International Journal of Environmental Research and Public Health

Research

331 KiB

Open AccessArticle

Obesity, Physical Activity and Sedentary Behavior Amongst British and Saudi Youth: A Cross-Cultural Study

by Yahya Al-Nakeeb, Mark Lyons, Peter Collins, Anwar Al-Nuaim, Hazzaa Al-Hazzaa, Michael J. Duncan and Alan Nevill

Int. J. Environ. Res. Public Health 2012, 9(4), 1490-1506; https://doi.org/10.3390/ijerph9041490 - 16 Apr 2012

Cited by 79 | Viewed by 12779

Abstract

This study explores differences in weight status, obesity and patterns of physical activity (PA) in relation to gender and age of youth from two culturally, environmentally and geographically diverse countries, the United Kingdom (UK) and Saudi Arabia (SA). A total of 2,290 males [...] Read more.

This study explores differences in weight status, obesity and patterns of physical activity (PA) in relation to gender and age of youth from two culturally, environmentally and geographically diverse countries, the United Kingdom (UK) and Saudi Arabia (SA). A total of 2,290 males and females (15–17 years) volunteered to participate in this study. Participants completed a validated self-report questionnaire that contained 47 items relating to patterns of PA, sedentary activity and eating habits. The questionnaire allows the calculation of total energy expenditure in metabolic equivalent (MET-min) values per week. Significant differences in percentage of overweight/obese and levels of PA were evident between the youth from the two countries, with males being generally more physically active than females. Additionally, there were significant associations between Body Mass Index (BMI), PA and sedentary behaviors; the youth with higher BMI reported lower levels of PA and higher amounts of sedentary time. These findings highlight the diverse nature of lifestyle of youth living in different geographical areas of the world and the need for further research to explore the socio-cultural factors that impact on the prevalence of obesity and patterns of PA of youth in different populations. Full article

(This article belongs to the Special Issue Childhood Obesity: Prevention and Treatment)

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328 KiB

Open AccessArticle

Socioeconomic Patterning of Childhood Overweight Status in Europe

by Cécile Knai, Tim Lobstein, Nicole Darmon, Harry Rutter and Martin McKee

Int. J. Environ. Res. Public Health 2012, 9(4), 1472-1489; https://doi.org/10.3390/ijerph9041472 - 16 Apr 2012

Cited by 82 | Viewed by 14382

Abstract

There is growing evidence of social disparities in overweight among European children. This paper examines whether there is an association between socioeconomic inequality and prevalence of child overweight in European countries, and if socioeconomic disparities in child overweight are increasing. We analyse cross-country [...] Read more.

There is growing evidence of social disparities in overweight among European children. This paper examines whether there is an association between socioeconomic inequality and prevalence of child overweight in European countries, and if socioeconomic disparities in child overweight are increasing. We analyse cross-country comparisons of household inequality and child overweight prevalence in Europe and review within-country variations over time of childhood overweight by social grouping, drawn from a review of the literature. Data from 22 European countries suggest that greater inequality in household income is positively associated with both self-reported and measured child overweight prevalence. Moreover, seven studies from four countries reported on the influence of socioeconomic factors on the distribution of child overweight over time. Four out of seven reported widening social disparities in childhood overweight, a fifth found statistically significant disparities only in a small sub-group, one found non-statistically significant disparities, and a lack of social gradient was reported in the last study. Where there is evidence of a widening social gradient in child overweight, it is likely that the changes in lifestyles and dietary habits involved in the increase in the prevalence of overweight have had a less favourable impact in low socio-economic status groups than in the rest of the population. More profound structural changes, based on population-wide social and environmental interventions are needed to halt the increasing social gradient in child overweight in current and future generations. Full article

(This article belongs to the Special Issue Childhood Obesity: Prevention and Treatment)

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Open AccessArticle

The Influence of Local Food Environments on Adolescents’ Food Purchasing Behaviors

by Meizi He, Patricia Tucker, Jason Gilliland, Jennifer D. Irwin, Kristian Larsen and Paul Hess

Int. J. Environ. Res. Public Health 2012, 9(4), 1458-1471; https://doi.org/10.3390/ijerph9041458 - 16 Apr 2012

Cited by 113 | Viewed by 13530

Abstract

This study examined the relationship between the neighborhood food environment and the food purchasing behaviors among adolescents. Grade 7 and 8 students (n = 810) at 21 elementary schools in London, Ontario, Canada completed a questionnaire assessing their food purchasing behaviors. Parents of [...] Read more.

