in turn serve as a motivating factor in talking about their children's weight. Parental perceptions of their children's weight and healthy lifestyle choices are of potential public health importance since they could affect parental participation in preventive interventions. Order.
13. Morais Gonçalves,Régis Jhonatan, Azevedo Silva,de Castro, Silva Belo,Vinícius, et al. Online Health: Impact on the Prevalence of Obesity and Body Satisfaction of Adolescents. REV ENFERMAGEM UFPE. 2018 12 2 312-319 Objective: to evaluate the effect of a health education action, conducted by Facebook, on the prevalence of overweight/obesity and adolescent body satisfaction, as well as the relationship between these measures and differences among adolescents. Method: quantitative study, uncontrolled trial, in which 69 adolescents of both sexes, from 13 to 19 years old, were evaluated in four months regarding nutritional status and body perception, before and after health education intervention on nutrition. Results: 20.8% were overweight, 20.3% perceived as overweight and 36.2% presented body dissatisfaction. There was a higher prevalence of body dissatisfaction among overweight / obese female adolescents. Conclusion: there was no statistically significant impact of the health education strategy, implemented in the prevalence of overweight/obesity and satisfaction with body image. The factors associated with the low impact of the intervention and the importance of studies of this nature were discussed, since obesity is multidetermined, which implies that the approaches used for the prevention and control of this condition should be evaluated for their successes and failures to be improved in future studies.
14. Mustila,Taina, Raitanen,Jani, Keskinen,Pä, Luoto,Riitta and Keskinen,Pä. A pragmatic controlled trial to prevent childhood obesity within a risk group at maternity and child health-care clinics: results up to six years of age (the VACOPP study). BMC Pediatr. 2018 18 1-1 Background: Obesity in childhood appears often during the toddler years. The prenatal environment influences obesity risk. Maternal gestational diabetes, the child's diet, and physical activity in the first few years have an important role in subsequent weight gain. A study was conducted to evaluate effectiveness of a primary health-care lifestyle counselling intervention in prevention of childhood obesity up to 6 years of age.Methods: The study was a controlled pragmatic trial to prevent childhood obesity and was implemented at maternity and child health-care clinics. The participants (n = 185) were mothers at risk of gestational diabetes mellitus with their offspring born between 2008 and 2010. The prenatal intervention, started at the end of the first trimester of pregnancy, consisted of counselling on diet and physical activity by municipal health-care staff. The intervention continued at yearly appointments with a public health-nurse at child health-care clinics. The paper reports the offspring weight gain results for 2-6 years of age. Weight gain up to 6 years of age was assessed as BMI standard deviation scores (SDS) via a mixed-effect linear regression model. The proportion of children at 6 years with overweight/obesity was assessed as weight-for-height percentage and ISO-BMI. Priority was not given to power calculations, because of the study's pragmatic nature.Results: One hundred forty seven children's (control n = 76/85%
and intervention n = 71/56%) weight and height scores were available for analysis at 6 years of age. There was no significant difference in weight gain or overweight/obesity proportions between the groups at 6 years of age, but the proportion of children with obesity in both groups was high (assessed as ISO-BMI 9.9% and 11.8%) relative to prevalence in this age group in Finland.Conclusion: As the authors previously reported, the intervention-group mothers had lower prevalence of gestational diabetes mellitus, but a decrease in obesity incidence before school age among their offspring was not found. The authors believe that an effective intervention should start before conception, continuing during pregnancy and the postpartum period through the developmentally unique child's first years.Trial Registration: ClinicalTrials.gov NCT00970710 . Registered 1 September 2009. Retrospectively registered.
15. Norman,Åsa, Bohman,Benjamin, Nyberg,Gisela and Schäfer Elinder,Liselotte. Psychometric Properties of a Scale to Assess Parental Self-Efficacy for Influencing Children’s Dietary, Physical Activity, Sedentary, and Screen Time Behaviors in Disadvantaged Areas. Health Educ.Behav. 2018 45 1 132-140 Background. According to social cognitive theory, self-efficacy is central to behavior change. Consequently, parental self-efficacy (PSE) for influencing children’s dietary, physical activity (PA), sedentary, and screen time behaviors is important for child obesity prevention. The aim of this study was to evaluate the psychometric properties of an instrument to measure PSE regarding these behaviors in disadvantaged areas. Method. Parents (n = 229) of whom 47% had completed secondary school or less, and who participated in the Healthy School Start trial, responded to a 15-item PSE instrument. Children’s diet and screen time were measured through parent reports. PA and sedentary behaviors were measured using accelerometers. Construct validity was assessed using exploratory factor analysis (EFA), criterion validity by correlations with child behaviors, and internal consistency by Cronbach’s alpha. Results. The EFA yielded three factors: (a) PSE for promoting PA; (b) PSE for limiting intake of unhealthy foods, unhealthy drinks, and screen time; and (c) PSE for promoting intake of fruits and vegetables, all with acceptable to good internal consistency (α = .77-.81). Significant correlations (p < .01) were found between children’s dietary (rs = −.19 to −.29) and screen time (r = −.29) behaviors and Factor 2, and dietary behaviors and Factor 3 (rs = .20-.39) but not regarding PA and sedentary behaviors and Factor 1. Conclusion. The instrument demonstrated good construct validity and acceptable to good internal consistency regarding all but PA behaviors. It may be useful for assessing PSE in child obesity prevention interventions in disadvantaged settings after some refinement.
