Hip-Hop to Health Jr., an obesity prevention program for minority preschool children: baseline characteristics of participants

BACKGROUND: The prevalence of obesity in the United States is a significant public health problem. Many obesity-related risk factors are more prevalent in minority populations. Given the recalcitrant nature of weight loss interventions for adults, prevention of overweight and obesity has become a high priority. The present study reports baseline data from an obesity prevention intervention developed for minority preschool children. METHODS: Hip-Hop to Health Jr. is a 5-year randomized controlled intervention that targets 3- to 5-year-old minority children enrolled in 24 Head Start programs. Our primary aim is to test the effect of the intervention on change in body mass index. Data were collected on sociodemographic, anthropometric, behavioral, and cognitive variables for the children and parents at baseline. RESULTS: Participants included 416 black children, 337 black parents, 362 Latino children, and 309 Latino parents. Using body mass index for age and sex > or = the 95th percentile as the definition of overweight, 15% of the black children and 28% of the Latino children were overweight. More than 75% of the parents were either overweight or obese. DISCUSSION: The development of interventions to effectively prevent or control obesity early in life is crucial. These data highlight the escalating problem of weight control in minority populations.     

乌鲁木齐学龄前儿童超重肥胖现状及相关因素分析

  目的  了解学龄前儿童超重肥胖现状及其影响因素,为预防和控制乌鲁木齐市学龄前儿童超重肥胖的发生提供参考依据。  方法  采用分层整群抽样方法,于2021年10—12月抽取乌鲁木齐市10所幼儿园1 897名学龄前儿童,通过对身高、体重的测量了解学龄前儿童超重肥胖现状,应用一般资料调查问卷、学龄前儿童饮食行为量表、学龄前儿童照护人喂养行为量表、3~6岁儿童家庭养育环境量表、学龄前儿童体力活动问卷等分析其相关因素。  结果  学龄前儿童超重肥胖检出率为31.21%(592名),其中超重率为19.50%(370名),肥胖率为11.70%(222名)。儿童超重肥胖检出率在不同年龄、性别、儿童饮食习惯(喜食肉类)、父亲体质量指数、母亲体质量指数、母亲孕前体质量指数间差异均有统计学意义(χ2值分别为19.63,28.75,9.45,18.21,18.45,19.36,P值均 < 0.05)。多因素Logistic回归分析显示,性别、儿童饮食习惯、父亲体质量指数、母亲孕前体质量指数、过饱响应、外因性进食、主动进食能力、体重担忧、饮食行为限制、体力活动、家庭体力活动环境是学龄前儿童超重肥胖的相关因素(OR值分别为0.52,1.43,1.51,1.44,0.69,0.74,1.35,1.71,0.81,0.96,1.10,P值均 < 0.05)。  结论  乌鲁木齐市学龄前儿童超重肥胖问题严峻,应加强教育、控制饮食、科学锻炼,以防止儿童超重肥胖的发生。     

上海静安区学龄前儿童超重肥胖及高血压流行现状

目的 了解上海静安区学龄前儿童超重、肥胖及高血压的流行现状,为制定相关干预措施提供依据。方法 以参加2017年上海静安区幼儿园体检的3 608名3~7岁学龄前儿童为研究对象,按照世界卫生组织儿童生长发育标准和中国儿童青少年血压参考标准进行超重肥胖和高血压的调查,采用SPSS 24.0进行统计学分析。结果 上海市静安区3~7岁学龄前儿童超重和肥胖的总检出率分别为9.3%和9.2%,男童肥胖检出率高于女童,6~7岁儿童超重及肥胖检出率高于其余年龄组(P＜0.05),而超重检出率的性别差异无统计学意义(P>0.05)。高血压的总检出率为1.5%,男童高于女童,肥胖儿童高血压检出率显著高于超重及非超重肥胖儿童(P＜0.001),而高血压检出率的年龄差异无统计学意义(P>0.05)。结论 上海市静安区学龄前儿童超重、肥胖检出率较高,相关慢性病的预防应早在学龄前期进行。     

