Moderate-to-vigorous physical activity and sedentary behaviours in relation to body mass index-defined and waist circumference-defined obesity

The aim of the present study was to investigate the relationships of physical activity types and sedentary behaviour with BMI and waist circumference (WC). The sample comprised 6215 adults (2775 men, 3440 women) aged 16 years and over living in Scotland. Self-reported physical activity of moderate to vigorous intensity (MVIA) included domestic activity, walking, and sports and exercises. MVIA levels were classified as being inactive, being insufficiently active, being sufficiently active for general health benefits and being sufficiently active for obesity prevention. Sedentary time was defined as television and other screen-based entertainment time (TVSE). Dependent variables were BMI-defined obesity (BMI-OB) and WC-defined obesity (WC-OB). TVSE was positively related to both WC-OB (adjusted OR 1.69 (95 % CI 1.39, 2.05) for > or = 4 h of TVSE per d compared with < 2 h/d) and BMI-OB (OR 1.88; 95 % CI 1.51, 2.35) independently of MVIA. Those classified as most active who reported > or = 4 h/d of TVSE had higher prevalence of BMI-OB (18.9 v. 8.3 %; P < 0.05) and WC-OB (28.0 v. 10.0 %; P < 0.01) than those equally active with < 2 h/d of TVSE. Sports and walking were related inversely to WC-OB (OR for no time compared with > or = 30 min/d: 1.55 (95 % CI 1.24, 1.94); 2.06 (95 % CI 1.64, 2.58)), but only walking was related to BMI-OB (OR 1.94; 95 % CI 1.58, 2.37). Domestic physical activity was not related to BMI-OB or WC-OB. In conclusion, physical activity and sedentary behaviour are independently related to obesity. Public health recommendations should both promote physical activity and discourage engagement in sedentary pursuits.     

Predictor factors for childhood obesity in a Spanish case-control study

OBJECTIVE: The aim of this study was to identify and characterize factors associated with childhood obesity risk related to lifestyle and perinatal life influences (dietary pattern, physical activity, family history of obesity, breast-feeding, sedentary behavior, and birth weight) in a case-control study design. METHODS: Cases were 185 obese (body mass index >97th percentile) children and adolescents (6-18 y old) from the Navarra region of Spain and control subjects were matched by sex and age. Anthropometric data were collected, and a personal interview about lifestyle parameters (dietary patterns, physical activity, family history of obesity, breast-feeding and sedentary behaviors) was performed with each participant. Conditional logistic regression was used to identify predictive factors of obesity. RESULTS: Leisure time physical activity proved to be a protector factor against obesity (odds ratio [OR] 0.94, 95% confidence interval [CI] 0.92-0.96), whereas family history of obesity (OR 4.18, 95% CI 2.20-8.62), watching television (OR 2.02, 95% CI 1.09-3.77), and sugar-sweetened beverage consumption (OR 1.74, 95% CI 1.05-2.89) were associated with a higher obesity risk. CONCLUSION: Our results suggest that leisure time physical activity, family history of obesity, watching television, and sugar-sweetened beverage consumption are important predictive variables for childhood obesity, whereas other factors including breast-feeding, birth weight, and time spent sleeping did not appear to play an important role in the development of childhood obesity.     

Environmental and lifestyle factors associated with overweight and obesity in Perth,Australia

PURPOSE: To examine associations between environmental and lifestyle factors and overweight or obesity. DESIGN: A cross-sectional survey and an environmental scan of recreational facilities. SETTING: Metropolitan Perth, Western Australia. SUBJECTS: Healthy sedentary workers and homemakers aged 18 to 59 years (n = 1803) living in areas within the top and bottom quintiles of social disadvantage. MEASURES: Four lifestyle factors, one social environmental factor, and five physical environment factors (three objectively measured). RESULTS: After adjustment for demographic factors and other variables in the model, overweight was associated with living on a highway (odds ratio [OR], 4.24; 95% confidence interval [CI], 1.62-11.09) or streets with no sidewalks or sidewalks on one side only (OR, 1.35; 95% CI, 1.03-1.78) and perceiving no paths within walking distance (OR, 1.42; 95% CI, 1.08-1.86). Poor access to four or more recreational facilities (OR, 1.68; 95% CI, 1.11-2.55) and sidewalks (OR, 1.62; 95% CI, .98-2.68) and perceiving no shop within walking distance (OR, 1.84; 95% CI, 1.01-3.36) were associated with obesity. Conversely, access to a motor vehicle all the time was negatively associated with obesity (OR, .56; 95% CI, .32-.99). Watching 3 or more hours of television daily (ORs, 1.92 and 1.85, respectively) and rating oneself as less active than others (ORs, 1.66 and 4.05, respectively) were associated with both overweight and obesity. After adjustment for individual demographic factors and all other variables in the model, socioeconomic status of area of residence and leisure-time physical activity were not associated with overweight or obesity. CONCLUSION: Factors that influence overweight and obesity appear to differ, but aspects of the physical environment may be important. Objectively measured neighborhood environment factors warrant further investigation.     