16. Ogden,Cynthia L., Carroll,Margaret D., Fakhouri,Tala H., et al. Prevalence of Obesity Among Youths by Household Income and Education Level of Head of Household - United States 2011-2014. MMWR Morb.Mortal.Wkly.Rep. 2018 67 6 186-189 Obesity prevalence varies by income and education level, although patterns might differ among adults and youths (1-3). Previous analyses of national data showed that the prevalence of childhood obesity by income and education of household head varied across race/Hispanic origin groups (4). CDC analyzed 2011-2014 data from the National Health and Nutrition Examination Survey (NHANES) to obtain estimates of childhood obesity prevalence by household income (≤130%, >130% to ≤350%, and >350% of the federal poverty level FPL]) and head of
household education level (high school graduate or less, some college, and college graduate). During 2011-2014 the prevalence of obesity among U.S. youths (persons aged 2-19 years) was 17.0%, and was lower in the highest income group (10.9%) than in the other groups (19.9% and 18.9%) and also lower in the highest education group (9.6%) than in the other groups (18.3% and 21.6%). Continued progress is needed to reduce disparities, a goal of Healthy People 2020. The overall Healthy People 2020 target for childhood obesity prevalence is <14.5% (5).
17. Paisi,Martha, Kay,Elizabeth, Kaimi,Irene, et al. Obesity and caries in four-to-six year old English children: a cross-sectional study. BMC Public Health. 2018 18 1-1 Background: Obesity and caries are common conditions in childhood and can have significant implications on children's wellbeing. Evidence into their association remains conflicting. Furthermore, studies examining the ssociation between obesity and caries commonly focus on individual-level determinants. The present study aimed to examine the association between obesity and caries in young English children and to determine the impact of deprivation and area-level characteristics on the distribution of the two conditions.Methods: This was a cross-sectional study among children in Plymouth city aged four-to-six years. Anthropometric measurements included weight and height (converted to Body Mass Index centiles and z-scores), and waist circumference. Caries was assessed by using the sum of the number of teeth that were decayed, missing or filled. A questionnaire was used to obtain information on children's demographic characteristics, oral hygiene, and dietary habits. The impact of deprivation on anthropometric variables and caries was determined using Linear and Poisson regression models, respectively. Multiple logistic regression was used to assess the association between different anthropometric measures and caries. Logistic regression models were also used to examine the impact of several demographic characteristics and health behaviours on the presence of obesity and caries.Results: The total sample included 347 children aged 5.10 ± 0.31 (mean ± SD). Deprivation had a significant impact on caries and BMI z-scores (p < 0.05). Neither BMI- nor waist circumference z-scores were shown to be significantly associated with dental caries. Among the neighbourhood characteristics examined, the percentage of people dependent on benefits was found to have a significant impact on caries rates (p < 0.05). Household's total annual income was inversely related to caries risk and parental educational level affected children's tooth brushing frequency.Conclusions: No associations between any measure of obesity and caries were found. However, deprivation affected both obesity and caries, thus highlighting the need to prioritise disadvantaged children in future prevention programmes.
18. Perez,A. J. and Ball,G. D. C. Paradoxically speaking about engagement in pediatric weight management. PEDIATR OBESITY. 2018 13 2 127-129 The article focuses on the pediatric weight management. Topics discussed include relationship between children's body mass index and social adversities; risk of obesity associated with the children of minority populations and lower-income families; and treatment and management of obesity using pediatric weight management services among the same.
