International Journal of Environmental Research and Public Health

Research

19 pages, 616 KiB

Open AccessArticle

Predictors of Participant Attendance Patterns in a Family-Based Intervention for Overweight and Obese Hispanic Adolescents

by Sara M. St. George, Mariya Petrova, Tae Kyoung Lee, Krystal M. Sardinas, Marissa A. Kobayashi, Sarah E. Messiah and Guillermo Prado

Int. J. Environ. Res. Public Health 2018, 15(7), 1482; https://doi.org/10.3390/ijerph15071482 - 13 Jul 2018

Cited by 7 | Viewed by 4168

Abstract

This study examined participant attendance patterns and individual (e.g., income), family dynamics (e.g., communication), and cultural (i.e., Americanism, Hispanicism) predictors of these patterns among Hispanic families enrolled in a 12-week family-based intervention, Familias Unidas for Health and Wellness. Hispanic adolescents (n = [...] Read more.

This study examined participant attendance patterns and individual (e.g., income), family dynamics (e.g., communication), and cultural (i.e., Americanism, Hispanicism) predictors of these patterns among Hispanic families enrolled in a 12-week family-based intervention, Familias Unidas for Health and Wellness. Hispanic adolescents (n = 140, 49% female, 13.04 ± 0.87 years old, 36% overweight, 64% obese, 39% immigrants) and their parents (87% female, 42.09 ± 6.30 years old, BMI 30.99 ± 6.14 kg/m², 90% immigrants) were randomized to the intervention condition. A repeated measures latent class analysis that included 12 binary variables (yes/no) of attendance identified three subgroups of attendance patterns: consistently high, moderate and decreasing, and consistently low. An ANOVA was then conducted to examine whether the identified attendance patterns differed by individual, family dynamics, and cultural characteristics at baseline. Parents in the consistently high attendance group had lower Americanism than those in either of the other attendance groups. Adolescents in the consistently high attendance group had lower Hispanicism than those in either of the other attendance groups. No other variables significantly discriminated between attendance groups. Sustained attendance in the Familias Unidas for Health and Wellness intervention may be driven by Hispanic parents’ desire to better understand their host culture, connect with other culturally similar parents, and reconnect adolescents with their heritage culture. Full article

(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)

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12 pages, 709 KiB

Open AccessFeature PaperArticle

Observing Maternal Restriction of Food with 3–5-Year-Old Children: Relationships with Temperament and Later Body Mass Index (BMI)

by Claire V. Farrow, Emma Haycraft and Jacqueline M. Blissett

Int. J. Environ. Res. Public Health 2018, 15(6), 1273; https://doi.org/10.3390/ijerph15061273 - 15 Jun 2018

Cited by 19 | Viewed by 5503

Abstract

Overt parental restriction of food has previously been associated with child weight; however, most research has relied on self-reported feeding behaviour, or observations which give little opportunity to observe restriction of food. Using a novel lab-based observational technique to increase the opportunity to [...] Read more.

Overt parental restriction of food has previously been associated with child weight; however, most research has relied on self-reported feeding behaviour, or observations which give little opportunity to observe restriction of food. Using a novel lab-based observational technique to increase the opportunity to observe maternal feeding restriction, we explored the relationships between maternal restriction, child responses to restriction and child temperament with child body mass index (BMI) Z-scores over time. Sixty-two mother child dyads were recruited to the study when their children were aged 3–5 years and were followed up 2 years later (N = 39 dyads). Families were observed during a feeding interaction in the laboratory where cookies were offered with the main meal to increase the opportunity for maternal restriction of food. Feeding observations were coded and child temperament and BMI were measured. Controlling for current child BMI Z-scores, greater maternal verbal and physical restriction of food at 3–5 years was related to higher child BMI Z-scores at 5–7 years. More emotional children were less likely to experience restriction and less likely to accept attempts to restrict their food intake. Further research should consider children’s reactions to parental feeding behaviours in greater depth and explore how feeding practices interact with child temperament in the prediction of changes in child weight. Full article

(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)

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12 pages, 313 KiB

Open AccessArticle

Physical Activity-Related Injury and Its Associated Factors among Middle School Students in Southern China

by Weicong Cai, Yang Gao, Wenda Yang, Fuyuan Cheng, Dongchun Tang and Liping Li

Int. J. Environ. Res. Public Health 2018, 15(6), 1244; https://doi.org/10.3390/ijerph15061244 - 12 Jun 2018

Cited by 34 | Viewed by 4669

Abstract

Physical activity (PA) promotion is beneficial to gain and maintain optimal health, but might increase risks for physical activity-related injury (PARI). This cross-sectional study aimed to investigate the incidence rate and identify risk factors of PARI among Chinese middle school students. Selected via [...] Read more.