广州市城区小学二年级学生家庭在外就餐频次与学生肥胖的关系

目的 了解广州市城区小学二年级学生的家庭在外就餐现状及其影响因素,并分析其与儿童超重肥胖的关系。方法 抽取广州市12所小学的二年级学生2 206名,进行问卷调查和体格检查。应用logistic回归模型分析家庭在外就餐的影响因素及其与儿童超重肥胖的关系。结果 学生家庭在外就餐≥1次/周者占53.99%。多因素分析显示,独生子女家庭比非独生子女家庭有更高的可能性在外就餐（OR = 1.45,95% CI:1.18～1.78,P＜0.001）。与家庭人均月收入＜5 000元的家庭相比,收入高的家庭在外就餐的可能性更高（家庭人均月收入为5 000～9 999元:OR = 1.60,95% CI:1.21～2.13,P = 0.001;≥10 000元:OR = 2.22,95% CI:1.68～2.94,P＜0.001）。类似,与父母文化程度为高中及以下的家庭相比,父母文化程度为大专或本科的家庭有更高的在外就餐可能性（OR = 1.87,95% CI:1.44～2.43,P＜0.001）。而中等营养知识得分的家长较得分高的家长有减少带孩子外出就餐的倾向（OR = 0.75,95% CI:0.59～0.95,P = 0.016）。此外,家庭在外就餐与儿童超重肥胖风险增高存在统计学关联（OR = 1.31,95% CI:1.03～1.67,P = 0.032）。结论 广州市城区小学二年级学生家庭在外就餐现象较为普遍。独生子女家庭、家庭收入和父母文化程度和营养知识水平是家庭在外就餐的影响因素。家庭在外就餐可能会增加儿童超重肥胖的风险。     

浙江省某市2002-2015年婴幼儿营养状况分析

目的 了解浙江省某市2002-2015年婴幼儿营养状况,分析有关影响因素。方法 利用该市电子医疗记录数据库,提取孕妇首次随访数据与婴幼儿体格检查数据。采用Z值评分对婴幼儿营养状况进行评价,应用Logistic回归探讨婴幼儿生长不良的影响因素。结果 在48 827名体检的婴幼儿中,低体重、生长迟缓、消瘦、超重、肥胖率分别为1.43%、1.31%、1.90%、2.62%、0.34%。不同性别间肥胖发生率的差别具有统计学意义（χ2=5.164,P=0.023）。婴幼儿超重、肥胖检出率呈逐年下降趋势,低体重率呈上升趋势。Logistic回归分析显示,母亲高文化程度是婴幼儿低体重、生长迟缓、消瘦的保护因素;孕前体重指数（body mass index,BMI）较高是婴幼儿超重（OR=1.063,95%CI:1.057~1.069,P<0.001）、肥胖（OR=1.074,95%CI:1.060~1.088,P<0.001）的危险因素;高危妊娠是婴幼儿低体重（OR=2.214,95%CI:1.928~2.542,P<0.001）、生长迟缓（OR=2.543,95%CI:2.193~2.949,P<0.001）、消瘦（OR=1.211,95%CI:1.062~1.380,P=0.004）的危险因素。结论 该地区婴幼儿生长发育情况总体良好,但仍面临营养不良与营养过剩的双重问题。母亲孕前BMI、文化程度及是否高危妊娠是儿童生长不良的影响因素。     

Overweight and obesity related to activities in Portuguese children, 7-9 years

BACKGROUND: The purpose of the study was to explore the association among the following variables: physical activity, TV, videogames, and obesity. The study included a Portuguese random nationally representative sample of 3365 children (1610 girls and 1755 boys) 7-9 year olds. METHODS: A general questionnaire was completed by the parents of participating children to provide information about the hours spent per week watching television, computer use and electronic games, and the participation in physical education. Overweight and obesity were calculated by using the body mass index (BMI) assessment and the cut-off points for overweight (25 kg/m(2)) and obesity (30 kg/m(2)). RESULTS: The data from the association between BMI and the independent variables (analysis of variance) were only significant for time playing electronic games for boys and girls (P < 0.001; P < 0.029). The association between hours of watching TV and BMI was significant only for boys (P < 0.016). The results from the logistic regression were only significant for electronic games both for boys and girls (P < 0.000; P < 0.000). CONCLUSIONS: The results of this study suggest that the time spent playing electronic games is associated with obesity. Reducing childhood obesity calls for the reduction in sedentary behaviours, and the promotion of a more active lifestyle.     

