Association of reduction in parental overweight with reduction in children's overweight with a 3-year follow-up

BACKGROUND: Parental overweight has been reported to be a risk factor predicting obesity of their children. However, the effect of changes in parental overweight on the changes in children's overweight is not yet characterized. METHODS: Six hundred five children of 9-10 years underwent physical examinations and a survey concerning parents' body mass index (BMI) with a 3-year follow-up. RESULTS: In families where both parents' BMI was above 25 at baseline, when either parents' BMI decreased to less than 25 kg/m(2), children improved their adiposity, atherosclerosis index (AI), and systolic blood pressure (SBP). No such improvement was observed in children both of whose parents maintained BMI > or =25 kg/m(2). CONCLUSIONS: Improving parental overweight possibly reduced the risk of overweight in their children. Changes in parental overweight status were associated with changes in overweight status of their children.     

Influence factors on the development of obesity in 3-year-old children based on the Toyama study

BACKGROUND: Obesity in childhood increases the risk of obesity in adulthood. Obesity in adulthood is a risk factor for chronic diseases such as hypertension and atherosclerosis. Therefore, it is important to eliminate factors influencing the development of obesity in children from the viewpoint of preventive medicine. The purpose of this study is to elucidate the relationship between obesity and lifestyle in 3-year-old children in a case-control study. METHODS: Subjects were selected from the Toyama study at health checkups for 3-year-old children which are done routinely by local governments in Japan on all children of that age. A special questionnaire consisting of items on lifestyle and environmental factors of the children and past histories of parents was distributed to the Toyama study participants beforehand and was collected at the checkup. Matched-pair comparisons were performed between obese children whose body mass index was 18 or more (N = 427) and control children (N = 854) matched by sex and birth month. Multivariate stepwise conditional logistic regression analysis was also applied to assess the influence of confounding factors. RESULTS: The following six factors significantly influenced the development of obese 3-year-old children using the Mantel-Haenszel method: the mother's job, limited playtime outdoors (1 hour or less), snacking irregularity, an overweight father (body mass index >/= 24), an overweight mother (body mass index >/= 24), and overweight at birth (birth weight >/= 3,500 g). An overweight mother or father, limited playtime outdoors, overweight at birth, and snacking irregularity were significantly related to obesity in 3-year-old children after adjusting for confounding factors by multivariate stepwise conditional logistic regression analysis. CONCLUSIONS: We have suggested several factors influencing the development of obesity in 3-year-old Japanese children: parental overweight and overweight at birth as host factors, physical inactivity and snacking irregularity as behavioral factors, the mother's job as an environmental factor.     

Does Overweight and Obesity Impact on Self‐Rated Health? Evidence Using Instrumental Variables Ordered Probit Models

This paper, for the first time, presents estimates of the causal impact of overweight and obesity on self‐rated health (SRH) using instrumental variables (IV) econometric methods. While a number of previous studies have sought to better understand the determinants of SRH, there is no consensus in relation to the impact of overweight and obesity. Using data from a large nationally representative sample of Irish parents and their children, we estimate a range of ordered probit models to isolate the causal effect of overweight and obesity on SRH. Our data includes independently and objectively recorded weight and height measures for parents and their children and we instrument for parental body mass index (BMI) status using the BMI of a biological child. After controlling for a range of individual, socioeconomic, health and lifestyle related variables, we find that being overweight has a negligible impact on SRH, while being obese has a practically and statistically significant negative impact on SRH, with these effects most pronounced for those who are most obese. We find only minor differences in these effects across gender. Copyright © 2015 John Wiley & Sons, Ltd.     