Physical activity (PA) promotion is beneficial to gain and maintain optimal health, but might increase risks for physical activity-related injury (PARI). This cross-sectional study aimed to investigate the incidence rate and identify risk factors of PARI among Chinese middle school students. Selected via the method of cluster random sampling, students graded 7–8 (junior) and 10–11 (senior) from five middle schools (aged from 10 to 18 years old) in Shantou were invited to participate in the survey. Information on socio-demography, PA involvement, sleep duration, individual safety awareness and exercise behavior, and PARI experiences in the past 12 month was collected. Multivariate logistic regression model was performed to estimate the risk factors of PARI. A total of 3082 participants completed the valid questionnaires, with an overall incidence rate of 25.1%. Boys, junior school students, sports team members, and those with lower safety awareness, living with single parent, and without any chronic conditions were at higher risks for PARI. Moreover, exercising on wet floor or with illness frequently would also be more likely to experience injury, especially those with at least 120 min per day. In conclusion, PARI was prevalent among middle school students in southern China. The above data provide insights that were focused and effective actions should be taken to prevent school-aged adolescents from PARI and maximize the benefits of PA. Full article

(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)

9 pages, 311 KiB

Open AccessArticle

Factors Associated with Maternal Worry about Her Young Child Exhibiting Choosy Feeding Behaviour

by Pauline M. Emmett, Nicholas P. Hays and Caroline M. Taylor

Int. J. Environ. Res. Public Health 2018, 15(6), 1236; https://doi.org/10.3390/ijerph15061236 - 12 Jun 2018

Cited by 4 | Viewed by 5941

Abstract

Choosiness in young children is a normal behaviour that sometimes worries parents. The study aimed to investigate factors that are associated with a mother being worried about her child’s choosy feeding behaviour. Parents of singleton children from the Avon Longitudinal Study of Parents [...] Read more.

Choosiness in young children is a normal behaviour that sometimes worries parents. The study aimed to investigate factors that are associated with a mother being worried about her child’s choosy feeding behaviour. Parents of singleton children from the Avon Longitudinal Study of Parents and Children (n = 5710) completed a questionnaire assessing perception of their child’s choosy feeding behaviour at 15 months of age and whether this choosiness worried them. Feeding behaviours and practices throughout the first 15 months were captured. Multinomial logistic regression models with three levels of worry (not at all, a bit and greatly) as the dependent variables tested associations with variables from pregnancy and infancy. Half of the children (56%) were described as choosy at 15 months; of these 27% had mothers who were a bit worried and 5% greatly worried. Mothers showed greater odds of being worried if the child was first born, difficult to feed or refused solids by 6 months of age. Worried mothers had shown greater odds of introducing lumpy foods late (after 9 months). Feeding vegetables regularly by 6 months was associated with lower odds of worry at 15 months. Support and advice to parents at the start of complementary feeding could help to alleviate worry. Parents should be reassured that choosiness is a normal part of child development. Full article

(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)

8 pages, 320 KiB

Open AccessFeature PaperArticle

Poverty, Weight Status, and Dietary Intake among UK Adolescents

by Robert J. Noonan

Int. J. Environ. Res. Public Health 2018, 15(6), 1224; https://doi.org/10.3390/ijerph15061224 - 10 Jun 2018

Cited by 25 | Viewed by 9325

Abstract

The aims of this study were to (1) determine whether an income gradient to overweight and obesity exists in UK adolescents, and (2) examine associations between poverty, weight status, and dietary intake among adolescent girls and boys. Data is from wave six of [...] Read more.

The aims of this study were to (1) determine whether an income gradient to overweight and obesity exists in UK adolescents, and (2) examine associations between poverty, weight status, and dietary intake among adolescent girls and boys. Data is from wave six of the UK Millennium Cohort Study. Adolescent height and weight were measured. Body mass index was calculated (kg/m²) and used to classify overweight and obesity. Family income and poverty were determined using equivalised household income. Adjusted logistic and multinomial logistic regression analyses were conducted. Ten thousand seven hundred thirty-six adolescents (5425 boys) had complete data. Adolescents in the lowest income group were at greatest risk of overweight and obesity. Adolescents living in poverty were more likely to be overweight and obese, and reported more frequent consumption of sweetened drinks and fast food and less frequent consumption of fruits and vegetables (p < 0.001). The magnitude of poverty differences in weight status and dietary intake were greatest among girls. This study evidences a strong income gradient to overweight and obesity among UK adolescents. The findings of this study encourage researchers and policy makers to be equally mindful of the social determinants of health when advocating adolescent behavioural dietary interventions. Full article

(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)

14 pages, 385 KiB

Open AccessArticle

The Stability and Continuity of Maternally Reported and Observed Child Eating Behaviours and Feeding Practices across Early Childhood

by Faye Powell, Claire Farrow, Caroline Meyer and Emma Haycraft

Int. J. Environ. Res. Public Health 2018, 15(5), 1017; https://doi.org/10.3390/ijerph15051017 - 18 May 2018

Cited by 24 | Viewed by 4783

Abstract

Given that many eating behaviours and food preferences develop early in childhood and track across childhood, adolescence and into adulthood, interest has grown in the developmental trajectory of these behaviours. The aims of this study were twofold. First, to explore whether maternal reports [...] Read more.