This study examined the relationship between the neighborhood food environment and the food purchasing behaviors among adolescents. Grade 7 and 8 students (n = 810) at 21 elementary schools in London, Ontario, Canada completed a questionnaire assessing their food purchasing behaviors. Parents of participants also completed a brief questionnaire providing residential address and demographic information. A Geographic Information System (GIS) was used to assess students’ home and school neighborhood food environment and land use characteristics. Logistic regression analysis was conducted to assess the influence of the home neighborhood food environment on students’ food purchasing behaviors, while two-level Hierarchical Non-Linear Regression Models were used to examine the effects of school neighborhood food environment factors on students’ food purchasing behaviors. The study showed that approximately 65% of participants reported self-purchasing foods from fast-food outlets or convenience stores. Close proximity (i.e., less than 1 km) to the nearest fast-food outlet or convenience store in the home neighborhood increased the likelihood of food purchasing from these food establishments at least once per week by adolescents (p < 0.05). High fast-food outlet density in both home and school neighborhoods was associated with increased fast-food purchasing by adolescents (i.e., at least once per week; p < 0.05). In conclusion, macro-level regulations and policies are required to amend the health-detracting neighborhood food environment surrounding children and youth’s home and school. Full article

(This article belongs to the Special Issue Childhood Obesity: Prevention and Treatment)

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Open AccessArticle

Childhood Obesity among Puerto Rican Children: Discrepancies Between Child’s and Parent’s Perception of Weight Status

by Winna T. Rivera-Soto and Linnette Rodríguez-Figueroa

Int. J. Environ. Res. Public Health 2012, 9(4), 1427-1437; https://doi.org/10.3390/ijerph9041427 - 16 Apr 2012

Cited by 17 | Viewed by 8823

Abstract

Public concern about childhood obesity and associated health problems calls for the identification of modifiable factors that could halt this epidemic. Parental perceptions of their children’s weight status could be associated to how parents influence children’s eating patterns. We aimed to identify the [...] Read more.

Public concern about childhood obesity and associated health problems calls for the identification of modifiable factors that could halt this epidemic. Parental perceptions of their children’s weight status could be associated to how parents influence children’s eating patterns. We aimed to identify the perceptions Puerto Rican parents have of their children’s weight and children’s own perceptions of weight status as compared to real weight. A cross sectional survey was performed in a representative sample of 1st–6th grade students. Only half of the children correctly identified their weight, and only 62.4% of the parents correctly classified their children’s weight. Most obese/overweight children did not perceive themselves as such. Almost half of obese/overweight children were identified by the parents as normal weight while over half of the underweight children were perceived by their parents at normal weight. More girls than boys perceived themselves as obese/overweight and more parents of girls than of boys perceived them as such. Higher-educated parents were better at recognizing overweight/obesity among their children compared to less-educated parents. This study suggests an influence of parents’ SES characteristics on their perceptions of children’s weight status as well as on children’s own perceptions of their weight status. Full article

(This article belongs to the Special Issue Childhood Obesity: Prevention and Treatment)

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Open AccessArticle

Parenting Styles and Home Obesogenic Environments

by Rachel Johnson, Greg Welk, Pedro F. Saint-Maurice and Michelle Ihmels

Int. J. Environ. Res. Public Health 2012, 9(4), 1411-1426; https://doi.org/10.3390/ijerph9041411 - 16 Apr 2012

Cited by 75 | Viewed by 13382

Abstract

Parenting behaviors are known to have a major impact on childhood obesity but it has proven difficult to isolate the specific mechanism of influence. The present study uses Baumrind’s parenting typologies (authoritative, authoritarian, and permissive) to examine associations between parenting styles and parenting [...] Read more.