Trends in childhood and parental asthma prevalence in Merseyside, 1991-1998

OBJECTIVE: To determine changes in childhood and parental asthma prevalence in Merseyside between 1991 and 1998. METHODS: Three standardized cross-sectional respiratory health surveys using a parent-completed questionnaire were completed in 1991 (n = 1171), 1993 (n = 2368) and 1998 (n = 1964) amongst primary school children (5-11 years) attending the same 10 schools. The main outcome measures were prevalence of reported doctor diagnosed asthma, the symptom triad of cough, wheeze and breathlessness (C+W+B+) and parental asthma. RESULTS: Significant changes in prevalence for all respiratory variables occurred between 1991 and 1998, except for the symptom triad C+W+B+. Between 1991 and 1998 the prevalence of reported doctor diagnosed asthma increased from 17.7 to 29.8 per cent (p < 0.001), history of wheezing increased from 22.5 to 29.4 per cent (p < 0.001). The symptom triad of C+W+B+ changed from 9.6 to 9.9 per cent (p = 0.78). Childhood reported hospital admissions for respiratory illness increased from 5.5 to 10.7 per cent (p < 0.001). Paternal asthma increased from 6.5 per cent in 1991, to 8.6 per cent in 1998 (p = 0.031), and maternal asthma almost doubled in the same period from 6.6 to 11.2 per cent (p < 0.001). Children living in poorer areas (Townsend score 8-11) were more likely to have doctor diagnosed asthma (OR = 2.99, 95 per cent CI, 2.06 to 4.33) and C+W+B+ (OR = 2.17, CI 1.13 to 4.18). Childhood obesity was significantly associated with increased risk of both doctor diagnosed asthma (OR = 1.74, 95 per cent CI, 1.29 to 2.37) and C+W+B+ (OR = 1.88, 95 per cent CI, 1.21 to 2.90). CONCLUSION: A rising prevalence of reported doctor diagnosed asthma, but not C+W+B+ was observed during the 1990s in a low socio-economic area of Liverpool. Asthma prevalence was related to socio-economic deprivation and was associated with obesity. The rising prevalence of reported doctor diagnosed asthma is likely to be attributable to several factors, including changes in diagnostic labelling and the distribution of factors related to socio-economic status.     

The association between information and communication technology exposure and physical activity, musculoskeletal and visual symptoms and socio-economic status in 5-year-olds

BACKGROUND: Increasing use of computers by children has raised concerns over the potential impact on their cognitive, social, educational, visual and physical development. Despite this concern, there are no large-scale studies relating the use of computers to specific health indicators in children as they reach school age. METHODS: A cross-sectional analysis of 1600 5-year-old Western Australian children participating in a longitudinal cohort study was conducted to ascertain their computer use, other activities (watching television and videos, playing electronic games, reading and looking at books, drawing on paper and moderate to vigorous physical activity), and specific health indicators. RESULTS: More than half (56%) of the children used computers each week. Computer use was significantly related to TV viewing (OR 1.97 weekday) and electronic game use (console games OR 2.48 weekday, 1.81 weekend; hand-held games OR 1.88 weekend) and negatively associated with vigorous physical activity on weekends (OR 0.72). Computer use was also significantly related to socio-economic indicators such as the mother being older (40+ years, OR 1.70 weekend, 1.73 weekday), tertiary educated (OR 1.63 weekend) and studying (OR 1.52 weekend, 1.41 weekday). Almost 1% children were reported to have complained of tired or sore muscles, and 2.2% had complained of tired or sore eyes, after watching television or using a computer. CONCLUSION: A substantial proportion of 5-year-old Western Australian children are using computers. Computer use was related to other sedentary activities and less vigorous activity. While musculoskeletal and vision problems are not widespread, their presence and the sedentary nature of computer use is of public health concern.     

