Risk of obesity enhanced by poor physical activity in high school students

BACKGROUND: The aim of this study was to elucidate the interactions between a family history of obesity and poor physical activity. METHODS: A case-control study was performed based on medical check data for all first year high school students admitted to Aichi Prefectural public high schools in the 2004 academic year. Prior to the post-admission medical check up, all students received an interview sheet containing questions on family history of obesity and extent of physical activity. Experienced nurses measured body mass and height. Valid answers and measurements were obtained from 20,155 boys and 19,682 girls. RESULTS: A family history of obesity, reluctance to exercise, current and recent past sedentary lifestyles each significantly increased risk of obesity (body mass index [BMI] >or= 25) and severe obesity (BMI >or= 30) in both boys and girls. Two-way ANOVA revealed that a family history of obesity, associated with poor exercise, positively affected BMI in both boys and girls. Moreover, significant positive interaction was found between a family history of obesity and each of the unfavorable physical activity conditions. Synergistic effects (synergy indexes >1) increasing risk of obesity were noted in both boys and girls when a family history of obesity overlapped with reluctance to exercise, current physical inactivity, or recent physical inactivity. CONCLUSION: Overlapping of family history of obesity and exercise risk factors synergistically increase the BMI and risk of obesity in both boys and girls. Intervention to promote exercise in adolescents who have obese family member(s) should be encouraged.     

Cardiovascular Risk Factors and Carotid Intima-Media Thickness in Asymptomatic Children

Atherosclerosis, beginning in childhood, is dependent on several risk factors and may be predictive of coronary artery disease in adulthood. The risk factors for subclinical atherosclerosis are similar to those for clinical disease. Carotid intima-media thickness is a measure of subclinical atherosclerosis and a predictor of subsequent vascular events. This study aimed to examine the relationships of carotid intima-media thickness with known risk factors in asymptomatic children. Family history of cardiovascular disease was collected, together with anthropometric, demographic, and clinical data. Body mass index z-scores were calculated. Serum glucose, lipid fractions, fibrinogen, and C-reactive protein were determined. High-resolution ultrasonography was used to assess intima-media thickness. Associations and relationships of risk factors with composite intima-media thickness were explored. The study enrolled 93 children (44 girls) ranging in age from 49 to 169 months. The boys had a thicker intima-media (0.46 ± 0.06 mm) than the girls (0.43 ± 0.06 mm; p = 0.028). The unadjusted triglyceride levels were significantly higher in the overweight and obese children (p = 0.010). Body mass index and overweight/obesity were positively related to intima-media thickness (r = 0.259; p = 0.012 and r _s = 0.230; p = 0.027, respectively), whereas family history of cardiovascular disease was unrelated. Only gender and overweight/obesity were related to intima-media thickness in a multiple linear regression model (R ² = 0.125; p = 0.002). Male gender and overweight/obesity were associated with increased intima-media thickness, whereas family history of cardiovascular disease was unrelated.     

Healthy active living: A goal or a mirage? A survey of Canadian paediatricians

Childhood obesity is a major health concern. Inactivity is a major cause of this epidemic. The Healthy Active Living Committee of the Canadian Paediatric Society sampled 1866 paediatricians across Canada to assess members’ knowledge of healthy active living (HAL), how they currently use HAL materials, what new materials would be most useful, and who would be most likely to carry the messages forward. The survey had only a 16% response rate. The results are published to help educate members, demonstrate the apparent lack of interest in a decidedly important area (and give reasons for this apathy), provide members with information on HAL materials, and update members on HAL committee actions since the survey was sent.     

Pediatrician's office: a solution in the prevention of childhood obesity

A mother's ability to correctly perceive her child's weight status and her concern toward the overweight status of her child are important in the prevention of childhood obesity. Mothers should have adequate nutrition knowledge that enables them to plan and provide nutritious meals to their children.

Conclusion: Pediatricians may play a role in childhood obesity prevention interventions by helping mothers understand growth charts and by providing mothers with appropriate nutrition guidance for planning a balanced diet.     

Randomised controlled trial: A parent-based group education programme for overweight children

AIM: Childhood overweight and obesity is a significant community health problem with severe long-term complications. This paper aims to evaluate a four-by-two-hour weekly group parent education programme targeting children who are overweight. METHODS: A randomised time series design with wait-list controls was conducted for overweight and obese children aged 3-10 years. RESULTS: A statistically significant reduction in child body mass index and energy intake was found post treatment; no differences were reported for child sedentary electronic media time, physical activity and waist circumference. Children's baseline activity levels were found to be at or slightly above national recommended standards. No change occurred in primary parent body mass index or waist circumference after treatment. CONCLUSIONS: A brief group education programme for parents was effective in reducing childhood overweight at 3 months follow-up.     