Parenting behaviors are known to have a major impact on childhood obesity but it has proven difficult to isolate the specific mechanism of influence. The present study uses Baumrind’s parenting typologies (authoritative, authoritarian, and permissive) to examine associations between parenting styles and parenting practices associated with childhood obesity. Data were collected from a diverse sample of children (n = 182, ages 7–10) in an urban school district in the United States. Parenting behaviors were assessed with the Parenting Styles and Dimension Questionnaire (PSDQ), a 58-item survey that categorizes parenting practices into three styles: authoritative, authoritarian, and permissive. Parent perceptions of the home obesogenic environment were assessed with the Family Nutrition and Physical Activity (FNPA) instrument, a simple 10 item instrument that has been shown in previous research to predict risk for overweight. Cluster analyses were used to identify patterns in the PSDQ data and these clusters were related to FNPA scores and measured BMI values in children (using ANCOVA analyses that controlled for parent income and education) to examine the impact of parenting styles on risk of overweight/obesity. The FNPA score was positively (and significantly) associated with scores on the authoritative parenting scale (r = 0.29) but negatively (and significantly) associated with scores on the authoritarian scale (r = −0.22) and permissive scale (r = −0.20). Permissive parenting was significantly associated with BMIz score but this is the only dimension that exhibited a relationship with BMI. A three-cluster solution explained 40.5% of the total variance and clusters were distinguishable by low and high z-scores on different PSDQ sub-dimensions. A cluster characterized as Permissive/Authoritarian (Cluster 2) had significantly lower FNPA scores (more obesogenic) than clusters characterized as Authoritative (Cluster 1) or Authoritarian/Authoritative (Cluster 3) after controlling for family income and parent education. No direct effects of cluster were evident on the BMI outcomes but the patterns were consistent with the FNPA outcomes. The results suggest that a permissive parenting style is associated with more obesogenic environments while an authoritative parenting style is associated with less obesogenic environments. Full article

(This article belongs to the Special Issue Childhood Obesity: Prevention and Treatment)

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Open AccessArticle

Eating Behavior and Childhood Overweight Among Population-Based Elementary Schoolchildren in Japan

by Hirotaka Ochiai, Takako Shirasawa, Rimei Nishimura, Aya Morimoto, Naoki Shimada, Tadahiro Ohtsu, Masayasu Hashimoto, Hiromi Hoshino, Naoko Tajima and Akatsuki Kokaze

Int. J. Environ. Res. Public Health 2012, 9(4), 1398-1410; https://doi.org/10.3390/ijerph9041398 - 16 Apr 2012

Cited by 6 | Viewed by 6899

Abstract

This study investigated the relationship between eating behavior and childhood overweight among population-based elementary schoolchildren in Japan. Data was collected from fourth graders (9 or 10 years of age) from Ina Town, Saitama Prefecture, Japan from 1999 to 2009. Information about subjects’ sex, [...] Read more.

This study investigated the relationship between eating behavior and childhood overweight among population-based elementary schoolchildren in Japan. Data was collected from fourth graders (9 or 10 years of age) from Ina Town, Saitama Prefecture, Japan from 1999 to 2009. Information about subjects’ sex, age, and lifestyle, including eating behaviors (eating until full and chewing thoroughly), was obtained using a self-administered questionnaire, and height and weight were measured directly. Overweight was determined according to the definition established by the International Obesity Task Force. Data from 4027 subjects (2079 boys and 1948 girls) were analyzed. Chewing thoroughly was associated with a significantly decreased odds ratio (OR) for being overweight, whereas eating until full significantly increased the OR for being overweight (OR: 1.50, 95% confidence interval: 1.16–1.94) among boys. However, eating until full was not associated with a significantly increased OR for being overweight among the group that reported chewing thoroughly, whereas it was associated with a significantly increased OR for being overweight (2.02, 1.38–2.94) among boys who did not chew thoroughly. In conclusion, eating until full or not chewing thoroughly was associated with being overweight among elementary schoolchildren. Results of this study suggest that chewing thoroughly may be an avenue to explore childhood overweight prevention efforts. Full article

(This article belongs to the Special Issue Childhood Obesity: Prevention and Treatment)

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Open AccessArticle

Vegetable and Fruit Intakes of On-Reserve First Nations Schoolchildren Compared to Canadian Averages and Current Recommendations

by Allison Gates, Rhona M. Hanning, Michelle Gates, Kelly Skinner, Ian D. Martin and Leonard J. S. Tsuji

Int. J. Environ. Res. Public Health 2012, 9(4), 1379-1397; https://doi.org/10.3390/ijerph9041379 - 16 Apr 2012

Cited by 22 | Viewed by 7683

Abstract

This study investigated, in on-reserve First Nations (FN) youth in Ontario, Canada, the following: (a) the intakes of vegetable and fruit, “other” foods and relevant nutrients as compared to current recommendations and national averages, (b) current prevalence rates of overweight and obesity and [...] Read more.