Given that many eating behaviours and food preferences develop early in childhood and track across childhood, adolescence and into adulthood, interest has grown in the developmental trajectory of these behaviours. The aims of this study were twofold. First, to explore whether maternal reports of child eating behaviour and feeding practices are validated by independent observations of these constructs. Second, to explore the continuity and stability of both maternally reported and independently observed child eating behaviours and maternal feeding practices during early childhood. Sixty-five mothers completed measures of their child’s eating behaviour and their own feeding practices and mother–child dyads were observed during a family mealtime at approximately 3 and 4 years of age. Maternal reports of their child’s eating behaviours were validated by independent observations, however maternally reported feeding practices were not validated by observations of these behaviours. Maternally reported and independently observed child eating behaviours and parental feeding practices remained stable and showed continuity between 3 and 4 years of age, with the exception of child difficulty to feed and maternal pressure to eat which both significantly decreased over time. Findings provide an insight into the validity of maternal reports of fussy eating behaviour and parental feeding practices and the developmental trajectory of these behaviours across early childhood. Full article

(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)

15 pages, 376 KiB

Open AccessArticle

Improving Physical Fitness and Cognitive Functions in Middle School Students: Study Protocol for the Chinese Childhood Health, Activity and Motor Performance Study (Chinese CHAMPS)

by Zhixiong Zhou, Shanshan Dong, Jun Yin, Quan Fu, Hong Ren and Zenong Yin

Int. J. Environ. Res. Public Health 2018, 15(5), 976; https://doi.org/10.3390/ijerph15050976 - 14 May 2018

Cited by 10 | Viewed by 5472

Abstract

Background: Sedentary lifestyles and their associated harmful consequences are public health concerns that impact more than half of the world’s youth population in both developed and developing countries. Methods: The Chinese Childhood Health; Activity and Motor Performance Study (Chinese CHAMPS) was [...] Read more.

Background: Sedentary lifestyles and their associated harmful consequences are public health concerns that impact more than half of the world’s youth population in both developed and developing countries. Methods: The Chinese Childhood Health; Activity and Motor Performance Study (Chinese CHAMPS) was a cluster randomized controlled trial to modify school physical activity policies and the physical education (PE) curriculum; using teacher training and parent engagement to increase opportunities and support students’ physical activity and healthy eating. Using a 2 × 2 factorial design, the study tested the incremental effects of increasing the amount and intensity of physical activity, alongside adding support for healthy eating, on health-related and cognitive function outcomes in Chinese middle school students. Results: The intervention was implemented by PE teachers in 12 middle schools in three Chinese cities, with a targeted enrollment of 650 students from August 2015–June 2016. The assessment of the outcomes involved a test battery of physical fitness and cognitive functioning at both baseline and at the end of the intervention. Process information on implementation was also collected. Discussion: The Chinese CHAMPS is a multi-level intervention that is designed to test the influences of policy and environmental modifications on the physical activity and eating behaviors of middle school students. It also addresses some key weaknesses in school-based physical activity interventions. Full article

(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)

10 pages, 667 KiB

Open AccessArticle

The Comprehensive Snack Parenting Questionnaire (CSPQ): Development and Test-Retest Reliability

by Dorus W. M. Gevers, Stef P. J. Kremers, Nanne K. De Vries and Patricia Van Assema

Int. J. Environ. Res. Public Health 2018, 15(5), 862; https://doi.org/10.3390/ijerph15050862 - 26 Apr 2018

Cited by 16 | Viewed by 5275

Abstract

The narrow focus of existing food parenting instruments led us to develop a food parenting practices instrument measuring the full range of food practices constructs with a focus on snacking behavior. We present the development of the questionnaire and our research on the [...] Read more.

The narrow focus of existing food parenting instruments led us to develop a food parenting practices instrument measuring the full range of food practices constructs with a focus on snacking behavior. We present the development of the questionnaire and our research on the test-retest reliability. The developed Comprehensive Snack Parenting Questionnaire (CSPQ) covers 21 constructs. Test-retest reliability was assessed by calculating intra class correlation coefficients and percentage agreement after two administrations of the CSPQ among a sample of 66 Dutch parents. Test-retest reliability analysis revealed acceptable intra class correlation coefficients (≥0.41) or agreement scores (≥0.60) for all items. These results, together with earlier work, suggest sufficient psychometric characteristics. The comprehensive, but brief CSPQ opens up chances for highly essential but unstudied research questions to understand and predict children’s snack intake. Example applications include studying the interactional nature of food parenting practices or interactions of food parenting with general parenting or child characteristics. Full article

(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)

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13 pages, 660 KiB

Open AccessArticle

Reciprocal Associations between Electronic Media Use and Behavioral Difficulties in Preschoolers

by Tanja Poulain, Mandy Vogel, Madlen Neef, Franziska Abicht, Anja Hilbert, Jon Genuneit, Antje Körner and Wieland Kiess

Int. J. Environ. Res. Public Health 2018, 15(4), 814; https://doi.org/10.3390/ijerph15040814 - 21 Apr 2018

Cited by 66 | Viewed by 19383

Abstract

The use of electronic media has increased substantially and is already observable in young children. The present study explored associations of preschoolers’ use of electronic media with age, gender, and socio-economic status, investigated time trends, and examined reciprocal longitudinal relations between children’s use [...] Read more.