Prevalence and socio-demographic associations of undernutrition and obesity among preschool children in Cyprus

OBJECTIVE: To estimate the prevalence of undernutrition and obesity in preschool children in Cyprus and identify possible associations. DESIGN: Cross-sectional study. SETTING: Private and public nursery schools. SUBJECTS: A representative sample (n=1412) stratified by age, gender, district and area of residence. INTERVENTIONS: Weight (kg) and height (cm) were obtained and BMI (kg/m2) was calculated. Z scores for weight-for-age, height-for-age, and weight-for-height were calculated using the cutoffs from the CDC/WHO 1978 reference. Socio-demographic associations with nutritional status were examined in a logistic regression analysis. RESULTS: The prevalence of undernutrition (WHO definition, Z-scores <-2) was low. Specifically the prevalence of underweight was 2.3%, wasting 2.8%, and stunting 1.1%. Undernutrition was associated with a low birth weight (LBW); odds ratio (OR) for underweight 4.1 (95% CI: 1.4, 12.2), P=0.012, stunting 5.2 (95% CI: 1.1, 23.3), P=0.033, and wasting 4.2 (95% CI: 1.3, 14.3), P=0.021.The prevalence of obesity (IOTF definition) was higher than undernutrition, and increased with age: 1.3% in 2 y olds to 10.4% in 6 y olds. Overweight and obesity prevalence were higher in rural (16.1%) than urban children (12.8%; P=0.046). Obesity in preschool children was associated with paternal obesity, OR 3.24 (95% CI: 1.59, 6.61), P=0.001, and maternal obesity 3.91 (95% CI: 1.78, 8.59), P=0.001. A birth weight (BW)> or =4000 g was associated with obesity compared to a BW between 2501 and 3000 g, OR 7.63 (95% CI: 1.91, 30.52), P=0.004. CONCLUSIONS: The prevalence of undernutrition among preschool children in Cyprus was low but obesity prevalence was higher. Parental obesity and high BW were significantly associated with obesity while LBW was associated with undernutrition in preschool children.     

Overweight among children and adolescents in a Native Canadian community: prevalence and associated factors

BACKGROUND: The prevalence of pediatric obesity in North America is increasing. Native American children are at especially high risk. OBJECTIVES: The objective was to evaluate the prevalence of pediatric overweight and associated behavioral factors in a Native Canadian community with high rates of adult obesity and type 2 diabetes mellitus. DESIGN: Height and weight were measured in 445 children and adolescents aged 2-19 y. Fitness level, television viewing, body image concepts, and dietary intake were assessed in 242 subjects aged 10-19 y. Overweight was defined as a body mass index > or =85th percentile value for age- and sex-specific reference data from the third National Health and Nutrition Examination Survey (NHANES III). Multiple logistic regression was used to examine factors associated with overweight, with adjustment for age and sex. RESULTS: The overall prevalence of overweight in subjects aged 2-19 y was significantly higher than NHANES III reference data [boys: 27. 7% (95% CI: 21.8, 34.5); girls: 33.7% (95% CI: 27.9, 40.1)]. In the subset aged 10-19 y, > or =5 h television viewing/d was associated with a significantly higher risk of overweight than was < or =2 h/d [odds ratio (OR) = 2.52; 95% CI: 1.06, 5.98]. Subjects in the third and fourth quartiles of fitness had a substantially lower risk of overweight than did those in the first quartile [third quartile compared with first quartile: OR = 0.24 (95% CI: 0.09, 0.66); fourth quartile compared with first quartile: OR = 0.13 (95% CI: 0.03, 0. 48)]. Fiber consumption on the previous day was associated with a decreased risk of overweight (OR = 0.69; 95% CI: 0.47, 0.99 for each 0.77 g/MJ increase in fiber intake). CONCLUSIONS: Pediatric overweight is a harbinger of future diabetes risk and indicates a need for programs targeting primary prevention of obesity in children and adolescents.     