This study investigated, in on-reserve First Nations (FN) youth in Ontario, Canada, the following: (a) the intakes of vegetable and fruit, “other” foods and relevant nutrients as compared to current recommendations and national averages, (b) current prevalence rates of overweight and obesity and (c) the relationship between latitude and dietary intakes. Twenty-four-hour diet recalls were collected via the Waterloo Web-Based Eating Behaviour Questionnaire (WEB-Q) (n = 443). Heights and weights of participants were self reported using measured values and Body Mass Index was categorized using the International Obesity Task Force cutoffs. Food group and nutrient intakes were compared to current standards, Southern Ontario Food Behaviour data and the Canadian Community Health Survey, Cycle 2.2, using descriptive statistics. Mean vegetable and fruit, fibre and folate intakes were less than current recommendations. Girls aged 14–18 years had mean intakes of vitamin A below current recommendations for this sub-group; for all sub-groups, mean intakes of vegetables and fruit were below Canadian averages. All sub-groups also had intakes of all nutrients and food groups investigated that were less than those observed in non-FN youth from Southern Ontario, with the exception of “other” foods in boys 12–18 years. Prevalence rates of overweight and obesity were 31.8% and 19.6%, respectively, exceeding rates in the general population. Dietary intakes did not vary consistently by latitude (n = 248), as revealed by ANOVA. This study provided a unique investigation of the dietary intakes of on-reserve FN youth in Ontario and revealed poor intakes of vegetables and fruit and related nutrients and high intakes of “other” foods. Prevalence rates of overweight and obesity exceed those of the general population. Full article

(This article belongs to the Special Issue Childhood Obesity: Prevention and Treatment)

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Open AccessCommunication

Are Changes in Consumption of “Healthy” Foods Related to Changes in Consumption of “Unhealthy” Foods During Pediatric Obesity Treatment?

by Shannon M. Looney and Hollie A. Raynor

Int. J. Environ. Res. Public Health 2012, 9(4), 1368-1378; https://doi.org/10.3390/ijerph9041368 - 16 Apr 2012

Cited by 18 | Viewed by 5923

Abstract

Increasing fruits and vegetables (FVs), a dietary recommendation for pediatric weight management, is theorized to reduce energy intake by reducing intake of more energy-dense foods, such as snack foods (SFs). This study examined the relationship between changes in FV, SF, and energy intake [...] Read more.

Increasing fruits and vegetables (FVs), a dietary recommendation for pediatric weight management, is theorized to reduce energy intake by reducing intake of more energy-dense foods, such as snack foods (SFs). This study examined the relationship between changes in FV, SF, and energy intake in children enrolled in a 6-month, family-based behavioral pediatric weight management trial. Secondary data analyses examined dietary intake in 80 overweight ( ≥ 85th to < 95th percentile for body mass index [BMI]) and obese ( ≥ 95th percentile for BMI) children (7.2 ± 1.7 years) with complete dietary records at 0 and 6 months. Participants were randomized to one of three treatment conditions: (1) increased growth monitoring with feedback; (2) decrease SFs and sugar sweetened beverages; or (3) increase FVs and low-fat dairy. With treatment condition controlled in all analyses, FV intake significantly increased, while SF and energy intake decreased, but not significantly, from 0 to 6 months. Change in FV intake was not significantly associated with change in SF consumption. Additionally, change in FV intake was not significantly related to change in energy intake. However, reduction in SF intake was significantly related to reduction in energy intake. Changing only FVs, as compared to changing other dietary behaviors, during a pediatric obesity intervention may not assist with reducing energy intake. Full article

(This article belongs to the Special Issue Childhood Obesity: Prevention and Treatment)

351 KiB

Open AccessArticle

The Impact of an Intervention Taught by Trained Teachers on Childhood Overweight

by Rafaela Rosário, Bruno Oliveira, Ana Araújo, Oscar Lopes, Patrícia Padrão, André Moreira, Vítor Teixeira, Renata Barros, Beatriz Pereira and Pedro Moreira

Int. J. Environ. Res. Public Health 2012, 9(4), 1355-1367; https://doi.org/10.3390/ijerph9041355 - 16 Apr 2012

Cited by 35 | Viewed by 8517

Abstract

The purpose of this study was to assess the effects of a six-months’ nutrition program, delivered and taught by classroom teachers with in-service nutrition training, on the prevention of overweight and obesity among children in grades 1 to 4. In this randomized trial, [...] Read more.