Early Predictors of Obesity and Cardiovascular Risk Among American Indian Children

American Indian (AI) children have the highest rates of obesity among ethnic groups in the United States, and rates continue to increase. This study was designed to examine the effects of prenatal and early postnatal factors on AI children??s body mass index (BMI) trajectories, adiposity, and cardiovascular risk markers during early childhood. We screened 471 AI children (ages 5?C8) from three Wisconsin tribes. Screenings included anthropometric and body fat measures and non-fasting lipid and glucose via fingerstick blood samples. Tribal records from Women Infants and Children (WIC) programs and clinic charts provided data on children??s BMI trajectories, maternal prenatal factors, and the early postnatal feeding environment. Forty-seven percent of children were overweight or obese. Analysis of growth trajectories showed that children??s BMI category was largely determined within the 1?year of life. Significant predictors of children??s BMI category at age 1 included macrosomia (OR 4.38), excess gestational weight gain (OR 1.64) and early termination of breastfeeding (OR 1.66). Children who were overweight/obese at age 1 had greater odds of being overweight (OR 3.42) or obese (OR 3.36), and having unhealthy levels of body fat (OR 2.95) and LDL cholesterol (OR 1.64) at ages 5?C8. Children??s BMI category is determined in the early post-natal environment, within the 1?year of life, by factors including excess gestational weight gain and early termination of breastfeeding. In turn, children??s BMI category at age 1 predicts the emergence of cardiovascular risk markers in early childhood.     

Individual,Family, and Community Environmental Correlates of Obesity in Latino Elementary School Children*

BACKGROUND: The prevalence of overweight children has reached epidemic proportions, and affects Latinos youth more than other subgroups in the United States. Given the prevalence of obesity and its economic consequences, community health initiatives have shifted toward primary prevention at younger ages. METHODS: Data representing all levels of the ecological systems theory were collected using diverse methods. Participants were children enrolled in K-2nd grade and their parents. RESULTS: Overweight children were less active compared to normal weight children. The parents of overweight children provided less instrumental support to engage in activity and set fewer limits on their child's activities. Similarly, parents of overweight children were less likely to control, but more likely to set limits on their child's diet compared to parents of normal weight children. Parents who rated their health more positively and were less acculturated were more likely to have children who were overweight. School and community level variables were not significantly correlated with children's weight. Adjusting for the aforementioned variables, parents' weight status was positively associated with children's weight. CONCLUSIONS: Social and structural environments in which Hispanic children are reared may play an important role in determining their risk for obesity and related behaviors. Parents' weight was among the strongest correlate of child weight; however, the extent to which this influence functions primarily through biological or social/structural influences is not entirely clear. The role of school and community factors on child's health practices and body mass index needs to be further examined.     

Association between overweight or obesity and household income and parental body mass index in Australian youth: analysis of the Australian National Nutrition Survey, 1995

This study is a secondary data analysis based on the 1995 Australian National Nutrition Survey (NNS). A random subsample of 1581 school children aged 7-15 years old from the NNS was studied. The results show the prevalence of overweight, obesity and combined overweight and obesity was 10.6-20.9%, 3.7-7.2% and 15.6-25.7%, respectively. The odds ratio of overweight or obese boys with highest household income was significantly smaller than those with the lowest household income. The proportion of combined overweight and obesity in children whose parents were overweight or obese was significantly greater compared with those whose parents were not. The trend of increasing prevalence of overweight or obesity among children with increasing parental body mass index (BMI) was significant after adjusting for age except the trend of father's BMI for boys. This study provided baseline data on the recent prevalence of overweight or obesity of Australian school children using new international absolute BMI cut-off points. It indicated that young school girls (7-9 years) were more likely to be overweight or obese compared with boys, the prevalence rates of overweight or obesity in older boys (13-15 year) was significantly greater than in other age groups while in girls it was the opposite. The boys with lowest household income ($0-17 500) were more likely to be overweight or obese compared with those with the highest household income (greater than $67 500). Having parents especially mothers who were overweight or obese may increase the risk of children being overweight or obese.     