19. Rodriguez-Ayllon,M., Cadenas-Sanchez,C., Esteban-Cornejo,I., et al. Physical fitness and psychological health in overweight/obese children: A cross-sectional
study from the ActiveBrains project. J.Sci.Med.Sport. 2018 21 2 179-184 Objectives: To examine the associations of physical fitness (i.e. cardiorespiratory fitness, muscular strength, and speed/agility) with psychological distress and psychological well-being in overweight/obese pre-adolescent children.Design: 110 overweight/obese children (10.0±1.1years old, 61 boys) from the ActiveBrains project (http://profith.ugr.es/activebrains) participated in this cross-sectional study.Methods: Physical fitness was evaluated by the ALPHA battery test. Cardiorespiratory fitness was additionally evaluated by a maximal incremental treadmill. Stress was assessed by the Children's Daily Stress Inventory, anxiety by the State-Trait Anxiety Inventory, depression by the Children Depression Inventory, positive affect and negative affect by the Positive and Negative Affect Scale for Children, happiness by the Subjective Happiness Scale, optimism by the Life Orientation Test, and self-esteem by the Rosenberg Self-Esteem questionnaire. Linear regression adjusted for sex and peak height velocity was used to examine associations.Results: Absolute upper-body muscular strength was negatively associated with stress and negative affect (β=-0.246, p=0.047; β=-0.329, p=0.010, respectively). Furthermore, absolute lower-body muscular strength was negatively associated with negative affect (β=-0.301, p=0.029). Cardiorespiratory fitness, expressed by the last completed lap, and relative upper-body muscular strength were positively associated with optimism (β=0.220, p=0.042; β=0.240, p=0.017, respectively). Finally, absolute upper-body muscular strength was positively associated with self-esteem (β=0.362, p=0.003) independently of sex and weight status (p for interactions >0.3), and absolute lower-body muscular strength was also positively associated with self-esteem (β=0.352, p=0.008).Conclusions: Muscular strength was associated with psychological distress (i.e. stress and negative affect) and psychological well-being (i.e. optimism and self-esteem) as well as cardiorespiratory fitness was associated with optimism. Therefore, increased levels of physical fitness, specifically muscular strength, could have significant benefits for overweight/obese children psychological health.
20. Schalkwijk,Annemarie A. H., van,der Zwaard, Nijpels,Giel, Elders,Petra J. M. and Platt,Lucinda. The impact of greenspace and condition of the neighbourhood on child overweight. Eur.J.Public Health. 2018 28 1 88-94 Background: Childhood overweight/obesity has been associated with environmental, parenting and socioeconomic status (SES) factors. This paper assesses the influence of the amount of green space, accessibility to a garden and neighbourhood condition on being overweight/obese. It investigates whether parental behaviours moderate or mediate this influence and evaluates the interaction of SES with environmental context. Methods: 6467 children from the UK Millennium Cohort Study living in England were analysed. We estimated logistic regressions to examine the initial association between environment and overweight. Subsequently, parenting determinants comprising: food consumption, physical activity, rules and regularity were evaluated as moderators or mediators. Lastly SES related variables were tested as moderators or mediators of the associations. Results: Statistically significant associations were found between low levels of green space, no access to a garden, run down area and childhood overweight/obesity odds ratio (OR) 95% confidence interval (CI)] respectively: 1.14 (1.02-1.27), 1.35 (1.16-1.58), 1.22 (1.05-1.42)]. None of the parental constructs mediated or moderated the relationships between environment and childhood overweight/obesity. Including SES, parental
education moderated the effect of environmental context. Specifically, among lower educated households lack of garden access and less green space was associated with overweight/obesity; and among higher educated households poor neighbourhood condition influenced the probability of overweight/obesity respectively: 1.38 (1.12-1.70) OR 1.38, 95% CI (1.21-1.70). Conclusions: This study suggests that limits on access to outdoor space are associated with future childhood overweight/obesity although the ways in which this occurs are moderated by parental education level. Order.