学龄前儿童身体活动和视屏时间与超重肥胖的关联

  目的  分析学龄前儿童身体活动和视屏时间与超重肥胖的关联,为学龄前儿童超重肥胖的预防和控制提供依据。  方法  采用病例对照研究设计,选取北京市朝阳区某社区4所幼儿园109名超重肥胖儿童作为病例组,在同样的幼儿园内选择体重正常的117名儿童作为对照组,对照组与病例组的年龄和性别频数匹配。用单因素分析比较两组人口学、身体活动时间、视屏时间、睡眠、饮食等特征,采用Logistic回归在调整协变量的情况下分析学龄前儿童身体活动和视屏时间与超重肥胖的关联。  结果  在调整年龄、性别、平均每日睡眠时间、儿童睡眠习惯问卷(CSHQ)总评分、中国学龄前儿童平衡膳食指数(DBI-C)正端分等因素后,每日身体活动时间 < 3 h的儿童与身体活动时间≥3 h的儿童相比超重肥胖风险增加1.55倍(OR=2.55,95%CI=1.16~5.64,P=0.02),儿童每日视屏时间每增加一个四分位数超重肥胖风险增加1.44倍(OR=2.44,95%CI=1.69~3.52,P < 0.01)。  结论  学龄前儿童身体活动时间不足和视屏时间较长都与超重肥胖相关。应采取综合干预措施有效增加身体活动时间并且减少儿童的视屏行为,降低学龄前儿童超重肥胖的发生率。     

Physical activity and dietary behaviors associated with weight gain and impaired glucose tolerance among pregnant Latinas

Pregnancy has been proposed as a critical period for the development of subsequent maternal overweight and/or obesity. Excessive gestational weight gain is, in turn, associated with maternal complications such as cesarean delivery, hypertension, preeclampsia, impaired glucose tolerance, and gestational diabetes mellitus. Although there is substantial evidence that targeting at-risk groups for type 2 diabetes prevention is effective if lifestyle changes are made, relatively little attention has been paid to the prevention of excessive gestational weight gain and impaired glucose tolerance during pregnancy. Latinos are the largest minority group in the United States, with the highest birth and immigration rates of any minority group and are disproportionately affected by overweight and obesity. However, due to cultural factors, socioeconomic factors, and language barriers, Latinos have had limited access to public health interventions that promote healthy lifestyles. Therefore, the objective of this article is to review the scientific evidence regarding the association between physical activity, dietary behaviors, and gestational weight gain and impaired glucose tolerance among Latinas. A second objective is to discuss how lifestyle interventions including weight management through diet and exercise could be successful in reducing the risk of excessive gestational weight gain and gestational diabetes mellitus. Finally, recommendations are provided for future lifestyle intervention programs in this population with a focus on translation and dissemination of research findings.     

深圳市学龄前儿童超重肥胖的影响因素研究

目的 探讨深圳市学龄前儿童超重肥胖的影响因素,为开展儿童超重肥胖的防治工作提供理论依据.方法 随机整群抽取深圳市17所幼儿园737名超重肥胖儿童纳入超重肥胖组,按照1:1病例对照研究方法选择737名正常体质量的健康儿童为对照组.采用多元Logistic回归分析学龄前儿童超重肥胖的影响因素.结果 父母亲肥胖、照顾者文化程...     

祖辈带养对学龄前儿童饮食行为、身体活动和超重肥胖的影响

目的 探究祖辈带养对学龄前儿童饮食行为、身体活动和超重肥胖的影响。方法 采用文献研究法,检索中国知网、万方数据库、维普数据库和PubMed 数据库中近5年发表的祖辈带养对学龄前儿童饮食行为、身体活动和超重肥胖影响的文献,进行描述性统计分析。结果 最终纳入16篇文献。文献研究结果表明,祖辈带养可能是学龄前儿童超重肥胖的危险因素,可能的原因主要为祖辈带养导致学龄前儿童不健康的饮食行为和身体活动减少。结论 祖辈带养对学龄前儿童饮食行为、身体活动和超重肥胖有影响,对祖辈进行营养健康教育可能对学龄前儿童超重肥胖的防控有着重要作用。     