The importance of parental knowledge: Evidence from weight report cards in Mexico

The rise of childhood obesity in less developed countries is often overlooked. We study the impact of body weight report cards in Mexico. The report cards increased parental knowledge and shifted parental attitudes about children's weight. We observe no meaningful changes in parental behaviors or children's body mass index. Interestingly, parents of children in the most obese classrooms were less likely to report that their obese child weighed too much relative to those in the least obese classrooms. As obesity rates increase, reference points for appropriate body weights may rise, making it more difficult to lower obesity rates.     

Collective Efficacy and Obesity-Related Health Behaviors in a Community Sample of African Americans

The social environment is important to body mass index and obesity. However, it is unknown if perceptions of the social environment are associated with obesity-related behaviors in populations at greatest risk for being overweight or obese. We evaluated the relationship between collective efficacy and diet and physical activity in a community-based sample of African American adults who were residents in an urban area. Data were collected as part of an academic-community partnership from November 2009 to 2011. We evaluated whether participants met the recommended guidelines for diet and physical activity based on collective efficacy and their sociodemographic background, health care variables, and self-efficacy in a community-based sample of African American adults (n = 338) who were residents in the Philadelphia, PA metropolitan area. Overall, many participants did not meet the recommended guidelines for fruit and vegetable intake or physical activity. The likelihood of meeting the recommended guidelines for fruit intake increased with greater levels of collective efficacy (OR 1.56, 95 % CI 1.18, 2.07, p = 0.002) and self-efficacy for diet (OR 1.56, 95 % CI 1.19, 2.04, p = 0.001). Collective efficacy was not associated with physical activity and the positive association between collective efficacy and vegetable intake was not statistically significant (OR 1.25, 95 % CI 0.94, 1.65, p = 0.12). It is important to determine the most effective methods and settings for improving diet and physical activity behaviors in urban African Americans. Enhancing collective efficacy may be important to improving adherence to recommended guidelines for obesity-related health behaviors.     

Exploring the Relationship Between Parental Concern and the Management of Childhood Obesity

Parental concern about child weight has been identified as a factor in parental monitoring and regulation of child diet. However, little is known about factors that influence parental concern or about how concern may influence parent management of child physical activity. The objectives of the current study were to identify the factors associated with parental concern about child weight and determine if parental concern is associated with specific actions to improve diet and increase physical activity. A stratified random sample of 1,500 parents of children in kindergarten, 2nd, 4th, 5th, 7th, and 9th grade were interviewed. Interviews addressed: (a) child and parent physical activity, (b) child and family nutrition, (c) child and parent BMI weight category, (d) interactions with health care providers, (e) parent obesity knowledge, (f) school assessment of BMI, and (g) parent perception of and concern about child weight. Child gender, weight status, and parent perception of child weight were significant predictors of parental concern. Parents were significantly more likely to report concern if their child was female, they believed their child to be overweight/obese, or their child was overweight/obese as indicated by BMI percentile. Concerned parents were significantly more likely to limit child screen time, take steps to improve child diet, and increase child physical activity than were parents who reported no concern. Treatment and prevention efforts should emphasize parental concern and awareness about child weight by providing accurate feedback on child weight status and education regarding the health risks associated with childhood overweight and obesity. Schools can play an important role in this process through the incorporation of BMI screenings.     

Childhood Overweight/Obesity and Pediatric Asthma: The Role of Parental Perception of Child Weight Status

Childhood obesity and asthma are on the rise in the U.S. Clinical and epidemiological data suggest a link between the two, in which overweight and obese children are at higher risk for asthma. Prevention of childhood obesity is preferred over treatment, however, in order to be receptive to messages, parents must perceive that their child is overweight. Many parents do not accurately assess their child’s weight status. Herein, the relation between parental perceptions of child weight status, observed body mass index (BMI) percentiles, and a measure of child feeding practices were explored in the context of asthma, food allergy, or both. Out of the children with asthma or food allergy that were classified as overweight/obese by BMI percentiles, 93% were not perceived as overweight/obese by the parent. Mean scores for concern about child weight were higher in children with both asthma and food allergy than either condition alone, yet there were no significant differences among the groups in terms of pressure to eat and restrictive feeding practices. In summary, parents of children with asthma or food allergy were less likely to recognize their child’s overweight/obese status and their feeding practices did not differ from those without asthma and food allergy.     