The use of electronic media has increased substantially and is already observable in young children. The present study explored associations of preschoolers’ use of electronic media with age, gender, and socio-economic status, investigated time trends, and examined reciprocal longitudinal relations between children’s use of electronic media and their behavioral difficulties. The study participants included 527 German two- to six-year-old children whose parents had provided information on their use of electronic media and their behavioral difficulties at two time points, with approximately 12 months between baseline and follow-up. The analyses revealed that older vs. younger children, as well as children from families with a lower vs. higher socio-economic status, were more often reported to use electronic media. Furthermore, the usage of mobile phones increased significantly between 2011 and 2016. Most interestingly, baseline usage of computer/Internet predicted more emotional and conduct problems at follow-up, and baseline usage of mobile phones was associated with more conduct problems and hyperactivity or inattention at follow-up. Peer relationship problems at baseline, on the other hand, increased the likelihood of using computer/Internet and mobile phones at follow-up. The findings indicate that preschoolers’ use of electronic media, especially newer media such as computer/Internet and mobile phones, and their behavioral difficulties are mutually related over time. Full article

(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)

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11 pages, 752 KiB

Open AccessArticle

Exercise Caution: Questions to Ask Adolescents Who May Exercise Too Hard

by Emma Forsén Mantilla, Johanna Levallius, Elin Monell and Andreas Birgegård

Int. J. Environ. Res. Public Health 2018, 15(4), 797; https://doi.org/10.3390/ijerph15040797 - 19 Apr 2018

Cited by 4 | Viewed by 4909

Abstract

When the primary goal of exercise is to compensate for food intake and to alter body shape and weight, it is considered compulsive and may be harmful. Compulsive exercise (CE) is important in the pathogenesis of eating disorders (EDs). Many healthy adolescents engage [...] Read more.

When the primary goal of exercise is to compensate for food intake and to alter body shape and weight, it is considered compulsive and may be harmful. Compulsive exercise (CE) is important in the pathogenesis of eating disorders (EDs). Many healthy adolescents engage in CE too, and this may indicate a risk for EDs. Our aim was to learn more about ED risk factors tied to CE and to try to isolate questions to ask in order to probe for high ED risk in adolescents engaging in CE. Using two well-established instruments (the Structural Analysis of Social Behavior and the Eating Disorders Examination Questionnaire), we studied associations between ED variables and CE in healthy adolescent boys and girls. We examined gender-specific items to generate the best possible fit for each gender. Individuals with CE displayed significantly greater ED pathology and more self-criticism, and this pattern was stronger in girls than in boys. Risk factors for ED among individuals with CE differed slightly for boys and girls. We put forward a set of gender-specific questions that may be helpful when probing for ED risk among adolescents engaging in CE. Full article

(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)

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12 pages, 358 KiB

Open AccessArticle

Friday Night Is Pizza Night: A Comparison of Children’s Dietary Intake and Maternal Perceptions and Feeding Goals on Weekdays and Weekends

by Debra A. Hoffmann, Jenna M. Marx, Jacob M. Burmeister and Dara R. Musher-Eizenman

Int. J. Environ. Res. Public Health 2018, 15(4), 720; https://doi.org/10.3390/ijerph15040720 - 11 Apr 2018

Cited by 17 | Viewed by 4812

Abstract

Childhood obesity is a serious issue in the U.S. While obesity is the result of a multitude of factors, a great deal of research has focused on children’s dietary intake. While children’s eating patterns vary throughout the week, not much else is known [...] Read more.

Childhood obesity is a serious issue in the U.S. While obesity is the result of a multitude of factors, a great deal of research has focused on children’s dietary intake. While children’s eating patterns vary throughout the week, not much else is known about weekday-weekend differences. Therefore, the current study examined differences in the frequency and portion size of school-age children’s consumption of common foods and beverages, as well as mothers’ perceptions of those items and their child feeding goals, on weekdays and weekends. A total of 192 mothers of children aged 7 to 11 were recruited through Amazon’s Mechanical Turk. Results showed a consistent pattern of more frequent consumption and larger portions of unhealthy foods and beverages on weekends. This aligned with mothers’ perceptions of those foods and beverages as weekend items, as well as their feeding goals of health and price being less important on weekends. It is quite possible that weekends are viewed as having less structure and facilitate schedules that allow children to consume more meals away from home. These findings shed light on additional risk factors in children’s eating patterns and highlight the serious implications that day of the week can have on childhood obesity. Full article

(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)

13 pages, 1699 KiB

Open AccessArticle

Promoting Water Consumption on a Caribbean Island: An Intervention Using Children’s Social Networks at Schools

by Saskia C. M. Franken, Crystal R. Smit and Moniek Buijzen

Int. J. Environ. Res. Public Health 2018, 15(4), 713; https://doi.org/10.3390/ijerph15040713 - 10 Apr 2018

Cited by 21 | Viewed by 8016

Abstract

Sugar-sweetened beverage (SSB) consumption and the associated childhood obesity are major concerns in the Caribbean, creating a need for interventions promoting water consumption as a healthy alternative. A social network-based intervention (SNI) was tested among Aruban children to increase their water consumption and [...] Read more.