顺义区学龄前儿童超重/肥胖的危险因素Logistic分析

目的 了解北京市顺义区学龄前儿童超重/肥胖的流行特征及其危险因素,为儿童肥胖的预防和临床干预提供科学依据。方法 采取整群分层随机抽样的方式,于2017年9—11月抽取顺义区5所幼儿园共1 238名儿童作为研究对象。采用自行设计的调查问卷方式研究儿童肥胖的危险因素,对相关危险因素进行多因素Logistic回归分析。结果 顺义区学龄前儿童超重/肥胖发生率分别为13.3%、15.2%。学龄前儿童超重/肥胖的危险因素包括:剖宫产(OR=1.333,95%CI:1.032~1.722)、父亲超重/肥胖(OR=1.723,95%CI:1.293~2.295)、母亲超重/肥胖(OR=1.617,95%CI:1.234~2.119)、进食速度快(OR=1.403,95%CI:1.125~1.748)。而平均户外活动时间>2 h(OR=0.649,95%CI:0.549~0.771)是儿童超重/肥胖发生的保护因素。结论 学龄前儿童超重/肥胖是诸多因素共同作用的结果,应制定父母参与的综合防治措施,以减少儿童超重/肥胖的发生。     

扬州市城区学龄前儿童腰围特征及影响因素分析

目的 研究扬州市城区学龄前儿童腰围特征,并分析其影响因素,为我国学龄前儿童腹型超重/肥胖筛查与防治提供依据。方法 于2015年4-5月分层整群抽取7所幼儿园2 531名儿童,对家长进行问卷调查;采用集中体检的方式,测量儿童体重、身高、腰围等;对其腰围和腰围身高比进行描述性分析,并通过单因素和多因素Logistic回归分析腰围的影响因素。结果 扬州市城区学龄前儿童腰围随年龄增长逐渐增加,各年龄组男童均大于女童;女童腰围身高比随年龄增长逐渐减低,男童则有波动。单因素分析结果显示,父母体重指数(BMI)、母亲学历、儿童每日睡眠时间、户外活动时间、视屏时间等对儿童腰围有影响(P<0.05)。多因素Logistic回归分析结果显示,父母高BMI是学龄前儿童高腹围的危险因素(母亲BMI:OR=1.15,95%CI:1.09~1.18,P＜0.001;父亲BMI:OR=1.12,95%CI:1.07~1.15,P＜0.001)。结论 需逐步建立我国学龄前儿童腰围正常范围与腹型超重/肥胖腰围筛查界值点,为学龄前儿童腹型超重/肥胖筛查与防治提供依据;要控制腹型肥胖需进行以家庭为中心的饮食、生活方式的综合性干预。     

北京市东城区学龄前儿童超重/肥胖现状及影响因素分析

目的 了解北京市东城区学龄前儿童超重和肥胖现状及影响因素,为儿童合理膳食干预提供数据支持.方法 采取分层整群随机抽样方法,在北京市东城区抽取18所幼儿园,调查中班和大班学龄前儿童的饮食情况,测量儿童的身高和体重,采用x2检验和Logistic回归模型进行统计学分析.结果 2985名学龄前儿童超重、肥胖检出率分别为8.1...     

Soft drinks, childhood overweight, and the role of nutrition educators: let's base our solutions on reality and sound science

The percentage of overweight children in the United States and other countries has now reached epidemic proportions. Both physical activity and food intake contribute to the energy equation, but research increasingly points to physical inactivity as the primary culprit in weight gain. Singling out and restricting specific foods and beverages are unlikely to be effective in reducing the prevalence of overweight children. Nutrition educators need to emphasize overall lifestyle, including physical activity, as well as caloric intake, in childhood overweight intervention efforts. Long-lasting solutions to the obesity epidemic must be comprehensive and must include all of the key stakeholders: children, parents, schools, health professionals, businesses, and community leaders and organizations. Nutrition educators can play a key role in developing wide-ranging and diverse coalitions, including food and beverage companies, designed to affect social change aimed at achieving healthy weight for children.     

Early intervention of multiple home visits to prevent childhood obesity in a disadvantaged population: a home-based randomised controlled trial (Healthy Beginnings Trial)

Background  

Studies have shown that a proportion of children as young as two years are already overweight. This indicates that obesity prevention programs that commence as early as possible and are family-focused are needed. This Healthy Beginnings Trial aims to determine the efficacy of a community-based randomized controlled trial (RCT) of a home visiting intervention in preventing the early onset of childhood overweight and obesity. The intervention will be conducted over the first two years of life to increase healthy feeding behaviours and physical activity, decrease physical inactivity, enhance parent-child interaction, and hence reduce overweight and obesity among children at 2 and 5 years of age in the most socially and economically disadvantaged areas of Sydney, Australia.     