Unsung heroes who put their lives at risk? Informal caring, health and neighbourhood attachment

BACKGROUND: Previous studies have highlighted the effects of informal caring on mental health, but evidence for its wider impact remains scant. We explored associations between informal care and a range of health (and health-related) measures. We also considered previously neglected differences between informal care 'at home' and care elsewhere, along with neighbourhood attachment as a possible modifier of the associations we found. METHODS: The study involved a large population survey in two Primary Care Trusts. Data were collected by postal survey of 15,465 adults; subjects were selected from the local General Practice register. 12.7 per cent of respondents identified themselves as carers. Health measures included psychiatric morbidity, bodily pain, self-assessed health, health-related behaviours, obesity, prescribed drugs and high levels of GP consultation. RESULTS: Of nine measures considered, care at home was associated with psychiatric morbidity (OR 1.46, 95 per cent CI 1.25--1.70), bodily pain (OR 1.19, 95 per cent CI 1.02--1.39), and obesity (OR 1.59, 95 per cent CI 1.34--1.89). Care 'away' was associated with smoking (OR 1.26, 95 per cent CI 1.03--1.54), and inversely with both sedentary living (OR 0.70, 95 per cent CI 0.58--0.85) and poor self-assessed health (OR 0.78, 95 per cent CI 0.62--0.99). Health tended to be poorer when carers lacked a sense of neighbourhood attachment. CONCLUSIONS: Informal carers are likely to face serious health challenges besides anxiety and depression. Caring is associated with several aspects of poor health, which are themselves predictors of premature mortality. Proactive and wide-ranging support is required, the more so in neighbourhoods where carers feel alienated. Research and policy should distinguish carers 'at home' from carers 'away'.     

Perception of overweight is associated with poor academic performance in US adolescents

BACKGROUND: To improve understanding of the mechanisms affecting the relationship between adolescent obesity and poor academic performance, we examined the association of overweight or perceived weight status with academic achievement. METHODS: We performed a cross‐sectional study of 14–17‐year‐olds (N = 11,012) from the nationally representative 2003 Youth Risk Behavior Survey. The main outcome measure was self‐reported grades (mostly A, B, C, D, or F). The primary independent variables were medically defined overweight (body mass index [BMI] ≥ 85th percentile), obesity (BMI ≥ 95th percentile), and participants' perception of their weight status. RESULTS: Medically defined overweight youth were less likely to report higher grades in unadjusted analysis (OR 0.67, 95% CI: 0.60‐0.76, p < .001) and after adjustment for demographics, depression, television and video game use, and physical activity (OR 0.83, 95% CI: 0.74–0.94, p = .003). Statistically significant results also were seen with medically defined obese participants. Youth who perceived themselves as overweight were less likely to report higher grades (OR 0.82, 95% CI: 0.73–0.92, p = .001) in unadjusted analysis and after adjustment for the same variables (OR 0.79, 95% CI: 0.68–0.91, p = .002). The perception of overweight was a more significant determinant of academic performance (OR 0.81, 95% CI: 0.69–0.95, p = .012) compared to medically defined obesity (OR 0.90, 95% CI: 0.77–1.05, p = .174). CONCLUSIONS: Perceived overweight status is negatively associated with academic performance, regardless of actual weight status. These findings suggest that perception of overweight may be a mechanism for prior results indicating a negative association of obesity and academic achievements, and have implications for the academic health of these adolescents.     

Betel-quid use is associated with the risk of the metabolic syndrome in adults

BACKGROUND: Betel-quid use has been associated with obesity and hyperglycemia in previous studies. OBJECTIVE: The aim was to test whether betel-quid use contributes to the metabolic syndrome, as defined by the National Cholesterol Education Program Adult Treatment Panel III. DESIGN: Associations between betel-quid use and the metabolic syndrome, obesity, hypertriacylglycerolemia, low HDL cholesterol, hyperglycemia, and high blood pressure after adjustment for sex, age, smoking, alcohol drinking, physical activity, and dietary intakes were studied in nonpregnant adults aged 20-64 y (n = 1986) from the Nutrition and Health Survey in Taiwan (1993-1996). RESULTS: The prevalence of the metabolic syndrome was not significantly different between the men and women (10.1% compared with 9.7%), whereas the prevalence of betel-quid use was higher in the men than in the women (31% compared with 2.3%; P < 0.001). The daily rate of betel-quid use was associated with the metabolic syndrome [odds ratio (OR) associated with a betel-quid consumption rate of 10 times/d: 1.31; 95% CI: 1.12, 1.55; P = 0.003], abdominal obesity (OR: 1.42; 95% CI: 1.2, 1.7; P = 0.001), hypertriacylglycerolemia (OR: 1.33; 95% CI: 1.02, 1.73; P = 0.037), and high blood pressure (OR: 1.2; 95% CI: 1.01, 1.4; P = 0.04). However, the daily rate of betel-quid use was not associated with low HDL cholesterol or hyperglycemia. CONCLUSION: The daily rate of betel-quid use is independently and positively associated with the metabolic syndrome in adults.     