Sugar-sweetened beverage (SSB) consumption and the associated childhood obesity are major concerns in the Caribbean, creating a need for interventions promoting water consumption as a healthy alternative. A social network-based intervention (SNI) was tested among Aruban children to increase their water consumption and behavioral intention to do so and, consequently, to decrease SSB consumption and the associated behavioral intention. In this study, the moderating effects of descriptive and injunctive norms were tested. A cluster randomized controlled trial was completed in schools (mean age = 11 years ± SD = 0.98; 54% girls). Children were assigned to the intervention group (IG; n = 192) or control group (CG; n = 185). IG children were exposed to peer influencers promoting water consumption and CG children were not. Regression analyses showed that water consumption increased for IG children with a high injunctive norm score (p = 0.05); however, their intention to consume more water remained unchanged (p = 0.42). Moreover, IG children showed a decrease in SSB consumption (p = 0.04) and an increase in their intention to consume less SSB (p = 0.00). These findings indicate that SNIs are a promising instrument for health behavioral changes for Aruba and other islands in the Caribbean region. Full article

(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)

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14 pages, 319 KiB

Open AccessArticle

Determinants of Child Health Behaviors in a Disadvantaged Area from a Community Perspective: A Participatory Needs Assessment

by Manou Anselma, Mai Jeanette Maidy Chinapaw and Teatske Maria Altenburg

Int. J. Environ. Res. Public Health 2018, 15(4), 644; https://doi.org/10.3390/ijerph15040644 - 31 Mar 2018

Cited by 19 | Viewed by 6308

Abstract

Children from disadvantaged areas are hard to reach for interventions aimed at promoting healthy lifestyles. We conducted a participatory needs assessment, in which researchers collaborated with a community in a disadvantaged area in Amsterdam to gain an understanding of the health-related issues of [...] Read more.

Children from disadvantaged areas are hard to reach for interventions aimed at promoting healthy lifestyles. We conducted a participatory needs assessment, in which researchers collaborated with a community in a disadvantaged area in Amsterdam to gain an understanding of the health-related issues of children within this community. Qualitative data was collected through: three to four participatory group meetings with three groups of 9–12-year-old children (n = 5–9 per group); nine interviews with professionals working with youth; two interviews with parents and their children; and informal meetings including 31 parents. All transcriptions or summaries were coded and analyzed. Childhood overweight/obesity was indicated as the main health issue. A lack of physical activity and unhealthy dietary behavior were identified as the main risk factors, with underlying determinants such as culture, habits, finances, and social norms. Identified needs included more supervised, low-priced sports activities at a nearby location and more education on adopting a healthy diet. Our participatory health needs assessment resulted in a comprehensive overview of the most relevant risk factors and determinants of childhood overweight/obesity and needs from the community’s perspective. This knowledge aids in the development of better tailored, and thereby potentially more effective, interventions. Full article

(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)

13 pages, 354 KiB

Open AccessArticle

by Hongyan Liu, Xianglong Xu, Dengyuan Liu, Yunshuang Rao, Cesar Reis, Manoj Sharma, Jun Yuan, Yao Chen and Yong Zhao

Int. J. Environ. Res. Public Health 2018, 15(4), 615; https://doi.org/10.3390/ijerph15040615 - 28 Mar 2018

Cited by 35 | Viewed by 9024

Abstract

Kindergarten teachers play an important role in providing kindergarten children with education on nutrition. However, few studies have been published on nutrition-related knowledge, attitudes, and practices (KAP) of Chinese kindergarten teachers. This study aimed to assess the nutrition-related knowledge, attitudes, and practices (KAP) [...] Read more.

Kindergarten teachers play an important role in providing kindergarten children with education on nutrition. However, few studies have been published on nutrition-related knowledge, attitudes, and practices (KAP) of Chinese kindergarten teachers. This study aimed to assess the nutrition-related knowledge, attitudes, and practices (KAP) of kindergarten teachers in Chongqing, China. Thus, a cross-sectional survey was conducted using a structured KAP model questionnaire administered to 222 kindergarten teachers, who were senior teachers from 80 kindergartens in 19 districts and 20 counties in Chongqing. Multiple regression analysis was used to analyze the influential factors. Among the participants, 54.2% were familiar with simple nutrition-related knowledge; only 9.9% of them were satisfied with their knowledge of childhood nutrition; and 97.7% of them had a positive attitude to learn nutrition-related knowledge. Only 38.7% of the participants had attended pediatric nutrition knowledge courses or training. Multiple regression analysis confirmed significant independent effects on the nutrition knowledge score (p < 0.0001) of respondents on age, type of residence, type of kindergarten, body mass index(BMI), professional training of kindergarten teachers, behavior of having ever participated in childhood nutrition education knowledge courses or training, and behavior of having ever paid attention to children’s nutrition knowledge. The model indicated that independent variables explained 45.4% (adjusted R²) of the variance found in the knowledge scores of respondents. While there were low levels of nutrition knowledge and training, it was still encouraging to note that there were positive attitudes towards acquiring nutrition-related knowledge among kindergarten teachers in Chongqing, China. These findings provide some implications that necessary training measures need to be carried out to improve the nutrition-related knowledge level among kindergarten teachers in China. Full article