The purpose of this study was to assess the effects of a six-months’ nutrition program, delivered and taught by classroom teachers with in-service nutrition training, on the prevention of overweight and obesity among children in grades 1 to 4. In this randomized trial, four hundred and sixty four children from seven elementary schools were allocated to a nutrition educational program delivered by their own teachers. Intervened teachers had 12 sessions of three hours each with the researchers throughout six months, according to the topics nutrition and healthy eating, the importance of drinking water and healthy cooking activities. After each session, teachers were encouraged to develop activities in class focused on the learned topics. Sociodemographic, anthropometric, dietary, and physical activity assessments were performed at baseline and at the end of the intervention. In the intervention group the increase in Body Mass Index (BMI) z-score was significantly lower than in the control group (p = 0.009); fewer proportion of children became overweight in the intervened group compared with the control (5.6% vs. 18.4%; p = 0.037). Our study provides further support to decrease the overweight epidemic, involving classroom teachers in a training program and making them dedicated interventionists. Full article

(This article belongs to the Special Issue Childhood Obesity: Prevention and Treatment)

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302 KiB

Open AccessArticle

Paediatric Obesity Research in Early Childhood and the Primary Care Setting: The TARGet Kids! Research Network

by Julia Morinis, Jonathon Maguire, Marina Khovratovich, Brian W. McCrindle, Patricia C. Parkin and Catherine S. Birken

Int. J. Environ. Res. Public Health 2012, 9(4), 1343-1354; https://doi.org/10.3390/ijerph9041343 - 16 Apr 2012

Cited by 13 | Viewed by 6984

Abstract

Primary paediatric health care is the foundation for preventative child health. In light of the recent obesity epidemic, paediatricians find themselves at the frontline of identification and management of childhood obesity. However, it is well recognized that evidence based approaches to obesity prevention [...] Read more.

Primary paediatric health care is the foundation for preventative child health. In light of the recent obesity epidemic, paediatricians find themselves at the frontline of identification and management of childhood obesity. However, it is well recognized that evidence based approaches to obesity prevention and subsequent translation of this evidence into practice are critically needed. This paper explores the role of primary care in obesity prevention and introduces a novel application and development of a primary care research network in Canada—TARGet Kids!—to develop and translate an evidence-base on effective screening and prevention of childhood obesity. Full article

(This article belongs to the Special Issue Childhood Obesity: Prevention and Treatment)

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Open AccessCommunication

A Pilot Study of a Pictorial Bilingual Nutrition Education Game to Improve the Consumption of Healthful Foods in a Head Start Population

by Veronica Piziak

Int. J. Environ. Res. Public Health 2012, 9(4), 1319-1325; https://doi.org/10.3390/ijerph9041319 - 16 Apr 2012

Cited by 16 | Viewed by 7787

Abstract

The prevalence of early childhood obesity has increased dramatically particularly among the Mexican American population. Obesity leads to earlier onset of related diseases such as type 2 diabetes. The Head Start population of Texas is largely Mexican American. Dietary intake in this population [...] Read more.

The prevalence of early childhood obesity has increased dramatically particularly among the Mexican American population. Obesity leads to earlier onset of related diseases such as type 2 diabetes. The Head Start population of Texas is largely Mexican American. Dietary intake in this population demonstrated a diet very low in fiber, high in salt, and containing excessive calories with a low intake of fruit and vegetables. This study was performed in a Texas Head Start population to evaluate a bilingual pictorial nutrition education game. Acceptance of the bilingual concept and the game had been previously studied in a Head Start population in five Texas counties. The effectiveness in producing a change in eating habits was studied as a pilot project 413 children and their parents at the Bastrop County Head Start. Parents were asked to supply data about at home food frequency at the beginning and the end of the school year and the results compared. The parents were given a demonstration of the educational objectives and the students played the game throughout the year. By the end of the school year there was a statistically significant increase in the vegetables offered to this population both during the week at home (p = 0.009) and on the weekends (p = 0.02). Full article

(This article belongs to the Special Issue Childhood Obesity: Prevention and Treatment)