Additive interactions of maternal prepregnancy BMI and breast-feeding on childhood overweight

OBJECTIVE: To examine the interactions of maternal prepregnancy BMI and breast-feeding on the risk of overweight among children 2 to 14 years of age. RESEARCH METHODS AND PROCEDURES: The 1996 National Longitudinal Survey of Youth, Child and Young Adult data in the United States were analyzed (n = 2636). The weighted sample represented 51.3% boys, 78.0% whites, 15.0% blacks, and 7.0% Hispanics. Childhood overweight was defined as BMI >/=95th percentile for age and sex. Maternal prepregnancy obesity was determined as BMI >/=30 kg/m(2). The duration of breast-feeding was measured as the weeks of age from birth when breast-feeding ended. RESULTS: After adjusting for potential confounders, children whose mothers were obese before pregnancy were at a greater risk of becoming overweight [adjusted odds ratio (OR), 4.1; 95% confidence interval (CI), 2.6, 6.4] than children whose mothers had normal BMI (<25 kg/m(2); p < 0.001 for linear trend). Breast-feeding for >/=4 months was associated with a lower risk of childhood overweight (OR, 0.6; 95% CI, 0.4, 1.0; p = 0.06 for linear trend). The additive interaction between maternal prepregnancy obesity and lack of breast-feeding was detected (p < 0.05), such that children whose mothers were obese and who were never breast-fed had the greatest risk of becoming overweight (OR, 6.1; 95% CI, 2.9, 13.1). DISCUSSION: The combination of maternal prepregnancy obesity and lack of breast-feeding may be associated with a greater risk of childhood overweight. Special attention may be needed for children with obese mothers and lack of breast-feeding in developing childhood obesity intervention programs.     

Self-Reported Sedentary Behavior and Metabolic Syndrome among Children Aged 6–14 Years in Beijing,China

(1) Objective: This study aimed to examine the prevalence of metabolic syndrome (MetS) in children aged 6–14 years in Beijing, and to determine whether sedentary behavior is a risk factor. (2) Methods: Using a multistage stratified cluster random sampling method, 3460 students were selected for the Nutrition and Health Surveillance in Schoolchildren of Beijing (NHSSB). Data on children’s sedentary behavior time and MetS indicators were collected using the questionnaires, physical measurements, and laboratory tests. MetS was defined according to the CHN2012 criteria, and logistic regression analysis was used to compare the effects of different sedentary time on MetS and its components. (3) Results: The overall prevalence of MetS among children aged 6–14 in Beijing was 2.4%, and boys, suburban children, and older age were associated with a higher prevalence (χ² values were 3.947, 9.982, and 27.463, respectively; p < 0.05). In boys, the prevalence rates of abdominal obesity, hyperglycemia, high triglycerides (TG), and low high-density lipoprotein cholesterol (HDL-C) were higher in the high-level sedentary behavior group than those in the low-level sedentary behavior group (p < 0.05); and in girls, the prevalence rates of high TG, low HDL-C, and MetS were higher in the high-level sedentary behavior group than those in the low-level sedentary behavior group (p < 0.05). After adjusting for confounding factors, the multivariate logistic regression results showed that compared with children with low-level sedentary behavior, the risks of abdominal obesity and low HDL-C were higher in boys with high-level sedentary behavior (odds ratio (OR) 1.51, 95% confidence interval (CI) 1.10–2.07, p = 0.011; OR 2.25, 95% CI 1.06–4.76, p = 0.034, respectively); while the risk of abdominal obesity was higher in girls with medium and high-level sedentary behavior (OR 1.52, 95% CI 1.01–2.27, p = 0.043; OR 1.59, 95% CI 1.04–2.43, p = 0.032, respectively). (4) Conclusions: Higher sedentary behavior time was related to the higher risk of MetS components among children aged 6–14 in Beijing. Reducing sedentary behavior may be an important method for preventing metabolic diseases.     