21. Shi,Zumin, Makrides,Maria and Shao,Jia Zhou. Dietary patterns and obesity in preschool children in Australia: a cross-sectional study. Asia Pac.J.Clin.Nutr. 2018 27 2 406-412
22. Teevale,Tasileta and Kaholokula,Joseph K. Using appreciative inquiry methodology to develop a weight management program for obese children in New Zealand. AUST NZ J PUBLIC HEALTH. 2018 42 1 7-11 Abstract: Objectives: Paediatric obesity predicts adult obesity, and alarming new data in New Zealand reveals that obesity among the young continues to rise. In this study, we used a
novel solution‐focused paradigm, or appreciative inquiry perspective, to explore the factors that influence not just obese but non‐obese states (that is, healthy weight as well as obesity), in Pacific adolescents (aged 13–17) living in socioeconomically
deprived neighbourhoods. Methods: Sixty‐eight parents and adolescents from 30 families were recruited and interviewed, resulting in 15 obese and 15 healthy weight adolescents participating in the study. Results: Our findings showed that, despite living in low socioeconomic circumstances, parents were able to alter their
micro‐environments to prevent obesity in their children. Parents with healthy weight adolescents had food rules in the home and monitored their children's eating and television viewing time. Conclusions: An appreciative inquiry approach to obesity research can uncover resiliency factors within families that can be applied to obesity prevention and treatment programs. Implications for public health: Appreciative inquiry methodology is a promising alternative qualitative research strategy for developing health interventions for low‐income ethnic minority communities.
23. Tolfrey,Keith, Zakrzewski-Fruer,Julia and Thackray,Alice Emily. Metabolism and Exercise During Youth-The Year That Was 2017. PEDIATR EXERC SCI. 2018 30 1 38-43 Two publications were selected because they are excellent representations of studies examining different ends of the exercise-sedentary behavior continuum in young people. The first study is an acute response study with 13 mixed-sex, mid to late adolescents presenting complete data from 4 different randomized experimental crossover conditions for analyses. Continuous glucose monitoring showed that interrupting prolonged continuous sitting with body-weight resistance exercises reduced the postprandial glucose concentration compared with a time-matched uninterrupted period of sitting. Furthermore, the effects of the breaks in sitting time were independent of the energy content of the standardized meals, but variations in the area under the glucose time curves expression were important. The second study adopted a chronic 12-week exercise training intervention design with a large sample of obese children and adolescents who were allocated randomly to high-intensity interval training (HIIT), moderate-intensity continuous training, or nutritional advice groups. HIIT was the most efficacious for improving cardiorespiratory fitness
compared with the other interventions; however, cardiometabolic biomarkers and visceral/subcutaneous adipose tissue did not change meaningfully in any group over the 12 weeks. Attrition rates from both HIIT and moderate-intensity continuous training groups reduce the validity of the exercise training comparison, yet this still provides a solid platform for future research comparisons using HIIT in young people. Order.
24. Yli-Piipari,Sami, Berg,Alison, Laing,Emma M., et al. A Twelve-Week Lifestyle Program to Improve Cardiometabolic, Behavioral, and Psychological Health in Hispanic Children and Adolescents. J.Altern.Complement.Med. 2018 24 2 132-138 Objectives: To examine the effectiveness of a 12-week lifestyle program on cardiometabolic, behavioral, and psychological outcomes among overweight Hispanic children and adolescents. Design: A case series study with pre- and post-test analyses. Subjects/Settings/Location: A convenience sample of high-risk pediatric primary care patients ( n = 22; 6 girls, 16 boys; M age = 11.73 ± 1.39 years) and their guardians in the Southeast United States. Intervention: Twice per week 60 min (total of 24 h) of moderate-to-vigorous intensity boxing exercise training, 12 h of nutrition education for guardians, and a 30-min pediatrician appointment. Outcome measures: Cardiometabolic (height m], weight kg], waist circumference cm], body-mass index BMI], BMI-z, BMI%, cholesterol mg/dL], triglycerides mg/dL], glucose mg/dL], and low-density lipoprotein and high-density lipoprotein cholesterol mg/dL]), behavioral (objective free time physical activity PA] and sedentary time min/day]), and psychological (self-determined exercise motivation) outcomes were measured/calculated, and paired-samples t-tests were conducted. Results: A significant reduction was observed in waist circumference t(17) = −2.57, p = 0.020, d = 0.64; BMI% t(15) = −2.53, p = 0.023, d = 0.20; fasting glucose t(15) = −6.43, p < 0.001, d = 1.67; and amotivation (−) t(17) = −2.29, p = 0.036, d = 0.64; whereas a significant increase was identified in moderate t(10) = 4.01, p = 0.002, d = 1.23 and vigorous t(10) = 3.41, p = 0.007, d = 1.07 intensity PA; intrinsic motivation t(17) = 2.71, p = 0.015, d = 0.38; and introjected regulation t(17) = 2.74, p = 0.014, d = 0.64. Conclusions: A 12-week lifestyle program can be effective in improving selected health markers among overweight Hispanic children and adolescents. The positive changes in fasting glucose, BMI, and waist suggest that the participants are currently at lower risk for both type 2 diabetes and cardiovascular disease as a result of the Confidence, Ownership, Responsibility, and Exercise program. Order.