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Open AccessArticle

Lessons Learned from the Implementation of a Provincial Breastfeeding Policy in Nova Scotia, Canada and the Implications for Childhood Obesity Prevention

by Sara F. L. Kirk, Sarah Meaghan Sim, Erin Hemmens and Sheri L. Price

Int. J. Environ. Res. Public Health 2012, 9(4), 1308-1318; https://doi.org/10.3390/ijerph9041308 - 16 Apr 2012

Cited by 9 | Viewed by 7470

Abstract

Healthy public policy plays a central role in creating environments that are supportive of health. Breastfeeding, widely supported as the optimal mode for infant feeding, is a critical factor in promoting infant health. In 2005, the Canadian province of Nova Scotia introduced a [...] Read more.

Healthy public policy plays a central role in creating environments that are supportive of health. Breastfeeding, widely supported as the optimal mode for infant feeding, is a critical factor in promoting infant health. In 2005, the Canadian province of Nova Scotia introduced a provincial breastfeeding policy. This paper describes the process and outcomes of an evaluation into the implementation of the policy. This evaluation comprised focus groups held with members of provincial and district level breastfeeding committees who were tasked with promoting, protecting and supporting breastfeeding in their districts. Five key themes were identified, which were an unsupportive culture of breastfeeding; the need for strong leadership; the challenges in engaging physicians in dialogue around breastfeeding; lack of understanding around the International Code of Marketing of Breast-milk Substitutes; and breastfeeding as a way to address childhood obesity. Recommendations for other jurisdictions include the need for a policy, the value of leadership, the need to integrate policy with other initiatives across sectors and the importance of coordination and support at multiple levels. Finally, promotion of breastfeeding offers a population-based strategy for addressing the childhood obesity epidemic and should form a core component of any broader strategies or policies for childhood obesity prevention. Full article

(This article belongs to the Special Issue Childhood Obesity: Prevention and Treatment)

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Open AccessArticle

The Centre for Healthy Weights—Shapedown BC: A Family-Centered, Multidisciplinary Program that Reduces Weight Gain in Obese Children over the Short-Term

by Constadina Panagiotopoulos, Rebecca Ronsley, Mohammed Al-Dubayee, Rollin Brant, Boris Kuzeljevic, Erin Rurak, Arlene Cristall, Glynis Marks, Penny Sneddon, Mary Hinchliffe, Jean-Pierre Chanoine and Louise C. Mâsse

Int. J. Environ. Res. Public Health 2011, 8(12), 4662-4678; https://doi.org/10.3390/ijerph8124662 - 15 Dec 2011

Cited by 21 | Viewed by 12644

Abstract

The objective was to conduct a program evaluation of the Centre for Healthy Weights—Shapedown BC (CHW-SB), a family-centered, multidisciplinary program for obese children, by assessing the change in weight trajectories from program intake to completion. Secondary outcomes included changes in clinical, biochemical and [...] Read more.

The objective was to conduct a program evaluation of the Centre for Healthy Weights—Shapedown BC (CHW-SB), a family-centered, multidisciplinary program for obese children, by assessing the change in weight trajectories from program intake to completion. Secondary outcomes included changes in clinical, biochemical and psychological parameters, and in physical activity (PA) levels. The CHW-SB program was evaluated over 10 weeks. Data collection included anthropometric, metabolic, PA and psychological measures. Longitudinal mixed effects regression was performed to evaluate weight change from Phase 1 (before program on waitlist) to Phase 2 (during program). 238 children < 18 years of age were referred to the program of which 119 were eligible for participation. There was a significant decrease in weight trajectory in children following program entry. Participants experienced an average .89% monthly increase before program entry, compared to a .37% monthly decline afterwards, a drop of 1.26% (p < 0.0001, 95%CI 1.08 to 1.44). zBMI (2.26 ± 0.33 to 2.20 ± 0.36, p < 0.001), waist circumference (99 ± 15.7 to 97 ± 16 cm, p < 0.0001) and fasting insulin (137 ± 94.8 to 121 ± 83.4 pmol/L, < 0.001) also decreased in participants who attended the final visit. Significant improvements were seen in all measures of PA, self-concept, and anxiety. CHW-SB, a government-funded program, is the first obesity-treatment program to be evaluated in Canada. While short-term evaluation revealed significant improvements in adiposity, PA, and psychological measures, the lack of full follow-up is a limitation in interpreting the clinical effectiveness of this program, as drop-out may be associated with lack of success in meeting program goals. These data also emphasize the need for ongoing evaluation to assess the long-term implications of this unique program and ultimately optimize utilization of governmental resources. Full article