Use of food labels,awareness of nutritional programmes and participation in the special supplemental program for Women,Infants and Children (WIC): results from the National Health and Nutrition Examination Survey (2005–2006)

Use of nutritional labels in choosing food is associated with healthier eating habits including lower fat intake. Current public health efforts are focusing on the revamping of nutritional labels to make them easier to read and use for the consumer. The study aims to assess the frequency of use of nutritional labels and awareness of the United States Department of Agriculture (USDA) nutritional programmes by low‐income women including those participating in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) as surveyed in the National Health and Nutrition Examination Survey 2005–2006. Many low‐income women do not regularly use the nutrition facts panel information on the food label and less than half had heard of the USDA Dietary Guidelines for Americans (38.9%). In multivariate logistic regression, we found that WIC participation was associated with reduced use of the nutrition facts panel in choosing food products [odds ratio (OR) 0.45, 95% confidence interval (CI) 0.22–0.91], the health claims information (OR 0.54, 95% CI 0.32–0.28) and the information on carbohydrates when deciding to buy a product (OR 0.44, 95% CI 0.20–0.97) in comparison with WIC eligible non‐participants. Any intervention to improve use of nutritional labels and knowledge of the USDA's nutritional programmes needs to target low‐income women, including WIC participants. Future studies should evaluate possible reasons for the low use of nutrition labels among WIC participants in comparison with eligible non‐participants.     

Obesity and associated modifiable environmental factors in Iranian adolescents: Isfahan Healthy Heart Program − Heart Health Promotion from Childhood

OBJECTIVE: To evaluate the prevalence of overweight and obesity among Iranian adolescents and their relationship with modifiable environmental factors. METHODS: The subjects of the present study were 1000 girls and 1000 boys, aged between 11 and 18 years selected by multistage random sampling, their parents (n = 2000) and their school staff (n = 500 subjects) in urban and rural areas of two provinces in Iran. Data concerning body mass index (BMI), nutrition and the physical activity of the subjects were analyzed by SPSSV10/Win software. RESULTS: The prevalence of 85th percentile 95th percentile in girls was significantly higher than boys (10.7 +/- 1.1 and 2.9 +/- 0.1%vs 7.4 +/- 0.9 and 1.9 +/- 0.1%, respectively; P < 0.05). The mean BMI value was significantly different between urban and rural areas (25.4 +/- 5.2 vs 23.2 +/- 7.1 kg/m2, respectively; P < 0.05). A BMI> 85th percentile was more prevalent in families with an average income than in high-income families (9.3 +/- 1.7 vs 7.2 +/- 1.4%, respectively; P < 0.05) and in those with lower-educated mothers (9.2 +/- 2.1 vs 11.5 +/- 2.4 years of mothers education, respectively). The mean total energy intake was not different between overweight or obese and normal-weight subjects (1825 +/- 90 vs 1815 +/- 85 kCal, respectively; P > 0.05), but the percentage of energy derived from carbo-hydrates was significantly higher in the former group compared with the latter (69.4 vs 63.2%, respectively; P < 0.05). Regular extracurricular sports activities were significantly lower and the time spent watching tele-vision was significantly higher in overweight or obese than non-obese subjects (time spent watching telelvision: 300 +/- 20 vs 240 +/- 30 min/day, P < 0.05). A significant linear association was shown between the frequency of consumption of rice, bread, pasta, fast foods and fat/salty snacks and BMI (beta = 0.05-0.06; P < 0.05). A significant correlation was shown between BMI percentiles and serum triglyceride, high-density lipoprotein-cholesterol and systolic blood pressure (Pearson's r = 0.38, -0.32 and 0.47, respectively). CONCLUSIONS: Enhanced efforts to prevent and control overweight from childhood is a critical national priority, even in developing countries. To be successful, social, cultural and economic influences should be considered.     

Evaluation of a smartphone nutrition and physical activity application to provide lifestyle advice to pregnant women: The SNAPP randomised trial

Our objective was to evaluate the impact of a smartphone application as an adjunct to face‐to‐face consultations in facilitating dietary and physical activity change among pregnant women. This multicentre, nested randomised trial involved pregnant women with a body mass index ≥18.5 kg/m², with a singleton pregnancy between 10 and 20 weeks' gestation, and participating in 2 pregnancy nutrition‐based randomised trials across metropolitan Adelaide, South Australia. All women participating in the SNAPP trial received a comprehensive dietary, physical activity, and behavioural intervention, as part of the GRoW or OPTIMISE randomised trials. Women were subsequently randomised to either the “Lifestyle Advice Only Group,” where women received the above intervention, or the “Lifestyle Advice plus Smartphone Application Group,” where women were additionally provided access to the smartphone application. The primary outcome was healthy eating index (HEI) assessed by maternal food frequency questionnaire completed at trial entry, and 28 and 36 weeks' gestation. Analyses were performed using intention‐to‐treat principles, with statistical significance at p = .05. One hundred sixty‐two women participated: 77 allocated to the Lifestyle Advice plus Smartphone Application Group and 85 to the Lifestyle Advice Only Group. Mean difference in HEI score at 28 weeks of pregnancy was 0.01 (CI [?2.29, 2.62]) and at 36 weeks of pregnancy ?1.16 (CI [?4.60, 2.28]). There was no significant additional benefit from the provision of the smartphone application in improving HEI score (p = .452). Although all women improved dietary quality across pregnancy, use of the smartphone application was poor. Our findings do not support addition of the smartphone application.     