(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)

8 pages, 317 KiB

Open AccessArticle

Classification Accuracy of a Wearable Activity Tracker for Assessing Sedentary Behavior and Physical Activity in 3–5-Year-Old Children

by Wonwoo Byun, Jung-Min Lee, Youngwon Kim and Timothy A. Brusseau

Int. J. Environ. Res. Public Health 2018, 15(4), 594; https://doi.org/10.3390/ijerph15040594 - 26 Mar 2018

Cited by 24 | Viewed by 5051

Abstract

This study examined the accuracy of the Fitbit activity tracker (FF) for quantifying sedentary behavior (SB) and varying intensities of physical activity (PA) in 3–5-year-old children. Twenty-eight healthy preschool-aged children (Girls: 46%, Mean age: 4.8 ± 1.0 years) wore the FF and were [...] Read more.

This study examined the accuracy of the Fitbit activity tracker (FF) for quantifying sedentary behavior (SB) and varying intensities of physical activity (PA) in 3–5-year-old children. Twenty-eight healthy preschool-aged children (Girls: 46%, Mean age: 4.8 ± 1.0 years) wore the FF and were directly observed while performing a set of various unstructured and structured free-living activities from sedentary to vigorous intensity. The classification accuracy of the FF for measuring SB, light PA (LPA), moderate-to-vigorous PA (MVPA), and total PA (TPA) was examined calculating Pearson correlation coefficients (r), mean absolute percent error (MAPE), Cohen’s kappa (k), sensitivity (Se), specificity (Sp), and area under the receiver operating curve (ROC-AUC). The classification accuracies of the FF (ROC-AUC) were 0.92, 0.63, 0.77 and 0.92 for SB, LPA, MVPA and TPA, respectively. Similarly, values of kappa, Se, Sp and percentage of correct classification were consistently high for SB and TPA, but low for LPA and MVPA. The FF demonstrated excellent classification accuracy for assessing SB and TPA, but lower accuracy for classifying LPA and MVPA. Our findings suggest that the FF should be considered as a valid instrument for assessing time spent sedentary and overall physical activity in preschool-aged children. Full article

(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)

9 pages, 289 KiB

Open AccessArticle

The Health Halo Trend in UK Television Food Advertising Viewed by Children: The Rise of Implicit and Explicit Health Messaging in the Promotion of Unhealthy Foods

by Rosa Whalen, Joanne Harrold, Simon Child, Jason Halford and Emma Boyland

Int. J. Environ. Res. Public Health 2018, 15(3), 560; https://doi.org/10.3390/ijerph15030560 - 20 Mar 2018

Cited by 37 | Viewed by 9649

Abstract

Monitoring the creative content within food marketing to children is strongly advocated by public health authorities, but few studies address the prevalence of health-related messaging in television adverts. Food and beverage adverts (n = 18,888 in 2008, n = 6664 in 2010) [...] Read more.

Monitoring the creative content within food marketing to children is strongly advocated by public health authorities, but few studies address the prevalence of health-related messaging in television adverts. Food and beverage adverts (n = 18,888 in 2008, n = 6664 in 2010) from UK television channels popular with children were coded and analyzed. Physical-activity depiction displayed an 18.8 percentage point increase from 2008 (4.4%) to 2010 (23.2%). Of the food adverts containing physical-activity depiction in 2010, 81.1% were for non-core foods. The appearance of health claims in food adverts in 2010 increased 4.1 percentage points from 2008 levels (20.7% to 24.8%) where the majority of food adverts featuring health and nutrition claims were for non-core foods (58.3%). Health-related (e.g., health/nutrition, weight loss/diet) appeals were used in 17.1% of food adverts during peak child-viewing times, rising to 33.0% of adverts shown on dedicated children’s channels in 2010. Implicit (physical activity) and explicit (health claims) health messages are increasingly prevalent in UK television food advertising viewed by children, and are frequently used to promote unhealthy foods. Policy makers in the UK should consider amendments to the existing statutory approach in order to address this issue. Full article

(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)

10 pages, 314 KiB

Open AccessArticle

The Relationship between Obesity, Sleep and Physical Activity in Chinese Preschool Children

by Meimei Ji, Amber Tang, Yefu Zhang, Jiaojiao Zou, Guangyu Zhou, Jing Deng, Lina Yang, Mingzhi Li, Jihua Chen, Hong Qin and Qian Lin

Int. J. Environ. Res. Public Health 2018, 15(3), 527; https://doi.org/10.3390/ijerph15030527 - 15 Mar 2018

Cited by 55 | Viewed by 10340

Abstract

Background: Pediatric overweight and obesity has become a major public health problem in China. The goal of this study is to understand overweight and obesity in preschool children in Changsha City in the context of their sleep and physical activity. These results offer [...] Read more.