The mediating effect of parents’ educational status on the association between adherence to the Mediterranean diet and childhood obesity: the PANACEA study

Objectives

To investigate the potential mediating effect of parental education on the association between adherence to the Mediterranean diet and obesity, in 10–12 years old children.

Methods

A cross-sectional survey was performed among 1,125 (529 male) children in Greece. Children and their parents completed standardized questionnaires, which evaluated parents’ educational level and dietary habits. Body mass index was calculated and children were classified as normal, overweight or obese (IOTF classification). Adherence to the Mediterranean diet was assessed using the KIDMED score.

Results

27.7% of the children were overweight and 6.3% were obese; 12.3% of children reported high adherence to the Mediterranean diet. Multi-adjusted analysis, stratified by parental education, revealed that adherence to the Mediterranean diet was inversely associated with children’s obesity status only in families in which at least one parent was of higher educational level (stratum-specific adjusted odds ratio: 0.41; 95% CI 0.17–0.98), but not those in which both parents were of low educational level.

Conclusions

Parental education status seems to play a mediating role in the beneficial effect of Mediterranean diet on children’s obesity status.     

Unhealthy behaviors and psychosocial difficulties among overweight adolescents: the potential impact of familial factors.

PURPOSE: To compare overweight and non-overweight youth on a selection of self-reported eating, physical activity, dieting, educational, and emotional variables and identify familial factors that serve as protective forces against unhealthy behaviors and psychosocial difficulties among overweight adolescents. METHODS: Data were taken from a 1996 cross-sectional school-based survey of 9957 adolescents in grades 7, 9, and 11. Based on self-reported heights and weights, respondents were categorized as "overweight" (body mass index) > or =85th percentile or "non-overweight." Student's t-tests were used to compare the non-overweight and overweight sample on the self-reported health-related behaviors and psychosocial variables. Logistic and linear regressions were used to identify familial factors associated with a reduced risk of engaging in unhealthy behaviors and experiencing psychosocial distress. RESULTS: Overweight adolescents reported engaging in significantly more unhealthy behaviors and experiencing more psychosocial distress than their non-overweight peers. Among the overweight youth, higher levels of reported family connectedness and parental expectations and moderate levels of parental monitoring were associated with the lowest levels of unhealthy behaviors and psychosocial distress. CONCLUSIONS: Satisfying and developmentally appropriate parent-adolescent relationships are associated with reduced behavioral and psychosocial risk factors associated with overweight during adolescence.     

父母肥胖对儿童期肥胖的影响

目的：探讨父母肥胖对儿童期肥胖的影响。方法：以北京市近万名6－8岁儿童为调查对象，测量其身高、体重，并发放调查问卷以获得父母的身高与体重。以体重超过身高标准值的120％为标准筛选出肥胖儿童，以BMI超过25或28kg/m^2为标准筛选出超重或肥胖家长。结果：当父亲正常、超重及肥胖时儿童肥胖率分别为12．3％，20．0％和25．0％，当母亲正常、超重及肥胖时儿童肥胖率分别为13．8％，26．5％和30．0％，各组的肥胖率之间差别显。父母均正常的儿童肥胖发生率为11．1％，而父母均超重或肥胖的儿童肥胖率则上升至33．6％。儿童BMI与父亲和母亲BMI均明显相关，相关系数分别为0．195和0．214。结论：父母肥胖是儿童肥胖的重要危险因素，父母肥胖的儿童应成为预防肥胖的重点人群。     

Overweight and obesity in primary school: native children versus migrant children

Aim

To compare the means of body mass index (BMI) and the prevalences of overweight and obesity between native Dutch and migrant primary school children and to assess to what degree differences between these children could be explained by socioeconomic position and BMI of the mother and the father.