Toddler obesity prevention: A two‐generation randomized attention‐controlled trial

Rapid weight gain increases risks of obesity and associated co‐morbidities. The objective was to reduce the rate of body mass index (BMI) growth (BMI z score), relative to control. Secondary outcomes were toddler–mother physical activity, mealtime interactions and fruit/vegetable intake. The randomized three‐arm, eight‐session, 4‐month trial, conducted 2009–2013, included two intervention arms (responsive parenting and maternal lifestyle) and an attention control (home safety). Baseline and 6‐ and 12‐month follow‐up evaluations included weight and length/height, ankle accelerometry, video‐recorded mealtime interactions (Emotional Availability Scales) and 24‐h diet recalls (Healthy Eating Index‐2015 [HEI‐2015]). Analyses used linear mixed‐effects models with repeated measures comparing intervention versus control changes in BMI z score. We recruited 277 racially mixed (70% African American) toddler–mother dyads (mean ages 20.1 months and 27.3 years) from US WIC and primary care clinics and randomized them into intervention versus control; 31% toddlers and 73% mothers were overweight/obese. At follow‐up, changes in the rate of toddler BMI z score and maternal BMI were non‐significant. Maternal lifestyle group toddlers and mothers spent 24.43 and 11.01 more minutes in physical activity (95% confidence interval [CI]: 2.55, 46.32, and 95% CI: 1.48, 20.54, respectively). Fruit intake increased in both intervention groups. Hostile mealtime interactions increased in the maternal lifestyle group, and in supplementary analyses, mealtime interactions were significantly higher in the responsive parenting group than in the maternal lifestyles group, suggesting that toddler dietary interventions include responsive parenting. Intervention effects were stronger among older versus younger toddlers. Despite no impact on weight gain, additional research should examine integrated two‐generation responsive parenting and maternal lifestyle interventions among toddler–mother dyads.     

High-Density Lipoprotein Cholesterol Levels in Middle-School Children: Association with Cardiovascular Risk Factors and Lifestyle Behaviors

To examine factors associated with low high-density lipoprotein cholesterol (HDL-C) levels among middle school children. HDL-C levels were the primary outcome of interest. A total of 1,104 middle-school children (mean age 11.6 years, 51.2 % female) were included in this analysis, of whom 177 (16 %) had an HDL-C level ≤40 mg/dL. More than half of those with low HDL-C were overweight or obese (62.2 %) and had greater systolic and diastolic blood pressure, triglyceride (TRG) levels, and low-density lipoprotein cholesterol levels compared with children with an HDL-C level >40 mg/dL. Among those with an HDL-C ≤ 40 mg/dL, 35 % also had body mass index ≥85 % and TRG levels ≥150 mg/dL. Exercise habits were significantly associated with HDL-C level, whereas sedentary behaviors, such as screen time, were not significantly associated with HDL-C level. Fruit and vegetable intake was also not significantly associated with HDL-C level. Children with low HDL-C levels are more likely to be overweight and to have other physiological indicators of increased cardiovascular risk. Further research is needed to determine if school-based interventions can result in long-term improvements in HDL-C.     

Depressive Symptomatology, Perceptions of Attractiveness, and Body Image in Children

Abstract— Fifty-seven children, aped 9–12 completed the Children's Depression Inventory, rated their bodies on dimensions of attractiveness, effectiveness and vulnerability, and rated themselves and three other children on global attractiveness. Dysphoria was significantly correlated with both measures of dissatisfaction of own attractiveness. No significant correlations occurred between CDI scores and effectiveness or vulnerability. Stepwise regression showed dysphoria to be predicted by dissatisfaction with the body's attractiveness and by age with the former being the most powerful. No subject differences were found on rating the attractiveness of other children. Results are compared to research with adult subjects.     

PRESTO—Prevention Study of Obesity: A project to prevent obesity during childhood and adolescence

The PRESTO project has been launched as a school-oriented pilot project. The aims were to influence nutrition, physical activity and health. The intervention was performed by a multiprofessional team and covered 11 nutrition and health-related sessions with 1 h per week in each class. The initial poor knowledge was improved significantly to the control group with better results in grammar schools compared to comprehensive schools. BMI was not improved in overweight children. However, this project could serve as a successful model in Austria.