Hospitalizations for infectious diseases in Jewish and Bedouin children in southern Israel

Two different population groups reside in the Negev region of southern Israel and have equal, and free from financial barrier, access to tertiary care at a single regional hospital. The Jewish population has a largely urban and industrialized lifestyle, while the Moslem Bedouins are in transition from their traditional nomadic life to settlement. To examine the differences in morbidity patterns reflected in hospitalizations, the computerized hospitalization records of children <15 years of age, for 1989–1991 were used (n = 15,947). Rates of hospitalizations for infectious diseases were significantly higher for Bedouins in comparison to Jews (250 and 121/10,000 child years, respectively, odds ratio (OR): 2.1, 95% confidence interval (CI): 2.0–2.2, p < 0.001). Rates of hospitalization per 10,000 child years in Bedouins and Jews for diarrhea were 114 and 32 (OR: 3.7, 95% CI: 3.3–4.0, p < 0.001), respectively, and for pneumonia 55 and 19 (OR: 2.9, 95% CI: 2.6–3.3, p < 0.001), respectively. In infants the differences were even more pronounced, especially for diarrheal diseases. In Bedouin children infectious diseases were associated with longer hospital stay, more pediatric Intensive Care hospitalizations (OR: 2.7, 95% CI: 1.7–4.5, p < 0.001), and higher in-hospital mortality (OR: 5.7, 95% CI: 2.8–12.2, p < 0.001). Thus, Bedouin children are at higher risks of hospitalizations for infectious diseases in early childhood, as compared to Jewish children. This may reflect the differences in lifestyle, environmental and social conditions of the two populations.     

Positive effects of family dinner are undone by television viewing

The purpose of this cross-sectional study was to test the independent associations of eating dinner as a family and having the television on during dinner with child feeding behaviors. Parents/guardians of children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children in New York state were surveyed (n=1,336). Main outcome variables were frequencies of serving fruits, vegetables, and milk. Main exposure variables were the number of days per week the family ate dinner together and the number of days per week the television was on during dinner. Multiple logistic regressions assessed the association between the exposure variables and each of the main outcome measures controlling for race/ethnicity and parental educational attainment. Each night the family ate dinner together was positively associated with serving fruits (odds ratio [OR]=1.14, 95% confidence interval [CI] 1.07 to 1.21) or vegetables (OR=1.15, 95% CI 1.08 to 1.23). Serving fruits (OR= 0.95, 95% CI 0.91 to 0.99) or vegetables (OR=0.94, 95% CI 0.90 to 0.98) decreased with each night the television was on during dinner. Neither family dinner nor television on during dinner was significantly associated with serving milk. Family dinners and dinners without television on are independent predictors of servings of fruits or vegetables offered to preschool children. Because dietary habits and preferences are established early in life, parents should be counseled to promote family meal environments that support healthful eating.     

Health care reform in Oregon: the impact of the Oregon Health Plan on utilization of mammography

BACKGROUND: In 1994, Oregon implemented the Oregon Health Plan (OHP), extending health care coverage under a system of capitated managed care to uninsured citizens living below the Federal Poverty Level (FPL). We conducted a study to measure receipt of clinical preventive services among women newly enrolled in the OHP. METHODS: Six hundred and sixty six women aged 52-64, and living below the FPL in Oregon were randomly selected from OHP enrollment rosters and interviewed by telephone. A follow-up survey was conducted 1 year later. The main outcome of interest was receipt of a screening mammogram during the first year in the OHP. RESULTS: At enrollment 17% (65/383) of participants had never had health care coverage. Sixty-six percent of the women (220/333) were overdue for a mammogram. Fifty-five percent (121/220) reported cost as the main reason they had not had this procedure. Mammography rates doubled under the OHP (21% to 52%, 95% CI = 0.25-0.38, p < 0.001). Among women who were overdue for a mammogram at the time they enrolled, an expressed plan to get a mammogram (OR3.0, 95% CI = 1.1-8.7, p = 0.04), citing cost as the main reason for being overdue (OR3.0, 95% CI = 1.3-7.2, p = 0.014), receipt of a routine checkup (OR9.5, 95%CI = 3.7-24.9, p < 0.001), and health care provider's (HCP's) recommendation for mammography (OR8.1,95% CI = 2.9-23.0, p < 0.001) were independently associated with receipt of a mammogram. CONCLUSION: The OHP enrolled and successfully delivered clinical preventive services to a medically under served population. Even after removing the financial barrier, obstacles to mammography remain. These may be overcome by health systems changes to insure receipt of routine checkups and appropriate provider recommendations.     