Subjects and methods

A cross-sectional survey was performed among children at the age of 8–9 years old. Subjects were a total of 1,943 children and their primary caregiver. Outcome measures were BMIs and the prevalence of overweight, including obesity. Main independent variables were migrant background, based on country of birth of the parents, socioeconomic status, as indicated by educational level, and parental BMI. Other independent variables were the age and sex of the child.

Results

Overall, our findings show that overweight and obesity are significantly more prevalent among migrant children of non-Western descent as compared to native children and children of Western descent.

Conclusion

Parental BMI is an important predictor of a child’s BMI. However, socioeconomic position is not. Because children of non-Western migrant origin are at higher risk for overweight and obesity, insight into differences in both physical activity and energy intake as well as how these behaviors relate to cultural contrasts in parental beliefs and practices is needed.     

The impact of being overweight on the mobility,temporal-spatial and kinematic aspects of gait in children with cerebral palsy

AimObesity causes altered gait patterns in typically developing children, but its effect on gait in children with physical disabilities is largely unknown. This study explores associations between body mass index (BMI), functional mobility and gait in children with cerebral palsy (CP).MethodAn observational cross-sectional study was conducted using three-dimensional gait analysis data from 197 children with CP, Gross Motor Functional Classification System (GMFCS) levels I to III. BMI values were categorised using the Centres for Disease Control and Prevention (2000) BMI percentiles, which are specific to age and gender. Regression analyses, with GMFCS level as a covariate, explored associations between BMI category and temporal-spatial, kinematic and functional mobility variables. Analyses included children categorised as healthy weight and overweight/obese only (n = 174), with underweight children excluded (n = 23).Results131 children (mean age 10.5 years, SD 3) were categorised as healthy weight and 43 children (mean age 9.6 years, SD 2.5) as overweight or obese. BMI was not associated with most gait variables. Increased double support time, reduced hip extension and increased ankle dorsiflexion were observed in children that were overweight, but most differences were small and of uncertain clinical significance. A lower proportion of overweight children walked independently over 500 m.ConclusionWe found little evidence that BMI has a substantial influence on gait patterns in children with CP but some to suggest it may affect long-distance mobility. Different research strategies are required to improve understanding of relationships between adiposity, strength and function, for effective targeting of interventions to improve mobility.     

Predictors of diet quality among overweight and obese postmenopausal women

Previous studies have shown that sociodemographic characteristics can be determinants of healthful eating. However, health characteristics such as smoking status have not been well studied. The objective of this research, therefore, was to determine predictors of diet quality in postmenopausal women. We included 164 overweight or obese postmenopausal women aged 50 to 75 years living in and around Seattle, WA, and intake, measured by food frequency questionnaire, was used to calculate scores for the Diet Quality Index and Healthy Eating Index. Information on sociodemographic factors and health behaviors was collected by self-administered questionnaire. Body mass index was computed using duplicate measures of height and weight. Percent body fat was measured by dual-energy x-ray absorptiometry. Following data collection, one-way analysis of variance, chi(2), and Pearson correlations were used to compare means of diet quality scores across participant characteristics. We found that predictors of better diet quality in this study population were higher education and former smoking history (compared to never-smokers); there was no evidence for a relationship with income level. Individuals with higher-quality diets were more likely to have lower body mass index or percent body fat. Based on the results of this study, education level and smoking history are predictors of diet quality among overweight and obese postmenopausal women. These findings add to the increasing evidence for targeting public health interventions to individuals with lower education because this group stands to benefit from improved dietary intake. In addition, these results suggest that the timing of smoking cessation is a possible teachable moment for food and nutrition professionals.     

Are Parental Perceptions of Child Activity Levels and Overall Health More Important than Perceptions of Weight?