Background: Pediatric overweight and obesity has become a major public health problem in China. The goal of this study is to understand overweight and obesity in preschool children in Changsha City in the context of their sleep and physical activity. These results offer feasible proposals to reduce levels of overweight and obesity among preschool children. Methods: A total of 112 preschoolers aged three to six years old were investigated using multiple stage stratified cluster sampling and simple random sampling. Questionnaires were used to collect general information about children and their families. Body mass index (BMI) was used as an indicator of overweight and obesity. Age- and sex-specific cutoff values for Chinese children and adolescents were used to determine child weight status. Children’s sedentary time was reported by caregivers, while physical activity and sleep were recorded using fitness bracelets (Misfit Shine 2). Results: The prevalence of childhood overweight and obesity were 15.2% and 9.8% respectively. Preschool-aged children travelled 11,111 ± 3357 and 10,350 ± 2973 steps per day on weekdays and weekends respectively. The number of daily steps was not statistically different between weekdays and weekends. The amount of time spent daily doing vigorous activity on weekdays and weekends was significantly different, with an average time of 20.5 ± 31.6 min and 10.3 ± 15.3 min respectively (p = 0.002). Furthermore, 10.7% and 50.9% of children used screens for more than two hours on weekdays and weekends respectively (p < 0.001). Children slept for significantly longer on weekends (8.3 ± 0.9 h) than on weekdays (8.1 ± 0.7 h) (p = 0.037). A significantly higher proportion of students also fell asleep before 10:00 p.m. on weekends (26.8%) compared to weekdays (15.2%) (p < 0.001). Parent’s BMI values were positively correlated with child BMI, the monthly household income was negatively associated with child BMI. Male children were more likely to have a higher BMI than female children. Children who were obese were also more likely to have shorter sleep times compared to children of normal weight (p = 0.047). Conclusions: There was a high prevalence of overweight and obesity among the Chinese preschool children in this study. Students also demonstrated poor sleep and physical activity habits. Future research is necessary to explore the relationship between sleep, physical activity and weight status for young children in China. Full article

(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)

14 pages, 320 KiB

Open AccessArticle

Parental Education and Pre-School Children’s Objectively Measured Sedentary Time: The Role of Co-Participation in Physical Activity

by Suvi Määttä, Carola Ray, Henna Vepsäläinen, Elviira Lehto, Riikka Kaukonen, Anna Ylönen and Eva Roos

Int. J. Environ. Res. Public Health 2018, 15(2), 366; https://doi.org/10.3390/ijerph15020366 - 20 Feb 2018

Cited by 17 | Viewed by 6075

Abstract

Parental co-participation in physical activity (PA) may be a beneficial parenting practice for diminishing children’s sedentary time (ST). Less information is available, however, on the explanatory role of co-participation in PA regarding parental educational differences in children's ST. Preschool-aged children (N = 864, [...] Read more.

Parental co-participation in physical activity (PA) may be a beneficial parenting practice for diminishing children’s sedentary time (ST). Less information is available, however, on the explanatory role of co-participation in PA regarding parental educational differences in children's ST. Preschool-aged children (N = 864, mean age 4.8, 52% boys) with their parents participated in a cross-sectional DAGIS (Increased Health and Wellbeing in Pre-schools) study between years 2015 and 2016. Children (N = 821) wore an accelerometer for one week. Parents were informed of their educational background, and the frequency of visits with their child in nature, to parks or playgrounds, their own yard, and indoor sport facilities (N = 808). Testing the associations required multiple regression analyses. Parents with a low educational background reported more frequent visits with their child to their own yard, and these visits were associated with children’s lower ST. More highly educated parents co-visited indoor sport facilities more frequently, although this did not have a significant association with children’s ST. More frequent visits in nature were associated with a lower ST at weekdays, regardless of educational background. Future health promotion strategies should inform parents that frequent co-participation in PA, for example, in one’s own yard, is beneficial for lowering children’s ST. Full article

(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)

14 pages, 850 KiB

Open AccessArticle

Daily Patterns of Preschoolers’ Objectively Measured Step Counts in Six European Countries: Cross-Sectional Results from the ToyBox-Study

by Vicky Van Stappen, Delfien Van Dyck, Julie Latomme, Ilse De Bourdeaudhuij, Luis Moreno, Piotr Socha, Violeta Iotova, Berthold Koletzko, Yannis Manios, Odysseas Androutsos, Greet Cardon and Marieke De Craemer

Int. J. Environ. Res. Public Health 2018, 15(2), 291; https://doi.org/10.3390/ijerph15020291 - 7 Feb 2018

Cited by 6 | Viewed by 4693

Abstract

This study is part of the ToyBox-study, which is conducted in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain), aiming to develop a cost-effective kindergarten-based, family-involved intervention to prevent overweight and obesity in four- to six-year-old preschool children. In the current [...] Read more.