Associated Factors of Sarcopenia in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis

(1) Background: To review the associated factors of sarcopenia in community-dwelling older adults. (2) Methods: PubMed, Embase, Web of Science, and four Chinese electronic databases were searched for observational studies that reported the associated factors of sarcopenia from inception to August 2021. Two researchers independently selected the literature, evaluated their quality, and extracted relevant data. The pooled odds ratio (OR) and its 95% confidence interval (CI) were calculated for each associated factors of sarcopenia using random-effects/fixed-effects models. Publication bias was assessed using funnel plot and the Eggers test. We performed statistical analysis using Stata 15.0 software. (3) Results: A total of 68 studies comprising 98,502 cases were included. Sociodemographic associated factors of sarcopenia among community-dwelling older adults included age (OR = 1.12, 95% CI: 1.10–1.13), marital status (singled, divorced, or widowed) (OR = 1.57, 95% CI: 1.08–2.28), disability for activities of daily living (ADL) (OR = 1.49, 95% CI: 1.15–1.92), and underweight (OR = 3.78, 95% CI: 2.55–5.60). Behavioral associated factors included smoking (OR = 1.20, 95% CI: 1.10–1.21), physical inactivity (OR = 1.73, 95% CI: 1.48–2.01), malnutrition/malnutrition risk (OR = 2.99, 95% CI: 2.40–3.72), long (OR = 2.30, 95% CI: 1.37–3.86) and short (OR = 3.32, 95% CI: 1.86–5.93) sleeping time, and living alone (OR = 1.55, 95% CI: 1.00–2.40). Disease-related associated factors included diabetes (OR = 1.40, 95% CI: 1.18–1.66), cognitive impairment (OR = 1.62, 95% CI: 1.05–2.51), heart diseases (OR = 1.14, 95% CI: 1.00–1.30), respiratory diseases (OR = 1.22, 95% CI: 1.09–1.36), osteopenia/osteoporosis (OR = 2.73, 95% CI: 1.63–4.57), osteoarthritis (OR = 1.33, 95% CI: 1.23–1.44), depression (OR = 1.46, 95% CI: 1.17–1.83), falls (OR = 1.28, 95% CI: 1.14–1.44), anorexia (OR = 1.50, 95% CI: 1.14–1.96), and anemia (OR = 1.39, 95% CI: 1.06–1.82). However, it remained unknown whether gender (female: OR = 1.10, 95% CI: 0.80–1.51; male: OR = 1.50, 95% CI: 0.96–2.34), overweight/obesity (OR = 0.27, 95% CI: 0.17–0.44), drinking (OR = 0.92, 95% CI: 0.84–1.01), hypertension (OR = 0.98, 95% CI: 0.84–1.14), hyperlipidemia (OR = 1.14, 95% CI: 0.89–1.47), stroke (OR = 1.70, 95% CI: 0.69–4.17), cancer (OR = 0.88, 95% CI: 0.85–0.92), pain (OR = 1.08, 95% CI: 0.98–1.20), liver disease (OR = 0.88, 95% CI: 0.85–0.91), and kidney disease (OR = 2.52, 95% CI: 0.19–33.30) were associated with sarcopenia. (4) Conclusions: There are many sociodemographic, behavioral, and disease-related associated factors of sarcopenia in community-dwelling older adults. Our view provides evidence for the early identification of high-risk individuals and the development of relevant interventions to prevent sarcopenia in community-dwelling older adults.     

Helicobacter pylori prevalences and risk factors among school beginners in a German urban center and its rural county.

In 1998, the Helicobacter pylori [(13)C]urea breath test was offered to all school beginners (birth cohort 1991/1992) in the city of Leipzig and in Leipzig County, Germany, to determine the colonization prevalence and potential transmission pathways of the bacterium. A total of 3,347 school beginners participated in the test, and 2,888 parents completed the detailed, self-administered questionnaire. The H. pylori prevalence was 6.5% [95% confidence interval (CI), 5.3-7.6] in the city and 5.7% (CI, 4.2-7.0) in the county. Using cluster analysis (WARD's method, Euclidean distances), we identified different sets of variables (confirmed by multivariate logistic regression analyses [odds ratios (ORs)] that are signficantly associated with H. pylori positivity. Among city children, the risk is significantly increased with contact to a pet hamster (OR = 2.4; 95% CI, 1.2-4.7; p < 0.015) and travels to Asian countries (OR = 3.7; 95% CI, 1.6-8.7; p < 0.002). Among county children, H. pylori positivity increased significantly with drinking of water from nonmunicipal sources (OR = 16.4; 95% CI, 3.1-88.5; p < 0.001), more than 3 children living in a household (OR = 4.2; 95% CI, 1.2-14.6; p < 0.02), and contact with pet hamsters (OR = 2.4; 95% CI, 1.0-5.7; p < 0.04). These data suggest that, in a general population sample, indirect fecal-oral transmission and living conditions are important risk factors in the spread of H. pylori infection. However, clinical symptoms do not necessarily indicate H. pylori positivity.