(This article belongs to the Special Issue Childhood Obesity: Prevention and Treatment)

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Open AccessArticle

by Young-Gyu Cho, Jae-Heon Kang, Yang-Im Hur, Jihyun Song and Kang-Sook Lee

Int. J. Environ. Res. Public Health 2011, 8(12), 4596-4607; https://doi.org/10.3390/ijerph8124596 - 12 Dec 2011

Cited by 2 | Viewed by 7242

Abstract

Increased adiposity and unhealthy lifestyle augment the risk for type 2 diabetes in children with familial predisposition. Insulin resistance (IR) is an excellent clinical marker for identifying children at high risk for type 2 diabetes. This study was conducted to investigate parental, physiological, [...] Read more.

Increased adiposity and unhealthy lifestyle augment the risk for type 2 diabetes in children with familial predisposition. Insulin resistance (IR) is an excellent clinical marker for identifying children at high risk for type 2 diabetes. This study was conducted to investigate parental, physiological, behavioral and socio-economic factors related to IR in Korean children. This study is a cross-sectional study using data from 111 children aged 7 years and their parents. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated using fasting glucose and insulin level as a marker of IR. All children’s adiposity indices (r = 0.309–0.318, all P-value = 0.001) and maternal levels of fasting insulin (r = 0.285, P-value = 0.003) and HOMA-IR (r = 0.290, P-value = 0.002) were positively correlated with children’s HOMA-IR level. There was no statistical difference of children’s HOMA-IR level according to children’s lifestyle habits and socioeconomic status of families. An increase of 1 percentage point in body fat was related to 2.7% increase in children’s HOMA-IR (P-value < 0.001) and an increase of 1% of maternal level of HOMA-IR was related to 0.2% increase in children’s HOMA-IR (P-value = 0.002). This study shows that children’s adiposity and maternal IR are positively associated with children’s IR. Full article

(This article belongs to the Special Issue Childhood Obesity: Prevention and Treatment)

Review

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253 KiB

Open AccessReview

After-School Based Obesity Prevention Interventions: A Comprehensive Review of the Literature

by Paul Branscum and Manoj Sharma

Int. J. Environ. Res. Public Health 2012, 9(4), 1438-1457; https://doi.org/10.3390/ijerph9041438 - 16 Apr 2012

Cited by 44 | Viewed by 10560

Abstract

The purpose of this article was to review primary prevention interventions targeting childhood obesity implemented in the after school environment from 2006 and 2011. A total of 20 interventions were found from 25 studies. Children in the interventions ranged from kindergarten to middle [...] Read more.

The purpose of this article was to review primary prevention interventions targeting childhood obesity implemented in the after school environment from 2006 and 2011. A total of 20 interventions were found from 25 studies. Children in the interventions ranged from kindergarten to middle schoolers, however a majority was in the 4th and 5th grades. Most of the interventions targeted both physical activity and dietary behaviors. Among those that focused on only one dimension, physical activity was targeted more than diet. The duration of the interventions greatly varied, but many were short-term or brief. Many interventions were also based on some behavioral theory, with social cognitive theory as the most widely used. Most of the interventions focused on short-term changes, and rarely did any perform a follow-up evaluation. A major limitation among after school interventions was an inadequate use of process evaluations. Overall, interventions resulted in modest changes in behaviors and behavioral antecedents, and results were mixed and generally unfavorable with regards to indicators of obesity. Recommendations for enhancing the effectiveness of after school based childhood obesity interventions are presented. Full article

(This article belongs to the Special Issue Childhood Obesity: Prevention and Treatment)

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Open AccessReview

Physical Activity Promotion in the Preschool Years: A Critical Period to Intervene

by Gary S. Goldfield, Alysha Harvey, Kimberly Grattan and Kristi B. Adamo

Int. J. Environ. Res. Public Health 2012, 9(4), 1326-1342; https://doi.org/10.3390/ijerph9041326 - 16 Apr 2012

Cited by 186 | Viewed by 21338

Abstract

The primary aim of this paper is to provide a rationale for the necessity of intervening with a physical activity intervention in the preschool years and why the daycare environment is amenable to such intervention. We also review the prevalence of physical activity, [...] Read more.