CHILE: Outcomes of a group randomized controlled trial of an intervention to prevent obesity in preschool Hispanic and American Indian children

ObjectiveWe examined the outcomes of the Child Health Initiative for Lifelong Eating and Exercise (CHILE) study, a group randomized controlled trial to design, implement, and test the efficacy of a trans-community intervention to prevent obesity in children enrolled in Head Start centers in rural American Indian and Hispanic communities in New Mexico.MethodsCHILE was a 5-year evidence-based intervention that used a socioecological approach to improving dietary intake and increasing physical activity of 1898 children. The intervention included a classroom curriculum, teacher and food service training, family engagement, grocery store participation, and healthcare provider support. Height and weight measurements were obtained four times (fall of 2008, spring and fall of 2009, and spring of 2010), and body mass index (BMI) z-scores in the intervention and comparison groups were compared.ResultsAt baseline, demographic characteristics in the comparison and intervention groups were similar, and 33% of all the children assessed were obese or overweight. At the end of the intervention, there was no significant difference between the two groups in BMI z-scores.ConclusionsObesity prevention research among Hispanic and AI preschool children in rural communities is challenging and complex. Although the CHILE intervention was implemented successfully, changes in overweight and obesity may take longer than 2 years to achieve.     

山东省城市学龄儿童超重、肥胖现状及影响因素研究

目的 了解山东省城市学龄儿童超重、肥胖的流行现状,探讨其影响因素,为预防干预学龄儿童超重、肥胖提供理论依据。方法 采用多阶段随机整群抽样法,抽取山东省济南市、淄博市、临沂市3所小学共1 584名学龄儿童进行问卷调查和体格测量。结果 山东省城市学龄儿童超重检出率13.76%,肥胖检出率13.26%,超重、肥胖合并检出率27.02%;多因素分析结果显示,细嚼慢咽、挑食/偏食与否、是否每天吃水果、喝甜饮、吃早餐等饮食习惯因素,以及性别、周岁体重、父母体质指数等因素是学龄儿童超重、肥胖的可能影响因素。 结论 山东省有超过1/4的城市学龄儿童超重、肥胖。建议教育并引导儿童培养合理的饮食习惯,采取综合措施对学龄儿童超重、肥胖进行干预。     

母乳喂养持续时间与学龄前儿童超重和肥胖的关联性分析

目的 分析宝鸡地区母乳喂养持续时间与学龄前儿童超重和肥胖的关系,为预防宝鸡地区儿童超重和肥胖提供科学依据。方法 以2015年8月-2016年12月在宝鸡市妇幼保健院进行预防接种的3 586名3~6岁学龄前儿童作为研究对象。采用问卷调查获得学龄前儿童的母乳喂养情况,测量学龄前儿童的身高和体重,了解学龄前儿童的体格发育情况。通过Logistic回归分析计算母乳喂养持续时间与学龄前儿童超重和肥胖患病风险的OR值和95%的可信区间(CI)。结果 超重和肥胖患病率分别为12.5%和9.8%,母乳喂养持续时间与学龄前儿童超重和肥胖的患病风险呈负相关,母乳喂养≥12个月的学龄前儿童超重和肥胖的患病风险是未经母乳喂养的学龄前儿童的0.58倍。结论 较长时间的母乳喂养是学龄前儿童超重和肥胖的保护因素,应提倡长时间的母乳喂养,预防学龄前儿童超重和肥胖的发生。     

Parents' stage of change for diet and physical activity: influence on childhood obesity

Highly visible public health education efforts have resulted in increased awareness of the childhood obesity epidemic but not a related decline in the number of overweight children. The Transtheoretical Model was used to examine the associations among child risk factors, parent's knowledge of factors associated with childhood obesity and their access to healthy foods in their community and parent's stage of change (SOC) in making behavior changes to improve their child's diet and level of physical activity. Parents (n = 124) of children between 6-12 years of age were surveyed. Perceived weight of the child and the child's body mass index (BMI) were found to be associated with parent's SOC for food portions and dietary fats, yet this was not observed for the fruits and vegetables or physical activity domains. Food availability and parent's childhood obesity knowledge was not found to be associated with parent's SOC. This study provides evidence that intervention efforts that stress knowledge of the causes and harmful effects of being overweight may have limited effectiveness.     