Objectives To examine relationships between parental perceptions of child weight and overall health, reported lifestyle behaviors and measured body mass index (BMI). Methods Using community-partnered methods, we surveyed families residing in a two census tract area identified for targeted interventions to decrease diabetes related disparities. The survey included demographics, child dietary and physical activity behaviors, and parental perception of child’s health and weight. We measured child BMI using a standardized protocol. Results We surveyed parents of 116 children with a mean age of 7 years (range 3–15) with 51 % boys, 74 % Hispanic, and 26 % Black. Over half of the children (55 %) were overweight or obese. Half (50 %) of the parents underestimated their children’s weight. Reported daily hours of walking and/or running trended higher (3.6 vs. 2.6 h, p = 0.08) for children perceived to be of normal weight. Parents who correctly estimated their child’s weight status reported more hours of daily walking/running than parents who underestimated child weight status, 4.5 versus 2.4 h, p = 0.0002. Parents of healthy weight children were more likely to report that children were in excellent or very good health compared to parents of overweight/obese children, 75 versus 56 % respectively (p = 0.04). We found significant racial/ethnic differences in reported diet and physical activity behaviors and perception of overall health. Conclusions for Practice Parental perceptions of child health and physical activity level may be related to perceptions of their child’s weight status. Study findings informed community-based initiatives for reducing diabetes risk among children.     

Body mass index and body fatness in childhood

PURPOSE OF REVIEW: The prevalence of overweight, as assessed by a high body mass index (kg/m), has greatly increased among children and adolescents over the last three decades. Because body mass index is a measure of excess weight rather than excess body fatness, it is important to understand the ability of a high level to identify children who truly have excess adiposity. This review covers the measurement and classification of overweight and obesity, the expression of body composition data, and the relation of body mass index to adiposity. RECENT FINDINGS: Although adiposity has typically been expressed as percentage body fat, the use of the fat mass index (fat mass/height) and the fat-free mass index (fat-free mass/height) may provide more information. For example, body mass index differences among relatively thin children have been found to largely reflect differences in fat-free mass index, whereas differences among relatively heavy children are primarily due to differences in fat mass index. In addition, the ability of overweight to identify obese children is greatly influenced by the cutpoints selected for body mass index and adiposity. The use of inappropriate cutpoints, rather than the limitations of body mass index, may account for the frequently reported finding that many obese children are not overweight. SUMMARY: The use of fat mass index and fat-free mass index in expressing body composition data allows one to easily assess the contribution of each to body mass index. If appropriate cutpoints are used, a high body mass index level is a moderately sensitive and a very specific indicator of excess adiposity among children.     

Peer Reviewed: Lifestyle Behaviors and Physician Advice for Change Among Overweight and Obese Adults With Prediabetes and Diabetes in the United States, 2006

Introduction

The objective of this study was to examine the lifestyle behaviors of overweight and obese people with prediabetes or diabetes and to determine whether an association exists between reported behaviors and physician advice for behavior change.

Methods

This investigation included overweight and obese people (body mass index ≥25.0 kg/m²) with prediabetes and diabetes aged 40 years or older identified from the 2006 National Health Interview Survey. Respondents reported attempts to control or lose weight, reduce the amount of fat or calories in their diet, and increase physical activity. Respondents also reported receipt of a physician recommendation for behavioral change in 1 or more of these areas. Data analysis included use of logistic regression stratified by sex and prediabetes/diabetes status to model odds of behavior by physician advice.

Results

Most people reported trying to control or lose weight (prediabetes, 82%; diabetes, 75%). Fewer identified efforts to reduce the amount of fat or calories in their diet (prediabetes, 62%; diabetes, 71%) or increase physical activity (prediabetes, 53%; diabetes, 57%). Approximately one-third reported not receiving physician advice for each of these behavior changes. In logistic regression, physician advice for reducing the amount of fat or calories in the diet and increasing physical activity was generally associated with the reported corresponding behavior.

Conclusion

Many respondents reported trying to control or lose weight, but fewer reported actually reducing fat or calories in their diet or increasing physical activity. Physician advice may influence attempts at behavior change among overweight and obese patients with prediabetes and diabetes.