The primary aim of this paper is to provide a rationale for the necessity of intervening with a physical activity intervention in the preschool years and why the daycare environment is amenable to such intervention. We also review the prevalence of physical activity, sedentary behaviour and obesity in the preschool population and the impact that these lifestyle behaviours and conditions have on the health of preschool aged children, as secondary objectives. Moreover we discuss implications for intervention and research using a “lessons learned” model based on our research team’s experience of conducting a randomized controlled trial aimed at increasing physical activity, reducing sedentary behaviour and improving motor skill development and body composition in preschoolers. Lastly, we make conclusions based on the literature and highlight issues and directions that need to be addressed in future research in order to maximize health promotion and chronic disease prevention in the pediatric population. Full article

(This article belongs to the Special Issue Childhood Obesity: Prevention and Treatment)

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Open AccessReview

Can We Modify the Intrauterine Environment to Halt the Intergenerational Cycle of Obesity?

by Kristi B. Adamo, Zachary M. Ferraro and Kendra E. Brett

Int. J. Environ. Res. Public Health 2012, 9(4), 1263-1307; https://doi.org/10.3390/ijerph9041263 - 16 Apr 2012

Cited by 113 | Viewed by 17466

Abstract

Child obesity is a global epidemic whose development is rooted in complex and multi-factorial interactions. Once established, obesity is difficult to reverse and epidemiological, animal model, and experimental studies have provided strong evidence implicating the intrauterine environment in downstream obesity. This review focuses [...] Read more.

Child obesity is a global epidemic whose development is rooted in complex and multi-factorial interactions. Once established, obesity is difficult to reverse and epidemiological, animal model, and experimental studies have provided strong evidence implicating the intrauterine environment in downstream obesity. This review focuses on the interplay between maternal obesity, gestational weight gain and lifestyle behaviours, which may act independently or in combination, to perpetuate the intergenerational cycle of obesity. The gestational period, is a crucial time of growth, development and physiological change in mother and child. This provides a window of opportunity for intervention via maternal nutrition and/or physical activity that may induce beneficial physiological alternations in the fetus that are mediated through favourable adaptations to in utero environmental stimuli. Evidence in the emerging field of epigenetics suggests that chronic, sub-clinical perturbations during pregnancy may affect fetal phenotype and long-term human data from ongoing randomized controlled trials will further aid in establishing the science behind ones predisposition to positive energy balance. Full article

(This article belongs to the Special Issue Childhood Obesity: Prevention and Treatment)

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Other

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Open AccessMeeting Report

Early Origins of Child Obesity: Bridging Disciplines and Phases of Development - September 30–October 1, 2010

by Katherine Kaufer Christoffel, Xiaobin Wang and Helen J. Binns

Int. J. Environ. Res. Public Health 2012, 9(4), 1227-1262; https://doi.org/10.3390/ijerph9041227 - 16 Apr 2012

Cited by 11 | Viewed by 8523

Abstract

This report summarizes a conference: “Early Origins of Child Obesity: Bridging Disciplines and Phases of Development”, held in Chicago on September 30–October 1, 2010. The conference was funded in part by the National Institutes of Health and the Williams Heart Foundation, to achieve [...] Read more.

This report summarizes a conference: “Early Origins of Child Obesity: Bridging Disciplines and Phases of Development”, held in Chicago on September 30–October 1, 2010. The conference was funded in part by the National Institutes of Health and the Williams Heart Foundation, to achieve the conference objective: forging a next-step research agenda related to the early origins of childhood obesity. This research agenda was to include working with an array of factors (from genetic determinants to societal ones) along a continuum from prenatal life to age 7, with an emphasis on how the developing child deals with the challenges presented by his/her environment (prenatal, parental, nutritional, etc.). The conference offered a unique opportunity to facilitate communication and planning of future work among a variety of researchers whose work separately addresses different periods in early life. Over the span of two days, speakers addressed existing, critical research topics within each of the most-studied age ranges. On the final day, workshops fostered the discussion needed to identify the highest priority research topics related to linking varied early factor domains. These are presented for use in planning future research and research funding. Full article

(This article belongs to the Special Issue Childhood Obesity: Prevention and Treatment)

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