青岛市城区学龄前儿童体格发育及肥胖发生变化分析

目的 了解青岛市城区学龄前儿童近十二年体格发育及肥胖构成变化情况,为学龄前儿童健康管理提供依据。方法 采用分层整群抽样方法,抽取城区13所幼儿园,于2018年3-4月测量评价在园儿童身高、体重与营养状况,统计超重、肥胖检出率,与2006同质人群肥胖流调数据比较分析。结果 与2006年相比,2018年青岛市城区学龄前儿童总体身高变化差异无统计学意义(P>0.05),体重下降(P<0.001,3岁～组除外);2018年青岛市城区学龄前儿童肥胖检出率(7.5%)、超重检出率(15.9%)、生长迟缓检出率(0.2%)均低于2006年(P<0.05)。结论 青岛市2018年学龄前儿童在身高发育正常的前提下,肥胖、超重检出率较2006年呈下降趋势,佐证始于生命早期,基于社区、幼儿园及家庭的、持续开展的儿童综合肥胖防控措施行之有效。     

Overweight children in Beirut: prevalence estimates and characteristics

OBJECTIVE: To estimate, for the first time, overweight prevalence and associated characteristics in a representative sample of prepubertal children in Beirut, Lebanon's capital. DESIGN: A cross-sectional study with a home interview including measurements of weight and height and a structured questionnaire. SUBJECTS: A total of 234 children aged 6-8 years in Beirut: 131 boys, 103 girls. METHODS: Prevalence of overweight and obesity was based on the international cut-off points for body mass index (BMI) by age and gender proposed by the International Obesity Task Force. The characteristics of overweight examined were: age, gender, household and family size, single- vs. two-parent family, parents' level of education and profession, physical activity and dietary intake of children. RESULTS: Prevalence of overweight and obesity was 26% and 7% respectively in boys, 25% and 6% in girls. Overweight was significantly associated with low physical activity (P < 0.05) and mother's BMI (P < 0.05). CONCLUSIONS: This study identified a high proportion of overweight in 6- to 8-year-old children in Beirut. Reduced physical activity was the most significant factor associated with childhood overweight. Further studies in different regions in Lebanon are necessary to identify national characteristics; prevention efforts will be designed accordingly.     

成都市学龄前儿童肥胖影响因素的病例对照研究

[目的]了解成都市学龄前儿童肥胖的影响因素,为儿童肥胖的预防和控制提供基础资料。[方法]在成都市幼儿园随机选取50名年龄3￣6岁肥胖儿童,按1︰2的比例与100名同性别、同身高、同年龄的正常儿童配对,通过问卷调查方法进行儿童肥胖影响因素的病例对照研究。[结果]本次病例对照研究结果表明,遗传因素和环境因素对学龄前儿童肥胖均有影响。学龄前儿童肥胖危险因素主要是食量、出生巨大儿、父母BMI、进餐速度及运动时间。[结论]学龄前儿童肥胖的危险因素多与生活行为方式密切相关,因此应加强对家长和幼教人员的营养教育,增强其健康意识,培养儿童良好的饮食和运动习惯,从而达到有效地预防和控制儿童肥胖的目的。     

Lifecourse approach to racial/ethnic disparities in childhood obesity

Eliminating racial/ethnic disparities in health and health care is a national priority, and obesity is a prime target. During the last 30 y in the United States, the prevalence of obesity among children has dramatically increased, sparing no age group. Obesity in childhood is associated with adverse cardio-metabolic outcomes such as hypertension, hyperlipidemia, and type II diabetes and with other long-term adverse outcomes, including both physical and psychosocial consequences. By the preschool years, racial/ethnic disparities in obesity prevalence are already present, suggesting that disparities in childhood obesity prevalence have their origins in the earliest stages of life. Several risk factors during pregnancy are associated with increased risk of offspring obesity, including excessive maternal gestational weight gain, gestational diabetes, smoking during pregnancy, antenatal depression, and biological stress. During infancy and early childhood, rapid infant weight gain, infant feeding practices, sleep duration, child's diet, physical activity, and sedentary practices are associated with the development of obesity. Studies have found substantial racial/ethnic differences in many of these early life risk factors for childhood obesity. It is possible that racial/ethnic differences in early life risk factors for obesity might contribute to the high prevalence of obesity among minority preschool-age children and beyond. Understanding these differences may help inform the design of clinical and public health interventions and policies to reduce the prevalence of childhood obesity and eliminate disparities among racial/ethnic minority children.