This study is part of the ToyBox-study, which is conducted in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain), aiming to develop a cost-effective kindergarten-based, family-involved intervention to prevent overweight and obesity in four- to six-year-old preschool children. In the current study, we aimed to examine and compare preschoolers’ step count patterns, across the six European countries. A sample of 3578 preschoolers (mean age: 4.8 ± 0.4) was included. Multilevel analyses were performed to take clustering of measurements into account. Based on the average hourly steps, step count patterns for the six European countries were created for weekdays and weekend days. The step count patterns during weekdays were related to the daily kindergarten schedules. Step count patterns during weekdays showed several significant peaks and troughs (p < 0.01) and clearly reflected the kindergartens’ daily schedules, except for Germany. For example, low numbers of steps were observed during afternoon naptimes and high numbers of steps during recess. In Germany, step count patterns did not show clear peaks and troughs, which can be explained by a less structured kindergarten schedule. On weekend days, differences in step count patterns were observed in the absolute number of steps in the afternoon trough and the period in which the evening peak occurred. Differences in step count patterns across the countries can be explained by differences in (school) policy, lifestyle habits, and culture. Therefore, it might be important to respond to these step count patterns and more specifically to tackle the inactive periods during interventions to promote physical activity in preschoolers. Full article

(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)

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12 pages, 315 KiB

Open AccessArticle

Sex-Specific Associations in Nutrition and Activity-Related Risk Factors for Chronic Disease: Australian Evidence from Childhood to Emerging Adulthood

by Erin Hoare, Sarah R. Dash, Garry L. Jennings and Bronwyn A. Kingwell

Int. J. Environ. Res. Public Health 2018, 15(2), 214; https://doi.org/10.3390/ijerph15020214 - 26 Jan 2018

Cited by 8 | Viewed by 4998

Abstract

Global assessments of burden of disease suggests there are sex differences in risk factors for chronic disease, including overweight/obesity, dietary patterns and habitual physical activity. Given that prevention efforts aim to target such factors to reduce disease risk, the age at which sex [...] Read more.

Global assessments of burden of disease suggests there are sex differences in risk factors for chronic disease, including overweight/obesity, dietary patterns and habitual physical activity. Given that prevention efforts aim to target such factors to reduce disease risk, the age at which sex differences may occur is of particular interest. Early life to young adulthood is the optimal time for intervention, with lifestyle habits typically forming during this period. This study aimed to identify the sex differences in risk factors for chronic disease during childhood (5–9 years), adolescence (10–17 years) and emerging adulthood (18–25 years) in a large population-representative Australian sample. Among children in this study (n = 739), no sex-related differences were observed. Among adolescents (n = 1304), females were more likely than males to meet daily fruit and vegetable recommendations (12.9% vs. 7.5%; OR = 1.84, 95% CI = 1.16, 2.93, p < 0.05). Among emerging adults (n = 909), females were less likely to be overweight/obese (30.1% vs. 39.8%; OR = 0.65, 95% CI = 0.44, 0.95, p < 0.05) and more likely to meet physical activity recommendations (52.1% vs. 42.3%; OR = 1.44, 95% CI = 1.01, 2.06, p < 0.05). These findings suggest that sex differences for risk factors of chronic disease occur during adolescence and emerging adulthood, although the differences are not consistent across age periods. From adolescence onwards, it appears that females exhibit lower risk factors than males and a life span approach to risk factor monitoring is warranted. Full article

(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)

650 KiB

Open AccessArticle

Impact of Distance on Mode of Active Commuting in Chilean Children and Adolescents

by Fernando Rodríguez-Rodríguez, Carlos Cristi-Montero, Carlos Celis-Morales, Danica Escobar-Gómez and Palma Chillón

Int. J. Environ. Res. Public Health 2017, 14(11), 1334; https://doi.org/10.3390/ijerph14111334 - 2 Nov 2017

Cited by 28 | Viewed by 5601

Abstract

Active commuting could contribute to increasing physical activity. The objective of this study was to characterise patterns of active commuting to and from schools in children and adolescents in Chile. A total of 453 Chilean children and adolescents aged between 10 and 18 [...] Read more.

Active commuting could contribute to increasing physical activity. The objective of this study was to characterise patterns of active commuting to and from schools in children and adolescents in Chile. A total of 453 Chilean children and adolescents aged between 10 and 18 years were included in this study. Data regarding modes of commuting and commuting distance was collected using a validated questionnaire. Commuting mode was classified as active commuting (walking and/or cycling) or non-active commuting (car, motorcycle and/or bus). Commuting distance expressed in kilometres was categorised into six subgroups (0 to 0.5, 0.6 to 1, 1.1 to 2, 2.1 to 3, 3.1 to 5 and >5 km). Car commuting was the main mode for children (to school 64.9%; from school 51.2%) and adolescents (to school 50.2%; from school 24.7%). Whereas public bus commuting was the main transport used by adolescents to return from school. Only 11.0% and 24.8% of children and adolescents, respectively, walk to school. The proportion of children and adolescents who engage in active commuting was lower in those covering longer distances compared to a short distance. Adolescents walked to and from school more frequently than children. These findings show that non-active commuting was the most common mode of transport and that journey distances may influence commuting modes in children and adolescents. Full article

(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)

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